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21120 86TH PL W.PDF111111111111 8245 21120 86TH PL W 8 9 0 . 199 — FsI rn City of Edmond's ILIL Am_. &WHT-OF-WAY CONSTRUCTION PERMIT Permit Number: :� 3 — z 4G\(X to"<,> Issue Date: � -d 7- Z3 - 141P4 , 2;� A. Address or Vicinity of ConJel4on: 21120 86 P1. W. (9�13732) B. Type of Work (be specific): ' Install New Service C. Contractor: Washington Natural Gas Co. Mailing Address:815 Mercer St.Seattle, Wn. State License #: Contact: Frank Swan Phone: 224-2278 Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. , F] Commercial El Subdivision F1 City Project V Utility (PUD, GTE, WNG, CABLE, WATER) F-1 Multi -Family El Single Family F� Other INSPECTOR: INSPECTOR: "AW-A F. Pavement or Concrete Cut : ff] Yes E]No G. Sizeofcut:(1)2 x 4@WaterH. Charge$ APPLICANT TO READAND SIGN INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless)ror miuries,, damages, or claims of any kind or description whatsoever, foreseen or unforeen, that may be nuide against the City of Edmonds, or any of its departments or employ- ees, including or not limited to the defense of any legal proceedings including defense,,qosts attorneyfees by reason of gria'fnting'this�'�ermit. ,�;ajd THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP AND MA TERIALS FOR A PERIOD OF ONE YEAR FOLLO WING THE FINAL INSPECITON AND ACCEPTANCE OF THE WORK ES77MATED RESTORA77ON FEES WILL BE REiD_EWqL THE FINAL STREET W.GyfS G PLETEDBY f CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. ;0t, Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Departmrftl�15,,111_1_ Work is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Trafri,c,,C,Ontrol,,and�Public-Safet,rshall'h6'i'n—a'ccordance with City -reju-lations as required by th e - City Engmieer. All st . reet cut ditches shall be patched with asphalt or City approved material prior to the enii of tl�'w'or'ki_n_g-_d'ay; NO'EXCEPTIONS. I have read the above statements and understand the permit requirements and the pink copy of the permit will be available on site at all timesfor inspection purposes. Signature: � Date: April 15, 1993 (Contractor or Agent�..�17_` t2g CALL DIAL -A -DIG PRIOR TO BEGINNING WORK NO.WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 FIELD INSPECTION NOTES Comments: Diagram: M (Fund I I I - Route copy to, Street D ep t. a CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. July 1985 Addendum to City of Edmonds Right of Way Permit Application Submitted by: GQ"'4L.&- CowQ0.2-:3 Engineering Aide Washington Natural Gas 52 1- 5046 WkLG,30B*-q31B73Z Z_ ( L 2z--) 8& PL - W. -EDMONDS \E:],,,NEW CONST. JZ EXISTING /--N WNG to window Water main depth UPAR9 5511a 21-11 gas main e--- Key: 10 -w- water -g- gas - -ss- sewer -e- water hydrant 0 water valve 815 M=cr St. (PO, Box 1869). Seattic, WA 98111 (206) 622-6767 STREET FILE City of Edmonds Critical Areas Determination 1 -1 D CA-93-33 Applicant: 1 Dunne, Joseph etermination #: I Project Name: I Dunne Remodel Permit Number: Site Location: 1 21120 86th PI W I Property Tax Acct #: 1 3736-005-016-11 1 Project Description: Remodel due to fire damage, along with small addition. Waiver Criteria (all criteria must be found to apply): xx There will be no alteration of the Critical Area or its required buffers; xx 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; xx The development proposal meets the minimum standards of the Critical Areas ordinance; xx The above findings are based on the following conditions of approval: 1. That any development, within 50' of the top of the bank located to the west of the property which would require any disturbance of soil, would require another evaluation of the Critical Areas Checklist for steep slopes and unstable soils. 2. The applicant- must follow the requirements of the Engineering Division for erosion control (ECDC title 18). $ 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. 