21600 HIGHWAY 99.PDF11111111111111
11574
21600 HIGHWAY 99
AD
TAX ACCOUNT/PARCEL NUMBEIV 0058D76� 6�731 01001 15007 Z� OZ,71�200/
BUILDING PERMIT (NEW STRUCTURE): /,?Y, 5-03,90
COVENANTS (RECORDED)
CRITICAL AREAS N ZDETERMINATION: E] Conditional Waiver F1 Study Required K Waiver
2-&
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:' i1q
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: gbk� 712-&1e(-
SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED: /
LATEMP\DSTs\Fomis\Street File Checklist.doc
#P20
CA File No: UA 2-vo-7 od3-
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/vegetation)
1.. Site Address/ Location: Wsp t!WY, ?f
2. Property TAxAccount Number: 0017cgo'-7 QCX�Q:)9c)0 onx�-Rc
3. Approximate Site Size (acres or squarefeet)-
4. Is. this site currently developed? Xyes; _ no.
If yes; how is. site developed?. M014 omerp
5. Describe the general site topography. Check all that apply.
Flat less than 5-feet elevation* change over entire site..
Rolling: slopes on.site generailly 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: - A(O Approx. Depth:
7. Site contains areas of seasonal standing water: ;Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodolain of a watercourse.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
Flows are seasonal? (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 Plan Check Number, if applicable? N,A \Ij
2. Site is Zoned? CG— 2)
3. SCS mapped soil type(s)?
4. Critical Areas inventory or C.A. map indicates Critical Area on site?
-OiN (>C- -aq�,czaV An E�-or=�On A�--,-ndkrn�
V
5. Site within designated earth subsidence landslide hazard area?
DETERMINATION
-ST R UIRED WAIVER
Reviewed by- Date:
Feb.27. 2007 11:14AM MORRIL PIHA REAL ESTATE
FD 4V--
City of Edmonds
Fax: 425,771-0221
Development Services Department
Planning Division
phone: 425.771.0220
-ne 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
hisfher submittal of -the application 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 fi-om obsemfions; of the site or data available at
City Hall (Critical areas inventories, maps) or soil
surveys).
No. 1277 P. 2
Date Received: " '-k4'R440-11
City Receipt#,
Critical Areas File #:CA - 2004 -
Critical Areas Checklist Fee: $135-00
Date Mailed to Applicant: --
A property owner, or his/her authorized representative,
must fIll Out,the checklist, sign and date it, and Subrilit 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 developmait
permit application.
Please submit a vicinity map, along with the signed copy
of this form to. assist City staff in finding and locating the
specific piece of propffty described on this form. In
addition, the applicant shall include other pertimt
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in cornpleting their preliminary assessment Of the Site- .
The undersigned applicant,'and his/her/its heirs, and assigns, in consideration On the processing of the application agrees
to release, indemnify-, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, atising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete infonnation furnished by the applicant, histher/its agents or employees.
J It
By rny signature, I cer* that the jrIfOTIn
knowledge and that Lam authorized to file
SIGNAWRE Of APPLICANVAGENT
exhibits herewith subrriitted are true and correct to the best of my
ition on the behalf of the owner as listed below.
DATE
Property Owner's Authorization P f
13y my signature, I certify that I have authorized k above.Applicant/Agent to apply for the subject land use application,
and grant rny permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
Ownelr/Apphcant:
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Street Address
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City �itate Zip
Telephone: I
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Applicant Representative:
Name
No- ��F
Street Address
-3elff V.*
city St te -02,4 �06Q Zip
Telephone: (2,W)
Email Address (optional):
E
Rose Water Engineering
STORMWATER COLLEeTION & RETENTION SYSTEM
DESIGN CALCULATIONS
FOR
Edmonds Specialty Group
Medical Offices Building
4/19/85
FILE Copy
Design: W.R. Butcher, EIT
-Checked/Approved: A.J. Haugerud, P.E.
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Civil Consulting 7728 1st Avenue N.E., Seatfie, Washington 98115
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,,IIPE COEFFOCIENT�_,_-
REMARKS,'
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JOG NO.-35=0 DATE ��35SHEETeLoFaSHEETS
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RoseWater Engineering
7728 - lst Avenue N.E.
seat"le, VVA 98115
23 5
ZLT HLE0 APR: " 198
Rose Water Engioneenng
STORK19ATER COLLECTION'& RETENTION SYSTEM
DESIGN CAL CULATIONS
FOR
Edmonds Specialty Group
Medical Offices Building
4/19/85
Design: W.R. Butcher, -IT
Checked/Approved: A.J. Haugerud, P.E.
V%tl 4a t 3
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Civil Consulting 7728 ist Avenue N E, Sectfle, Vooshingtcn 98115 (206)522-7776
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RoseWater F-ingineering
7728 - Ist Avenue N.E.
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S7R-7'-EE7 FILE
LEGAL DESCRIPTION Tract 29L except the Westerly 3311more or less
condemned in Superior court cause #78-2-01473-7 and,,.that_portion
of tract 31, Solner's 5 "acre tracts.,--according_to the plan thereof
recorded in volume 7 of plats, p._25, records of Snohomish_County,
Washington, lying Westerly of the Westerly line of State Road #1;
together with that portion of vacated Spruce Street lying between
said tracts 29 & 31. Situate in the county of Snohomish, State
of Washington.'
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-KRUGER'
CLINIC
—#21600
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SIDE END
SIDEVIALK DETAIL. SIGN ELEVAilONS
r,--%_CURB DETAIL
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rvA -"%-a .51, e4 FMAOCEL OF
ALLOWABLE AM ADCnMM M
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LEGAL DESCRIPTION �5,PLAN INITY M�AP.T- ENTRY PLAN
Aumm 2z I=
=--A 1. 1
I
STR HLE 0
CITY OF EDMONDS SIDE SEWER PERMIT
9 0 1 9 PERMIT j`t,,J0 8,321
Address of Construction:
Property Le.qal Description (Include all easements):��[� zm
VIA BALLINGER
Owner and/or Contractor:
>
State License No. din —vl— or —I
L I
Building Permit No.
0. Single Family
0 Multi -Family (No. of Units
K"'Icommercial
El Public
Invasion into City Right -of -Way: El No IR Yes
RW Construction Permit No.
Cross other Private Property: El No 0 Yes
Attach legal description and copy of recorded easement
I certifyWat I haFe'rbad ald shall comply with a . 11 city requirements
as indicated on fhe back of the Permit Card.
Date
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE USE-ONLT,
FOR INSPECTION CALL 771-3202, PUBLIC WORKS DEPT.
-Permit Fee: Issued By
Trunk , Charge: Date Issued: 7 .71
Assessment Fee: Receipt No.: V Vs rl'_�
Lid No.: 1zJ1z'eq
Partial Inspection: Date —Initial —
I Comments
Reason Rejected: Date —Initial
Final Inspection Approved: Datie'716-9 I InitiaA:
PERMIT MUST BE POSTED ON. JOBSITE
W . hIte Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 3190
CITY OF EDMONDS
PUBLIC WORKS' I DEPAR4W. FOR" INSPECTION CALL% Permit
SIDE SEWER PERMIT 775-2525 Ext. 1 220 Issue Date
PERMITIMUST BE POSTED ON JOB SITE
g�lj, Address 'of Construction
'Property Legal Description (include all easements)
Single Family Residence Multi -Family No. of Units
Commercial
4 . Owner and/or Builder F - F: - 4 n b i- 1 1 r,% G, 9 4- q
5. Contractor & License No. T, �1 Ir 4:� V 4 4-� i., 1:� y r� -tr �i 4- 1 rN rr T n e- 7. r, V�' T
6. Invasion into City Right -of -Way: No y Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
E-4 7. Cross other private property: Yes No Easement required
attach legal description and county easement number.
�4 READ THE FOLLOWTNG AND SIGN:
04
P4
a. Property owners must obtain a permit to install side sewers on
their property. A licensed side sewer contractor must be employed to
construct side sewers in the public' right-of-way.
b. The side sewer contractor assumes full reponsibility for each
E-1 installation for one year.
W
�4 C. Commercial establishment requires a minimunCALL A ARODU (6
P4
2� side sewer line. kFQ
0 d. Side sewers may not be installed closer A in (30")
U IR
to any structure. 1- 800 . 5f2U-6,47, 0
e. Side sewer lines must be laid at a minimum grade of 2% (1.15
and maximum grade of 100% (450). 0
E-4 f. No turn in side s8wer greater than 45 (1/8,bend) isoallowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line rur�.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k. Side sewer must be left uncovered until inspected and appro-yed
by the City.
1.� Inspection during normal working hours only. Two (2) working
days 'notice required.
DATE:
APR 1981
that I have read
and shall
comply with the above
Dir. 01 PUL"ic WWAS
PERMIT FEE: <
DISAPPROVED BY:
Date:
By:
Date:
P4
CONNECTION FEE:
APPROVED By:
Date:
0
A 100ro e
PERMIT
MUST BE POSTED ON JOB S I TE
el
DIXY LEE RAY JAMES HUGHES
GOVERNOR wW STATE OF WASHINGTM DIRECTOR
DEPARTMENT OF LABOR AND INDUSTRIES
THIS CERTIFIES THAT THE PERSON NAMED HEREON IS REGISTERED AS PROVIDED BY LAW AS A
CONTRACTOR -GENERAL
LAKE VIEW EXCAVATINGIINC
PO BOX 279
KENMORE WA 98028
01�� *Ii-"
DIRECTOR V
ACCOUNT NUMBER -r-EXPIRATION
DATE
223-01
1 LA-KE-VI-*2ioaD
1 01-04-82!9j
21606 Highway 99, Edmonds
Legal:
Tract,29, except the westerly 331 feet; more or less, condemned
in'.Superior Court Case 4 78-2-01473-7: and that portion,*of tract
31, Solner's 5 acre tract, according to the plat recorded in volumne 7".,,
of plats, page 25, records of Snohomish County, Washington, lying
�i^"the westerly line of state road # 1: together with that
westerly of
portion of vacant Spruce Street lying between said tracts 29 and 31.
Situated in the county of Snoho.mish in the state of Washington.
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CITY of EDM41DS RECEIVED
Q A E SEWER PERMIT
For Inspection Call 771-3202 All C1 15 196. PERMIT NO.
Address of Constructio . n: 0 �UBLIC AW
Property Legal Description (Include all easements):
�IA BALLINGER
L I F_'
IF-T $TATIOIJ
Owner and/or Builder: r, e-
_5 7aeo.,o '
Contractor,& License No: 14) g 5- o 0 Co (?,P, af 5--r Cd C 0 14 ?X
Oingl:e Family Residence
�_�Multi-Family (No. of Units
MIJ
p,,�jCommercial (No. of fixture Units
invasion into City Right -of -Way: No Yes (if Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No X Yes Of Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
Vertify that Mave read ant;9rall comply t e/
ith the -items listed on the back.
Permit Fee:
0,00
Trunk Charge: gs-_ 00
Assessment Fee:
Partial Inspection:
Issued By: J. I_ 6rz�w
Date Issued:
Receipt No.: 411?0
Comments Date Initial
Final Inspection Approved: 8.21.8 , - 'J.1fgZ&1
Date 17 �T A�al
Rejected:
eason
** PERMIT MUST BE POSTED ON JOB SITE **
Date Initial
N
Wh.ite Copy - File Green Copy —Inspector
Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing EASEMENT NO - -------------------------------
NEW CONSTRUCTION REPAIRS F-� LID NO. .119 -------- ASMT. NO . ..........
OWNER EX)MO-P-ADS ----- CONTRACTOR --- W-F-S--r-W.0-0-D ----------- CO -RP- ................ PERMIT NO. 7355
JOB ADDRESS ZG-0-0 --------- H-lwi ----- 9-9 --------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK N -,V --BA-L
.1-A -LINGER.- -
LIFT STATION
------------------------ -------------------------------------------------------------------------------------------- 12 - ---- ]-
NAMEOF ADDITION ---------------------------------- ------------------------------------ ------------------ ------------
i z
(0
1 (10 0 0 "W 1.6. 9 9
30'
larca. C-Ap
30 S1,
rcemc- wvklm
top.
IVASSATA-Tee TH
C.0"UrECTION 2�G STRE-E-T SNA/
Approved:
I (, -
DATEOU
PWW-0001-11175 (REV.11/78) JYB5--- By --- ------ ------- ------ -17
The City of Edmonds Side Sewer Drawing EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION X REPAIRS F-1 LID NO. .11')— ---- ASMT. NO . ..................
OWNER ...KR.-U--GZR --------- CL!t-41C ----- ----------------------------- CONTRACTOR -------------------- PERMIT NO. 118-3zl
-------------------
JOB ADDRESS ---- ?---A --- G ---- 0 .... 0 ------------ " --- W.---3 ---------- ----------------------- LEGAL DESCRIPTION: LOT NO - ---------- --------------------------- BLOCK NO - ------------------- ----------------
------------------------------------------------------------------------------------------------------------------------ -- EVI-A f3ftl-INNG�EP - -- ----
��L
LIFT STATION]
NAME OF ADDITION ----------------------------------------------------------------------------- --------
44.5'
4�'C- -
Qrc-.*..S'DP
12lo-rm c.o. c APs P.V.C.
VDF-EP G"C-0- G'DP
30
C4MC. -rEF
171DP
ST. !�;.W.
Approved:
z
PWW-0001-1 1/75 (REVA 1/78) DATE ................. By,,Lf --V ---------------------------
A
Feb. 27-720,0 1 1 -14AM MORRIS PIHA RELAL ---SWEL
city o9iEdmonds
r
Development Services D Vnent
Planning Division
phone: 425.771,0220
Fax: 425,771-0221 4e4�
-17he 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 subluittal Of.the applicadon 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 (Crifical areas inventories, maps, or soil
surveys).
N o - 12 -,,� -1 1'. 2
Date ReceiveU: oL :X
City Receipt#;
Critical Areas File #:-C--�
Critical Areas Checklist Fee: $135-00
Date Mailed to Applicant:
,W*b
A property owner, or his/her authorized representative;
must fill out the checklist, sign and date it, and subrnit it
to the City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps liec=ary to complete a development
pern-dt application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography Imp$ etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their prelirninary assessment Of the 5ite-
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
. defend and hold the City of Edmonds harmless from any and all damages, including reasonable
to release, indemnify, inaccurate or
attorney,s fees, arising from any action or infraction based in whole or part upon false, misleading,
incomplete inforination furnished by the applicant, his/herlits agents or employees.
J If
By MY signature, I certify that the inforin
knowledge and that Larn authorized to file
SIGNATM Of AppLICANTIAGENT
,exhibits herewith submitted are true and correct to We ocst OIL iny
ition on the behalf of the owner as listed below.
DATE
Property owner's Authorization � I
By my signature, I certify that I have authoftd I above Applicant/Agent to apply for the subject land use application,
and grarit rny permission for the public officials and the staff of the City of ]Edmonds to enter the subject property for the
ownei/Appucant:
�N707 A s I
0
m Z, /6 Tom // hJo A
arrie 0/0 TO M 11'h /hc,
�of
Street Address 9 F ffoo&
City State Zip
Telephone: - 0-
-i
— -AA�p Inntinnal):
Applicant Representative:
Name
12:�Y
Street Address
--Jfjjt,� �V.11
city St te Zip
Telephone: Z,*() 742,41060
Email Address (optional):
X A 00
To.�rLA A�i
elod
#P20
Critical Areas Checklist
Site Information (soils/ topogra:phy/ hydrology/ vegetation)
L Site Address/ Location: Wep I-fwy, ?I
CA FilQo:_UA ZbD--( 0053
"e"" tie
APR 20
2. Property Tax Account Number: QQjc7S('--
7Dj=:)9QQ
3. Approximate Site Size (acres or square feet):
4. Is. this site currently developed? Xyes; — no. A,
If yes; how is site developed? poepifA gfflC0
5. Describe the general site topography. Check all that apply.
Flat less than 5-feet elevation change over entire site.
Rolling: slopes on. site gen erally 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: A( 0 Approx. Depth:
7. Site contains areas of seasonal standing water: N'O ;Approx. Depth:
What season(s) of the year?
8. Site is in the floodway — floodplain of a watercourse.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
Flows are seasonal? (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. Plan Check Number, if applicable? t4 A
2. Site is Zoned?
3. SCS mapped soil type(s)?
4. Critical Areas inventory or C.A. map indicates Critical Area on site?
or.N CX-
5. Site within designated earth- subsidence landslide hazard area?
DETERMINATION
D RPUIRED WAIVER
Reviewed by. Date: a/r_-Z'/n7
PLANNING DATA
— Signs —
, 1011cr
STREET:FAILE
Name:
Wate-- 0 1 Vc)o*
SiteAddress: 7.11(poo ffighwag
Plan Check #: BLD-2007- 00 57 g
Project Description: 7, moviumewi-f- I wall c;,f,3YI pyvPO6ed
Reduced Site Plan . Provided: (19NO)
Zoning:
Comp�ehensive P'la"in Desighation:wehwaj� 99 tvrvv&pY-. / aoivr-ty ay, kw-yv�
MapPage: (15-1-
Corner Lot: NO)
Flag Lot: (Y�S
ADB File # (or date MGW: 0 1 VV0--1-
TOTALAreap Typeof
Type of
Allowed in
Matrix
conditions
Allowed
area per
-Pnit
sign area
Proposed
Sign
zone?
met?
unit
allowed for
sign area
this sign
Example
wall
wfinternal
Yes, with
conditions
Yes
I sq. fl.11ineal
ft. attached
41 ft.
attached wall
41 square
feet
20 square
feet
illumination
wall
Sign #1
fyce -
D'X 6'
fyve*M.
-ro e-
\A.1JjVVKVn41
'011AV4
CP
C,
r-e
. 17 �PWCA ";t,
Sign #2
freeounJ
061
illLA64
Sign #3
VV,bL
jJILAJAM
AULAVV% -
V/
TO TA L Sign A rea for Tenani;§Ite
Max Permitted: 0
Previous Total: N I C',
I Proposed Total: (P 4 IF
Sign Height
S i g n Ty p e: fitzelta V1 AA�l 3
Max Permitted:
Actual Height:
S i g n Ty p e: fytt, &A -AM CL4'"
Max Permitted: I I
;p
ctual Height:
Sign Type: W6W
Max Permitted: WA It
Actual Height:
Sign Lighting
Sign Type: ffxt)qt74&1AA4j�)
Proposed: *jVkk(/VVVA[ ',tkAVn
Allowed in zone:
Sign Type: fy-C.,rc1J7AA,16Ur1 0
Proposed: fk-oy%- jkkkAVV%
Allowed in Zone:
Sign Type: Wa
Proposed: rkM-jJJkAp%
Allowed in Zone: o
'2'5% b 2-5 K 4- g I= I �, ?,0
PLANNING DATA REET�F�ILE
11 ST
Signs --
Colors
Proposed: it 5(pCdJ5
WfMdy WAY,''--; MA"IYU,117PL,
Acceptable? Yrz r2
FReq ires ADB Appro'.' ?
val'
5� Locafi6n
If freestanding �and 3-feet or over (unless a fence) meets setbacks?
We Setbacks
St et-,
P I
F§ i7d- e:
r. '
Side:
I \A/
-Reaf:
ActualSetbacks'
St et:
Side:
Side:
Rear:
W .==[
6
Landscaping for Fr6dstandihg Signs ,
Size:
rld,�a p W, 5
1 Location: Ve_41. elaAgt-, Of
Critical Areas Determination #:
C/ PA VOO:� - DO 7
Study Required
Waiver
Other
STREET FILE
Plan Review BY:
CITY OF EDMO,NDS
DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE, Sec. 306
A t 2 1600 Iii gbway 99 Building Permit Number #850320
Occupancy established by this certificate:
Floor Load signs — in place (per Sec. 2308 U.B.C.) — Capacity signs — posted (per Sec, 3301 (i) U.B.C.)
Floor load and room capacity signs, when required, must remain posted at all th'ites.
WITH
THE Medical 'Ri)i1ding HAS BEEN INSPECTED AND APPROVED AS COMPLYING
PROVISIONS OF THE. EDMONDS BUILDING CODE AND WITH UNIFORM BUI LDING CODES.
T9 86
Issued this Twentieth day of March
t B y
CHIEF BUILDING OFFICIAL
A, This certificate shall be posted in a conspicuous public area and shall not be removed, mutilated or obscured and shall be main-
tained in.legible condition at all times. Any change of occupancy requires a new certif icate.
14/1 INC,
- ?40�
voll I ix%51� a, - , wo - MAER\\e— M OR— P, "i
'i
PLANNING DATA 11 STREET:F:IL:EJ
New Commercial / Multi -Family Projects
Name: �r \_)!� Q_ yl- Y\
Date: [_6.<1)?
