20901 80TH AVE W.PDF111111111111
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20901 80TH AVE W
ADDRESS:--J20�0/ 4s
TAX ACCOUNT/PARCEL NUM13ER:
BUILDING PERMIT (NEW STRUCTI
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:.9 5 - 9
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
a,(�e 0
02-�a- OPIT
DETERMINATION: Ej Conditional Waiver tudy Required Ej Waiver
AS
PLANNING DATA CHECKLIST DATED: Z-7
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
Z2 C)
SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
LATEMP\DS'rs\Fonns\Street File Checklist.doc
Folk
I PERMIT EXPIRES
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
ER NAME/NAME OF BUSINESS
MAILING ADDRESS
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PLUMBING / MECH
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CHANGE OF
19 REMODEL MUL11FAMILY
13 SIGN
GRADING FENCE
1:1 REPAIR CYDS 11 ( — X FT)
:3 15,940LISH TANK
1:1 OTHER
-----------
GARAGE 0 RETAININGWALL FIRE SPRINKLER
0 CARPORT ROCKERY 0 FIRE ALARM
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(ME OF USE. BUSI 9 , IVrM EXPLA'
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— PLAT NAME/SUBDIVISION NO. LOT NO. LID No.
LID FEE $
TESCIP APWOVW
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required
Sir" Use Permit RWd
Msp9coon Required
EXISTING — PROPOSED aideoralk Required
Undewound
REQUIRED DEDICATION FT wiringreqi1red
— 1 OUIRED
NO. OF FIXTURES PRV RE
M7� U YE A No 13
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
— - - —, - .— _. — . , , I �' A I , n, :r_j It )4 1 —
DATE
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS* MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION. 180 DAYS
PERMIT UUrp
. I yEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY �i THE cnys ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
.......... eeeeeeee�
RMATION.
HEREBY ACKNOWLEDGE tHAr I HAVE READ THIS APPLICATION: THAT THE INFO
I I Y AUTHORIZED AGENT OF
GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE DUL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
nworMNI COMPENSATION INSURANCE AND RCW 18-27.
DATE SIGNED
4% ga.l '5 — I -Z — j>+
REMARKS A dT q ( / f f ���
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REQUIRED [] YES
REMARKS r&-,( 1 P15kzC_W-;;
PRnGRESS INSPECTIONS PER U13C I 08/FI14AL INSPECTION REaD
VALUATION
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. inspection
Fire Review
Fire Inspection
La�ndsc�apelnsp.
pe
Be
[Recorcing Fee
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FEE *Description FEE
C) State Surcharge
City E
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CALL
FOR INSPECTION
(425)
771-0220
r-XT 1233
P Chk. Deposit
lan
Receipt # Wit
Total Amt. Due
Receipt # 4] L
APPLICATION APPROVAL
This application is not a permit unto signed by the
Building otficlai or his/her Deputy: and Fees are paid. ant
r�pelpt is acknov649dged in space provided.
f I — naTr
A'I'TENTPN / I L----1
0
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL YELLOW - INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE *
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER - GOLD - ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 CO ES
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S- TREET FILE
STATEMIENT ON ACCESSORY DWELLING UNITS
Property Address:— ),09 o 1 7611- AVE W WA 91Q�
Edmonds, Washington
Assessor's Parcel Number: oollq 3 C) op() g,�o a
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of
the Edmonds Community Development Code (ECDC) and understand that an accessory
dwelling unit as defined in ECDC Section 21.05.015 is prohibited until an Accessory
Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved unless all
the criteria in Chapter 20.21 are met, and all the necessary items are submitted,
including an affidavit of occupancy and a covenant to be filed with the Snohomish
County regarding the regulations imposed on Accessory Dwelling Units.
Property Owner Signature:
Property Owner Name (printed):
Date: 1) L4
STATE OF WASHINGTON)
COUNTY OF SNOHOMISH)
0
Pusor
(P
I certify that I know or have satisfactory evidence that #- &,ye,�Q
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's pressure seals must be smudged. Dated:
Signature of
Notary Public:
Residing at:
My Appointment
Expires:,
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
ADUstatement
0 0
Peter Bauer
20901 80'h Ave W
Edmonds, WA 98026
City of Edmonds Zoning Dept.
Re: Waiver of Critical Area Study
Dear Sir, Madam,
RECEIVED
MAR 12 2004
PERMIT COUNTER
KEET FILE
I am requesting a conditional waiver of the critical area's study due to the proposed
addition's non -impact to any potential wetland.
Information can be obtained in the CA File # 95-94 that was assigned in 1995
for a garage addition. The inspection of the property revealed no evidence of a wetland
on site. The site is located on a small hill above the potential wetland to the east.
The current construction activity does not alter the east portion of the house.
The activity consists of fire damage repair and adding to the building footprint
on the West or opposite side ( the uphill side ) of the residence.
I can be reached at 206-510-5856.
Sincerely,
Peter Bauer
City of Edmonds
Critical Areas Determination
Applicant: Peter Bauer Determination M CA-95-94
Project Name: Fire Damage Repair and Permit Numb er: PC-04-080
Additions
Site Location: [207901 — 80th Avenue W. Property Tax. Acct #: 1 6143-000-026-02
Project Description:
Remove fire damaged roof and garage; replace roof and add
bedroom above garage, expand kitchen and add covered porch.
Waiver Criteria (all criteria must be found to apply):
X There will be no alteration of the Critical Area or its required buffers;
X The development proposal will not impact the Critical Area in a manner contrary to
the goals, purposes, objectives and requirements of the Critical Areas ordinance;
X The development proposal meets the minimum standards of the Critical Areas
ordinance;
X The above findings are based on the following conditions of approval:
1 . This conditional waiver is only for work done as shown on the attached site
plan which repairing flre damage and adding an addition above an existing
garage and additions to the west of the house towards the street. The
additions are on the opposite side of the house from potential wetland.
2. Owner/contractor is responsible for erosion control and damage.
3. A building permit is required for all work.
Based on the above findings and conditions, the requirement for a Critical Areas Study
associated with this development permit is hereby Waived, as authorized by Chapter 20.15B.040
(A)(2) of the Edmonds Community Development Code.
Meg Gruwell April 1. 2004
Name Sign"e Date
EL
IDLE
OlvVNER/CONTRACTOR IS RESPONSIBLE
FOR EROSION CONTROL AND DAMAGE
cl
I,Jpc,l tit
ADD GUTTERS /DOWNSPOUTS
AND SPLASHBLOCKS .
4e
—/ -7-c
r-oc,vc-: CF= ppoe"e�xT--7 AFFHOVED AS NOTED
BY ENGINEERING
-=.
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Date:
ZO N E
SETBACKS:' �-JQ 9-'rJ4
FRONT
SIDE
REAR
Crje-s A-4iol
=375-04
3757. 0 4 q3.74 Fluerql e G-J e
c113.716 f-
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RECEIVED
MAR 12 2004
PERMIT COUNTER
'1* 20010 1 SCJT�A k1olE
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(e)AC
PLANNING DATA
`7 t
NAME: DATE: 0-i
SITE ADDRESS: 2--o Lw' I PLAN CHK#: 04 - oFa
PROJECT DESCRIPTION: Ire— rrarl—
C-V AiA
REDUCED SITE PLAN PROVIDED?:
MAP PAGE: 14 6' CORNER LOT: (Yes / No FLAG LOT: (Yes No
ZONING: P,5-q' —CRITICAL AREAS DETERMINATIONM '25-94-
0 Study Required: f�- pqt.\��4 64-(f 3 �/ 2-5-' 6,/%, r w-1,,A -A
U.Walver
2fConditional Waiver
SEPA DETERMINATION:
U Fee
13 Checklist
L3APO list w/ notarized form
0 (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
Ej Exempt
SETBACKS:
Required Setbacks:
Street: 2,6' Left Side: Right Side: -7, Rear:
Actual Setbacks: 311)
Street: 7_5' Left Side: -7- 1; Right Side: Rear:
Street map chocked for additional setback required? No DNA.) ms'"
DETACHED STRUCTURES- 5b
ROCKERIES:
Ll FENCES/TRELLISES:
BAY WINDOWS / PROJECTING MODULATION:
STAIRS/ DECKS:
PARKING: Required: -7 Actual,: 7-
LOT AREA: 9 0),7 b,
LOT COVE lip 39
'Irlf 7, o 9 3 07.
Calculatlo� 1,t. 9?
BUILDING HEIGHT:
Datum Point: —,-A,, k.Lc a,, 9'6- 4.,c Ld - Datum Elevation:
Maximum Allowed:- - �,57, Actual Height: 14�
--'> A.D.U. CIREATED?:
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: ffe—sn"o
OTHER:
Plan Review By -
ell
NewBPP1anningDataForm.D0C
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OWNER/CONTRACTOR IS RESPONSIBLE
FOR EROSION CONTROL AND DAMAGE
049i"
t7yje�,,Tj�.A_7�
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ADD GUTTERS/DOWNSPOUTS
AND SPLASHBLOCKS
=375.04
375'. 0 4 — 4 q3,71, Ave,lkj e GJ e
93.716 f- 9.5'
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CF APPROVED AS NOTED
. BY ENGINEERING
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31;4
ZONE Date:
7 4,5 f,
SETBACKS: . . -1 c; ...mat �-io?rrp!
t-mull I
SIDE
""REET FILE
REAR_
OTHER-
HEIGHT-
RECEIVED
MAR 12 2004
PERMIT COUNTER 0
-Fp,x Pccovl-r Gi 43 - ciou- ozre- ri z- I i
PLA
f
RECEIVED
. MAy 2 2 1995
COMMWVV SEFMMS
*90 19cl
City of Edmonds
Critical Ar� e"*� ankli-4f.-
as.
The Critical Areas Chaddist FF, �4-_S�6M`kitto_thcaty. MjeCfty-,WiU-
this form is'to be Mod CPA by. any pecson
io=ziozy site
preparing a Development Permit
vWitnd make i determination of the
Pnor'
Application for the City of FAmonds "Mbscquent SITS nccessmY to complete a
to Wsftw submiftal'of a#velop
dkowcaup permit application.
permit to the City.
"Wilh a C-W,.Of this form, the
iIONJV?��,!.,�'�'...
ne purpose of the CheMst is to a""'
#4
8POliCant dmdd also submit a vidnity 'map
city staff to determine wheMer any_
or pRVpFan Vw individdff 169—BrWgRg
potential Critical Areas am or, may be-
vA& enough detail that City staff can fInd
present on the subject proputy. Ihe
and idea* the -subject parcd(s).' 1j,
h&rmation needed to amplete the
addition, the appficant dmU Indude
Checidist should be easily avaiIable, from
other mtinent MIOR (eg. Si&
daservations of die she or data avwHable at
plang-t—Dwyourpa Misnappetc.),orstudiesin
City Hall (Cddcal Areas inventories,
coldunctim with this ChecIdIist to assist
or soil surveys).
staff in Completing their preliminary
of the site.