1.50 (B) of the Edmonds Commu )evelopWnt Code. 7�1 1, Stephen F. Bullock Name Si(nature- Date TO: The City of Edmonds Regarding Critical Areas Checklist The accompanying Critical Areas Checklist is for a residence that is presently unoccupied due to extensive fire damage in October of 92. The owner proposes to rebuild the structure on the existing foundation with the exception of increasing the depth of the garage. The below sketch notes the extension of the garage in blue lines. Formal architectual drawing will follow this checklist. We would ask that if at all possible the checklist and plans revi ' ew be completed as quickly as possible due to the hardship caused by the fire. . ............ ub- fl 0,� Critical Areas Checklist' Site Information Project Name: - Permit Nuinber. — Site Location: 2- D uALJP erty Tax Account Number. 37?(, — 00 57— 6 J rop Approximate Site Size (acres or square fee): -3 Have you filled out a Critical Areas Checklist for a project on this site before? VAO General Site Conditions 1. Has the site been cleared or logged? Nk 0 Date of most recent action: Soils / Topography 2- In the Snohomish County Soil Survey, what is the mapped soil type(s)? A_LVCA,� 6YAvt,�7� !�,A r4 3. 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-) JE113r. slopes present on site of more than 15% and less than 30Y* a vertical rise of 10 feet of horizontal distance.) Steep: grades of greAter than 30% present on site. Comments Hydrology/Vegetation 4. Site contains areas of year-round standing water: U RZ. C E I V E D 19RO City of Edmonds Critical Areas Checklist 'Me Critical Areas Checklist co* ntaincd 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� 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. 7he information needed to complete the Checidist should be easily available fromobscrvations of the site or data available at City Hall (Critical Areas invcntorics� maps, or soil surveys). FEB 0 b PERMIT COUNTER An applicant� or his/her representative, must fill out the chccklist� sign and daft it, and submit it to the City- The City will review the chccldis4 make a precursory site visit� and make a determination of the subsequent steps necessary to complete a developinent Permit application. With a signed copy of this form, the applicant should also submit a vicinity map of the parcel with enou ,gh detail that City staff can find and identify the subject parcel(s)- hi addition. the applicant is encouraged to include any other pertinent information or s-tudies in conjunction with this Checklist to assist staff incompleting their Preliminary assessment of the site. I have completed the attached Critical Area Chwldist and attest that the answers provided -are factUal, to the best of my knowledge (fill out the appropriate column below) - Owner / Applicant: -)`:�E-4 V\— IV\ 9-- Name Tide a 11 Street Address rAz V4 9 4�6 n'o City, state, ZIP Phone Applicant Representative: Jk C'I-- 61 et-f- If\ Name Ge- V-\kCCJ (0,\ � V- 0�c Title I %'�() '�- Street Address -7 -7 City, State, ZIP Phone 2 4-5-/-q� S 4it�Qur- e� —_ 5 Dat Signature Date %-Anneop— C� 9 0 . 19 FILE EDMONDS 250 - 5TH AVE EDMONDS. WA 98020 - (206) 771-3202 COMMUNFYSERVICES: Public Work-;z * Planning " Parks and Recreation - Engineering May 11, 1990 Mr. Doug -Reilly 21218 - 86th Pl. W. Edmonds, WA. 98020 LARRY S. NAUGHTEN %!.;Yo;; Re: Letter from residents of 86th Pl. W. to City dated May 8, 1990 Dear Mr. Reilly: PETER E. HAHN DIRSCTOR We received your May 8, 1990 letter and concur with your recommendation that a new waterline be installed. We will consider your letter as permission to work within the private drive. The City crews will schedule the installation of a new pipeline this year. The exact schedule is not known at this time. The City's contact persons for this project will be Bobby Mills and Archie Brena. Please feel free to contact them at your convenience. Sincerely, ROBERT J. ALBERTS, P.E. City Engineer RJA/sdt c: Bobby Mills REILLY/TXTST530 * Incorporated August 11, 1890 0 Sister Cities International — Hekinan, Japan 7-, - I, Y '-� 1590 Dear Sir: As residents of Edmonds, we write this