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21130 SHELL VALLEY RD.PDF11111111111111 13053 21130 SHELL VALLEY RD 0 TAX ACCOUNT/PARCEL NUMBER.:_0 L� 025:5� BUILDING PERMIT (NEW STRUCTURE): ;�C,25rlc COVENANTS (RECORDED) FOR: CRITICAL AREAS DETERMINATION: Ej Conditional Waiver E] Study Requiredfflaiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: SHORT PLAT FILE: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR WATER METER TAP CARD DATED: LID LOT: BLOCK: LATEMP\DST's\Fonns\Street File Checklist.doc Fill PERMIT r NUMBER I BUILDING WART Applicant PLIC PERFAIT APPLICWAT Inside Heavy Lin2s '00 ADORESS "� / / NAME (OR NAME OF ujSINES�;) AD9 HEIGHT NO.. 1 �E VARIANCE OR CCN.. 130 r —LA t�___CJUA . MAILING ADD ESS V - OS - R GE C31 0 a -s 19 tv N�'z JLOI FRONT SID I, REAR E NU D CITY ELEPHONE NU.1.ER — A SIGN AREA ALLOWED PROPOSED comp...rTc: z z NAME REMARZ —DATE U W ADDRESS PL NING oT. Al".. Il: TV TCLEPHOMP NUMBER L AL L LO ARE. S DIVISIcON NO. —?A 2-00 t7A i S A M STREET R /W MIS PROPERTY EXISTING STRCZ-T R/W A-4CD FT. DEFICIENCY THIS PROPERTY FT. M COMP. PLAN ST. P/W +1 FT. ) R _KS < M C�JTY T LEPHONE NUM13ER z L' HECKED By z 1ATE -�2U CITY ,ICENSE NUMBE 2 U 1) C Description f roperty (Show Belo 5 STREET AND/OR JTIL.Ty WORK C YES N 0 T REQUIRED PrRMIS I E 3LN D 0 Y W Legal Z- U 7 CERGROUND z WIRING REO'D. myrs NO 2. TYPE COW1 1��ECTI..tj Es VERIFIE)BY SAIJITARY SEWER or SEPTIC SNS7 y ES PFRMI'l NUMBER U APPVD By CITY E-G. r. No .j R EM AR. KS W .j METE -7 JSERVICF S111 -It/ I T__ O.AS CODE LINE FIRE ZONE TV SIGN —1 f CCUPANT AD. RETAINING SPECIAL INSiECTO A UP ILOAD 3 0 IOCCU ANCY 0 REQUIRl"D d R. E] OrMCLI111 ALL 3 E] EXCAVATE FENCE YES .— NO �ITY W -LT.. 1,_ PLAN CHECK THIS SITE 15 LOUTED IN THE OR FILL DMONDS. LOCAL SALPS AX REPAIR PRr-MOVE olm BE D Spw OL 1NSP. E� R NUMBER OF Xpd �A OWELLIN UNITS IA. A L A-_UATtON FEE PROVO-1ED �Sc' PLAN CHCC 0 PLOT PLAN WINDI ATE BUILDI G SETOP-CKS- PUILDING AB TTING STREETS) U PLUP-113ING HEAT & GAS LINE In FENCE SIGN RETAINING WALL SWIMMING POOL I heieLy acknowledge that I have read this application; that the in- TOTAL Al,,1011T DUE fo formation Oven is -orrect: and that I arn the owmer, Or the duly aLthor- gu- ized agent of the owne-.. I a,cc to com,,)Iy with city and tate laws regu ATTENTION APPLICATION APPROVAL IaLing construction; and in doing the work authorized thereby, no peison will�ecmploved in -violation ofthe Labor Code ofthe State ofWashington THI I S PERMIT TIL's appliCatiOA is not a permit until AU,'HORIZES rel, 0 ONLY THE ting to W rknjen's Compt.-nution elgried bv the )3uildirg Official or his Dep L uty; and 140TE: Permit Limit one Yearq:xccp, DrMOLITIONS ai.d 1-11-0 fees are paid, and receipt is Be - IT "" ' 0 WORK NO'17.0 n U" S PERMITS without ccnditional use permit, wnich shall be conipleted in 9 knowledged in space provided. P" 0'. D- 13 1 teted in six months.) days�, 14OVED-IN BUILDINGS shall be comn INSPCCTI ON 4__M - N CIE"ARTMENT TMN.TU N OL LM 7 ; SIG ATU F( 0 MR OR AGEN I DATE SIGNED TOR C .TY L EDMONDS DATE IV07_ . Applicallt SlIkiect to Plan Oneck Fee 75-2525 L This Permit covers work to be done on private propertY ONLY. ORIGINAL Fov YELLOW 1,:% -:0, AnV construction on the public domain (curbs, sidewalks, driVeWaYs, GOLD-As�c,��. Pjt4K-0cr marquees, etc.) will require separate permission. I Rowl" LEGAL DEg;. F- LOT 23 SHELL PARK DIVISION 2 ZONE SET'RACK _jL -.!�HELL- VALLt'-_Q'�A T� .0TH Ef 4a. K, i3 CA FILE NO. C'Rical Areas Checklist 0 -------------------------------------------------------------- Site Information (soils/ topography/ hydrology/ vegetation) 1. Site Address/ Location: 7, q W Z, 2. Property Tax Account Number: 7 --z 3. Approximate Site Size (acres or square feet): 4. Is this site currently developed?!2L yes; no. If yes; how is site developed? 5. Describ the general site topography. Check all that ap' ly. p 7FIat: less than 5-feet elevation change over entire site. F I V F. D APR 2 1 1999 PUiws'+;u�u DEPT. 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). RECEIVEr) Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet). JUN I a 1999 Other (please describe): Mm WIE��M tT 6. Site contains areas of year-round standing water: Approx. Depth: 7. Site contains areas of seasonal standing wqter: Approx. Depth: What season(s) of the year? 8. Site is in the floodway floodplain of a water course. 