Site Address: yl Uo Plan Check #: BLD - (39
Project Description:
0��es
Use(s) Proposed:
C
Allowed Use: NO)
V1, C
CUP File Number:
To Allow What Uses:
Legal Nonconforming Land Use Determination Issued: (YES i NO)
Reduced Site Plan Provided: (YES I
vy)
Zoning:
C_
Map Page: __7
Comp Plan Designation:
Corner Lot: (YES
Flag Lot: (YES i
ADB File Number (date waived):
Lot Area:
Plans Match ADB Approved: (YES / NO)
Shoreline Required: (YEJ�N�)
Critical Areas Determination #: CM '0_7 - X3
tudy Required
w aiver
SEPA Determination:
JX"Exempt
Needed (for sites with 500 cubic yards of grading or within 200 feet of Puget Sound or Lake
Ballinger. Requires: (1) Fee, (2) Environmental Checklist, and (3) APO List with notarized form).
Required Setbacks
Street:
Side:
Rear:
Actual Setbacks
Street:
Side:
Side: C>
Rear:
Lot Coverage/FAR Required:
Lot Coverage/FAR Provided:
Lot Coverage/FAR Calculations:
Building Height
Datum Point:
Datum Elevation:
Maximum Height:
Actual Height:
Subdivision: J
Lot Aggregation Required:
Landscaping
Landscaping Matches ADB Approved:
Landscaping Bid Provided: (YES / NO)
Bond Amount (100% Bid):
Plan Review By:
PLANNING DATA STREET FILE
New Commercial / Multi -Family Projects
Commercial farking A nalysis
Business Name
Type/Use
Parking
Ratio
Tenant
Area
Required
Parking
Total Parking Required. -
Total Parking Provided.-
fulti amily, Par" A
b -F
7# 7B e—d-r :d er Dwelling Unit
Parking Ratio
# Units
Requi
,-�;arkiing
r
Studio
1-2/D.U.
I Bedroom
- U,,---�'
2 Bedrooms
1.8/D.U.
3 + Bedrooms
2.01D.U.
Total Parking Required.,
Total Parking Provided.
Plan Review By:
of ED, 0
CITY OF EDMONDS
1h
121 5 Avenue North Edmonds, WA 98020
Phone: 425.771.0220 Fax: 425.771.0221 - Web: www.ci.edmonds.wa.us
DEVELOPMENT SERVICEs DEPARTMENT: PLANNrNG DiVISION
ADMINISTRATIVE DESIGN REVIEW
FINDINGS, CONCLUSIONS, AND DECISION
TO: B Architects
FROM:
L --6 Planner
ernen Lien, AsJsociate
DATE: January 8, 2009
BLD-2009-0005: The Kruger Clinic proposes replacing a 620 square foot wood canopy with an
800 square foot steel and glass canopy.
A. Property Owner
Kruger Clinic — Goodman Real Estate
509 Olive Way, Suite 1062
Seattle, WA 98 101
B. Introduction
The applicant is proposing to remove the
existing 620 square foot wood canopy that
covers the entry way of the Kruger Clinic
and replace it with an 800 square foot steel
and glass canopy. The new steel columns
will be erected using the existing concrete
footings. The glass will be 9/16' laminated
frosted glass and the steel columns will be
wrapped in manufactured stone veneer.
C. Findings and Conclusions
The subject property is zoned CG2 —
General Commercial (See map to the
right). The property to the south is also
zoned CG2. The City of Lynwood
borders the site to the east. The
properties to the north across 216th St
SW have a variety of zonings including
RM 2.4, RM 1.5 and CG2. The site is
bordered by the Medical Use Zone
(MU) to the west.
Applicant
TGB Architects
21911 76 1h Ave W, Suite 2 10
Edmonds, WA 98026
Page I of 2
File No. ADB-2008-55
Edmonds Medical Center
Landscape Plan Modification
2. The subject property is within three City of Edmonds Comprehensive Plan Overlay areas
including the Medical[Highway 99 Activity Center, the Highway 99 Corridor, and a Highrise
node.
3. The proposed replacement canopy would not substantially alter the appearance of the
building.
4. The proposal would not affect existing landscape at the subject property.
5. The proposal is consistent with the use, development and design standards of ECDC 16.60.
6. The proposal is consistent with the City of Edmonds Comprehensive Plan.
F. Decision
Based on the findings and conclusions, staff finds that the design review for file number
BLD-2009-0005 is APPROVED.
G. Reconsideration and Appeals
Per 20.95.040, a permit applicant may request a reconsideration of this decision by either the
original decisionmaker or the planning manager. If the applicant requests reconsideration by the
planning manager and the planning manager is not available to render a decision with the time
limits required by the ECDC, the planning manager shall designate a supervisor of the original
staff decisionmaker to rule on the reconsideration. The request for reconsideration shall be filed
in writing with the planning manager within 14 working days after the date of the decision. The
requested decisionmaker for the reconsideration shall approve, conditionally approve, or deny the
application. The decision shall be in writing, and shall be appealable to the hearing examiner
under Chapter 20.105 ECDC.
Page 2 of 2
00 � 60 1 Cfl
When recorded mail to:
City Clerk
City of Edmonds
121 Fifth Avenue North
Edmonds, WA 98020
200708221062 CONFORMED Copy
6 PGS
0812212007 4 27 1,45,00
SNOHOMISH C060'
, ASHINGTON
I I
If4 plit
SPACE ABOVE THE LINE FOR RECORDERS USE
Assessor's Parcel No.: 06S60 70000 2-17 00
Applicant: --rth*njt�-)J.-,�a k�Lqen- 46,vic4i-5
ENCROACHMENT AGREEMENT
This ENCROACHMENT AGREEMENT ("Agreement") is entered into between the
'CITY OF EDMONDS ("City") and Tvf%111',jj��'oAj KfLv&C&-ei±^('Le-
("Owner[s]"), in accordance with Chapter 18.70 of the Edmonds Community Development
Code.
1. The Proper . Owner is the owner of that certain real property located at
((,00 fh,2V lqq . within the City of Edmonds,
Washington, Assesso�s Parcel Number 005`60 7 0000:?=q 6 L
and more particularly described as follows -S-2-q —1-?-17. Po
as described in Exhibit "A" attached hereto and incorporated herein by reference.
2. The Easement. The City right-of-way adjacent
existing easement used for (strike those that don't apply) [street,
bik-e�th, pedes ian-easement, sanit �L�, wfttep,--s�, other
or
to owner's property or. an
road, agey, 4fifil, sidewal ,
3. The Encroachment. The Owner desires to encroach upon the public
easement and the City hereby covenants and agrees and grants its permission to Owner to
allow Pr-t%161A.9A-,i D i a C-C-4ioAs Pr ) 51 & At
to remain in a portion of
the City right-of-way/easement. A partial site plan, scaled I "=20', showing the location of the
encroachment is attached as. Exhibit "B" and incorporated by reference. This Agreement is
subject to the following terms and.conditions:
- I of4-
11A
�rtlpl
... 41. 0 0
a. On behalf of themselves, their successors and assigns, the Owner promises to
maintain, repair, remove and/or replace the encroachment located in the easement
at their sole expense to the standards established by the City. All maintenance,
repair, removal and/or replacement shall be conducted solely at the Owners'
expense.
b. The Owner, on behalf of themselves and their successors and assigns,
acknowledge that the City had no obligation to approve the encroachment within
the easement for the sole benefit of the Owner, and the agreements contained
herein, provide sufficient consideration for the Owner and their successors and
assigns to maintain, repair, remove and/or replace said encroachment located in the
easement at their sole expense in perpetuity.
c. The Owner promises to indemnify and hold harinless the City, its officers, agents
and employees from any loss, claim or liability of any kind or nature arising fi7orn
or out of its promises contained within this agreement, including any damage that
may be caused to the encroachment. by the City's operation, maintenance, repair,
replacement or other work related to construction activity within the easement
This promise to hold harmless and indemnify includes defense by counsel of the
City's choosing, the payment of reasonable attorney's fees and court'costs.
Nothing herein, however, shall be. interpreted to require the Owner to indemnify
the City from the negligence or intentional tortuous act of its employees, officers,
or agents.
d. The Owner shall at the request of the City, promptly remove, repair, reconstruct,
and/or replace the encroachment at the Owners' sole expense. Upon receipt of
notification from the City that the City requires removal of all or portions of the
encroachment from within the easement, the Owner will promptly remove those
portions of the encroachment from within the easement area as required by the
City at their sole expense. If the portions of the encroachment required by the City
to be removed are not timely removed by the Owner, they shall be removed by the
City at the expense of the Owner, and the Owner shall reimburse the City for the
costs of removal of the encroachment and disposal of materials as well as for any
increased construction costs or consequential damages incurred by the City due to
the Owners' delay. In the event that portions of the encroachment must be
removed to facilitate utility and/or construction activity by the City within the
easement or other requirements of the City, the Owner.shall be solely responsible
for replacement of the encroachment at their expense upon completion of the
utility and/or construction or other activity by the City.
e. Whatever rights and obligations were acquired by the City with respect to the
easement -shall remain and continue- in full force and effect and shall in no way be
affected by City's grant of permission to construct and maintain the encroachment
structure.
- 2 of4 -
0 0
f. The property owner is required to provide and continually maintain during the
term of the permit a certificate of insurance naming the City as an additional
insured, with respect to liability, and providing that it shall be primary as to any
other policy of insurance. A copy of the insurance certificate shall be provided to
the City at the beginning of each calendar year, no later than the 21" day of
January.
4. Entire AlZreement. This Agreement constitutes the entire agreement between
the parties with respect to the subject matter hereof and supersedes and replaces all other
agreements, oral or written, between the parties with respect to the subject matter. This
agreement may not be amended except in writing in a document filed of record with the
auditor of Snohomish County, Washington.
5. Notices. Any notice which is required or may be given pursuant to this
Agreement shall be sent in writing by United States mail, first class, postage pre -paid,
registered or certified with, return receipt requested, or by other comparable commercial
means and addressed as follows:
ff to the City:
City Engineer
City of Edmonds
121 Fifth Avenue North
Edmonds, WA. 98020
t(to the Owner:
-7-0/tI 11"Q,<VeJ kfzu6-E-fL
7-,Opl IIAJPA) &C,
oeflvuc- , too C) Z>
which addresses may be changed from time to time by providing notice to the other party in
the manner described above.
6. Waiver. City's consent to or approval of any act or omission by Owner shall
not constitute a waiver of any other default by Owner and shall not be deemed a waiver or
render unnecessary City's consent for approval to any subsequent act by Owner. Any waiver
by City of any default must be in writing and shall not be a waiver of any other. default
concerning the same or any other provision of the Agreement.
7. Termination of Aj!rcement. In addition to any other remedy provided for by
law, the City reserves the right to terminate this agreement in the event the encroachment
negatively impacts or damages the City's easement and/or underlying utility systems or
violates any condition of service adopted by the City, at its sole discretion, as may be
necessary to -prevent damage to the City's utility system, or any other public facility which
may be impacted by the Owners' failure to properly use the. easement-
8. Successors and.Assians. This Agreement shall. -be binding and inure to the
benefit. of the parties hereto and their respective legal representatives, successors,and assigns.
Owner* agrees to. incorporate this agreement by- reference in any subsequent deeds to the
property, but any failure to do so does not invalidate this provision.
-3 of 4 -
0 .0
9. Capacity. Each party represents that the person(s) executing this Agreement
on behalf of such party has the autho6ty to execute this Agreement and by such signature(s)
thereby bind such party.
IN WM%TESS WHEREOF, the parties -hereto have executed this Agreemcrit on this day
of 20
OWN,Ei(�).-
STATE OF WASHINGTON
KI
COUNTY OF -5. �..
This day, personally appeared bef6re me, a-CL.4 0 km LL:� bir—
tome known to be- the person(s) who. executed the withir? d foregoing document and that
(helshelthey) A.& signed thR#RW as (hisfizerltheir) at- free and voluntary act
and deed for the uses and
upentioned.
6tary Public
V b rDh.4 6
Ali
ovr- ame
_yped or Printed V
III 1.V OP WA�; �-'Z�Iy- Commission expires: /o
-4of4-
Kruger Clinic
21600 Highway 99
Edmonds, WA 98026:
Parcel Number 00,580100002900
Parcel Legal Description
Section 29 Township 27 Range 04 Quarter NW SOLNERS
5 ACRE TRACTS BLK 000 D-00 - TR 29 LESS W 331.6FT
IN WIDTH OF SD TR 29 & TGW TH PTN VAC SPRUCE
ST (AKA 72ND AVE) LY ADJ PER VOL 30 PQ 165 OF
COMM REC DATED APRIL 9,1928
j5000x[fl5rr IWA 't
GARY HAAKENSON
CITY OF EDMONDS MAYOR
. . . . . . . . . . . . . . . . P�v
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 FAX (425) 771-0221
Website: wwwdedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
it, C. Planning - Building - Engineering
March 14, 2007
I Now
Kruger Clinic, LLC
C/O Tomlinson, Inc.
14100 SE 36 1h Street, #200
Bellevue, WA 98006
Subject: Determination regarding Critical Areas Checklist: CRA20070033.
Dear Applicant:
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 (bottorn of page).
IT IS VERY IMPORTANT FOR YOU TO RETAIN A COPY OF THIS `�`dk!TICAL AREAS
"DETERMINATION" FOR YOUR RECORDS.
Please examine this Determination for additional requirements. You may need to -submit additional
information such as an Environmental Checklist or Critical Areas Study..
The Determination for the Critical Areas Checklist you. submitted is a site -specific determination, not a
project -specific determination.
YOU MUST SUBMIT A COPY OF THE CRITICAL AREAS CHECKLIST and DETERMINATION WITH
ALL PERMIT APPLICATIONS OR YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you,
Planning Secretary
C:National Sign Corp./Steve Zimberlin
*Architectural Design Board
Enclosure
CAMy Documents\LINDA\Linda's CACL.doc
Incorporated August 11, 1890
C, ! - � - .. 411 ! .. . T T - I - : - - .- T - .- - -
#P20
Critical Areas Checklist CA File No:UA Zcu C;i�
Site Information (soils/ topography/ hydrology/vegetation)
1.. Site Address/ Location: W4*9 /-fWX.
2. Property MixAccount Number: .00,79070cco;l9op
3. Approximate Site Size (acres or square feet)-
4. Is. this site currently developed? Xyes; no.
If yes; how is site developed? MOP14 offlerp
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation'change over entire site..
z� Rolling: slopes on site grenerailly less thart 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 deiscribe):
6. Site contains areas of year-round standing water: 0 Approx. Depth:
7. Site contains areas of seasonal standing water: e 0 Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a watercourse.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
Flows are seasonal? (What time of year? Y
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
\j
1. Plan Check Number, if applicable?
2. SiteisZoned? CG-,Z
3. SCS mapped soil type(s)?
4. Critical Areas inventory or C.A. map indicates Critical Area on site?
-Or'N CC 1c, Ecmc=�6,, Are�
V
5. Site within designated earth subsidence landslide hazard area?
DETERMINATION
\ 17
WAIVER
Reviewed
#P20 CA File No:ckA1W-(
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/vegetation)
1.. Site Address/ Location: wep t!WY,
2. Property TaxAccount Number:
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? Xyes; — no.
If yes; how is. site developed? MOP14 dMeirp
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: W 0 Approx. Depth:
7. Site contains areas of seasonal standing water: 0 Approx. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a watercourse.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
Flows are seasonal?. (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn, shrubs etc)
11. Obvious wetland is present on site:
M!,
For City Staff Use Only
\j
1. Plan Check Number, if applicable? N.A
2. Site is Zoned? C-.�G-
3. SCS mapped soil type(s)? A- &Ater&:x)r-W- UAn-.., k"j
4. Critical Areas inventory or C.A. map indicates Critical Area on site? We-r�e�
.Orix CX- -a�,cp-A- At, Ec-ar=;C�C%
14
5. Site within designated earth subsidence landslide hazard area?
DETERMINATION
\K�l
-S]FD R�QUIRED WAIVER
Reviewed.br. Date: I lo
STREff FILF
-7-
0C I 'A
STATUS: APPROVED
Pernik Number: ENG20070128
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDSWA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
Address of Pubfic Use/Encroachment: 21600 HIGHWAY 99, EDMONDS
1`1101"EIZINOWNEIZ BUSINLSS OWNIN
TOMLINSON KRUGER CLINIC LLC NATIONAL SIGN CORPORATION
14 100 SE ST 4203 1255 WESTLAKE AVE N
BELLEVUE, WA 98006 SEATTLE, WA 98118
206-282-0700
ENG20070128
STREEI'US FIENCROACI ENIENT
ENTRANCE SIGN AT WEST END OF PROPERTYON 216TH ENCROACHING IN RIGHT-OF-WAY. SIGN L)OCATED TBEHIND
SIDEWALK
STREET USE: Placement o anv temporary or movable objects in anv portion of public space or City right-of-way
shall meet all code requirements as setforth in thefollowing chapters of the Edmonds Community Development
Code.
ENCROACHMENT. Permanent structures encroaching upon any portion ofpublic space, City right-of-way or
easement area shall meet all Code Requirements as setforth in thefollowing chapter of the Edmonds Community
Development Code.
CODE APPLICATION. Chapter 18.70, 17.65, and 17.70.040 of the Edmonds Community Development Code. All
terms of the adopted ordinance are incorporated herein as if setforth in full and this permit therefore is subject to
the terms of those chapters.
FOR THE TERMIN WHICH THIS PUBLIC USEIENCROACHMENTIS INEFFECT, THE OWNER SHALL COMPL Y WITH
THE PERMIT CONDITIONS SET FOR TH B Y THIS PERMIT
NOTE: The issuance of this permit is understood by the owner to be of a temporary nature, shall vest no
permanent right and shall be issued and may in any case be revoked at the sole discretion of the City per ECDC
18. 70.040. Applicant is responsible to provide a copy of the insurance certificate to the City at the beginning of
each calendar year, no later than the 21st day of January.
INDEMNITY: The Applicant understands and agrees to hold the City of Edmonds harmlessfrom any injuries,
damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the
applicant or the City of Edmonds, or any of its departments or employees, including but not limited to the defense
of any legal proceedings including defense costs, court cost, and attorneyfees by reason of granting this permit.
In addition, the applicant understands that helshe shallprovide and continually maintain during the term of the
permit a ceritificate of insurance naming the city as an additional insured, with respect to liability, andproviding
that it shall be primary as to any otherpolicy of insurance.
THISAPPLICATION ISNOTA PEPMITUNnL SIGNED BY THE CITY ENGfNEEROR HISMERDEPUTY: AND FEESARE PAID,AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED.
N FILE
F-1 INSPECTOR COPY
Monday. December 3
E] APPLICANT COPY
0
0
STATUS: APPROVED ENG20070128
CONDITIONS i
• The proposal will not adversely impact public space open to vehicular or pedestrian travel.
• Architectural Design Board Approval has been granted or the process has been administratively approved.
• The proposal will not unreasonably interfere with the rights of the public.
• The proposal either benefits the public interest, safety or convenience (e.g., supports or protects the city street)
or is an accessory structure such as fence normally associated with residential use of the property as My
complies with the requirements of criteria 3 above.
* None
~Rp' rx4l M-
- - "p, �, . 11 W I dL.L;
0TY OF EDMONDS RECEIVED qetrmit No. Z4
COMMUNITY SERVICES DEPARTMENT
RIGHT OF -WAY CONSTRUCTION PERMIT Issue Date'
A. *Owner.G95U?CWJ1C (4-D W KK�C� �+ N f %61- T_ 0 G WST
1. 0 V_oi�fractor:
Name Z%00 �AWY 91 Name � &,-71 t 50TH�[-_ Lt WE
Mailing Address �_-bmopbs CV20 Mailing Address,5�_-MT LL (ig 1 �6
City State Zip City State Zip
\)J I LU P\ 0- U?-FT -Z66 - -�6s - gi O-D
State License Number Telephone Number
C. 9 Address or Vicinity of Construction: Vl000 PW\T- .91
Type of Work to be Done: 7�016L-WISUr-&-UPOR5i
D. 0 Work in Connection With: El Sub or Plat IV I El Single Family
)<Commercial /�/ "', El Multifamily
E. 0 Pavement Cut: El Y >(N F. 9 Size of Cut: - X
ptys
0 City Projects
0 utility
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds
harmless from any injuries, damages, or claii.ns of any4ind or description whatsoever, forseen or unforseen, that may,
be made against the City of Edmonds, or any of its departments.or employees, including or not limited to the defense
r ife4s by reason of granting this permit.
of any legal proceedings including defense costs, cou�t-,cdsts, and ad'ouney
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Estimated restoration fees will be held until the final street patch is completed by City forces, at which time a debit or credit will be
processed for issuance to the applicant.
• A 24 hour notice is required for inspection; Please call Engineering: 771-3202
• Work is to be inspected during progress and at completion.
