21704 82ND AVE W.PDF111111111111
7587
21704 82ND AVE W
CA FILE NO. ge
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soil s/top o graphy/hy dro lo gy/vegetati on)
1. Site Address[Location: --a, 1 -7 e) N--A- A V - 6d
2. Property Tax Account Number: c-"o-V — e�� / —
3. Approximate Site Size (acres or square feet): n4Al2X
4. Is this site currently developed? yes;
If yes; how is site developed?
no.
e_ 11 L,_q
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
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
T A
Other (please describe): 10 7
6. Site contains areas of year-round standing water: )nec� ; Approx. Depth:
7. Site contains areas of seasonal- standing water: nZ Approx. Depth:
What season(s) of the year? -AZIA
8. Site is in the floodway AD - floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are r-
round? Y\'n Flows are seasonal? . W (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: Y\Z
-------------------- -------------- ____".For.City Staff Use Only ----- — ---------------------------- 4 -----------
site is Zoned?
SCS mapped soil type (sr
Wetland inventory or C.A. map indicates wetland present on site? �0
:4. Critical Areas inventory or C.A. map indicates Critical Area on site? N 0
5'. Site,within. designated earth subsidence landslide hazard.,area?
Site des ignate d on the Enviro nmentally Sensitive Areas Map
i)ETkAMINAMN
1m_chk.doc; Rev 10/03/97
Edmonds
CRITICAL AREAS CHECKLIST
The Critical Areas Checklist contained on this form is
to be filled out by any person preparing a
Development Permit Application for the City of
Edmonds prior to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The
information needed to complete the Checklist should
be easily available from observations of the site or
data available at City Hall (Critical Areas inventories,
maps, or soil surveys).
An applicant, or his/her representative, must fill out
the checklist, sign and date it, and submit it to the
City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map along with the signed
cor)v of this fortil to assist City staff In f,--A.
ding 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
map, etc.) or studies in conjunction with this Checklist
to assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
Name
,3 --� f -
Street Address
Applicant Representative:
e
W
Name
-� -� E� - 6 --� 4y,
Street Address
57 A-,�
C(M 6XJ S
J&;W
City State Zip city State ZiD
��-51 21-1F-0 LIZ15
Telephone
'Signature
Date
c:recepdon\jana\cac1.doc
Signature
�z
Date
7 "-07 cIz:2/ —0 ��;3
(over)
7
PC.
June 22, 1998
CITY OF EDMONDS BARBARA FAHEY
MAYOR
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works - Planning/Building - Parks and Recreation e Engineering - Wastewater Treatment Plant
Rochelle A. Goldberg
338 8t� Ave. South
Edmonds, WA 98-020-3412
Subject: Determination regarding Critical Areas Checklist # 98-163
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 (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
IMPORTANT INFORMATION TO BE NOTED:
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS OR CRITICAL AREAS STUDY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
,moo, You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL -.111101111111
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. -
Eric: Critical Areas Determination
* Architectural Design Board
Thank you.
Shada Graham
Acting Planning Secretary
C:ReceptIon\Jana\CRLTR.doc
ib Incorporated Auqust,11, 1890
Sister Cities International — Helkinan, Japan
O—L4-00 4-40M w i T ur cvoiviw" 44� 40 �OO�;4 4
CA FILS NO.
Critical Areas Checklist
------------------ ------------------
Site Information (soils/topography/hy&ology/vegetation)
1. Site Address/Location: a 1-704Z - JBZ hcL AV. &).. S
2. Property Tax Account Ntunber: (0 — C�,� CPL-
3. Approximate Site Size (acres or square hot): n*&
4. is thii'site currently developed? /Ycs;—no.
VIP al
S. Describe the general site topo hy. Ch 11 that apply.
Flat: less than 5-feet elevation change tire sjte.
Rolling: slopes on site generally less thin &I rise of I 0-feet o ver a JUL 2 1 '1998
horitontaidistance of 66-foet).
Hilly: slopes present on site of more than 15% and less th9ho)rvertical rise of
X1,
10-feet over a horizontal distance of 33 to 66-feet).