9. Site contains a crep� or an area where water flo across the grounds surface? FI are year-round? Flows are seasonal? -,I'm (What time of year? 10. Site is primarily: forested meadow ;shrubs mixed urban landscaped (lawn,shrubs etc) 11. Obvious wetland is present on site: For City Staff Use Only---- 1. Site is Zoned? 2. SCS-mapped soil type(s)? 3 - S�� 3. Wetland inventory or C.A. map indicates kret.land present on site? 4.' Critical Areas inventory or C.A. map indicates Critical Area on site? +5 - 614L, s 2 6 /�qld Ok 5. ...5ite.withiP designated earth subsidence landslide hazard area? .6. 'Site. designa . ted on the Environmentally Sensitive Areas Map? Yv� .�Logp i 6, --A AL DETERMINATION STUDY REQUIRED . . .... CONDITIONAL WAIVER Revi ed: by: PI An Pate ACa�chk.doc; Rev 02/11/97 0 City of Edmonds Critical Areas Checklist "Oe. IS9V The Critical Areas Checklist contained on this form is to be filled out by any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of 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. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. 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 Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner/ Applicant: Name VA LL Street Address A City, State, ZIP Phone Signature Date Applicant Representative: Name A-; , 71/' �'-' �z �' , �--7— �-; §tre-et'Xddress zvl2v7&t�nd Citi, State, ZIP Phone Signature Date �tl) C. so\) Deck Crafters 1030 1164�' Steet SW Lynnwood, WA 98037 Subject: Dear Applicant: 0 0 CITY OF EDMONDS 121 5TH AVENUE NORTH . EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 DEVELOPMENT SERVICES DEPARTMENT Planning - Building - Engineering May 6,1999 Determination regarding Critical Areas Checklist # 99-113 BARBARA FAHEY MAYOR Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City is located on the reverse side of the form (bottom of page). It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records. PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHEVWST OR CRITICAL AREAS STUDY. The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a project -specific determination. mo, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL .40 PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED. Permit applications include the following: Enc: Determination cc: Coburn Douglas 21130 Shell Valley Rd Edmonds, WA 98026 * Architectural Design Board C:ReceptIonUana\CRLTR.doc Building Permits Conditional Use Permits Subdivisions Variances Applications to the ADB* Land Use Applications Any other development permit applications. Thank you. Planning Secretary Incorporated August 11, 1890 Sister City - Hekinan, Japan APPLICATION The City of Edmonds for SIDE SEWER PERMIT EASEMENT NO - --------------------------------------- NEW CONSTRUCTION REPAIRS E] LID NO - ------------------ ASMT. NO . .................. OWNER --- - ----------- ....................... CONTRACTOR t< - — -------- PERMIT NO. ----------------- JOB ADDRESS ------ LEGAL DESCRIPTION: LOT NO . ......... -------- ---------------- BLOCK NO - ------------------------------------ Lip __j 0 0 ------------------------------------------------------------------------------------------------------------------------------------------------------------------ NAME OF ADDITION ------- -------- Approv DATE /1-w .......... !.� .. . . ... :w-, --- --------------- By a LM ADDRESS LiOCAIXON OF CON&MUCTION .. ....... .................................... '"ItOPERTY LEGAL -DESCRIPTION ...... Ze . .................................................................................... ....... . .................. . ................................... OWNBRANDIOR BUIIMER ........ _Z ........ . .................................................... 00NISACTOR'S NAME ADDRESS ...... ........... Permission U granted /.;a . . ................ 19.-7.7, for repair and/or connection of & side sewer to the city sanitary r sewe w "�Edmonds ordinances. system In accordancie lihirli� lot Iiii A JNTION IS CALLED TO THE FOLLOWING: NOTE No. I —The owners of the property may obtain a Permit to construct sewer Inside Property line. A licensed Side Sewer Contractor must be employed to construct side "war In street area. Do not cover any portion of sewer before It has been Inspected. NOTE No� 2—All work performed in city right-of-wav requires an Invasion of Right-of-way Permit obtainable from the City Engineer's office. NOTE No. 3--Obtain 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 least 30 Inches coverage at property line and 12 Inches inside property line; minimum grade of 2%. No bends In grade #harper than % will be Permitted, NOTE No. 5—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper work which may develop wit4jn 6ne Year of completion. NOTE No. 6--It is Unlawful to alter or do any other work than to provided for In the permit, or to do any work on the ma4n sewer or its appurtenances except to in- sert the pipe Into the wye. DISAPPROVED Date ... ...................... By ................ Date ...... ........... BY ............ _ Date ........... . .. . ................... . By ........... ;"_().PR4DVZD dZ7 ...... _/9_r ... ... .................. By .. . ....................................................................................... 1 11;1 Remarks: ........... . .............................. . ........................ ... . ........ ............ . ...................................... . ................................................................... ................................................................ ........................................................................................ . ..................... I ..................................................................... BOM Pormit Copie)rjMUST�Be S gnedd B Owner of Firm Performing Construction PRIOR To Request For Inspection .......... . ....... ................... hereby certify that the side sewer installation constructed under this permit Mtaned(Owner of Contracting rm in accordance with all governing ordinances of the City of Edmonds. Datedthis .......... . ............... day of ........................................................ ....... 119 ......... . -4 A_ 4 Check BEFDRE you dig for: Water 0, am [3, Tmjepb9ne 0, power 0, 71 Sewer Other[] t WW" The City of Edmonds EASEMENT NO - -------- ------------------------------- LID NO. � ----------------- ASMT. NO - ----------------- P ------------------------------ ----------------------- PERMIT NO. OWNE -------------- ;0 ------ CONTRACTOR ---- Ji ------------------- ----------- ---------- - ------ ........... JOB ADDRESS .... LEGAL DESCRIPTION: LOT BLOCK NO - ------------------------------------ --- --------- NO. ------- ........................................................ :'ll -- ---------- 11 ................................. / ..................... ................................ NAME OF ADDITION --- -------------- -- / - -------- ...................................................... uu .j uj uj APPLICATION lor SIDE SEWER PERM NEW CONSTRUCTION E] REPAIRS Fl A Approved: DATE .... BY--------------------------------------------------- i . i7.yg PLANNING DATA NAME: CM61AM V�E "q SITE ADDRESS: D :7/10 ZONING: Q;—� t PLAN CHK# :qq- PROJECT DESCRIPTION: CORNER LOT-- NQ _(Yes/No) FLAG LOT Nb _(YesINo) SETBACKS: Required Setbacks: Front: '1-< '. Left Side-7 Right Side: Rear: Actual Setb ck Front�&�"*L'eft Side: Right Side: Rear: Street map checked for additional setback required?��(Yes/No) . v LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED -(Y/N) LOT COVERAGE: Maximum Allowed:. -:Jdo —Actual:A/(A r V BUILDING HEIGHT: Maximum Allowed:- Z5;-" -Actual Height:. NA I Datum Point: Datum Elevation: A.D.U. CREATED?: Al 0 — "b— SUBDIVISION: CRITICAL AREAS #: cfq — 115 SEPA DETERMINATION:. IN\) �� — -71 LOT AREA: OTHER: CITY OF EDMONDS_ CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS I MIT[MG-A654SS� 0 211 CITY - I - ZIP tMPHOiTE &-f41,44 NAME P ADDRIM CITY ZIP TTELEPHONE Er z 0 U RE L) W Uj 0 NAME NUMBER r * A - MN OF PR7P ZIP I TELEPHONE PERMIT EXPIRES USE ERMIT PIUMBEIR ZONE g!�g 9 9 JOB ulTE/APT# ADDRESS ZA) I N6 111 IA LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO. ) PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved 0 RW Permit Required 0 EXISTING — REQUIRED DEDICATION Street Use Permit Req'd [I inspection Required 0 PROPOSED Skle..Ik Required 0 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 0 NO 0 REMARKS Uj z z 0 A z Uj ENGI EE EMO DATED FIRE PMEM6 DATED REVIEWED BY W- - REVIEWED BY U, gac 2a -3 VARIANCE OR CU ADB# SHO R INE # EAPIRATIONDATE I CHECKEDBY A11A A11A 7A S�E!IiA AE�VI�W SIGP AREA EIGH / / /,.-,?, EXEMPT ALLOWED JROPOSED ALLOWED PROP A L L fUE S ' 1 EA11!r1j� �74:� ED LOT10 E AGE REOUI��DAETgACKS IF ) PROPOS SET BAIKS (FTj ALLOWE PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR r A)1A -7,- kl� z PROPERTY TAX ACCOUNT PARCEL NO. - A F 1� Z) 4--Zl z -/L-OTARE� . V 'UAfl: PLA G R IEW BY 5< NE W(reoa(t) T- RESIDENTIAL I - - PLUMBING / MECH '.