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
.9 All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and that this permit must be available at the job site for inspection purposes at all times.
Signature.<0 J/� � &;i� - WiLUAm5 -*A6t6TT Date:
%,/ 1. V , C�,)U;er or ko�Ktractor �11o)�_-CT tWG(L .
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
A1313Dn1/PnQV- Alcl PFRMIT FFF-
Z Time Authorized: Void after -f-30 days. Restoration Fee:
0
Special Conditions: Ataw--a 00 Receipt No.:
En
Fund 111 Fee:
Street Cut Dimensions: x
U RELEASED BY: Date_,,K�_ V INSPECTED BY Date
C4 C/ R-r-O")z
0
NO WORK TO BEGVN�PRIORfkT.OtPfiR_MIT ISSUANCE
Enj�. Div. March 1989
FIELD INSPECTION Nos (FIld I I I - Route copy to Street Dept. -
Comments:
I Diagram:
CONTRACTOR CALLED FOR INSPECTION El YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. T
MAY 08 '91 05:21PM CIS NEWHOUSE
P. 3/3.
..two
su
FIE
'u- .. -
low -
REMODEL OF, AND ADDMON TO
IL
UJ
Em
8 V.-
RLE
KRUGER CLINIC OOHOPAEDICS
Thomas J. Degan, M.D. FAAos
Loren J. Jensen, M.D. *7
" I _� I`% k I A
Orthopaedic Surgery
Fractures
Sports Medicine
CNA Architecture Group
Vaughn D. Bray
3050 152nd Ave NE
Suite 600
Redmond, Washington 98052
January 28, 1991
RE: X-ray film processing chemicals
Dear Sirs:
JAN 3 fl 1991
PROJECT: ri A"6A.
PROJ. NO.:
FILE NO .:
COP!ES TO:
Enclosed is some information I requested from Advanced
Images; the company who provides service for our X-ray
developer. I spoke with them today and they have advised
me this should be the information which you are seeking.
Please review this in your quest for information regarding
.-the x-ray,developer -chemicals. If -I can be of further
-:�asslstance,pl ease feel free�.to contact me.
Sincerely,
Ma3k_rXynVManager Kruger Clinic Orthopaedics
MD1md
2160OHwy.99#7 Edmonds.WA98026 206/774-2636
4L * 2-1� 0 -�ro K, "
Si i -- ET F �'L Ev" "- 90(14-13-,8
ISED 0
REV# 01
HATFRIAI W-FT nATA (WFT 3 0 1991
pfjOjF-C,T*
SMI(W I GFNFRAI TWIRMATION
PON ICT NAMF: PFt0j. NO.*
AUTEX Developer Replenisher I FwE NO.' e4 —
Working Strength (1CP!SS'TO:
CHEMICU FAMT1 Y
Photographic Developer Aqueous Mixture
EMR n-n-J. cmippim mw
Not Regulated Not Applicable
MW FAM IRER MAU E T1 F mif"
ALLIED PHOTO PRODUCTS CO. (404) 448-0250
5440-A Oakbrook Parkway CBEMTRFr PHNIF NUdRFR
Norcross, Georgia 30M (OW) 424-rJOO
CFrTInN TT TWMnIFNTS
PRTNCIPAI HWARMIS akEMMS r-AA-1- PFRf-'FNT II&CM1 n I ihii-v&m
CAS# 123-31-9 1 - 2 2MG--H3 2MG-M3
SODIUM SULFITE CAS4 7757-83-7 3 - 8
POTASSIUM WDROXIDE CAR 1310-58-3 .1. - 2 2MG--M3 (C)
WINA
W11 Mr, PnINI-- (;PFrTFI ARA Jj"ATFR
Greater Than 212 Deg. F. (1000 Approx. 1.080
VAPnR PREMIRE (mm HG-) ILEJA-VOLUdE
Approx. 17 Approx 92
VWM rFNRTTV I AIR -11
Approx. 0.6 Not Available
C
M 11A11 ITY TN UATFR Efl
Coaplete Approx. 10.55
WWARMrf MO-M
Pale Yellow, odorless liquid
MATERIAL SWETY DATA SHEET# M-0 'T FLE REVISED LS 04-13-88
S Z REW 0 1
SECI lij I F Akin cy
�IR oSIOU HAMM RAT
11kL.
EIACN ECINLITEST METHO I WID-IGNIIIULIEWER lUid:-
Non Combustible Not Applicable
R AMMO E I IMIT LEL LIEL
None None
None
E11INGUISHING mEnT
Use the media suggested to extinguish the source of the fire.
SEECTAI FIRE IGHYING EMEWBE
None
1UGW FTW ANn FYPI NIM HWAR
None
. itacmd n i i m i T w i iF
See Section 11 See Section 11 See Section 11
r"TWGR - NTP MMAH CARUNGOL.- TAR KALB
None Known None Known
SYNTnKq rF FYP(MK
Coaplaints of burning or irritation of the eyes and mucous membranes as well as the development
of skin irritation or Bereatitis.
matra rwomw Mr3RAVATFn gy Fyprrjiw
None Known
PRIBURY FAIIE(q) OF ENTRY
Eyes, skin and ingestion
FWROCY FIRST Ain
EYES: Flush with water for at least 15 minutes and get medical attention. SKIN: Flush skin with Plenty
of water. If skin irritation or allergic reaction develops, set medical attention. -
INGESHON: Seek immediate medical advice giving full details of amount swallowed and toxicity.
SIARY1 I TY
Stable
INMMPATIRTITTY IMATFRIAlq Tn Mini
Mineral Acids
2= :;='"
711WO.
; T.
- W. IC, Will
6MIONIEM,
rmniunhe To Am
None Known
COMILL(Vajo-ffiffill)
None Known
-2-
MATERIAL SAFETY DATA SHEET# REVISED BATF&-13-1�3
REVI 0
SMUH-VILEW18MOTAI
,,Z,ET FLE
SETI I RF
Wear Protective clothing as specified in Section VIII. If Federal, State and/or Local regulations
Permit, neutralize with Sodium Bisulfate and flush to sewer with large amounts of water. Otherwise add
Dry absorbent, clean up and Place in an approved D.O.T. container, label and seal for disposal
UARTF WN&N MENG
If Federal, State and -or Local regqlation Permit, flush neutralized material to sewer with
large amounts of water. Otherwise dispose of contaminated Product and haterials used in cleaning up
Spills in a manner approved for this material. Consult Proper FederaL. State and -or Local regulatory
agencies to ascertain Proper disposal Procedures.
��Iw s Ic"RIJ I I lci� Ili F!, W �r' j)Jjjj $ If"M lljjjl�
FyF PgnIECIMN
Safety Glasses or Goggles
RRSPIRATARY EMTFrTTnN (SEECTEY TYPE)
None should be needed
As ecessary to Prevent eye and skin contact.
SK1Uj2UM1W
Impervious gloves should be worn
vF NTI[ATTAN RFfT1MmFNr1Ffi
Good general ventilation
14YATF-Mir PRAUTM; TN HMN W ANn MIRAW
Keep tightly sealed. Do not store or consume food, drink or tobacco in area where they may
become contaminated with this material. Store above 40 Deg. F (40. Avoid unnecessary Personal contact.
Avoid incompatible substances. Wash thoroughly after handling.
nTWR PRFr-Al[jf
The routine use of a non -alkaline (acid type) hand cleaner will winfikize the possibility of al lergic
skin reaction.
HMIS RATING: HEALTH 1, FIRE 0, REACTIVITY 0, PERSONAL 8
The information contained in this Material Safety Data Sheet is furnished without warranty of ariy
kind. The user must make independent determination of suitability and completeness of iriforaiation
to assure Proper use and disposal of this material and safety and health of employees and customers.
This statement is incorporated as Part of this Material Safety Data Sheet.
-3-
PgnnllcT WTG
AUTEX Fixer & Replenisher
Working Strength Dilution 1+4
rt"TCa FA14TI -
Photographic Fixer
MM D-BJ--CNTPPI -Haff-
Not Regulated
HOLEWMEEEL
ALLIED PHOTO PRODUCTS CO.
5440-A Oakbrook Parkway
Norcross, Georgia -3M
..EMIPAI HA7ARDQLM-00MeMMS-
R"IUM THIOSLUATE
SODIUM SUUITE
ACETIC ACID
E
6
SMIGN I MnAl i wagm iom
Off
CAS# 7783-18-8 8 - 12
CAS# 7757-83-7 1 - 2
CAS# 64-19-7 1 - 2
SECII(IN ITT 1CALJ=
B01UNG20.18L
Greater Than 212 Beg. F. (100C)
on PF (MM MA
Approx. 17
VfieDR_DWM_(A1R = 11
Approx. 0.6
M-UBTl ITY TH-WAM
Complete
APEFARANCE AD -ODOR
Colorless liquid with a slight ammoniacal odor.
MSD# M- 13 0
REVISED DATE: 04-12-88
REV# 01
EORBLU
Aqueous Mixture
D-Od- HAMM 0 ASSIFIrATT
Not Applicable
(404) 448-0250
oEmr am
(8DO) 424-M
THREN01 n I I M T T VAI I 1E
ACGIH . 0SHLEEL
10PPM
S2Fr1FTC-=IIY-iWUU—=-U
Approx. 1.085
Approx. 88
RAPDRATHIN RATE
Not Available
EN
Approx. 4.20
F,
MATERIAL' SAFETY DATA %EET# M-13 REVISED DATE: 102-88
REV# 01
SECTION 1V-E1RE-2M-EXaMbLWffiDJM
aA%U)OTNI ( EST-MEIM- WM_jGHITTQN TRMAII
Non Combustible Not Applicable
R AMMAH E 11MIS LEL UEL
None None None
EXTINMISHIMMIA
Use the media suggested to extinguish the source of the fire.
SeECIALEIRE-EIMMM-MMUM
None
ISLIAL FTRF FYPI 1"ZAM
None
qFr-TlrN V HFALTH 7 D-MIA
IM l:lO1JLLMLMLlJE M nffigm -11-LIHILaff— AM114 TIMSM n I IMIT VAl UE
See Section 11 See Section 11 See Section 11
Aw- �MAM
None Known None Known
Low hazard for usual industrial handling
MEDICALCOMIUMMAMMEBALUME
None known.
PRTMAR ROUW(Sj-rF FNTRY
Eyes, skin and ingestion
EtEROM FIRST Al
EYES: Flush with water for at least 15 minutes and get medical attention. SKIN: Flush skin with Plenty
of water. If skin irritation or allergic reaction develops, get medical attention.
INGESTION: Seek immediate medical advice giving full details of amount -swallowed and toxicity.
qTART1 ITY
Stab I e
INCOMEMBIl TIY iWERIALS-IOAVOID1
Strong Alkalies
HAZARDOUSiML)MMAHOL
Will not occur
Ammonia
MNDITTW O-MID
None Known
CONDHIM-IO-AVOID
None known
E 1E E T F L E
MATERIAL SAFETY DATA SHEET# M-13 REVISED DATE: 02-88
REV# 01
SECUOU11-EWIROMMAI IEUM-MOCEDIM
sell-L-Emoba
Wear Protective clothing as specified in Section VIII. If Federal, State and/op Local regulations
Permit flush to sewer with large amounts of water. Otherwise add
dry absorbent, clean up and Place in an approved D.O.T. container, label and seal for disposal
WASIE-DIS120SA METHO
If Federal, State and/or Local regulations Permit, flush material to sewer with
large amounts of water. Otherwise dispose of contaminated Product and materials used in cleaning up
spills in a manner approved for this material. Consult Proper Federal, State and/or Local regulatory
agencies to ascertain Proper disposal Procedures.
SECI1M-UU-%MTA1 MUECUM IME TIM
Eff-EROIECIURL SKIN Emi=ffl
Safety Glasses or Goggles Impervious 9.1oves should be worn.
RFSEIRAT08LMECIMH-LSffL0-TyEE1
None should be needed
nTWR TFUT
As necessary to Prevent eye and skin contact.
SECIUN TY SEECTAI PRPMRIONS
VFNTTIATTflN-RFfnMMFN
Good ventilation required
UYUBJr. PRAUUTS IN HAM TUG AND STORAGE
Keep tightly sealed. Do not store or consume food, drink or tobacco in area where they may
become contaminated with this material. Store above 40 Deg. F (4C). Avoid unnecessary Personal contact.
Avoid incompatible substances. Wash thoroughly after handling.
OBJEUMECMUOUS
None
MIS RATING: HEALTH I , FIRE 0, REACTIVITY 0, PERSONAL G
The information contained in this Material Safety Data Sheet is furnished without warranty of any
kind. The user must make independent determination of suitability and completeness of information
to assure Proper use and disposal of this material and safety and health of employees and customers.
This statement is incorporated as Part of this Material Safety Data Sheet.
7-
JURGEN K. RIEGER, M.D. INTERNAL MEDICINE
21600 HWY 99 S., SUITE 4
EDMONDS, WA 98020
774-2626
AN 3 0 toll
Pjj0.jr:C r.
. A1eAAA-.&. e4... 6&4- L
January 24, 1991 PROJ. No.: '2--77
PLE No. Zes 6
\/QUJKn CCPIES 41-6. 1
TO:
Vbs Bray clz�
Vau hn:
6
Dear Valf,
Per our conversation yesterday, we performed very few laboratory evaluations in our "lab"
area. Basically, we check an occasional urinalysis, usually at the end of the day when our
building lab is closed, as well as vaginal wet mounts. For the later we would use potassium
hydroxide at a rate of a small bottle consisting of 2-3 tablespoons that would last most of
the year. There is also a cleaning powder concentrate with disinfectant that is used to
disinfect Dr. Zufall-Larson's metal vaginal specula at approximately four gallons per month.
Isopropyl alcohol at less that one gallon per month. There is a germicidal solution for
soaldng instruments in to sterilize them, ie. suture removal equipment, etc. and derma scrub
soap, quantity unknown. There are no real chemicals or reagents per say that are utilized
in this area.
Sincerely,
Jurg n
JKR:hnc
71,
I
RFrm CNIA
JOHN L. HEADLEY, M.D., P.S. El SHAROrTNIC'OLAZZI, M.D.' D JETTIE M. PERSON, M.D.
DIPLOMATES AMERI5M T35RWgf DERMATOLOGY
PROJECT: 1490&6P. (�Ll L)
PROJ. NO.:
FILE NO.'ZI 0
CCP',SS TO:
"j
Lo
611-
Al.
1 11 1 L.
Sr--� 22EY' P" E
KAUFFMAN'S PHARMACY, INC. (206) 774-2601
21600 Highway 99 * Edmonds, Washington 98020
� C'r'� it) I q 9 1
-F0 W k"O)M a � M I cArxjl� I
-r4
a,k K
alv-
f f V-f
ktv-
r)U� a"- ptJ
AN '2 2 !991
PROJECT:
PROJ. NO.:
FILE NO.:
r:�prlz -rO-
`7 7�
�ET F", E
FILE # ADB-36-89
DETERMINATION OF NONSIGNIFICANCE
Description of proposal Addition of 20,000 square feet of space to a medical
office building. Proposal includes parking and landscaping.
Proponent Group Clinic R & D; Robert Chaffee, M.D., Representative
Location of proposal, including street address, if any
21600 Highway 99, Edmonds, WA 98020
Lead agency City of Edmonds Planning Division
The -lead agency for this proposal has determined that it does- not have a prob-
able significant adverse impact on the environment. An environmental impact
statement (EIS) is not required under RCW 43.21C.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.
There is no comment period for this DINS.
./5�X7 This DNS is issued under 197-11-340(2); the lea� agency will not act on
this proposal for 15 -days from the date below. Comments must be submitted
by June 7, 1989
Responsible official Leigh Francis
Position/title Associate City Planner Phone 771-3202
Address 250 5th Ave. N., Edmonds, WA 98020
Date May 23, 1989 Signature
ZEW You may appeal this determination of nonsignificance
to- James Driscoll , Hearing Examiner
at- 250 5th Avenue North, Edmonds, WA 98020
no later than 5:00 PM, June 16, 1989
by filing a written appeal
You should be prepared to make specific factual objections. Contact
Leigh Francis to read or ask about the procedures for SEPA appeals.
`7 There is no agency appeal.
sr_-. -1 --= F--
1. 11 E
'd J -�"U H.
CONDITIONS OF APPROVAL
FILE NO. ADB-36-89
This Mitigated Determination of Non -Significance is subject to the
following conditions:
1. Prior to any grading activity, the Applicant shal-1 obtain a
-grading permit from the Building Division and comply with all
conditions of permit approval. In addition, a conditional use
permit for grading shall be obtained for the Edmonds Hearing.
Examiner.
2. The Applicant shall submit an erosion control plan for review and
approval by the City Engineer prior to issuance of a grading
permit.
3. All excavation and grading shall comply with chapter 70 of the
Uniform Building Code, 1985 edition.
4. The Applicant shall submit a truck route p.lan to the City Engineer
for approval prior to removal of excavated material.
5. The Applicant shall be responsible for keeping all streets clean
and free of debris.
6. The Applicant shall be responsible for providing verification of
the total amount of excavated material prior to finalizing the
gra.ding-permit and obtaining a building permit for the building.
Verification shall be by a letter from a licensed civil engineer
stating that he/she has inspected the site and that the grading
conforms to Chapter 70 of the Uniform Building Code, 1985 edition.
7. All grading work shall be done during normal working hours of the
City of Edmonds, 8 AM to 5PM, Monday through Friday. All other
construction.hours shall be limited to 7 AM to'10 PM Monday
through Friday and 10 AM to 6 PM weekends and holidays.
8. If deemed necessary by the City, the Applicant shall provide
traffic control during removal of the grading material.
9. Prior to issuance of any building permit, a detailed storm water
plan shall be submitted to the Building Division.
10. Facilities shall be provided to ensure that undesirable substances
are not washed into the storm sewer.
KRUGER/TXTLAF52
E NV I RONME NT AL CHECKLIST
purpose of Chccklist:
8 � �_*: L�z
7-d--i'"ET FLIE
The Staic Environmental Policy Act (SEPA). chaptc-, 43.21C RCW. require.-, all govcrninctital agencies to consider
the cn%-ironmcnial impacts of a proposal b=forc making dcclsions. An envirorimcrital impact statement (EIS)' must be
prepared for all proposals with probable significant adverse imp:!cts on the quality of the environment. The purpose of
this checklist is to provide inforination to �clp you and th.- agency idcnilf)- impacts from your proposal (and to reduce
or avoid impacts from thc'proposal. ir it can be done) and to hc;o the zecncy decide whcChcr an EIS is required.
Instructions for Applicants:
This cnvironm ' ental checklist asks you to describe som-. basic information about your proposal. Governmental agcn-
cies use this checklist to determine whether the envirorment2! lmpac�s of your proposal.are significant. requiring
preparation of an EIS. Answer the questions briefly. with th-- rnost precise information known, or give the best de-
scription you can.
You must answcr each question accurately and c3rc-fuliy. to -.h: b--sz of your knowledge. In most cases, you should
bc able to answer the questions from your own obscrvatiens o. proicc: Plans Without the need to hire experts. Ir you
really do not know the ans*wcr, or ir a question does not 2pply zo your proposal, write 'do not know' or -'does not ap-
ply". Compl--tc answers to the.qucstions now may avoid unnec:ssarx- dc!2vS 12L--r.
Some questions ask about governmental reculations. such as zoning. shoreline, and landmark designations. Answer
these questions if you can. If you have problems, the eove.-nmental 2ecncics can assist you.
The checklist questions ap�ly to all parts of your p-roposal. ---.---n if -you plan to do them over a period of time or on
difrzrcnt parcels of land. Attach any additional infor-.-.vation th--:- A -ill ilcip dcsc7ibe your proposal or its environmental
effects. The a ency to which you submit this checklist m2y ask you to zxplain your answers or provide additional in-
formation reasonably related to determining if there m?y be signific-triz -1avc.-sc impact.
Us.- or checklist for nonprojcci proposals:
Complete this checklist for nonproject proposals. cvtn -.�oug-: au.-stions may be answertd "dots not apply." N' AD-
DITION, complete the SUPPLEMENTAL SHEET For, NON.-PRO.'ECT zXTIONS (part D).
For nonproject actions, the references in the ch.eckils-, to th: \vo.-dz -projec-,,* "applicant," and 'property or site*
should be read as 'proposal,* 'proposer.' and 'affcctcd ar:a. . rc�spectivclv.
A.BACKGROUND
1. Name or proposed project. if applicable:
Kruger CLinic Expansion
2. Name of applicant: Group CLinic R&D Partnership
3. Address and phone number ofapplicant and contact pL.,son: Robert Chaffee, M.D.
21600 Highway 99
Edmonds, WA 98020
4. Date checklist prepared: Apri L 7, 1989 774-2611
5. Agency requesting checklist: City of Edmonds, WA
6. Proposed timing or schedule (including phasing. if appilcabl:):
Construction approx. August, 1989-ApriL 1990
7. Do you have any plans ror future additions. cxpanslon. or fu.-,.hcr 2c-.I%-ity rclatcd to or connected with this proposal?