An applicant� or his/her
must fin out die checHist, Agn and date it,
I have cmplded die aftadied Cdfical Area Cheddistand attest dal the answers provided we
fictud to do beaef my IMOWIGO&C'(fiR out dw IMOV61ccalumn bdm).
Apprmg
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Date
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City of Edmonds
Critical Areas Determination
Applicant: Don Russell Determination CA-95-94
Project Name: Permit Number:
Site Location: 20901 80th Avenue West Property Tax Acct #: 6143-000-026-0203
Project Description:
Non -project specific
There is a potential Class 3 wetland immediately adjacent to this property which may require a
25-foot buffer from the edge of the wetland. My inspection of the subject property on May 26,
1995 revealed no evidence of a wetland on site, as the site isjocated on a small hill above the
potental wetland. However, it is very likely that the buff6r will encroach onto the subject
property.
Based on the above findings, a CriticalAreas Study is required to deliniate the approximate
boundaries of the potential wetland and identify its buffers. All critical areas studies shall be
performed as three party agreements with the city selecting the consultant- and the property owner
or applicant paying the fees.
If the property owner wishes to apply for a specific development permit which they feel would
not impact the Critical Areas located on the site, they may submit their proposal to the Planning
Department for review. If the Planning Department finds that th ' e proposed development permit
will not adversely impact a Critical Areas or its buffers, a conditional waiver may be��issued on a
project by project basis.
Ann Bullis
Name
Signature
May 26. 1995
Date
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7
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works * Planning * Parks and Recreation e Engineering
89.0 q
June 16, 1995
Don Russell-
20901 80th Avenue West
Edmonds, WA 98026
RE: Request for conditional waiver from Critical Areas Study
File # CA-95-94
Dear Mr. Russell:
LAURA M. HALL
MAYOR
This letter is in response to your request for a Critical Areas Review conditional
waiver. In reviewing the sketches of your proposed garage expansion, since you will
be adding to the existing garage only on the street side and not on the wetland side, no
Critical Areas Study will be required for this project pursuant to Section 20.15B.040 of
the Edmonds Community Development Code.
Please be advised that work in addition to that which is described for this project in
your letter dated March 28, 1994 may require further review to determine if a study is
required.
When submittint for the subject permit, please bring a copy of this letter with your
application for reference.
Sincerely,
9A&-
Ann Bullis
Planning Division
cc: Street File
CA-95-94
incorporated August 11, 1890 !P
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USE PERMIT
ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION
7
SUITE APT
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, 61
LEGAL DESCRIPTION CHECKI
SUBDIVISION NO LID
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Pe—1 Reqet 0
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TELEPHONE NUMBER
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inspection
Use Pe —I Req*a 0
Required
NAME
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Requ,red 0 a
METER SIZE
LINE SIZE
NO, OF FIXTURESF
PRV REOUIR ED
YES 0 NO 0
ADDR
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REMARKS
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NUMBER
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ITA�0"SEr EXPIRATION DATE
SIGN AREA
SEPA REVIEW
AD8 NO,
LeTal Description of Property - include all easements
ALLOWED
PROPOSE 0
COMPLETE
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REMARKS
Par, 61q CZ 6 -('A (a
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ADDITION
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COMMERCIAL
MECHANICAL
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CHECKED BY
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I
CODE
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OODSTOVE El SWIM POOL
DEMOLISH INSERT HOT TUB/SPA
—IAL INSPECTOR
REOUIRED
0
JAREA
2-63)k
GCdU�IkNT
LOADL.
Ul
"`�ARAGE RETAINING WALL/
El ROCKERY RENEWAL
YES
MARKS
PROGRESS INSPECTIONS PER USC 305
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER
NUMBER OF
CRITICAL
OF
DWELLING
I
AREA
I NUMBER 191
UNIT
L—
TORIES S TACH PLOT PLAN)
DESCRTS-E ORKTO BE DONE (AT
III
FINAL INSPECTION REQUIRED
VALUATION
FEE
1
PLAN CHECK FEE
BUILDING
HEAT SOURCE
0/0
#4
PLUMBING
Plan Check No.
MECHANICAL
N L Y
This Permit covers work to be done on private property ONLY.
GRADINGIOILL
I
Any construction on the public domain (curbs, sidewf-lks.
0 In
marquees, etc.) will require separate permission.
STATESURCHARGE
—driveways,
Permit Application: 180 Days
STORM DRAINAGE FEE
a
Permit Limit: 1 Year - Provided Work is Started Within 180 Days .
-
a n d
"Applicant. on behalf of his Or her spouse, heirs, assigns and
ENO. INSPECTION FEE
in
h d
successor in interest. agrees to indemnify, defend and hold
C I a I
Washington, Its officials,
harmless 'he City of monds,
is 0
employees, and agents from any and all claims for damages of
g
Us In
whatever nature, arising directly or Indirectly Irom the Issuance
-ad to
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
0
inance
modify. waive or reduce any requirement of any city ordinance
I nance
Tig-9-sp
�Do
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision." I
I at I he
I hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
. duly
information given is correct; and that I am the owner, or the duly
'y and
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
This application is not a permit until
tale laws regulating construction; and In doing the work authoriz-
AUTHORIZES
signed by the Building official or his/her
Let 0 r
:d thereby, no person will be..employed in violation of the Labor
ONLY T HE
WORK NOTED
Deputy; and fees are paid, and receipt is
odeo the State of Washington atinWorkmen.'s Compensa.
acknowledged in space provided.
Insure ce and RCW 16,27.
INSPECTION
I A`71OWNER 0 VGEY
DEPARTMENT
SIGNATUPE DATE
CITY OF
EDMONDS
fk&g
CALL FOR
13Y
C1
ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A F:NAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — File YELLO%IJ — inspector
A CERTIF CATE OF OCCUPANCY HAS BEEN GRANTED. USC
CHAPTER 3.
PINK — Owner GOLD — Assess-
10247
0 0
PLANNING DATA
SITE ADDRESS:&20/ DATE:
ZONING: 6 -8 PLAN CHK#:- ?5—/,,35—
PROJECT DESCRIPTION:
SETBACKS:
Required Setbacks: .. �//
Front: '?-'5 Left Side: 7 Right Side:'A01*'/2!-Rear:
Actual Setbacks:
Front: :Z< Left Side: '7 Y?-- Right Side: Rear:
CORNERLOT
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED
LOT COVERAGE: 1�00 ctual:
. Maximum Allowed: -
BUILDING HEIGHT: V
-1) ( ight:
Maximum Allowed:- P.16 1141) Actual He
SUBDIVISION:
CRITICAL AREAS#: q6 —!!Z�z
SEPA DETERMINATION:
LOT AREA: lfl�/19
OTHER:'
Plan Review By:
RECEIVED
J U L,,2 t".0
MkOlddu
wqof%r OF �160f� of- a� tobrr l=NM
4A 6fa UN Of VHQNM Sp S-%-IL7
\jq� LLow t?AAe G"Dt,4 s Z;N -
�L� 000, Vol, 10
pf.* lieu%r" APPRnVEn By PLANNING
47
TWO bki:�rb'
A<AUAto
CALM tc.lwke, a
is
AqEKM* . MW
ON OF 0
I.Cel ol
0011
4w e. a A-j Ao9r
11) k e.
e�c A
APPR ED AS N?OTAE
RECEIVED
JUL 2 6 1995
�ct li w Rorr OF � 160 Fr 0� a> tob rr PEW COUNER
4A - A, eir (Wq Ota ewwv--, Sip CI'S - I
Wk LUW DA�� C-AWeg S Xj� . I �
t�wv- ("00. D-02. vot, to
to
& Ai, -
to -4- ?S,
(00
Piz NrcvOrl
Al'
6
APPIR �EDAS INDIM
QTO
-**STREET FILE
October 19, 1979
To Whom It May Concerns
This is to verify that I will grant a sewer easement over the
south portion of the lot I own located at 20901 80th W
I agree to grant this easement to Mr. Jerry Labelg if and when
he requires it.
/(-;- / �6 7e,
5 'at e d
er
Patrick PlU4
0
STREETIDE.
PIONEER NATIONAL
TITLE INSURANCE
OCTOBER 1., 1979
F-232098
UNIT 2
REID, MIDDLETON & ASSOCIATES
324 MAIN ST.
EDMONDS, WA. 98020
PROPOSED SHORT PLAT
CC: SCOTT LABEL
GENTLEMEN: ATTENTION: ROBERT STEVENSON.
YOUR: 79-167
THIS IS A CERTIFICATE AS OF SEPTEMBER 19, 1979 AT 8:00 A.M.
FOR FILING A SHORT PLAT OF THE FOLLOWING:
SEE EXHIBIT A, AS ATTACHED.
THIS COMPANY CERTIFIES THAT RECORD TITLE IS VESTED IN
GARY H. FERREL AND EDITH M. FERREL, HUSBAND AND WIFE, AS TO
LOT 3, PLEASANTVALE;
JERRY LABEL, A SINGLE MAN AT DATE- OF ACQUIRING TITLE, AS TO LOT 26,
WILLOWDALE GARDENS DIVISION NO. 1, EXCEPT THE EASTERLY 323 FEET
THEREOF, EXCEPT THE SOUTH 8 FEET THEREOF, AND EXCEPT THAT PORTION
OF SAID LOT DESCRIBED AS THE NORTH 100 FEET OF THE SOUTH 108 FEET
OF THE WEST 90 FEET;
PATRICK M. PLUMMER, A SINGLE MAN AT DATE OF ACQUIRING TITLE, AS TO
THE NORTH 100 FEET OF THE SOUTH 108 FEET OF THE WEST 90 FEET OF
TRACT 26, WILLOWDALE GARDENS DIVISION NO. 1.
AND THAT THE FOLLOWING ARE CONSIDERED ADDITIONAL PARTIES'NECESSARY
TO EXECUTE THE PROPOSED PLAT:
BENEFICIARIES OF DEEDS OF TRUST: UNIVERSITY FEDERAL SAVINGS
AND LOAN ASSOCIATION, A
CORPORATION; -
CASCADE SAVINGS AND LOAN
ASSOCIATION, A CORPORATION
CONTRACT PURCHASERS: MELTON ALBERT PLACE AND KATHLEEN ANN
PLACE, HIS WIFE.
NO SEARCH MADE AS TO TAXES AND ASSESSMENTS.
FOR EASEMENTS, SEE EXHIBIT B, AS ATTACHED.
(CONTINUED)
SNOHOMISH COUNTY OFFICE
Pioneer National Title Insurance Company, S.E. Corner Colby and Pacific P.O.Box75O Everett, Washington 98206
2062594111 South Area 206 743 3621
A71COR COMPANY
F-232098
PAGE 2
THIS CERTIFICATE DOES NOT PURPORT TO REFLECT A FULL REPORT
ON CONDITION OF TITLE AND SHALL HAVE NO FORCE OR EFFECT EXCEPT
AS A BASIS FOR THE CERTIFICATE APPLIED FOR.