�uac�k 7 Zt, Allkiry,l 711106 REMARKS- dt F-1 ADDITION E] COMMERCIAL Ei COMPLIANCE OR CHANGE OF USE a 4W t� 69 Old 14 4, k'�tz F-1 REMODEL 0 APARTMENT C) SIGN A�* fA 0 REPAIR C3 GRADING CYDS El FENCE ( — X FT) CHECKED BY TY1-6ONSkCTION CODE OCC6"PANT DEMOLISH TANK OTHER GROUP A GARAGE CARPORT RETAINING WALL ROCKE Fly E) RENEWAL SPECIAL INSPECTO'rr- REQUIRED [:) YES IAAET I OCCUPANT LOAD (TYPE OF USE. BUSINESS OR ACTIVIT A -EXPLAIN. - REMARKS ff - PROGRESS INSPECTIONS PER UBC 108 NUMBER NU BER OF CRITICAL . OF D ELLING AREAS STORIES UNITS NUMBQ� DESCRIBE WORK TO BE DONE A FINAL INSPECTION REQUIRED IVALU'ATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING % LOT SLOPE % 1 BUILDING -:2� (n, PLAN CHECK NO: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC M DOMAIN (CURBS,SIDEWALKS, DRIVEWAYS, IMARQUEES,ETC.) WILL REQUIRE GRADING/FILL SEPARATE PERMISSION. STATE SURCHARGE W PERMIT APPLICATION: 180 DAYS STORM DRAINAGE FEES PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS 00 -APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS W ENG. INSPECTION FEE IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF f-'LA cc EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY j 0 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE -j 0 DEEMED To MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE PLAN CHECK DEPOSIT NOR LIMIT IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINA NICE PROVISION." TOTAL AMOUNT DUE . — 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECTAND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED This application is not a permit until signed by the IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building Official or his/her Deputy: and Fees are paid, and WORKMEN'S COMPENWION INSURANCE AND RCW 18.27. receipt is acknowledged in space provided. (425) ,-,52PE DATE SIGNED OFF U E DATE � �ERENT) AISIIGN 41", Ak k OiA 771-0220 �A - RELE ED B Y- f r;jTc/ / ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL ---- A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL-FILE YELLOW- INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 5/98 41 PC. 1891, Date: To: Subject: Transmitting CITY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 DEVELOPMENT SERVICES DEPARTMENT Planning - Building - Engineering Letter of Transmittal July 7, 1999 Environmental Review Section Department of Ecology PO Box 47703 Olympia, WA 98504-7703 PC-99-171 Determination of Nonsignificance For Your Information: X As you requested: For your file: Comment: Note attachments: X CC: Doug & Linda Coubern PC-99-171 SEPA Notebook Sincerely, Sharla Graham, Administrative Assistant BARBARA FAHEY MAYOR Incorporated August 11, 1890 Sister City - Hekinan, Japan 0 CITY OF EDMOND? 121 - 5TH AVENUE NORTH, EDMONDS, WA 98020 (425) 771-0220 RCW 197-11-970 Determination of Nonsignificance (DNS) DETERMINATION OF NONSIGNIFICANCE Description of proposal: The demolition and replacement of an existing deck (City of Edmonds Plan Check #99- 171). Proponent: Doug and Linda Coubem Location of proposal, including street address if any: 21130 Shell Valley Road, 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. X 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 14 days from the date below. Comments must be submitted by Responsible Official: Jeffrey S. Wilson Position/Title: Planning Supervisor, Department of Community Services - Planning Division Phone: (425) 771-0220 Address: City of Edmonds, 121 - 5th Avenue North, Edmonds, WA 98020 Date: -1 Iq Cr Signatusr- XX You may appeal this determination to Robert C�ave, Planning Manager, at 121 - 5th Avenue North, Edmonds, WA 98020, no later than 7/ 1999, by filing a written appeal citing the reasons. You should be prepared to make specific factual objections. Contact Jeffrey S. Wilson to read or ask about the procedures for SEPA appeals. XX Posted on :1 / -7 , 1999, 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 PL98363.DOC 7/2/99.SEPA 0 0 - - -W Mailed to the following along with the Environinental Checklist: XX Environmental Review Section Department of Ecology P.O. Box 47703 Olympia, WA 98504-7703 XX Owner/Applicant Doug and Linda Coubern 21130 Shell Valley Road Edmonds, WA 98026 cc: File No. Plan Check —99-171 SEPA Notebook Page 2 of 2 PL98363.DOC 7/2/99.SEPA "-, —', S ') "� Date: July 2, 1999 To: File No. Plan Check 99-171 From: Kate Galloway Via: Jeffrey S. Wilson, Responsible Official Subject: ENVIRONMENTAL DETERMINATION FOR A DECK REPLACEMENT, 21130 SHELL VALLEY ROAD, EDMONDS. I have had the opportunity to visit the site