18301 85TH PL W.PDFIIIIIIIIIIII
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18301 85TH PL W
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ADDRESS: 1:6 '&3-a OL W
TAX ACCOUNT/PARCEL NUMBER: q q (0'0� noo nns- --() 0
BUILDING PERMIT (NEW STRUCTURE): n34 -61S2
COVENANTS (RECORDED) FOR: DNS 91 is 19q
CRITICAL AREAS: CA - q3-Q1(p - DETERMINATION: n Conditional Waiver n Study Required )� Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED: I qq -5
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:14 4
LOT: �5 BLOCK:
SIDE SEWER AS BUILT DATED:
jatj13/q4,,
jj1jq1q4
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DA
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED
OTHER:
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184TH ST. S W
c?3 STREET FILE
CA FI*rO.
STREET FIJKical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: 61601 eff ""' Alae(f Zo
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet): /4000
4. Is this site currently developed? —yes;
If yes; how is site developed? VACA147-
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).
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: /19 C) —, Approx. Depth:
7. Site contains areas of seasonal standin water: /) 0 —;Approx. Depth: _
What season(s) of the year?
8. Site is in the floodway //?(,) floodplain /)0 of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? 1*20 Flows are seasonal? - /)o (What time of year?
10. Site is primarily: forested ;meadow _;shrubs mixed
.urban landscaped (lawn,shrubs etc) — -
11. Obvious wetland is present on site: Z/20 -
---For City Staff Use Only -
Site is 7-,6ned7
SCS mapped soil type(s)?
3. Wetland inventory or C.A. inap indicates wetland present on site? A)
:4. Critical Areas inventory or C.A. map indicates Critical Area on site?
5. Site within designated earth subsidence landslide hazard area? -- -A/D
6. Site designated on the Environmentally Sensitive Areas Map? K5
DETERMWATION
STUDY REQUIRED
WAIVER
Reviewed by:7��-
Planner
CONDITIONAL WAIVER
— I'l /1 4) � 3 —
Datet
Rev 09rl"3
FILE
PLANNING DATA
SITE ADDRESS: I S3C) I tc�,6 -PL - W . DATE: 11101.1.q
ZONING: 1, Z 5 - 12- PERMIT#: 9 ---�> - 2 2 Ity
PROJECT DESCRIPTION:
SETBACKS:
Reguired Setbacks:
Front: ]Z,!� Left Side: /0 Right Side: Rear:
Actual Setbacks:
Front: 4g__Left Side: 10.6 Right Side:_ZQ. Rear:
FLOOR AREA:
LOT COVERAGE:
Maximum Allowed
BUILDING HEIGHT:
Maximum Allowed: Actual Height: AfA�e
SUBDIVISIO
CRITICAL AREAS #:
SEPA DETERMINATION:
LOT AREA:
OTHER:
-�4 4
0
CITY OF EDMONDS
8 9 0 . 1 9 q
SIDE SEWER PERMIT
Address of Construction: /9 J0 / a S- ,,��Z_ /-�)
PERMIT N 0- 86,35
Property Legal Description (Include all easements): 7766? - na) ncf) R
RECEIVED
OCT 2 1
1JUBLIC WORKS Drp,
EDMONDS
Owner and/or Contractor: 14`�eki A?)o1e_v_se,,,7 (�ms,4,4,47-vli
State License No. ktAi A \j c o sa _D vJ - Building Permit No. 9vo z�t�
3--Single Family
El Multi -Family (No. of Units-)
El Commercial
0 Public
10
Invasion into City Right-of-Way:Z""No El Yes
RW Construction Permit No.
Cross other Private Property: d"No 11 Yes
Attach legal description and copy of recoided easement
I certify that I have read and shall comply with all city requirements
as indicated on the back of the Permit Card.
/6-
Date
11
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVA�ION
OFFICE USE.ONLY.
FOR INSPECTION CALL 771-3M, PUBLIC WORKS DEPT.