PIONEER NATIONAL TITLE INSURANCE COMPANY
SNOHOMISH COUNTY OFFICE
AUTHORIZED SIGNATORY
DH/KC
F-232098
PARCEL A:
EXHIBIT A
LOT 3, PLEASANTVALE, ACCORDING TO PLAT THEREOF RECORDED IN
VOLUME 37 OF PLATS., PAGES 143 AND 144J. RECORDS OF SNOHOMISH
COUNTY, WASHINGTON.
PARCEL B:
LOT 26, WILLOWDALE GARDENS DIVISION NO. 1, ACCORDING TO PLAT
THEREOF RECORDED IN VOLUME 10 OF PLATS, PAGE 72, RECORDS OF
SNOHOMISH COUNTY, WASHINGTON;
EXCEPT THE EASTERLY 323 FEET THEREOF;
EXCEPT THE SOUTH 8 FEET THEREOF; AND
EXCEPT THAT PORTION OF SAID LOT DESCRIBED AS THE NORTH 100 FEET
OF SOUTH 108 FEET OF THE WEST 90 FEET.
PARCEL C:
THE NORTH 100 FEET OF THE SOUTH 108 FEET OF THE WEST 90 FEET
OF TRACT 26, WILLOWDALE GARDENS DIVISION NO. 1, ACCORDING TO
PLAT THEREOF RECORDED IN VOLUME 10-OF PLATS, PAGE 72, RECORDS
OF SNOHOMISH COUNTY, WASHINGTON.
god
F-232098
EXHIBIT B
EASEMENTS
1. EASEMENT PROVISIONS AS CONTAINED IN SAID PLAT, AS FOLLOWS:
IS HEREBY RESERVED FOR AND GRANTED TO SNOHOMISH
AN EASEMENT
COUNTY PUBLIC UTILITY DISTRICT NO. 1 AND GENERAL TELEPHONE
COMPANY AND THEIR RESPECTIVE SUCCESSORS AND ASSIGNS UNDER, UPON
AND ADJACENT -TO THE STREET FRONTAGE OF ALL LOTS, IN WHICH TO
INSTALL, LAY, CONSTRUCT, RENEW, OPERATE AND MAINTAIN UNDERGROUND
CONDUITS, CABLES AND WIRES WITH NECESSARY FACILITIES AND OTHER
EQUIPMENT FOR THE PURPOSE OF SERVING THE SUBDIVISION AND OTHER
PROPERTY WITH ELECTRIC AND TELEPHONE.SERVICE, TOGETHER WITH THE
RIGHT TO ENTER UPON THE LOTS AT ALL TIMES FOR THE PURPOSES
STATED.
AFFECTS EXTERIOR 7 FEET PARALLEL WITH AND ADJOIN'ING
THE STREET FRONTAGE OF ALL LOTS
(AFFECTS LOT 3, PLEASANTVALE).
2. EASEMENTS AND SET BACK LINES AS SHOWN ON THE PLAT.
(AFFECTS LOT 3, PLEASANTVALE).
"END OF EXHIBIT Btl
SIREET FILE6
W11
AM
1-11,
let
:' �7�14-19eio 'I', 1�
tI All 81f - 10, 1.,
TR Z.(. VJIL.LOW1741 6MDEN5 PIV. I
[LEGAL DESCRIPTION
Lot 3, Pleasantvale, according to the plat thereof recorded in Volume 37
of Plats, pages 143 and 144, records of Snohomish County, Washington;
ALSO, Lot 26, Willowdale Gardens Division No. l,'according to the plat
thereof recorded In Volume 10 of Plats, page 72
EXCEPT the easterly 323 feet thereof; and
EXCEPT the south 8 feet thereof;
Situate in Snohomish County, Washington.
V.
-,124)ff J7UEW1V1/7101J 4 LOT LW� APJU5MFWf
LABE�[, * r*FI? P.,FL.
1w 15F, 4 A)F1 4 11>u— 19, T 27 M.,F.4 E., W. M.
L-
9 If
f.r.:
C
REID. MIDDLETON A ASSOCIATES. INQ
DEB. fZL-5.
DATZjC)A0jjq
FILENO.
� "No ENGINEERS 0 SURVEYORS, pLANNE its
824 MaIn Shoo, Edmonds. Waddogt" "no
71?- 167
I
Kw
p.m.
4& /16
cm- IM5
L!c"'r r;oj
206ITY54W34
emawr Cw
ST, Jjy J
ToSPLE
R: HORT SUBDIVISION
APPLICATION FO [EIS (Check applicable)
. 9LOT LINE ADJUSTMENT
OWNER'S NAME Scott Label/
TELEPHON E NUM ER
Gary Ferrel
622-5232/292-5626
STREET ADDRESS CITY
223 Yesler Way/ Seattle
STATE -ZIP
—
98104/
F998020
7914 - 209th S.W. Edmonds
WA
AGENT'S NAME
TEL PHONE NUMBER
Robert L. Stevenson, c/o Reid, Middleton & Assoc., Inc.
775-3434
STREET ADDRESS
ITY
STATE
ZIP
324 Main St.
Edmonds
WA
98020
ADDRESS OF PROPERTY TO BE SUBDIVIDED:
NURER OF —LOTS
PROPOSED:
East of 80th Ave. W. and approx. 210th Ave. S.W.
J_
4
APPLICANT REQUESTS T THE FOLLOWING VARIANCE OF REQUIREMENTS BE CONSIDERED:
None
CERTIFICATION: I certify that I own the above described property, and further, that
all adjacent property which I own, which has not received a previous subdivision
approval, is shown on the preliminary plat.
I further certify that the attached list contains the names, addresses and zip
codes of all owners of property within 80 feet of the proposed subdivision as
recorded with the County Assessor, and that all of the attached requirements
have been met.
I understand that strept dedications may be required in conformance with t
,pe
Official Street Plan of the City of Edmonds. p lot linfyju s)
,_11 - ti
A -X, Q4Aa
'KigAluFie -0 F'rop erty Owner- Y (�r
THIS SECTION IS FOR THE USE OF THE EDMONDS PLANNING DEPARTMENT
Date F i I e # C—S_��_-_71'.Fee $ �5'0, 4rb Receipt c;2#0,2__/
Zone Designation Env. Sensitive Area? APO's
Title Report Legals I Map
E x i s 1 i n g P _r —op-o-s-e-d
Future Development Plan Env. Assessment Env. Checklist
Grading Plan Drainage Plan
Park Dedication Prop. In -lieu Fee $ — Receipt #
Hearing Date 1�:� —( �
`L
CITY POCP�ME Label -Ferrel
"-ggET FILE BMI
ENVIRONMENTAL M DATE S TTED
The in formation on this form will be used to determine the effect of your action upon the
environment of the City of Edmonds. Please answer each question as thoroughly as possible.
l.-LAND Ald6rwood gravelly loam,
Area 39,308 sq. ft. Soils Type& saturated forest imitations Easterly lot not
dUT b u i 7a-a-Fre—
Description of topography (% slope) Varies from flat marsh area in easterly portion
to max. 20% slope NOTE: If grading or filling will
.Grading: Estimated cubic yards 50 exceed 500 cubic yards a*grading
and filling plan must be sub -
Filling: Estimated cubic yards 400 mitted with thle application".
Estimated area to be paved (including buildings) *8840 sq. ft.
I
Estimated area in open space (pervious surface) *21,84o sq. ft.
2. WATER *these figures do not include Parcel A
Stream - Estimated flow (cubic feet per second)— Natural depression
Will stream be altered? No If yes, to what degree?
Other water bodies',
Impact on storm drainage Minimal Method of handling runoff Retention pond
Adjacent to shorelines zone?- No Within 200 feet of MHHW?
3. VEGETATION
Type and approximate number of trees Ornamental trees on Parcels A & B will remain.
Parcel D will remain in natural condition other than pond area.
Minimum diameter of trees to remain % of trees to be removed 0
Ground cover Swamp grass & willows % to be removed go% on Lots B & C__
Proposed landscaping, if any Typical residential landscaping
4. EXISTING LAND USE WITHIN 300 FEET RADIUS OF PROPOSED DEVELOPMENT:
Single Multi -
Vacant Family_ Family Commercial Other
North X
South X
East X
West
5. CIRCULATION
Estimated increase in auto trips dail 14
Availability of public transportation Presently adequate
AREA OF IMPACT
Neighborhood X
I
C i ty-wi de Regional
7. EFFECT ON AIR QUALITY None, except during construction period
8. CHANGES IN NOISE GENERATION- Minimal increase due to typical residential co-1 4r.
(11/78)
AMh\ AM
0STREET FILE 0 6
Za, 17", ENGINEERS * SURVEYORS ar PLANNERS
324 Main Street * Edmonds. Washington 98020 9 Teiephone (206) 775-3434
Revised November 2, 1979
October 1, 1979
File No. 79-167
LEGAL DESCRIPTIONS FOR LABEL7FERREL SHORT SUBDIVISION AND LOT LINE ADJUSTMENT
PARCEL A
The north 100-00 feet of the south 108.00 feet of the west 90.00 feet of Tract 26,
Wi I lowda)e Gardens Division No. I , according to the plat thereof recorded in
Volume 10 of Plats, page 72, records of Snohomish County, Washington;
SUBJECT TO an easement for installation and maintenance of underground utilities
over the south 15.00 feet thereof;
Situate in Snohomish County, Washington.
PARCEL B
That portion of Tract 26, Willowdale Gardens Division No. 1, according to the
plat thereof recorded in Volume 10 of Plats, page 72, records of Snohomish
County, Washington, described as follows: Beginning at the northwest corner of
said Tract 26; thence S89*11'39"E 155-18 feet;.thence SIO*54106"E 126-76 feet
to the north line of the south 8.00 feet of said Tract 26; thence N89*10'55"W
along said north line 90.00 feet to the east line of the west 90.00 feet of said
Tract 26; thence NO*23'28"E, along said east line 100.00 feet; thence N89010'55"w
90.00 feet to the west line of said Tract 26; thence NO*23'28"E 24.og feet to
the True Point of Beginning;
SUBJECT TO an easement for ingress and egress over that portion of the above -
described tract lying north of the south 100'.00 feet thereof;
ALSO, SUBJECT TO an easement for installation and maintenance of underground
utilities over the south 15-00 feet thereof;
ALSO, TOGETHER WITH an easement for installation and maintenance of underground
utilities over the north 15.00 feet of the south 23.00 feet of that portion of
said Tract 26 lying west of the main tract;
Situate in Snohomish County, Washington.
