23925 74TH AVE W.PDFIIIIIIIIIIII
5929
23925 74TH AVE W
I
ADDRESS: z,23 qc?- S-
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE): q-7 9 -0
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: Ej Conditional Waiver F] Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
-7
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED: U- 11—
SIDE SEWER PERMIT(S) #: b a6%
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
BLOCK:
I I
*THER: 6�0 U) -7<6' -
Tia WJaAA'0i &UJW &�In,
LATEMP\DS'Ps\Fonns\Street File Checklist.doe
OCITY OF EDMONDS
PUBLIC WORKS.DEPA NT
SIDE SEWER,,PERMIT
FOR INSPECTION CALL
775-2525 Ext. 220
Permit NOO
Issue Date
%*_PERMIT MUST BE POSTED ON JOB SITE
, W3WAWWWNWZW3WAW=WAWAW
1 Address of Construction
2. Property Legal Description (include all, easements)
me4m 0.
3. Single Family Residence.,,--- Multi -Family No. of Units
Commercial
4. Owner and/or Builder !J
5. Contractor & License No.
6. Invasion into City,Right-of-Way: No..,' Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
7. Cross other private property: Yes No Easement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
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
installation for one year.
C. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
d. Side sewers may not be installed closer than thirty inches (30")
to any structure. 0
e. Side sewer lines must be laid at a minimum grade, of 2% (1.15
and maximum grade of 100% (450). 0
f. No turn in side s8wer greater than 45 (1/8;bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, f.00ting 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 i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 1001 along sewer 'line run.
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 sewermust be left uncovered until inspected and approved
by the City.
1.'. Inspection during normal working hours only. Two (2) working
days notice required.
DATE:
I' certify that I have read
and shall comply with the above
TERMIT FEE: f $0 Ve
CONNECTION FEE.,
PERMIT MI
�P'lk _
'01 K-) DISAPPROVE D BY: Date:
By - 0 . Date:
APPROVED By: Date:
JST BE POSTED ON JOB SITE
I
The City of Edmonds Side Sewer Drawing EASEMENT NO - -----------------------
--------------
NEW CONSTRUCTION REPAIRS LID NO - ------ ----------- - ASMT. NO - ------------------
OWNER ----- FLA—A��t . .......... �—IL'Mt-A ----------------------------------- CONTRACTOR -JLJE---,t--4�� ------- ------------------- PERMIT NO.
JOB ADDRESS ILN, \,-N� ------------ --- LEGAL DESCRIPTION: LOT NO - ----- ? ------------ .- BLOCK NO - ------------------------------------
PWW-0001-11/75 (REV.11/78)
N I
NAME OF ADDITION ------
-------- --
Approved:
DATE------------- ---------- -----------
'City of Edmond*
RIGHT-O&WAY CONSTRUCTION
9 0
PERMIT Permit Number.
Issue Date:
RU` too
A. Address or Vicinity of Construction: - 23925 74 Av. W. (9327563)
B. Type of Work (be specific): Install New Service
C. Contractor: Washington Nat'll Gas Co.
Mailing Address:815 Mercer St.Seattle, Wn.
State License #:
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 224-2278
Liability Insurance: ' Bond: $
Sidi Sewer Permit # (if applicable):
E. 0 Commercial EJ Subdivision 0 City Project RJ Utility (PUD, GTE, VING, CABLE, WATER)
F] Multi -Family [:] Single Family E] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: iSWes 0No. G. Size of Cut: (112 x 4 Cut @ H. Char-ae-$
Water
APPLICANT TO READ A . NNT1P-N
INDEMNITY. Applicant understands and by his signature to this application, agrees to t e City of Edmonds harm J0%h drpp-sNs, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be ma A,
&,�ainst the City of Edtnon orA�yoftfAepartmentsoe
employees, including or not limited to the defense of any legalproceedings including ddfen e t and attorney fees by reason of granting this permit.
141AG THE FINAL
6r 0
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIAL OD OF ONE YEIR FOLLif
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED B Y CITY FORCES, AT WHICH TIAIE A DEBIT OR CREDIT WYIB FfFAPPLICANT.
,�,,�OCESSED FOR ISSUANCE TO T
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
IhaUe read the above statements and understan�,;,termitrequirements and thepink copy of thepermititlill be
available on site at all times for inspection oses.
1p�/ 79�
Signature: 01�4119jlw Date: Ach, 4, 1993
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
run U11 I
APPROVED BY:' I-A.Jtli 4z A
TIME.AUTHORI ZED: VOID Ab-rER DAYS
SPECIAL CON DITIONS:
COMMENTS:
unrl VINJIj I
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PE . RMIT ISSUANCE Engrg. Nv. 1991
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.),�
Cominents:
I Diagram 1:
CONTRACTOR CALLED FOR INSPECTION El YES NO
Partial Work Inspection b'Y,P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
I . i
Addendum to
City of Edmonds
Right of Way
Permit Application
... Submitted by: Guyla Connors
Engineering Aide
Washington Natural Gas
521-5248
0'744V \AI
Q-6a*q,52-756,5 9
) (Z x 4) �f � \ J/-�7 - Z=S 7 C
11
W WNG to window
N
Key:
CW4ater main depth -w- water
-g- gas -
-ss- sewer
2:::�' gas main -E�- water hydrant
0 water valve
815 M=cr SL (P 0. BOX 1869), Scanle, WA 98111(206) 622-6767
BUILDING DIVISION
PERMIT APPLICATION
NAME JOR NAME OF BUSINESS)
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2W -W—AiLiRr. ADDRESS
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NAME
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Applicant Fill
Inside Heavy Lines
O�E NUMBER
" C, 61 S (
ELEPHONE NUMBER
VZEA'D q
�LEPHONE NUMBER
—o cl
TY LICENSE NUMBER
or Attach Four Copies)
ZONE NUMBUT-
JOB
ADDRESS' AV&
LEGAL DESCRIPTION-T—SUBDIVISION I SHORT SUB NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING /110
PROPOSED
DEFICIENCY OF HIGI-IT OF WAY
PUBLIC IMPROVEMENTS REQUIRED
0
DRAINAGE IMPROVEMENTS REQUIRED
0
DRAINAGE PLAN REQUIRED
0
UNDERGROUND WIRING REQUIRED
0
CONNECTION TO SANITARY SEWER
0
SEPTIC TANK PERMIT REQ'D 0
NO.