�3 (f�. O'b oi;kAo
Permit Fee: Issued By
Trunk Charge: Date Issued- -9sl
Assessment Fee: Receipt No.: 490-5-1
Lid No.: -
Partial Inspection:
Comments
Date - Initial
Reason Rejected: Date -Initial
Final Inspection Approved: Datei4L-A �-Initi
I � I T_
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3190
I
The City of Edmonds
Side Sewer Drawing
EASEMENT NO . .... ..................................... .
i
NEW CONSTRUCTION 2' REPAIRS F-1 LID NO . .................. ASMT. NO . ..................
OWNER................................................. ---------------------------------------------- CONTRACTOR .................................................................................... PERMIT NO.
JOB ADDRESS - t 3 �) C) I - � . ..... 14.
............................... ................ .......... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
..................................................................................................................................................................
MAMF OF AnnITTON
.................................................... . .........................................
12"
14
PWW-0001-1 1/75 (REV.1 1/78)
0
,�� S-rq �L. V� ,
Approved:
....................................
DATE I.L.Aq . ..... ....... I
NOTICE:
No ... wa r-r a MY 0. Cz . F
The -information on the attached
iled for use by the City Of
map(s) was cOMP
Edmoncls� its Employees and Consultants.
Th.e City of Edm.onds does not ' wa rra nt t, ie
accuracy of anything set for.th on t ' hese
Map(�_). Any person or e.n.tity -requesting a
copy should conduct an independent
0 'ation shown on
inquiry regarding the inf rm
_tFe -map(s), including, but not limited to
th'e lociation of any sew-er stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the city of Edrno'nds nor its
empl-o-yee-s o-r office-rs -sh-a-11.1 be 11a-b-'Fe for the
i n on this ma p(s), nor for
information g ve
based
any one representation provided
upon . said map(s).
0
The City of Edmonds Water Service Drawing EASEMENT NO . ............................................
NEW CONS TRUCTION REPAIRS LID NO . .................. . ASMT. NO . ..................
N6T
OWNER ..... .......................................................................................... CONTRACTOR A.N.o.i�iRsat4 ....................................... ..PERMIT NO . ....................
JOB ADDRESS V�303 ......... 8.5. -r . " ...PL, W�
....... ............. AL DESCRIPTION: LOT NO . ...................................... BLOCK NO . .............................
................................................................................................................................................................
T NAME OF ADDITION ..: ............................................. I ..................................................... I ................
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Approved:
PWW-0001 -11175 (REV. 11/78) DATED By .......... . ..................................
CITY OF EDMONDS
250 STH AVENUE NORTH, EDMONDS, WA 98020 (206) 771-0220
RCW 197-11-970 Determination of Nonsignificance (DNS)
DETERMINATION OF NONSIGNIFICANCE 4
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P4
Description of proposal: New Single -Family Residence (totaling 4,375 sq.ft.) 61
(City of Edmonds Building Plan Check No. 93-226). 1-919f
Proponent: Jeff Eppler
Location of proposal, including street address if any: 18301 85th Place West, Edmonds, Washington
Lead agency: CITY OF EDMONDS
The lead agency for this proposal has determined that it does not have a probable significant adverse impact on the
environment. An environmental impact statement is not required under RCW 43.21.030(2)(c). This decision was
made after review of a completed environmental checklist and other information on file with the lead agency. This
information is available to the public on request.
XX There is no comment period for this DNS.
This DNS is issued under 197-11-340(2); the lead agency will not act on this proposal for 15
days from the date below. Comments must be submitted by .1993.
Responsible Official: Ann Bullis
Position/Title: Code Enforcement Technician, Department of Community Services - Planning Division
Phone: 771-0220
Address: City of Edmonds, 250 5th Avenue North, Edmonds, W 98020
Date: Februa!y 18, 1994 Signature:
XX You may appeal this determination to Rob Chave, Planning Manager, at 250 5th Avenue North,
Edmonds, WA 98020, no later than 5:00 p.m., March 8,1994 1993, by filing a
written appeal citing the reasons.
You should be prepared to make specific factual objections. Contact Rob Chave to read or ask about the
procedures for SEPA appeals.
XX Posted on February 18,1994 1993, at the Edmonds Public Library, Edmonds
Community Services Building, and the Edmonds Post Office.
XX Distribute to "Checked" Agencies on the reverse side of this form, along with a copy of the
Checklist.