Ste ep; 'grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of lose than 33-feet).
Other (please deserlbe): -991a --AkZ:,�t ... 7.
6. Site contains areas of year-round standing waten _; Approx, Depth:
7. Site contains areas of seasonal statnding water-, Approx; Depth:
What season(s) of the year? A
R. Site is in the floodway ah floodpI%in__jnL_ of a water course.
9. Site contains a creak or an area where'. water flows across the grounds surface? Flows are year-
round? IN-C Flows are seasoual? 4C (What time ofyear? AIIA
$I --- -
10. She Is primarily: fore8ted xneadow shrubs mixed
urban landscaped (lawn,shrubs ate) ' X
11. Obvious wetland is present on site: - , Y\Z
>, g3,
�4
OR N P
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M
R alom
H FILE -
E I
SITE PLAN FOR HOUSE OWNED
BY ROCHELLE GOLDBERG AND LOCATED AT
21704 82nd AVE W, EDMONDS WASHINGTON
YARD OF CHASE LAKE ELEM ' ENTARY SCHOOL
ON NORTH AND WEST SIDE
SHED
x 16
North
SLOPE DOWN TO BACK YARD —
GARAGE 15 X 24
LOT SIZE 64 X APROX 150
(EDGE OF STREET TO BACK FENCE)
BACK YARD (WEST SIDE) IS LEVEL AND
APROX 6 FEET LOWER THAN STREET LEVEL
HOUSE 25 X 34
2 STORY
DAYLIGHT BASEMENT
ON WEST SIDE
WEST EDGE OF 82 AVE W
DRIVEWAY 19 X 33
FRONT YARD IS LEVEL
BEAR
AREA OF FOUNDATION REPAIR
APRDX 7 FEET LONG STEPS DOWN TO BACK YARD
RESIDENTIAL LOT DN SOUTH SIDE
I
JUL
21704 82nd AVE W
APPLICATION
for
The City of Edmonds SEDE SEWER PEPwNaT EASEMENT No . .............................
famu-NEW CONSTRUCTION REPAIRS E]
SIVEE LkC-) �'a)2
41�
0 E R C PERMIT No . ......................
WN --------------------------------------------------------------------------------------------------- CONTRA TOR ........ ............................ 014-NER .................................
ADDRESS ... ��17C-)� 4�,\JE-= -\�q- - LEGAL DESCRIPTION: LOT No . ................... i BLOCK No.
................................................................................. ........... ........................... ............... ...........................
k—F( C) ��
NAMEOF ADDITION .........................................................................................................................................
By
3Y
APPUCATION
lbo"City of Ednionds ur
SMIC SEV"M PER&M
NEW CONSTRUCTION REPAIRS 0 EASEMENT NO . ..........................................
OWNER . ........................... CONTRACTOR .................................
. ....... 6A4.16AAA ................................................................. PERMT No.
ADDRESSiZt.7 ......... . ........ &Ae ........ ....... .............. LEGAL DESCRIPTION: LOT No. .1 -- ----- aien-5-1444�.-IBILOCK No. .........................................
NAAM OF ADDITION
04-14
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> .20
i iirz Approved:
DATE............... ........... . ................... ............... ......
STREET FILE
CITY OF EDMONDS LARRY S. NAUGHTEN
MAYOR
Z; -�* 250 51h AVE. N. EDMONDS, WASHINGTON 98020 , (206) 771-3202
COMMUNITY SERVICES PETER E. HAHN
DIRECIOR
March 30, 1988
Rochelle A. Goldberg
Ronald B. Borovec
21704 82nd Avenue West
Edmonds, Washington 98020
RE: Request for address change 331 8th Avenue South
The Fire and Building departments have reviewed your request and
approved the proposed address change at 331 8th Avenue South.
�31 8th-Avenu-e S-o-uth CHANGED - TO 338 8th - Avenue S o u th
The City will notify all interested City departments it is your
responsibility to notify all others.