ELEVATION OF PROPERTY CORNERS
0
& FOOTINGS REO'D
SEE ENGINEERING MEMO DATED-- k--?'t2
CHECKED BY F, - Al
��z \— :A7 4
G SUPPLY SIZE
I OLI <—:7 & ra I c (:---
SIGN AREA REVIEW
I POSED 1COMENV.
ALLOWED PRO PLETEI EXEMPT
SH
REMARKS
ADD NO.
VARIANCE OR CU JPUANNING REVIEW BY I DATE
YARDS jIOT COVERAGE
GAS
FILI"11
FRONT SIDE
REARI
NEW
R:SIDENTIAL
N I
I
FIRE ZONE
OF CONSTRUCTION
CODE
N N-RESIDENTI^L
SIGN
JT�7
H�G
I
ElAD 0
_ RETAINING
SPECIAL INSPECTOR
I AREA
OCCI
PA NCY
L_j DEMOLISH
Li WALL
REQUIRED
1:1 ALTER
-10 XCAVATE
f R FILL
FENCE
'— X—FT1
0 YES El No
PLAN CHECKED BY
r-1 REPAIR
PRE -MOVE
1:1 INSP.
swim
POOL
REMARKS
Z NUMBER OF STORIES
NUMBER OF
0
DWELLING
I
IPLAN
UNITS
- NATURE OF WORK TO BE DOME
sysFxK
W
CHECK FEE
Lq BUILDING
PLUMBING
MECHANICAL
FENCE
SIGN
"Applicant, on behalf of his or her spouse, heirs, assigns and
W
.J successors in interest, agrees to indemnify, defend and hold harmless
I the City of Edmonds, Washington, its officials, employees. and
0: agents from any and all claims for damages of whatever nature,
4
x arising directly or indirectly from the issuance of this permit. Issu-
0 1 ance of this permit shall not be deemed to modify, waive or reduce
.j
RETAINING WALL
SWIMMING POOL
HEIGHT
PANT
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
VALUATION I FEE
Is
0
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PUBLIC UORKS DEPARD= aiEacusT
BUILDING PERMIT REVIEW a�,& "') U-J��
f3 I LL le ( Al 0- (address) (date)
/S-b'2dO 1144WWIM LVIIA1
Street Right -of -Way Exist
Z
Access Easements Existing_-,t�j �-���'�_REQD
C4
Utility Easement ExistingL-.,�.5.�.,-
REQD
Lot Per Subdivision P at
Assessor Map__!��
Site Plan Checked for Accuracy.
Z
Underground Wiring Reqd. XIZ4
Check Accuracy of DescripAon
Z
:ga
Review by
-V -
Date
W I
I
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Exist'
P4
Hydrant Reqd Per Fire Code
Size
Detector Check Yleter Reqd.
E-4
Cross Connection Inspection) I S KEOVI em
Fps%-Cea VAcVVM ORAAM.01-e a�V(OeWl
F APPkdv*9Z 7-y Pr-- L4m 60efi t_ # pj gE,
Fire Department Conments
S ePF -D4Mr-C'"C-- Srs4eUcf-
Water YEter Charge Reqd.
Review by. cC s 7 Fr I
Date e.
Septic Tank Design Approved
Date
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer. Availability�-Proj
DrM,7ing No.
File No.
Side Sewer Availabili
Sanitary Sewer Connection Fee Reqd.
:3:
Review
Open Ditch
Culvert Reqd.
Size
C4
Catch Basin Reqd.
Indicate on Site Plan
0
Shoulder drainage maintain collection on swale open runoff
H
U)
Manhole reqd.
Indicate on' Site Plan
Soil Conditions and Ground Water Field Checked
Review
Rev:Lsed: Iv10-1977
Page 2
Street Paving Reqd.
Curb and Cutter Reqd.
Sidewalk Reqd.
94 Curb Cut for Driveway Reqd.-
C4 Right -of -Way Construction Permit Reqd.
Bond Reqd. for Public Iupravanents
Street Nane Sign Reqd.
Other Signing Reqd.
