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17016 74TH AVE W.PDFIIIIIIIIIIII 5858 17016 74TH AVE W #P20 Critical Areas Checkrist CA File No (?4 Zo O V00 13 Site Information (soils/ topography/ hydrology/vegetation) 1. Site Address/Location: 1 7L) l ! y h % 2. L�I25 �,n0/ICys 2. Property Tax Account Number: d O S f 3 10 O O 127 9 6 3. Approximate Site Size (acres or square feet): 06a 4. . Is this site currently developed? Y yes; no. If yes; how is site developed?. rl o US e, Gb rn21 C-T E-Q1 I `1 5. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 66-feet). X- Hilly: slopes present on site of more than 15% and less than 30% (a vertical rise .of 10-feet over a horizontal distance of 33 to 66-feet). Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: A)Q Approx. Depth: 7. Site contains areas of seasonal standing water: ; Approx. Depth: _ What season(s) of the year? - 6J_Z14_ 8. Site is in the floodway 4) b_ floodplain A)Q of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round? YcxLr- you n d flan A cl,�E b_10*lows are seasonal? (What time of year? ). 10. Site is primarily: forested ; meadow ;shrubs ; mixed urban landscaped (lawn, shrubs etc) 11. .Obvious wetland is present on site: O 1. 2. 3. 4. For City Staff Use Only Plan. Check Number, if applicable? Site is Zoned? SCS mapped s Critical Areas inventory or C.A. map indicates Critical Area on site? 5. Site within designated earth subsidence landslide hazard area? //yO DETERMINATION �ry �(-t'r ffl D REQUIRED WAIVER. Reviewed b Date: Z 26 0 #P20 'QC. 189- City, of Edmonds Development Services Department Planning Division Phone: 425.771.0220 Fax: 425.771.0221 The Critical Areas Checklist contained on this form is to be filled out by any person preparing a Development Permit Application . for the City of Edmonds prior to his/her submittal of the application to the City. The purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are, or may be, present on the subject property. The information needed to complete the Checklist should be easily available from observations of the site or data available at City Hall (Critical areas inventories, maps, or soil surveys). Date Received: City Receipt #: Critical Areas File #: kA 200 g o p13 Critical Areas Checklist Fee: $135.00 Date Mailed to Applicant: A property owner, or his/her authorized representative, must fill out the checklist, sign and date it, and submit it to the City. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. Please submit a vicinity map, along with the signed copy of this form to assist City staff in fmding and locating the specific piece of property described on this form. In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assistant staff in completing their preliminary assessment of the site. The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information furnished by the applicant, his/her/its agents or employees. By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge and that I am authorized to file this application on the behalf of the owner as listed below. SIGNATURE OF APPLICANT/AGENT � �l/ DATE Property Owner's Authorization `i By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the purposes of inspection and posting attendant to this application. SIGNATURE OF OWNER Owner/Applicant: /V,C-l67e-,l Z- /a,,/1Cti6� Name / l -7a 16 - � �" �� 'l ve- GJ�s f Street.A s 9 ,6 City State Zip Telephone: 06'�.� d 60 DATE Applicant Representative: Name Street Address City State Zip Telephone: Email address (optional): Email Address (optional): 11), h 0-th G,W a � � M .510. 