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17006 76TH AVE W.PDF1111111111116183 17006 76TH AVE W E NO TAX ACCOUNT/PARCEL NUMBER: �7LO40 7400 / 66 0 V BUILDING PERMIT (NEW STRUCTURE): COVENANTS(RECORDED)FOR: CRITICAL AREAS: DISCRETIONAR PERMIT #'S: fiNS h DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PERMITS (OTHER): PLANNING DATA CHECKLIST DATED:_ SCALED PLOT PLAN DATED: SEWER LID FEE $: SHORT PLAT FILE: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: SOILS REPORT DATED: STREET USE / ENCROACHMENT PERMIT FOR: WATER METER TAP CARD DATED: �j DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver 1-79 LID #: LOT: BLOCK: i 1 LATEMPOSTsTormAStreet File Cheeklist.doc City of Edmonds Critical Areas Determination Waiver Applicant: Larry Murphy, Shoreview Determination #: Not yet done Construction Inc. Project Name: Zoloth Remodel / Repair Permit Number: PC-04-350 Site Location: 17006 76th Ave. W. Property Tax Acct #: 27040700100800 Project Description: Roof repair and footing replacement The building permit under review is for the repair of a pof and the replacement of a footing between the garage doors. The only exterior work is surro`x un�ed %y tte- e stmggarage slab and the asphalt paving of the driveway. In consideration of the scope of work, the applicant was not required to obtain a critical areas determination.. Based on the above findings and conditions, the requirement for a Critical Areas Determination associated for this development permit is hereby Waived. Star Campbell_ _ _-� A , _ 8/5/04 Name Signature --F Date • WORK THIS PERMIT lilt SITE FLAN SCALE: 1" = 60' STREE7 FILE � =CxAL DESGRiPtION: 21 01 TWP 21 RCaE 04 BAAP ON E LN SEC 1 DIST 50015FT NOI#II 45E FIR EI/4 COR SD SEC TH W OFT TAP ON WLY MGN MEADOWDALE RD SD PT BEING TPB TH W 29ID-FT TH N 26531FT TH E 1FT TH ALC% WLY MGN BERTOLA RD ON CRY TO L HAVGINITIAL CRSE OF 623.01 30E t RAP OF FT DIST OF 80.69FT TH 561#33 10E 19853FT TH ALG WLY MGN MEADOWDALE RD 501•11 45W 11226FT TPB EXC PTN DAF BAAP ON E LN SO SEC DIST 50015 FT NOloll 45E FIR El/4 COR SD SEC TH W OFT TAP ON WLY MGN MEADOWDALE RD SO PT BEING SELY COR HEREIN DESC TR t POB TH W L44FT TH N01.15 33E 10625FT TH N31.42 31E 55:11FT M/L TO SLY MGN OF BERTOLA RD TH 561*33 10E s SLY MGN OF BERTOLA RD SOFT TO ILLY MGN MEADOWDALE RD TH SOI*II 45W ALG WLY MGN ADOWDALE RD 11226FT TPB RECEIVED rizUCTURAL NOTES: APPA0Vff9Y PLANN'IN 8 JUL 2 r. DE-- PERMIT RNATIONAL RESIDENTIAL CODE (IRC) 2003 EDITION, E LOADS• CI,IND SNOW LOAD (Ce = LO, Ct =10) )OR CERA . LOADS- 0-- BASIC WIND SPEED 3MIC: SEISMIC DESIGN CATEGORY 62004 COUNTER APPROVED AS NOTED BY ENGINEERING 25 PSF 114, , 40 PSF Dale: 85 MPH, EXPOSURE B 02 "K.ft� t:2 3lt vS • • 1 1631 16320 16330 16340 16404 ,�, z 16414 16420 g 1 yy" 16508 16510 9 i< yPQr m N 1661 m W ` Brook'° u s Acres 1g6,E cc 7gg26 .. n 16621 . Bridge: i - 40KLb. 1 Limn 16711 16717 7735 jp11000, ►I10101 1001 m i 3" 7711 < 167z1 . .♦, Lynnwood 16W q<s 17000 A® Treatment Plant 16854 ,6877 7 16838 16901 16858 t� ,8900 } 16905 16900 168511 16833 1690Z 7� 17920 16911 16907 16900 17041 r 16917 /ip, '10 17015 E 16931 16825 17003 c 'b o �i \\ \J, \\\d �7 17008 0.777 17018 !.? i 1701 \ J� 17017 /19 .i 7927 ` \ i�\ , Tijy, 17024 17020 I1 S'Ly H� 17029 7819 7617 n . / 8005 \ 7931 8011 QO 17107 3 /\ c 17,ST ST Sw S 17 BO15 P\' 17112 17715 J!/ Jo 17101 7624 7614 17114 17 \ 8017� '0 8007 t'' \ 9001 \� 17131 \ 5 ;� 8\ \ 17170 e\ 8125 �s 17201 17210 17211 .... ..7 d- y .�•117211 JJ \\ 8.7 ` J� 17208 17207 8209 / 999 tiA 17181 i J W z 8211 B008 / 17pz 17214 > 17215 17218 i_ J /7217 6215\ /$ 17232 9124 $ 78p5 g m' � 7709 17217 8219 O,� 17212 17222 17228 1723, 7507 82DO a 79zs 7 RD S C` 8025 $ i 3 8235 / 8229 �T ai `9GS ^ ^ 7923 7802 m ^ �^ ^ e 7529 751s m ^ ^ m Side Sewer Drawing The City of Edmonds EASEMENT NO_ ------------ ------------------------------- NEW CONSTRUCTION REPAIRS F7 LID NO . .................. ASMT. NO. ------- ---------- ------------------- 77. OWNER --- ------------- CONTRACTOR ------ - ----------------------------------- -------- ....... PERMIT !-.-- - JOB ADDRESS A-7-CD10-C=.7-71<�� ------- I�N-E-- LEGAL DESCRIPTION: LOT NO - ------------- 2 — --------------- .... BLOCK NO. ----------- ------------------------ ---------------------------------------------------------------------------------------------------------------------------------- ------------------------------- -Cnr — NAME OF ADDITION ------ .......... S-> ---------------- ---- ------ 74�!, PWW-0001-11/75 (REV.11178) f�..�t��v�ery-`�f U��r;{�''�'?t+n''cJri�K�'�l.�.J`w.tiia�,tf'Uyu��fr'••-.�`"v,�.,.�„1,,. c*n•rtiiti.��^'i''iiM"'{i'"'nl,"°.- r`�'ft'i" . i,;.�i�v�rR'tiY%�'Rs,•°"s'^�'.'���4M/1r"BV.t"'"`, "'�'�'�=s�'v'��"�'�`''�v y�r«�' RECEIVED y.- CITY S 92SIDE SEWER.. PERMIT - PUBLIC WORKS pEpT 1890 19�° PERMIT iV2 84 Address of Construction: / 7 6 1t4 ('y e t Property Legal Description (Include all easements): LYNNWOOD Owner and/o Contracto . 8ax, er y- 00kerE qU`Ar C 'ty W I zaaJ State License No. !?�x�"��� Id LA Building Permit No. Single Family Invasion into City Right -of -Way: No ❑ Yes ❑ Multi -Family (No. of Units ) RW Construction Permit No. ❑ Commercial Cross other Private Property: No ❑ Yes ❑ Public Attach legal description and copy of recorded easement 1 certify that I have read and shall comply with all city requirements Date as indicated on the back of the Permit Card. * CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION OFFICE USE ONLY * FOR INSPECTION CALL PUBLIC WORKS DEPT. p� 771 �� . Permit Fee: •V� Issued By - Trunk Charge: Date Issued: .Assessment Fee: fv Receipt No.:�- Lid No.:- 24 7/ Partial Inspection: Comments Date Initial Reason Rejected: Date -Initial - Final Inspection Approved: Date Z v Initial ** :PERMIT MUST BE POSTED ON JOB SITE ** White Copy: File Green Copy: Inspector Bull Copy: Applicant Revised 3!90 I t The City of Edmonds Side Sewer Drawing EASEMENT NO_ ____________________________________________ NEW CONSTRUCTION ❑ REPAIRS []� LID NO--------------------ASMT. NO. .................. OWNER------------------------------------------------------------------------------------------------ CONTRACTOR-----------------------_---.