Pre Pennit Site Inspection mde on
z
0
BY: S94ER
WATER
04
En
Z STREET
ENGINEERING
14 Speadl-Req e
*i 'ts lis t- 'd in merm tdb�i� men men
emen Develop t Depart t,
Buirding 'Division
BY Date
c) All item filled in on Building PernrLt Applicatiah,
BY Date
Drawings Stanp*ed and Notations Made
P4 BY Date
Approved by Public Works Departa-Ent
Revised: lv 10-1977
D A TE:
C011111ILMiLy Dcvelopmenc -Dcp,,.ii-LmenL
l7riginecri.ng, Division
Public Work's Deparment
SUBJECT:
i%fter revie�': Of 010 SLII)jCcc buildinp I)c,,,-mi.c
Ole F011OWilli;
'Pplicacion,
vre have
corginciiLs:
Complaint voiced by: JUN 6
Name: Water Department Dir. Of Public W01
Address:
Property owner: Yes No
Where -
Address of property
to be investigated: 21925 74th Ave W
Name of owner:- D6:vid-I. Lavin -
Address: 239,15 74th Ave- W. 776-6659-
Description of complaint:
Inst'alling,Lawn S&inkler without Permit
Result of investigation:
Permit # 780370 Build N ew Residence eXl�CX�
Permit #,780472
install
deck*ar-ound house
_6*'L- 3 - -�-o
S ry 0Q V 6
IAJ
x /6
M (A,<"
h/q,L/ili .19,
1C)e,�-KI;
r) -,,�ALWZLL
(20 /V �f
C-L' /,IA-
t::a
0
0
I
Gl')-,(�f a Hut,
4.1ovi oildU9 10 'lio
CIVY 0"
I); L 7
C0jND!T;lC)N,,' - -TIT
1 V2. p- k A T
j -../I/
00
OWNER
APPROVED D,'�
13Y
K E
P L A ON JO�-j'SITE f C)R
I - IONS
S H E E T-
11Y,
1 C. PID5 L F, 4 0 1";"1,
.0. ONUS
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STREET FLE
M E M 0 R A N D U M
November'14, 1986
TO: Bob.Alberts
Bobby Mills
FROM: Geri Tompkin
s
SUBJECT: LAKE BALLINGER SAMPLING
I was requested by Bobby Mills and Archie'Br'ena''to
sample at three locations on Lake Ballinger.in line with
our sewer line. The results of the analysis of this
sampling. is as"follows:
B. 0. D.
FECAL
1.65 mg/l
3
�23525-74,th
2'3'9'2'5'*' 74"th
2. 5 mg/l
3
.24129 Beeson Pl.
1.75 mg/l
6
If you'have any
questions, please contact me.
GT/cr
cc: Archie Brena
CITY OF EDMONDS
PUBLIARKS DEPARTMENTj ENGINEERS DIVISION
APPLICATION FOIRRIGHT-OF711AY CONSTRUCTION PERMI1
THIS PERMIT;MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES
Applicant to Complete Parts A and B
Permit to be issued to:
cc�
For Work at:(address or vicinity) pjVe,
Type of Work to be done: r P_ CE QC Q to
(attach drawing when applicable)
Time Required Start: Finish:
Owner:
Name
1 C)
Mailing Address
"7 C� 0
State zip —Telephone Nu; er
Contractor: F) c� .
Name
2-10 1 S U-S viuil
Mailing Address
UW, Vim 3
City State 'Zip
State -License Number,
_Z112
L
Telephone Number
B. INDEMNITY: Applicant understands andby his signature to thi . s 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 applicant -or the City of Edm.onds,or any of its departments or employees,
including or not limited to the defense of any legal --proceeding ' s including,defe . nse
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.(estimate'd 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 subject to inspection and restoration in accordance with City Code. -A
24-hour notice.is required for inspection by Engineering. Call 775-'?525, ext.�'-220-,
I understand that this permit must eavailable at the Job site for inspection*
purposes at all times Date': 1� 79 a
I ""D
Signature,
Owner or Agent --,A
C. TO BE COMPLETED BY IZSUING AGENCY:
Date -Issued:_AZ�2/7K —Permit No.: 7,?-,.706 Fee:
Security Bond:
Time Authorized:
APPROVED BY Date:
I (I- I I I i, IV 4 o- A I
Jt J
W.O. No.
..� r
MEMO TO:
FROM:
SUBJECT:
I n
STMET
DATE: (0 115 1
Building Division'
Community Development DeT)artment
Engineering Division
Public Works Department
2: . LAN
�02_5__1444 ANE vi
After review of the subject building permit application, we have
the following comments:
(1) Coordination of the location of any structure with respect to
utilities, streets, property lines and driveway grades is t
responsibilitv of the contractor.
(2) The contractor is required to keep the.abutting streets clean-
ed of dirt and debris caused by the construction.
(3) A "Right -of -Way Construction Permit" is required, from the
Engineering Division of Public Works, for any work within
the Public RiQht-of-1,,Iay or T)ublic easement.
_(4) Driveway slope not to exceed 14%.
((0) S(M- TD p5E DQLX�Tm Tn L41--h-VRE
R_ Au Li ��71 9R Au I T-H 0 1 L__ V_V�Q_I Q
1AAALA
PW 5/77
WORKS DEPART= QECKLI
B�=NG.PmnT RonEw
.0
AV
DA
.21r4p
Street Right-of-Way.Existing AL-Aje 0 , ,
REQD
GO
Access Easements Existing moo& REQD
Utility Easement Existing 0 REQD
Lot per,Subdivision OPIUM Plat GOWEN* Assessor Ma
.Site Plan Checked for Accuracy e4 o*
Z
Underground Wiring Reqd.
Check Accurac� of Legal.Depeription
Environmentally Sensitive Area
Environmental Checklist R6qd.
CD PLGT�
Z.,
�-4 -�` FlQod.Hazard Zone
.UIC Shoreline Management Area
Z Slope, Soil, Vegetation
Strearn, Creek, Drainage Basin
-,,,Existing Zoning Per�Code
Anienities Design Board Approval Reqd., ADB # Approvar'
�Board of Adjustment Approval Reqd. %,ftk %
Review By: fb Date: Col 144-10
Existing Water Main Size
Water Main Reqd.