PARCEL C
That portion of Tract 26, Willowdale Gardens �ivision No. 1,.according to the
plat thereof recorded in Volume 10 of Plats, page 72, records of Snohomish County,
Washington, described as follows: Commencing at the northwest corner of said
Tract 26; thence S89*11'39"E along the north line thereof, 155.18 feet to the
True Point of Beginning; thence S89*11'39"E 55.82 feet; thence S37*39,22,,E 30.83
feet; thence S21*21'01"E 107-98 feet to the north line of.'06 south 8.00 feet
of said Tract 26; thence N89*10'55"W, along said north line, 90.00 feet; -thence
N10054106"W 1.26-76 feet to the True Point of Beginning;
SUBJECT TO an easement for installation and maintenance of storm sewer facilities
over that portion of the above -described tract lying north of.the south 100.00
feet; ALSO,
TOGETHER WITH an easement for ingress and egress over that portion of said Tract
26, lying west of the main tract above described and lying north of the south
108.00 feet of said Tract 26;
ALSO, TOGETHER WITH an easement for installation and maintenance of underground
utilities over the north 15-00 feet of the south 23-00 feet of that portion -of
said Tract 26, lying west of the main tract;
Situate in Snohomish County, Washington.
NON,
ReAR, November 2, 1979
October 1, 1979
File No. 79-167
LEGAL DESCRIPTIONS FOR LABEL-FERREL SHORT SUBDIVISION AND LOT LINE ADJUSTMENT (cont.)
PARCEL D.(to be combined with Lot 3, Plea'santvale Addition, by lot line adjustment)
That portion of Tract 26, Willowdale Gardens Division No. 1, according to the plat
thereof recorded in Volume 10 of Plats, page 72, records of Snohomish County, Wash-
ington, described as follows: Commencing at the northwest corner of said Tract 26;
thence S89*11'39"E along the north line thereof 211.00 feet to the True Point of
Beginning; thence S89*11'39"E 112-38 feet toa point on the west line of the east
323-00 feet of said Tract 26; thence SO*25'40"W along said west line 124.16 feet to
the north I i ne of the south 8. 00 f eet of sa i d T ract 26; thence N89* I O'55"W a I ong
said north line 53-30 feet; thence N21'2110]"W 107.98 feet; thence N37*39'22"W 30.83
feet to the True Point of Beginning;
Situate in Snohomish County, Washington.
STEvr "RELIMU RA'ft
........ 'Po N KY
14 A 0% 4�
4� %
V"ONAL
NOTICE:
No warranty of accuracy.
The information on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Eclmonds does not warrant the
accuracy of anything set forth on these
map(s-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
�h-e -map(s), including, but not limited to,
the loc'ation of any sewer stub shown. Such
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
emp-l-o-yee-s o-r officer-s sh-all be Iia-b-l-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
for -
The City of-f4monds SEDE SEWER P MIT
FuFw CONSTRUCTION ff7 REPAIRS E]
�LYRN PLANT
I
No. ....................
7 u - ul") 1( 6) C/
OWNER
40-Al ..... . .. ... CONTRACTOR ...... /... No.
A ................ .... . ... 4 .... .. PERMIT �21
-- ---------------
0 07t
ADDRES ............... _5�
s - ....... ..... - ............ . . .... J. LEGAL DESCRIPTION: LOT No. ............................... BLOCK No.-.... ......................
.. ... ... . ? .......
NAME OF ADDITION ...... . ....
21) 96 1 -,66 - - ----- .......
C
4
APPROVED
APR 2 0 1961
cj rt�-
r7—
Approved:
DATE ....
.................. By ... . ...... ........................................
y OF EDMONDS 0
for IMP601P!!- (,NO jr rpee- 2071
I)F
ATER-SEWER PARTJ�WNT is ready di r h6lld-Y
tions S'aturday,�Sun aYP
C
P IT
-E SEW ERM
SID
...................................
......................................
----------
Ave. South
6% ... ..................... ................ ..
... .......... ... ..........................
'ADDRESS ................... - TOR
CONTRAC -------
aox.don ... J ...... Rack ...............
OWNER ....... ............
1667, for ------------------------ days to REPAIR or CONNECT a side sewer
d .............. A-PX: ...... ile and governing ordinanCOS,
permission is grante -til application On f
Nvitil. City Sc,;vers in ar-cordallee NVI �d Side Sewer contractor must
CALLED TO THE roLLOWING:,., a permit to construct sewer inside property line. A, license een inspected.
-ATTENTION I ion of sewer before t has b
I —The owner.'Of the property may 't area. Do not cover any Port
NOTE, No. g side sewers when YOU get permit
be employed to construct side sewer in street IT.16.030 and Regulations governin c rty line; minimuni'grede Of 2%,
4. atlon regarding Ordinance . I c at property line and 12 in h�s inside prope
N' NO. 2—Obtain full inform ve at least 30 inches coverag
tractors shall be responsible for
-'Ro 3—TOP of side sewer must he' an % will be permitted. to original condition. Con
No -bends in grade Shaxper th surface of 'itreet restored or its &ppur-
must be water settled and r of completion. on the main sewer
No' 4_-�Trenches in street hlh may develop within one Yea to do any work
failure due to improper work W
is provided for in the Permit, or
It is unlawful to alter or do any other work than
TE No. 5— e pipe Into the Wye*
tenences except to insert th
STREET FILE
STATEMENT ON ACCESSORY DWELLING UNITS
Property Address: a0901 90"i- -Aut W
Edmonds, Washington
Legal Description:
Assessor's Parcel Number: 00 6 14 3 0 0 06 a0c-4
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of the
Edmonds Community Development Code (ECDC) and understand that an accessory dwelling
unit as defined in ECDC Section 21.05.015 is prohibited until an Accessory Dwelling Unit
Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved unless all the
criteria in Chapter 20.21 are met, and all the necessary items are submitted, including an
affidavit of occupancy and a covenant to be filed with the Snohomish County regarding the
regulations imposed on Accessory D elling Units.
Property Owner Signature: &al
Property Owner Name (printed): Re-ie-r iA. &%4ev-
Date: -7 1-1 1 Qq
I I
STATE OF WASHINGTON
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that �A � �La-kj��
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's pressure seals must be smudged. Dated:
Signature of
OLSEN
HUDA E. L NotaryPublic:
NOTARY PUBLIC
T
STATE OF WASHiJINGTON
aXPIS S Residing at: ;2�� zp,
COMMISSION EXPIRES
FEi3RUARY 1, 2006 My Appointment
Expires: 0\0 6
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
ft
A3?
ADUstatement
CONFORMIED C()P,*,
200507,260739 1 PG 00 T ON
2()05 01 - 569M $1 jNG
07 - 2E - SH COUNV
SOHO
CITY.CLERK
CITY OF EDMONDS
121 STH AVENUE NO.
EDMONDS, WA 98020. STREET FILE,
ACCESSORY DWELLING UNIT COVENANT
Property Address: �Zoqoj go
Edmonds, Washington
Assessor's Parcel Number:
Legal Description:
1,- .7 , . "
I, the undersigned, have attained approval for an accessory dwelling unit (ADU) at the,
property address above., in accordance with the provisions of Chapter 20.21- (Accessory
Dwelling Units) of the Edmonds Community Development Code,
I agree and understand that it is my responsibility to notify all future property owners or long-
term lessors of the existence of the ADU and that its existence is predicated upon the
occupancy of either the ADU or primary dwelling unit by the owner of the property,
Additionally, I will notify all prospective buyers of the limitations on use and maintenance of
the, ADU As stipulated in Chapter 20,21 , (Accessory Dwelling Units) of the Edmonds
Community Development Code. An examp I le of the limitations of t . he ADU per Chapter
20.21 is the property.owner is d -t eside in the unit f6r
require P r pnmary or accessory 6velling
6 months out.o.of every year,
Finally, this covenant shall be recorded in order to notify all current and future property'
owners that if any conditions of the ADU approval are violated, the property owner will be
required to remove all improvements which were added.to convert the primar'y dwelling unit
intb an ADU and restore the site to a single-family dwelling unit.
Property Owner S*igyAature:
,�Zo_ Tce c7e 7
Print Narne:yez�,071,
Property Owner Signature:
Print Name:
� /C
Date:
STATE OF WASHINGTON
COUNTY OF SNOHOMISH)
I certif� that I know.or have sati s factory evidence that Ve—V d bp n V N
signed this instrument and acknowledge it to be hisiherf�ee and voluAtary act for the uses and
Purposes mentioned in this instrument.
IN % I
Nota PM�"W� must be smudged.
Signature of
vi, Notary Publi
PLpoi_%- c Residingat-
Mv Annoint
op W�o Expires:
lit L�2
THIS bOCUMtNT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDIT011.
I -rl /�
05/14/2004,.-13:31 253-536-8488 F.S.&GS. SERVICES PAGE 01
ri
F.S. & GS. Services, Inc.
16214 57b Ave E. Suite A
Puyallup, WA 98375
Phone: 253-548-1011 Fax- 253-536-8488
Universal Buildin& Inc.
&300 61st Ave NE
OIYMP14 WA 9896
Asbestos Removal
W!
Edmotfcki-W& -98026 -
Prepared by
Gordon L. Williams
r-1
JUN 0; 12004
DEVELOPMENT �MICES CTR.
CITY 00 EDMONDS
05/14/2004 13:31 253-536-B4BB F.S.&GS. SERVICES PAGE 02
TABLE OF CONTENTS
SE ION 1 STATE ACCREDITED CONTRACTOR
State License and Registration
Labor and Industries Contractors Registration
Labor and Industries Asbestos Certification
SECTION 2 ACCREDITED ASBESTOS SUPERVISOR
Supervisor Certification Number
Worker Certification Number
SECTION-3 AIR MONITORING RESULTS
Name and Address of Analytical Lab
Air Monitoring Data Sheets
SECTION 4 11JANSPORTATION AND DISPOSAL OF A.C.M.
Disposal Certificate
DisposalFacility Permit
SECTION 5 PROCEDURES FOR ABATEMENT ACTIVITIES
Labor and Industries Notice of Intent
Visitor Sign In/Sign Out Log
05/14/2004 13:31 253-536-848B F.S.&GS. SERVICES PAGE 03
SECTION-1 STATE ACCREDITED CONTRACTOR
State License and Registration
Labor and Industries Contractors Registration
Labor and Industries Asbestos Ccrtification
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 04
05/14/2004 13:31 253-536-848B F.S.&GS. SERVICES PAGE 05
IABOR Ami
W�.<)r t)
llottrm* AS . PRCIV-1-Dib. 13Y. ..Lt*w Ag
a
uv� ViA.- - "375
MUM
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 06
SECIION- 2 ACCREDITED ASBESTOS SUPERVISOR
Supervisor Certification Number
Worker Certification Number
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 07
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 08
WCTION-3 AIRMONIT9MGRESU�.LTS
Name and Address of Analytical Lab
Air Monitoring Data Sheets
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES
:IOWICKI &ASSOCIATES, IN -..-
a
ASBESTOS AIR MONITORING
ANALYSIS REPORT
Lab Number 40373
Page: I of I
Date Sampled: 3-24-04
Submitted By: Mario Rabauliman
Project: Universal Building, Inc. #04081
Client: FS & GS-Services, Inc.
