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CA FILE NO. S�_ I — 19 �p
Critical Areas Checklist
Site Iinformation (soils/ topography/ hydrology/ vegetation)
1. Site Address/ Location: 2 Lq / D C) 4� tl
2. , Property Tax Account Number: 5(o 4�,7 - oo Z
3. 'Approximate Site Size (acres or square feet): 9 2-30
4. Is this site currently developed? _!:f'yes; _ no.
If yes; how is site developed? S I "�_LF F4^ I L:1!z 4n A� cz-
5. Describe the general site topography. Check all that apply.
L-"�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: W0 ; Approx. Depth:
7. Site contains areas of seasonal standing water: �VD Approx. Depth:
What season(s) of the year?
8. Site is in the floodway— floodplain_ of a water course.
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: A� Q
City Staff Use 0rdy___
Site is Zoned?
mapped'soil type(sg
_L�-cf-t 5 4
V V
:3. Wetland inventory or C.A. map indicates wetland present on site?
4. Critical Areas inventory or C.A. map indicates Critical.Area.on site? ^/0
:5.. Site within designated earth subsidence landslide hazard area? No
Site designated on the Environmentally Sensitive Areas, Map?,
DETERMINATION
City of Edmonds
4tek'r.
V41
A
CRITICAL AREAS CHECKLIST"01%%,
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
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
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
Street Address
city State Zip
Telephone
Signature
Date
c:reccption\jana\cac1.doc
Applicant Representative:
PAC-lFic 67A2,46ES C)L<
Name
mQ LAUaEL 'np-
Street Address
C�'
city State Zip
L/Z,�- 2--",-/3/�
Tee
Signature
Date
/,>/ a /,F-7
(over)
-, - 913
�?C. 18
Ed Olson
Pacific Garages, Inc.
616 Laurel Drive
Everett, WA 98201
Subject:
Dear Applicant:
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 e Planning/Building o Parks and Recreation - Engineering * Wastewater Treatment Plant
October 3, 1997
Determination regarding Critical Areas Checklist # .977196
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.
IMPOR7ANTINFORMATIONTO:�9.e�N.6.'t
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.
Permit applications include the following:
L
Enc: Determination
*Architectural Design Board
C:Reception\Jana\CRLTR.doc
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Diane Cunningham
Planning Secretary
9 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
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APPROVED BY PLANNING
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CA FILE NO.
Critical Areas Checklist C�(C-U&
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: 1410P 107 Ty F� - VA a�MMz,'S/ kk, 1po�p
-9
2. Property Tax Account Number: V2&4q 0o to ,
3. Approximate Site Size (acres or square feet): e-1 epf
`X es; '144*
4. Is this site currently developed? -y no.
N*
If yes; how is site developed? Wl--'
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 Pore 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: Approx. Depth:
7.' Site contains areas of seasonal standing water: Approx. Depth: -
What season(s) of the year?
S. Site is in the floodway floodplain of a water course.
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 wedand is present on site:
For City Staff Use Only
4;;-*..*.. Site is Zoned?
Sa
mapped soil type(s)?
inventory or C.A. map indicates wetland present on site?,
Critical Areas inventory or C.A. inap indicates Critical Area on site?
within designated -ea�i w1midence- landslide hazard area?
6.'*.*-. Sit e desipated on the Environmental ly Sensitive Areas Map. 0
DETERNWATION
R
-STUDY REQUIRED CONDITIONAL WAIVE
Al
VER-,
Reviewed by:"-:
bat�
r
P" 0 1 f"194
9 0 - i 9 9
City OfEdmonds
Critidal'Areas Checklist,
The Critical Areas Checklist contained on -.'and submit it to the City. Tiiecitywill!
this form is to be filled out by an y person review the checklist,. m.ake a precursory site
preparing a Development Permit visit, and -make a d6termination of the
Application for the City of Edmonds prior -"subsequent steps necessary to c omplete a -
to his/her submittal of a development clevelopment permit application.
permit tc the City,
With a signed copy of this form, the
The purpose of the Checklist is to enable applicant should also submit a vicinity map
City staff to determine whether any or plot plan for individual lots of the parcel
potential Critical Areas are or may be "with enough detail that City, staff can find, N
ject property. The
present on the sub and identify the subject parcel(s).
information needed to complete the additiom6 the applicant shall include
Checklist should be easily available from other pertinent information (eg. site
observations of the site or data available at 'plkx4 topography map, etc.) or studies in -
City Hall (Critical Areas inventories, maps, conju'rction with this Checklist to assik
or soil surveys).
staff in completing their preliminary
assessment of 'the site.