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CITY OF EDMONDS CRITICAL AREAS RECONNAISSANCE REPORT Site Location: 17016 74t' Avenue West Tax Acct. Number: 00513100012206 Determination: Study Required Determination #: CRA-2008-0013 Applicant: Michael L. Hathaway Owner: Michael L. Hathaway CRITICAL AREAS RECONNAISSANCE REPORT: STUDY REQUIRED During review and inspection of the subject site, it was found that the site contains and/or is adjacent to critical areas, including Geologically Hazardous Areas, pursuant to Chapters 23.40 and 23.80 of the Edmonds Community Development Code (ECDC). The subject parcel slopes east to west towards Puget Sound. According to the City's LIDAR data, the steepness of the slope varies from approximately 25% to nearly 40%. There is a water feature which essentially follows the fall line west of the current residence leading off -site but field observation confirmed that the feature appeared to be a drainage ditch rather than a stream. GENERAL CRITICAL AREAS REPORT REQUIREMENTS Critical Areas Reports identify, classify, and delineate any areas on or adjacent to the subject property that may qualify as critical areas. They also assess these areas and identify any potential impacts resulting from your specific development proposal. If a specific development proposal results in an alteration to a critical area, the critical areas report will also contain a mitigation plan. You have the option of completing the portion of the study that classifies and delineates the critical areas and waiting until you have a specific development proposal to complete the study. You may also choose to submit the entire study with your specific development application. • Please review the minimum report requirements for all types of Critical Areas that are listed in ECDC 23.40.090.D. There are additional report requirements for different types of critical areas (see below). • Note that it is important for the report to be prepared by a qualified professional as defined in the ordinance. There are options on how to complete a critical areas study, and there is an approved list of consultants that you may choose from. You may contact the Planning Division for more information. • General Mitigation Requirements for all Critical Areas are discussed in ECDC 23.40.110 through 23.40.140. STUDY REQUIREMENT — EROSION HAZARD AREA It appears that this property contains or is adjacent to an Erosion Hazard Area. Erosion Hazard Areas include: • Those areas with Alderwood and Everett series soils on slopes of 15 percent or greater. Any area with slopes of 15 percent or greater and impermeable soils interbedded with granular soils and springs or ground water seepage. • Areas with significant visible evidence of ground water seepage, and which also include existing landslide deposits regardless of slope. DEVELOPMENT PROPOSALS ASSOCIATED WITH EROSION HAZARD AREAS Development within an Erosion Hazard Area must meet additional criteria. • For erosion hazard areas with suitable slope stability, the only critical area study needed is an erosion and sediment control plan prepared in compliance with the requirements set forth in Chapter 18.30 ECDC as part of the construction documents. This option is at the director's discretion, per Edmonds Community Development Code section 20.80.050.G. • In areas where the slope stability is not suitable, projects within Erosion Hazard Areas will require a report by a licensed Geotechnical Engineer or other qualified professional. Note that it is important for the report to be prepared by a qualified professional as defined in the ordinance. • Report requirements are given in ' ECDC 23.80.050, and more generally in ECDC 23.40.090. D. • Development standards are given in ECDC 