and review the environmental checklist, which have been prepared for the project. A copy of these are filed in the official file for this permit. Based on my review of all available information and adopted policies of the City, I recommend that an environmental determination of non -significance be issued for the project. Review by Responsible Official I concur: I do not concur: Comments: -7 fafl?cr I I Je e W�ilson Date Attachments File No. Plan Check 99-171 City of Edmonds czq Planning Division PL893632.DOC 07102/99. As of October 8, 1993, Environme- ntal Checklists must be - submitted with the following: 1. An $85 application fee. (An additional fee may be charged for those reviews requiring more than 2.5 hours of staff time to review.) 2. An adjacent property owners list property owners within 300 feet of property. (These must be in a 3 label format.) including all the subject across mailing For questions, ask for a Planning staff person. 0 M 0 C= M C= C/) M W C-) --J CITY OF EDMONDS ENVIRONMENTAL CHECKLIST St. Purpose of Checklist. The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all governmental agencies to consider the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal (and to reduce or avoid impacts from the proposal, if it can be done) and to help the agency decide whether an EIS is required. Instructionsfor Applicants: This environmental checklist asks you to describe some basic information about your proposal. Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of 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 answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the answer, or if a question does not apply to your proposal, write "do not know" or does not apply". complete answers to the questions now may avoid unnecessary delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have 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 significant adverse impact. Use of checklistfor nonprojectproposals. Complete this checklist for nonproject proposals, even though questions may be answered "does not apply." IN ADDITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D). For nonproject actions, the references in the checklist to the words "project," "applicant," and "property or site" should be read as "proposer," and "affected geographic area," respectively. A. BACKGROUND 1. Name of proposed project, if applicable: -,TLAag k--) T 2. Name of applicant: 3. Address and number of applicant and contact person: Page I of 24 CHUTD001-NOV-93 MASTERWEA 4. Date checklist prepared: - '(' —/ 0 -q? 5. Agency requesting checklist: City of Edmonds. 6. Proposed timing or schedule (including phasin g, if applicable): (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) 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. link, (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) Page 2 of 24 CHUTZ001-NOV-93 MASMR\SPEA 0 0 10. List any government approvals or permits thit will be needed for your proposalif known. (STAFF COMMENTS) 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 repat those answers on this page. 12. (STAFF COMMENTS) - t 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 Z=' Oaoc--5 (STAFF COMMENTS) Page 3 of 24 CHUT.D001-NOV-93 MAMMMA 0 * 0 - - TO BE COMPLETED BY APPLICANT B. ENVMONMENTAL ELEMENTS 1. Earth a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous, other: (STAFF COMMENTS) b. What is the steepest slope on the site (approximate percent slope)? -1, 51" '�� (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. (STAFF COMMENTS) A I K110-99d CP1 A k PP d. Are there surface indications or history of nstable soils in the immediate vicinity? If so, describe. (STAFF COMMENTS) Page 4 of 24 CHUT.DMI-NOV-93 MASTEMSPEA 0 e. Describe the purpose, type and approximate quantities of of fill. f. filling or grading proposed. Indicate source (STAFF COMMENTS) g. About what percent of the site will be cove impervious surfaces after project construction (for example, asphalt or buildings)? 7/; (STAFF COMMENTS) h. Proposed measures to reduce or control erosion 0 ther impacts to the earth, if any: (STAFF COMMENTS) 2. AIR a. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities if known. A / A (STAFF COMMENTS) Page 5 of 24 CHUT.DMI-NOV-93 MASMMPEA b. Are there any off -site sources of emissions or odor tha/ Tay effect your proposal? If so, generally describe. (STAFF COMMENTS) C. Proposed measures to reduce or control emissi9fis or other impacts to the, if any: JA (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. �7 (STAFF COMMENTS) (2) Will the project require any work over, in, or adj cent to (within 200 feet) the described waters? If yes, please describe and attach available via (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 e that would be affected. Indicate the source of fill material. (STAFF COMMENTS) Page 6 of 24 CHUTDOMI-NOV-93 MASTEMPFA 0 (4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. .-A f t; (STAFF COMMENTS) (5) Does the proposal lie within a 100-year flood I If so, note location on the site plan. 77V (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 dischargg. AO (STAFF COMMENTS) b. Ground: (1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose, and approximate quantities if known. /YVU (STAFF COMMENTS) Page 7 of 24 CHUTDOMI-NOV-93 MASTERWEA 0 0 (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. (STAFF COMMENTS) C. Water Runoff (including storm water): (1) Describe the source of runoff (including storm water) and method of collection and disposal, if any (include quantities, if known). Where will this water flow? Will this water flow into other waters? If so, describe. (STAFF COMMENTS) (2) Could waste materials enter ground or surface waters? If so, generally describe. 4 11, — Nflj (STAFF COMMENTS) d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: - It / - V 114 Y I (STAFF COMMENTS) Page 8 of 24 CHUTD001-NOV-93 MASTEMSPEA 0 4. Plants a. Check or circle types of vegetation found on the site: deciduous tree: alder, maple, aspen, other: evergreen tree: fir, cedar, pine, other: shrubs grass pasture crop or grain wet soil plants: cattail, buttercup, bulrush, skunk cabbage, other: water plants: water lily, eelgrass, mill'bil, other: other types of vegetation: (STAFF COMMENTS) b. What kind and amount of vegetation will b Map r altered? (STAFF COMMENTS) C. List threatened or endangered species known to be on or (STAFF COMMENTS) Page 9 of 24 CHKLT.DCOI-NOV-93 MAMEMSPEA 0 E d. Proposed landscaping, use of native plants, site, if any: A// (STAFF COMMENTS) 5. Animals other materials to preserve or enhance vegetation on the 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, songbirds, other: 1/4 N't mammals: deer, bear, elk, beaver, other: fish: bass, salmon, trout, herring, shellfish, other: (STAFF COMMENTS) b. List any threatened or endangered species known to be on or near the site. JAIDIW� (STAFF COMMENTS) C. Is the site part of a migration route? If so, explain. A / A (STAFF COMMENTS) Page 10 of 24 CHUTDOCU-NOV-93 MASMR\SPFA 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. (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? List other proposed measures to reduce or control energy impacts, if any: (STAFF COMMENTS) Page I I of 24 CHUTD001-NOV-93 MASTEMPEA 0 0 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. (STAFF COMMENTS) (1) Describe special emergency services that might be required. (STAFF COMMENTS) (2) Proposed measures to reduce or control environmental health hazards, if any: (STAFF COMMENTS) b. Noise (1) What types of noise * exist in the area which may affect your project (for example: traffic, equipment, operation, other)? If (STAFF COMMENTS) Page 12 of 24 CHKUDOCU-NOV-93 MkMR\SPEA (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. (STAFF COMMENTS) (3) Proposed measures to reduce or control noise impacts, if any: FUOH .J V I - (STAFF COMMENTS) 8. Land and Shoreline Use a. What is the current use of the site_and adjacent properties? (STAFF COMMENTS) b. Has the site been used for agriculture? If so, (STAFF COMMENTS) Page 13 of 24 CHUTD001-NOV-93 MAgrER\SPFA 0 C. Describe any structures on the site. (STAFF COMMENTS) d. Will any structures be demo i hed? If so, what? (STAFF COMMENTS) C. What is the current of the 1. 1 " (STAFF COMMENTS) cas-q)- U f. What is the current comprehensive plan designation of the site? L (STAFFCOMMENTS) U g. If applicable, what is the current shoreline master plan designation of the site? -1 a t . (STAFF COMMENTS) Page 14 of 24 CHKLTDOCU-NOV-93 MASTERWEA h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. 