Date Analyzed: 3-25-04
Date: 3-25-04 Received By: PAG
PAGE 09
Sample
Description
Type
Time Start
Flow
Fiber
Of
A, PA
Time End
Rate
Per
Fiber/CC
Sample
POP P, C
Total Time
Total
Fields
Prep work
S: 830
R: 10.0 L/rn
MR1
Flonus Room - popcorn
PA
E: 950
116/100
0.071
Mario Rabauliman #22708A
T, 80 min
V: 800 L
CLEARANCE
Encap work area
S:3110
R: 11.0 Urn
MR2
Bonus Room - popcorn
C
E:450
6/1 DO
0.002
Mario Rabauliman #22708A
T: 100 min
V: 1100L
S:
R:
E:
T:
V:
S:
R:
E:
T:
V:
S:
R:
E:
T:
V:
S:
R*
E:
I
T: t
V:
(A) Area Sample (PA) Pre Abatement (PO) Post Abatement (P) Personal (C) Clearance
Comments:
Phase Contrast Microscopy (PCM): NIOSH Analytical Method 7400. A Rules
Minimum Detection Limit. 2 FIBERS1100 FIELDS
Lower QuantItation Limit (LQL)* 10 FIBERS/100 FIELDS
Proficiency In Analytical Testing (PAT) PROGRAM ID NUMBER: 101842
-----------------------------------------------------------------------------------------------------------------------
33516 9th Avenue South,'Bldg #6 0 Federal Way, WA 98003 -.(253) 927-51233 - (253) 924-0323 FAX
Asbestos Mouttoring Data Sheet V.-S. & US. ber4ces, Lac. rage of
16214-57" Ave E. Suite A Lp�,13
Same Day 24 hour ZRush Puyallup, WA 98375 Phone; (253) 548-1011
Fax: (253) 536-8488
Project Name: Univ . ersal Building, Inc. Sampled byAo"IM.A4, Date Sampled: 0 z) I 2,�/
A IL'KT A ngn-tjC T.41h WOMIM. 1vk
J9JJr.J;& J%UU5GaZJ.
Sample
J.W.7UJL JU". —1. 11 .. ---- 1. ,
Semple DescripfiomMftftcdfo.U_W_V,M" ^ - ____
Ctr-ck Type-:
Thne Start
FlawR@tr
Volum
irbers per
Fftwrlcc
ED#
Deacciptlan oractivity invelv-Wg vcpowntoasbcdos Was nionitamd
Tbad Lad
Fields
Work paformad:
V
Start
Stan: 19
Comments
a
Personal
End:
End- N.0
11�_"
Stel -
Clamce
Ual
Tow '0
I k,
1 %oo
Ma"dal Type A-�, —
r%
can#:
Work pefformeck taja."IEb \,Qoa..Y—
Pre
awt: 1,0
Start:
Comments
Area
Fersmal
End:
En&
JIOA_ -
Ste]
TOW
Total J i
Malefial Type
Work petibrmed:
Pre
Start:
Staxt:
CMnmCnts
Area
personal
End:
End:
Locadcn:
Std
Clearam
TOW
TOW
NWmial Type
'Namc. Cat M:
Work performed:
Pft
Stmt:
Start:
Commeins
Am
Personal
&&-
End:
Locaflon:
SftI
Clearance
TOW
Total
Material Type
Name: Cwt N:
A Arco Samples Nag -Air Exboust Outaide Arcs rA rrel-ADolemcni r, rICIMAIM W �W� (/w
outside Docon Inside Ama Brea:WAg 0
Analyzed by:
gL
Date Analyzed: 40�10 4
05/14/2004 13:31 253-536-848B F.S.&GS. SERVICES PAGE 11
-S
CHNEIDER LABORATORIES
INCORPORATED
2512 W. Cary Street * Richmond. Virginia - 23220-5117
804-363-6778 - 800-785-LAFIS (5227) - (FAX) 804-353-6928
Excellence In Service and Technology'
AIHAIELLAP 100527, NVLAP 101150-0, NYELAPINELAC 11413, CAELAP 2078, NC 593
LABORATORY ANALYSIS REPORT
Asbestos and Other Fibers Counted By NIOSH 7400 Method, Iss*ue 2, Aug. 12, 1994
ACCOUNT:
2269-04-892
DATE COLLECTED:
3/25/2004
CLIENT:
F.& & G.S. SERVICES INC.
DATE RECEIVED:
3/26/2004
ADDRESS:
16214 57TH AVE EAST STE A
DATE ANALYZED:
3/2iV2004
PUYALLUP, WA 98375
DATE REPORTED:
3/28/2004
PO NO.:
04081
RESPIRATOR:
PROJECT NAME:
Universal Building
PROJECT NO.:
04081
JOB LOCATION:
20901 80th Ave. W.
Area and Environmental Samples
SLI Client Sample Sample Flow Sample sample Fiber Actual
Sample Sample Identification Date Rate Time Volume Count Exposure
No. No. (Umin) (min) (L) (fflield) (1/cc)
27144507 MR4 Outside Decon Unit 3125/2004 10.00 60 600.0 < 0.055 < 0.004
Rebaullman, M.
ANALYST, KATHERINE M. CWLES
Total no. of pages in report REVIEWED BY 13EVERLY
OSHA PEL Is 0. 1 f/cc for 8h TWA, Method fimit.- 0.01 f1cc. Results are not blank -corrected unless noted by analyst
Exposure calculations are based on client -supplied information. 8 hour TWAs assume zero exposure for time not sampled
Microscopic field area (mm-); 0.00785. Estimated limit of defection: 7 flmm�
Estimated relative standard deviations., Intra-1-aboratory., ± 0.26; Inter -Laboratory., 10,41.
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 12
SCHNEIDER LABORATOWES.
INCORPORATED
2512 W. Cary Street - Richmond, Virginia - 23220-6117
804-353-6778 - 800-785-LASS (5227) , (FAX) 804-353.f)928
Excellence In Service and Technology
AIHAIELLAP 100527, NVLAP 101150.0, NYELAPINELAC 11413, CAELAP 2078, NC 593
LABORATORY ANALYSIS REPORT
Asbestos and Other Fibers Counted By NIOSH 7400 Method, Issue 2, Aug. 12, 1994
ACCOUNTM 2269-04-892
CLIENT:
F.S. & G.S. SERVICES INC.
ADDRESS:
16214 57TH AVE EAST STE A
PUYALLUP, WA 98375
PO NO.:
04081
PROJECT NAME:
Universal Building
PROJECT NO.:
04081
JOB LOCATION:
20901 80th Ave. W,
Personal and Excursion Samples Collected For OSHA Compliance.
DATE COLLECTED:
3/25/2004
DATE RECEIVED:
3/26/2004
DATE ANALYZED:
3/28/2004
DATE REPORTED:
3/28/2004
RESPIRATOR:
SLI
Client Sample
Sample Flow Sample Sample
Fiber
Actual 30 Min
a Hr
Sample
Sample Identification
Date Rate Time Volume
Count.
Exp. TWA
TWA
No.
No.
(UmIn) (min) (L)
(f/field)
MCC) MCC)
MCC)
271"505MR2 Bonus Rm. 3/26/2004 2.00 30 60.0 Too overloaded to count
Tallano, T.
27144506MR3 Bonus Rm. 3125/2004 2.00 300 600.0 Too overloaded to count
Taftano, T
ANALYST, KATHERINE M. CHARLES
Total no. of pages in report REVIEWED BY BEVERLY A. SCHRAGE
OSHA PELs are 1.0 f1cc for30 min excursion and 0.1 f/cc for-8 hour MA. Method Limit' 0.01 Mcc. Microscopic field
area (mm2): 0.00785. Esilmated lift Of detection, 7 MMM2� Results are not blank -corrected unless noted by analyst.
Exposure calculations are based on c1lent-suppfied information. 8 hour TWAs assume zero exposure for time not sampled
Estimated relative standard deviations; Intra-Laboratory. ± 0. 26,' Inter -Laboratory.- 10.41,
Asbestos Monitoring Data Sheet F.S. & US. Services, Inc.
16214-57th Ave E, Suite A
Lsame Day 24 hour Rush Puyallup, WA 98375 Phone: (253) 548-1011
Fax: (253) 536-9488
Project Name: Universal Building, Inc. —Sampled by:. V40641MA, -,Wk' Date Sampled: P ;7rl �!E I
I
PrAlpvt AAA rpq-e- -Ift9fil Rfklh Avp. W__ Rdmand-a- WA 9R026 Proiect N.- 04081 Likh Nskme!
Sample
Sample DescriptlextProtection Worm
areleType:
Tim S"
Flow Rote
Volume
Vibers per
Filier/te
EDH
Deswiption aT acfivo hmlving expogwe to asbmtoi bgb* mnitoged
Tian End
Fields
Work performed: Ift"
Pro
Sim: 01V
Swt-
Area
Location: INM
POW41
arel J
End: Im
End:
C1,eamce
Total
Total 7,
Material Type
I Vyapry
i
Nbame. , 1�* CertH:
Wc* pdformod: NA)OAJ��A
Pro
Start: low
start: -2-
Comracats
Am
Location: e�'�
Stel
End:
End: 2,
�� .
Type
Clemnee
Total
Total 1-
Maraw
Name&60 i Ccrt hr:
Workp4bruied:
Pre
Start:
Stwr
CmMents
16pe1r)
'IrM&W
Location:
Std
Clewance
End:
Total
End: 10
TOW 149
tit
Material Type
Name;
Alork per"-od- I
ple'
Start:
Start:
CDMMentS
Area
I'Monal
End:
End:
Location:
Stel
Clemmm
ToW
TOW
MeterW Type
Name: Cc" 0:
A Area Samples Neg-Air ffxlh us[ Uutude Area rA rM-ACRTen=1 r rey3ow
Outside Decon Wide Area
'73 7
MCI I- %_LCH71n=
Breathing
Analyzed by:
Date Analyzed:
05/14/2004 13:31 253-536-6488 F.S.&GS. SERVICES PAGE 14
SE!CTION 4 TRANSPORW19�! AND DISPOSAL OF A.C.M.
Disposal Certificate
Disposal Facility Permit
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 15
Job# 04091
Container # 480321
WASTE SHIPMFNT RFr.nRr)
I. Waste Generated Site Name and Address;
20901 6M Ave W.