23.80.060 and 23.80.070. ALLOWED ACTIVITIES Certain activities are allowed in or near critical area buffers as specified in ECDC 23.40.20. If you have any questions about whether your proposed development qualifies as an allowed activity, please contact a Planner for more information. EXEMPT DEVELOPMENT PROPOSALS Certain development proposals may be exempt from Critical Areas Requirements (ECDC 23.40.230). If you think that a specific development proposal may be exempt, contact a Planner for more information. n. Planner �. Name Signature Date NOTE: Cited sections of the Edmonds Community Development Code (ECDC) can be found on the City of Edmonds website at www.ci.edmonds.wa.us. 2 N., g 16 74th Avenue West kp ak 'D N, XNII IS, Nr M 01 1'r R 7- ,T. "This map displays LIDAR data at approximate 2-foot contour This map is for information purposes only and should not be relied upon for any action. Actual topography should be verified in the field by survey for accuracy. This map is provided with all L faults on an "as is" and "as available" basis. No warranty is any kind is given. Users of this map agree to indemnify and save Warniess tWe Citv of Edmonds. its officials, officers, employees CITY OF EDMONDS 121 5TH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771-0221 Website: wwwdedmonds.wa.us DEVELOPMENT SERVICES DEPARTMENT Planning • Building • Engineering April 23, 2007 Michael Hathaway 17016__7�4�' t�uenue'WA'_, Edmonds, WA 98020 GARY HAAKENSON MAYOR Re: Tree topping on steep slope within critical area at 17016 — 74`h Ave. W. without required permits Dear Mr. Hathaway: This letter is a follow-up to an April 18, 2007 conversation you had with Planning Manager Rob Chave and myself in response to the Stop Work Order placed on your property at 17016 - 74`h Avenue West the previous day (April 17`h). The Order was in response to a citizen complaint regarding the cutting or topping of trees on the property. As you are aware, there appear to be steep slopes and slopes with erosion potential on your property which triggers the need to apply for a tree cutting permit with the City. To bring your property into code compliance, you will need to file the required tree cutting permit application. To assist you, I have attached the applicable materials. The land use application should be for "tree cutting," and should be accompanied by a filled -out SEPA checklist, a critical areas checklist, and a mailing list for all properties (including both site addresses and owners) within a 300-foot radius of the property. The decision on a tree cutting permit is a staff decision, and the decision is mailed to everyone on the mailing list. Because the tree cutting is within a critical area (slope), your tree cutting application will need to be accompanied by a tree cutting and restoration plan, showing the trees that have been cut (and any others that are planned) and what restoration work will be undertaken. The plan will need to be prepared by a certified arborist, in consultation with a geotechnical engineer. In particular, the geotechnical engineer will need to prepare a written report that meets the requirements of the City's critical areas regulations (ECDC 23.40 and 23.80). ECDC 23.40.240, for example, describes what is required for a restoration plan, and 23.80.50 speaks to the report requirements within slope areas. Your professionals will need to address these code requirements, and the standards found in the Land Clearing and Tree Cutting Code (ECDC 18.45). Because the work was done without applying for the required permits and is therefore in violation of city codes, the City has the ability to assess fines of from