Service Line Reqd.
Hydrant Size Existing n
Hydrant Reqd. Per Fire Code Size
Detector Check Meter Reqd.
Cross Connection Inspection
Fire Department Comments
Water Meter Charge Reqd. io 6'0
Review by. )W/S Date:
61h
�)eptlC -.uariK I)esign Approvect A, --A uate: _
Septic Tank Permit Reqd. A,) Permit No.
Sanitary Sewer Availability Proj. —
Drawing No. File No.
Side Sewer Availability
Sanitary Sewer Connection Fee
Review By: W/S
XXX
rm
0 9
Pen Dit:di Existin Req d.
Culvert Reqd.
&au __ —Size
P4. Catch Basin Reqd. &,22.e Indicate on Site Plan
0 Shoulder drainage mkiintah-i collec tim,on s-wale' open runoff Ae,.�ZL41 A
U) reqd. Indicate on Site Plan
Soil Conditions and Groun.d Water Field Checked
b
�Street Paving Reqd. Abut.
Curb and Cutter Reqd.
Sidewalk Reqd.
Curb Cut for Driveway Reqd.
v4 -Right-of-Way Construction Permit Reqd.
Bond Reqd. for 'Public Inprovements
Street Nwm- Sign Reqd.
,.10ther SiViincl, Reqd.
t::� . �iPre Perndt Site Inspection made on (Oft
BY: SMTER
W WN . WATER
" M& � - It2l
:;_11 STREET -A I --J
44 Z ENGIN=,, RING
Special ReqtLireiamts listed in mom to Comm1h.ity Development 'Departimnt.,
Building Division
BY Date
c) All items filled in on Building Perndt Appli&ation
BY .—Date'
Drawings Stan-ped and Notations �L-ide
,lBY Darte
Approved by Public Works Departincnt:
Revised; IV 10-1977
U
Z
Z
Z
W
OBLIC WORKS DEPARTT,,04T CHECKLIS01- 611441S Da,e
B�ILDMG PERMIT R=4
Street Right -of -Way Existing 6-9"D(6 C) REQD 1�
Access Easements Existing I'-.. I %-T.4 REQD OrAmm-
%'.'J n') -taw
Utility Easement Existing REQD
Lot per Subdivision Plat AssessorMa
0
Site Plan Checked for Accuracy CO it
Underground Wiring Reqd.
Check Accuracy of Legal Description
Environmentally Sensitive Area
Environmental Chec
Flood Hazard Zone
Shoreline Manageme
Slope, Soil, Vegetation WWWWO.Ma"
Stream, Creek, Drainage Basin,
Existing Zoning Per Code 2o
Amenities Design Board Approval Reqd. _.ADB # Approvaf"
Board of Adjustment Approval Reqd.
Review By:*_ Date:
Existing I%Tater IeAlin Size
Water Main Reqd.
Service Line Reqd.
Hydrant Size Existing n
Hydrant Reqd. Per Fire Code Size
Detector Check Meter Reqd.
Cross Connection.Inspection A-),
Fire Department ConTnent
Water Meter Charge R
Review bv,:
.7 57?3 ene�'
Date:
Septic TanI,7 Design Approved --------- ----------------- Date:
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availab��Y�-4-:' Proj.
Drawing No. File No.
Side Sewer Availability 401-
Sanitary Sewer Connection Fee Reqd.
Revia,7 Bv: Date:
CO
L':J
(M)
(Z)
C5
L,('N
F�
BUILD'ING DEPARTMENT Applicant Fill
USE PERM 177-
zO NP NUMBER
scul
PERMIT APPLICATION In . side Heavy Lines
'_ - I ;)-
- JOB
A D D R E S Sj-'3 9 a 6u
NAME (OR NAME OF BUSINESS)
m
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SUBDIVISION NO.
PLAT NAME
ASSEP�OR MAP NO.
Y4 - t�S '2
AILING ADDRESS
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PUBLIC RIGHT OF WAY PER ORDINANCE NO
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0
CITY
TELEPHONE NUMBER
EXISTING RIGHT OF WAY
PROPOSED RIGHT OF WAY
NAME
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DEFICIENCY'OF RIGHT OF WA . Y
VI
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III
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ADDRESS
6-6 --3 /Or_� AL/
STREET/UTILITY WORK REQUIRED D Y ES idNO
PERMIT FOR WORK IN PUBLIC R/W DYES IM NO
UNDERGROUND WIRING REQUIRED D YES *-N 0
CONNECTION TO SANITARY SEWER 19YES 0 NO
SEPTIC TANK PERMIT REQUIRED El YES _XNO
CITY
0
TELEPHONE NUMBER
ea,"23 4 4207
NAME
Aj E11-
SEPTIC TANK PERMIT NO.
ADDRESS
SEE MEMO DATED.
0
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CITY
TELEPHONE NUMBER
REMARKS
It
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0
STATE LICENSE NUMBER
CITY LICENSE NUMBER
CH
TIAT, f It
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Legal Description of Property (Show Below or Attach Four Eopies)
METER S10
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REMARKS
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0
SIGN AREA
ENV. REVIEW
ADB NO.