If ycs, explain. This expansion is phase II of originaL-pLanned project & wi.LL',com—
pLete faciLity capabiLities on the site.
�d'_d.HET F'
7
S. List any crivironnicrital inforniatiun you knw-% about thai has bc-en
this pr opo . sa 1. None prepared. oy -ill bc 11--eparcd. directly related to
9. Do vou know %%-hcthcr applications arc p,-ndin,- for govcrrimcrital approvals of other proposals directly arrecLing the
property co%,crcd by your proposal' If vcs. explain.
None
10. List any government lapprovals or permits that will be nceded for your proposal. if known.
AppLicabLe BuiLding Permits
11. Give brief, Complete description of your proposal, including the proposed uses and the size of the project and site.
There are several auestions later ir. this checklist that ask vou to describe certain aspects o; . your proposal. You do not
need to repeat thoic answers on this page. (Lead agencies- mav modifv this form to includ'
mation on project description.) . C - -- additional specific infor-
20,000 + SF, 2 story expansion of an existing medical. office SuiLding
(22,400 SF). Site area 136,800 SF.
12. Location of the proposal. Give sufficient information for a person to understand the precise location of your pro-
posed project, including a street address, if Pany, and section, township. and range, if known. If a proposal would occur
over a range of area. provide the r?ncc or boundaries of the site(s). Providc a legal description, s:tc p!an, vicinity map,
and topographic map. if reasonab!% available. While you should submit any plans required by the agency, you are not
required to duplic2tc maps or detailed plans submittc� with any permit applications. related to this checklist.
Address: 21600 Highway 99 Legal.:
Edmonds, WA 98020
(corner of 216th and Highway 99)
TO BE COMPLETED BY APPLICANT
B. ENVIRONMENTAL ELEMENTS
Tracts 29 & 31 (patti.aL) of SoLnr
5 acre tracts according to the
pLan recorded in VoL.7 of pLats,
p. 25, Snohomish Co. WA records
EVALUATION FOR
AGENCY USE ONLY
1. Earth
a. Gcncral dcscription of the sitc (circl.c onc): Flat, rolling, hilly. steep slopcs, mountainous.
other moderate sLope
b. What is the steepest slope on the site (approximate percent slope)?
% 4.0% t
-2-
ET F.-
TO nc cosirLET17-0 BY APPLICANT
UVAIMATION FOR
A (; L".q C %* US E 0 NLY
s
c. %Vhat general t)'Pcs of soils arc found on thc �itc (for c.-:irnple. clay. %and, gravcl, ficat.
muck)? If you know the classiflication of agriculiural soil�. 'N-pcclf% 0-1cin and flotc MW prinic
farmland.
SiLty sand
I . I :11C 1%
d. Arc there surface indications or history of unstable soil� in the iriniccli vicini irso.
describe. None I
c. Describe the purpose. type, and approxi
imatc quantiti;:i of any filling or grading pro-
poscd- IndicaEc source of fill. Z�
Fi LL wi LL be required for parking areas to deveLop appropriate site drainage,
aLso for buiLding footings depending on depth of original. soil. type. FiLL wiLL
come from off site & consist of compactibLe materialL to meet Washington Sta'te
CLass B BackfiLL.
f. Could erosion occur as a result of clearing. construction. or use? If so. generally describe.
Not anticipated.
a
,-. About what percent of the site will be covered with Imoervious sur(uces/aftcr project
construction (for example. asphalt or buildings)? 81 X*
h. Proposed measures to reduce or control erosion. or other impacts to the earth, ir any:
Storm retention to be provided on site for aLL paved areas.
2. Air
a. What (%Pes or emissions to the air would result from the proposul (i.e.. dust. automubile.
odors. industrial wood smokc) during construction and whcn the project is completed*! If
any. generally describe and
. Z give approximate quantities if k�oxvn.
AutomobiLe exhaust; since size of parking & buiLding wiLL be cloubLed, current
exhaust LeveLs couLd aLso doubLe. I
b. Arc there any ofr-sitc sources of emissions or odor that mav affec, your proposal! if so.
gcncrallv describe.
None
c. Proposed measurcs to reduce or control erilissions ur 0,11C7 impacts to air. if anv:
None
-3-
TO III: COMPLETED BY API'LICANT
3. NVater
a. Surfacc:
17VALUATION FOR:
AGCNCN* USE ONLY'
1) Is there any surface waicr body on or in ilic imnicdiate vicinfly of Ilic sitc (Inclu'-4."'Ic
year—round and seasonal streams. saltwater. lakes. ponds. wctland.')? If yes. descrioc, ty-1c
and providc names. If appropriate. state what sircam or-rit-cr it no%k.., into. None
2) Will the project require any work over. in. or adjacent to (within 200 feet) th.- describ::d
,Lvatcrsl If ycs. pl--.-sc de , scribe and attach available plans. None
3) E�timate the amount of fill and dredge material that would b.- placed in or re.movcd
from surface water or wetlands and indicate the area of the site that would b: zfrectcd. In-
dicate the source.. of fill material. None
4) Will the proposal require surface water withdrawais�or diversions? Give 2--neral de-
scription, purpose. and approximate quantities if known. None
5) Does the proposal lie within a 100—year floodplain? If so. note locatior, on zh.- Z:te
plan. No
6) Does the proposal involve any discharges of -waste materials to surface uaters! If so,
describe . the type of waste and anticipated volumc of discharge. No
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. No
2) Describe waste material that will be discharged into the ground from *septic lanl:s or
other sources, if any (for example: Domestic sc\vigc; industrial, containing the following
chemicals . . .; agriculturni; ctc.). Describe the gcncral size of (lie system, the numb�r of
such systems. the number of houses to be scrvcd (if applicable), or the number of animals or
humans the systern(s) are expected to 'serve. None
-4-
TO BE COMPLETED 11Y AVVI.OtANT
c. Water izuriar (including Storm witcr):
1) Dcscribc the source of runoff (including storm watzr) and nicthod of collection and
0
disposal, if any (include quantities, if known). %Vhcrc wil! till's water now?Will this water
flo-w into other watcrs? If so, dcscribc. Existing on site storm retention system
wiLL be extended to handLe aLL addtiionaL run —.off in dry—weLLs.
2) Could waste materials enter ground or surfacc %A-2ters" If so. generally describe.
No
d. Proposed measures to reduce or control surface, eroLnd, and runoff water impacts, if
any: None
4. Plants
a. Check or circle types of vc-ctation found on thc site:
T
x deciduous tree: alder, maple, aspen, other
_X_ evergreen tree: fir, cedar, pinc, other
shrubs
a rass
— pasture
— crop or grain
X wet soil plants: cattail. buttercup, bullrush, skunk czbbZggc, Other
— water plants: water lily, celprass. milfoil, other
— other types of vegetation
b. What kind and amount of vegetation will be -cmovcd or altered?
Wet soil. p�ants wiLL be removed for new pavino area.
c. List threatened or endangered species known to be on o.- near the site.
None
EVALUATION FOR
AGENCY USE ONLY
d. Proposed landscaping. use of native plants, or other measures to preser or enhance
vegetation on the site, if any: New Landscaping, incLuding deciduvocus trees, evergreen trees, shrubs
F, grass wiLL be provided to meet City of Edmonds requirements. I
5. Animals
a. Circle any birds and animals %vhich havc becii observed on or ne2r the sitc or are known
to be on or near the site: None
birds: hawk, heron, eagic. songbirds. otlicr:
mammals: deer, bcar. clk. beavcr. othcr:
fish: bass, salmon, trout. licrring, shellfish. othcr:
b. List any threatened or cndangcred species'kno-n to bc on or near the site.
None
-5-
T6 It[ COMPLETEA) ON' AXPLICANT
c. B the sitc part of a migration routc? If so. c),pialn. NO
d. Proposed mcasu.-cs to preserve or cnhancc tk lidlifc, if any: . None
6. Enerav and Natural Resources
a. What kinds of eneray (electric, natural ps. oil. wood siovc. solar) will be used to meet
the complei-ed proi-ect's energy needs? Describ.- whether it \rill be used for heating. manu-
facturine. etc.
ELectric power used for heating, Lighting, etc.
b. Would vour proJect affect the potential use of solar enerey by ad.izcen-, properties? If so,
general]y d--scribc. NO
c. What kinds of eneray conservation features are included in 'the plans al this proposal?
List other xoposed measures to reduce or control eneray impacts. if anY: None
7. Envitonmental Health
a. Are thert any environmental health hazards. includine -"Dosur-, to toxic chemicals. risk
of fire and explosion. spill, or hazardous waste, that could�_occur as a result of this proposal?
If so, describe. No
1) Describe special emergency services that might be required.
None
2) Proposed measures to reduce -or control crivironmental health hzzards, if an\ -
None
b. Noise
1) What typcs of noise exist in the area -hich rilly iffcct your projcci (for example:
traffic, cquipmcnt. operation, other)? None
I'VALUATION FOR'
ACENCY USr.
2) What types and levels of noise would be crc3tcd by or associatcd with the project on a
short—term or a long—term basis (for cxamplc: traffic, c"onstruction, operation, other)? Indi-
catc what hours noise would come front the site. Traffic and construction' activities during
general. business hours: 8:00am-5:00pm.
0 0
TO BE CON11 VIXT ED 1.1- APPLICANT
3) Proposcd mC3surcs to reduce or control noisc imp.icts. if any:
Extensive Landscaping wiLL reduce traffic noise generated.
EVALUATION FOR
AGENCY USE ONI.y
8. Land and Shoreline Use
a. What is the current usc of the site and 3djaccnt properties?
Existing site is a medical. office buiLding with on —site parking. Adjacent properties
usage ranges from commercial. retail. space to residentiaL.
b. Has the site been uscd'for arricultur'c? If so, describe.
No
c. Describe any structures on the site.
Medical. office buiLding, approximateLy 22,400 SF
d. Will any structures be demolished? If so. what?
No
c. What is the current zoning classifica'
(ion of the site? CG
17- What is the current comprehensive plan designation of the site? i4q4o-.�
g. If applicab . 1c, what is the current shoreline master program designation of the site? None
h. Has any part of the site been classified as an "environmentally sensitive" area? If
specify. No so.
i. Approximately how many people would reside or work in (he completed project?
Per UBC TabLe 33 A. 442 occupants possibLe.
j. Approximately ho%v many people would the completed project displace'?
None
k. Proposed measures to avoid or reduce displacement Impacts. If any:
None
1. Proposed measures to ensure the propos;-,l I . s com palible %vith existing and [)rojcctcd land
Use.,; and plans. if any: Proposed is an v
expansion of existing and wiLL match finished surfaces.,
(ie: waLL, roof, Landscaping, etc)
—7—
0
TO III COMPLETED 11Y APPLICAN'T
9. Housing
a. Approximately ho\v many units would bc provided. if any' lldicZic \'-hcth-.r hir_h. mid-
dIc. or low-income housing. None
b. Approximately how many units, if any, would be cfim1rZ-.:d' Indicate \X-hcthcr high,
None
middle. or low-incomc housing.
C. Proposed measures to reduce or control housing imp--cs. if None
EVALUATION FOR
AGENCY USE QNLY.
10. Aesthetics
a. What is the tallest hcight of any proposed structurc(.$). no: �nclu_`inc antennas. v.-hat is
the principal exterior building material(s) proposed? 25 ' wood siding, metal. roofing (SLoped).
b. What views in the immediate vieinity would be alt-----d or o'_-struc-.cd? - None
c. Proposed measures to reduce or control aesthetic im:;:!cts..i,-- any:
ProposaL wiLL match existing aesthetics.
11. Light and Clare
a. What type of light or glare will the proposal produc:' Xk�hZ_. 'irrl! Of d2\. would it mainiv
occur? ftne
b. Could light or glare from the finished project bc 2 s2fety h-n---rd -.- interfere %vith Views? No
c. Wh2t existing off -site sources of light or glare may affect ycur proposal? Not.;.a
d. Proposed measures to reduce or control licht and elzrc irnp---.is. if 2ny : None
12. Recrea(ion
a. What designated and informal rccrcitional opporturiltics ar.- in th.�: inimccliate vicinity?
b. Would the proposed project displ3cc any cxisting rccrcation-a! uscs? If so, describe. No
.NI on g
10 BC C:011114.1:11:011V AVVIACA.":l
I-'- --LUAi-ioN roR
A(,rNCN* USC ON(-)'
c. Proposed nicisurcs to reduce. or control inipicts oil rccrcailon. Mcludin,-, rec"c3tion op-
portunitics to be provided by the project or npp'llcant. if :illy: None
13. Historic and Cultural Prcscry�(ion
a. Arc there any places or objects listed on. or proposed for. national. statc. or loczl preser-
vation rcoisicrs �nown to be on or next to the site? If so. generally describe. No
0 -
b. Gencrally describe any landmarks or evidence or historic. archacologic 1. 1
a SZ;C,1EiflC. or
cultural importance known Eo*bc on or next -to the site. None
c. Proposed measures to reduc.- or control imDacts. if anv: Mone
14. Transportation
a. Identify public streets and highw3ys serving the site. and describe proposed acc:ss to tl*-
existing street SVSECM. Show on site plans. if anY, 216th SW, Highway 99
b. IS Site currently serve
d by public transit? If not. whUE is the approximatc to th�
nearest transit stop?
Yes, Highway 99
C. How many parking spaces would the completcd project have" How many -xoLold L h c
project eliminate!
214 total. spaces, those remove are repLaced.
d. Will the proposal require any new roads or -itrct:ts. or improvernents to ro�,.ds :r
strcc,s. not includinu, drivcxu�'S'.' If so. -_,crieraliv describe (Indicutc :ublic or
privatc). No
C. Will the projccl use (or occur tF40tlic liTunedlate vlcinliy of) uEcr. rall. or
Lion? If so. generally describe.
f. How inany vehicular trips per d:i%. %�otild bc -cricrited by the complcjc� le
known. indic3te when peak v0luff'"' -Ould occur. Unknown, traffic study to be provided to determine
this information.
L
9
Li
T6 BE COMPLETED BY APPLICANT EVALUATION For
AGENCY USE ONLY
g. Proposed measures to reduce or control transportation Imp2cu. if any: None
Fri
'A T1
15. Public Senices
a. Would the prioject result in an increased need for public scrvices (for example: fire pro-
tection. police protection, health care. schools. other), If so. cencrally dcscribe. No -
b. Proposed measures to reduce Or control direct impacts or. public scrvices, if any. None I
16. Utilities
a. Circle utilities currently available at the site: cl--ctricitN-. nzzural eas. v.-ater, refuse scrv-
ice, telephone, sanitary sewer, septic system. other. ELectri city, w ate r,. teLe phone, s an it a ry sewer,
refuse service. '
b. Describe the utilities that are proposed for the pro ' i-.ct, th.- utility providing the service,
and the -eneral construction activities on the site -or in the imm.-_di?te vicinity which mir-lit
be needed. SimiLar to above, extension of original. services.
C. SIGNATURE
The above answers are true and complete to the best of mv knov.-ledect. I understand that
the lead ageaeprellyin. o',n them to make its decision.
DaLe A. Ancle.rson,..Alk.
Signature: ............................ I .. ....
Date Submitted: Ap r i L - Z, .198.9 ................ The. Tsang. Rastrier-s-hip/MEI
_10—
0 0
.,( "
TO IIII COMPLETED It%' APPLICANT EVALUATION FOR
AGENCY USE ONLt'
D. SUPPLEMENTAL SHEET FOR NONIIROJC-CT ACTIONS ( Rezones , Code Cha nges , Ann*exa t i ons , e tc - )
(do not use this Sheet for project actions)
Bccausc thcsc questions arc very gencral, it mi), bc liclpful to rcad 111cm in conjunction
with the list of the elements of the cnvironnicni.
When answering tlicsc clucstiobs, be aware of the extent the proposal, or the.typcs of
activities likely to result from the proposal. would affect Ilic i1cm at a greater intensity or
at a faster rate than ir the proposal were not implemented. Rcspond briefly and in general
terms.
1. How would the proposal be likely to increase discharge to water; emissions to air: pro-
duction, storage, or release of toxic or hazardous substances; or production of noise?
0
None anticipated
Proposed measures to avoid or reduce such incrcnscs are: None
2. How would the proposal be likely to affect plants. animals, fish. or marine life? None
Proposed measures to protect or conserve plants, animals. fish, or marine life are: None
3. How would the proposal be likely to deplete energy or natural resources? None
Proposed measures to protect or conserve energy and natural resources are: None
4. How would the proposal be likcly to usc or affcct cnvironmcntally sensitive arcas or ar-
cas dcsianatcd (or cligibic or undcr study) for pvcmincrital protcction, such as parks. wil-
derncss, wild and sccnic ri%,crs, thrcatcned or endangered specics habitat, historic or cultural
sitcs. wetlands, noodplains. or prime farnilands? Mone
Proposed mcasurcs to protect such resources or to avold or rcducc impacts arc: None
5. How would the proposal be likely to affect land and shoreline use, Including whether it
would allow or encourage land or shoreline uscs incompatible with cx1sting plans'? None
T<) BI* CONIVI.C.TED UN Al'I'LICAN'T
Proposcd mcasurcs to avoid or rcdtjcc shorelinc and kind usc inipacts arc: None
7—
C U,
EVA,LUATION For,
AGENCY t:SE ONLY
6. How %%-ould thc proposal bc likcl\ to iticrc:lsc demands on transportation or public scr-
viccs and utilitics? Inc,reased usage potential. of pubLic transportation to the
pr6posed faciLity.
Proposed mc2sures to rcducc or respond to such demand(s) arc: Mone
7. Identify. if possible, whether the proposal may conflict with local, state. or federal laws
or requirements for the protection of the environment. None
—12�
RLE
l(*t4
57
Ile
I
M/loo
MEMORANDUM All 11 8
ENGINEEPIA't-,
TO: Bob Alberts
y or
Ca gipO
FROM: Bob Bower
teb �'t m ei�t.'. lant Supervisor
DATE: April 11, 1991
RE Pretreatment requi, rements
I called Doug Knutson at Ecology in reference to my letter
of 2/j,,!5/q1.which,r,equested his review of the clinic discharges to
th a'.-. gan"i t4i-. tem. Doug indicated that Ecology would
y
consider -the discharge to be ihe same as resioentialj�rade sewage
and that a State Discharge perm-jit. would"'*.not be,i-equ:i-ted. He will
send us a confirming letter.
4
0 Ts�_z
R F. C E I V F-.
CNA ARCHITECTURE GROUP 4tK - 4 *01
RECORD OF TELEPHONE CONVERSATION ENGINEERING
PROJECT NAME: PROJECT
DATE: —TIME:
CALL (TO__) (FR(�M L,-�NAME:
REGARDING: (2,14 &� z62 aA=
I - I Iff V Z_ �f
EIR
WE
M�00.2?wva i
_.ZA
MAIL COPY TO:
SIGNED: /A A J 4/9607--z' '-, L.�ndividualContacted
cc: '41=rne
A. z�nlJ.A)5 on
ldlf.Q -
The foregoing notes are based upon the above signed CNA representative's interpretabon of discussions or decisions that
transpired during the documented telephone conversafion. Anyone wishing to amend these notes are requested to do so in
written form, delivered to CNA Architecture Group, not later than one week from receipt: otherwise, these notes shall stand
as written.
10 ( 4A"10k q S� Z- -6 0(,;' a
R E: C F_ I V F_ D
CNA ARCHITECTURE GROUP 4'0�1
RECORD OF TELEPHONE CONVERSATION
ENGINEERING
PROJECT NAME: PROJECT NO.:2— 5-4f) -;2, - 1�7_/
DATE: Arata TIME:
CALL (TO__) (FR(�M L�-�NAME:
REGARDING:
" 'j/
-MAIL COPY TO:
SIGNED: ndividual on acted
7— - _.- �� =�
��Zr ICUMZ'I_Z� Z��—
cc: VI) &'), 4 -/
ii:�42_5
The foregoing notes are based upon the above signed CNA representative's interpretation of discussions or decisions that
transpired during the documented telephone conversation. Anyone wishing to amend these notes are requested to do so in
written form, delivered to CNA Architecture Group, not later than one week from receipt: otherwise, these notes shall stand
as written.