-------------------------------------------------------- PERMIT NO. "f _ JOB ADDRESS CI_Q�_�. �C�-r�-----------------�4_---.-.---- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO. ------------------------ ........... PWW-0001-11/75 (REV.11/78) NAME OF ADDITION----------------------------------------------------------------------------------------------------------------- Approved: DATE 2 ,�• ........ BY ----. LYNiVWOOD LIN EX�s-cCw� s4jsr6W. 0 Date Akhn_•nber 15, 1978 MEMO TO: John B. Mitchell, Supt. Water/Sewer Division FROM: Fred F. Herzberg City Engineer SUBJECT: SEWER CONNECTION CHARGES 17006 76th Avenue West Edmonds Washington Street A dress K" & 'K- Home.s- Lega Owner Single Family Residence X Subdivision Plat P.R.D. Multiple Commercial LEGAL DESCRIPTION: Lot 2 of K & K Homes Subdivision, S-9-78 Z.F.F. Calculation: ( 261v07) Z.F.F. x (5..50 ( ) Lateral x( ( ) Unit(s) x( $25 - $ 1,435.89 _ $ 0 $ $ 25.00 $ 10.00 Connection Fee Lateral Charge Equivalent Count (when applicable) Trunk Charge Permit $ 1,470.89 TOTAL CC: Owner E Q APPROVED BY: �2 FF-A Leif R. Larson Director of Public Works 10/78 Ll Date 9 942 MEMO TO: John B. Mitchell, Supt %g Water/Sewer Division K71 , FROM: Fred F. Herzberg, P.E. City Engineer SUBJECT: SEWER CONNECTION CHARGES Leal Description: Rat portion of Government Lot 2, Section 7, Township 27 North, Range 4 East, W.M., described as follows: Beginning at a point on East line of Section 7, distant North 1011'45" East 500.75 feet from the East quarter corner of said Section 7 and proceeding thence West 20.01 feet to a point on the westerly margin of the Meadowdale County Road, which point is the southeasterly corner of the tract herein described and the true point of beginning; thence West 297.07 feet; thence North 265.37 feet; thence East 71.57 feet; thence along westerly margin of Bertoia Road on a curve to the left having an initial course of South 23001'30" East and a radius of 120.0 feet or a distance of 80.69 feet; thence South 61033'10" East 198.53 feet; thence along the westerly margin of the Meadowdale.County Road South 1011'45" West 112.26 feet to point of beginning. Situate in the County of Snohomish, State of Washington. Commonly known as: privAi5D6th Ave. W. Owner: x & x HOMES Z.F.F. Calculation: ( 361.53 ) Z.F.F. x ( . 5.50 ) _ $ 1,988.42 Connection Fee ( 0 ) Lateral x ( 0 ) _ $ Lateral Charge ( ) Unit (s) x ( $25 ) _ $ 25.00 Trunk Charge $ 10.00 Permit $ 2,023.42 TOTAL APPROVED BY cc: Owner Lei Larson, P.E. Direct r of Public Works 6/30/78 jac .r�'�''� #*'��"�{"� am�twH1 L` n-.�1'. W Ca[L�. UL' YAtL'11Y,??1^•�.L'y��LVp 13.r ik � :�/ ^s '- C ''.i' � � ,C/�, •i� • <_ y; ^•�' �t-w. J ,I ; Cam,.(- i i 1 (/��) 7. PERMIT' e 6 11.. p r/'Call 175-2525 for -side sewer inspections, BEFORE covering-. any portion. of the construction.1- _\dnspection.will be provided within;24�hours,after requst. -NO Sat. -,Sun.; or holiday Inspections./ - -j t1DDRESS: L`OCATION,-OF,CONSTRUCTION'.-. � _4. �, p .. `..:._ � .._a, ...�f L :_. PERTYLEGAL DESCRIPTION.. -._a....,> :-f..�ii:- �t.t_h��4.n..............'=z`........ ............................................ ................................................................................ .................................................... __ =•-- OWNER AND/OR ,BUILDER ::.: -.-.: .. .. > ...:. `.. - �' �Y1!i ..........::'........... ......... . . G�'�TTR?ICTOR!S:NAME '.& DRESS ................ :.. P 'ss1b is granted -_ :�" .. ...:....... ........ ............. IQ, , for repair and/or, connectiow.of a -side' sewer to, -the city sanitary sewer J system:ih',accordance.with City of -Edmonds ordinances. e ATTENTION IS CALLED'TO. THE FOLLOWING: �_. - NOTE No:.-1=The ;owners of the property-�may obtain a permit. to construct sewer :inside`property line. A licensed Side-Sewer-Contractor.muIstL_be employed to --construct .r ' slde,seweriln.street area. :..D6- not cover any portion of. sewer before it has been inspected.- 'NOTE �No a2 All-work;`;prfoarmed in?city'right•;_of-way"requires an- Invasion,. of Right -of -Way Permit obtainable: from the City Engineer's'.office. • - NOTE No 3'%Obtain-full,information-regs-rding.Ordinance-11.16.030 and Regulations governing side sewers.when you get permit. -NOTEINo_4=Top,ofsidmhaealeast3m2ngradevm',bends -.j sharper:than 1/. will be Permitted. 'NOTE No.�,-S=Trehciteskin; street, must be .water-settled'and'surface of street restored to original condition. Contractors `shall be responsible 'for failure-:due,=to: impr6per:.. i `•. work•:whichmaY- develop within one Year of completion. NOTE No -,6 'I I!Aunlawful';to-alter; or � do: any other work. than is' -provided for in the permit, or- to •do any work "on the main sewer -or. its-appurtenances-except�to'-in 0 •.sen'the,pipe,into -the -wye. .,• ,. - r.. - - - DIS'APPItUVED. `'0 .:Date By ..........:.... Date By..._:....:.:... Date ........... By'. OWED ❑p' '.Date....... ..... .d� g 3_..-......: BY .....s , ..._ yRelnarks: _........................................................................................................-..................... ......... ......... . .. --'--'........-'-'-'-...'-'--"" ... ....:..:........:..:.:............................ -... ..:... _. j r BOTH Permit Copies MUST Be Signed ' By`. -Owner of Firm Performing_ Construction PRIOR To Request For -Inspection:— - yak . , ' • _ �` ]{1 c I ....................................................................... .... hereby certify, that ahe side • sewer installation constructed under.: -this. Perm,tl (Owner of contracting Firm Performing Construction) 3, 1 was installed in accordance with all governing ordinances of the City of Edmonds:; ',... Dated this day of 18 Check BEFORE you dig for: Water 0, • Gas E]; Telephone 0; Power- F], Sewer Other J r -� STREET FLE August 9, 1983 MEMO TO: Rhonda March Office Administrator FROM: Gordy Hyde Engineering Department SUBJECT: 17010/17006 - 76TH /70/5 Due to confusion resulting from combined files for and 17006 - 76th Avenue W., I recommend that separate files be set up for these addresses. GH/st ,%r STREET FILE August 9, 1983 MEMO TO:, Jeff Ristau Finance Department FROM: -. Gordy Hyde Engineering Department SUBJECT: .17019/1,7606 .-. 76th I have checked the addresses in all our files and in the field. The following is for your information and should allow you to clean up this mess: 4 ` 0 Address per side -sewer as -built 17010 17006 Billing Account Number 302-25950 302-26000 Address per Fire Dept. book 17010 17006 Lot # (S-9-78) 2 1 Address per '-field check (on 17006 17010 Address per assessor's book 170'10 17006 Assessor's # 072704-1-008-0008 072704-1-069-0004 Owner per,assessor Wash. Federal Nelson, Abner, Jr. - Savings & Loan Dizard Bros. Inves Zoloth, A.M. 12633 Stone Ave. N 50-206-46-768-5 Seattle, Wa. 98133 1423 Fourth Ave.. Seattle, Wa. 98101 Please let me know how this turns out, so that we can change the files. } GH/st Ji ams Dt C:I'.` c`! 1:[i':O:;W; 11U1;1,1C I�:••. i ::. ' ' �� ---...__�%�U.�o —_��o_ __lid_ ��WWaeo- Cleo N N �I 700 A STREETFILE .'r 7,80 - FILE'# FORM FOR [� /FIi� 111 DE-CI.F RATION OF t5WMM sE7tXU/XOti'SIG�tIrICtw E Description of proposal Single Family Dwelling ' Proponent K 8 K Homes Location of Proposal Southwest corner of the intersection of Meadowdale Road(76th.Ave W.) and Bertola Road - 17006 76th Avenue West Lead Agency ':'City of Edmonds This proposal has been cict:ermi.ned to WU/not have] a significant -ad- verse i-m-poct upon -the envirormicnt. An EIS 4*/is not] required unacr 10-1 43.21C.0.30(2) (c) , This decision t•:as rnadc after reviev., by the lead agency of a completed envirorr:ental chec)dist and other information on file with the lead agency. Responsible Official Mary Lou Block Position/Title Associate City Planner Date July 11, 1978 Signature a PROJECT NAME' 179 DATE SUBIMITTED 4`17 7e ENVIROM'IENTAL ASSESSMENT In order to meet the requirements of the State Environmental Policy Act of 1971, the responsible official must make a declaration of environmental impactas early as possible in the process of evaluating a project. The information in this form will be used to determine whether it will be necess- ary to require an environmental impact statement. If an impact statement is not required, a Statement of i"Iegative Declaration will be placed in the file. If an impact statement is required, a draft statement must be filed with this office, public notice given and a reviela period of 30 days allowed. The final statement and comments must be filed with the Department of Ecology, Office of the Governor and the Ecological Commission. The Edmonds Planning Staff will assist you in any way we can in accumulating this information and we would.appreciate your cooperation. 1. Land: Area in acres 1 3 Soils.type Limitations Description of topography (% slope) AV 9ct IluriP1 (3t�ti%� lL0 ay e S' La & AvbGl! / f Oy! _ Qum ✓ll�r ltt�y. �9� 1 / f� Grading: estimated cubic yds. )"o7' a, /00 NOTE: If grading or filling will exceed 500 cubic yards Filling: estimated cubic yds. ,(,oa,uh /00. a grading and filling elan must be submitted with the 2. Water: application. / y �YQ1R Cr / Stream - estimated flora (cubic feet per second) Will stream be altered? To what degree? Impact on storm drainage (increase in run-off) Estimated area.to be paved Al Estimated area in open space ��, $� % Shorelines: within 200 ft. of 'lean Higher High !dater Adjacent to shorelines zone A/� N, N Environmental. Assessment, page 2 3. Ve4etati on Type of trees g! �gree4. a&fVga,,s % to be removed S09T�(,�/�,. V Minimum diameter of trees to remain Ground cover RA(A �Grrits� 6ks� rssa/d % to be removed s-a7 Proposed landscaping, if any TyPic�L Glrouy��t h� 4. Existing Land Use within 300 ft. radius of proposed development: Vacant Single. Famil Multi - Family Comm. Other North x' South X East X Wes t 5. Circulation: Estimated increase in auto trips daily 2 x /D 2-0 A D T Estimated demand for public transportationlh,h,� T Degree of change on adjacent streets ra, 6. Area of impact: neighborhood X /�l�r1(a� of . 2 Aowes city-wideyziL�_ LiAlr . .. . regional very 7. Effect on air quality: /12/him�f G4xt u'laae_ %ra ri-ic 8. Changes in noise generation: pith nq/ �1 2 ..4 5 6 7 !� 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 •41 '42 43 44 45 46 47 48 49 50 51 52 53 54 55' 56' 57 58 59 60 N DATE: /2- 28 A•$25 fee will be collected by the City of Edmonds for analysis of the Environmental Checklist and the preparation of a Threshold Determination. No fee will be charged for proposals which would be categorically exempt if they.were not located in an environ- mentally sensitive area. ENVIRONIIENTAL CHECKLIST FORM I. BACKGROUND 1. Name of Proponent `{ k Aop? ex 2. Address and Phone NLmiber of Proponent: 20O. /9,�T6l Ste, LWA/J✓004 Wk.(11 79036' 3. Date CTccic�st: Su mitre C`l2--79 4. Agency Requiring; Checklist C •tr OF 7/7/OOAf) 5. Name of Proposal, if applicable: V-0/- 6. Nature and brief llescription. of tiie Proposal inc u - ing but not limited to its size; general design ele- ments, and other factors that will give an accurate understanding of its scope and nature): , t TPPAve D e.-2 .-f oaf- Foy__ _PI'Ivlc7�Q oTe r,i/!