ALLOWED PROPOSED
COMPLETE EXEMPT
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<
REMARKS
0
W
VARIANCE OR CU 7--TNNING
REVIEW BY
DATE
YARDS
/S' FRONT /0 SIDE REAR
ILOT COVERAGE
GAS
NEW. RESIDENTIAL I ]AL LINE
NON-RESIDENTIAL SIGN
El ADD El
DEMOLISH RETAINING
EIWALL
EXCAVATE FENCE
ALTER DOR FILL I— X—FT)
FkRE ZON . E
TYPE OF CONSTRUCTION
1CODE
HEIGHT
SPECIAL INSPECTOR
REQUIRED
El YES 0 NO
OCCUPANCY
GROUP
P
OCCU ANT
LOAD
PLAN CHECKED BY THIS SIT E IS LOCATED IN THE CITY
REPAIR PRE -MOVE swim
1:1 INSP. POOL
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS .
NUMBER OF STORIES
—
NUMBER OF
Z-r 63-11�tVOVT
DWELLING
I UNITS
z
W
NATURE OF WORK TO BE DONE
W
PLAN CHECK FEE
VALUATION
FEE
z
0
U
0
W
z
W
0
J
W
>
PROPOSED USE
PLOT'PLAN [INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
BUILDING
00 0
Z'
PLUMBING
MECHANICAL
0
W
FENCE.
z
SIGN
0
RETAINING WALL
U
)OL
Owmic 14ORKS DEPARIMWr CHEC1W..
Date
BuiwiNG Puu-aT
7 ILE.
REvm4
Ad4ess
Street Right -of -Way Existing
REQD
Access Easements Existin&
REQD
Utility Easement Existing
REQD
Lot per Subdivision Plat_
Assqssor
Map
Site Plan Checked for Accuracy
Z
Underground Wiring Reqd.
od
Check Accuracy of Legal Description
Environmentally.Sensitive Area
Envirornental Checklist Reqd.'
Flood Hazard Zone
Shoreline Management Area
Soil, Veg etation
Stream, Creek, Drainage Basin
Existing Zoning Per Code
Amenities Design Board Appr 1 Reqd.
ADB #
Approval
Board of Adjustment 1 Reqd.
Review By:
Date:
Existing Water in*Size
Water Main Reqd.
Service Line Reqd.
w--'
Hydrant Size Existing -
Hydrant Reqd. Per Fire Code
Size
Detector Check Meter
.__Req4�.
Cross Connection Inspection
Fire Department Camchts
Water Meter Charge Reqd.
Review by:
Date:
ept)-c Tai. -sign Aporovecl
'at'
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer.Availability
Proi.
lawing_lo.
File No.
Side Sewer Availability
w-
Sanitary,Sewer Connection Fee Reqd.
Review By:
Date:
q)en_Ditch_E\isting __2eqd.
Culvert Reqd._ Size
c4 Catch Basin Reqd. Indicate on Site Plan
0 - Siloulder drainage miimaixi collection)l-i si�ale open runoff
1.1-u-diole rcqd. —Indicate on S'ite.Plan
Soil Conditions and Grouild I -later Id Checked
Re by- TX-ite
Street Paving Rcqd.
Curb and Cutter Reqd.
Sidewalk Reqd.
Curb Cut for Drivewa
v4 Right -of -Way Cons truction, Pe Reqd.
Bond Reqd. for Public Inmrov nts
Street Nam Sign Reqd.
Ot.her Signing Read.
ID
Pre Permit Site Inspection mde n
0
BY: S E1.7- R
U
ILI E.-I WATUR
S=T
'G
E2\'GII\T=, REN
Special P\eq-LLire_,:-.anLs listed n ni,�_�w to Comaxnicy Develop'mnt Deparment,
Building Division
By Da
o All iLC-lnS*filled /0 '1 ing Permit Application
BY. Da
PL4 E�- awings Sta'rned and No t on 1,1-ide
LU
Approved hy Pt�blic '%,;,01- Dcpartixnt:
/Is
Revised: lv 10-1977
0
PUBLIC WORKS ENVIRONMENTAL REVIE'd
PROJECT NAME: \1 0 LANA hnj FILE
ASSESSMENT DATED:
Z- 2r17 Y
AN ENVIRONMENTAL,REVIEW OF THE PROPOSAL HAS BEEN
COMPLETED AND THE FOLLowING DETERMINATIONS HAVE
BEEN MADE:
F9 Wc —m— 6 3 WX = re-P K- Wo
-*REPARED BY: 110 FAIN I
R`: \1 I S F T) : 1. 0 /
78 0-370
FILE #
FOR4 FOR [MMM/F11,�U1 DE-CL0ATION OF [SM)MMU/1NOINSIGNIFICANICE]
780472
Description of proposal Single 'family residence
Proponemt Dave & Paula Lavin
Location of Proposal 23925 74th Avenue West
Lead Agency City of Edmonds
This p-roposal has been dc1-.ermi.ned'toxF&=o/not have] a significant a.d-
ETS J�:RjiS
verse aji,.pact upon -the enviroriacnt,� Ali -L not] rc'C'[Llj.red under
101 43.2l.C.030(2) (�) , This decision was Made after review by the lead
aocn-cy of a co.-ilpIcted enviroiu-ticntal checklist and other information on
file with the lead agency.
Responsible Official Ma ry Lou Block
Position/Title Associate City Plbhher
Date June 30, 1978 Signature
PROJECT NAME & V/
DATE SUBMITTED
'IME,
EUVI RO, 11TAL. ASSESSMENT
In order to meet the requiremen ts of the'State Environmental Policy Act of 1971
the responsible official must�make a declaration of environmental impact as early
as possible in the process of eValuating:a project.:
The information in this form will be used to determine whether it will be necess-
ary to require an environmentalAmpact statement. If an impact statement is —
not required, a Statement of lNegative Declaration will be -placed in the file.