letter with the hope that you may provide us with a better quality of water. We reside on 86th Place West, which we are aware of is a private street. Our water problem has been an ongoing dilemma for us. The severely rusted and corroded main water line has reached a point where your city crews are spending more and more time flushing out the lines to help clean it out. It hasn't been helping the water quality however. We find our white landry coming out with rust stains. We are forced to buy bottled water to avoid drinking the "brown" water, which is an expensive substitute. Our bathroom fixtures are water stained with no hope in sight. A few of us who are looking at home additions and remodeling face the inevitable staining when our new fixtures are installed. We are discouraged to invest money in our homes with this in mind. Our fear is that we would not be able to recover our investment due to poor water quality. Our request'is that you take into consideration the replacing of our water main for our 6 homes on 86th Place West. This would eliminate the necessity of having city crews come out to continuously maintain the.pipes. It would also enable us to feel safe using our water for drinking purposes once again. We look forward to hearing from you. Please contact Doug Reilly at 778-5993 or 344-6688(work). Sincerely, The Residents of. 86th Pla st: L I c) o ro tl -5-/, / j CY0 C e LA t4 1* APPLICATiON flor �TREATMENV eW4T' The City of SME SEWER P EAS12AENT No. NEW CONSTRUCTION 7MTREPAIRS E] OWNER --------- ------------------------------------- ----- CONTRACTOR ------ j N -V.w.h --- ax/ .... s'c.-VY'g).Z ----- P C-O.,V "EMM No . . ........... / ADDRESS 25� ............... Y-4714-4 ..... LEGAL DESCRIPTION: LOT No - ---------------------------------------------- BIA)CK No . ..... ................................ NAME OF ADDITION Th 9 C- Asr 3 0, '7' oic 7-5 9 F:: .0 19, a /4 gko"-K L fAdept w"4 MA�?JPk No#, NCO, -rd 'r-. A vit, ep 11WEIVEID P#,0,6 94coltds AUG 5 M &A10, C-VvVly W454, �' r A r—,- iWeVl qP 4 ';Z1 16r- 1 weirsroep,. 7)?Ac-7--/(4 r1),g4,,6e 4 Ta rh -e Ph -Al I 1A1' /41 I t 3 /!2 0 Or rTA A- Al Ailfloa A$7-4- Z A A, SA/d wi 3 f- J fi/r:� 0 rie + 477 ,,vr 4,v t-,z- w, 7- Al, so wo6r1*a.cvkrro rho Po Approved: D. A T1 By -;J::, ...... NOTICE: No---wa rra nt-y- OT -at.(_,u1-. Y.... The information . shown on the attached Map(s) was compiled for use by the City Of Edmonds/ its Employees and Consultants. The City of �Edm.onds does not - warrant the accuracy of anything set for.th on t * hese Map(�_). Any person or entity -requesting a copy should conduct an independent orm ation shown on inquiry regarding th'e infi -map(s), including, but not limited to, -h the lociation of any sew-er stub shown. Suc exist and may sewer stubs may or may or may not exist at the location shown. Neither the city of Edmonds nor its empl-o- ee-s o-r office-rs -sh-a-I'l be !Jab -'Fe for the Y information given on this Map(s), nor for tation provided based any one represen upon said map(s). CITY OF EDMONDS - SIDE SEWER PERMIT 01 Flo WATER -SEWER DEPARTMENT PERMIT , "J. � L Call 7.76-1107 for side eewer inspections BEFORE covering any portion of the construction.) Inspection will be providsd within 24 hours after request. NO Sat., Sun., or holiday inspections. ADDRESS LOCATION OF CONSTRUCTION ......... ........ .... .................... ........ ------- -------------------- - --------------- * ---------- -------- ----- - -- ------------ PROPERTY LEGAL DESCRIPTION .......................... ................. ................. -- -------- ------- .......... ---------------------------------- .................................. ------ ------------ 7 ...................................................................... ...................... . .......................... . .......... . .......... . ................... z ......................................... z .......................................... .......................... .................................... OWNER AND/OR BUILDER ...................... ....................................... ....................................................... 