Thank you,
Jeannine L. Graf
Permit Coordinator
cc: Utility Billing
Public Works
Fire Department
Police Department
PUBLIC WORKS PLANNING PARKS AND RECREATION ENGINEERING
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C41'�k OF EDMONDS V-,W- rmit No.
PUBLIC WORKS DEPARTMENT . m7sue Date
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. eAddress or viciRV of Construction
21704 82 W Plat # 164-69F�8
0 Owner: Washington Natural Gas
Name
805 156 AV NE
Mailing Address
Bellevue, Wa. 98007
City, S ta te, Zip Code
Contractor: Same As Above
Name
Mailing Address
9 Permit Issued To: &)A)G
• Type of Work to be Done:
Install Test Leads
• Work in Connection With:
0 Sub or Plat 0 Single Family
0 Comml. / Ind. 0 Apt. Condo.
• Pavement Cut: El Yes El No
State License Number
City, State, Zip Code Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit must'15e`�kailable at
I 1 0.1-
Signature:— I I
Owner or Agent
forf#pection purposes at all times.
te Sept 2, 1982
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Volfafter k3e) —days
Special Conditions:
Ammendments:
Permit Fee: h 30, 00
Security Deposit:
Receipt No.:
Fund Ill Fee:
Street Cut Dimensions
X
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. Deccmbcr 1978
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NOTICE:
ty of accuracy.
N'o ... wa rra n
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edm.onds does not warrant the
accuracy of anything set forth on these
map(§-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
Fe -m a p (s), Including, but not limited to,
'tub shown, Such
the location of any sewer S
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
ernp-to-yee-s or offiClers -sh-a-11.1 be I'l-a-b-.11--e for the
information given on this map(s), nor for
ion provided based
any one representat'
upon said map(s).
CITY OF EDMONDS SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.)
(Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.
ADDRESS LOCATION OF CONSTRUCTION ------- 21704 32nd Awnue Oest ................... . .......................................................
..................................................................................
PROPERTY LEGAL DESCRIPTION ....... Oden's-.Additinn- armrd1n.o .... M ... n1mat ... ....................
.. ..... . .. .. .... ....
in Volume 14 of plats .. .... p'a-0 ...... 90 ...... r'a C 6', * ds"'of Snohomish CountY, UashingtOP . ..............
..,e
...................... . .......................... . ........... .......... . ........................................................................ ............... ...............................................................
/OR BUILDER ...... -�, ro
_��.!qh.ael --- A.._..Co1Ab.e.rq .... and .... Roch.e.1.1e .... A Gole_e .............
....................................................... OWNER AND , I s wl.�e
Mi ch ae I A. Gold'oera. 21704 82nd Pl. H_ Edrogids (AvPJj1 ...
CONTRACTOR'S NAME & ADDRESS ............................................................... ........................ .............................. . . ........... ......... ................... ...........
April 13,) 19 ... 74, for repair and/or connection of a side sewer to the city sanitary sewer
Permission Is granted ...... -------------------------------------------------
in accordance with City of Edmonds ordinances.
A.,TTION IS CALT D TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been Inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3--Obtain full information regarding Ordinajice 11.16.030 and Regulations governing side sewers when you ge t permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends In grade
sharper than % will be permitted.
NOTE No. 5---Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED E] Date -_ - ------ ---------------------- .... By ---------------- Date .......... / - By ................ Date ---------------- ------------------- 'BY ................
...........................
APPROVED Date... --------------- B y
.. . ...................... ................................................................
V ....... . ..
�114 - ---------------- --- --- ----------- ..... -------- - --
Remarks: ................ ------------------------------- /I -------------------------------------------------------------------------------------------------------------------------------
..................................................................... . ................................... .................................................... . .................................. . ............................................. .........
— BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection —
....................................................................................... ... I hereby certify that the side sewer installation constructed under this permit
(Owner of Contracting Firm Performing Construction)
%_.astalled in accordance with all governing ordinances of the City of Edmonds.
Datedthis ............... . ........... day of ---------------------------------------------------------------- 1 19 .........