EDMONDS CITY COUN CIL
AGENDA MEMO
S -i, 7f:-�EET FILE
em num�er:
Originator: Robert J. Alberts For Action: x For Information:
SUBJECT: APPROVAL OF JOINT UTILITIES EASEMENT AT KRUEGER CLINIC AT 21600
HIGHWAY 99
AGENDA TIME: Consent
AGENDA DATE: February 16, 1993
EXHIBITS ATTACHED:
Exhibit A - Consent to Grant of
Easement
Exhibit B - Vicinity Map
Clearances: Dept./Indiv./Initials
ADMIN SVCS/FINANCE
CITY ATTORNEY
CITY CLERK
COMMUNITY SER ��S
ENGINEERING
PARKS & RECREATION
PLANNING
PUBLIC WORKS
FIRE
PERSONNEL
POLICE
COMMITTEE
MAYOR
COMMENTS:
EXPENDITURE AMOUNT APPROPRIATION
REQUIRED: $0 BUDGETED: $0 REQUIRED: $0.
FUNDING SOURCE:
N/A
HISTORY AND SUMMARY STATEMENT:
The Krueger Clinic granted a utility easement to the City in 1985. They granted
an easement to P.U.D. over the same property in 1991. Krueger Clinic's lender
needs confirmation of the City's consent to share this easement.
RECOMMENDED ACTION:
Council'accept the easement.
COUNCIL ACTION:
KRUEGER.ESM/TXTAGNDA
y
CONSENT TO GRANT OF EASEMENT
Pursuant to a certain Easement Agreement, dated October 25,
1985, recorded under Snohomish County Auditor's Number 8512040180,
Group Clinic R&D, a Washington general . partnership ("Grantor")
granted to the undersigned City of Edmonds, a municipal corporation
("Grantee") an exclusive easement (the "City Easement") over a
portion of certain property described therein (the "Easement
Property").
Pursuant to a certain Distribution Easement, dated April 1,
1991, recorded under Snohomish County Auditor's Number 9104190207,
Grantor also granted to Public Utility District No. 1 of Snohomish
County (11PUD11) an easement (the "Distribution Easement") over,
under and upon the Easement'Property.
Grantee hereby consents to present activities and uses by PUD
pursua nt to the Distribution Easement. Grantee further consents
to subsequent activities and uses by PUD pursuant to the
Distribution Easement to the extent the same do not unreasonably
interfere with the City Easement.
CITY OF EDMONDS, a municipal
corporation, ATTEST:
By
Mayor City Clerk
Approved as o form:
City Att6i-ney
STATE OF WASHINGTON
SS.
COUNTY OF SNOHOMISH
On this day personally appeared before me I
known to be the of the City - of
Edmonds, a municipal corporation and who executed the within and
foregoing instrument and acknowledged said instrument to be the
free and voluntary act and deed of said corporation for the uses
and purposes therein mentioned and on oath stated that he/she is
authorized to execute said instrument on behalf of the corporation.
SUBSCRIBED AND SWORN to before me this day o f
1993.
NOTARY PUBLIC in -and for the state of
Washington, residing at
65/wtn.079 My commission expires:
EXHIBIT A — PAGE 1
S 0 L N
R S
E N'S/
3 4
S C
H
2
E
N
3 'S/
4
.w 5
60
16 15.
T 23
j
CL
14 t�7
13
71
13
D NJ 0. 3
12 9
60 10 F I V E
'D 216TH ST. S.W.
UT(8512040180:
5.UBJECT PROPERTY
TRACTS
29
01
z
c\j
rll-
60
0
to
21 1
A C'R E
216 T
33 1
30
CITY OF EDMONDS
DATE FILE NO# RES. NO# ORD. NO#
EXHIBIT
EXHIBIT B - PAGE 2
.xOTPjDEN
&U&PHT
Y
CEATTORNE YS AT LAW
,
ENGINEERING
DATE: - February 5, 1993
TO: Gordy Hyde
City of Edmonds
250 - 5th Ave. N.
Edmonds, WA 98020
RE: Consent to Grant Easement
MEMORANDUM OF TRANSMITTAL
ENCLOSED: Please find an original Consent to Grant Easement that Scott
asked me to forward to you.
OGDEN MURPHY WALLACE
April Evans
Secretary to W. Scott Snyder
BY
0 Seattle Office: 2100 Westlake Center Tower, 1601 Fifth Avenue, Seattle, WA 98101-1686, (206) 447-7000, FAX (206) 447-0215
0 Wenatchee Office: 1 South Chelan Stree� P.O. Box 1606, Wenatchee, WA 98807, (509) 662-1954, FAX (509) 663-1553
STAFF04PD FREY COOPER 6 PEWART
RONALD SCOTT BEMIS-
ROMNE Y R. 13RAIN
JOHN BUDLONG
HOWA R 0 W.CARSMAN-
JOHN G COOPER
A. RICHARD DYKSTRA-
THOMAS M. FITZPATRICK'
TNO M AS 0 FREY
ARNOLD L GRAY'
STEPHEN P LARSON
DIAN E G E IGER LI By
WILLIAM L. NEAL'
JAN 0 SOKOL '
SHANNON STAFFORD. P.S.
JOHN SPENCER STEWART3
PH, LLI P L.THOM
JAMES P. WAGNER'
OF COUNSEL
DAVID E. HARTMAN
VIA NESSENGE
ATTORNEYS
500 WATERMARK TOWER
88 SPRING STREET
SEATTLE. WASHINGTON 98104-1095
1206) 6 2 3-9900
FAC S1 MILE : (2 0 6) 6 2 4 - 6 8 8 5
PORTLAND OFFICE
1700 BENJAMIN FRANKLIN PLAZA
ONE S.W. COLUMBIA
PORTLAND. OREGON 97 2 58-2097
15031 221-0699
FACSIMILE: 15031 223-5706
February 4, 1993
W. Scott Snyder, Esq.
OGDEN MURPHY WALLACE
1601 Fifth Avenue, #2100
Seattle, Washington 98101
Re: Group Clinic R&D Partnership
Consent to Grant Easement
Our File Number 3101/6252
Dear Scott:
ANNE M. BREMNER
H. LEE COOK ,
KURT OENKE-
HE N RY K. HAMILTON
K N
ENNETH HOBBS'
MA RCUS a NAS
CHRISTOPHER A. RYCEWICZ'
JEFFREY a. W I LKINSON'
J A MIES T. YANDI
WASHINGTON BAR
OREGON BAR
ALASKA BAR
OREGON_ WASHINGTON BAR
ALASKA-WASHINGTON BAR
CALIFORNIA-WASHINGTON BAR
:DAHO-OREGON BAR
LLI NOIS-WASHINGTON BAR
PENNSYLVANIA-NEW JERSEY-
WASHINGTON BAR
Enclosed is the Consent to Grant Easement regarding Group Clinic
R&D, the City of Edmonds and Public Utility District No. 1 of
Snohomish County.
Sincerely,
STAFFORD FREY COOPER & STEWART
/W5illiyaL. Neal
WLN: k1
Enclosure
65/win.094
EDMONDS CITY COUNCIL APPROVED MINUTE-,
February 16, 1993
THESE MINUTES WERE APPROVED BY THE CITY COUNCIL ON MARCH 2, 1993
.The regular meeting of the Edmonds City Council was called to order at 7:00 p.m. by Ma�or Laura
Hall at the Library Plaza Room, 650 Main St., Edmonds. The meeting was preceded by a flag salute.
PRESENT
Laura Hall, Mayor
REVEIVED
Dave Earling, Council President MAR 5 1993
Steve Dwyer, Councilmember
Michael Hall, Councilmember ENGINEERING
William Kasper, Councilmember
John Nordquist, Councilmember
Jeff Palmer, Councilmember
Tom Petruzzi, Councilmember
Rachelle Eshleman, Student Representative
CONSENT AGENDA
STAFF
Paul Mar, Community Srv..Dir
Art Housler, Admin. Srv. Dir.
Rob Chave, Planning Manager
Dan Prinz, Police Chief
Bob Alberts, City Engineer
Noel Milleri Public Works Supt.
Rhonda March, City Clerk
Scott Snyder, City Attorney
Barb Mehlert, Recorder
Items (E), (F), (H), (J), (K), (L), and (M) were removed from the Consent Agenda.* COUNCILMEMBER
PALMER MOVED, SECONDED BY COUNCILMEMBER PETRUZZI, TO APPROVE THE BALANCE OF THE CONSENT AGENDA.
MOTION CARRIED. The approved items are as follows:
(A) ROLL CALL
c APPROVAL OF MINUTES OF FEBRUARY 2, 1993
k4C) APPROVAL OF CLAIMS WARRANTS FOR WEEKS OF FEBRUARY 1 AND FEBRUARY 8, 1993, AND PAYROLL WAR-
RANTS FOR FEBRUARY 5, 1993.
(D) ACKNOWLEDGE RECEIPT OF CLAIM FOR DAMAGES FROM CURTIS AND JANICE THOMSON�(AMOUNT UNKNOWN)
(G) APPROVAL OF JOINT UTILITIES EASEMENT AT KRUEGER CLINIC AT 21600 HIGHWAY 99 L—""
(I) AUTHORIZATION TO PURCHASE ONE 42" BY 42" LIGHTWEIGHT SHORING BOX FROM SHORING INTERNATIONAL
FOR TAPPING WATER MAINS ($4,782.44, INCL. W.S.S.T.)
As the presenter for Item 4 had a time co I nstraint, COUNCILMEMBER KASPER MOVED, SECONDED BY COUN-
CILMEMBER NOROQUIST, TO PLACE DISCUSSION ON THE PULLED CONSENT AGENDA ITEMS FOLLOWING ITEM 4.
MOTION CARRIED.
AUDIENCE
As no member of the audience came forward, Mayor Hall closed the audience portion of the meeting.
PRESENTATION OF PLAQUE TO STUDENT REPRESENTATIVE RACHELLE ESHLEMAN
�,,jpvj Council President Earling presented Ms. Eshleman with a congratulatory plaque and thanked Ms.
Eshleman for her participation as Student Representative. Ms. Eshleman thanked the Mayor and
Council and said it was a good experience for her.
PRESENTATION BY DJ MICHELL, II, ASSISTANT TO -THE CHAIRMAN OF BURLINGTON NORTHERN ON PROPOSED
COMMUTER RAIL SYSTEM
or- . Mr. Michell narrated a slide presentation concerning Burlington Northern's proposal to provide
.jll�lcommuter rail service between Tacoma and Everett.
Mr. Michell said approximately four months ago, Community Transit asked Burlington Northern to
make a presentation regarding the possibility of commuter rail service between Everett and down-
town Seattle. Mr. Michell said Burlington obliged and put together a Capital Improvement Program,
Operating Budget, and Service Plan and presented it to Community Transit. Since that presenta-
tion, Mr. Michell said other people have asked Burlington, Northern for the same presentation, and
with Community Transit's permission, Burlington Northern has done so.
Mr. Michell's presentation indicated that a successful commuter rail could be implemented between
Tacoma and Everett within 18 - 24 months, which would include Edmonds as a rail stop. Mr. Michell
said the capital costs for the service north would be less than $100 million dollars or approxi-
mately $3 million dollars a mile. Mr. Michell said this number may be a little high, at it con-
tains contingencies such as the possibilities of adding grade separations, etc. Mr. Michell said
the operating cost would be approximately $8 million per year or 5t per seat mile. Mr. Michell
said an estimated travel time from Seattle to Edmonds.would be 28 minutes.
cal
M-
M-4
aim
doom
.%P _PARKING 8IGN
KRUGER'&
CLINIC lij
21000
........ .
ARCIH14
GWU
SIDE END
SID CURB DETAIL SIGN ELEVATIONS
_MALK DETAIL 4 No
fjo- WMMUT
*.V� A
S11.84 FEMOOMCF
ALLOWABLE AM ACOMM 10
KRUGER CLINIC
Vb4-
NG—Z ON SITE PLAN @) �ICINITY~�.T &��j�—�EIMYPLAN
V - W-W
290
-- A 1.1
L. LO
MEMO FOR RECORD
February 6, 1992
TO: Dick Mumma
Building Official
FROM: Ron Holland POIA
Water/Sewer Supervisor
2/6e7a, lApt 47�
SUBJECT: OUTSTANDING WATER REPAIRS AT 7315 212TH ST; KRUGER CLINIC
(216TH & HWY); AND 7025 210TH
The above addresses have outstanding water repairs that need to be
correc*ted before finalization can be approved. All contractors have
been notified and have had no response from them as of to date.
I ask that in order to force them into doing these repairs on hydrants
and fire line vaults, you do not close or finalize these structures
until they are completed.
The following are the repairs needing action:
1. 7315 212th (Edmonds Professional Center)
Hydrant at east entrance off 212th needs raising one (1) foot.
2. 216th & Highway 99 (Kruger Clinic)
Hydrant need raising one foot in parking lot.
3. 7025 210th
a. Fire line vault needs repairs to meet city standards.
b. Fire hydrant needs raising one (1) foot.
c. Pressure test has not been recorded on fire line double
check valve assembly.
RH/l k
cc: Lyle Chrisman
Street Address File
WATER/RE/TXTWATER
CY 9 0 - 1 9 9 -
. 0 1 City of EdmondOSTRi-ETFILE
RIGHT-OF-WAY CONN'E. BE, QT%0N
RECEIVEOPERMIT DEC I I %eAit Number:
b 0 1991 ENGINEER11VU:Date: 5V
A. �VdWN i i9of Construction: 216ato ,so, 47,7
B. Type of Work (be specific): &W -.q-r .9Z%97�c—
C. Contractor: ),qn,6 e46&r7r &&S-r 4,4— Contact: 11,4AI-P 66,&11 F7- of jo*t-
--7-7
Mailing Address:/3�2., Z &7/ ile 40�, /&Z' 5WIrPhone:
State License #: 1Jt4 41,q - C 20 -Z PT Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. 14 Commercial E] Subdivision [1 City Project [-] Utility (PUD, GTE, WNG, CABLE, WATER)
F] Multi-Fatnily EJ Single Family n Other
INSPECTOR: A14*L&,AJ INSPECTOR:
F. Pavement or Concrete Cut El Yes ANo G. Size of Cut: — x H. Charge$
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harrnlessftom injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be made 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 costs, and attomeyfees by reason of granting this permit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP AAD MA TERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC17ON
A AD ACCEPTANCE OF 7HE WORK . ES77MA TED RESTORA TION FEES WILL BE HELD UN77L THE FINAL STREET PA TCH IS COMPLETED BY
CHY FORCES, A T WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUA NCE TO THE A PPLICANT
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Department- 771-3202.
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.
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.
I have read the above statement nd u iderstand the permit requirements and the pink copy of the permit will be available
on site at all times. or i es.
Signature: Z'/ Date: 0
APPROVED BY:
DIA1,A-DIG PRIOR TO BEGINNING WORK
;E ONLY
-J, 6 CA
R1GHT..OFWAY.-.DEP.O.SJT::: .
.TIME —AUTHORIZED: YOU*AKER.. ... ..... PAYS
...........................
..... .. ... . .. .... ........ , ......
.......... ...
. .. ... ... . . ...... . .
�-.COMMENTS:
_REqE1PT..NO:
DATE:
NO, WORK $11ALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION
Comments:
Diagram:
I I I - Route copy to Street Dept.)
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 198r
s- r-r--. -f--
� :.,CET F�lll
RECEIVED
0 C 1 2 1 1991
ENGlNEJjrqlNG
ARCHITECTURE
TELEPHCNr=.FACSIMILE.CCMMUNICA'nCN -GROUP
Project Name:.
Project No..
TO:
PAX NUMBER:
ATTENMON:
r —CM:
lm
DATE S ENT� /0 =L1 — fZ I - -MME'SENr
Re.- L,4401:k,-� )9�4) MQUAYM7700 A70 xie,� 67cl
PAGES SENT'INCLUDING COVER SH EEM
COMM04TS:
MAIL COPY TO:
L�f �A&iessee
S..Ea aw
10SO 712NO AVENUE N/E
40.M0N0.WASHlNGTCN
)WS2
7:,.E?40NE:Mfii dill -Wail
;AX NO. 11061969-;S91
ARLAN E. COLLINS
KEITH �L NULL.
MARK L WOERMAN
;;A
F F7
me,
S7j � "'a L6w
Prp. I I "Col
C..,V\e, Yvv, c (S) s � -& - -&,, . I
k -Csq S)POJECO-�
.�O.:
p Roj.,
�h � cz) kt:)
Lz,\5 L-� cz -tiL
C4 )4 e
C 67, c" er4
W,,O, LASe- gr\fop�,
�� - Lo\r- 4-N-VII9
"Ot, dot�t
zw -
JASON 1. SCHNEIER, M.D.
i_�,'..ET RLE
Gastroenterology & Liver Disease
January 28, 1991
Vauqhn Bray, M.D.
CNA Archit�ct Group
3050 152nd N.E., Suite 600
Redmond, WA 98052
Dear Vaughn :
21600 Highway 99, Suite 5
Edmonds, Washington 98020
Phone (206) 774-2612
A
F179 0 7 1991
PROJECT: I'l-eu6e't
PROJ. NO.: S�o
FILE NO,:4—'.!�H
--D!cr -rc).
U013
I am writing you regarding our Endoscopy�Suite chemical use. We use
1/2 gallon of Gluteraldehyde in a dilute solution, with.;a 2" final con-
'0
centration. One-half gallon is used per week of this. Also, 70%
Isopropyl Alcohol is used in the Endoscopy Suite, averaging about one.gal-
Ion per month.
Finally, Endozyme, an enzomatic cleaner is used one-half ounce per day dil-
uted in one-half gallon of water. These are used throughout the United
States and are all safe to use in the city sewage systems.
Very truly yours,
Jason Schneier, M.D.
JS/f c
73"
FILE
DEBRA A. GOLLER, M.D.
General and Mascular Surgery 21727 76th Ave. W., Sulte 104
Doorwte. American Board of Surgery Edmonds, WA 98020
(206) 672-4534
February 6, 1991
City of Edmonds
Edmonds,
Washington 98020
To Whom It May Concern:
FEB 0 8 1991
PROJECT*. 406c&-
PROJ. NO.: MID
FILE NO.:
1-0-cc, TO:
VP t5
We were ask to report the chemicals that we use routinely in our
medical office.
The following are the only chemicals that we use at this time.
Buell Cleaner 222, which contains sodium tripolyphosphate, Sodium
carbonate, Sodium sulfate, Sodium bicarbonate, Sodium doderylbenzene-
sulfinate, Sodium sesquicarbnole, Urea tetrasodium EDTA, p6lyoxyethy-
lene octylphenyl ether, Sodium carboxymethyl cellulose. The container
states the Buell cleaner NO-222 contains 7.2 phosphorous in the form
of phosphates which is equivalent to 1 gram per 112- oz use level. We
us oz. per 1 gallon of warm water every 14 days. We also use Nuta
ph Instrutment Milk lubricant - antimicrobial activity, 2ozs mixed
with six parts water every 14 days. Occasiorially we use Isoproyl
alcohol 700%.
If any further information is needed please contact our office.
Sincerely,
jz'�'I
Irl-0 W—at—,
Susan Paq'uZte
Office Manager
February 12, 1991
Bob Alberts, Engineering
City of Edmonds
250 Fifth Avenue North
Edmonds, Washington 98020
RE: Kruger Clinic
Plan Check #201
Medical Practice Solutions and Cleaners
Dear Mr. Alberts:
F�' 'tz--�t
ralllpTko
-GROUP-
I
VC
. 'Fj\jED
e13 1-3 1991
04GINE�RING
As a result of our January 17, 1991 telephone conversation CNA requested of the practitioners of offices
within the new construction an identification of the solutions and cleaners used during their daily
business. We have included the correspondence of the following medical practices:
Suite 1E
Debra Goller, M.D.
Suite 1D
Dr. Cox & McCoy
Suite 1E
Thomas Deagan, M.D., and Loren Jensen, M.D.
Suite 1 F
Jeff Kauffman, R. Ph
Suite 2P
Jason Schneier, M.D.
Suite 2Q
John Headely, M.D., et a[
Suite 2R
Jurgen Rieger, M.D.
If you need additional information please call. The contractor, Williams and Abbott, will commence site
operations and construction upon receipt of the building permit.
VB/cf
Enclosures
cc: Robert Chaffee, M.D.
Partnership Representative
Jerry Rehn
Rehn & Skorheim
SO(e 600
3050
Jim Houston
Williams &Abbott
152ND AVENUE N/E
REDMOND, WASHINGTON
Arlan Collins
CNA Architecture Group
98052
Keith Null
CNA Architecture Group
TELEPHONE (206) 882-6060
FAX NO. (206) 869-1592
ARLAN E. COLLINS
KEITH A. NULL
3-28OLT01 5
MARK L. WOERMAN
AIA
FRIHCIPA� ARCHIT�C7S
7
REHN+
SONMEW
TO:
rwll*-RF
Vaughn Bray
Gerald F. Rehn
sor'7 I -- L Onning and Rehn + Skorheim Inc
L" T F 9i 1,U7 tC
PO-reo, en onsullants 401 Kirkland Parkplace Suite 220
Kirkland, Washington 98033
206822-9018
FAX206822-9606
N A
RS"D
MEMORANDUM
SUBJECT: E.I.S., Kruger Clinic
DATE: May 14, 1990
Enclosed is a copy of the E.I.S. you requested.