Mailed to the following along with the Environmental Checklist:
XX Department of Ecology XX Jeff Eppler (Applicant)
Environniental Review Section 12011 Bel -Red Road, #207
P.O. Box 47703 Bellevue, WA 99005
Olytnpia, WA 98504-7703
Attachments:
Critical Areas Detennination # CA-93-276
Environniental Checklist
PC: j3pilding. Plan Check No. 93-226
" " z ' V
SEPA Notebook
Page 1 of 2
BUILDING
CITY OF EDMONDS 11994
ENVIRONMENTAL CHECKLIST
'y go - 199 -
Purpose of Checklist:
The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all governmental agencies to consider the
environmental impacts of a proposal before making, decisions. An environmental impact statement (EIS) must be prepared for all
proposals with probable significant- adverse impacts.on the quality of the environment. The purpose of this checklist is to provide
information to help you and the agency identify impacts from your proposal (and to reduce or avoid impacts from the proposal, if it
can be done) and to help the agency decide whether an EIS is required.
Instructionsfor Applicants.
This environmental checklist asks you to describe some basic information about your proposal. Governmental agencies use this
checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of a*n EIS. Answer
the questions briefly, with the most precise information known, or give the best description you can. '
You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you should be able to
answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the
answer, or if a question does not apply to your proposal. write "do not know" or does not apply". complete answers to the
questions now may avoid unnecessary delays later.
Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions.
if you can. If you have problem:, the governmental agencies can assist you.
The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or on different parcels
of land. Attach any additional information that will help describe your proposal or its environmental effects. The agency to which
you submit this checklist may ask you to explain your answer.% or provide additional information reasonably related to determining
if there may be signifi 'cant adverse impact.
Use of checklistfor nonproject proposals:
Complete this checklist for nonprcject proposals, even thouoh questions may he answered "does not apply." IN ADDITION,
complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D).
For nonproject actions, the references in the checklist to the words "project," "applicant,"'and *property or site" should be read as
.proposer," and "affected geographic area," respectively.
A. BACKGROUND
1. Name or proposed- prqiect, if applicable: /JZ U-
2. Name of applicant:
3. Address and phone number or applicant and contact person:
1 11.9
ared
4. Date ch�cklist prep, �>
Page I of 22
5. Agency requesting checklist: City of Edmonds.
KA A4-,,-e,
6. Proposed timing or schedule (including phasing, if appli cable):_
(STAFF COMMENTS)
7. Do you have any plans for future additions, expansion, or further activity related tor or connected with this
proppsal? If yes, explain.
(STAFF COMMENTS)
8. List any environmental information you know about that has been prepared, or will be prepared, directly
related to this proposal.
(STAFF COMMENTS)
9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting
the property covered by your proposal? If yes, explain.
A/ ()
(STAFF COMMENTS)
10. List any government approvals or permits that will he needed for your proposal, if known.
(STAFF COMMENTS)
Page 2 of 22
CHKMIG-25-93MASTER
11.
Give brief, complete description of your proposal, including the proposed uses and size of the project and site.
There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You
do not need to.repeat those a"vers on this page.
(STAFF COMMENTS)
12. Location of the proposal. Give sufficient information for a person to understand theprecise location of your
proposed project., including a street address, if any, and section, township, and range, if known. H a proposal
would occur over a range of area, provide range or boundaries of the site(s). Provide legal description, site
plan, vicinity map,.and topographic map, if reasonably available. While you should submit any plans required
by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications
related to this checklist.
Z- <9'9-;J 0 ig
.g6i I-Jq- .'Z4 fuj4z7zo
(!�- 15z4'1L 11- --, !
(STAFF COMMENTS)
TO BE COMPLETED BY APPLICANT
B. ENVIRONMENTAL ELEMENTS
1. Earth
a. General description of the site (circle (me): Flat, rolling, hilly, steep slopes, mountainous, ther.�\
SLV , I
C' f5
V
(STAFF COMMENTS)
b. What is the steepest slope on the site (approximate percent slope)?
(STAFF COMMENTS)
C. What general types of soils are found on the site (for example, clay, sand, gravel, peat, muck)? If you
know the classification of agricultural soils, specify them and note any prime farmland.