two to five times the application fee. In addition, the tree cutting chapter of the code (18.45) authorizes the City to levy additional fines based on the number of trees that were cut. During our discussion on April 18`h, Mr. Chave determined that you would be fined twice the fees for all of the required Incorporated August 11, 1890 Sister City - Hekinan, Japan submittals. We will not levy any additional fines at this time, but reserve the right to assess additional fines authorized by ECDC 18.45.070 once the extent of the tree cutting is determined and the timeliness and extent of the restoration plan is confirmed. Should you have any questions, contact me at 425-771-0220, extension 1223, or via e-mail at pansa@ci.edmonds.wa.us. Thank you for your attention to this matter. Sincerely, -9 N"kJT�� Martha Pansa Senior Planner Attachments: ECDC Chapter 18.45 Land Clearing and Tree Cutting Code Land Use Application Public Handout #P46 - Land Clearing/Tree Cutting Public Handout #P2 Mailing List Instructions Public Handout #P20 Critical Areas Checklist Public Handout #P71 SEPA Checklist Copies: Street file: 17016 74`h Ave. W. Mike Thies, Code Enforcement CITY OF EDMONDS NEW ❑ ADDITION ❑ RETIREMENT i ASSET INFORMATION SHEET J � T F � L E ASSET NO. �` 6%3 / l ADDITION TO ASSET NO. DESCRIPTION / SERIAL NO. LOCATION * * PURCHASE ORDER NO. PURCHASE ORDER DATE COST * PROJECT NUMBER G[/,�12,0,2 PROJECT COMPLETION DATE COST Ia•� B.A.R.S. ACCOUNT NO. ESTIMATED LIFE o?c� INITIATED BY DATE APPROVED BY **SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY M DEPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT 0 G.L. ENTR REFERENCE DATE VERIFIED BY PROCESSED BATCH NO. - b P INITI DEPARTMENT FILE 00 _o a V) a CITY of EDMONDS SID.Ei SE,�INIA-!f.PE .MIT': For,. Inspection;Call 771-3202 PEI--'NO_: �TMITT r R'EC,EIVED Address,of Construction:-. ��-//111111 / �� ��7[� �(� 7 ��J. AlW 1 n 1a�� Property Legal Description ( Incl ude al 1 easements) / t -�Q Owner and/or Builder: Contractor &.License No: Single Family Residence Multi -Family (No. of Units ), LYNNWOOD LFNE Commercial (No. of fixture Units ) Invasion into City Right-of=Way: No ✓ Yes (If Yes, Right -of -Way Construction Permit required. Call One -Call -Center (1=800-424-5555) before any excavation.) .Cross other Private Property: No Yes L/ (If Yes, easement required, atta•�h legal description and county easement number.) PLEOV READ'THE ITEMS LISTED ON THE BACK /X5�/n eGtheyitems -at I have read and shall comply to with listed on the back. Permit , cro IlIssued j; Charge:Trunk !DateIssued: •- • • • Partial Inspection: Comments' Date Initial' Final Inspection Approved: a (S D �✓� Date Initial Rejected: eason ** PERMIT MUST BE POSTED ON JOB SITE ** Wh.ite Copy - File Green.Copy - Inspector Date Initial Buff Copy - Applicant I ,The City of Edmonds Side Sewer Drawing EASEMENT NO ____________________________________________ NEW CONSTRUCTION REPAIRS ❑ LID NO_ __________________ _ASMT. NO..--___.--_.___---- OWNER--------------------------------•--------------------------------------------------------------- CONTRACTOR----••---•-------------•----•-----------------------•------------------------------- PERMIT NO. 1 l ���_._______ `___ _ ______________ LEGAL DESCRIPTION: LOT NO. --------------------------------------- BLOCK NO. JOB ADDRESS 1�-----------•-'-•--�-�---------------- � -- l? O . e. 40 NAME OF ADDITION ------------------------••---------------------- •-------.........................-LYNNWOOD--LfME- y�y L_ L-7' a ti C�AeIEQ Polt ` ' �.5 I J 99r 2 I � •CAE, q f I' Deaf 00 9 o cpKfi, O -I.