7� CONTRACTOR'S NAME & ADDRESS --_-_----------- : -------------------------------------- --------------------------- ---------- �n --------------- _... �7 .............. ...................................... Permission Is granted ........... ............................................ for repair and/or connection of a side sewer to the city sanitary sewer system in accordance with City of Edmonds ordinances. ATTENTION IS CALLED TO THE FOLLOWING: 'ZE No. I —The owner of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct side sewersin street area. Do not cover any portion of sewer before it has been inspected. i—TE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office. NOTE No. 3—Obta-in full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 4—Top of side sewer must have at leazt 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade sharper than % will be permitted. NOTE No. 5—Trenches in street must be water settled and surface of street mstored to original condition. Contra.ctors shall be responsible for failure due to improper work which may develop within one year of completion. NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appurtenances except to in- sert the pipe into the wye. DISAPPROVEDDate---- . ..................... By ........ ------- Date ................................. ;�,, By .. . ....... Date .................................... BY ................ APPROVEDDate.w�c� ..... ----------- BY ...... .............................................................. Remarks: ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ..................................................................... . ......................................... ................................................................................................................................. I ......... BOTH Permit Copies MUST Be Sign5p-By Owner of Firm Performing Construction PRIOR To Request For Inspection hereby certify that the side sewer installation constructed under this permit (Owner oT&hQcting 'r ---------- ---- d4 i ',__,,.krX4no uetion) was installed in accordance Witt lr governing ordinances of the City of Edmonds. zs -,? Dated this ............................ day of ................................................................ 1 19 ------- --lb - 70 - Check BEFORE you dig for: Water F], Gas [3, Telephone E], Power E], Sewer I-], Other E] -V V ._1 _:5 E_ _PA "�'\ � I c;� C) �AJ 7 RLE CITY OF EDMONDS 250 STH AVENUE NORTH, EDMONDS, WA 98020 (206) 771-3202 RCW 197-11-970 Determination of Nonsignificance (DNS) DETERMINATION OF NONSIGNIFICANCE Description of proposal: Remodel and Addition to a Single Family Residence Building Plan Check Number 93-12 Proponent: Jim Barger and Joseph Dunne lAcation of -proposal, including street address if any: 21120 86th Pl. W. Lead agency: CITY OF EDMONDS The lead agency for this proposil 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. J XX There is no comment period for this DNS. This DNS is� issued under 197-11-340(2); the lead agency will not act on this proposal for 15 days from the date below. Comments must be submitted by 1993. Responsible Official: Jeffrey S. Wilson Position/Title: Current Planning Supervisor, Department of Community Services - Planning Division Phone: 771-0220 Address: City of Edmonds, 250 5th Avenue North, Edmonds, WA 98020 Date: _V-.X1q:t Signature,�_�_ XX You may appeal this determination to Robert Chave, Planning Manager, at 250 5th Avenue North, Edmonds, WA 98020, no later than 1993, 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 1992, at the Edmonds Public Library, Edmonds Community Services Building, and the Edmonds Post Office. XX Distribute to "Checked" Agencies, along with a copy of the Checklist. Mailed to the following along.with the Environmental Checklist: Department of Ecology Environmental Review Section P.O. Box 47703 Olympia, WA 