If an impact statement is required, a draft statement must be filed with this
office, pub.lic notice given andia reviL-a period of 30 days allowed.- The final
statement, and comments -must be fil.,ed with the Department of Ecology, Office of
the Governor and the Eco'log'ica'l,Commission.
The Edmonds Planning Staff will'assist you'in-any way we can in accumulating
this information and we would appreciate your cooperation.
1. Land:
Area in acres '-25 000
Soils type Limitations
Description of topography (% slope)
64 �1
Grading: estimated cubic yds. S-0- c NOTE: If grading or filling.
wi 7 exceed 500 cubic yards
Filling: estimated cubic yds. a grading and filling plan
must be submitted with the
2. Water:' application.
Stream - estimated flow (cubic feet.per second)
Will stream be.altered,,? X11A 1A
To what degree? IVIA
Impact on storm drainage (increase in run-off)
Estimated area Ao be paved F- %
Estimated area in open space Za2 coo 5 %
Shorelines: within 200 ft—of I'lean H i gher High Water Z_,411C(_7 /34 ct Ix 6-,L,
Adjacent to shorelines zon . e
Environmental Assessment, page 2
3. Vegetation:
Type of trees (!i� 701V % to be removed
Minimum diameter of trees to remain -
Ground cover 4!�I?A &4clt 13C-rnnle�) % to be removed 10
Proposed landscaping, if any
4. Existing Land Use within 300 ft. radius of proposed development:
Vacant
Single
'Famfly
Multi -
Fami ly
Comm.
Other
North
Sou th
Eas t
Wes t
5. Ci rcul ati on:
Estimated increase.in auto trips daily.
Estimated demand for public transportati(�n
Degree of change on adjacent streets
6. Area of imoact:
neighborhood
city-wide
regional
2-
I
I
7. Effect on air quality: ItIal.-Ve .
8. thanges in noise generation: zt_/O_Ift�
2�
3.
4
5
6
7
8
9
10
11
12
13
14
15
16
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
-41
42
43
414
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
DATE: 117 6
A $25 fee will be collected by the City of Edmonds for analysis
of the Environmental Checklist and the preparation of a Threshold
Determination. No -.fee will be charged for proposals which would
be categorically exempt if they were not located in an environ-
mentally sensitive area.
ENVIRONMENTAL CHECKLIST FORM
1. BACKGROU14D
1. Name of Proponent OAVO � P,4LICA 414VI IV
2. Address and Phone NLuiil�e_rof Proponent:
3. Date CTiec list Submitted (P- ZUR
4. Agency Requiring ClictklisL F QV
5. Hame of Proposal, if applicable:'
120-1110EWCE
66 r4atur—C.1ind Briet DescripLion of t5e ProposaI__C1En(_[_uT:
ing but not limited to its size, gencral desi;zn cle-
merits, and other factors that will' give an accurate
understanding of its scope and naturL):
OF5If26=AIC(-7 0 C?2- 5F 2- 57'C#2Z , DOC,&
7. Location or Proposal (je-s-cribe the physi_c_�iT —seLLing of
the proposal, as well as che e-.,ucnt of the land * area
affected by riiiy environmental impacts, including any
other information needed to give an accurar_� understand-
3-1-1Z of the environmental settin,�
2_3 I z,�;— 7 4- A (le- VA ) the proposal)
8. - Z_stI`i_ii,_iLe(I Date for Conipletion-oT-T-In—c- _11ro-Clo-se Act on:
9. 11 Permits, Licenses or Government Approvals
Required for the Proposal (federal, state atid local --
including rezoAp- S) :
f3wto/nk 6-'&qW/7_
-31-
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
10. Do you have any plans for future additions, expansion,
or further activity related to or connected with this
proposal? If yes. explain:
X/O
11. Do you know of any p by others whic 1i may attect
the property covered b your proposal? If yes, explain:
12. Attach any other a pplication form that has been com-
pleted regarding the proposal; if none has been com-
pleted, but is expected to be filed at some future
date, describe the nature of such application forrft:
1410 WC
II. ENVIROZIPMENTAL IMPACTS
(Explanations of all "yes" and "maybe" answers are
required)
Yes Maybe No
(1) Earth. Will the proposal result in:
(a) Unstable earth conditions or in
changes in geologic subs tructures?
(b) Disruptions, displacements, com-
paction or overcovering of the soil?
(c) Change in topography or ground
features?
surface relief
(d) The destruction,,covering-or
modification of'any unique geologic
or physical features?
(e) Any increase in wind or water
,erosion of soils, either on or off
the site?
(f) Changes in deposition or ero-
sion of beach sands, or changes
in siltation. deposition or erosion
which may modify the channel of a.
river or stream or the bed-oC the
ocean or any bay, inlet or lake?
Explanation:. Pl/g, rej Anx Ae/ 111.,Jda..
L
(2) Air. Will the proposal result in:
(a) Air emissions or deterioration
of ambient air quality?
(h) The creation of objectionable
odors?
(c) Alteration of air movement,
moisture or temperature, or any
change in c' imate, either locally
or regionally?
Explanation:
-32-
Pq
Yes Maybe No
2
3';
4
5
61
7 1
8
9
10
11
12 i
13
14
161
17
181
191
20
21
22 1
23 1
2410
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
(3) Water. Will the proposal result in:
(a) Changes in currents, . or the
course or direction of water move-
ments, in either marine or fresh
waters?
(b) Changes in abso*rption rates,''
drainage patterns, or the rate and
amount of surface water runoff?
(c) Alterations to theicourse or
flow of flood waters?
(d) Change in the amount of sur-
face water in any water body?
