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21005 PIONEER WAY.PDF11111111111 12825 21005 PIONEER WAY Lot lit + 'A u "ILIeLlt-L), Nfw rwiL Lim, t77�- CA FILE NO.. Critical Areas Checklist Site Information (so'l;ls/topography/hydrology/vegetation) 1. Site Address/Location: Qiec� E(Avy(co,8s P6(,\Z6/ L-0 t 2. Property Tax Account Number: 000 — C)Q(o — 0008 3. Approximate Site Size (acres or square feet): 0. 4. Is this site currently developed? yes; — no. If yes; how is site developed? V�o,,Lse- 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: n 0 ; Approx. Depth: -- 7. Site contains areas of seasonal standing water: _V) C', Approx. Depth: What season(s) of the year? 8. Site is in the floodway (,x(-) — floodplain T) C) of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- round? 00, Flows are seasonal? — (What ti 'me of year? 10. Site is primarily: forested meadow ixed _; shrubs mi urban landscaped Qawn,shrubs etc) e)u.%,- L(_ii,)dsc_&pec1 VxC)niE!_� 11. Obvious wedand is present on site: -n 0 aylrL . Rcv0l/04(94 890.194- City of E&mon& Critical, Areas Checklist The Critical Areas Checklist contained on this form is to be filled out by any person preparing a Deyelopment Permit Application for the City of Edmondspnor to his/her submittal of a development permit to the City. The purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are or may be present on the subject property.. The information needed to complete the Checklist should be easily available from observations of the site or data available at City Hall (Critical Areas inventories, maps, or soil surveys). An applicant, or his/her representative, must fill out the checklist, sign and date it, and submit it to the City. 17he City will review the checklist, make a precursory site visit, and . make a determination of the subsequent steps necessary . to complete a development permit application. With a signed copy of this form, the applicant should also submit a vicinity map or plot plan for individual lots of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assist staff in completing their preliminary assessment of the site. I have completed the attached Critica ' I Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner / Applicant-. Nam a1605- P/ kla Street Addrew 1,JP 990Z(g 676-R5.3 City, State, ZIP Phone Applicant Representative: Nam 117601 A) k) Street Addrew �Ieaelelbjp --5-q6-2298 City, State, ZIP . . Phone # q Date Signature Date y-i C I T Y f EDMONDS SIDE SEWER PERMIT For Inspection Call 771-3202 STREET FILE PERMIT NO. 07639 EDMONDS . ky REATMENT PLANT Address of Construction: os FT Property Legal Description (Include all easements) Owner and/or Builder: ec"-�-3 6()A ++L) -S -TV\ C- Contractor & License No: 'S 'g-d-L'3 Single Family Residence RECE, VEJ) Mu.lti-Fami - ly (No. of. Units JAN 2 9 1987 Commercial (No. of fixture Units PUBL'C WORKS., Invasion into City Right -of -Way: No Yes (If Yes, Right-o'f-Way Construction Permit required. Call One -Call -Center (1-800-424-5555) before any excavation.) Cross other Private Property: No Yes (If Yes,easement required, attach legal description and county easement number.) PLEASE READ THE ITEMS LISTED ON THE BACK I C6-rtify tRat/�l a e read and shall comply Date with the iteWi.isted on the back. Pe'rmit Fee: issued By: Trunk Charge: Date Issued: Assessment.Fee: Receipt No.: Partial Inspection: Comments, Date Initial Qr7 Final Inspection Approved: Date Initial 00 Rejected: -5-a t -e"� -1 n i -ti a 1 Reason PERMIT MUST BE POSTED ON JOB SITE Wh.ite Copy File Green Copy - Ins,pector Buff Copy Applicant AL %� 4� The City of Edmonds Side Sewer Drawing EASEMENT NO. - ......................................... - . NEW CONSTRUCTION % REPAIRS 0 LID NO - ------------------ ASMT. NO - ------------------ OWNER ----- "-Qt--,ss ------ lt4r - ------------------ CONTRACTOR PERMIT NO. JOB ADDRESS -2.1.0-0.5 ------- -------- LEGAL DESCRIPTION: LOT NO . ...... 6 --------------------------- BLOCK N ------- f-DM(-)T4DS --------- (19 --- 9 TREATMENT PLANT ................................................................................................... ----------------------- - ..... NAME OF ADDITION PLAU ------- OS Z- Exe-.P�,- -o.