-V V Check BEFORE you dig for: Water E], Gas E], Telephone E], Power [:], Sewer F], Other E] V V
CITY OF MmoNbs
USE
ZONE PERMIT
NUMBER
9's - T
CONSTRUCTION PERMIT APPLICATION
JOB OJITE/APT #
All s
1
OWNER NAMEINAME OF BUSINESS
ADDRESS /3()V '177
U .0 C, Ar . &,1
LEGAL DESCRIPTION CHECKI
SUBDIVISION NO.
LID NO�
c J Le T-2
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W
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MAILING ADDRESS
PUBLIC RIGHT OF WAY PER STREET MAP.
TESCP Approved 13
0
OFFICIAL
EXISTING —REQUIRED DEDICATION
RW Permit Required 11
Street use Permit Req*d 13
CITY ZIP
4�6492
TELEPHONE NUMBER
�e.7S' 7 7 6 -0
C/Iff 4
f;IP
'If
PROPOSE
Inspection Required 0
Sidewalk Required 11
cc
Lu
NAME
METER SIZ
E SIZE
NO. OF FIXTURES
PRV,REQUIRED
YES 0 N C )0
0
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ADDRESS
REMARKS
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cc
CITY ZIP
TELEPHONE NUMBER
NAME
ir
ADDRESS
ENGINEERING MEMO DATED REVIEWED BY
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CITY ZIP
TELEPHO E NUMBER
FIRE MEMO DATED REVIEWED BY
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cc
STATE LICENSE NUMBER EXPIRATION DATE
VARIANCE 08 CLI
ADB#
SHORELINE III
Legal Description of Property - include all easements
SERA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED
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1PROPOSED
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LJA (502
EXP
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LOT COVERAGE
REOUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (FT.)
uj
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT L/R SIDE REAR
0
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Z
Z
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Property
Tax Account
LOT AREA
PLANNING REVIEW BY
DATE
CIL
Parcel No.
REMARKS
NEW RESIDENTIAL PLUMBINGIMECH
COMPLIANCE OR
ADDITION COMMERCIAL CHANGE OF USE
APT. BLDG.
REMODEL SIGN
HECKED BY
TYPE OF COSTRUCTION
I V
COD
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OCCUPANT)
GRO
GRADING FENCE
REPAIR CYDS. I x —FT)
DEMOLISH WOODSTOVE SWIM POOL
INSERT HOT TUB/SPA
R "JARFA
REQUIRED 0 YES
LOAD
GARAGE RETAINING WALL/
RENEWAL
REMARKS
CARPORT ROCKERY
PROGRESS INSPECTIONS PER UBC 108
(TYPE OF USE. BUSINESS I LAIN:
rlymmgm) J-g-i VIA
3
NUMBER
OF
2
_0 M_ _B E h 0 F'
DWELLI
CRITICAL
AREAS
0
zr-44ff Z I 1�
STORIES
UNITS
NUMBER
DESCRIBE WORK TO BE DONE (ATTAC PLOT PLAN)
FINAL INSPECTION REQUIRED
k1
LA, <, �-,
VALUATION
FEE
PLAN CHECK FEE
-7
BUILDING
HEAT SOURCE:
GLAZING
%
PLUMBING
Check No.
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curts, sidewplks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
ENG. INSPECTION FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
LOU)
harmless I h e City of Edmonds, Washington, its officials,
_j
2
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
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
0
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
on.'
i provision.'
I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL
information given is correct; and that I am the owner, or tho duly
authorized agent of the owner. I agree to comply with city and THIS PERMIT
This application is not a permit until
state laws regulating construction; and in doing the work authoriz- AUTHORIZES
THE signed by the Building Official or his/her
ed thereby, no person will be employed in violation of the Labor ONLY
WORK NOTED Deputy; and fees are paid, and receipt is
Code of the State of Washington relating to Workmen's Compensa-
ance aria RCW 18.27. INSPECTION acknowledged in space provided.
ER 0 AGEWL DATE SI NED DEPARTMENT
OF�Cl� IG IE ATE
OF
CITY
EDMONDS
A
CALL FOR RELEASED BY:
TION I"PE ION AU
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR �220 ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109 PINK — Owner GOLD — Assessor