Owners Namc
Owner's Phone No:
Edmonds. WA 99020
Pater Bauer
2. Operators Name and Address:
Operators Phone No:
6
F.S. & GS. Services Inc., 16214-571h Ave E, Suite A, Puyallup, WA 98375
253-548-1011
E
N
3. Waft DisPosall SRO (WDS) Name. Address, and Physical site Uwation:
WDS Mone No:
E
Columbia Ridge Laridlill & Recyding Center
541-454-3318
18177 Cedar Springs Lane, Adinigton, OR 97812
R
30 fleopmsible Lwai, Sm or EPA Agency Name and Address:
A
PSCAA, I 10 Union street, SU1% 500, Seattle, WA 98101
T
5. Description of Woote Moterisk,
6. Containers
7. Total Quantily
0
WalboaLd,:,�
Type
M3
(yd3)
R
(FRIABLE) / NON FRIABLE
39
Bags
3.9
Asbestos Containing Materials
2
Wraps
.2
I
S. Special Handling Instructions and additional infonnation:
g. OPERATORS CERTIFICATION: I hereby declare that the contents of this consignment are Uly and accurately descdbed above by pmpershipping name and
ore classified, pocked, marked and labeled, and am in all respects In pmper condilian fur ttenWrt by highway accooding to applicable international and government
regulations. I
Prink,d/Typed Name
Signahn
Month
Day
Year
John Voughn
t
10. Tmnsporler I Acknowledgmem of Rece0t of materials
R
A
PrintedfTyped Name
Sil;Inature
Month
Day
ear
N
CO21 nhw I
P
-r-Tr
a
0
If. Tromportir 2 Acknowleeg&-ePTV Receipt of miWals
R
PrintedRyped Name
S4nature
I Yimr
T
E
R
w
12. Discrepancy IndkWon Spam
A
a
T
E
13. Authortzed Waste Disposid Site Owner or Operator Cedificatilim of teceipt of astiestos m*dah covered by this manifest except as noted In
8
dem 12
I
T
P 7 yped N
rintedff
Signattire
Month
I Day
Year
E
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 16
9d
ft Nuifter W
supbudm DOW June V. Me?
pace I at=
MUD WA9M DMPOSAL WM PERNOT., Swidpoi =ad vmgtg looM
ONO= OWPOftent ef ftvbwmuntd QMMI
400 L 3amic Or, sWb 3c7
The 05AON OR 87M
T*Wphoft- (541) ZW7=
'a-M'n "�m anmwMdl9WWWwWafOft3Chzptwr4WwW
subjecttDdwtm4uwCmj tibft*Wwmntmftei bolow,
VMEQ TO: FAOUTY NAME AND LOCAMON:
ofcmm CdMI62 MOM LMM W4 Rfialcft Cwter
RUN WnM mt Recycorq C4MW
ism QbdW 8pbW Los
A*qM OMW WM2
Tek (541) 454JM
Fmc(541)464-W12
oftift
%W MW*Pff-d MWO 3wffte of OrmM
W-
OPERATM
vow-,, Dwposismimpolomm
UW. -
MOM IN PMOPOME TQ-.
am*%mwpwfmmfwm I . .1
Un e-WOMY =-YAM "M GMMC4u* dOMd AWA21, IW?.
- I , bAnnoft VKOAI@d b, ft pw" Maud
WMM gy ll� CREOM DWARTMW 01, M&MONMENTAL. QUAUrY
,A��, . JejV4Z11_44fjj 0 - 4,30-F7
negim A*Movw Dow
ParMiftd AcrAfts
Urd' no "MO 10 MAW Or Maked. Me PWofto k aambed a
W
imm im mit dmw4m i%mmv el aftdvnom.
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 17
SECTION 5 PROCEDURES FOR ABATEMENT ACTIVITIES
Labor and Industries Notice of Intent
Visitor Sign IDISign Out Log
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 18
r Aimd Ibdbstries
Libo`
NOTICE OF
inidu'striai.njilene Complih�, ASBESTOS ABATEMENT
(Regiobal addresses. and phone is . : . I I . ..
1. PROJECT
1"Aul VA VAA P49V 16)
TMS NOTICE WM BE RECEIVED NO LATER THAN 10 CALENDAR DAys pRioR To THE sTART DATE.
COMPLETE ALL APPLICABLE BO)MS-INCOWLETE OR ULLEGIBLE NOTICES WILL NOT BE ACCEPTED
MAIL OR FAX TO TM REGIONAL 0"ICE - CIRCLE CIJANGES ON ANM*NDED N077CES
Notice Date: 3/15/04 Initial 0 Amendedn Site Work Hours Su Mo Tu We Th F�r Sa
-Start Date: 3-24-04 On hold [] Off Hold [1 8 Am 11:30 am x
to
I Completion: 3-24-04 El 12:30 Pm, Proic . &,Pefta and Work Hours mint be exm
I ]Bpkd�gen
CONTRACTOR\, ' I PRO
OWNER
Company Name
F.S. and GS Services, Inc.
Peter Bauer
Contractor Certification Number
Owner's Agent
1022
Universal Building, Inc.
Sft
I ftim 4 M
—Nam
Company
rrmi-ted a
Address
-Gordon Williams
20901 80th Ave W
roone INUMDer city State Zip
253-549-1011 Edmonds WA 98026
Job Site C.A.S. Phone Number
I JOB SITE I FACILITY I
Aaaress Type
20901 80th Ave W. Residential
Building Name ROOM Age size
40+ 7,000 sf
city 0 Remodel El Nmolition
Edmonds WA
1Zip +4 County 13 Repair Maintenance
98026 5nohofrtPsh I
OUANTITV OF A9RFqTnq Tn Riv. uwmnvvn M V1QrADQ1t1 AqrWlM
Quaixtity MQ square feet
Indoors Outdoors
E] Fireproofing
0 Boiler Insulation
CONTROL MEASURES
W Popcom 6e_ifing
Duct paper
N N% pros. Enclosure
Wrap & cut
CAB
VAT
�Glove bag
We—t methods
D Sg�t v�iy_f
Roofing
Mini enclosure '70
-E
EPA vacuum
Ll Asbestos paper
Other
Critical Barriers
Manual methods
Quantity finew feet
-Other
Other
LJ Mag pipe insulation
EJ Cement —asbestos pipe
RESPIRATORY PROTECTION
Air cell pipe insulation
El Mudde—d pipe is
El % n1ask-APR
El Type C continuous flow—
Ducting(duct insulation
[:] Duct tape
APR
Type C pressure dexnand
Other
EJ Other
PAPR
Other
F413-025-000 notice of asbestos abateownt project 9-02 FAXED:
TMN: A2,10AM
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES PAGE 19
JOB SIGN-IN/SIGN-OUT VISITOR LOG
DATE:_t�p -k JOB # 04081
(Print Name)
NOTE: ALL PERSONNEL MUST SIGN IN OR OUT EVERY TIME THEY
ENTER OR EXIT THE REGULATED WORK AREAM!
PLEASE PRMT CLEARLY
M13MMM
mommm
MEMMM
05/14/2004 13:31 253-536-8488 F.S.&GS. SERVICES
PAGE 20
DAMY PROJECT SIGN IN SHEET
PROJECT: versal Buildin& Inc. DATE:
PROJECT#
DAY LUNCH It2
WORK SHIFT — 8 10 OTHER OVERTIME YES No
Time sheets will he prepared from this form. Failure to sign In or out Will CRUM
delay in receiving your proper pay.
CMAWME?
PER
Aav-6
7�V 7AMD
V — r
-MM4 fdAr affAdp�
TIMM IN TIME OUT
�A
Sw�rvisor Signature
05/27/2004 17:16 14254812510 NELSON CEO'MCHNICAL
FIELD REPORT
NELSON Proj Oct: Foundation Evaluation
GEoummeAL Owner: Pete Bauer
AssociATEs, iNc 1=61tion: FM-1 : - 8 e A Vie W,- E—d m— &—d s
17311 135TH Ave. NE #A-500 Weather: HinjURI 50"S
Woodinvik, WA 98072 Purpose Of Visit: Construction Monitoring
(425)486-1669 PAX481-2510
PAGE 02/04
File No.. 395504
Date: ' 5/27/04
Report No: I
Page I of
ADJ
We visited the site today at the request of Pate Satier, the owner, for the piapose of evaluating the
footing subgrade for the planned addition to the existing residence loextod at 20901 - go* Avenue West
in Edmonds, Washington.
Upon arrival, we met with Pete. He informed us dat the footing lines had been excavated down to the
PU11110d. ckvation within the addition arca along the wee and nordi side of the exisdng building (see sac
plan).
Nailb-m EQ2ft U—ne
The fbol;ing line along the north side of the existing residence was part of the daylight basement
foundation (see site plari, page 2). T1w footing line subgrade consisted of gray, -brown, silty fine to
mediurn sad with gravel. We evaluated the subgrade by probing with a Yz-mch owl diameter probe
rod, under moderate pressure, and found that it peneftWed V2 to I Y2 inches. We Werpreted this material
to be medium dense to demo native soil.
XQMM FOR&& une
The footing fine subgrade, along the western side of the existing residence, exposed brown, silty fine to
coarse send with gravel and trace organics (see site plan, page 2). We evaluated the subgrade by
probing and found that it penetrated 6 to 18 inches. We interpreted this to bevery loose fill material.
We recommended to Pete to remove the loose fill material down to medium dam or better native soil to
reduce the potential, for settIment. He agreed and informed us that he would just Wend the footings
down to the new subgrade.
RWI ON VISM,
Upon arrival, we met wi Pete. He informed us dW they had found bricks in the upper brown material.
He also Informed us that they had over-excavaW approximately two to Om fed below the planned
footing subgrade elevation to expose the n&ve sod, in the wutl�ern end of the footing line (we site plan,
page 3). We observed the over -excavation subgrade exposed brown -gray, silty fine to medium s8nd
with gravel. We evaluated the subgrade by probing aW finmd that it penetrated I to 2 inch=. We
interpreted this mamal to be medium dense to dense native soil.
EWsed on our observations, it is our opinion that the exposcil nadve subgrade should provide adequate
support for the plumed loads. Any ponding waw or surficial water -loosened material dud might
develop due the weather or changing site conditions "uld be removed from the excavation prior to
pouring conoreft.
Attachment Site Plans Sigaed:A
Distribution:
RECEIVED
JUN.-Q) 2004
J)eMOPMENT. SERMES CTFt-
t,ITY OF EMONDS
05/27/2004 17:16 14254812510 NELSON GEOTECHNICAL PAGE 03/04
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05/27/2004 17:16 14254812510 NELSON GEOTECHNICAL PAGE 04/04
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MIMSON GROTECHMICAJL ASSMIATES9 INC-
CONFORMED COPY
200507110903 1 PG
07-11-2005 04:29pm $19.00
SNOHOMISH COIJNTY� WASHINGTON
CITY CLERK
CITY OF EDMONDS.
121 5TH AVENUE NO.