<)r-> -------------------------------------------- P \,AIA:l I OP 1.5,0p. 8,0P 4:' T.T. 2W 'CUP13 WhAF- I -Pl 0 1-4 c F- R \pj &,y Approved: PWW-0001 -11175 (REV. 11/78) DATE��.O .�..198.7... By I- - - ------------------------ CITY OF EDMONDS ASSET INFORMATION SHEET VNEW 1-1 ADDITION El RETIREMENT ASSET NO. ADDITION TO ASSET NO. DESCRIPTION ZI 7 e 0,V SERIAL NO. LOCATION DE T NO PURCHASE ORDER NO. PURCHASE ORDER DATE COST 0 *PROJECT NUMBER PROJECT COMPLETION DATE COST B.A.R.S. ACCOUNT NO. ESTIMATED LIFE INITIATED BY DATE APPROVED BY "SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE- OF PROJECT ACCOUNTING ONLY JXDEPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT G.L. ENTRY REFERENCE DATE VERIFIED BY PROCESSED BATCH NO. - itnp INITIA DEPARTMENT FILE CITY OF EDMONDS BUILD114G., 250 STH AVENUE NORTH, EDMONDS, `WA 98020 (206) 771-0220 IF RCW 197-11-970 Determination of Nonsignificance (DNS) "ry Cz= CITY1 DETERMINATION OF NONSIGNILFICANCE - Description of proposal: Second -story addition to single family residence totaling approximately 900 square feet, with no change in the footprint of the existing building. (City of Edmonds Building Plan Check No. 94-85STREETFILE Proponent: MaryJo and Jeffrey M. Sakoi Location of proposal, including street address if any: 21005 Pioneer Way, 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 .1994. Responsible Official: Jeff Ley S. Wilson Positioriffitle: Current Planning Supervisor, Department of Community Services - Planning Division Phone: 771-0220 Address: City of Edmonds, 250 5th Avenue North, E4mon&, WA 98020 Date: Eb, f-t Signature-.�_�� XX You may appeal this determination to Robe Chave, Planning Manager, at 250 5th Avenue North, Edmonds, WA 98020, no later than QV Iq 1994, by filing a written appeal citing the reasons. You should be prepared to make specific factual objections. Contact Jeffrgy S. Wilson to read or ask about the procedures for SEPA appeals. XX Posted on R"�v 1994, 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. Page I of 2 Mailed to the following along with the Environmental Checklist: xx Department of Ecology Environmental Review Section P.O. Box 47703 Olympia, WA 98504-7703 x x Maryjo and Jeffrey, Sakoi i(Applicant) 2 1005 Pioneer Way Edmonds, WA 98026 xx Ron D. Johnson 19601 23rd Avenue N.W. Seattle, WA 98177 JEWLI =t5.1 %W Critical Areas Determination # CA-94-67 Environmental Checklist PC: Building Plan Check No. 94-85 SEPA Notebook Robert Chave, Planning Manager Page 2 of ((PUB fj)IZN/(((DATR))PWA MEMORANDUM CITY OF EDMONDS PLANNING DIVISION 250 STH AVENUE NORTH, EDMONDS, WASHINGTON 98020 TO: BUILDING DEPT. PLAN CHECK NO. 94-85 FROM: Ann Bullis, Code Enforcement Technician.r.\/C1___1 <_Z�� k . DATE: MAY 2,1994 SUBJECT: ENVIRONMENTAL DETERMINATION FOR A SECOND -STORY ADDITION FOR A SINGLE FAMILY DWELLING AT 21005 PIONEER WAY, EDMONDS, WASHINGTON I have had the opportunity to visit the subject site, review the environmental checklist, and Critical Areas Determination, a copy of which are filed in the official file for this permit. The proposed project will not create a significant impact on the environment as the proposed second -story addition will be constructed within the footprint of the existing building. There is no tree removal proposed, nor any grading. The project should have an insignificant impact on the racoons and songbirds noted to be occasionally seen on site. Based on my review of all available information and adopted policies o f the City, I recommend that a determination of nonsiznificance, be issued. Review by Responsible Official: Iconcur I do not concur Comments: -T/q "k Jeffirey S. Wilson, AICP Date Responsible Official - Attachments PC: FILE NO. 94-85 Robert Chave, Planning Manager Page 3 of 2 'y go - 199 - Purpose of Checklist: CITY OF EDMONDS REE C ENVIRONMENTAL CHECKLIST APR2.5 191911 PERNONT 00! tprat-r 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. Instructions for 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 an 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 Z answer the questions from your own observations or prqlect 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 problems, 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 answers or provide additional information reasonably related to determining if there may be signific'ant adverse impact. Z Use of checklistfor nonproject proposals: Complete this checklist for nonprqleci propo%als, even though questions may be answered *does not apply." IN ADDITION, Z 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 of proposed'prqiect, if applicable: Jj.J . A 2. Name of applicant: ()Jov1,,J Tr, 4 Tjffrc-k�l MCI -VC- 5-QkC.L'- 3. Address and phone number of applicant and contact person: CILOW ' 01ONTO i T�Ae,4 M -WCOL' (C--K�1-15�) A Yelti V-J kcil b�Jchnson (5q�.