Pa.-C 3 of 22
(STAFF COMMENTS)
d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe.
(STAFF COMMENTS)
e. Describe the purpose, type and approximate quantities of any filling or grading proposed. Indicate source
of rill.
hi 6
(STAFF COMMENTS)
f. Could erosion occurasa result of clearing, construction, or use9 If so, generally describe.
(STAFF COMMENTS)
g. About what percent of the site will be covered with impervious surfaces after project construction (for
example, asphalt or buildings)?
?2
(STAFF COMMENTS)
OWLT110-15-93MA.WER
Pa�-c 4 of 22
h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any:
(STAFF COMMENTS)
2. AIR
a. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors,
industrial wood smoke) during construction and when the project is completed? If any, generally describe
and give approximate quantities if known.
Af-pl -IQ-z ,,
(STAFF COMMENTS)
b. Are there any off -site sources of emissions or odor that may effect your proposal? If so, generally
describe.
(STAFF COMMENTS) -
C. Proposed measurL-i to reduce' or control emi.sisions or other impacts to the, if any:
(STAFF COMMENTS)
3. WATER
a. Surface:
(1) Is there any surface water body on or in the immediate vicinity of the site (including year-round
and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide names.
If appropriate, state what stream or river it flows into.
4Z2�
(STAFF COMMENTS)
Page 5 of 22
0 ' 0
(2) Will the pro.ject require any work over, in, or ad.jacent to (within 200 feet) the described waters? If
yes, please describe and attach available plans.
(STAFF COMMENTS)
(3) Estimate the amount of fill and dredge material that would be placed in or removed from surface
water or wetlands and indicate the area of the site that would be affected. Indicate the source of fill
material.
6:o
(STAFF COMMENTS)
(4) Will the proposal require surface water withdrawals or diversions? Give general description,
purpose, and approximate quantities if known.
(STAFF COMMENTS)
(5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan.
(STAFF COMMENTS)
(6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the
type of waste and anticipated volume of discharge.
(STAFF COMMENTS)
'Pag� 6 of 22
ri TK iTtIM75-93. KI A.KrER
0 0
Ground:
(1) Will ground.water be withdrawn, or will water be discharged to ground water? Give
general description, purpose, and approximate quantities if known.
(STAFF COMAIENTS�
(2) Describe waste material that will be discharged into the ground from septic tanks or
other sources, if any (for example: Domestic sewage; industrial, containing the
following chemicals ... ; agricultural; etc.). Describe the general size of the system, the
number of such systems, the number of houses to be served (if applicable), or the
number of animals or humans the system(s) are expected to serve.
A -
(STAFF COMMENTS)
C. Water Runoff (including storm water):
(1) Describe the source of runoff (including storm water) and method of collection and
disposal, if any (include quantities, if known). Where will this water flow? Will this
water flow into otherwaters? If so, describe.
-S 125/4� C�Ieg�2-� W-" e�
(STAFF COMMENTS)
(2) Could waste materials enter ground or surface waters? If so, generally describe.
(STAFF COMMENTS)
Pa�-e 7 of 22
4. Plants
a.
d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any:
(STAFF COMMENTS)
Check or circle types or vegetation round on the site:
deciduous tree: alder, maple, aspen, other:
evergreen tree: fir, cedar, pine, other:
pasture
crop or grain
wet soil plants: cattail, buttercup, bulrush, skunk cabbage, other:
water plants: water lily, eelgrass, milfoil, other:
other types of vegetation:
(STAFF COMMENTS)
b. What kind and amount of vegetation -.vill be removed or altered?
(STAFF COMMENTS)
C. List threatened or endangered species known to be on or near the site.
(STAFF COMMENTS)
d. Proposed landscaping,. use of native plants, or other materials to preserve or enhance vegetation on the
site, if any:
Pine 8 of 22
OWLT110-IS-91MASTER
(STAFF COMMENTS)
5. Animals
a. Check or circle any hir&s and animals which have been observed on or near the site or are known to be on
or near the site:
birds: hawk, heron, eagle, songbirds, other:
mammals: deer, bear, elk, beaver, other:
fish: bass, salmon,trout, herring, shellfish, other:
(STAFF COMMENTS)
b. List any threatened or endangered specie; known to he on or nmu- the site.