1, 1 AFF COMMENTS) AA a r) AA i w i A A ' J-- Approximately how many people would reside or work in the C101pleted project? -I J�J (') (STAFF COMMENTS) Approximately how many people would the completed project displace? (STAFF COMMENTS) k. Proposed measures to avoid or reduce displacement impacts, if any: (STAFF COMMENTS) Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: i (STAFF COMMENTS) CHKLT i DWI-NOV-93 Page 15 of24 MASMMSPEA 0 0 9. Housing a. Approximately how many units would be p housing. I if any? Indicate whether high, middle, or low-income (STAFF COMMENTS) b. Approximately how many units, if any would be eliminated? Indicate whether high, middle, or low- income housing. a (STAFF COMMENTS) C. Proposed measures to reduce or control housing im cts, 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) Page 16 of 24 CHKLT * D001-NOV-93 MAMTR\SPEA b. What views in the immediate vicinity would be alterqd 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 bela safety hazard or interfere with views? (STAFF COMMENTS) C. What existing off -site sources of light or glare njay affect your proposal? (STAFF COMMENTS) Page 17 of 24 CHKLT.DOC\I.NOV-93 MASMMPEA 0 0 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? V F/f I (STAFF COMMENTS) b. Would the proposed project displace any existing ecreation uses? If so, describe. YA (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: .4 (STAFF COMMENTS) Page 18 of 24 CHKLT i D001-NOV-93 MAS7TR\SPEA 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. (STAFF COMMENTS) b. Generally describe any landmarks . or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to thesite. (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. If (STAFF COMMENTS) Page 19 of 24 CHKLMD001-NOV-93 MASMUSPFA b. Is site currently served by public transit? If no, what is the approximate distance to the nearest transit stop? N (STAFF COMMENTS) C. How many parking spaces would the completed roject have? How many would the project eliminate? 7, A (STAFF COMMENTS) d. Will the proposal require any new roads or streets, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether public or private). (STAFF COMMENTS) e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. fi (STAFF COMMENTS) Page 20 of 24 CHUTDOMI-NOV-93 MASTRWEA f. How many vehicular trips per day would be generated by the completed project? If known, indicate when peak volumes would occur. (STAFF COMMENTS) g. Proposed measures to reduce or control transpqrtation 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. (STAFF COMMENTS) b. Proposed measures to reduce or control direct impacts on public services, if any: (STAFF COMMENTS) Page 21 of 24 CHKLT ' DOOI-NOV-93 MASMR\SPEA 0 0 16. Utilities Circlt-udl-it'ie) currently available at the site: natural gas, mnitary r, septic system, other: (�t� a. b. (STAFF COMMENTS) 6�refuse service, (i 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. (STAFF COMMENTS) C. SIGNATURE The above answers are true and complete to the best of my knowledge. make its decision. th Q- Signature of Proponent I understand that the lead agency is relying on them to Date Submitted Page 22 of 24 CHUTD001-NOV-93 MAMR\SPFA 0 0 D. SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (do not use this sheetfor project actions) Because these questions are very general, it may be helpful to -read them in conjunction with the list of the elements of the environment. When answering these questions, be aware of the extent the proposal, or the types of activities likely to result from the proposal, would affect the item at a greater intensity or at a faster rate than if the proposal were not implemented. Respond briefly and in general terms. 1. How would the proposal be likely to increase discharge to water; emissions to air; production, storage, or release of toxic or hazardous substances; or production of noise? Proposal measures to avoid or reduce such increases are: 2. How would the proposal be likely to affect plants, animals, fish, or marine life? Proposed measures to protect or conserve plants, animals fish or marine life are: _�Z 3. How would the proposal be likely to deplete energy or natural resources? it 0 ot 01 / Ma7Q�_ Proposed measures to protect or conserve energy and natural resources are: 1_/0' Page 23 of 24 CHKLT.D0C\1-N0V-93 MAMMSPEA 4. How would the proposal be likely to use or affect environmentally sensitive areas or areas designated (or eligible or under study) for governmental protection; such as parks, wilderness, wild and scenic rivers, threatened or endangered species habitat, historic or cultural sites, wetlands, floodplains, or prime farmlands? Proposed measures to protect such resources or to avoid 0 d cts are: 5. How would the proposal be likely to affect land and shoreline use, including whether it would allow or encourage land or