-2?801 I C, Q 9 P 4. P er IkkA "i .23"'-L Ak;CQU-) 4. Date checklist prepared: 4 1119 � Pa.-e I of 22 C1 IKLT/I 0-25 -93.M ASTER 5. Agency requesting checklist: City of Edmonds. 6. Proposed timing or schedule (including phasing, if applicable): UfAMN "AMOMIM&F (STAFF COMMENTS) 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. 06 (STAFF COMMENTS) 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. H&Ye- Vkak V" Kk-- n-,Ob�WA -x- Gf-fh'Cat arpzct.-'�' an (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. "e arn ai-wrp— (STAFF COMMENTS) 10. List any government approvals or permits that will be needed for your proposal, if known. (STAFF COMMENTS) Page 2 of 22 CHKLT11 0-25-93.M ASTER 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 answers on this page. k)q- (7f& I() a6d a z"- ft� Cis( ty-k JrinQ h�-,foe p f--eCvc C1. . KCUV�C-�- V, V1 CL cc, 11:5 1 -5 �- c' (STAFF COMMENTS) 12. Location of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, and section, township, and range, if known. If 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. Our q P, 6, 21. (STAFF COMMENTS) TO BE COMPLETED BY APPLICANT B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description or the site (circle one): Flat, "I hilly, steep slopes, mountainous, other: ftlo hoe iCk pollfrt_ 40tl5t :s / 't5 fhz hez(.-Ic- 9,4 -1he Vrj -d/-s -'7nere f-10 Z lin-5 a, rv,- eua U hcult In hin d /hoa (STAFF COMMENTS) b. What is the steepest slope on the site (approximate percent slope)? Ltp (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. Page 3 of 22 C1 1KLT/1 0-15-93.M ASTER -67ravd.(H. --5--LndLi iogim (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. Nona- Ry-opc5q& -b O'e�� V (STAFF COMMENTS) f. Could erosion occur asa result of clearing, construction, or use? If so, generally describe. K0 dVV'wqqq'C- voi\� ba, -MMe -M Jne- 1&t ek-S a resvl-kv C� J tj --'hot- (STAFF COMMENTS) g About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? ni cpv-e,(ed IL tAJM -AOA- 0��(MqR- CIUC- b tkC- oiLTAsmwJimn. IV,,t o.ufrenk- C'A, -Yy\la�' �)t hq Ae �Anmo- , HYWe\,,od-U t cykhL*� 30"Zo P to (STAFF COMMENTS) Pap 4 of 22 ClIKU/10-25-91MASTER h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: MOY161- �2yQqo-,Wd (Ai JLQ Vo Ae, -"Okure- 4 �Vt,--Pct (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. ej rL- -2yd- (STAFF COMMENTS) h. Are there any off -site sources of emissions or odor that may effect your proposal? If so, generally describe. (STAFF COMMENTS) C. Proposed measure; to reduce or control emissiows 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'. (STAFF COMMENTS) ' Page S of 22 CIIKLT/10-25-93.MA.STER (2) Will the prqiect require any work over, in, or adjacent to (within 200 feet) the described waters? If yes, please describe and attach available plans. Wo K/A bnec; ct p1p (STAFF COMMENTS) (3) Estimate the amount of rill 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 rill material. Mone. / N LA \"bce� -nm- (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-yearnoodplain? 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) Pap� 6 of 22 CliKLT/10-25-93.MASTER b. Ground: (1) Will ground water he withdrawn, or will water. be discharged to ground water? Give general description, purpose, and approximate quantities if known. (STAFF COMMENTS) (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 chernicalsi...; 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. we- have- a--Wplaz� .6ml )�j L fnyc� tile (STAFF COMMENTS) C. Water Runoff (including storm water): (1) Describe the source or runoff (including storm water) and method or collection and disposal, ir any (include quantities, ir known). Where will this water flow? Will this ,-%v.tterno,vintot)ther,.v.iter.