-] C D 9L 1%1 P Z 3g' Ro�KP.1y -- 4. ,, L L-Vm (�lje CAQ=� i b 1 O r q NO WARRA'17's 0' AGC'.1 ACY Ths inform2tEcn c mt, c, the r;:-_ rrc: cc: tc; c,, b'a ty, City of Elmc-. _ _J c-- _ . -s. Th: G ofi Ed,r!icuds dog. no. warn. frrth osr t..• raa � A.iv persc,, or enQj i u ; y reg W ;::, the ins; .::.._: :' z,i ti r..,. •. ir: -' j, t r . i;;: ' c . t: - tn�- loCQ--L! � of 2n, S : IS i s- c rn:''- not E::izt atjid may cr ri.-, vc. _.:.I tt Ir c _ .I, Nl- `. G: : Edmond, nci is c ..,,lc cl o';:... .: t . k ;;,'a f; t:,. �; ,1;::.0:+ giver on this map, nor for z_ ; cr rt : ;i.aii .i p`cvidaa b:-..:.�i LOU,. �-'=lf1 rnac 4"'►P o.. Gl o �9sGP. 11 7► y 13, I e`l: t, C �:tIJe4_ c F 1_lo�sE r `?I V p-v•c Cho V Dfq. 41� s� _I l ? l 0 3 — 70- Aura. \(, Approved: PWW-0001-11175(REV.11/78) DATE/�_' --•••-•-- B �� r f o-O 8g199 CITY OF EDMONDS 250 - 5TH AVE. N. • EDMONDS, WA 98020 • (206) 771-3202 COMMUNITY SERVICES: Public Works • Planning • Parks and Recreation • Engineering January 23, 1991 Shawn Parsons Land Plan P.S. 7603 - 218th St. S.W. Edmonds, WA. 98026 Re: Driveway slope waiver for 17016 - 74th Ave. W. Dear Shawn, LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR After reviewing the circumstances surrounding the subject address and the problems with road grades in the area, and after site visits, a driveway slope waiver is granted. If you have any questions, please call. Sincerely, ADDISON L. CHRISMAN Uv Engineering Inspector ALC/sdt c: Sverre Waage University Savings Bank Attention: Tony Costa Greening America R 4(,.._ Alberts i ( I Z'L-'P- a';6� 710� ) PARSONS/TXTST530 • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan STREET FILE LANDIPMAEffMo 00 T. SHAWN PARSONS, REG. LANDSCAPE ARCHITECT January 18, 1991 City of Edmonds Engineering Department 520 Bell St. Edmonds, WA 98020 Attn: Lyle Chrisman IV Re: Holiday Residence Dear Mr. Chrisman: 14 4-,C el Z JAN221997 &NGlN,,F81 As per our conversation the other day, let this letter serve as a formal request to waive the maximum slope requirement of 14% for the private -single family residential driveway at the Holiday Residence, 17016 - 74th Ave. W., Edmonds, WA. Waiver of this requirement would be based on existing conditions prior to the general contractor commencing his work. The proposed plan calls for lowering the adjacent neighbor's driveway to comply with slope requirements. This neighbor, south of the constructed house, has elected not to allow for any demolition and subsequent repair of their driveway. The general contractor has agreed to work with City staff to minimize percentage grade of slope. It is anticipated that the majority of the proposed driveway, 80-90%, can be constructed at less than the maximum allowed slope of 14%. The area that would be most difficult for compliance is the interior angle area formed where the Holiday residence driveway meets with the common shared driveway. This area is not an useable maneuverable area and justification for steeper slopes are warranted. If you should have any further questions, please call. Sincerely, . Shawn Parsons Principal Landscape Architect TSP:rb cc: Sverre Waage University Savings Bank, Attn: Tony Costa Greening America (206)776-4932 LANDSCAPE ARCHITECTURE . SITE PLANNING 7603 218th ST. S.W. EDMONDS, WA. 98026 S f/01DARD OfIlIII!! ~LAN UPPLP, C ATC H BASIN (Vf.N'�\ orTEICTIOH PIP: -«-TN CO/fT nOL Lr.TC., C.0v[P, ? f 117. 5--vPF- I ,t I SYSTEM CROSS SECTION rtSEE P4GE 3 FOR OUTL_-- CONTROL_ DETAIL_ O VTLCT CONTRo1" I 'TO OUT lc7E T (NIP RAP OR {IUNOF F SPRFI�DER� ._ 0 A' 6" SPALLS (oL cou�L� CRUSIAZD ROr-V CCN:-Rol RIPRA? OUTLET -rP, NCH, MIN 10' LONG, TOP 4 -A- PCKF PIPE -M DE L.HVCI. 7 V- 4- Pc'« PIPE WITH CAPS RUNOFF SPREADER OUTLET 'JUN, 015$Z pERMIi COUNTER , DETENTION SYS �-^ p PAGE gg I OF 71 3 T� CiVA7 for �l�� TI 'C®. location plan by 01V�iL90�m0./ phone date DESIGN DATA System Imperm Pipe Number Area Diam I. '{ Pipe Length Orifice Diameter Ll o" 3�� NOTES 1. Call Engineering Division (771-3202) for prebackfill and final inspections. 