EDMONDS, WA 98020
STATEMENT ON ACCESSORY DWELLING UNITS
Property Address: wammum 634-g-&'o wt,
Edmonds, Washington
Ft
a35r
Assessor's Parcel Number: Ob � I tj 3 6 o ob a 0a
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of the
Edmonds Community Development Code (ECDC) and understand that an accessory dwelling
unit as defined in ECDC Section 21.05.015 is prohibited until an Accessory Dwelling Unit
Permit is approved.
I also understand that an Accessory Dwelling.Unit Pennii cannot be approved unless all the
criteria in Chapter 20.21 are met, and all the necessary items are. submitted, including an
affidavit of occupancy and a covenant to be filed with the Snohomish County regarding the
regulations imposed on Accessory'DWelling Units,
Property Owner Signature: /V' 1jagla,
Property Owner Name (printed): Nief i�- i11Rk4eV-
Date: -7 1-7 Dq
STATE OF WASHINGTON)
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses'' and
purposes mentioned in this instrument.
Notary's pressure seals must be smudged. Dated: :1
Signature of
A E " OLSENJ
LC
HUDA E.'OLsEN Notary Public: V
NOTAR PUBLIC
' y P
STATE OF WASHINGTON
XP S Residing at: <C-�Za
COMMISSION tXPIFRIES
E
0
FEBIRUARY 1, 2006 My Appointment
Expires:
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
ADUstaiement
CONFORFjeo G()PY
,200507280739 1 PG a 00
, ,C105 01-56pm VI jNG-TON
07 - 21 - ouq-Ty
SN0Vj0t41SVi C
CITY CLERK
CITY OF EDMONDS
121 STH AVENUE NO.
EDMONDS, WA 98020.
ACCESSORY DWELLING UNIT COVENANT
s: Ile -
Property Addres
Edmonds, Washington
Assessor's Parcel Number: 0 0 C
Legal Des cription: S Fe., T 1 1
,/I. - - I"
1, the undersigned, have attained approval for an accessory dwelling unit (ADU).at the.
.property address above, in accord . ance with the provisions of Chapter 20.21- (Accessory
Dwelling Units) of the Edmonds Community Development Code.
I agree and understand that it is my responsibility to notify all future property owners or long-
terth lessors of the existence of. the ADU and -that its existence- is predicated upon the,
occupancy of either the ADU or primary dwelling unit by the owner of the property.
Additionally, I will notify all prospective buyers of the limitations on use and maintenance of
the ADU As stipulated in Chapter 26.21 - (Accessory Dwelling Units) of the Edmonds
.Community Development Code. An examp . le of the limitations of the ADU per Chapter
20.21 is the property.owner. is, reqUireid to' reside in the prima y 'or- I apees . sor . y d0elling t-in
it.-f6r
6 months out. 'of every year.
Finally,. this covenant shall be recorded in order to notify all current. and future property'
owners that if any conditions of the ADU approval are violated, the property owner will be
required to remove all improvements which were added. to convert the primary dwelling unit
into an ADU and restore the site to a single-farnily dwelli , ng unit.
Property Owner Signature:
Print Name: qe.vheell,'�a 18ce ae,�—
Property Owtier Signature:
Print Name:
Date: ZLI� /0S_
STATE OF WASHINGTON
COUNTY OF SNOHOMISH)
I certify that I k-now.or have satisfactory evidence that 6;4�-ee—
signed this instrument and acknowledge it to be his/her fiee* and v6.luAtary act for the uses And
purposes mentioned in this instrument.
must be smudged.
Sbo Signature of
Notary Publi
A'
N
W
Residingat:
Mv Ahnoint
Expires:
THIS 6.00UMENT MUST DE PttCORIAD WITH THt SNOHOMISH COUNTY AUDITOIL
/74
CITY COPY
c."A� �0 &AA�,r�
di
1 r-7
STATEMENT ON ACCESSORY DWELLING UNITS
Property Address: W-A- -91Du
Edmonds, Washington
Assessor's Parcel Number: —QOLIH-3000oa�j)a
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of
the Edmonds Community Development Code (ECDC) and understand that an accessory
dwelling unit as defined in ECDC Section 21.05.015 is prohibited until an Accessory
*Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved unless an
the criteria in Chapter 20.21 are met, and all the necessary items are submitted,
including an affidavit of occupancy and a covenant to be Med with the Snohomish
County regarding the regulations imposed on Accessory Dwelling Units.
Property Owner Signature:
Property Owner Name (printed):
Date: qjanji)4
. I
STATE OF WASBINGTON
COUNTY OF SNOHONHSH)
-4
0
G
PU130
, .0
,',..OF W
I certify that I know or have satisfactory evidence that #- 1,3taeR
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's pressure seals must, be smudged.
Signature of
Notary Pubb
Residing at:
My Appointment
Expires:
THIS DOCUMENT MUST BE RECORDED NVITII THE SNOHOA . HSH COUNT . Y AUDITOR.
ADUstatement
'a 00io\ %(S& Av_(�vj
OWNER/CONTRACTOR IS RESPONSIBLE ADD GUTTERS /1DOWNSPOUTS
AKIn QPi,&.qWPJ WKS
rj
09
97
Qc. I k
rF_L_ "i
Le
t
cF 1Fpjer-ikF�,ri
ReiAt Ceele-5 R;Aj,& @, hjr.Ff A-4u.1
qztcjj).&j+%.z3*qfjz.T =375-04
375.04 -:-&1 q3.71, Rve,,kje &,-.�oe
9 3.7 16 1- as kit DLWQ'61 r-
0 V7 L 10 &
P)'7,Nj' 01 1 S
I ( , bo <, -I c%j 5-F � leis&
ctyos-, , 1 ;19,5,
2w,* fjl�to
IJAP09VOU-S
&..,, -- A-
I __ - Iq, ',� e7r-7 'P,- I -Zr, 4-"T_ ioo,-/
-7 'A
L'T ( I c),_
RECEIVED
MAR 12 2004
PERMIT COUNTER
TH
ZONE t7 I S
SErBACKS:L2eq., _-7 "("' 7( 15-
FRON 24 -
TPIX ACc-ovi-T- pA-rj
f — Goo- OZ Z_ I
SIDE APPROVED AS NOTED
REAR BY ENGINEERING RPR&OVD 1B1Y OPLI ING
OTHER ?
HEIGHT—
--Date:—.
AECEIVED
JUL 0 8
CITY CLF-RK %MONDS C1 - TY CLERK
CITY OF EDMONDS 200406020177 1 PG
121 STH AVENUE NO, 06-02-2004 09:29am $19-00
EDMONDS. WA 90020 � -
SNOHOMISH COUNTY. WASHINGTON
STATEMENT ON ACCESSORY DWELLING UNITS
Property Address: a09 01 %6� Ave. Fdmoy)J s, WA 9na�
Edmonds, Was]-iington
Legal Description:
Assessor's Parcel Number: ool,14 300C)C)a�O a
I have read the requirements for accessory dwelling units contained in Chapter 20.21 of
the Edmonds Community Development Code (ECDC) and understand that an accessory
dwelling unit as defined in ECDC Section 21.05.015 is prohibited until an Accessory
Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit ' cannot be approved unless all
the criteria'in Chapter 20.21 are met, and all the necessary items are submitted,
including an affidavit of occupancy and a covenant to be filed with the Snohomish
County regarding the regulations imposed on Accessory Dwelling Units.
Property Owner Signature:
Property Owner Name (printed):
X
Date: 13, 0 10 L4 x
:-Z�
:0
\o
PUB - -0.
STATE OF WASHINGTON Is rP '-. ..*.Xz _-,
oil
44ttiolz
V, -a S
COUNTY OF SNOHOMISH)
I certify that I know or have satisfactory evidence that #-
signed this instrument and acknowledge it to be his/her free and voluntary act for the uses and
purposes mentioned in this instrument.
Notary's pressure, seals must be smudged. Dated: �1-aj -,12 117Z
Signature of z2
Notary Public:
Residing at:
My Appointment
Expires: �F- 12-,12Z
THIS DOCUMENT MUST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
ADUstatement
STREET FILE
STORM DRAINAGE REPORT
SITE PLAN
for
THE EDMONDS BUILDING CO.
for
2 SINGLE FAMILY RESIDENCES
located at
8th & MAPLE
prepared by 600
(Lp f ile J,
,)If
John W. Mellor,'P.E.
W�Als
0
-A
J
19P43
EXPIRE8 F/2097 RECEIVED
ar,
J U 2 7 1 ON 5
PERWT bvkm
UNDEVELOPED SITE
The majority of the subject property is moderately sloped with a topographical
change from the SW corner of the existing building to the top of the berm near the
NW corner of the property, a change of 123.0' - 110.8' =1 12.2'. This change
occurs over a distance of 105' for a slope of 11.6%. The runoff then drops down
the berm a vertical distance of 110.8' - 101.8' = 9.0' to the back of the sidewalk
along 8th Ave. This occurs over a distance 25'for a slope of 36%.
The acreage of the subject property is:
100 x 120 = 12,000 sq. ft. = 0.27548 acres
43,560 43,560
The existing impervious surfaces presently on the subject site include a larger older
house, with some concrete walks, and stairs. These impervious areas, if they are to
be removed, under the new drainage ordinance must be counted as areas of 2nd
growth woods along with the remainder of the subject site.
The existing site will be considered for purposes of determining existing runoff as
2nd growth woods or forest, with no impervious areas.
CN values for the site:
2nd growth woods or forest ........................................................................ 81
Time of Concentration for the Onsite Runoff
Refer to the enclosed map:
The runoff route consists of sheet flow from the SW property corner over lawn
105' to the top of the berm at NW corner of the lot. The runoff route then
continues from the top of berm to the back of sidewalk a distance of 25'.
The times of runoff are asIcalculated from the following:
Tt = 0.42(n SQO,8, where So slope of watercourses are 12.2/105 11.6% &
(P2) 0.5(SO)OA 9.0/25 36%
L length of watercourses are 105' & 25'
k 27 for paved areas
ns= Manning's coeff. 0. 15
P2= 2yr-24hr rainfall 1.50
Ttj = 0.42(0.15 KLO5 - 8, = 3.811 = 7.366 min
10
(1.5) 0-5(0.1 16) 0.4 0.5174
Tt2= 0.42(0.24 x 25) -8, = 1.761 = 2.164 min
(1.5)0-5(0.36) 0-4 0.8139
Tc = Ttj + Tt2= 7.366 + 2.164 9.530 min
pervious, area CN impervious area CN Tc
0.2755 81 0 98 9.53
SBUH results are contained in the back of this report.