'NJ Gk)
(STAFF COMMENTS) I
c- Is the site part of a migration route? If.so, explain.
(STAFF COMMENTS)
d. Proposed measures to preserve or enhance wildlife, if any:
(STAFF COMMENTS)
6. Energy and Natural Resources
Page 9 of 22
a. What kinds of energy (electric,(natur.�i�, oil, wood stove solar) will be used to meet the completed
er it will he use
.v�pro�lject's energy needs? Describe %v et i it d �o heaZg�,anufacturing, etc.
(STAFF COMMENTS)
b. Would your prqject affect the potential use of solar energy by ackjacent properties? If so, generally
describe.
(STAFF COMMENTS)
C. What kinds (of energy conservation features are included in the plans of this proposal? List other
proposed measure:s to reduce or control energy impacts, if any:
Pj e)
(STAFF COMMENTS)
7. Environmental Health
a. Are there any environmental health havards, including exposure to toxic chemicals, risk of fire and
explosion, spill, orhazardous waste, that could occur as a result of this proposal? If so describe.
(STAFF COMMENTS)
Page 10 of 22
CUKLT/10-25-93.M ASTER
0 0
(1) Describe special emergency services that might be required.
'L< . ,
1
(STAFF COMMENTS)
(2) Proposed measures to reduce or control environmental health ha7ards, if any:
424X)!�-
b. Noise
(1)
(STAFF COMMENTS)
What types of noise exist in the area which may affect your project (for example: traffic.,
equipment, operation, other)?
(STAFF COMMENTS)
(2) What type; and levels of noise would be created by or associated with the project on a short-term or
a long-term basis (for example: traffic, construction, operation, other)? Indicate what hours noise
would come front the site.
:Z2 OA b "t -6
(STAFF COMMENTS)
(3) Propoyed measures to reduce or control noise impacts, if any:
V?
A-9
(STAFF COMMENTS)
Pa�-e I I of 22
8. Land and Shoreline Use
a. What is the current use of (lie site and adJacent properti
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(STAFF COMMENTS)
b. Has the site been used foragriculture? If so, describe.
&�) Aep
(STAFF COMMENTS)
C. Describe any structures on the site.
(STAFF COMMENTS)
d. Will any structures be demolished? If so, what?
(STAFF COMMENTS)
e. What is the current zoning, classification of the site?
(STAFF COMMENTS)
Pa�-e 12 of 12
CHKLT/10-2i-93.MM7ER
f. What is the current comprehensive plan designation of the site?
(STAFF COMMENTS)
g. N applicable, what is the current shoreline master plan designation- of the site?
(STAFF COMMENTS)
h. Has any part of the site been clas;sified as in "environmentally sensitive" area? If so, specify.
(STAFF COMMENTS)
i. ApproxiVa ely how many people would reside or work in the completed pro.ject?
(STAFF COMMENTS)
J. Approximately how many,people would the completed proiect displace?
- (D
(STAFF COMMENTS)
Page 13 of 22
OWLT11MISAIMASTCR
k. Proposed me4tsures to avoid or reduce displacement impacts, if any:
(STAFF COMMENTS)
1. Proposed measures to ensure the- proposal is compatible with existing and projected land uses and plans,
if any:
(STAFF COMMENTS)
9. Housing
a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income
housing
(STAFF COMMENTS)
b. Approximately how many units, if any would be eliminated? Indicate whether high, middle, or low-
income housing.
(STAFF COMMENTS)
C. Proposed measures to reduce or control housing impacts, if any:
JA � 4 /Jt�
(STAFF COMMENTS)
CIMMIG-25-93MASTER
Page 14 of 22
0
10. Aesthetics
a. What is the tallest height of any proposed structure(s), not including antennas; what is the principle
exterior building material(s) proposed?
�5 Z) k-�r — .
(STAFF COMMENTS)
b. What views in the immediate vicinity would he altered or obstructed?
(STAFF COMMENTS)
c- Proposed measure; to reduce or control aesthetic impacts, if any:
(STAFF COMMENTS)
Lightand Glare
a. What type of light or glare will the proposal produce? What time of day would it mainly occur?