(e) Discharge into 'surface waters,
or in any alteration -of surface
water quality, incltiding but not
limited to temperature, dissolved
oxygen or turbidity?
(f) Alteration of the direction
or rate of flow of ground waters?
(g) Change in the quantity of
.ground waters, either through
direct additions or withdrawals,
or through interception of an
aquifer by cuts or excavations?
(h) Deterioration in ground water
quality, either through direct in-
jection, or through the seepage of
leac*hate, phosphates detergents,
waterborne virus or Lcteria, or
other substances into the ground
waters?
(i) Reduction in the amount of
water otherwise available for
public water supplies?
Explana t ion: we-c-Pi re-S
U-ITH _� O)z I v C—
(4) Flora. Will th� proposa�fresult in:
(a) Change in the diversity of
species, or numbers of any species
of flora (including trees, shrubs,
grass, crops, microflora,and
aquatic plants)?
(b) Reduction of the numbers of
any unique, rare or endangered
I species of flora? I,<
-33-
- - V_
- - X
Z 900 �r ZA,40
d,
Yes
Maybe No
(c) Introduction of new species
of flora int.o an area, or in a
31
barrier to the normal replbnish-
41
ment of existing species?
5
6
(d) Reduction in acreage of any
7
agricultural crop?
.8
9
Expianation:
10
12
(5)
Fauna. Will the proposal result in:
13
14
(a) Changes in the diversity of
15
species, or numbers of any species,
16
of fauna (birds, land animals
17
including reptiles, fish and shell-
18
fist', benthic organisms, insects or
19
microfauna)?
20
21
(b) Reduction of the numbers of
22
any unique, rare *or endangered
23
species of fauna?
24
25
(c) Introduction of new species
26
of fauna into.an area, or result
27
in a barrier to the migration or
28
movement of fauna?
29
30
(d) Decerioration to existing
31
fish or wildlife habitat?
32
33
Explanation:
34
35
36
(6)
Noise. Will the proposal increase
37
existing noise levels?
38
39
Explanation:
40
41.
42
(7)
Li�,,hc and Glare. Will the pro-
43
posal prk.)�I`uce new light or
44
glare?
45
46
Explanation:
47
48
49
(8)
Land Use. U'ill the proposal
-17L
so
i 7s
L, t Til the alteration of the
51
present or plannbd land use of an
52
area?
53
54
Explanation:
55
1
2
3
4
5
6
T
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
.38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
U
Yp--q Mavbe No
(9)
Natural Resources. Will the pro-
posal result in;
(a) 1ncrease in the rate of use
of any natural res.ources?
(b) Depletion of any nonrenewable
natural resource?
Explanation:
(10)
Risic f 11 set Does the proposal
or
�ariRsk
�3—nvol7ve of an explosion or
the release of hazardous substances
(including, but not limited to,
oil; pesticides, chemicals or
,radiation) in the event of an acci-.
dent or upset conditions?
Explanation:
.(Il)
Pyotillation- Will the proposal
a ter t e location, distribution..
a or th
density, or growth rate of the
human population of an area?
Explanation:
(12) Houring. Will the proposal affect
exi.sting housing availability, or
create a demand for additional
housing?
Explanation:
(13) Lation. Will
the proposal resuic n:
(a) Generation of addition al
vehicular movement?
(b) Effects on existing parking
facilities, or demand for new
parking?
(c) Impact upon existing trans-
portation systems?
(d) Alterations to present
.patterns of circulation or move-
ment of people and/or goods?
(e) Alteratior's to waterborne,
rail or air traffic,?
-35-
— . V
-0
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
,34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
Yes Maybe No
in traffic hazards
to motor vehi-cles, bicyclists or
pedesLrians?
Explanatio n:
(14) Public Services. Will the pro-
Tosal H!F,,i_J_an effect: upon, or
result in a need for now govern-
mental services in any of the
following areas:
(a) Fire protection?
(b) Police protection?
(c) Schools?
(d) Parks or other recreational
facilities?
(e) Maintenance of public facili-
ties, including�roads?
(f) Other governmental services?
Explanation:
(15) Energy. Will the proposal result in:
(a) Use of substantial amounts of
fuel or energy?
(b) Demand upon existing sources
of energy, or require the develop-
ment of new sources of energy?
Explanation:
(16) Utilities. V!ill the proposal
r*ZT�stjj_Lj._n a need for !Zvstems,
or alterations to the following,
utilities:
(a) Power or natural gas?
(b) Co rrawinications systems?
(C) water?
(d) Sewer or septic tanks?
Storm wat:er drainage?
(f) Solid waste and disposal?
E,xplanation:
a
-36-
2
3
41
5
61
7
8
9
101
Ill
121
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41.
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
Yes Maybe No
Human 11calth.. Will the proposal
M—Ti-THe creation of any
resu t i
health hazard or potential health
hazardi(excluding mental health)?
Explanation: I
(18) Aesthetics. Will the proposal
resu t�in the obstruction.of any
scenic.vista or view open to the
public, or will the proposal re-
sult in the creation of an
aesthetically offensive site open
to public view?
Explanation:,
(19) Recreation. Will the proposal
r in an impact upon the
quality or quantity of existing
recreational opportunities?
Explanation:
(20) Arclicolopi(-;il./Iii-stori-cil. I -Jill the
proposal resuYEE—in an a teracion of
a significant archeological or his-
torical site, structure, object
or building?
Explanation:
III. SIGNATUIU,
1 1, the, undersiVned, state that to the best of my knowledge
the above information is true, and complete. It is understood
that the lead agency may withdraw any declaration of hon-signi.-
ficance that it might issue in, reliance upon this c hecklist
should there be any misrepresentatio or 1-ck of full �.Ysclosur I e
on my part.