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
I have completed the attached Critical Area Checklist and attest that the . answers provid . ed are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner i Applicani: Applicant Representative:
1_411�7 Its -
Name
Address
City, State, ZIP Phone
,06ature( 61-- Date
Name
Street Address
'S ZIP
& 04 � 9.?
Phone
A ��A
Date
PLANNING DATA
NAME:
.
SITE ADDRESS: Z41 OX - / 07 -6 P/ &--' DATE: � - 7,e(- F,(
ZONING- PLAN CHK#: (7-1
PROJECT DESCRIPTION: :57r-k
CORNERLOT VO —(Yes/No)
SETBACKS:
Required Setbacks:
Front: 2.�- Left Side: 7 kz- Right Side:—f!7Z:�r-Rear:
Actual Setbacks:
Front: '3,( Left Side: I p Right Side: Ll? Rear: 7
Street map checked for additional setback required? .(Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE:
1087.65- Maximum Allowed: 3 J-7, Actual: 13%
Tj TI? 11 1272
BUILDING HEIGHT:
Maximum Allowed: Actual Height: —
Datum Point: 'rele. Datum Elevation: I DO. 17
SUBDIVISION:
qt_ 4 ?
CRITICAL ARE -AS #:
SEPA DETERMINATION:
LOT AREA: I I ?65r7 - 5-0
OTHER:
Plan Review By: /( -�4 vl.�
CA FILE NO.
19 ..Critical Areas. Checklist 6�b-6q"'
Site Information (soils/topography/hydrology/vegetation) POP
1. Site Address/Location: 1410P JoTY F�, VA,'�0W;Nr4fZ)/
2. Property Tax Account Number: C2 &4-q 00
3. Approximate Site Size (acres or square feet): — I$L "14f I?
4. Is this site currently developed? yes; no-
VqM 1W P%&/� MUNn5' 17,k
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
X 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 6640.0.
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. _;Approx. Depth:
7.' Site contains areas of seasonal standing water: Approx. Depth: -
What season(s) of the year?
8. Site is in the floodway floodplain 1A0 of a water course.
9., Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? W �-' Flows are seasonal? M (What time of year? 1� ft
10. Site is primarily: forested ; meadow —; shrubs mixed
urban Jandscaped (lawn,shrubs etc) X
11. Obvious wetland is present on site:
For City Staff Use Only
11 !:.. -..Site is �ned? rZ
-SCS* mapped soil type(s,
IRmOM04
090 -J99-
City of'Edmonds
Criti-daF 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 ir thi- V;ty
and submit it to the City. City will'
review the checklist, make a precursory, site
viAt, and'hiake a d6termination of the
subsequent steps necessary to complete a-
ddvelopment permit aipplication.
With a signed copy of this form, the
The purpose of the Checklist is to enable
applicant should also submit a vicinity map
City staff to determine whether any
or plot plan for individual lots of the parcel
potential Critical Areas are or may be
-withenough detail that City taf can f
f ind.
present on the subject property. The
'and identify the subject parcel(s)' In
information -needed to complete the
addition, the applicant shall include
Checklist should be easily available from
other pertinent information (eg. site ')1.1'.�:7,
observations of the site or data available at
--olan, topogra dies id-
phy map, etc.) or stu
City Hall (Critical Areas inventories, maps,
conj*u'nction with this Checklist to as's"M'
or soil surveys).
staff in completing their preliminary,
assessment of 'the site.
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Gwner i Applicant: Applicant Representative:.
Name
124 � ot> 10-7 �4
Street Address
tt'N�Nt::5, OJ,,k,
City, State, ZIP Phone
Signature Date
I
9ST?T,N�bx �--e7l C4+W
Name
Street Address
Phone
Sighlature Date
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VICINITY MAP
No Scale
RESIDENCE - Mr/Mrs Larry Zolton
24108 107 h Place W Edmonds, Washington
98020
CHUN/Pacific Design Group
Subject
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RESIDENCE - Mr/Mrs Larry Zolton
24108 107'h Place W Edmonds, Washington
98020
CHUN/Pacific Design Group
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CITY OF EDMONDS
PERMIT 446
NUMBER 96.0
USE
ZONE
CTION PERMIT APPLICATION
CONSTRW'
joB
ADDRESS
SUITE/APT
#
OWNER NAME /NAME OF BUSINESS
�A r- ao�/ Vft*
LEGAL DESCRIPTION CHECKI
SUBDIVISION NO.