%? ir.so,descrihe. No acki0lonal 0-L-k(te-01 'yun-OK dMALS, ip-iatvl f-y-c"rit- 10-r OA& ,'rl tu C, t hi d ra(wq2 gy-a les. (STAFF COMMENTS) (2) Could waste materials enter ground or surface water,%? If so, generally describe. (STAFF COMMENTS) Pa�-c 7 of 22 CUKU/10-25-93MASTER d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: -wona, pyt�j?�d Akk Ac� -Ae- n\nhual-0- rd- 46. py'ocej 'N (STAFF COMMENTS) 4. Plants a. Check or circle types of vegetation found on the site: J(AndsCaKd V\tme-4 deciduous tree:<�� maple, aspen, other: 'jhVaVV.% MLkDk-- evergreen tree:( 311 (ee:da?, pine, other: cLjpj'nL. 4 bjo�--ck shrubs '�i,olecd -6,Y- lunscapad, �Xny VIA I I —A Lir V�bufflktlm C-4c 1. J, j grass pasture crop or grain wet soil plants: cattail, buttercup, hulriLsh, skunk cabbage, other: water plants: water lily, eelgrass, milfoil, other: other types of vegetation: (STAFF COMMENTS) b. What kind and amount of vegetation will he removed or altered? �jo n a- - D.0 ry m nvcd b y- a Vi ro �k t--Y\ (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: Pige 8 of 22 CHKLT/10-25-93.MA.VTER (STAFF COMMENTS) 5. Animals W Win, F01110 0 a. Check or circle any birds 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, 414 �n�ghir other: iuvir"d -tr- E-Afflfms V11 (clMa-Ama. mammals: deer, bear, elk, beaver, other: fish:. bass, salmon, trout, herring, shellfish, other: (STAFF COMMENTS) b. List my threatened or endangered species known to be on or near the site. . t'b na-, (STAFF COMMENTS) C. Is the site part or a migration route? If so, explain. tl�o — MA thIn E C' VY\ I -A I JA (STAFF COMMENTS) d. Proposed measures to preserve or enhance wildlife, if any: . �;nfia - (STAFF COMMENTS) 6. Energy and Natural Resources Page 9 of 22 C1 IKLT/ 10-25-93A ASTER a. What kinds of energy (electric, natural gas, oil, wood stove, solar) ' will be used to meet the completed project's energy needs? Describe whether it will he used for heating, manufacturing, etc. Oluryenf- Viaahng �-,. yiniumf qq5 w3k YmcLin naluad :J Q-C;OrIC 1(4 UM d- �6y � Lq�t +1 liq i a lk-, (STAFF COMMENTS) b. Would your project affect the potential use of solar energy by actiacent 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 me;Lsures to reduce or control energy impact,;, if any: Meng, (STAFF COMMENTS) 7. Environmental Health a. Are there any environmental health hwzrds, including exposure to toxic chemicals, risk of * fire and explosion, spill, or hayardows waste, that could occur as a result of this proposal? If so describe. N (STAFF COMMENTS) Page 10 of 22 CHKU/10-25-93MASTER (1) Describe special emergency services that might he required. (STAFF COMMENTS) (2) Proposed measures to reduce or control environmental health ha7ards, if any: (STAFF COMMENTS) b. Noise (1) What types of noise exist in the area which may af fect your prqject (for example: traffic, equipment, operation, other)? (STAFF COMMENTS) (2) - What types -and levels of noise would he 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 from the site. 'Tlnit�t ft�- k.e.. (k cc �v� raf! - Al 1 �5 Y-t T) �j _M1 ho I ( Kf_1 14 CC'-,M- IYU C h,-*-.:V-\ �2 Y'C;bu . b�,'j uoo( bq- fyc-rn (STAFF COMMENTS) (3) Proposed measures to reduce or control noise impacts, if any: (STAFF COMMENTS) Pige I I ol'22 C1 1K LT/ I 0-25-93A A.vr[:R 8. Land and Shoreline Use a. What is the current use of the site and a4jacent properties? (STAFF COMMENTS) b. Has the site been used for agriculture9 If so, describe. No nc+- +ha+- T'w) niiyirer�- (STAFF COM N1 ENTS) C. Describe any structures on the site. Our- ex.1st-09 . I&- lsfpw- Y-Omb)Gir 64ackua- qaocy CL.rd 0 (STAFF COMMENTS) d. Will any structures he demolished? If so, what? (STAFF COMMENTS) e. What is the current YA)ning classification of the site? (STAFF COMMENTS) CIIKLT/10-25-93.MASTER Page 12 of 22 f. What is the current comprehensive plan designation of the site? kOLA-) &A5itk4 .