98504-7703 Joseph Dunne 21120 86th Edmonds, WA 98020 Green leaf Construction Jim Barger 18305 Bellflower Rd. Bothell, WA 98012 #9312.DOC Page 1 of 2 MEMORANDUM. CITY OF EDMONDS PLANNING DIVISION 250 5TH AVENUE NORTH, EDMONDS, WASHINGTON 98020 TO: FILE NO. BUILDING PLAN CBECK NUMBER 93-12 FROM: John Bissell, Code Enforcement Tech. Jeffrey S. Wilson, AICP Responsible Official DATE: MARCH 2,1993 SUBJECT: ENVIRONMENTAL DETERM[INATION FOR A BUILDING PERMIT FOR AN ADDITION AND REMODEL OF AN MaSTING BUILDING FILE NO. 93-12 I have had the opportunity to visit the site, review the environmental checklist, site. plan a n*d building plans. A copy of which are filed in the official file f6r this permit. Based on my review of all available information and adopted policies of the City, I recommend that a determination of nonsinificance, be issued. The site has been classified as environmentally sensitive due to steep slope and habitat in the area. The subject property is located away from the subject steep slope and outside of the habitat area. Therefore, no m�itigation is required with the subject project. Review by Current Planning Supervisor: Iconcur I do not concur Comments: ZI /a r-r Jeffi-ev S. Wilson Date Attachments PC: FILENO. (51--1 0—kee�-- I-T-(:L Robert Chave, Planning Manager Page 2 of 2 #9312.DOC RECEIVED CITY OF EDMONDS FEB 1 6 1993 ENVIRONMENTAL CHECKLIST PERMIT COUNTER A. BACKGROUND Name of proposed project, if applicable: \-C, z COA u u- C C)�7 t. e t' 2. Name of applicant: rlxl_ 3. Address and phone number of applicant and contact C- t person: 41 CW1 -77 4 (f LIZ "J 4. Date checklist prepared: 5. Agency requesting checklist: City of Edmonds. 6. Proposed timing or schedule (including phasing, if applicable): 1, C� � -11, &A V\- . ar'(k. con t - J 0 Au)� f 'ALkYY� -6 (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. (STAFF COMMENTS) r.WW1T/10-Q-Q1 hAA<TC:Q ne 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal.. C EJ,"Q rug-: r cr k Vst a rr 0 rk (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. (STAFF COMMENTS) 10. List any government approvals or permits that will be needed for your approval, if known. � V % - \,-, w o � oo (STAFF COMMENTS) 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. elk ��.k *c , V(Z (�CKQY�Ue\k_.�� IVIJ �J -e Y, -A, (STAFF COMMENTS) CHKLT/10-8-9l.MASTER Page 2 of 26 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. C CIL %N (STAFF COMMENTS) TO BE COMPLETED BY APPLXCANT ENVXRONMENTAL ELEMENTS 1. Earth a. General. description of the sit e (circle one): Flat, rolling, hilly, steep slopes, mountainous, other: (STAFF COMMENTS) b. What is the steepest slope on the site (approximate percent slope) ? (STAFF COMMENTS) T3 I A 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' Alsf specify them a d note.any prime farmland. s, t-W L-,U, k (A TNT Cn mp��K, 2- — 16 (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 gradinj proposed. Indicate source of fill. (STAFF COMMENTS) f.- Could erosion occur as a result of clearing, construction, or use? If so, generally describe. k-k r. (STAFF COMMENTS) CHKLT/10-8-9l.MASTER Page 4 �f 26 9- About what percent of the site will be covered with Impervious surfaces after project construction (for example, asphalt or buildings)? C'X (STAFF COMMENTS) h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: . I ILy S /r 14 s-,W knu-, CJL 11.�r 4-1-1- & k 4CA (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. k (STAFF COMMENTS) b. Are there any of f -site sources of emissions or odor that may effect your proposal? If so, generally describe. (STAFF COMMENTS) C. Proposed measures to reduce or control emissions or other impacts to the, if any: eL 7L (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) (2) Will the project require any work over, in, or adjacent to (within 200 feet) the described waters? If yes, please describe available plans. (STAFF COMMENTS) (3) Estimate the amount of fill and dredge material that would be placed in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicate the source of fill material. CHKLT/10-8-9l.MASTER Page 6 of 26 (STAFF COMMENTS) (4) Will the proposal require surface water withdrawals or .diversions. Give general description, purpose, and approximate quantities if known. C;7- ff (STAFF COMMENTS) (5) Does the proposal lie within a .100-year floodplain? If so, note location on the site plan. (STAFF COMMENTS) (6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type of waste and anticipated volume of discharge. (STAFF COMMENTS) b. Ground: (1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, propose, and approximate quantities if known. Al c; c . (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 chemicals... ; agricultural; etc.). Describe the general size of the system, the number of such systems, the number of houses to be served (if applicable), or the number of animals or humans the system(s) are expected to serve. r t, i cx-- C S (STAFF COMMENTS) Water Runoff (including storm water): (1) Describe the source of runof f (including storm' water) and method of collection and disposal, if any (including quantities, if known). Will this water flow into other waters? If so, describe. L! �-J�� /* I?d I A 0 ki Q (STAFF COMMENTS) (2) Could waste materials enter ground or surface waters? if sof generally describe. (STAFF COMMENTS) CHKLT/10-8-9l.MASTER Page 8 of 26 i d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: 4udo 4 - (STAFF COMMENTS) 4. Plants a. Check or circle types of vegetation found on the site: __IZdeciduous tree: (!a�ld�er, ple, : aspen, other: V"evergreen tree: (!��r,(:c::e::d�a;, pine, other: ____!�rubs 17- ___±Lgrass asture crop or grain ______�wet - soil plants: cabbage, other: cattail, buttercup, bulrush, skunk ---------water plants: water lily, eelgrass, milfoil, other: other types of vegetation: (STAFF COMMENTS) b. What kind and amount of vegetation will be remove or altered? -(-&" I , CL4, LU I I'l S or LAC (STAFF COMMENTS) C. List threatened or endangered species known to be on or near the site. 41 (STAFF -COMMENTS) d. Proposed landscaping, use of native plants, or other preserve or enhance vegetation on the site if,any: 0 C materials to (STAFF COMMENTS) S. Animals 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: VZbird.s: hawk, her on, e . agle,(:� �gbirds, other: mammals: deer, bear, elk, beaver, other: .fish: bass, salmon, trout, herring, shellfish, other: (STAFF COMMENTS) CHKLT/10-8-9l.MASTER Page 10 of 26 b. List any threatened or endangered species known to be on or near the site. el tnk (STAFF COMMENTS) C. Is the site part of a migration route? If so, explain. (STAFF COMMENTS) d. Proposed measures to preserve or enhance wildlife, if any: (STAFF COMMENTS) 6. Energy and Natural Resources 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 be used for heating, manufacturing, etc. fct r n 4-&— cvo le A- k,. k r— (STAFF COMMENTS) b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. (STAFF COMMENTS) C. What kinds of energy conservation features are included in the plans of this proposal? 74 U/4's 'J'14-L 'N )x7t- (STAFF COMMENTS) 7. Environmental.Health a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal? If so describe. Nell A (STAFF COMMENTS) (1) Describe special emergency services that might be -required. (STAFF COMMENTS) CHKLT/10-8-9l.MASTER Page 12 of 26 (2) ' Proposed measures to reduce or control environmental health hazards, if any: I 7' C)( (STAFF COMMENTS) b. Noise (1) What types of noise exist in the area which may.affect your project (for example: traffic, equipment, operation, other)? f 4K (STAFF COMMENTS) (2) What types and levels of noise would be created by or associated with the project on a short-term or a long-term basis (for example: traffic, construction, -operation, other)? Indicate what hours noise would come from the site. — kklt.� rz — f, am - Ak� r k�L (, 1� (STAFF COMMENTS) (3) Proposed measures to reduce or control noise impacts, if any: 'r �,I_Jct �__— _/� hz�l Z'f*!