2. Responsibility for operation and maintenance of drainage systens on private property is the responsibility of the property owner(s). Material accumulated in the storage pipe must be flushed out and re -moved from catch basins to allow proper operation. The outlet control orifice ^ust be kept open at all times. ,r CITY OF EOMONDS MEMO TO: Building Division 'FROM: Engineering Division n ,l ,SUBJECT. 4� `-"-'After 'review of the subject building permit application, we have the =':fol 1 owi ng comments: 1) Connection to City water system required. 2) Connection to City sanitary sewer system required. 3) Right-of-way permit required for any work_on City property. 4) Driveway slope not to exceed 14%. 5) Back water valve required if downstairs plumbing is below elevation of upstream manhole. 6) Water and sewer lines to be separated by 10 foot minimum. 7) Builder/owner responsible for containing all temporary runoff and erosion on site and may not impact neighboring properties in any way. 0 /a, Construction hours from 7:00 a.m. to 10:00 p.m. on weekdays and 10:00 a.m. to 6:00 p.m. on weekends and holidays. FIIIIIIII� N �, 0� Oil r � 1 ,ri r W. AI / Pf OMT REVIEW CHECKLIST PROi err NAME: I I I J , l l a PROJECT ADDRESS: AnnT T/'LTTr*j PP-PTUT MIFF.- ��� / n / s • r . r ` , ° C�Tl'S PLANNING Reviewed by: (initial/date) WTR/SWR STREET ENGNRNG f '� FIRE BUILDING tSINQE•FAMILY/MULTIPLE/COM 9hCIAL -:(Circle One) SETBACKS CtEMM,:- Planning , r � • ' VARIAIJCE/SEZZiAC7C • ADJ CONDITIONAL° USE. PER1,11T 7.f .4 f 7 ////// :l ' ADB�RDQUIREMENTS CHECKED :": ..3 *hi'+rP NT�1J .1:-.y� '.. -A iS '+y- �� t`1: :•1.r, J. .. --• OTHER ZCNING Pl=IREMENTS ////// ///////// -77-7-777-777 //////// // ////// tx S 4 , ENVIRONMENTAL FrATURES 777777 //////// 5 , 'ACCESS SLOPE VEHICLE ACCESS V `' ///////// ///////// //////// {; 6 ; .DRAINAGE PLAN, (On Site) w�' ////// ///////// ///////// ///// ,* 7 STREET FILE — ////// ///////// ///////// //////// '8 .. LEGAL DESCRIPTION VRRIFICATION " P ////// ///////// ///////// //////// ' '•` 9 QUIT CLAIM/DEDICATIONS ////// ///////// ///////// //////// 10 ` EhSDOW PUBLIC/PRIVATE / / CALCULATE SEWER CONNECTION IF tfO LID# ////// ///////// ///////// //////// 12 ^ ` PLAT/SUBDIVISION REQUIRQ4FNI'S' ////// ///////// //////// 13 3..• RIGHT OF -WAY CONSTRUCTION PERMIT READ 14 BCND REQD`FOR PUBLIC IMPROV1334ENPS SOILS CONDITIONS & GROUND 'WATER FIEQD CHECKED •' . -. ..`. ,^, ////// ///////// ///////// //////// ` ?s' 16 ;Y ,: STREET'PAVINGAMDUIRED Way ... _.. YCURB AND'GupmR REQUIRED' —iw ` �SIDEWALK•RDQUIRID "CURB CLIP: FOR DRIVEWAY REM: ////// ///////// ///////// /// 20 7; STREET NAME SIGN RDQD •r' SIGNING READ. r ,:�%.'OTHM k777777 ASIDE SEWER -AVAILABILITY �..:..:.' ...: EXISTING WATER MAIN SIZE " n r+ /////// ////////// 24 : _ WATER METER SIZE..' ////// /////////SkI//////// ////////// a 25 SERVICE LINE SIZE ////// ///////// 'y //////// ////////// 26`r. HYDRANT REQUIRED ///////// ///////// //////// //////// 27',. HYDRANT SIZE EXISTING ////// ///////// 11117117 //////// ///// 28 CRbss CONNECTION INSPECTION READ 29 l'' VMTER'ME'lER CHARGE RDQD ////// ///////// / r IOJD //////// //// 30 'FIRE LINE CHARGE READ - SPRINKLFJ2 ///////// //////// ////////// 31 STREET CITT „ '.. ////// ///////// ////////// 3i ' OPEr1 DITCH!EXISTING'` ,:•; ////// ///////// ///////// �:,• �L 3?� 33�� .•�r�" � - �'.-„ Wyk >�� � '. �•.