-re--51 aq-n �A (STAFF COM N1 ENTS) g. If applicable, what is the current shoreline master plan designation of the site? - Wof- --N-0c;e's -Ylp� (STAFF COMMENTS) h. Has any part of' the site been classified as -.in "environmentally sensitive" area? If so, specify. -X9, S 0, 1's t., n k i A 6 i, Q 11 G e CL a : 5 1 z --k V -v "! C', z C, f -, ey. (STAFF COMMENTS) i. Approximately how many p6)ple would reside or work in the completed proJect? -OjMr �C,Y'nl :Z 6�vdks Hovo fLJ1,i t rA A rA (i (A K, n (STAFF COMMENTS) Approximately how many people would the completed pn)Ject displace? (STAFF COMMENTS) Pa�-C 13 of 2) ClIKU110-15-91MASTER k. Proposed measures to avoid or reduce displacement impacts, if any: tQ 144 (STAFF COMMENTS) 1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: I&W11 ri = irl &S nL --5jV1q)e— -ktM1JSJ re-5 � CieVVL, (STAFF COMMENTS) 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income howsing. ouy hcma— '5& yyi e cas-auy-(ey)A-�.�:( emst'5 (STAFF COMMENTS) b. Approximately how many units, if any would be eliminated? Indicate whether high, middle, or low- income hotLsing. (STAFF COMMENTS) C. Proposed measures to reduce or control hotLsing impacts, if any: na- 1-� I A (STAFF COMMENTS) Pige 14 of22 C1 IKLT/10-25-93.M ASTER 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? 04VA4/iQ /q4 Y4 + cve,- +11C ex Ist-aNg 'huQ Y\t-, ?f wc f12 1�� ey VI 'I'cy- �M--, ayvi v�M ll(-,- fl,�nna J (STAFF COMMENTS) b. What views in the immediate vicinity,%vould be altered or obstructed? . - Mong, (STAFF COMMENTS) C. Proposed measures to reduce or control aesthetic impacts, il'any: Mt-.00. N /A (STAFF COMMENTS) If. Light and Glare a. What type of light or glarewill the proposal produce? What time of day would it mainly occur? b IA Ot, e S Y\ L-,r- a (STAFF COMMENTS) b. Could light or glare from the finished project be a safety ha7ard or interferewith views? (STAFF COMMENTS) Page 15 of 22 CI IK I.T/I 0�25-93. M A.WEIR C. What existing off -site sources or light or glare may affect your*proposal? Nona- Q pal (STAFF COMMENTS) d. Proposed measures to reduce or control light and glare impacts, if any: Nona. POW (STAFF COMMENTS) 12. Recreation a. What designatedand inrornial recreational opport unit iL-; are in the immediate vicinity? (STAFF COMMENTS) b. Would the proposed proJect displace any existing recreation uses? If so, describe. (STAFF COMMENTS) C. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the pro.ject or applicant, il'any: beCS nnt-'t ckppl�j (STAFF COMMENTS) Page 16 of 22 CUKU/10-2.5-91MASTER 13. Historic and Cultural Preservation a. Are there any places or obJects listed on, or proposed for, national, state, or local preservation registers known to be on or next to the site9 If so, generally describe. (STAFF COMMENTS) b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to he o*n or next to the site. -Nonc, (STAFF COMMENTS) C. Proposed measures to reduce or control impacts, if any: Nkmv- h3 1A (STAFF COMMENTS) 14. Transportation a. Identify public streets and highways serving the site, and describe proposed access to the existing street system. Show on site plans, if any. WQ- k, ;,e- on h6vigar V�hq rad �iovt a I fl� I t ---M,C5 03W ---AL+ dk(AMV �-'-N'yo li�e CarreAi- a (STAFF COMMENTS) b. Is site currently served by public transit? If no, what is the approximate distance to the nearest transit stop? tc� r) iAs S I-o 12 Page 17 of 22 C1 1K LT/1 0-2.5-93. M MaER (STAFF COMMENTS) C. How many parking spaces would the completed project have? How many would the project eliminate? (STAFF COMMENTS) d. Will the proposal require any new roads or streets, or improvements to existing roads or streets, not including driveivays? If so, generally describe (indicate whether public or private). No (STAFF COMMENTS) e. Will the- project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. KI (STAFF COMMENTS) f. How many vehicular trips per day would he generated by the completed project? If known, indicate when peak volumes would occur. ce'lf C(AMN &Ux�kk-C4 - 20( 3. No V1 C4 f rOYY\ -J (STAFF COMMENTS) Page IS of 22 C1 M LTI 10-25-93. M AS i'17R g. Proposed measures to reduce or control transportation impacts, if any:- �40nq_ "18 n6ocs. --Y1C'1rCuMV1 (STAFF COMMENTS) 15. Public Services a. Would the project result in an increased need for public services (for example: fire protection,. police protection, health care, schools, other)? If so, generally describe. No (STAFF COMMENTS) b. Proposed measures to reduce or control direct impacts on public services, if any: t'�Z)Ad 48 (STAFF COM NI ENTS) 16. Utilities a. Circle s currently available at the site: �l Dtricit , 6 Eat u�jl ivait e �r Ce C—ep --h o n e septic system, other: (STAFF COMMENTS) Pa.