- k��6
(STAFF COMMENTS)
b. Could light or glare from the finished proiect be a safety ha7Ard or interfere with views?
(STAFF COMMENTS)
Page IS of 22
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C. What existing off -site sources of light or glare may affect your proposal?
- Aj�) /tf .
(STAFF COMMENTS)
d. Proposed measures to reduce or control light and glare impacts, if any:
(STAFF COMMENT S).
12. Recreation
a. What designated and inronnal recreafional opportunities are in the immediate vicinity?
(STAFF COMMENTS)
h. Would the proposed pni.ject displace any existing recreation uses? If so, describe.
(STAFF COMMENTS)
C. Proposed measures to reduce or control impacts (in recreation, including recreation opportunities to be
provided by the pro.ject or applicant, if any:
6A) dj
(STAFF COMMENTS)
CUKUT110-Ii-93NASTER
Page 16 of 22
13. Historic and Cultural Preservation
a. Are there any places or ohiects; listed on, or proposed for, national, state, or local preservation registers
known to he on or next to the site? If so, generally describe.
(STAFF COMMENTS)
b. Generally describe any landmarks hr evidence of historic, archaeological, scientific, or cultural
importance known to he (in or next to the site.
- . -,V-L)8 ) fz-�'-
(STAFF COMMENTS)
C. Proposed measures to reduce or control impacts, if any:
- -A-)a-,L �JZ --
(STAFF COMMENTS)
14. Transportation
a. Identify public street:% and highways serving the site, and describe proposed access to the existing street
system. Show on site plans, if any. j
(STAFF COMMENTS)
b. Is site currently served by public transit? If no, what is the approximate distance to the nearest transit
stop?
Page 17 of 22
r11K1 TML'�.Ql h4
(STAFF COMMENTS)
C. How many parking spaces would the completed pMiect have9 How many would the project eliminate?
(STAFF COMMENTS)
d. Will the proposal require any new rouds or streets, or improvements to existing roads or streets, not
including driveways? If so, generally describe (indicate whether public or private).
(STAFF COM N1 ENTS)
e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so,
generally describe.
�U C>
(STAFF COMMENTS)
f. How many vehicular trips per day would be generated by the completed project? If known, indicate when
peak volumes would occur.
f
(STAFF COMMENTS)
Page 18 of 22
CMLT/10-2i-93.MA.WER
g. Proposed mensures to reduce or control transportation impacts, if any:
A)
(STAFF COMMENTS)
15. Public Services
a. Would the proiect result in an increased need for public services (for example: fire protection, police
protection, health care, schools, other)? irso, generally describe.
- A-Z
(STAFF COMMENTS)
b. Proposed measures to reduce or control direct impacts on public services, if any:
(STAFF C6NINIENTS)
16. Utilities
.j e utse servie��i�eleppl��one)
a. CjDle-utpies currently available at the site: (elect�rilcit 0 Ctu ra �j g wate�r(,;r;ft
aft- yI%
(STAFF COMMENTS)
Pne 19 of 22
CUKUMM15-91MASTER
0
0
b. Describe the utilities that are proposed for the proJect, the utility providing 'the service, and the general
construction ac�tivities on the site gr in the immediate vicinity which might be needed.
(STAFF COMMENTS)
I C. SIGNATURE
j
'Me above answer-, are true and complete to the best of my knowledge. I understand that the lead agency is relying on them
to make its decision.
Signature of Pmponent
Date Submitted
Pa�-e 20 or 22
CHKLT/10-25-93MASTER
D. SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS'
(do not use this sheetfor project actions)
Because these questions are very general, it may be helpful to read them in corijunction with the list of the elements of the
environment.
When answering these questions, be aware of the extent the proposal, or the types of activities likely to result from the
proposal, would affect the item at a greater intensity or at a faster rate than if the proposal were not implemented. Respond.
briefly and in general terms.
1. How would the proposal he likely to increase discharge to water; emissions to air; production, stor;ige, or release of
toxic or harArdoms substances; or production of noise?