LID NO.
a:
w
MAILING ADDRESS
Z
0
107"
PUBLIC RIGHT OF WAY PER
OFFICIAL STREET MAP.
TESCP Approved 0
CITY ZIP
TELEPHONE NUMBER
r
EXISTING — REQUIRED
DEDICATION
RW Permit Required 0
Street Use Permit Req*d 0
OSED
Inspection Required 0
NAME
Sidewalk Required 0
4:�WNW_11 14�,C7-
METER SIZEJ
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
UQJ
ADDRESS
YES El NO 0
401 �? VJU-NAk, 13.
REMARKS
CITY ZIP
TELEPHONE NUMBER
W
Lu
Not.) i I I. - 1,2 1
NAME
cc
0
ADDRESS
VTf+
REVIEWED BY
ENGINEERING MEMO DATED
0:
CITY ZIP
LEPHONE NUMBER
T7
FIRE MEMO DATED
Z
0
4) pri t7l
ut)15
REVIEWED BY
w
STATE LICENSE NUMBER EXPIRATION DATE
17_,96 CA/ 4`10
SIGN AREA
SEPA RE IEW
ADB NO.
Legal Dekription of Prope�ty - include all easements
ALLO
PROPOSED
COMPLETE EXEMPT
Z
SHORELINE 0
EXP
0.
VARIANCE OR CU
PLANNING REV "I'll EW BY
DATE
W
_j
HEIGHT
LOT COVERAGE
Z
SETBACKS —FEET
Lu
Property
FRONT 7, s IDE7.. REAR
7
Tax Account
REMARKS
t,
Parcel No.
R7
NEW
U= RESIDENTIAL
PLUMBING
ADDITION
COMMERCIAL
MECHANICAL
A PT. BLDG.
El
REMODEL
.
SIGN
GRADING FENCE
Z
rx 1:1
CHECKED BY
TYPE OF
CO STRUCTION CODE
OCCUPANT
REPAIR CYDS. x_
( F' n
1941
GRV �V
MI. 7.1 WOOOS�.OVE'_ M: SWIM pObL
I I DEMOLISH F INSERT L_j HOT TUB/SPA
AfIEA F. . 1 .! . .. .. :".
I .
OCCUPANT
SPEcIAL 114SPECTOR
'
REQUIRED
0 YES
[
LOAD
FIGARAGE RETAINING WALL/
C 11 El RENEWAL
REMARKS
Z
0—
ROCKERY
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
PROGRESS INSPECTIONS PER UEIC 305
Z
IL
IN rpi I I I v-1 riv r tt I kr& 150pi PM
W6
0
NUMBER NUMBER
OF DWELLING
OF
CRITICAL
AREAS
41 t_17
to
STORIES UNITS
NUMBE R
DESCRIBE WORK T BE DONE (ATTACH PLOT PLAN)
t W- Vil
FINAL INSPECTION
REQUIRED
FAj A at -;A PY/50N tLt�j 4
VALUATION
FEE
;r
PLAN CHECK FEE
HEAT SOURCE:
W6 pv�o
GLAZING
%
BUILDING
PLUMBING
?FEE
___
Plan Che'
MECHANICAL
-.=--4 , ., " /, kkj I
's Permit, covbT§'work to be d6rib 6h'pfIv1ate property ONLY.
GRADINGIFILL
Aly-construction on the public domain (curbs, sidewplks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
2
employees, and agents from any and all claims for damages of
cr
<
whatever nature, arlsing 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
X
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
9
provision."
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
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
AUTHORIZES
This application is not a permit until
ed thereby, no person will be employed In violation of the Labor
ONLY THE
signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt Is
tion Insurance and RCW 1 f27.
IN . SPECTION
acknowledged in space provided.
ESIGTATUR�
(QWNER OR &NT,
46 I
DATE SIGNED
DEPARTMENT
CITY OF
OFFICII L' Sf NAT 9ATE
tt
EDMONDS
71,10AI7
ATTENTION
CALL FOR
INSPECTIO N
RE17EAi
Ad
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
-
771 0'
ORIGINAL
I
'CERTIFICATE
- ;dZU
— File YELLOW —
A OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK — Owner GOLD' Assessor
110247