-e 19 of 22 OWLT/10-TO3.10ASTER b. Describe the utilities that are proposed ffir the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity which might be needed. - N6 cha%os im q-< %�i v i'aq i AWWhe-s nairerAq nualb-LL-i - (STAFF COMMENTS) C. SIGNATURE The above answers are true and complete to the best of my knowledge. I understand that the lead agency is relying on them to make its decision. Si -nature of Proponent 0 -*- 4 /2 5-ITA - Date Submitted K Page 20 of 22 C1[KLT/10-25-93.MAS-rER J V CAFILENO.. Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: 9i(�-(­*-, 0 'Tq 16 0, - 0 (-) 0 - 0 o (0 oc) 8 2. Property Tax Account Number: C) 3. Approximate Site Size (acres or square feet): 4. Is this site currently developed? __��_yes; no. If yes; how is site developed? 5. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. X 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: f) C, ; Approx- Depth: 7. Site contains areas of seasonal standing water: f) C-1 Approx. Depth: What season(s) of the year? 8. Site is in the floodway 1-\ c floodplain n L of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- round? n C, Flows are seasonal? — (What tii ne of year? 10. Site is primarily: forested meadow ;shrubs mixed urban landscaped (lawn,sbrubs etc) e)u tr to 11. Obvious wetland is present on sit e: Y) 0 withiddesi&a Pail Site desiknk6d 6n the Eji,� bEirERMINATION"'.- &AWL. .. . ..... . WA-i 'STUDY -REQ1JrRF�D. CONPITTONAL WAIVER:�*.:. V1 WAIVER Re*viewed by AR Plarm*er Date R-0110"4 -890-199- City of Edmonds Critical Areas Checklist 'Me Critical Areas Checklist contained on this form is to be filled out by any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of a development permit to the City. Tbe purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are or may be present on the subject property. The information needed to complete the Checklist should be easily available ftom observations of the site or data available at City Han (Critical Areas inventories, maps, or soil surveys). An applicant, or his/her representative, must fill out the checklist, sign and date it, and submit it to the City. The City Will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessaryto complete a development permit application. With a signed copy of this form, the applicant. should also submit a vicinity map or plot plan for individual lots of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant shall include other pertinent information (eg. site plan, topography map, etc.) or studies in conjunction with this Checklist to assist staff in completing thew preliminary assessment of the site. I have completed the attached Critica ' I Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill. out the appropriate column below). Owner I Applicant: Mar�To A, 24-Hrev Nam am5- Pluneer Street Addrew Applicant Representative: ,o�oln oroAns-cl? Cae-e 4 / /cc Nam -d AJI Shvet Ad&= �5,Z6,elel 99,07-4, 676-1-�53 City, State, ZIP Phone - City, State, ZIP Phone Date gigakur� Date Signattme ---------­---------- NIt cri. .1 O'bb yn!Lo e) _vr� al ul J09N4 mi-lv olmt tONEE Ad = I LOT P�?. Mal 5�11-D , 10 FILI�7 V._ I.P V, r-5-7 AVmArz Hr-j(-4jT UA l'-w Hei4w *-7F51 A(--WAL� fw&HT 9rREET FILE C ITY OF EDMONDS "'ERS--0 E PERMIT NUMBER C1�9 CONSTRUCTION PERMIT APPLICATION jos I SUITE!APT a ADDRESS OWNER NAME NAME OF BUSINESS GAL DESCRIPTION CHECK SUBDIVISION NO LID NO (nor"I Z-0 A i ul MAILING ADYHE55 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Appro ved 0 RW Permit Required 0 r g i Dog %'o ',e e r W 0- CITY ZIP TELEPHONE NUMBER EXISTING REOUIRED DEDICATION — PROPOSED Street Use Permit Req'd 0 inspection Required 13 Sidewalk Required cc W N. Ai EE� LINE SIZE NO. OF FIXTURES PRV �EOUIRED ,NO YES�d 9 16 ADDRESS -Z 3 REMARKS I Cl V) `I, Z a: W w cr ZIP TELEPHONE NUMBER 4 CITY Z 0 Z NAME cc ADDRESS 0 ENGINEERING MEMO DATED REVIEWED BY 0 — NE NUMBER < CITY ZIP TELEPHO cc 0- Z 4?q61Z(, 7 -4 L/ REVIEWED BY FIRE MEMO DATED W 0 -Edino-nds I(m-6) DATE STATE LICENSE NUMBER EXPIRATION . . I PR if!