Proposal measures to avoid or reduce such increases are:
2. How would the proposal be likely to arrect plants, animals, I ish, or marine life?
Proposed measures to protect or conserve plants, animals, Fish, or marine life are:
3. How would the propostl be likely to deplete energy or natural resources?
Proposed measure; to protect or conserve energry and natural resources are:
Page 21 of 22
4. How would the proposal he likely to use or affect environmentally sensitive areas or areas designated (or eligible or
under study) for governmental protection; such as parks, wilderness, wild and scenic rivers, threatened or endangered
species habitat, historic or cultural sites, wetlands, floodplains, or prime farmlands?
Proposed measures to protect such resources or to avoid or reduce impacts are:
5. How would the proposal he likely to affect land and shoreline use, including whether it would allow or encourage land
or shoreline uses incompatible with existing plans?
Proposed measures to avoid or reduce shoreline and land use impacts are:
6. How would the proposal be likely to incre�ase demands (in transportation or public services and utilities?
Proposed measure-i to reduce or respond to such deniand(s) are:
7. Identify, if possible, whether the proposal may connict with local, state, or federal laws or requirements for the
protection of the environment.
Pa.-e 22 of 22
CUKLT/10-25-93.MA.%-rER
APPLICATION REQUERENYMS
TO: ' Permit Coordinator, Building Division
FROM: Lyle Chrisman, Engineering Inspector
OWNER: 011-1-ox-
ADDRESS: /9,�/ 96"WA,
After review of the subject permit application, the following requirements mustbe met.
PLAN cK #
DATE:
1. Construction hours are: WEEKDAYS .......... 7:00 A.M.-10:00 P.M. VVTEKENDS/HOLIDAYS ..... 10:00 A.M.-,6:00 P.M.
2. A separate RIGHT-OF-WAY- Construction Permit is required for all work on Publicproperty. (ECDC 18.60)
3. Truck haul route plan must be submitted and -approved prior to permit issuance.
4. Builder/Owner is responsible for containing all lemporary runoff and erosion control on site. (ECDC i8.30.030d)
5. NO WORK SHALL BE DONE WMN 15 FEET OF STREAMS OR 10 FEET FROMANY CLOSED DRAINAGE FACIL-
177. BVILDERIOWNER IS REPSONSIBLE FOR MEM7MNG COND177ONS ON 771E DRAWING. (ECDC18.30.50G)
6 FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCTION,
(kCDC 18.30)
7. INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEM, TIGHTLINES, FOUNDATION DRAINS, AND
CATCH BASIN INSTALLATION. INSPECTIONS ARE REQUIRED PRIOR TO BACETILLING. (ECDC 18.30)
8. Repair or replace all defective existing curb, gutter, and sidewalk adjacent to the property. If an intersection is involved a
handicap ramp may be required. Contractor shall meet with the City Engineering Staff to determine the extent of repair prior to
issuance of the permit. (ECDC 18.90)
9. Driveway slope shall not exceed 14 % without a waiver. Every attempt should be made to keep the slope below 14
Waiver granted to —%. (ECDC 18.80.060D)
10. Driveway's must be paved from property line to City RIGHT-OF-WAY. A separate perimit is required. (ECDC
18.80.060C)
11. INSPECTIONS ARE REQUIRED ON DRINEWAYS AND SIDEWALKS PRIOR TO AND AFTER POURING.
(ECDC 18.30)
12. No burning of construction refuse without a permit from the Fire Department.
13. Connection to City water system is required. There is a separate charge for the water meter. (ECDC 7.30)
14. A back water valve is required if downstairs plumbing is below the elevation of upstream manhole. (ECDC 7.20)
15. Water and sewer mainlines should be separated by 10 feet minimum. (ECDC18.10)
16. Connection to the City sanitary system is required. A separate permit.is required.
LID# Feespaid: Yes --' No Charge i�7� (ECDC 18.10)
17. Underground wiring is required on all new construction; and for additions, alterations, and repairs that exceed 50 % of the total
assessed value oi the structure. (ECDC 18.05.010)
18. A FINAL ENGINEERING INSPECTION IS REQUIRED PRIOR TO THE BUILDING DIVISION GRANTING OCCU-
PANCY OF THE BUILDING OR STRUCTURE. (ECDC 18.90)
19.