� (STAFF COMMENTS) a.. Land and Shoreline Use a. What is the current e of the site and adjacent properties? sfn A- U-Je-- (STAFF COMMENTS) b. Has the site been used for agriculture? If so, describe. plo (STAFF COMMENTS) (STAFF COMMENTS) d. Will any structures be demoli hed 7 if so, what? /-n C, 1,7 ,,�L,4- (STAFF COMMENTS) e. What is the current zoning classification of the site? CHKLT/10-8-9l.MASTER Page 14 of 26 (STAFF COMMENTS) What is the current comprehensive plan designation of the site? Kno 0J (STAFF COMMENTS) Rel � r 171*� If applicable, what is the current shoreline master plan designation of the site? (STAFF COMMENTS) h. Has any. part of the site been classified as an -environmentally sensitive" area? If so, specify. A) "L -I/- ft-'n, (STAFF COMMENTS) v,1443::-7- OF Approximately how many people would reside or work in the completed project? (STAFF COMMENTS) Approximately how many people would the completed project displace? fceafrc (STAFF COMMENTS) k. Proposed measures to avoid or reduce -displacement impacts, if any: (STAFF COMMENTS) 1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: (STAFF COMMENTS) 9. Housing a. Approximately how many units would be provided, if any? indicate whether high, middle, or low-income housing. J4 (STAFF COMMENTS) CHKLT/1 0-8-9 1. MASTER Page 16 of 26 b. Approximately how many units, if any would be eliminated? .Indicate whether high, middle, or low-income housing. (STAFF COMMENTS) C. Proposed measures to reduce or control housing impacts, if any: (STAFF COMMENTS) 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?* (STAFF COMMENTS) b. What views in the immediate vicinity would be altered or obstructed? (STAFF COMMENTS) C. Proposed measures, to reduce or control aesthetic impacts, if any: (STAFF COMMENTS) 11. Light and Glare a. What type of light or glare will the proposal produce? What time . of day would it mainly occur? (STAFF COMMENTS) b.. Could light or glare from the finished project be a safety hazard or interfere with views? (STAFF COMMENTS) C. What existing off -site sources of light or glare may affect your proposal? A/ovC - (STAFF COMMENTS) CHKLT/10-8-9l.MASTER Page 18 of 26 d. Proposed measures to reduce or control light and glare impacts, if any: (STAFF COMMENTS) 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? 4— (STAFF COMMENTS) b. Would the proposed project displace any existing recreation uses? If so, describe. A/a (STAFF COMMENTS) C. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: /k e3 /I (' �- TY& (STAFF COMMENTS) 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 site? If so, generally,describe. 'i (STAFF COMMENTS) b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. ,(STAFF COMMENTS) C. Proposed measures to reduce or control impacts, if any: (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. 7A 1 '111 C J1 1-4. — i A 4 (STAFF COMMENTS) CHUT/10-8-91WASTER Page 20 of 26 b. Is site currently served by public transit? If no, approximate distance to the nearest transit stop? I what is the (STAFF COMMENTS) C. How many parking spaces would the completed project have? How many would the p ject eliminate? 70 'n 0 (STAFF COMMENTS) d. Will the proposal require any new roads or street, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether public or private). Ato (STAFF COMMENTS) e. Will the project use (or occur in the immediate vicinity of) water, raili or air transportation? If so, generally describe. (STAFF COMMENTS) f. How many vehicular trips per day would be generated by the completed proj ect? If known, indicate when peak volumes would occur. 4- Z, 7L "1^--J 19 1-t V U (STAFF COMMENTS) 9- Proposed measures to reduce or control transportation impacts, if any: (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. Alo (STAFF COMMENTS) b. Proposed measures *to reduce or control direct Impacts on public services, if any: o (STAFF COMMENTS) CHKLT/10-8-9l.MASTER Page 2.2 of 26 16. Utilities a. Circle utilities curren r akva �4y--f ilja-ble� at �thes�ite: c:Lt atural gas,% refuse service, elephon �sanitary sewer ------------ septic system, other: (STAFF COMMENTS) b. Describe the utilities. that are proposed for the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity which might be needed. J< (STAFF COMMENTS) C. SIGNATURE. The above answers are tru'e and complete to the best of my knowledge. I understand that the lead agency is relying on them to make its decision. agnature of Proponent Date Submitted ruvi-rtin-o,ai -AC-CM ---- I I - I I I ^Wra.