GFR: jm
Enclosure
M Al 16 1990.
pROjECT' ,:�12J
PROJ. NO.* Z�5
FILE NO-*
COpjr,S TO'
\, 6.t,),k
STDr- RUE
nuff . -,
2 1600 IqlN11104 Y In
&
MBF, INC. T F I CONFIRMATION RECORD
ENGINEERING DESIGNOF STRUCTURES
PC IRT P.O. BOX 4010 e SEATTLE, WAS-`HINGTON 98104
Job. No. 35,90, RECEIVED
MAY 3 1 1990
Proj t-
Locatio E N G)
Individual
Telephone
Direct
Date
Time
Responder: ().EL 0 1 LuF-K
Individual
OF E,0Mof3CS
1:i L
$4L) ST-
0-gao'0-- �4')"j
F7,2.L MA,�, w/a-� 9-F-goiji.,c UJ4'FSc Lvk&:,
'Mkq tOA-0
Copies To:
Location:
Action Req.:
For Info Only:
Copies To:
Location:
Action Req.:
For Info Only:
Dr
;1A
PHONE (206)621-2400 9 FAX(206)621-2412
Kieburtz & Associates
Consultants for Medical Facility Development
July 25, 1984
Mr. Jim Adams, City Engineer
City of Edmonds
505 Bell Street
Edmonds, WA 98020
Dear Jim:
It , I , G4
iLL
RECEIVEE)
U U L� 2 7 1984
ENGINEERING
I want to thank you for your help in solving our sewer
problems with regard to the proposed medical office
building. The holding tank should solve the problem if
it is ever needed, however, I believe as you do that the
sewer system will ultimately be completed before the
building is. Again, thanks very much for your
cooperation and assistance in resolving this problem.
Sincerely yours,
KIEBURTZ & ASSOCIATES
W
Ger Id F. Rehn
GFR:jm
8005 S.E. 28th
Mercer Island, WA 98040-3897
206/236-0803
0
DATE
ME140 TO: Building Division
Planning Department
FROM: Engineering Division
Public Works Department
SUBJECT: -21600
zEET F ia, I, E
After review of the subject Building Permit application, vie have the following
comments:
1. Connection to City water system required.
2. Connection to City sanitary sewer system reqi.iired.
3. Right-of-way permit required for any work on City property.
4. Driveway slope not to exceed 14".
5. Backwater val,ie required if downstairs plumbing is below elevation o-f
upstream manhoT—e.
6. Water and sewer lines to be separated by 10 foot minimum.
Li '. :
CITY OF EDMONDS LARRY S. NAUGHTEN
DEPARTMENT OF PUBLIC WORKS (206) 771-3202 MAYOR
Edmonds, Washington 98020
Administration — 250 - 51h Avenue North Maintenance & Operations — 200 Dayton Street
January 31, 1985
Ms. Maria Mackey
Pacific First Federal Savings & Loan
P. 0. Box 3587
Bellevue, WA 98004
Dear Ms. Mackey:
SUBJECT: MEDICAL FACILITY - 216TH ST. S.W. &
HIGHWAY 99
I sincerely apologize for the delay in providing you
with the cost estimate you requested. I have routed this
to other City departments and have obtained estimates only
since we do not have a complete plan. Once you decide how
you are going to provide water and sewer to this site, then
we could make better estimates. I have attached some
information which might be helpful regarding water meters.
I would like to set up a meeting with our City staff
and Kieburtz and Associates to discuss the site and your
request in more detail. I feel this meeting would be
beneficial to all.
Please give me a call -tat 771-3202 so we can schedule
this meeting.
Sincerely,
BOBBY R. MILLS
Acting Supt. of Public Works
BRM/ml
Attachments
cc: Kieburtz and Associates
0 0
FORMULA FOR CALCULATING WATER METER SIZE
1. Need a list of plumbing fixtures to be installed in
the building.
2. Need the number of fixture units per plumbing item.
Total these fixture units.
3. Figure the distance fro.n.where the water line will be
coming out of the building to the lcoation of the
water meter (calculate in feet).
4. With these two figures (fixture units and distance to
meter) use the charge on Page 83 of the 1982 Uniform
Plumbing Code -- Pressure Range -- over 60 psi -- to
figure the meter size.
CR/ml
1/30/85
4
)RM PLUMBING CODE
:as may be sized by the
section.
In sizing a water piping
Oure units or less, the
supply piping may be
,)t water piping ignored
ompensated for by the
I demand, using those
Pt and cold water use.
�-quired in (1) above, as
Dr inlet.
cold water piping and
the pipe sizing for the
i Table 10-2, using the
Jing in the fixture unit
computed in (1) above,
9 cold water branch or
ad size of the building
�r piping systems may
liPply piping from the
tr heater, to the most
2es of seventy-f ive (75)
-land as given in Table
iater to those fixtures
all be sized to deliver
I required cold water
er in size than that re -
on relative to size of
in accordance with
to the Administrative
Ig installations, pro -
,at there will be a
ures.
inces.
gement of the Ad-
IPPIY of water is pro-
ection (o) of Section
)iping installed out-
d from the potable
WATER DISTRIBUTION
F-1
water supply by means of an approved airgap or backflow
prevention device is not regulated by this Code. The potable
water piping system supplying each such irrigation system
shall be adequately sized as required elsewhere in this chapter
to deliver the full connected demand of both systems.
TABLE 10-1
Equivalent Fixture Units
(Includes Combined Hot and Cold Water Demand)
Number of Fixture
Units
Fixture
Private Public
Use Use
Barsink
Bath tub (with or without shower over)
1 2
2
.....
'
Dental unit or cuspidor ..................
4
— 1
Drinking fountain (each head) ...........
1 2
Hose bibb or sill cock (standard type)
3 5
Mobile home (each) ....................
6 6
Laundry tub or clotheswasher (each pair of
faucets) ...............
Lavatory
2 4
...................
Lavatory (dental)
2
.......... * '
Lawn sprinklers (standard type, each head).
1
1
Shower (each head) ......
1
2 4
Sink (bar)
................
Sink or dishwasher
1 2
......
Sink (flushing rim, clinic)
2 4
— 10
Sink (washup, each set of faucets) ........
— 2
Sink (washup, circular spray) ........
— 4
Urinal (pedestal or similar type) .......
— 10
Urinal (stall) ..........................
— 5
Urinal (wall)
.....................
Urinal (flush tank) ................
— 5
3
Water closet (flush tank) .......
3 5
*Water closet (flushometer valve) ........
6 10
Water supply outlets for items not listed above shall
be computed at
their maximum demand, but in no case less than:
3/8 inch. (9.5 mm) .....................
2
1/2 inch. (12.7 mm) .....................
2 4
3/4 inch .(19.1 mm) .....................
3
1 inch. (25.4 mm) .....................
6
6 10
*See subsection 0) of Section 1009 for method of sizing flushometer valve installations
using Table 10.2.
I
MM
I
As
REM
I
FIXTUR E UNIT TABLE FOR DETERMINING
WATO PIPE AND METER SIZ
Pf FOR FLUSH
TANK SYSTEMS 15 FEET R SECOND
MAXIMUM WATER VELOCITY
PRESSURE RANGE-30 to 45 psi
Meter Building
and supply
street and
Maximum Allowable Length In Feet
ser-Ace
(inches)
(inches)
40
60
80
100
150
200
250
300
400
500
600
700
800
900
1000
'A
'12
6
5
4
3*
2*
1*
V
V
0*
0*
0*
0*
0*
0*
3/4
�A
18
16
14 *
12*
9
6
5
5
4
4
3
2
2
2
1
3/4
1
29
25
23
21
17
15
13
12
10
9
7
6
6
6
6
1 -
1
36
31
27
25
20
17
15
13
12
10
8
6
6
6
6
1 -
1 'A
54
47
42
38
32
28
25
23
19
17
.14
12
12
11
11
11/2
1 'A
go
68
57
48
38
32
28
25
21
18
15
12
12
11
'20
11
1 '/2
11/2
151
124
105
91
70
57
49
45
36
.31
.26
23
21
20
2
1 '/2
210
162
132
110
80
64
53
46
38
32
.27
23
21
20
20
11/2
2
220
205
190
176
155
138
127
120
104
85
70
61
57
54
51
2
2
372
329
292
265
217
185
164
147
124
96
70
61
57
54
51
2
2 Y2
445
418
390
370
330
300
280
265
240
220
198
175
158
143.
133
PRESSURE RANGE-46 to 60 Psi
Meter
Building
and
supply
Maximum
Allowable
Length
In Feet
street
and
service
(inches)
branches
(inches)
40
60
80
100
150
200
250
300
400.
SM
600
700
800
9W.
1000
'A
1/Z
9
7
6
5
4
3
2
2
1 '
1 *
1 *
0
0
0
01
3/,
�14
27
23
19
17
14*
11*
9
8
6
5
4
4,!
3
3
3
3/4
1
44
40
36
33
28
23
21
19
17
14
12
10
9
8
8
1
1
60
47
41
36
30
25
23
20
18
15
12
10
9
8
8
1
11/4
102
87
76
67
52
44
39
36
30
27
22
20
19
17
16
11/2
11/4
156
130
106
89
66
52
44
39
33
29
24
20
19
17
16
30
1 Yz
11/2
270
225
193
167
128
105
90
78
62
52
42
38
35
32
30
2
11/2
286
286
242
204
117
98
84
67
55
42
38
35
32
11/2
2
360
360
340
318
.150
272
240
220
198
170
150
135
123
110
102
94
2'
2
570
510
470
430
368
318
280
250
205
165
142
123
110
102.
94
2
2 '/z
680
640
610
580
535
5()0
470
440
400
365
335
315
285
267
250
PRESSURE RANGE
—Over 60
psi
--Met r lldir�tj
and
supply
street
and
Maximum
Allowable
Length in Feet
service
(inches)
branches
(inches)
40
60
so
100
150
200
250
300
400
_,,W
600
700
8W
900
10()0
01
3/4
/2 **
11
9
7*
6,
5*
4*
3'
3'
2'
V
3/4
3/4
31
28
24
22
17
13 *
11'
10'
8'
7'
.. 6'
6'
5
4-
11
3/j
1
63
53
47
42
35
30
27
24
21
17
14
13
12
12
11
1
1
72
66
55
48
38
32
29
26
22
18
14
13
12
12
21
1
11/4
140
126
108
96
74
62
53
47
39
31
26
25
23
22
21
11/2
1 'A
156
156
150
127
93
74
62
54
43
34
26
25
23
22
43
40
11/2
11/2
286
286
273
240
186
154
130
113
88
73
51
51
46
43
40
2
11/2
286
286
286
275
220.
170
142
122
98
82
64
51
46
129
1 '/2
2
360
360
360
360
360
335
305
282
244
212
187
172
153
141
129
2
2
611
611
610
560
478
420
375
340
288
245
204
172
153
141
329
2
21/2
690
690
690
690
690
650
610
570
510
460
.430
404
380
356
4 . 11
0 0
WATER METER PRICES
3/4" meter $450.00 - meter charge
200.00 - connection charge
$650.00
plus any Street Restoration if needed
($75.00 - $150.00)
3/4" meter $175.00 - meter charge
200.00 - connection charge
$375.00
(no Street Restoration charge)
when service lines have been installed by a developer on plats or
subdivisions,
1" meter .$525.00 - meter charge
200.00 - connection charge
T725.00
(plus any Street Restoration if needed)
13-," meter $900.00 - meter charge
200.00 - connection charge
$1100.00
(plus any Street Restoration if needed)
2" meter $1500.00 - meter charge
- connection charge.
$1700.00
(plus any Street Restoration if needed)'
3" meter - call Archie and ask him
0 `)EET F2
M � iLt
Kieburtz & Associates
Consultants for Medical Facility Development
December 3, 1984
V E L)
DEC 5 1984
ENGINEERING
Mr. Bobby Mills
Public Works Superintendent
City of Edmonds
250 5th Ave. N.
Edmonds, WA 98020
Dear Mr. -Mills:
Our firm is in the process of developing a medical
facility on the old Roberts' ground, located on the SW
corner of 216th Street and Highway 99 in Edmonds. In
order to obtain financing for this project we need a
letter from the City specifying that water and sewer is
available and at what cost. We already have a letter
from the City assuring us that sewer is available,
however, we have -no such letter regarding water
availability.
Would you please send a letter to Ms. Maria Mackey,
Pacific First Federal Saving & Loan, P.O. Box 3587,
Bellevue, WA 98004, and state that the service is
available and your estimated cost for hook-up. Would
you please also send me a copy.
Thank you in advance for your help on this.
Best egards,
KL,EtURTJ" & SSOCIATES
a-r-Ti—D . K I a a s
LDK : jm
enclosure
8005 S. E. 28th
Mercer_lsland�—WA 98040-3897
206/236-0803
i
0
0
MEMO TO: Mary Lou Block
Planning Director
FROM: Cindy Ringstad
Permit Coordinator
SC--. 1, , . �.3
H E T F E
January 24, 1985
SUBJECT: FORMULA FOR CALCULATING WATER METER SIZE
The first item you need is a list of plumbing fixtures to be
installed in the buildinq.
Next, you assign the number of fixture units per plumbing item.
Total these fixture units.
Figure the distance from where the water line will be coming out
of the building to the'location of the water meter (calculate in
feet).
With these two figures (fixture units and distance to meter) use the
chart -.-on Page 83 of the 1982 Uniform Plumbing Code Pressure Range -
over 60 psi -- to figure the meter size.
I have attached both charts for calculating fixture units and meter
size and also the tosts-.for water meters.
'In - ' ' 4�
llm�u ALq cl,&-&
attachments 'i [_
Kieburtz & Associates
Consultants for Medical Facility Development
October 21, 1985 RECEIVED
MPT
OCT 23 1985
FILE ENGINEERING
Mr. Jerry Hough
Engineering Department
City of Edmonds
505 Bell St.
Edmonds, WA 98020
Dear Mr. Hough:
I am returning the Quit Claim Deed you left at the job site
regarding the corner of the Kruger Clinic property necessary for
the sewer lift station and fire hydrant. We are in the process of
having an easement executed and it will be to you shortly.
Please call if I can be of any help.
Sincerely,
KIEBURTZ & ASSOCIATES
Larry D. Klaas
LDK:jm
enclosure
8005 S.E. 28th
Mercer Island, WA 98040-3897
206/236-0803
CITY CLERK
CIVIC CENTER
KOMONDS, WA 98020 IR
EASEMENT AGREEMENT ml
THIS AGREEMENT is made this /K day of October, 1985, by and between
GROUP CLINIC R & D, a Washington General Partnership ("Grantor") and the CITY
C:111
.-OF EDMONDS, a Municipal Corporation ("Grantee").
WITNESSETH:
WHEREAS, Grantor is the owner of certain property. located in Snohomish County,
Washington, described on Exhibit "A" attached hereto ("the Property"), and
WHEREAS, Grantor is willing to grant an Easement to Grantee for a fire hydrant
and sewer pumping station in accordance with the terms and conditions set forth herein.
. NOW, THEREFORE, for valuable consideration, the receipt of which is hereby
acknowledged, the parties agree as follows:
1. GRANT OF EASEMENT. Grantor hereby grants, bargains and conveys to
Grantee a perpetual exclusive easement over that portion of the Property described
as follows:
Commencing at the Northeast corner thereof, thence North
89059'28" West along the North line thereof a distance of 18
feet; thence due South to the East line thereof; thence North
24058'10" East along the East line thereof to the Northeast corner
thereof.
The Easement shall be for the purpose of installing, operating and maintaining
electrical and mechanical equipment pertaining to a sewer pumping station, as well
as installing, operating and maintaining a fire hydrant. The Easement shall also include
all other uses reasonably incidental to the primary purpose of this Easement.
2. TERM. This Easement shall be perpetual and shall continue in full force
and effect until terminated by the parties, their successors or assigns.
3. NONEXCLUSIVE EASEMENT. Grantee acknowledges that Grantor has granted
an Easement to Snohomish County P. U. D. for electrical transmission lines over a portion
of the Property which includes the Easement property described above. Grantor makes
no representations regarding the impact of such Easement on the easement rights granted
herein.
4. COSTS OF INSTALLATION AND MAINTENANCE. Grantee shall be solely
responsible for all costs of installing, maintaining and operating any improvements
installed on the Easement property. Grantee shall hold Grantor harmless from all costs
associated with installing, operating or maintaining such improvements on the Easement
property. Grantee shall defend, indemnify and hold Grantor harmless from all claims,
causes of. action and liability of any nature whatsoever, including attorney's fees and
costs, which may result from damage caused to any property or injuries caused to any
person in connection with the installation, operation, maintenace or use of the Easement
property by Grantee herein. It is the intent of the parties that Grantor shall have no
responsibility whatsoever for any such damages or injuries occurring in the Easement
property.
NO EXCISE TAX'
1REQ1J1RtD
DEC 4 1985
351204018U FURK MEMP3106mi3h County IrWurel
By
D Fk D utv
EASEMENT AGREEMENT 1/9 VOL
CITY CLERK
CE14TER
S.
0 WA 98020
5. BINDING EFFECT. The Eastment rights granted herein shall be deemed
a covenant running with the Property and shall be binding upon and inure to the benefit
of the parties hereto, their successors and assigns.
6. ATTORNEY'S FEES AND COSTS. In the event either party is required to
commence legal action to enforce the terms of this Easement Agreement, then the
prevailing party in such action shall recover from the losing party all attorney's fees
and costs incurred in that action. Any such legal action shall be commenced in Snohomish
County Superior Court.
DATED this 2 day of October, 1985.
GRANTEE: GRANTOR:
CITY OF EDMONDS, GROUP CLINIC R & D,
a Municipal Corporation a Washington General Partnership
By: By: V.
Its: KATHRYN A. ZLIFALL-LARSO M.D.
Its: General Partner
By: k
v
Its: Partner
STATE OF WASHINGTON )
) ss
COUNTY OF KING )
On this _ day of October, 1985, before me, the undersigned Notary Public, in
and for the 9—tite of Washington, duly commissioned and sworn, personally appeared
to me known to be of the
CITY OF EDMONDS, a Municipal Corporation, and acknowledged the said instrument
to be the free and voluntary act and deed of said Municipal Corporation, for the uses
and purposes therein mentioned, and on oath stated that is authorized to execute
the said instrument.
WITNESS my hand and official seal hereto affixed the day and year first above
written.
Notary Public in and for the State of
Washington, residing at
STATE OF WASHINGTON )
) ss.
COUNTY 0 F *RIC )
On this OQJ� day of October, 1985, before me, the undersigned Notary Public in
and for the State of Washington, duly commissioned and sworn, personally appeared
KATHRYN A. ZUFALL-LARSON, M.D., to me known to be a General Partner of GROUP
CLINIC R & D, a Washington General Partnership, and acknowledged the said instrument
to be the free and voluntary act and deed of said General Partnership, for the uses and
purposes therein mentioned, and on oath stated that she is authorized to execute the
said instrument.
WITNESS my hand and official seal
written.
hereto affixed the day and --year first -above
'p
rVrhr�-Public in and for�
Washington, residing at
85120401BU
EASEMENT 2/3
',VOL J.930cE2218
#I Y CLERK,
CIVIC CENTER
MONDS. WA 98020
STATE OF WASHINGTON )
) ss.
COUNTY 0 F 4q-RG )
5A)WOM-Y
On this, day of October, 1985, before me, the undersigned Notary Public in
and for the State of as ington, duly commissioned and sworn, personally appeared
&" 41, 40*,l ..' to me known to be Managing Partner of GROUP
CLINIt ��a-Washingfon General Partnership, and acknowledged the said instrument
to be the free and voluntary act and deed of said General Partnership, for the uses and
purposes therein mentioned, and on oath stated tha 14442— is authorized to exectite
the said instrument.
WITNESS my hand and official seal hereto affixed the day and year first above
written.
b 6ry uhlic in an or I Stot� 6fr
4ashington, residin g* at.
0
01
851204UOU.,
EASEMENT 3/3 VOL ion6PAGE19 2.19
.1. U
0
Kieburtz & Associates
Consultants for Medical Facility Development
November 5, 1985
RECEIVED
Nov R 1985
-ENGINEEPJNA
Mr. Jerry Hauth
City of Edmonds
250 5th Ave. North
Edmonds, WA 98020
Dear Mr. Hauth:
Please find enclosed an Easement Agreement dated October 25, 1985,
between Group Clinic R&D and the City of Edmonds.
Sincerely,
KIEBURTZ & ASSOCIATES
Judith A. Meek
Secretary to Larry Klaas
/jm
enclosure
8005 S.E. 28th
Mercer Island, WA 98040-3897
206/236-0803
f
EDMONDS CITY COUNCIL
0 'AGENbA MEMO
I?