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CITY OF EDMONDS
USE
zo,g6_ PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
jog SUITE?APT 11
ADDRESS
OWNER NAME NAME OF BUSINESS
LEGAL DESCRIPTION CHECKI
SUBWVISION NO OD
NO
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MAILING ADDRESS
/-) "'r
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP, TESCP
Approved 0
3
0
.
4/& lo S -
RW
EXISTING — REQUIRED DEDICATION Street
Permit Required 0
Use Permit Req'd 0
'IX
CITY 7'1,'�411',:' zip
ILLtrHONENUMBER
-,771 -,�J f &I
Inspection
IOPOSED Sidewalk
Required
Required 0
NAME
Cr
w
METE5 S
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
4
L)
YE NO
ADDRESS
REMARKS
Cr
t:
Ide 1<10, Ij
<ICITY
W
W
ZIP ITELEPHONE
NUMBER
161,3)7-1?2�
Z
NAME
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Ab?
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0
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ENGINEERING MEMO DATED REVIEWED BY
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zip
TELEPHONE NUMBER
FIRE MEMO DATED REVIEWED BY
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Z
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LZ
STAE,LICENSE NUMBER., EXPIRATION DATE
SIGN AREA
SEPA REVIEW
ADB NO
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KJ!E C-0 tj_� C;"*"
ALLOWED PROPOSED
COM LETE EXEMPT
SHORCYNE#
Legal Description of Property -w'inclucle all easements
A)/
EXP
VARIANC OR CU
NINd IEW BY
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SETBACKS — FEET
-HEIGHT
LOT dOVERfAGE
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FRONT 'Z6 SIDE REAR
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Property
Tax Account 0 00 e
7960� _000
REMARKS
Parcel No.
NEW RESIDENTIAL PLUMBING
ADDITION COMMERCIAL MECHANICAL
EIREMODEL APT. BLDG. SIGN
CHECKED BY
-r�
TYPE OF CONSTRUCTION
lc�/
0
OCCUPANT
GR
OV 2
GRZ
CYOS FENCE
L_ x
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SPECIAL INSPECTOR
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LOAD
GARAGE RETAINING WALL/
ROCKERY RENEWAL
YES
EMARKS
Z
0
PROGRESS INSPECTIONS PER UBC 305
a
(TYPE OF USE. 05 ACTIVITY) EXPLAIN:
"'gee.
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CL
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iB;SIN;S
:! 5 F &fe_V(t
NUMBER
OF
STORIES Z,
NUMBER OF
DWELLING
UNITS
CRITICAL
AREAS
NUMBER
�5
W
0
W
r AalhW& aA4_7&lag7i,�
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
0
FINAL INSPECTION REQUIRED
VALUATION
FEE
PLAN CHECK FEE
BUILDING
�jZbt 0219
Z,70,7
HEAT SOURCE:
GLAZING
Im I %
PLUMBING
19r
/V1
FpIan Check No. Z6
MECHANICAL
GRADING/FILL
This Permit covers work to be done on private property ONL
Any construction on the public domain (curbs, sidewolks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
SIC
Permit Application: 180 Days
STORM DRAINAGE FEE
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
ENG. INSPECTION FEE
"Applicant. on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify. defend and hold
two
harmless the City of Edmonds, Washington, its officials
2
employees, and agents from any and all claims for damages o;
5
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
LAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
0
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
'�A
provision."
I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL
information given is correct; and that I am the owner, or th.e duly
authorized agent of the owner. I agree to comply with city and THIS PERMIT This application is not a permit until
state laws regulating construction; and in doing the work authoriz- AUTHORIZES
ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy: and fees are paid, and receipt is
acknowledged in space provided.
tion Insurance and RCW 18.27. INSPECTION
IGNATURE (OWNER OR AGENT) DATE SIGNED DEPARTMENT u RE DATE
I" CITY OF
Al� EDMONDS
CALL FOR I IF A DATE
INSPECTIO 41_�
TTENTION N
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 ORIGINAL — File YELLOW — In mtor
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
CHAPTER 3. PINK — Owner GOLD — Assessor