/sac s drnc�s. a rh{ 7. Location of Proposal uescri e the'physical Setting of the proposal, as well as the extent of the land area affected by any environmental impacts, including any other inlornuiti.on needed to give an accuracy understand- ing of the environmental setting of the propoj� al): �/r ` - f4V nlr' v f - 1�iai► A AYJda.2[OwGr4 oa 6 r& i¢✓ : N W ,e1.f e ;i rg✓ �(�C iU1�, d i.41el S/ 8. stimated Date tor Completion ot tnc: Proposed Action: 9. List of a les, Liccr.se_�. cr C;ovcrn;uent Approvals Required for the Proposal (federal, state and local -- including rezones): -31- 1 3 5 7 8 9 10 11 12 13 14 15 16 17 18 19' 20 21 22 23 24' 25' 26'i 27i 28 29 30 31 32 33 34 35 36 37 38 39 1►0 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 10. Do gave an plans for `future ads cx ansi Y P p on, or further activity related to or connected with this proposal? IC yes. explain: &O 11.. Do you noa of any p ans�y Hers which may attect theproperty covered by your proposal? If yes, explain: •12.. Attach any other application form that has been com- pleted regarding the proposal; if none has been.com- pleted, but is expected to be filed at some future date, describe the nature of such application form: (,//O,9T . 447- A 1111- KA77 07, II. ENVIROZIMENTAL IMPACTS (Explanations of all "yes" and "maybe" answers are required) • Yes Maybe No (1) Earth. Will the proposal result in: (a) Unstable earth conditions or in changes in geologic substructures? (b) Disruptions, displacements, com- paction or overcovering.of the soil? (c) Change in topography or ground surface relief features? (d) The destruction, covering or modification of'any unique geologic or physical features? (e) Any increase in wind or water erosion of soils, either on or off the site? (f) Changes in deposition or ero- sion of beach sands, or changes in siltation, deposition or erosion which may modify the channel of a river or stream or the bed'oC the ocean or any bay, inlet or lake? Explanation:./FZ"jC/``D� — X (2) Air. Will the proposal result in: (a) Air emissions or deterioration . of ambient air quality? — (b) The creation of objectionable odors? — (c) Alteration of air movement, moisture or temperature, or any change in C imate, either locally or regionally? Explanation: f�C -32- 1' 2� 3 4i 5: 61 7' 9! 10� 11i 12i 13i 14`` 15 I 161 17' 18 19. 20 21 22 23 11 24 . 25i 26 , 27 28 29 30 31 32 33 34 35 36 37 38 39 40, 41 42 43 44 45 46 47 48 49 . 50 51 52 53 54 55 56 57 58 N (3). Walter: Will the proposal result in: (a) Changes in currents, or the course or direction of water move- ments, in either marine or fresh waters? (b) Changes in absorption rates, drainage patterns, or the rate -and amount of surface water runoff?. (c) Alterations to the course or flow of flood waters? (d) Change in the amount of sur- face water in any water body? (e) Discharge into surface waters., or in any Ialteration-of surface water quality, including but not limited to temperature, dissolved oxygen or turbidity? (f) Alteration of the direction or rate.of flow of ground waters? (g) Change in the quantity of ground waters, either through. direct additions or withdrawals, or through interception of an aquifer by cuts or excavations? (h) Deterioration in ground water quality, either through direct in- jection, or through the seepage of leachate, phosphates, detergents, waterborne virus or bacteria, or other substances into the ground waters?. (i) Reduction in the amount of water otherwise available for public water supplies? Explanation: (4) Flora. Will the proposal result in: (a) Change in the diversity of species, or numbers of any species Of flora (including trees, shrubs, grass, crops, microflora and aquatic plants)? (b) Reduction of the numbers of any unique, rare or endangered species of flora? -33- 4—< 2 3 5 7 9 10 11 12 13 14 '5 16 17 18 .19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35j 36 37 38 39 40 41. 42 43 44 45 46 47 48 49 50 51 52 53 54 55 Yes Maybe No (c) Introduction of new species of flora into an area, or in a barrier to the normal replenish- ment of existing species? (d) Reduction in acreage of any agricultural crop? Explanation: fee QUA .mu* (5) Fauna. Will the proposal result in: (a) Changes in the diversity of . species, or numbers of any species of farina (birds, land animals including reptiles, fish and shell- fish', benthic organisms,, insects or microfauna)? (b) Reduction of the numbers of any unique, rare or endangered species of farina? — (c) Introduction of new species of.f-auna into.an area, or result -in a barrier to the migration or movement of fauna? (d) Deterioration to existing fish or wildlife habitat? Explanation: (6) ldoise. Will the proposal increase existing noise levels? JL Explanation: (7) Li-Lht and Glare. Will the pro- pos T prjdTCe new light or flare? Explanation: (8) Land Use. Will the proposal resu t in the alteration of the present or planned land use of an area? Explanation: QMl11C 1 1 1: 1� 1: D 1; if 1S 2( 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 -50 51 52 53 54 55 56 57 58 11 Yes a No —_ (9) Natural Resources. Will the pro posa� .resuZi�in:' (a) Increase in the rate of use of. any natural resources? (b) Depletion of.any nonrenewable natural resource? yj Explanation: (10) Risk of hPset. Does the proposal e invo va i. sk of an explosion or the release of hazardous substances (including, but not limited to, oil, pesticides, chemicals or radiation) in the event- of an acci- dent or upset conditions? _ Explanation: (11) Po ulaLion. Will the. proposal alter t}ic location, di.stribution,- densi:ty, or growth rate of the human population of an area? Explanation: (12) Housing. Will the proposal affect exi.stinF; housing availability, create a demand for additional or housing? (13) Trans or.tat:ion/Ci.rculation. i?ill tie proposa result in: (a) Generation of additional vehicular movemelit? (b) Effects on eyistin3 parking facilities, or demand for new parking? (c) Impact upon existing trans- portation systems? (d) Alterations to present patterns of circulation or move- ment of people and/or goods? (e) Alterations to ,waterborne, rail or air traffic? — Al -35- --9 — X- - A Yes Maybe 1 3 4� 5 6 7 ' 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 (30f 31 32. 