Proponent:. Alz_cH 1107C/
WAC 197-1.0-370 W . ITHDRAI-IAL OF AFFIRMATIV THRESHOLD
any time after Che entry of a declara-
tion of significance, the proponent modifies the proposal
-so that, in tile judgment of the lead agency, all significant
adverse environmental impacts resulting therefrom arc, elimin-
ated, the declaration of significance !;hall be withdrat..rn
and a declaration of non -significance entered instead. The
lead agency sh�111. also revise the re�,,istcrs at its SEPA
public information center accordingly. If the pro-
p011Cnt of' a proposal is a priva�e applIcant, the proposal
shall not be considered modified until all license applica-
tions -for the proposal are revised to reflect the modification.
-37-
A&WNVIRONMENTAL ASSESSMENT FILE
DESCRIPTION OF PROPOSAL:
PROPONENT:
EXISTING USE:
ENVIRONMENTAL IMPACTS FROM PROPOSAL:
SOILS/TOPOGRAPHY
74
c4K6
Ate, 'Ir
--ve
yfe
WATER/DRAINAGE
AIR QUALITY
CIRCULATION -X1 74
ze�
VEGETATION
ECONOMI C,
CITY SERVICES
ENVIRONMENTAL F-INDINGS:
There will be certain environmental impacts but they do not constitute a signif-
fcant adverse impact on the environment and, no environmental impact statement
will be required.
There will be significant adverse impacts on the environment and an environmental
impact statement will be required.
There will be certain impacts on the environment howeverit is necessary to obtain
more information before a declaration of significance or non -significance is made.
Af
CITY PLANNER /DATt -
CITY ENGINEER DATE '
E/A '76
D . ate mber 11, 1978
MEMO TO: John B. Mitchell, Supt
Water/Sewer Division
FROM: Fred F. Herzberg
City Engineer
SUBJECT: SEWER CONNECTIO14 CHARGES
23925 74th Avenue West
(Street AddressT
Paula and Lee Lavin
(Legal Owner)
Single Family Residence XX Subdivision Plat P.R.D.
Multiple Commercial
LEGAL DESCRIPTION:
SEE ATTACHED.
Z.F.F. Calculation:
106.47) Z.F.F. x ($5.50
) Lateral x(.
) Unit(s) x( $25
CC: Owner
APPROVED BY
rk.s
$ 585.58
$ 0
$ 25.010
$ 10.00
Connection Fee
Lateral Charge
Equivalent Count
(when applicable)
Trunk Charge
Permit
10/78
J*,;4,
JAMES, H. REID
LEROi)". MIDDLE7'ON
C. WAYNE JONES
LLOYD H. NELSON
*1 0
Rea, 7ft4ffe&a & .4"4641&40 47". ENGINEERS* SURVEYORS *PLANNERS
324 Main Street 0 Edmonds, Washington 98020 e (2061 775-3434
December 8, 1978
File No..5575
LEGAL DESCRIPTION FOR PAULA LEE LAVIN PROPERTY PURSUANT TO BOUNDARY LINE
AGREEMENT RECORDED DECEMBER 6, 1978, UNDER AUDITOR'S FILE 7812060185.
That portion of Tracts 7, Block.7, Lake Ballinger Land Company Is
Plat Subdivision No. 1, according to the plat thereof recorded in Volume
9 of Plats, on pages 57 & 58, records of Snohomish County, Washington,
described as follows:' Commencing at a concrete monument at the intersection
of the centerline of Bradley'Road (74th A�enue West) with the easterly
extension of the south line of the north 15-00 feet of Lot 11 in Block 6,
in said plat; thence N17*19'30"E, along said'centirline 283-74 feet to an
angle point; thence N3*55143"E along said centerli-ne 124.65 feet to an
intersection with the weste�ly extension of an established boundary line
between Siegrist and Gardner as recorded in a boundar� line agreement
dated December 6, 1978 under &td.i_to_r1s F-ile N6.--.Z.8.1.206,0185, in Block 7 of
said plat; thence N89*44'22"E along said westerly extension of said boundary
line 20.04 feet to the east right-of-way line of said road and the -,True
Point of Beginning of this description; thence S3*55143"W along said right-
of-way line, 95-00 feet to an established boundary line between,Gardner and
Molvik as recorded in said boundary line agreement; thence N89*44'2211E
along said boundary line to the east line of said Block 7; thence northerly
along the east line of said Block 7 to the aforesaid boundary line between
Siegrist and Gardner from wh,i.d,h the True Point of Beginn-ing
bears S89*44122"W; thence S89*22'22" . W along said boundary line to the True
Point of Beginning; I
TOGETHER WITH the shorelands of the second class lying adjacent thereto as
conveyed by the State of Washington;
Situate in Snohomish County, Washington.
a
ET P,
L
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5-5
Z/�� ers
z (I
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3
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1
27
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EXPENOITURE OETAIL
FUND
DEPT
BASIC
SUB
ELE
OBJ
DESCRIPTION
1977
ESTIMATED!
1978
ESTIMATED
oi
4�1
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i al
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1 01
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30
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IT
Reid, Middleton & A �i�iates,ID;- �6-
S-_.;*..
-4-
Engineers 9 Surveyors 9 Planners
Edmonds, Washington 98020
324 Main St. DA TE
SUBJECT--_A�
Phone 7,75-34
TO
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CP
C.)
PLEASE REPLY F1 NO REPLY NECESSARY
A