-ET FILE J-100 %g IN I'm '.t .104 ko-L dvt. 7: 1014 105- V). Din ?e*s,S1 ell APPRO ED'AS NOTED RECEIVED FEB 1 6 1993 Z-OT PERMIT COL rrK,p laoi AV, s "t t I Lc, Al*l y i" y C ulir 5-- SrREET HLE J-100 Ioq T.,gQ. r�,Zf.57- --Z t" nuz + 4ft" 4,16 C, 1-4 -D )05- I c 41�1 02- q I L )q 3 RECEIVED FEB 1 6 1993 ol PERMIT COUNTER 2-0 J100. 6A rcA ic .1 t I Lo vs - STREET FILE . ?//Zo ..i 4vX .0 STREET FILE USE CITY OF ED M11ONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME /NAME OF BUSINESS ,.-) o se p 1 b u n %NA-_ MAILING ADDRESS CITY ZIP t010 TELEPHONE NUMBER— NAME ADDRESS lagil P� CITY ZIP TELEPHONE NUMBER L4 —i- o 4 ZONE P VS,0NUMBER 9 JOB /APT # ADDRESS 2 11,2 0 6 1" /-)/-/V2c W LEGAL DESCRIPTION CHECKI SUBDIVISION NO. I LID No PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP, TESCP Approved RW Permit Required 0 EXISTING - REQUIRED DEDICATION 1 Street Use Permit Req*d 0 PROPOSED Inspection Required 13 . Sidewalk Required 0 9 J.j� Lie. ENGINEERING MEM j ADDRESS 0,� METER SIZE DING SUPPLY SIZE CITY ZIP TELEPHONE NUMBER 7 REMARKS STATE LICENSE NUMBER EXPIRATION DATET of Prooertv - include all ease _j Property Tax Account -7 ao Parcel No. EINEW RESIDENTIAL PLUMBING 1:1 E] ADDITION COMMERCIAL MECHANICAL APT. BLDG. L REMODEL El SIGN GRADING CYDS- FENCE F� REPAIR I— x _FT) DEMOLISH WOODSTOVE INSERT SWIM POOL HOT TUB/SPA GARAGE RETAINING WALL/ C RENEWAL ROCKERY Z 0 (TYPE OF USE.,B;SINESS OR ACTIVITY) EXPLAIN: STORIES NUMBER OF NUMBEROF DWELLING UNITS DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) Sa �k%k INN It, w/m%c\0' r Ooo( '?(a(\ 01�jt(Aiti SIGN AREA ALLOWED I PROPOSED VARIANCE OR CU SETBACKS — FEET FRONT ? (-'- SIDE REVIEW BY NO. OF FIXTURES SEPA REVIEW COMPLETE 1EXEMPT EXP"1' P6ANNING REVIEW BY HEIGHT LREAR/ 1_5 DATE �;HECKIEO BY TYPE OF CONSTRU HEIGHT I 2--S / SPECIAL INSPECTOR AREA AN Y OCCUPANT REQUIRED 0 YES 111877 / 1.0 ccu, P7 / R 3 LOAD PROGRESS INSPECTIONS PER UBC 305 I-WrAM41- _ZIMS41L /L§9 M9,il FINAL INSPECTION REOUIRED PLAN CHECK FEE BUILDING 'PLUMBING HEAT . SOURCE: GLAZING 0/0 Plan Check No.q-* 5_12 MECHANICAL --- This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewalks, STATE SURCHARGE driveways, marquees, etc.) will require separate permission. Permit Application: 180 Days Permit Limit: 1 Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE "Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE successors in interest, agrees to indemnify, defend and hold harmless the City of Edmonds, Washington, Its officials, z 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 I . imit In any way the City's ability to enforce any ordinance provision." PLAN CHECK DEPOSIT TOTAL AMOUNT DUE I hereby..acknowledge that I have read this application; that the information given is correct; and that I am the owner, or th.9 duly ATTENTION authorized agent of the owner. I agree to comply with city and -state laws regulating construction; and In doing the work authoriz- ed thereby, no person will be employed In violation of the Labor THIS PERMIT AUTHORIZES ONLY THE Cod,e-of the State of Washington relating to Workmen's-Compensa- WORK NOTED tiorilinsurance. I INSPECTION SIGNATURE tOWNER OR AGENT) DATE SIGNEI DEPARTMENT Ito CITY OF EDMONDS CALLIFOR ATTENTION INSPECTION IT IS UNLAWFUL TO USE OR OC�UPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. 10247 M/04725- Aetm- 0!,,0,qnM Aew /7- 5j APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his/her Deputy; and fees are paid, and receipt is acknowledged in space provided. ELEASED DATE J ORIGINAL — File YELLOW — Inspector PINK — Owner GOLD — Assessor