--ET Fllitl
Originator: James E. Adams
Item number:
For Action: X For Information:
SUBJECT: AUTHORIZATION TO ACCEPT AND RECORD
EASEMENT AGREEMENT FROM MEDICAL
CLINIC AT 216TH AND HIGHWAY 99
AGENDA TIME: Consent
AGENDA DATE: Nov. 12, 1985
EXHIBITS ATTACHED:
Proposed Easement Agreement
from the Medical Clinic at
216th and Highway 99
earances: Dept.
ADMIN SVCS/FINANCE
CITY ATTORNEY
CITY CLERK
COMMUNITY S RVICES
ENGINEER
PARKS &
PLANNING
PUBLIC WORKS
FIRE
PERSONNEL
POLICE
COMMITTEE
MAYOR
COMMENTS:
v./Initials
EXPENDITURE AMOUNT APPROPRIATION
REQUIRED: $ N/A BUDGETED: $ N/A REQUIRED: $ N/A
HISTORY AND SUMMARY STATEMENT:
The development at the corner of 216th and Highway 99 required the
relocation of the controls for the sewage lift station. The con-
trols for the lift station and a fire hydrant have been located on
the project site.
RECOMMENDED ACTION:
Accept and record the attached easement agreement.
COUNCIL ACTION:
Of"
rJA i n rXwk 1,
h lto"nd_a�'
V1,67 flautYi2" "t 'f" Dt
- SO
VA
�A\14
Cit�yerk Dt
THESE MINUTES SUBJECT TO
EDMONDS CITY COUNCIL MINUTES NOVEMBER 19, 1985 APPROVAL
November 12, 1985
Work Meeting
The regular meeting of the Edmonds City Council was called to order at 7:00 p.m. by Mayor Larry
Naughten in the Plaza Meeting Room of the Edmonds Library. All present joined in the flag sa-
lute.
PRESENT
Larry Naughten, Mayor
Steve Dwyer
Laura Hall
Jo -Anne Jaech
Bill Kasper
Lloyd Ostrom
Jack Wilson
Tammy Schwartze, Student Rep.
ABSENT
STAFF PRESENT
John Nordquist Mary Lou Block, Planning Div. Mgr.
Peter Hahn, Comm. Svcs. Director
Steve Simpson, Parks & Rec. Director
Jack Weinz, Fire Chief
Bobby Mills, Acctg. Pub. Wks. Supt.
Pat LeMay, Personnel Mgr.
Scott Snyder, City Attorney
Jackie Parrett, City Clerk
Margaret Richards, Recorder
Mayor Naughten congratulated the Council candidates who won election and re-election to the Coun-
cil: Councilmembers Wilson, Hall & Dwyer
CONSENT AGENDA
COUNCILMEMBER OSTROM MOVED, SECONDED BY COUNCILMEMBER HALL, TO APPROVE THE CONSENT AGENDA. MO-
TION CARRIED. The approved items on the Consent Agenda included the following:
(A) ROLL CALL
(B) APPROVAL OF MINUTES OF NOVE14BER 4, 1985
(C) APPROVAL OF 1986 EQUIP14ENT RENTAL RATES
(D) APPROVAL OF INTERLOCAL AGREEMENT BETWEEN CITIES OF BRIER, EDMONDS, LYNNWOOD, AND
MOUNTLAKE TERRACE FOR THEIR RESPECTIVE POLICE DEPARTMENTS TO LOAN EQUIPMENT TO ONE
ANOTHER
I'- (E) AUTHORIZATION TO ACCEPT AND RECORD UTILITY EASEMENT FROM MR. AND MRS. DONALD HANSEN
F ) AUTHORIZATION TO ACCEPT AND RECORD EASEMENT FROM MEDICAL CLINIC AT 216th S.W. AND
HIGHWAY 99 1%
BEACH RANGER PROGRA14 REPORT -- 1985
Parks & Recreation Director Steve Simpson noted that interest in the Beach Ranger Program has
increased dramatically in the last year due largely, he felt, to Shirley Pauls, who helped to
organize the program last Spring. Mr. Si . mpson showed a video tape of the educational 5omponent
of the program.
Beach Ranger Dale Dickinson related to Councilmembers that beach rangers were able to discern
what people were interested in by walking the beaches observing activities and talking to them.
He stated that a few problems had been encountered but were easily re�olved through reprimands.
Mr. Dickinson added that beach rangers see many of the children that attended the educational
programs, noting that they retained much of the information. Mr. Dickinson thanked the Police
Department, Fire Department, Steve Simpson and City Council for their support. Councilmember
Jaech expressed a concern that the rangers have a lot of territory to patrol, which is time consum-
ing. She asked Mr. Dickinson if motorized vehicles to transport them between beaches would be'
useful. Mr. Dickinson stated that patrolling the beache� is time. consuming and that motorized
vehicles would be useful, particularly in arriving at potentially hazardous situations. Council -
member Wilson asked Mr. Dickinson if tie knew what percentage of the Edmonds community was utiliz-
ing the beach facilities as opposed to nonresidents. Mr. Dickinson stated, in general, between
five to ten percent of Edmonds citizens utilize the facilities, noting that they tend to take
their resources for granted and go outside the community for recreation. He added that.he has
observed a lot of out -of -county users as well as out-of-state users. Councilmember Ostrom asked
0 LAW -OFFICES OF 47�-?�EET RLE
JA M ES A. MURPHY
JOHN D. WALLACE
DOUGLAS E. ALBRIGHT
LEE CORKRUM
WAYNE D. TANAKA
G. GEOFFREY GIBBS
LARRY C. MARTIN
ROBERT G. ANDRE,
MICHAEL G. WICKSTEAD
ROBERT A. KIESZ
STEVEN A. REISLER
RAYMOND D. OGDEN
(1876-1972)
RONALD A. MURPHY
(1930-1983)
OGDEN, OGDEN, MURPHY & WALLACE
2300 WESTIN BUILDING
2001 SIXTH AVENUE
SEATTLE. WASHINGTON 98121
(206) 448-4000
TELEX: 287941 OGDN UR
TELECOPIER: (206) 343-0886
I SOUTH CHELAN ST., SUITE 8
P.O. BOX 1606
WENATCHEE. WASHINGTON 98801
(509) 662-1954
PLEASE REPLY TO SEATTLE OFFICE
April 10, 1986
Kieburtz & Associates, Inc.
Attention: Judith A. Meek
7900 S.E. 28th, Suite 400
Mercer Island, WA 98040-3897
Dear Ms. Meek:
R. MARK ALLEN
LAURA C. INVEEN
CHRISTOPHER A. WASHINGTON
JAMES E. HANEY
ROSEMARY P. BORDLEMAY
SUE E. FREEBORN
W. SCOTT SNYDER
PHILLIP C. RAYMOND
ERIC J. THOMAN
PAMELA M. ANDREWS
JAN P. OLSON
CHARLES D. ZIMMERMAN
CAROL 0. BERNASCONI
MITCHELL V. MAURER
LINDA K. NORMAN
OF COUNSEL
RAYMOND D. OGDEN. JR.
100
Enclosed please find a Deed of Correction for execution by
the authorized representative of the corporate entity which owns
Kruger Clinic at 21600 Highway 99, Edmonds, Washington..
Thank you for your assistance. Please return the enclosed
document after execution to Jackie Parrett, City Clerk, for
execution by the City and filing.
Very truly yours,
OGDEN, OGDEN, MURPHY 6 WALLACE
W. Scott Snyder
WSS: kcf
WSS00059L/000,6.90000
Enclosure
cc: Jackie Parrett
Jerry Hauth V-1,
T
CITY OF EDMONDS LARRY S. NALIGHTEN
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-3202 MAYOR
COMMUNITY SERVICES: PETER E. HAHN
Public Works e Planning * Parks and Recreation * Engineering DIRECTOR
, 890 . 194
May 31, 1991
Vaughn Bray
CNA
3050 - 152nd Ave. N.E.
Redmond, WA 98052
SUBJECT: KRUGER CLINIC ADDITION - 21600 HIWAY 99
Mr. Bray,
Per our phone discussion and letter from the Department of Ecology
dated May 13, 1991, pre-treatment of sanitary waste is not required.
Sincerely,
GORDON C. HYDE
Engineering Coordinator
GCH/sdt
KRUGER/TXTST530
U -1
A'I berts t -
e Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
. —.. — — -- — I - .. — . — I-,- -
KRUGER CLINIC
EDMONDS, MASHINGTON
REW
PROJECT NO.: 280 DATE
9
Li"EF E
i L
a
Ind.. dw
10 15041) AVINUI N/l
I Ll. W 'Vit I VAJ ISI -6W
DM%MNS NO.; $ra I FAX Nu. IRA) my'l$12
0 E
RLE
TELEPHONE F,
Projerat Namw.
prolal No.:
TO: r-j a=n 110 21
FAXNUMBER.: Fal= (S
ATTENTION.- lAK V Z-17-
FROM: VALW60 ZSL�-x 11
Dora saNT.- M&Y A 108 if Timis sawj=
RE,
PAdI= SW4T INCLUDING COVEA GHGET:
OOMMU411.4
MAIL COPY TO:
E/T'd
Addroomw
Iva im
Go
X501SIND AVINUt Nd
TILPHOW IMM 1114W
PAM No.
ARLAN L CGLUNS
KKIVW A. MULL
MAAK L. WONAMAN
AJA
3snOHM3N AOOD Wd6T:SO
T6, 80 AUW
LE
WMUAMS AND ABBOTT COmbwwrx Ns INCe
GEMAL COMMA== — CONRAM= & =USTRIAL
OESIGN CLARIFICATIONNERIFICATION REQUEST
PROJECT: kVC�F_IL C_L$31C ocw 9
ORMATM A-P_c*vrlz-_rcr
ITEW tt4S IDZWh�SAP L�--M�IMEG
RUMCE DRAWN OR SPE=ATVb --&TrM
DATE REPLY REOUIRM
MMAL SCHMM NO
COST MECT; TV. OUT (CALMAR DAYS�
COST INMEME ($—) 5S277,07 E. INCREASEIN CONTRACT TK (— DAYS)
NO CHANGE IN PM :FNO, CHANGE IN =NTRACT TK
_.._�COST DECREASE —DECREASE IN CONTRACT TME (— DAYS)
PROICT MANAGM, DAM 4rh-C
r - ! � , 'A
j!qfjk_j:'j 't_j�j
i _jjjt� _
we
r�_l
F4
ARcwrzc-,-z REPRESENTATNL-
"bloi 0
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AW10 e-Mr =qikM WMELL WAY NE
149
`141.mv on ". 11 ij
P/7',4
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9AT MIR WA 98 155
PmoNz (206) 365-8800
__ - _:3SnQHM3W.>i0Q.0.Wcl02:90 TG, eO
u
1, ID
�L.s
STA
CHRISTINE 0. GREGOIRE r'7,7-' 7�
Director
d g �' ��L'H FIN E
STATE OF WASHINGTON
DEPARTMENT OF ECOLOGY
Northwest Regional Office, 3190 - 160th Ave S.E * Bellevue, Washington 98008-5452 & (206) 649-7000
May 13, 1991 RECEIVED
M AY 1 7 19 91
Mr. Bob Bower
City of Edmonds Community services PUBLIC WORKS DEPT.
250 - 5th Avenue North
Edmonds, WA 98020
Dear Mr. Bower:
I have reviewed the information submitted with your letter of
February 19, 1991, regarding the nature of discharge from the
offices proposed to be located in the Kruger Clinic.
Based on the information submitted,. I have determined that the
nature of the wastewater discharge will be substantively similar to
the discharge from a domestic source. Therefore, a state waste
discharge permit is not required at this time.
The main discharge of concern from the site will probably be that
from the photo (x-ray) finishing. Any discharge to the sewer of
silver bearing material should be run through a silver recovery
unit prior to discharge. Clinic personnel should also refrain from
the discharge of mercury compounds to the sewer as might be found
in amalgams, thermometers, tissue fixatives, and microscopic
stains. Discharge of phenolic compounds contained in disinfectants
can also cause problems for some POTW's with limits for phenolic
compounds in their NPDES permits.
USEPA is in the process of developing categorical pretreatment
limitations for hospitals. Therefore, it is conceivable that the
regulatory status of clinics could change. However, I anticipate
that clinics cf this size w-4-1-1 not be included in the 'L-Lospital
category when EPA publisheff the standards.
Please call me at 649-7025 should you have any questions.
DK:
Sincerely,
Doug Knutson, PE
Pretreatment Engineer
.000. 3
0 FLE
RECEIVED
APR 18 I�Jl
ENGINEERING
TELEPHONE FACSIMILE COMMUNICATION
Project Name:
Project No.:
ARCHITECTURE
'GROT TP
TO: 61-ry ivr- 8��ps
FAX NUMBER: /- 7-7L5- 5-32Z
ATTENTION: Boa Auagem f .f1m ww-iegg,
FROM: VALA6�4&4 &ZAY'
DATE SENT: 4PWI- TIME SENT_L.-2� �P
RE: �51-rC- - 41A.AAQU0WA-) &WOI(VL�-
PAGES SENT INCLUDING COVER SHEET: 3
COMMENTS:
fl-rA-,,,,,E, elsyl�-=W -rl4em— rm).-vY4))-46 GY-ET64FM-5 -4
As-5 - ISY-F-T6H Ae= --1. 1-5 A 19445-nAi- -SITF- KAW-A -T4F-
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6&-r6m aA�51w 1, A-�:, .6440WQ OQ 1 \N ILL
SIGNED:
cc:
3050 lS2ND AVENUE N/E
MAIL TO: REDMOND. WASHINGTON
98052
&,-' Addressee TELEPHONE 12061882-6060
01-r-r or- e0mmalos FAX NO. (2061869-1592
ARLAN E. COLLINS
KEITH A. NULL
MARK L WOERMAN
AIA
DIGESTIVE DISEASE CENTER
AT KRUGER CLINIC
21600 Hwy 99 Suite 2601
Edmonds, WA 98026
425-774-2650
August 11, 2004
City of Edmonds
Development Services
Edmonds, WA 98026
TO WHOM IT MAY CONCERN:
ROBERT G. CHAFFEE, M.D.
JASON SCHNEIER, M.D.
GARY N. DINES, M.D.
TIMOTHY E. LITTLE, M.D.
JINFENG JEFF GUO, M.D.
This is to serve as a letter of authorization for Architectural Werks is serving as our agent
for submitting the enclosed permits for remodeling in our office.
If you have any questions, please contact me at 425-774-2672
Thank you for your help with this matter.
Sincerely,
6
Office Manager
20Q1 Washington State Nonresidential
fing Sum" mary
gton State Nonresidential Energy Code Compliance Forms
Revised June 2002 - KJM
Project Info
MCEIVErn
4UG
ERMIT COUN
Project Address .1c .... tirig Office Remodel - Digestive Disease Center
Date 7/28/2004
21600 M 99, SUITE 220
For Building Department Use
EDMONDS, WA 98026
7-pplicant Name: Architiactural Werks, Inc.
f
Applicant Address: 11335 NE 122nd Way, Suits 140, Kirkland, WA 98034
*W*ant Phone: (425) 823-2244
rd - R PRM
Project Description New Building 0 Addition El�w4ticj rVW
Refer to WSEC Section 1513 for controlsand commissioning
ICompliance Option 0 Prescriptive * Lighting PowerAllowance 0 Systems Analysis
I (See Qualification Checklist (over). Indicate Prescriptive & LPA spaces clearly on plans.)
Alteration Exceptions
(check appropriate box)
No changes are being made to the lighting
Less than 60% of the fixtures are new, and installed lighting wattage is not being increased
Maximum Allowed Lighting Wattage (Interior)
Location
(floor/room no.)
Occupancy Description
Allowed
Watts per f12
Area in ft2
Allowed x Area
rioin i auie 10- 1 JUVUrl - UUGtJlnenL all exuepuon5 an TOrM L I t.3-1-f-A i otai Allowed vvatts
Notes:
1. Use manufacturers listed maximum input wattage. For hard -wired ballasts only, the
default table in the NREC Technical Reference Manual may also be used
2. Include exit lights unless less than 5 watts per fixture.
Proposed Lighting Wattage (Interi:bt)st all fixtures. For exempt lighting, not exception and leave Wafts/Fixture blank.
Location
(floor/room no.)
Fixture Description
Number of
Fixtures
Watts/
Fixture
Watts
Proposed
i otai t-roposea vvans may not exceed i otal Allowed vvatts; tor interior I otaf Proposed watts
Maximum Allowed Lighting Wattage (Exterior)
Allowed Wafts
Area in ft2
Allowed Wafts
Location
Description
per ft2 or per If
(or If for perimeter)
x fe (or x If)
Covered Parking
0.2 W/f12
(standard paint)
Covered Parking
0.3 W/f12
(reflective paint)
Open Parking
0.2 W/f12
Outdoor Areas
0.2 W/ft2
Bldg. (by facade)
0.25 W/ft2
[Bldg. (by perim)
7.5 W/If
niutt;. iur uiJiming exterior, unuo5e enner ine iacaue area or ine perimeter mein0a, out not Doln) i otal Allowed watts
Use mtgr listed maximum input wattage. For tixtutes WIL11 f1d[U-Wilreo Dallasis onI7'_J
Proposed Lighting Wattage (Exterior) the default table in the NREC Technical Reference Manual may also be used.
Location
Fixture Description
Number of
Fixtures
Wafts/
Fixture
Watts
Proposed
I - IV I �F�V VVOLLQ I I ICY I IUL VAkVVU I ULM MIVWUU VVdLLb I UF r-AMMUF i otai rroposea vvaus I I
, , r, 2001 Washington State Nonresidential Energy Code Compliance Form
Code Compliance Forms
Revised June 2002 - KJM
Prescriptive Spaces Occupancy: 0 Warehouses, storage areas or aircraft storage hangers * Other
Qualification CheddiSt Lighting Fixtures: El Check here if at least 95% of fixtures in the space meet all four criteria:
Note: If occupancy type is 'Other' and fixture
answer is checked, the number of fixtures in 1. Fixtures are fluorescent, non -lensed, with only one or two lamps, and
the space is not limited by Code. Clearly
indicate these spaces on plans. If not 2. Lamps are T-11, T-2, T-4, T-5, T-6, T-8 3. Lamps are 5-50 Wafts, and
qualified, do LPA Calculations. 4. Ballasts are electronic ballasts 5. Exit lights < 5 watts/fixture
6. Screw -in compact fluorescent fixtures do not qualify
TABLE 15-1 Unit Lighting Power Allowance (LPA)
_U -Se"r
LPA'
(W/sf)
Usd'
ILPA'
MM
Painting, welding, carpentry, machine shops
2.3
Police and fire stations"
1.5
Barber shops, beauty shops
2.0
Atria (atriums)
1.0
Hotel banquet/conference/exhibition hall
2.0
Assembly spaces', auditoriums, gymnasiaw, heaters
1.0
Laboratories
2.0
Group R-1 common areas
1.0
Aircraft repair hangars
1.5
Process plants
1.0
Cafeterias, fast food establishments�
1.5
Restaurants/bars'
1.0
Factories, workshops, handling 2 reas
1.5
Locker and/or shower facilities
o.8
Gas stations, auto repair shopsw-
1.5
Warehouses.". storage areas
0.5
Institutions
1.5
Aircraft storage hangars
0.4
Librarieso
1.5
ITe'tailretail banking
1.5
Nursing homes and hotel/motel guest rooms
1.5
Parking garages
See Sectio
1532
Wholesale stores (pallet rack shelving)
1.5
Mall concourses
1.4
Plans Submitted for Common Areas Only'
Schools buildings (Group E occupancy only),
school classrooms, day care centers
1.35
Main floor building lobbiesj (except mall
concourses)
1.2
Laundries
1.3
1
Common areas, corridors, toilet facilities and
washrooms, elevator lobbies
0.8
Office buildings, office/administrative areas in
facilities of other use types (including but not limited
to schools hospitals, institutions, museums, banks,
churches) d.7,1111
1.2
I
Footnotes for Table 15-1
1) In cases in which a general use and a specific use are listed, the specific use shall apply. In cases in which a use is not
mentioned specifically, the Unit Power Allowance shall be determined by the building official. This determination shall be based
upon the most comparable use specified in the table. See Section 1512 for exempt areas.
2) The watts per square foot may be increased, by two percent per foot of ceiling height above twenty feet, unless specifically
directed otherwise by subsequent footnotes.
3) Watts per square foot of room may be increased by two percent per foot of ceiling height above twelve feet.
4) For all other spaces, such as seating and common areas, use the Unit Light Power Allowance for assembly.
5) Watts per square foot of room may be increased by two percent per foot of ceiling height above nine feet.
6) Includes pump area under canopy.