33 .34 35 36 37 38 39 40 41 i 42 43 44 I 45 46 47 48 49 50 i 51 52 53 54 55 56 j 57 58 59 60 61 1 (f) Increase in traffic hazards to motor vehicles, bicyclists or pedestrians? — Explanation: �pcfA�IUF/� (14)' Public Services. Will the pro- '. ­­anffect posal—Piave upon, or result in a need for new govern- mental services in any of.the following areas: (a) Fire protection? (b) Police protection? (c) Schools? (d) Parks or other recreational facilities? _. (e) maintenance of'public facili- AL ties, including roads? _ (£) Other governmental services? Ex p l a n t i oQ/,u t i�i tiv't /�i 1r1 Yii� At Ih (15) Energy. Will the proposal result in: (a) Use of substantial amounts of fuel or energy? _ (b) Demand upon existing sources of energy, or require the develop- ment of new sources of energy? Liou.Cr ���2 Explanation: 2 (16) Utilities. V.the proposal res�il in a need for r.. 'Iz stems, or alterations to the following utilities: (a) Power or natural gas? _ (b) Communications systems? (c) Water? (d) Sewer or septic tanks? (e).. Storm water drainage? (f) Solid waste and disposal? Explanation: S'Z"C k�i�MffA -36- 0 91 (18) 10 111 12( 14 15 16 17 18 19' 20 22 23 24 25 26 27 281 29 30 31 32 33 34 35 36 37 38 39 40 41. 42 43 44 45 46 47 48 49 50 51 52 .53 54 55 56 57 58 59 Yes Maybe No llumfin 11 t Will the proposal result creation of any I N health .arc or potential health hazard (excluding niental.liealth)? Explanation: ' Aesthetics. Will the proposal result— 1n the obstructi.ott of any scenic vista or view open to the Public, or will the proposal re- sult it' the creation of all aesthetically offensive site open to public view?. ExplanaLi.on: (19) Recreation. Will the proposal resu- L in an impact upon the quali.t:y or quantity of existing recreational opportunities? Explanation: (20) Archeological./M stori.cal. Will the proposa rc.su t i.L an ' �tcration of a significant archeological or his- torical site, structure, object or building? Explanation: III. SIGNATURE X I, the undersil;rted, state that to the' best of my krtowlcdL!e the above information is true and complete. that the, lead aF;ency may witIt is understood hdra:o any declaration of non -signi- ficance that it might issue in reliance upon this checl:li n�t should there be any misrepresetation o- lack of full disclosure on my part. Proponent:. - /J WAC-197-1.0-370 WITHDRAV.7AL `` DETERA� h< OF AFI'IRi1�d4%1'I}7�1111;ES110LD I 1110�. - aL ally Lime after the ry of a declara- tion of: significance, the proponent modifies the proposal SO that, i.n the judgilicnt of the lead agency, a].1 siFni_ficant adverse environr„c ntal- impact:., resultinc; Chc therefrom are eicant ated, the declara.Lion of sil;nificancc ^ball be wiLhdra,.an and a declarlimin- ation of non-sil;rri.ficancc entc>red inste.ic?. lead al;enc}' shall also revise the registers at its The Public information center accordin 1. If the pro- ' potrcnt of a proposal is a private applicant, the proposal Shall not be considered modified until all license applica- tions for the proposal are revised to reflect the modification. -37- 1 N ENVIRONMENTAL CHECK LIST II. I. The project is designed to work within the existing soils conditions. 2.a b Approximately 4 cars will be added to the neighborhood. Some additional deterioration may take place during construction. 3. The project will be designed to maintain existing runoff patterns and flows. 4. c Some non-native landscape may be introduced around the house. 5c d Domestic anima;i:s will be introduced and some habitat will be destroyed by house construction. As only.two houses will be built this will be a minimal reduction. 6. Construtuion noise will be the largest potential increase. 8. Vacant land in a residential area will be built upon. 8. Resource use will take place regardless of site selection. Land itself is the primary non-renewable resourece used. 10. Limited to potential construction accidents. 13. Two households will not generate signinficant increase in traffic. 16. These systems will be extended onto the property. 18. The dwekI-fI'ngs on this site should not obstruct any existing residential views. One lot should be screened by existing rees in the ravine, the other %ouse will be in view of the road. ` tENVIROtJI ASSESSMENT FILE #;S'-.�:�% DESCRIPTION OF PROP A• `' PROPONENT: EXISTING USE: y y� ENVIRONMENTAL IMPACTS FROM PROPOSAL: SOILS/TOPOGRAPHYOpp- , 4 B 00— 'ate � A � WATER/DRAINAGE - -1- AIR QUALITY CIRCULATION VEGETATION - Zo-j, �tr�CLw �c.e-�-a iGGas' qsk, O ECONOMIC CITY SERVICES - ENVIRONMENTAL FINDINGS: There will be certain environmental impacts but they do not constitute a signif- icant adverse impact on the environment and no environmental impact statement will be required. There will be significant adverse impacts on the environment and an environmental impact statement will be required. There will be certain impacts on the environment however it is necessary to obtain more information before a declaration of significance or non -significance is made.. A11 v Ar CITY PLANNER DAT CITY ENGINEER DATE E/A '76 PUTLIC ;-,10!4,s V I U, I PROJECT wsv%vl%W F i LE DATED: 780369 IRF"llf-�1 OF TM: r,[,,Ono. C0111PLETFI) AM) THE FOLLONING DETFR-flli./"�T113NS HAVE 13EEIN MADE: • Gr AD mr14 orylst#ds -ro ILL o C-01Ls ofj -t-OT-1 • 01W COL-toudclej tAjtu. SLA orlLy C JECL) PREPARED BY: REVISED: 10177LV ATE: E ET BUU-DT-NG PERvaT REVIEW IC WRKS DEPARn1ENT CHECKLI09 rD" Date Street Right -of -Way Existing Access Easements Existing . Utility Easement Existing I�J( Lot per Subdivisions "a - �Plat Site Plan Checked for Accuracy Underground Wiring Reqd. Check Accuracy of Legal Description _ Environmentally Sensitive Area Environnental Checklist Reqd. Flood Hazard Zone Shoreline Management Area Slope, Soil, Vegetation _ Stream, Creek, Drainage