�'7-6 0?057 SIGN AREA DROPOSED SEPA REVIEW COMPIETE EXEMPT AD�� include all easements ALLOWED SHOR Legal Description of Property - 4 Z 0� EITP�h I 2 cc -fn VARIANC (�P)NJW.BY V DATF/ ezy L Lu Ij SETBAC F ET fSID3EK7REAR ZjrL�?" H GHT, L LOT Of RAP(V 0/n Z Z < ow FRONT t ,2 Z 4 Property Tax Account _+4 80 - 000 - 00(c - ows Parcel No. Pul Li NEW L0 RESIDENTIAL PLUMBING ADDITION COMMERCIAL MECHANICAL APT.BLDG. SIGN KIJI.REMODEL GRADING FENCE FT) CY EIREPAIR — DS ( X_ WOODSTOVE DDEIVIOLISH SWIM POOL INSERT HOT TUB/SPA GARAGE RETAINING WALL/ RENEWAL CARPORT ROCKERY TTYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: (e5j a 0 r% k I' at NUMBER CRITICAL OF' AREAS STORIES NUMBE R DESCRIBE WORK TO BE DONE (ATTACH ILV I -PLAN) A,z�, 2 141 rij ti f 5.4, u), th 1 6 /5t i(,vel_ PE OF 5THUQIIY ,HECKED BY ITY N 01!21 I , , 27 L 9�;� SPECIAL INSPECTOR OCCUPANT REQUIRED 13 1 X' LOAD PROGRESS INSPECTIONS PERUBC 305 FINAL INSPECTION REQUIRED fflpfflmfflm� VALUATION PLAN CHECK FEE BUILDING I'a 37/ HEAT SOURCE: GLAZING % f) Reg) Plan Check No. t 94 MECHANICAL GRADINGIFILL This Permit covers work to be done on private property ONLY. Any construction on the public domain (curbs, sidewEllks drivgways, marquees, etc.) will require separate permissio�. STATE SURCHARGE Permit Application: 180 Days STORM DRAINAGE FEE Permit Limit: 1 Year - Provided Work is Started Within 180 Days ENG, INSPECTION FEE 11 Applicant, on behalf of his or her spouse, heirs, assigns and see� S U ccessors in interest, agrees to indemnify, defend and hold Lv' harmless the City of Edmonds, Washington, its officials, JJ S employees, and agents from any and all claims for damages of cc whatever nature, arising directly or indirectly from the Issuance 4 not be deemed to Issuance of this permit shall PLAN CHECK DEPOSIT of this permit. modify, waive or reduce any ri equirement of any city ordinance 0 nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE .provision." mo�� 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 the 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 ONLY THE signed by the Building Official or his/her ed thereby, no person will be employed In violation of the Labor WORK NOTED Deputy; and fees are paid, and receipt is Code of the State of Washington relating to Workmen's Compensa- acknowledged in space provided. tion Insurance and RCW 18.27 INSPECTION DEPARTMENT OF it IA $1 NATURE DATE SIGNATURE (OWry­ER OR AGENT) DATt: SIGNED � 511t CITY OF EDMONDS CALL FOR ELEA DATE 7, ATTffNT10N INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 � ORIGINAL — File YELLOW — Inspector UNTIL A A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC PINK — Owner GOLD — AssesVr CHAPTER 3. PRWECT 1071EW PRa=P NI�Wt Pra7wr ADDRtSS: AM APPLICAT IPT DATE I -Reviewed by: (ifiitial/daFe-) COMA�2m PLANNING WTR/SWR I STREET ENGNRNG -fl-R-E BUILDING [777/7777 //T///77// SINGLE FAMILY/MULTIPLE/W&ERCIAL (Circle One) ////// ///////// ///////// 1 -�-i S %am 7T/7-1/// //////// VARIANCE/SETBACK ADJ. .77T7TR77-1117111 TRI111111 - CONDITIONAL USE PERMIT TfM7111 ////7777 /F/-/-/-//-/77 .:ADB R=REM1MS CHEImm MW ZONING REQUIREMENTS 7T/Tff -T-3 ENVIRONMENTAL FEATURES 7 /P 6 777177 ACCESS SLOPE & VEHICLE ACCESS r DRhn#= PLAN (On Sitei '77FIT-UT111117 P711111 7 //////. ///////// //////// STREET FILE /////// 777717,777-17TT71-7 LEGAL DESCRIPTION V 1IN11111 -111117TITTrIT1711 QUIT CXAIM/DEDICATICNS /97 1111IT77TF1777T 10 EASEMENT - PUBLIC/PRIVATE 11 qMGMTE SEWER Ca4NECTION IF LID# 12 111117TI77TIT7171 PLAT/SUBDIVISICN REQUIREMENTS 13 RIGffr-OF-WAY CONSTRUCTION PERMIT REOD P0 14 7777777TI-WIl BOND REQD FOR PUBLIC IMPROVEKDM A0,0�� ////// ///////// 7TT77777 7777777 15 SOILS CONDITIMS & GROUND 7T7Tff 7777777T ////// ///////// ///////// / 111Uh 16 WATER FIETD CHECKED 71RII STREET PAVING REQUIRED ////// 7.77774 -,A1;fr -77^ TFITITTR7 17 CURB AND GUTTER REQUIRED 7T17T777- 18 SIDEWALK REQUIRED -7 19 I / 7 7 7 7 7 TTF17TIT Tff ff 77 77 CURB CUr MR DRIVEWAY RMD 7TT17= 20 7TR11111 21 STREET NAME SIGN REQD 777T/7 7711////// OTHER SIGNING REOD 22 SIDE SEWER AVAILABILITY 7 7 T1 TM TF1 TT= 23 24 EaSTING WATER MAIN SIZE 777T///// 7777TI1111 25 WATER METER SIZE VRTI/ 77TI7777 SERVICE LINE SIZE 7/777777 26 ///////// 27 HYDRANT REQUIRED 771,171 7TI-111111 ////// ///////// 28 qr SIZE M(ISTING 777777 77TRIIII 7TFfMT 7M 7 7 7 7 7 7 CROSS CONNECTION INSPECTION REM TTF1-1 7797 29 30 WATER METER CHARGE REM 77f[///// 77TMI171 FIRE LINE CHARGE REM SPRrNKLER ///////// 1//////// //////////131 W/W// ///////// 32 STRELV CUP T17711111 171711 OPEN DITCH EXISTING 7TrT= 33 34 REOD V1711 CULVERT PBQD TMR77 71/////// 35 SIZE 777711111 7TM7111 36 777T/T CATCH BASIN REOD Wfl/Mg 7T[TTF7T 7r/T= 37 - 11MICATED ON SITE PLAN ...................... .. . 