shoreline uses incompatible with existing plans? Proposed measures to avoid or reduce shoreline and land use i acts are: 6. How would the proposal be likely to increase demands on transportation or public services and utilities? on 46:—_ OF Proposed measures to reduce or respond to such demand(s) are: 7. Identify, if possible, whether the proposal may conflict with local, state, or federal laws or requirements for the protection of the environment. Page 24 of 24 CHUTDOCU-NOV-93 MASMR\SPEA 8 9 0 - I C) 9 - City of Edmondj& RIGHT-OF-WAY CONSTRITCTION PERMIT Permit Number: C9 '�( Wue Date: 2, A. Address or Vicinity of Construction: 21130 Shell -Valley (9423872) _ B. Type of Work (be specific): Install New Service C. Contractor: Washington Natural Gas Company Contact: Frank Swan MailingAddress: 815 Mercer Strelgattle, WA Phone: 224-2278 State License #: luill Liability Insurance: _ Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. n Commercial F I I ] Subdivision El City Project g Utility (PUD, GTE, WNG, CABLE, WATER) F] Multi-Fan-jily F] Single Family n Other INSPECTOR: INSPECTOR: TZ V—A—t �r r-n� to r%lt - lc4voe nm� rZ �';— nf ('%It- 1 (2 � 4) In Asphalt over water APPLICANT TO READ AND SI-GN INDEMNITY. Applicant understands and by his signature to this application, agrees to hold C' y ofEdmonds harmleid �!r�nit 'o-ge.' or 0 claims of any kind or description whatsoever, foreseen or unforeseen, that may be made a katt the City of Edmonds, a " o it� plrtm.nt. or employees, including or not limited to the defense ofany legal proceedings including defense'costsv and attorney fees by reason Qfgrant�zg this permit. 1, " -1 . . ;' � THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORA TION,�&��HA,-,�D UNTIL THE Fj&4[�STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and material 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. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. Ihave read the above statements and understand the permit requirements and thepink copyof thO'Permit willbe available on site at all t' or i . nspectiop purposes. Signature: Date: . July 19, 1994 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: NA-A-41TC-Ull RIGHT OF WAY DEPOSIT — TIME AUTHORIZED: VOID AFTER e"'g jo� DAYS DISRUPTION FEE/FUND Ill: .' —I- SPECIAL CONDITIONS: AYA- RESTORATION FEE: COMMENTS: DATE: PERMIT FEE: :�" ) TOTAL FEE: RECEIPT FEE: ISSUED BY: 4 -, "'� W 40 NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 vft� -Addendum to*: -City of FAmonds Right ot Vay,.� Permit Applid"10"n" Pubmitted bys ,TCHELL S.-LANKFOO Ail Engi wring de ni Washington Uat'"" Ural Gas -7 -Z V .521-'5246 VAtt C—Tr I �7 Water main depth gas main Key: ._w_ water -g- gas -ss- sewer -e- watex hydramt 0 . wat(-, _.- valve ?1S ""=`f S1- (1 f-)- k:,A ISOM. Sc4W-. WA S 1111 '206) 6_22-.7.767 � 8 9 0 . 1 9 1�) - CITY OF EDM01\13S 250 - 5th AVE N -EDMONDS, WA 98020 - (206) 77 1-3202 COMMUNITY SERVICES: Public Works * Planning e Parks and Recreation e Engineering September 28, 1988 Mr. Abe Castillo 21130 Shell Valley Road Edmonds, WA. 98020 LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR IS 1V I% P4, I Kt- FILE L;E Re: Traffic Concerns and Petition - Shell Park II Dear Mr. Castillo: The Traffic Safety Committee met on September 27, 1988 to consider the comments regarding traffic in your area. The recent report of an arrest involving negligent driving by a young individual was taken into account. While our limited experience using "speed bumps" in a residential setting has been positive so far, the committee is still hesitant to install more bumps without a thorough investigation and use of less drastic speed deterrpnt options. I am compiling a set of criteria that other local jurisdictions are using to apply solutions to control neighborhood traffic. The committee members will review this material and visit your particular site prior to meeting again on this matter. In the meantime, the vigilance of you and your neighbors in apprehending individuals who endanger the welfare of others is appreciated. The eventual solution may involve a combination of physical and/or community group actions. Should you have questions in the near term, please contact Bob Alberts at 771-3202. Sincerely, CHRIS BECKMAN, P.E. Engineering Coordinator CB/sdt SHLPRKII/TXTST530 ple___ ALBERTS L 0 In(orporated Aij.qtist 11, 1890 0 Sister Cities International — Hekinan, Japan REcE:ivED JUN 10 1999 DEVELOPMENT SERVICES CTR. CITY OF EDMONDS 16 1 1- rl h7h 0 0