DEVELOPED PROPERTY
The developed property will contain two single family residences, the new homes
will have 3,785 sq ft and 2,793 sq ft for a total of 6,578 sq ft or 0. 1510 ac of new
impervious surfaces:
The remainder of the site, the pervious surfaces will be lawn and landscapping
12,000 - 6,578 = 5,422 sq. ft. or 0. 1245 acres
The CN value the pervious area is 86
Tt = 0.42(nsL)0,8, and V = kNrS—o,
(P2)0-5 (so)0.4
where So = slope of watercourse = 25%
L = length of watercourse = 24'
k = 27 for roof areas
ns= Manning's coeff. 0.24
P2= 2yr-24hr rainfall 1.50
Ttj = 0.42(0.24 x 24) 1.7044 = 2.423 min
(1.5)0.5(o .25)0-4 0.703
Tt2 = 0.40 min(run in 80' of 6" yard piping)
Ttj = Ttj + Tt2 = 2.423 + 0.40 = 2.823 min
pervious area CN impervious area
0.245 86 0.1510
SBUH results are at the'back of this report
CN Tc
98 2.823
2
Detention Requirements
The added impervious surfaces are 6,578 sq ft, requiring the use of the above
SBUH analysis. The RDFAC analysis was run for a 48" pipe. The 48" diameter
pipe was chosen for its ability to provide a wet pipe design with the bottom 1.5' of
storage below the outlet invert. The SBUH analysis indicates a required storage
capacity of 403 cu ft. Using the bottom 1.5' of a level detention pipe for dead
storage leaves a live storage capacity of 8.26157 cu ft/ft.
Checking Detention Capa�JtS
The detention provided by a 48" wet pipe design with the bottom 1.5' remaining
as dead storage is 8.26 sq ft/ft. Additional storage will be provided by a 48"
Type 11 catch basin with restrictor with a live storage depth of 2.5' and a 2nd
Type 11 catch basin at the opposite end of the detention pipe with another 2.5' of
live storage. The catch basins add 2(12.566 cu ft/ft x 2.5 ft) = 62.83 cu ft. The
detention pipe will have 2 ft long 36" foot sections of CMP at each end. These
sections will each provide, with the dead storage requirement of 1.5', a live
storage of 3.534 cu ft/ft. The two 2'end sections of 36" CMP will provide a live
storage of 2(3.534 cu ft/ft x 2) = 14.137 cu ft. The storage required in the
detention pipe is 403 - 62.83 14.137 = 326.03 cu ft. A 40'length of 48" CMP
pipe will be used for the bulk of the detention requirement.
2' of 36" CMP with 3.534 cu ft/ft x 2 .............. = 14.137 cu ft
48" catch basins with 2.5' x 12.566 cu ft/ft x 2 = 62.830 cu ft
40' of 48" CMP with 8.26157 cu ft/ft .............. 330.463 cu ft
407.430 cu ft
The detention provided 407.43 cu ft is slightly greater than the 403 cu ft
required.
3
S.C.S. TYPE-lA RAINFALL DISTRIBUTION
ENTER: FREQ(YEAR), DURATION(HOUR), PRECIP(INCHES)
2,24,1.50
----------------------------------------------------------------------
S.C.S. TYPE -IA DISTRIBUTION
2-YEAR 24-HOUR STORM **** 1.50" TOTAL PRECIP.
-----------------------------------------------------------------------
ENTER: A(PERV), CN(PERV), A(IMPERV), CN(IMPERV), TC FOR BASIN NO.
'0.2755,81,0,98,9.53
DATA PRINT-OUT:
AREMACRES) _PERYIOUS IMPERVIOUS TC(MINUTES)
A CN A CN
.3 .3 81.0 .0 98.0 9.5
P,EAK-Q(CF T-PEAK(HRS) VOL(CU-FT
01 7.83 314
ENTER [d:](pathlfilename[.extl FOR STORAGE OF COMPUTED HYDROGRAPH:
8&MO02E
SPECIFY: C - CONTINUE, N NEWSTORM, P PRINT, S STOP
C
----------------------------------------------------------------------
ENTER: A(PERV), CN(PERV), A(IMPERV), CN(IMPERV), TC FOR BASIN NO. 2
0.1245,86,0.1510,98,2.823
DATA PRINT-OUT:
AREA(ACRES) PERVIOUS IMPERVIOUS TC(MINUTES)
A CN A CN
.3 ..1 86.0 .2 98.0 2.8
PEAK-Q(CFS)/,.,T-PE'AK(HRS) VOL(CU-FT)
.07 "Y'.67 924
ENTER fd:lfpathlfilename[.ext] FOR STORAGE OF COMPUTED HYDROGRAPH:
8&MO02D
SPECIFY: C - CONTINUE, N - NEWSTORM, P - PRINT, S - STOP
S.C.S. TYPE -IA RAINFALL DISTRIBUTION
ENTER: FREQ(YEAR), DURATION(HOUR), PRECIP(INCHES)
10,24,2.00
----------------------------------------------------------------------
S.C.S. TYPE -IA DISTRIBUTION
10-YEAR 24-HOUR STORM **** 2.00" TOTAL PRECIP.
----------------------------------------------------------------------
ENTER: A(.PERV), CN(PERV), A(IMPERV), CN(IMPERV), TC FOR BASIN NO.
0.2755,81,0,98,9.53
DATA PRINT-OUT:
AREA(ACRES)' PERVIOUS IMPERVIOUS TC(MINUTES)
A CN A CN
.3 .3 81.0 .0 98.0 9.5
PEAK-Q(CFS) T-PEAK(HRS) VOL(CU-FT)
.03 7.83 604
ENTER fd:][pathlfilename[.ext] FOR STORAGE OF COMPUTED HYDROGRAPH:
8&M010E
SPECIFY: C - CONTINUE, N - NEWSTORM, P - PRINT, S - STOP
C
----------------------------------------------------------------------
ENTER: A(PERV), CN(PERV), AUMPERV), CN(IMPERV), TC FOR BASIN NO. 2
0.1245..86.0.1510,98,2.823
DATA PRINT-OUT:
AREA(ACRES) PERVIOUS IMPERVIOUS TC(MINUTES)
A CN A CN
.3 .1 86.0 .2 98.0 2.8
PEAK-Q (CFS) PEAK (HRS) VOL(CU-FT)
.11 7.67 1356
ENTER [d:lfpathlfilename[.ext] FOR STORAGE OF COMPUTED HYDROGRAPH:
8&MO10D
SPECIFY: C - CONTINUE, N - NEWSTORM, P - PRINT, S - STOP
I
0
S.C.S. TYPE -IA RAINFALL DISTRIBUTION
ENTER: FREQ(YEAR), DURATION(HOUR), PRECIPUNCHES)
100,24.,3.00
----------------------------------------------------------------------
S.C.S. TYPE -IA DISTRIBUTION
100-YEAR 24-HOUR STORM **** 3.00" TOTAL PRECIP.
------- 7 --------------------------------------------------------------
ENTER: A(PERV), CN(PERV), A(IMPERV), CN(IMPERV), TC FOR'BASIN NO.
0.2755,81,0,98,9.53
DATA PRINT-OUT:
AREA(ACRES)* PE-iiVIOUS IMPERVIOUS TUMINUTES)
A CN A CN
.3 81.0 .0 98.0 9.5
PEAK-Q(CFS) /T-PEAK(HRS) VOL(CU-FT)
.08 7.83 1312
ENTER fd:lfpathlfilename[.ext] FOR STORAGE OF COMPUTED HYDROGRAPH:
8&M100E
SPECIFY: C - CONTINUE, N - NEWSTORM, P - PRINT, S - STOP
C
----------------------------------------------------------------------
ENTER: A(PERV), CN(PERV), A(IMPERV), CN(IMPERV), TC FOR BASIN NO. 2
0.1245,86,0..1510,98,2.823
DATA PRINT-OUT:
AREA(ACRES) PERVIOUS IMPERVIOUS TC(MINUTES)
A CN A CN
.3 .1 86.0 .2 98.0, 2.8
PEAK-Q(CFSY' T-PEAK(HRS) VOL(CU-FT)
.1 7.67 2269
ENTER [d:lfpathlfilename[.ext] FOR STORAGE OF COMPUTED HYDROGRAPH:
8&M100D
SPECIFY: C - CONTINUE, N - NEWSTORM, P - PRINT, S - STOP
SUMMARY "i OF INPUT ITEMS&
1) TYPE OF . FACILITY: TANK
2) TANK DIAMETER(ft), STORAGE DEPTH(ft): 4.00, 2.50
-3) VERTICAL PERMEABILITY(min/in): .00
4) PRIMARY DESIGN HYDROGRAPH FILENAME:. 8&MlOOD
5) PRIMARY RELEASE RATE(cfs): .08
6) NUMBER OF
TEST HYDROGRAPHS: 3
TEST HYD
1 FItENAME:
8&MO02D
TARGET RELEASE(cfs):
.01
TEST HYD
2 FILENAME:
8&M010D
TARGET RELEASE(efs):
.03
TEST HYD
3 FILENAME:
8&MlOOD
TARGET RELEASE(cfs):
.08
7) NUMBER -OF
-ORIFICES..
RISER-HEAD(ft),
RISER-DIAM(in): 2, 2.50,
8
8) ITERATION
DISPLAY:
YES
ENTER ITEM NUMBER TO BE REVISED (ENTER ZERO'IF NO REVISIONS ARE REQUIRED):
0
INITIAL STORAGE VALUE FOR ITERATION PURPOSES: 738 CU-FT
BOTTOM ORIFICE: ENTER Q-MAX(cfs)
0.02 Z"'
DIA.= .68 INCHES
TOP ORIFICE: ENTER HEIGHT(ft)
1.09
DIA.= 1.37 INCHES
ITERATION COMPUTATION BEGINS ...
TRIAL TANK -LENGTH STOR-AVAIL STOR-USED
PK-STAGE
PK-OUTFLOW
1
89.3
738
511
1.48
.05
2
75.6
624
476
1.65
.05
3
66.7
550
456
1.82
.06
4
60.9
503
441
1.96
.06
5
57.2
472
430
2.08
.07
6
54.7
451
423
2.17
.07
7
52.9
437
418
2.24
8
51.8
427
414
2.30
01*
9
51.0
421
411
2.35
.08
10
50.4
416
409
2.39
.08
11
50.0
412
407
2.42
.08
12
49.7
410
406
2.44
.08
13
49.4
408
405
2.45
.08
14
.49.2
406
404
2.47
.08
15
49.1
405
404
2.47
.08
16
49.0
404
403
2.48
.08
17
48.9
404
403
2.49
.08
18
48.9
403
403
2.49
.08
19
48.8
403
403
2.49
.08
20
48.8
403
402
2.49
..08
PERFORMANCE:
IN -FLOW
TARGET -OUTFLOW
ACTUAL -OUTFLOW
PK-STAGE
STORAGE
DESIGN HYD:
.19
.08
.08
2.49
402
TEST HYD 1:
.07
.01
.01
1.08
170
TEST HYD 2:
.11
.03
.03
1.21
230
TEST HYD 3:
.19
.08
.08
2.49
400
SPECIFY: D
DOCUMENT,
R - REVISE, A
ADJUST
ORIF, E
- ENLARGE,
S STOP