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. C6 n1
16221
16310 t6238
7212
ti I n I 16318 �a -1-fi3�,163263116320
.1 1633073,6
1690163159 Wr16340 >
_1RdTH Ci RW ..... .. -. _ I b� �� m � s� t-
1sa14 $ 16411 7404 7317 701 a
1 � 6eo3
7320 n n 1 1 [7110 7040 7030 I �Bo� '1 .
16420 16429 16419
7406 y 1
16431 7314 0 7010 6811
16508 I n n n n 16423 7028 7020I S 1
6510 6801 Mleedowdele
Colnit =b 1
.. 16520 16510 I /6500 1650116
C:kb
Ij I ACF p,�
r S 39
765TH P.L SW. 7003
>
3 `,\ Q 7130
tLi
16525 O. o o 7010
n. 7124
w
F _ 16605 n
r" 16621 �16606 16605 0 16610 16607
16618 16614 16612 1 6606
16611 �j % 16615 16614 16611
16630 16618 3.. 16619 1 3
J 16620 16617 ;
1 1-3 - 16624 16622 16620 IM16 16624 Q. p'
i?r � 167/1 ~ 16625 166@a 16621 Meadow
' dale
16632 16627
1670 16710 Playfields
m o 16706 16703 16703
m: 16706 16722
16717 �\ 16742 1 O�Q�^ \ 16707 C�
16714 1672 / / V911
"gip\ ,f+ 16804 / S 16715 16711
16721 7421 7417 1672
16727
Y 16748 � 16610 ,^,I
f n
`e i HSTSW
q 7307 m
p� o
16827 o/y �l ,p� 16a0.9
16901 7414 H' '
�6a5G, o.Qv m m
y R 6832"15 16809
1685
16833 16905 721116031
16907 1 \
16900 `I
16917 18919 741e 740o Eagle's `
�p Nest 1
7691 1
18931 16925 ism 7420 7424
�l 1
N 17009 17010 7 7121 7103 ro39 Imo
�I lro,e
trots 17006 1 �' 17012 17
7037 17113 001
��11
ro71 7041
17020 Q, �.. �) 17J j 17016
701 17015
-. 170311;-4 7521 711, i') 1ts n 17020 ® 17020
Cj 17 �1 y 17017 Ta
�W? r'\ ro35/ 1 11t 1 i1 (% 17024 - 17109
no 17103
p 17105 7529 17110 -: _ 7311 17012 ' '�,0 7120 70299 7001 1 % i1 17118 17103
ntµ p( W 7 {q=.1.
,Q 7317 17/ / 7008 i 7 1 7 f D f m 17111
g126 7527 171 % / —1 17122 r
' 7517 7305 17t29 70D' g �71L1 17117
A: 7321 17110 :17122
m 11p 172NDS7 7f �7i ty n1z6 1
_
ll
n z7
06
7220 720217201 7062 -
�': )� ,1►
$• n n n 7010 s
17206
6920
172t7 O�AE a �" 1a05 7210 17206 17215 7062 6917
y
17231 7'� 7s1D 7� 17216 17223 ro20 6915 ` 17208 ; Q 6718
7404 7403 n 7012 - 69007 i
t 7229 7002 f O
o !� 7.5n 7515 75oe 173RD ST $W - :.� 17210 b^
17303
7220 7210 / 6905 t 17324
a m m
0 0 0
n m ra ...
g,;. > __ .
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