P Existing Zoning Per Code Ass Amenities Design Board Approval Regd. �� g ADB # Board of Adjustment Approval Reqd. T 1 Review By: Existing Water Hain Size Water Main Regd. t A. Service Line Reqd. Hydrant Size Existing 0 /G 9; ".0 r Hydrant Reqd. Per Fire Code — Detector Check Meter Reqd. 4J0 Cross Connection Inspection iV D Fire Department Conments Water Meter Charge Reqd 350� Review by : - ,- Date: Date: Size Septic Tank Design i�pprovcd `' llate: Septic Tank Permit Reqd. Permit No. Sanitary Sewer Availability� Proj. Drawing No.. File No. Side Sewer Availability Sanitary Sewer Connection Fee Reqd. Review By: =;` Date: S REQD USE REQD 1 REQD t sqor Map '~ Approval --- aWj Z B00ING DEPARTMENT Applicant Fill ~PERMIT APPLICATION Inside Heavy Lines USE ZONE +^�C NUMBER I C. J— I JOB n ADDRESS 00o(o w ` / / V " NAME OR NAME OF, BUSINESS) i MAILING ADDRESS SUBDIVISION NO. , P.LAT NAME ASSESSOR MAP NO. Y a' ; U m C PUBLIC RIGHT OF WAY PER ORDINANCE NO. �R1 EXISTING RIGHT OF WAY �LJJ PROPOSED RIGHT OF WAY DEFICIENCY OF RIGHT OF WAY In CITY TELEPHONE NUMBER w _ It Q NAME) ( STREET/UTILITY WORK REQUIRED YES El NO PERMIT FOR WORK IN PUBLIC R/W DYES ❑NO UNDERGROUND WIRING REQUIRED �YES El NO CONNECTION TO SANITARY SEWER OYES ❑NO SEPTIC TANK PERMIT REQUIRED DYES I&NO SEPTIC TANK PERMIT NO. ADDRESS � ) ,. ;"Z`J / CITY 1 �� /�� - /✓ TELEPHONE NUMBER !t I- 1- U Q Z F Z 0 U NAME _ ADDRESS �{ SEE MEMO DATED V✓ CITY TELEPHONE NUMBER REMARKS ^ / CHE KE B STATE LICENSE NUMBER CITY LICENSE NUMBER METER SIZ UILDING SUPPLY SIZE w Q 3 Z 0 H IL N W 0 Legal Description of Property (Show Below or Attach Four Copies) / REMARKS / SIGN AREA ALLOWED PROPOSED ENV. REVIEW COMPLETE EXEMPT ADB NO. REMARKS J Q D W J VARIANCE OR CU PLANNING REVIEW BY DATE YARDS / C a � FRONT SIDE aV REAR LOT COVERAGE ' " NEW © RESIDENTIAL ❑GAS LINE 10 FIRE ZONE TYPE OF CONSTRUCTION CODE HEIGHT NON-RESIDENTIAL SIGN ❑ ADD' RETAINING ❑ DEMOLISH ❑ WALL ❑ ALTER EXCAVATE FENCE OR FILL I X FT) ElREPAIR ❑ PRE -MOVE DSWIM INSP, POOL F Z W f SPECIAL INSPECTOR REQUIRED ❑ YES ❑ NO JAREA I OCCUPANCY GROUP OCCUPANT LOAD PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. REMARKS NUMBER OF STORIES NUMBER OF DWELLING / UNITS NATURE OF WORK TO BE DONEel F IL W D PLAN CHECK FEE VALUATION FEE -_— a. U N W 0 L 0 J W i 0 PROPOSED USE PLOT PLAN JINDICATE BUILDING SF BACKS, ABUTTING STREETS �J r / BUILDING _ ' PLUMBING '--__ MECHANICAL - FENCE f Z SIGN RETAINING WALL 0 ' — U g'.`WIMMING POOL 'C I-- �o�=� I x 50 �� 7-1 f. II � i 0�/_-� /- V Ry )-P- A�I-!_ 4► Z -L- o 0 - 0 ► s 0 9_ R- �_ i i 114 I RIGHT —OF -WA ity. of Edmonds Permit No• a2otd4-N86- . CONSTRUCTION PERMIT Issue Date: — A. Address or Vicinity of Construction c. (i cbu Lo Yrl� U e..- LO B. Types of Work (be specific): % C.9CSi L >� u c- � O tv�. 1 oZ A u `i' C. Contractor: 'Pe q� x c k_ �n A Mailing Address: I 33n S}o N2 Oky State License #: P( 1--C ki C_.-r i o l I Y1 19 I). Building Permit # (if applicable)- rtact Silo ,\tXck //6 ,11 Inv t _/ t Phone: a7G 6 V-o9J' c/ I a 60 Liability Insurance: Bond: Side Sewer Permit # (if applicable):_ E. ❑ Commercial ❑ Subdivision ❑ City Project ❑ EUC (PUD, VERIZON, PSE, AT& T, OVWD) ❑ Multi -Family [j Single Family ❑ Other INSPECTOR: .• F. PAVEMENT CUT: YES ❑ NO G. SIZE OF CUT X CONCRETE CUT: YES . ❑ NO INDEMNITY: Applicant understands by his/her signature to this application he/she holds the City of Edmonds harmless from injuries, damages or claims .of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or any of its departments or employees; including but not limited to the defense of any legal proceedings including defense costs and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE'FINAL INSPECTION AND A CCEPTANCE. OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A•DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. ♦ Traffic control and public safety shall be in accordance with City regulations as required by the City Engineer. Every flagger' must be trained as required by (WAC) 296-1557305 and must have certification verifying completion of the required training in their possession. ♦ Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City - approved material prior to the end of the workday — NO EXCEPTIONS. F ♦ Three sets of construction drawings of -proposed work are required with the permit application. ' ? CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE THAT I MUST MAKE THE PINK COPY OF THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS Signature: kCiL—U__. .C.� Date:, d (Contractor or Agent) FOR CITY USE ONLY Approved by: Right -of `ay'Fee: _i=#` is,,* . Time Authorized: Void After / "') / ' Disruption Fee/Fund '111: Special Conditions: , eill6 .b lot 5 Restoration Fee: 6f� 010;A ..'t r r. A1.. IC3 .l 'TBL# g& OVMAf7 Total Fee: 4= °6� t L�,�� i1 Y�G,YZt1�l►T11Ni' �111Q�S 'Receipt No: >r IM 't9lEiY_A10k1 J0L Ael? . f PSfi (XIS: fl-d,%4 ' Issued by: ' L wry" fi UPON-tCOMPLETION OF PERMITTED WORK, AN ENGINEERING. FINAL INSPECTION. IS REQUIRED PER CHAPT .00 OF THE EDMONDS COMMUNITY DEVELOPMENT CODE 42 1-02209 Ext- 1326) FINAL APPROVAL OF PERMITTED WORK: fl DATE: ¢ O ector's Signature For inspection requirements see Engineering Inspection Information handout. NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE J �beeors+� PRCHCno1Mw SERVICE PROVIDER FOR PUGET SOUND ENERGY 10/22/04 City of Lynnwood Public Works Department 19100 44'h Ave W Lynnwood, WA 98036 City of Edmonds C/o Jeanie McConnell 1215 5th AVE N Edmonds, WA 98020 To Whom it May Concern: n RECEIVES) OCT 2 6 2004 ENGINEERING DIVISION After meeting with Noel Miller from the City of Edmonds on site it was determined that the line of main for the natural gas installation needed to be changed to 10' S of the C/L of Bertola Rd. This is due to the City of Edmonds new storm drain installation. The enclosed drawing reflects those changes. We will call in our normal 48 hour job start once the permit's have been issued, but to ensure there will be no future conflict I will also contact Jim Kammerer with the City of Edmonds the day we start the project. If you have any further questions or concerns please feel free to -contact me at 206-418-4233 office or on my cell phone at 425-290-2678. 