� , - '_ l 34, CULVERT3,RMD, *11X !0�1,fix, `.:: ////// ///////// ///////// max, S F._..... _ 35 SIZE ��' .t'ae,'��}�'"':' 4-,:•, � '.� • - - . ////// ///////// ///////// �•t s 36 ; CATCH�BASIN:RDQD �; k�� 777777 ////// ///////// ///////// 3:' y 37 Zr1DICATED.XN SITE;PLAN.: �:'? :, ,r .,: 777777 38 7 �'-; SHOULDE77- R: DRAINAGE MAINTAIN , ` tx a" SHALE OPI1J•'RUNOFFkik, T'� "<. N"�•M-1 �t iR `•afc ' ram, , , "�',,BT� ` ��� t {r A ,� : t-� - 1 PLANNING MGR ,,, t ENGINEERING MGR. F PUBLX2 WORKS MGR.,'.fi CITY OF EDMONDS Z ONE ,,n PERMIT E � l� J NUMBER CONSTRUCTION PERMIT APPLICATIO 08 TAME(ORNAME OF BU/SINE/SS) ^^ O1 (,.Gt�k1 r L DESCRIPTION'CHECK SUBDIVISION N0. MAILING ADDRESS 1 n — _ If 5'3n 1 clrY T 6u-�v C, NAME - Gr pl 10 9- CITY E- //9778 Oe-- Nt NUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. !Q EXISTING__ REQUIRED DEDICATION V RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED ❑ STREET USE PERMIT REQUIRED ❑ SEE ENGINEERING MEMO DATED NUMBER _ NAM A Cp�Slr; �G Pates ADDRESS Avg CITY TELEPHONE NUMBER -�- 1,1 STATE LICENSE NUMBER Legal Description of Property -include all easements Z (show below or a c four copi T7 T z/qcT 12.Z a) f 2,-/ LX NEW L:hL RESIDENTIAL LINGJ PLUMB ADD/ALTER COMMERCIAL MECHANICAL REPAIR RETAINING WALL SIGN DEMOLISH REMODEL EXCAVATE OR FILL PRE -MOVE INSPJ COMPLIANCE INSP. FENCE ❑ ( x—Frn) ❑ SWIM POOL WOO INSERT ❑ APT. BLDG RENEWAL NUMBER OF STORIES rNUMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) N VY LID NOI�W- Mt: ITZE If IBUILDINGUPPLY SIZE `FIXTURE �TS ✓✓!![!///( I Z REMARKS XV 6>� SIGN AREA I ENV. REVIEW ADB NO. ALLOWED I PROPOSED COMPLETE I EXEMPT SHORELINE VARIANCE OR CU NING REVIEW BY I DATE YARDS n I ( HEIGHT LOT COVERAGE FRONT L SIDE3� REAR �/'� ��f BY SPECIAL INSPECTOR REQUIRED ❑ YES ❑ NO PLAN CHECK FEE BUILDING PLUMBING MECHANICAL This Permit covers work to be done on private property ONLY. GRADING/FILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Permit Application: 180 Days CODE Permit Limit: 1 Year• Provided Work is Started Within 180 Days ENERGY "Applicant, on behalf of his or her spouse, heirs, assigns and n successors in interest, agrees to indemnify, defend and hold 31 harmless the City of Edmonds, Washington, its officials, cemployees, and agents from any and all claims for damages of c whatever nature, arising directly or Indirectly from the issuance of this permit. Issuance of. this permit shall not be deemed to PLAN modify,. waive or reduce any requirement of any city ordinance nor limit in any way the City's ability to enforce any ordinance provision." TOTAL CHECK DEPOSIT AMOUNT DUE I hereby acknowledge that I have read this application; that the Information given is correct; and that I am the owner, or the duly authorized agent of the owner. I agree to comply with city and state laws regulating construction; and in doing the work authoriz• ed thereby, no person will be employed in violation of the Labor Code of the State of W hington relating to Workmen's Compensa• ti n Insurance ATTENTION THIS PERMIT S ONLY O THE WORK NOTED INSPECTION DEPARTMENT SIGNATURE T) DATE SIGNED ,t7 CITY OF �7 EDMONDS N T 10 N 771.3202 IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. — N AREA GROUP VALUATION OCCUPANT LOAD FEE _10c)ra I -7o35 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his Deputy; and fees are paid, and receipt is acknowledged in space provided. OFFICIAL'S SIGNATURE DATE RELEASED BY: DATE ORIGINAL — File YELLOW — Inspector I PINK — fl,.,r_ni n A_______ a Z 2 W Z 0 Z W W a 3 Z Z a 1 Qe o � 0-7�) o C,2 � r ate, Cr \ e / D o7Satoi �J Ab A9�mo'l me �a \ ,ol ( (-,I ' wrewr l-- 21- a � fi A MIZ/ 14VI-2y ,- YlWg 17) R APPROVED By PLANNING