7) In cases in which a lighting plan is submitted for only a portion of a floor, a Unit Lighting Power Allowance of 1.35 may be used
for usable office floor area and 0.80 wafts per square foot shall be used for the common areas, which may include elevator
space, lobby area and rest rooms. Common areas, as herein defined do not include mall concourses.
8) For the fire engine room, the Unit Lighting Power Allowance is 1.0 wafts per square foot.
9) For indoor sport tournament courts with adjacent spectator seating, the Unit Lighting Power Allowance for the court area is 2.6
wafts per square foot.
10) Display window illumination installed within 2 feet of the window, lighting for free-standing display where the lighting moves with
the display, and building showcase illumination where the lighting is enclosed within the showcase are exempt.
An additional 1.5 w/ft2 of merchandise display luminaires are exempt provided that they comply with all three of the following:
a) located on ceiling -mounted track or directly on or recessed into the ceiling itself (not on the wall).
b) adjustable in both the horizontal and vertical axes (vertical axis only is acceptable for fluorescent and other fixtures with
two points of track attachment).
c) fitted with tungsten halogen, fluorescent, or high intensity discharge lamps.
This additional lighting power is allowed only if the lighting is actually installed.
11) Provided that a floor plan, indicating rack location and height, is submitted, the square footage for a warehouse may be
defined, for computing the interior Unit Lighting Power Allowance, as the floor area not covered by racks plus the vertical face
area (access side only) of the racks. The height allowance defined in footnote 2 applies only to the floor area not covered by
racks.
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DATE E_ DATE.-
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Side Sewer Drawing EASEMENT NO - -------------------
. .............
NEW CONSTRUCTION REPAIRS El LID NO . .................. . ASMT. NO ----------
------------------ CONTRACTOR 44X ------------------ PERMIT NO.4.!��-72,
------ ------ ff --------------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
................... -------------------------------------------------------------------------------------------------------
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
L�J a-
77.-5-'-
Approved:
PWW-0001 -11/75 (REV. 11/78) DA .... .. . . .... .. By -------------------
MOTE
US
O
N E
CITY ur LUIVIU11111111119
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAMI: Ut- BUSINESS)
NK �-D "/009.. j�AJWYN bf-AU--
0;?Zyjp _W ?--
MAILING ADDRESS
lb I E NUMB R
CITY I
EIDMOnOS I VJk-
NAME IT LEI w-Y003.
ir-)ALM6r) f22AY DeS I lAt4 (A L) P
ADDRESS
149501
TELEPHONE NUMBER
CITY
NAME Wr 1, _W06,0 C(>9 -1 Ot4
ADDRESS
-7
,o Tb- ST.
CITY TELEPHONE NUMBER
S'�21 _O(P-56
ENSE NUMBER
STATE LICENSE NUMBER CITY LIC
Legal Description of Property - Include all easements
(show below or attach four copies)
6Tq RA(,J5
F�7
KNI
NEW
F-1 RESIDENTIAL
S
Lj PLUMBING
ADDIALTER
ND�N-RESIDENTIAL
MECHANICAL
REPAIR
RETAINING WALL
SIGN
DEMOLISH
EXCAVATE
OR FILL
FENCE
El L_ x _FT)
I I PRE -MOVE INSP-1
F-1 swim
117 FO F]
LCIJ SIDE SEWER L&J WATER LINE
11 E1___ 1:1
— �C QTnRIFS NUMBEROF
NUM L
on.6 t I: Nor\E.
,5,,,��mENT'UWLL INU
UNI I ti
NATURE OF WORK TO k3t: UUNt tATTACH PLOT PLAN)
nr- 1,9)1000 -54
eoluki_� OH�)66 501Lo
M Ck9_,5.
JOB
ADDRESS 21600
ON NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING - 119 REQUIRED DEDICATION
PROPOSE6_4,0__�_
RIGHT OF WAY CONSTRUCTION PERMI1 . REQUIREDif
STREET USE PERMIT REQUIRED 0
SEE ENGINEERING MEMO DATE,qw�*—&__
SEE PIW DEPT. REVIEW CHECK LIST DATED—
/ 7
METER SIZE f IBUILDIING SUPPLY
REMARKS
UNITS
SIGN AREA ENV. REVIEW T I ADS NO.
ALLOWED I PROPOSED I COMPLETE I EXEMP Z2____,f74
VARIANCE 08 CU PLANNING REVIEW By.
I -tl7z"Z�lh, Z;
YARDS 161 0,
FRONT SIDE
1404 - b-111- _7?72�
-1 1
-CH—ECKED Bf TYPE OF CO
SPECIAL INSPECTOR
REQUIRED
0 YES 0 NO
PLA14 CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
agrees to indemnify, defend and hold
successors in interest,
'u0i harmless the City of Edmonds, Washington ' its officials,
from a ny and all claims for damages of
2 employees, and agents
X whatever nature arising directly or indirectly from the issuance
be deemed to
,A/
pjp4
of this permit . I�suance of. this permit shall not
modify,.waive or reduce any rei quirement of any city ordinance
0 nforce any ordi
the City's ability to e nance
TOTAL AMOUNT DUE
nor limit in any way
provision."
I hereby acknowledge that I have read this application; that the
is correct; and that I am the owner, or the duly
ATTENTION
information given
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
will be employed in violation of the Labor
AUTHORIZES
ONLY THE
ed thereby, no person
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
tion lnsurgn-Zc�.. 1 I DATE SIGN
INSPECTION
DEPARTMENT
SIG RE
I Zq_
CITY OF
EDMONDS
D OA �7
771-3202
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.
UBC
CHAPTER 3.
102-78
LOT COVE
REARI
EN
E
1/0
HEIGHT
a:
Uj
: 0
K
Z
Z
1 <
I iL
OCCUPANCY OCCUPANT
GROUP ILOAD
0
Z
VALUATION I FEE
_--Zev. C-0
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
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
7 7 7
USE
CITY OF EDM ZONE NUMBER
.: . .
CONSTRUCTION PE13MIT APPLICATION- joe..
OWNER NAME/(4AME OF BUSINESS ADORE I SS
e�:2 Z (0 9
GROUP ftINIC'R &"D PARTNERSHIP
LEGAL DESCR PTION CHECKI SUBDIVISION NO. LID Nb.
cr
W MAlkeSaTIE
Z dhaf fees M.D.
3� TESCP
0 21600 Hwy. 99 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP,
CITY ZIP TELEPHONENUMBER EXISTING 6*0 REQUIRED DEDICATION ___' APPROVED BY
Edmonds ..980.20
PROPOSED
qAME
CNA AFq�-� RIGHT OF WAY CONSTRUCTION PERMIT REOUIREDII,�
_tec�ture Group,
STREET USE PERMIT REQUIRED 0
WO ADDRESS Suite 600
t
x REVIE
0 3050 152nd Avenup SEE ENGINEERING MEMO DATED,
cc . . ZIP - TELEPHONE NUMBER
< CITY ; - - 6) 882406
Redmond� -;98052 (20 REMARKS
NAM tJ5 —IlUrve �j &A) --;r
C4
ADDRESS adf
METER SIZE BUILDING SUPPLY SIZE IFIXTURE UNITS
0 ZI t?- aid x
S ATE LICE-96fBER
T�" -N
2_7 �g2Z-ZJ_-_T,4 - C, zo IcT
Legal Description of Property - include all easements
(show below or attach two copies)
See Attached
Tax Account Parcel No. ed
FLY NEW RESIDENTIAL F1 PLUMBING
ADD/ALTER COMMERCIAL, MECHANICAL.'
El�REPAIR APT. BLDG. SIGN
�4, EXCAVATE, FILL FENCE
OEMOLISH OR GRADE _FT)
CARPORT swim
REM'ODEL GARAGE D'POOL
ElWOOD STOVE/ RETAINING WALL/
INSERT 11 ROCKERY RENEWAL
(TYPE OF USE, BUSINESS 08 ACTIVITY) EXPLAIN:
Business Medical Offices
NUMBER OF STORIES NUMBER OF
2 DWELLING IVA
UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
General eonstruction Including
mechanical and el-eooc4aek, and site
I
SIGN AREA
ALLOWED PROPOSED
ENV. REVIEW
COMPLETE] EXEMPT
ADB NO.
A04i�,
MCC
SHORELINEM
VARIANbE-OR CU
NA
PLANNING REVIEW BY
DATE
-j 01
15f
r
9 �tw
SETBACKS - FE��,
FKUNI� SIDE
REAR
HEIGHI
LOT COYERAGE
NA
REMARKS
k�60__7,
1'fO
_AM I
4Z 2_-J�5-
4HECKE'
TYPE OF CONSTRUCTION
CODE
HEIGHT
I -z-
Ing—
/ 7a
-35
SPECIAL INSPECTOR AREA )17
JOCCUPANCY
OCCUPANT
REQUIRED .21,
000--\
GROUP
LOAD
0 YES 0 NO
REMARKS
PROGRESS INSPECTIONS PER UBC 305
-Mucr
c4z< s dy
FINAL INSPECTION REQUIRED
PLAN CHECK FEE
improvement.
BUILDING
PLUMBING
Plan Chec"O.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
Any condtruction on.the public domain (curbs, sidewelks,
STATE SURCHARGE
driv ways,1 marquees, etc.) will require separatq permission.
Permit Applid ation: 180 Days
I
Permit Limit: I Year- Provided WorK is Started Within 180 Days'
5VAM OM110V Fe e-
"ApplicarI4 on behalf.of his or he(. spouse, heirs, assigns and
w
successors ib interest, agrees to in'demnify, defend and hold
harmless t4 City of Edmonds, Washington, Its officials,
2
<
employees, al;ld\agents from any and ail claims for damages of
whatever nature,arising directly or Indirectly from the issuance
M
of this permit'� Issuance of. this permit shall not be deemed to
PLAN. CHECK DEPOSIT
a
modify,.walve or reduce any requirement of any city ordinance
0
I
nor limit In an§ way the City's ability to enforce any ordinan6e
TOTAL AMQUNT DUE
provision."
1 .
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 construetJon; 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 Insurance. -------
INSPECTION
SIGNAJ44-VIOWNER DAT,/ES NED
DEPARTMENT
CITY OF
EDMONDS
.ATTENTION
CALL FOR
INSPECTION
'T IS UNLAWFUL TO USE OR OCCUPY A BUILD ING bR,STRUdTURE
I 771-3202
'\UNTIL A FINAL INSPECTION HAS BEEN MADE�AND APPROVAL 08
CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED., UBC
,
.;HAPTER 3.
4, 264
6Y
16
.47DJ
coo, � 1�5
;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.
F IAL,S IG AT;URE
DAT
7/
R0
LE4sED BY: , I ) DATE�
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
cr
W
n ddl�
DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
;R NAME/NAME OF BUSINESS I
MAILING ADDRESS
L1 5;V-1'4
CITY Zip TELEPHONE
Fbftivlo�
NAME
ADDRESS
CITY ZIP I TELEPHONE
ESS
1,11 If
ZIP TELEPHONE
STATE LICENSE NUMBER EX . PIRAYTI N/DlkTE I CUCKED BY
, I C
r-14- , 0 r I
'I PROPgRTY TAX ACCOUNT PARCEL NO. / I
1% NEW
RESIDENTIAL
Rr'
PLUMBING / MECH
F1 AUDITION
COMMERCIAL
0
COMPLIANCE OR
CHANGE OF USE
F1 REMODEL
APARTMENT
0
SIGN
Fj REPAIR
GRADING
CYDS
FENCE
( — X FT)
DEMOLISH
C3 TANK
OTHER
o GARAGE
CARPORT
RETAINING WALL
ROCKERY
RENEWAL
(TYPF,OF USEIBUSINESS
OR ACTIVITY) EXP IN�
NUMBER
OF
STORIES
9?�'
NUMBER OF
DWELLING
UNITS
CRITICAL
AREAS
1 NUMBER
DESCRIBE WORK TO BE DONE
f') V Q — A_ 'el ,
7, — (9
�'� A A AM I P9:12ftfiff CY0111011=0
USE
ZONE
JOB
ADDREV,�,�
PERMIT
NUMBER
SUITE/APT#
'-�— I "!!�—
UDDIVISION NO. /I
LUT NO.-
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
0
RW Permit Required
0
EXISTING - PROPOSED
Str et Uae Permit Req'd
Inseection Required
0
0
Sidewalk Required
0
REQUIRED DEDICATION- FT
Underground
Wiring required
0
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES 0 NO 0
REMARKS
LLJ
z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
z
a
ENGINEERING
FIRE REVIEWED BY
z
"i
REVIEWED/DATE
DATE
5
LWL I
VARIANCE OR CU
SHORELINE OR ADB#
INSPECTION
. REO'D
IPBOND
OSTED
0 YES ONO
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
AL . LOWED PROPOSED
EXP I
,
I
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UR SIDE REAR
z
PARKING
LOT AREA
I
I PLANNING REVIEWED'BY DATE
REO'D I PROVIDED
CHECKED BY T ONSTRUCTION CODF_ OCCUPANT
l' ' GROUP
2 2�?
SPECIAL INSPECTOR JAREA OCCUPANT
REQUIRED [:] YES LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE0'9 30
VALUATION I FEE
PLAN CHECK FEE
HEAT SOURC
ZI
y W,
LOT SLOPE % BUILDING
M "+_
N/v
PLAN CHECK NO:
VESTED DATE PLUMBING
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
MECHANICAL
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE GRADING/FILL
SEPARATE PERMISSION.
'STATEISURCHARGE&-
PERMIT APPLICATION: 180 DAYS
REVIEW FEES
CIL
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS ENG.
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
"APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE
W IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
i —
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND LANDSCAPING
IM INSPECTION FEE
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
RECEIPT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE PLAN CHECK DEPOSIT
0 NOR LIMIT IN ANY WAYTHE CITY'S ABILITYTO ENFORCE ANYORDINANCE PROVISION.*
x
I
R CEIPY
I TOTAL
AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
4/27
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLIdATION APPROVAL
THE OWNER. I AGREE TO COMP NO STATE LAWS REGULATING CONSTRUC-
LY Wl� RIZED EREBY. NO PERSON WILL BE EMPLOYED
TION; AND IN DOING THE WORK AU 0�'
CALL
This application is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
LA
L A
__'! C
IN VIOLATION OF 'rE OF THE �TATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
PTH
IN RKMEN'S CC E AITION�,S RANCE AND fCW 18.27.
SI it'V
NA E(O E AGENT) DATEAGNE6/
(425)
OF;FTLS SIGINATVPE DATE
.
771 -0220
�DAT
RELEASED BY
AT#I`#1OkJ
EXT/333
IT IS &&AWFUL TO USZORdCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
I
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
OR IGINAL - FILE YELLOW - INSPECTOR
5/98
FAX
PINK - OWNER GOLD - ASSESSOR
DATERECErVED
�aroL-x CL4'iji,JKAh, ji��
CITY OF EDMONDS
CONSTRUCTION PERMIT APPUCATION
OWNER NAMFO�-OFBUSANSF� -:--t
w MAILING ADDRESS
w —
z
3 0 ID 00 V��l
: 9�
CITY
`_1169_00
10[
PERMIT EXPIRES
USE PERMIT
4
ZONE f6 NUMBER
00773
JOB
ADDRESS 2/&tQ0 1116�W,4v
SUITE/APT#
tn 4 'r --
.D-0.5
d�
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TIESCP Approved 0
RW Permit Required 0
Street Use Permit Req'd 0
EXISTING — PROPOSED
-
Inspect on Required 0
SIdewa:k Required 0
REQUIRED DEDICATION— FT
Underground
Wiring required 0
NAM E
ADDRESS
S�_P- 140
CITY ZIP
TELEPHONE
4-y-kialvLd
47
NAME
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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SEPARATE PERMISSION. Engr. Review
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT! 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
,Fire Review Plan Chk. Deposit
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS 160—
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0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
X, Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT: AND THATl AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application Is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LAPQkCODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged in space provided.
WORKMEN'S COMPENS�Mlsl INkURANCE AND RCW 18,27.
SIGNATURE (OWNER Ott AGEN-0 DATE SIGNED (425) OFF Cl MIG DATE
A 1!�
A1111,4k, 992 �a
L� 771-0220 E, ASED DATE
ATTENTION EXT 1333 (
IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL &zb, 0-,//&
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09/03 nOU00 U A or% %F^l I A OC RA A VIKIII11"M A ^^11211111CO
ATE RECEIVED
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CONSTRUCTION PERMIT APPLICATION
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SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
"APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED To MODIFY, WAIVE OR REDUCE ANY REOUIREMENTOF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDI NANCE PROW SION.-
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE 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 STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND FICW 18.27.
DATE SIGNED
�2 --,.;2.7 0 it
A17ENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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5/98
PERMIT EXPIRES 614 A/
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APPLICATION APPROVAL
CALL
This application is not a permit until signed by the
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FOR INSPECTION recei is ac
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(425)
OFFICIA�S '9VAT ATE
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771-0220
EXT 333
AELEAS91T64 DATE
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771-0221
FILE Y�LLOW - INSAECTOR'
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Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT; ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp.
Total Amt. Due
0 NOR LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
x
Recording Fee
Receipt #
1 HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
N IS
GIVE IS CORRECT: AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
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CALL
This application Is not a permit until signed by the
TION; AND -IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
recalpt Is acknovirledged In space provided.
WORKMEN�S COMPENSATIPOWVRANCE AND RCW 18.27.
SIGNAr (0 GE DATE SIG4ED
5)
URE DATE
14/4-/03
771-0220
I
RE 64'Y DATE
A17ENT16N
M 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
6
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
I
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL -FILE - YEI[OW-1NSA T"'
04/02
PINK -OWNER - GOLD -ASSESSOR
GREEN - ACCOUNTING
PRESS HARD -YOU ARE MAKING 5 COPIES
IVED
PERMIT EXPIRES
USE PERMIT
ZONE
CITY OF EDMONDS NUMBERCOeV,,4
JOB SUrMAPT#
CONSTRUCTION PERMIT APPLICATION ADDRE��,�
_x 0 R NAME/NAME OF BUSINESS
% A 4 0 i PLAT NAME/SUBDIVISION NO. LOAO. LID NO.
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ADDRESS REMARKS
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IL PERMIT ILIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
a EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
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 Landscapelnsp. Total Amt. Due
0
x NOR LIMIT IN ANY WAY THE CTIYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee Receipt #
I- HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT: AND 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- This application Is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or Wslhw Deputy: and Fees are paid. and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is ackrytorledged In space provided.
WORKMEN'S COMPENSATION CE AND RCW 18.27.
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Slq�?+ OWNER AGE DATE SIGNED 2 GMT
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ATTENTION 1 3
IT IS UNLAWFUL TO USE OR OCCWA BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 -77if- 3 ORIGINAL -FILE YELLOW- INSPECTOR
PINK -OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING
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THE GRANTOR, . , for and in consideration of
mutual benefits to be derived, convey and quit claim to the City of
Ec1monds, a municipal corporation, the following described real estate,
situated in the County of Snohomish, State of Washington, including any
interest therein which grantor may hereafter acquire:
A portion of Tract 31, Solner's Five -Acre Tracts, according
to the plat thereof, recorded in Volume 7 of plats, page 25,
records of Snohomish County, Washington, lying Westerly of
the Westerly line of State Road #1; TOGETHER WITH that
portion of vacated Spruce Street lying between Tracts 29
31, more particularly described as follows:
Commencing at the intersection of the Westerly boundary
of State Highway No. 1 and the Southerly boundary of
216th Street S.W., the true point of beginning; thence
Westerly, a distance of 18.0 feet along the Southerly
boundary of said 216th Street S.W.; thence Southerly,
perpendicular to the Southerly boundary of 216th Street
S.W., for 38.67 feet, more or less, to the intersection
with the Westerly boundary of State Highway No. 1; thence
Northerly along the Westerly boundary of State Highway 99,
for 42.65 feet, more or less, the intersection with the
Southerly boundary of 216th Street S.W., the true point of
beginning; situate in the County of Snohomish, State of
Washington.
together with the right to make all necessary cut or fill slopes on the
land of grantor's adjacent to the above -described real property in
connection with the construction, maintenance or improvement of the
above -described real property for purposes of a public roadway.
DATED this day of 19.
- _J
STATE OF WASHINGTON)
) ss
COUNTY OF SNOHOMISH)
On this _ day of 11 1911
before me, the undersigned, a Notary Public in and for the State
of Washington, duly ccnmissioned and sworn, personally appeared
J, to me known to be the President of
the corporation that executed the foregoing instrument, and
acknowledged the said instrument to be the free and voluntary act and
deed of said corporation, for the uses and purposes therein mentioned,
and on oath stated that they were authorized to execute said instrument
and that the seal affixed is the official seal of said corporation.
WITNESS my hand and official seal hereto affixed the day and year
first above written.
NOTARY PUBLIC in and for the State of
Washington, residing at
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