13330 Stone Ave N Seattle, WA 98133 Fax (206) 418-4260 Rklwck Contractors, Incag Job S 107021409 October 12.2004 Sheet 2 of 2 Rob Inglis TOO. LEGEND • 28' TRAFFIC COff w oa(ARFA y♦ TRAFFIC FLOW �I o smrrL tx�n viaac vex sxaiiOaaxxr i It Notes: 1. All signs and spacing to conform to the MU1CD and City of Lynnwood Traffic Control specs. 2. Channelhing devices are 28' traffic cones. 3. AB signs are 48' x 48' B/O unless otherwise specified. 4. Alert affected residents. 5. Work area will be 14' W of C/L of 76 Ave W & 14' S of C/L of Bertola Rd. 6. One Bagger will control alternating one lane traffic. WORK AREAS 2' x 4' IN GRASS SHOULDER a APPAR SON MMCE &V4CM WX VM WlGf M, WM 40 •0 ss/u ao ro 2S,W 20 �0 SCALER 1" - 50' PROPOSED 2" MPE—IP MAIN IO'S C/L E.O.M. — ` 2" MPE CAP t, \ 10'S, 137'W C/L 40' a ,,R/W �"'4Rio �oMo O T c�rY <iy�Ts 4 rs �. 00 p EX. 5/8" 263-N 1985 G1 I 40' R/W I I 60' R/W 3 I NCS n. M FI� N to rn LLlI I � I I I 71 ST SW. 60' R/W I 2" SERVICE TEE T/L WIRE & BOX IO'S, 12'W C/L 2" TRANSITION FITTING 10'S, 13'W CA FITTER (Check Box if Complete) • WORK AREA LEFT IN CLEAN/SAFE CONDITION. ❑ • COMPLETE ALL PIPE TABLES AND GAS PRESSURE STAMP. ❑ • FIELD CHANGES RED -LINED ON AS-BUILTS. ❑ • MATERIAL VERIFIED AND CHANGES NOTED ON PAPERWORK. ❑ • ALL VALVE AND TIE-IN LOCATIONS NOTED ON AS -BUILT. ❑ • NOTE BEGINNING OF MAIN, ECM,& LINE OF MAIN LOCATIONS. ❑ • SHOW ROPE LOCATONS & CUt--DE-SAC RADIUS ❑ Fitter's Signature Company -- DATE — STANDARD GAS CONSTRUCTION NOTES: I. FIELD LOCATE ALL UNDERGROUND UTILITIES. EXCAVATOR TO CALL "ONE -CALL" TWO WORKING DAYS PRIOR TO TO CONSTRUCTION. IN WESTERN WASHINGTON CALL: 1-800-424-5555. IN KITTITAS COUNTY CALL: 1-800-553-4344 2. NOTIFY APPROPRIATE PERMITTING AGENCY PRIOR TO JOB START (SEE PERMIT REQUIRMENTS). 3. ALL CONSTRUCTION IS TO CONFORM TO PSE GAS OPERATING STANDARDS AND GAS FIELD PROCEDURES. 4. EROSION AND SEDIMENT CONTROL SHALL BE PER PSE STANDARD PRACTICE 0150.3200 TECHNIQUES FOR TEMPORARY EROSION AND SEDIMENT CONTROL AND ANY ADDITIONAL LOCAL JURISDICTION REQUIREMENTS. 5. NOTIFY PROPERTY OWNERS ADJACENT TO PROPOSED CONSTRUCTION ACTIVITIES A MINIMUM OF TWO WORKING DAYS PRIOR TO BEGINNING CONSTRUCTION. USE ISI TO DISTRIBUTE FLYERS IF JOB IS LARGE, OTHERWISE HAND DELIVER FLYERS BE SURE TO INCLUDE THE LIST OF FREQUENTLY ASKED QUESTIONS AND INFORMATION ABOUT THE OPPORTUNITY TO PURCHASE AN EXCESS FLOW VALVE WHEN THEIR SERVICE IS INSTALLED OR REPLACED PER GAS OPERATING STANDARD 2550.1600. ALLOW ADEQUATE TIME FOR CUSTOMER DECISION AND RESPONSE. 6. ANY CHANGE IN ROUTE. PIPE SIZE/TYPE. TIE-IN METHOD OR ADDITIONAL MAIN FOOTAGE MUST BE APPROVED BY THE APPROPRIATE PSE ENGINEER OR PSE REPRESENTATIVE. 7. COMPLETE "PIPE CONDITION REPORT" ON ALL METALIC PSE FACILITIES. CHECK BOX ON REPORT FOR WIRE BOX (TEST LEAD) INSTALLATION. 8. PIPELINE MARKERS AND WARNING SIGNS SHALL BE INSTALLED AND RECORDED BY THE CONTRACTOR PER PSE GAS OPERATING STANDARD 2525.2500. 9. INSTALL MAIN VALVES OUT OF TRAFFIC WHERE POSSIBLE. VALVE MARKERS SHALL BE INSTALLED AND RECORDED BY THE CONTRACTOR PER PSE GAS OPERATING STANDARD 2525.2600 FOR ALL HP VALVES IF THE LOCATION IS NOT READILY ACCESSIBLE. AND FOR ALL VALVES WHERE PERSISTANT SNOWFALL MAY OBSCURE THE VALVE BOX. 10. TO PREVENT ACCIDENTAL OVERPRESSURE OF ADJOINING SYSTEMS, NO TWO MAINS SHALL BE CONNECTED EXCEPT AS SHOWN ON THIS DESIGN UNLESS APPROVED BY APPROPRIATE PSE ENGINEER OR PSE REPRESENTATIVE. 11. SYSTEM MAOP DENOTED BY: ISYSTEM MAOP = 45._ PS1G 12- GAUGE AND MONITOR USE OF ALL STOPPERS TO ENSURE ADEQUATE FEED. 13. RESTORE ALL DRIVEWAYS SUBJECT TO OPEN CUT TO ORIGINAL OR BETTER CONDITION. 14. PURGE POINTS AND PRESSURE TAPS TO BE INSTALLED PER PSE GAS OPERATING STANDARDS 2525.3300, AND 2525.1200. 15. MAINS AND SERVICES SHALL BE TESTED AND PURGED PER PSE GAS OPERATING STANDARDS 2525.3300 AND 2525.3400. 16. IF METALLIC PIPE IS INVOLVED. COORDINATE INSTALLATION WITH CP TECH. RLQK KEK1&11--------------. PHONE_ _?_Q6 _U_Z-79QQ . 17. NOTE ALL ACTUAL FOOTAGE, LOCATION AND MATERIAL CHANGES ON THE AS -BUILT IN RED. ( ') DENOTES FOOTAGE BETWEEN FITTINGS. GAS MAIN INSTALLATION/RETIREMENT TypeNVork Pipe Size Type Estimated Length Actual Length Manufacturer INSTALL 2" MPE 125' ___ GAS MAIN PRESSURE & TESTING T� TYPE TEST PRESSURE TESTED BY DATE ON TIME ON DATE OFF _ TIME OFF TYPE TEST PRESSURE_ BY DATE ON DATE OFF r Design Press 60 -__.----TESTED TIME ON TIME OFF SYS MAOP 45 PROJECT PHASE NOT IF# ORDER# (A 0 SAP Superior Service/Meter Service/Meter Service/Meter Service/Meter Service/Meter Service/Meter Service/Meter Service/Meter Relocate Retirement X414016320 107021409 X164372082 _ 106138073 _ -- ---- ------`--' -- Contractor. CONSTRUCTION COST CODES: 041-103-1 ns ri Vicinity Map r. L0 n WORK SITE r - � f Owner / Developer Contact Info. ARTHUR ZOLOTH 17006 76 AVE W EDMONDS, WA 98026 ATTN: ARTHUR ZOLOTH 360-437-0346 office Project Manager Contact Information: CALL (8 00 ) 4 2 4 -5 5 5 5 KIM GRAY 2 BUSINESS DAYS BEFORE YOU DIG CELL: 425-290-2678 THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF FACILITIES kim-grayepse.com REAL ESTATE/EASEMENT PERMIT NOT REQUIRED EDMONDS & LYNNWOOD REV# DATE BY DESCRIPTION FUNCTION CONTACT PHONE DATE_ 3 PROJECT MGR KIM GRAY 206-418-4234 9/18/04 2 _ ENGR - GAS 1 10/22/04 DAO/GRAY CHANGE LOM DUE TO CITY PROJECT. DRAWN BY PHUONG DAO 2 COUNTY SNOHO. 