38 Sf�UR FDIA��= �P"� HUMMON 39 SHALE OPEN RUNOFF -ITF177TF 40 ��ZREV333= By: ING MaR. ----§TG-IMRING PUBLIC PLANN MGR WORKS MG4. wk CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION NAME (OR NAME OF BUSINESS) ea(o o6S Ne's V1 Q, MAILING ADDRE S -7 z.,) CITY TELEPHONq NUMBER 1Se_&tGe_ 779--2-30 NAME �� U VA 70DRESS � � (, 0 CITY TTELEPHONE NUMBER �Se ��44 u a-a-Ve NAME �S eA�,) Z) 6 ADD13 S 7 ��s , -,�- CITY TELEPHONE NUMBER Se.c_#(e- 1 7-�:i;-734,j STATE LICENSE NUMBER A:�; 6 C_D Legal Description of Property - Include all easements (show below or attach four copies) NEW RESIDENTIAL PLUMBING ADDIALTER COMMERCIAL MECHANICAL 1:1 REPAIR El RETAINING WALL SIGN DEMOLISH EXCAVATE El OR FILL FENCE ( x-FT) PRE -MOVE INSPJ SWIM REMODEL COMPLIANCE INSP. POOL WOOD STOV6 INSERT APT.BLDG El RENEWAL 5 NUMBER OF STORIES NUMBER OF DWELLING 1UNITS NATURE OF WO KTO EDO E(ATTC 11 N A H PLOT PLAN) W L e-S &I -e-Al-T I USE 'qIWPERMIT ZONE 67 ,/ NUMBER JOB ADDRESS QjCC,5 ep 6) 1 Z—&l -.00, PUBLIC RIGHT6FUY PER OFFICIAL STREET MAP. EX REOUIREDDEDICATfON RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED toe'00" STREET USE PERMIT REQUIRED 0 SEJA�ERINGAEMO DATED RQJARKS if METER SIZE BUltDLOG SUPPLY SIZE FIXTURE UNITS REMARKS SIGN AR EA ENV. REVIEW ADB NO. ALLOWED I PROPOSED COMPLETE I EXEMPT I SHORELINE# VARIANCE OR CU IPLANNING REVIEW BY r YARDS HEIGHJ I LOT COVEOFAGE '7 -' I FROM __5 ' SIDr7-' � rAR lzs CHECKED By ITYPE OF CONSTRUCTION REQUIRED 0 YES 0 NO PLAN CHECK FEE BUILDING PLUMBING MECHANICAL This Perm * It covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. _�ermit STATESURCHARGE Application: 180 Days ENERGY CODE Permit Limit: I Year - Provided Work Is Started Within 180 Days "Applicant, on behalf of his or her spouse, heirs, assigns and ,n successors In interest, agrees to Indemnity, defend and hold funj harmless the City of Edmonds, Washington, its officials, m employees,.and agents from any and all claims for damages of < whatever nature, arising directly or Indirectly from the Issuance X of this permit. Issuance of. this permit shall not be deemed to PLAN CHECK DEPOSIT a 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 provision." I hereby acknowledge that I have read this application; that the Information given Is correct; and that I am the owner, or the duly ATTENTION authorized agent of the owner. I agree to comply with city and THIS PERMIT 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 Code of the State of Washington relating to Workmen's Compensa- WORK NOTED tion In5u.rance.. INSPECTION DEPARTMENT CITY OF EDMONDS SIG OURE WN ZROFQ�" �;Vo 14 �j DATE SIGNED —� k, / I OKI GROUP VALUATION E-11 FEE HEIGHT OCCUPANT LOAD APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his Deputy; and fees are paid, and receipt is acknowledged In space provided. OFFICIAL'S SIGNATURE DATE 771-3202 RELEASED BY: DATE ATTENTIQV� IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEWMADE AND APPROVAL (DR JU[. ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 8 RECID CHAPTER 3. PINK — Owner GOLD — Assessor 102-78 cr LU W Z 0 Z LU M Uj 3: 0 Z Z Z 5 a Z a _j D M July 24, 1986 mEMO TO: Building Division FROM: Engineering Division SUBJECT: After review of the subject building permit application, we have the following c=ents: 1) Connection to City water system required. 2) Connection to City sanitary sewer system required. 3) Right-of-way permit required for any work on City property. 4) Driveway slope.not to exceed 14%. 5) Back water valve required if downstairs plumbing is below elevation of upstream manhole. 6) Water and sewer lines to be separated by 1 0 foot minimum. 7) Builder/owner responsible for containing all temporary runoff and erosion on site and may not impact neighboring properties.in any I BLDGREVW/T=RMS ,q do EN ­ Al v ............. EWA' HEj( o�iT