1 /4 SEC N E-07-27-04 06-418-0218 10/4/04 q CHECKED BWB KIM GRAY 206-418-4234 b EMER SECT GAS WK CTR APPROVEDKIM GRAY 206-418-0234 c7T 4 — _ MNSNHG CP APPROKKESSLER206-571-7908 d0' OP MAP PLAT NIAP 156-068 158,069 M A P P I N G_ JOINT FACILITIES ARRANGEMENTS UTILITIES CONTACT PHONE# - — SOUND 2" MPE-IP MAIN EXT. ENERGY 17006 76 AVE W. EDMONDS, WA 98026 DESIGNED BY PILCHUCK CONTRACTORS INC. (ARTHUR ZOLOTH) N — — O t` -- O P Superior Order: 107021409 10 t - awing Number. C N/A SCALE: AGE: P� r 1"=50' 1/1 0 OP MAP PLAT NIAP 156-068 158,069 M A P P I N G_ JOINT FACILITIES ARRANGEMENTS UTILITIES CONTACT PHONE# - — SOUND 2" MPE-IP MAIN EXT. ENERGY 17006 76 AVE W. EDMONDS, WA 98026 DESIGNED BY PILCHUCK CONTRACTORS INC. (ARTHUR ZOLOTH) N — — O t` -- O P Superior Order: 107021409 10 t - awing Number. C N/A SCALE: AGE: P� r 1"=50' 1/1 0 SCALE: AGE: P� r 1"=50' 1/1 0 i1uob -764-'A k\vCk J e� � 0 ��,k� WORK THIS PERMIT Il't SITE FLAN SCALE: 1" = 60' AX AGGE SSOR5 NO. J" M RA selk_ 21 mo100100800 APPROVED _ B GAL D E SCR I FT I CN: Y PLANNING = 01 TWP 21 RGE 04 BAAP ON E LN SEC 1 DIST 500. El/4 COR SD SEC TH W OFT TAP ON WLY MGN MEADOWDALE RD SO PT BEING TP5 TH W 251.01FT TH N 26531FT TH E "1FT TW ALG WLY MGN BERTOLA RD ON CRV TO L HAVGINITIAL CRSE OF 623.01 30E t RAO OF FT DIST OF 80.65FT TH S61.33 10E IW53FT TH ALG WLY MGN MEADOWDALE RD 801.11 45W 11226FT TPB EXC PTN OAF BAAP ON E LN SO SEC DIST 500.15 FT NOI*II 45E FIR EI/4 COR SO SEC TH W OFT TAP ON WLY MGN MEADOWDALE RD SO PT BEING: SELY COR HEREIN DESC TR t POB TH W E44FT TH N01.15 33E 10625FT TH N31.42 31E 55.11FT M/L TO SLY MGN OF 5ER10LA RD TH 561.33 10E 3 SLY MGN OF 5ERTOLA RD SOFT TO ILLY MGN MEADOWDALE FRO TH 601•11 45W ALG WLY MGN ADOWDALE RD 112.26FT TPB COPIV rRUCTURAL NOTES: C�.1, I� cRNATIONAL RESIDENTIAL CODE.(IRC) 2003 EDITION, E LOADS: OLM SNOW LOAD (Ce=1.0, Ct=ifs) 25 PSF )OR 40 PSF EERAL LOADS: D: BASIC WHO SPEED 85 MPH, EXPOSURE SMIC: SEISMIC DESIGN CATEGORY 02 ne.C.elvef) JUL 2 6 2004 PERMIT COUNTER APPROVED AS NOTED BY ENGINEERING AA1PDrN 11 AA Zipper Zeman Associates, Inc. Geotechnical Engineers and Environmental Consultants 18905 33rd Ave. W, Suite 117, Lynnwood, WA 98036 (425) 771-3304 / FAX (425) 771-3549 DAILY FIELD REPORT # DATE 7 a4- PAGE OF PROJECT: /570040EZ IZt_2 �w � ZZA JOB NO: 193 S CLIENT: 5AOJeAi J C" ��"'��^ `,{j?"^ CONTRACTOR: ZZA FIELD REP: "� LOCATION: -7G ARR./DEP. TIME: �-' IO PERMIT NUMBER: `^�S , wA WEATHER: e- 10>°zr EQUIPMENT USED: vlC11 n C u1 G7� /e3yr a P 'r77J'jS It J�- W,YP so//S S 7 i z7'� �rz 17 `C5 e 'j�4?-.a &'r iREC:-Eefl,C PERMIT COUNTER REVIEWED BY: This report presents opinions formed as a result of our observations of the contractors activities relating to geotechmcal engineering. We rely on the contractor to comply with the plans and specifications throughout the duration of the project irrespective of the presence of the ZZA field representative. The presence of our field representative will he for the purpose of providing observation and field testing services. Our work does not include supervision or direction of the actual work of the contractor, its employees, or agents. Neither the presence of the ZZA field representative nor the observation and testing by ZZA shall excuse the contractor in any way for defects discovered in its work. ZZA will not be responsible for job site safety on this project. lu CLAI �y► ¢3,, I Tli lG'anta ..E.... .. rein earl. K.. Clay .and.-.0rP- a...L......C.1a ... ..F .....I.....L.......... Y . 1 Jau' ........................... { for the consideration of ....................g' 1 - 00 ............................................... ......................................................... the receipt of which + is hereby acknowledged, i y bed, and also of benefits to accrue .............................. by reason of laying out and establishing a public road through ...........:.......... hich is I release and quit -claim to the City of Edmonds, State of Washington', for the`t use of the public forever, as a convey, and highway, F public road rho icilawirig described real estate, including any interest therein which j grantor may hereafter acquire, viz: .�T0F THAT PORTION OF GOVERNMENT LOT 2, SECTION 7, TOWNSHIP RANGE 4 EAST, W.M,, DESCRIBED AS FOLLOWS: �7 NORTH., BEGINNING AT A POINT ON EAST LINE OF SECTION 7 1011'45" EAST 500.75 FEET FROM THE EAST ' CORNER RER NORTH SECTION 7 AND PROCEEDING THENCE WEST 20.01AFEET TONOF. SAID WESTERLY MARGIN OF THE MEADOWDALE COUNTY ROAD A POINT ON THE SOUTHEASTERLY CORNER OF THE TRACT HEREIN DES WHICH POINT IS THE POINT OF BEGINNING; THENCE WEST 2 DESCRIBED AND THE TRUE FEET; THENCE EAST 71.57 FEET;.THENCE FEET; THENCE NORTH 265.37 FEET; T ROAD 0 .THENCE ALONG WESTERLY MARGIN OF BE TOUT ° N A11CURVE TO THE LEFT HAVING A INITIAL COURSE H 23 01 30 EAST AND A RADIUS OF OF80.69 FEET; THENCE SOUTH 61° 120.0 FEET FOR A DISTANCE ALONG THE WESTERLY MARGIN .OF 33 10" EAST 198.53 FEET; THENCE 1011'45" WEST 112.26. FEE THE MEADOWDALE COUNTY ROAD SOUTH SITUATE IN THE COUNTY OFTSNOHOMISH,POINT OSTATE IOFIWASHINGT ON. situated in the County of Snohomish, State of Washington. II The Grantor.... hereby agree - and consent.... to the establishment of said road as surveyed and of record in the City of Edmonds Engineer's office as Survey No ........ and to the perpetual maintenance of the same as a City Street, and waive.... all claim for damages of whatever kind which may be occasioned to adjacent land by the location establishment, construction, drainage and maintenance of said street, and agrees and consents to the right of the City to ma}ce all necessary slopes for' cuts and fills whenever they extend beyond the right-of-way line, upon above mentioned street, all in enfu, ant 11.1 standard rd practices of City street construction, and to the same extent and purpose as if (� the rights herein granted had been acquired by condemnation proceedings under Eminent Domain Statutes of the State Of Washington, - ; ; j ................. Said covenants shall run with the land and be binding upon the grantor.-.., ..�.... . -... successors or assigns. t1,is day oy i•