431 12TH AVE N (2).PDF111111 lill
630
431 12TH AVE N
10/12/2010 14:23 4257761519 BLUEPRINt MGMT PAGE 01/03
-BLU .-PANT—
MANA43EME
837 Maple St. Edmonds, WA 98020 206.949.8893 Fax 425.771.5500
e- mail doug.herman2dverizon.net
FAX Transmittal Cover Sheet
Date: 10-12-10
To: City of Edmonds
Attn: Marie Harrison/ Jennifer- Engineering Dept.
Fax #: 425--771-0221
From: Doug Herman 206-949-8893
Including cover: 3
Comments,
Her'e is the parcel number with the new legezd for 43 1 120' Ave N.
Thank You,
Doug Herman
.206-949-8893
RESUB
OCT 12 2010
BUILDING DEPARTMENT
CITY OF EDMONDS
10/12/2010 14:23 4257761519 BLU EPRIN T MGMT PAGE 02/03
Snohomish"County
Astessor's Office
October 5, 2010
Cindy Portmonn
Courity Assessor
Linda Hj9IIe
Chief Deputy
C111GARAS JOHNN M/S #510
3000 Rockefeller Ave.
431 12TH . N Evereff. WA 98201-4Od6
EDMONDS, WA 98020 (425) 388-3433
FAX (425) 388-3961
RE: Tax Acco, ' unt No(s). 00507200002400 & 00507200002501,
ProjectNo.: C100442
Boundary Line Adjustment
Your Signed Request
Affidavit to Combine Lots
Levy Department Request
Other: City of Edmonds nonconforming lot regulations (ECDC 17.40.030).
Dew MR- CHMARAS:
We have combined the above -mentioned accounts into one parcel per the document(s).
indicated above. You* YAII -now receive tax statements for the following account'number:
00507200002400
If you have any questions, ple * ase contact me at the telephone number or e-mail address
listed below. For tax questions, please call the Treasurer's office at (425) 388-3366.
SincoTel
r
AA
Sandra L Smith
Land Segregation Dept
(425) 388-3299 - or -
T611 Free 1-800-562-4367 (Ext 3289)
-$andy.smitb@co.snobon-Lish.wa.i)s
RESUB
Enclosure
OCT 12 2010�
BUILDING DEPARTMENT
CITY OF SDMONDS
9Y*1: oounty.onanna- cosmhomhh.wow
�Vebl wwwJ?=0,or91DeP=trnents/Assessor
10/12/2010 14:23 4257761519 BLUEPRINT MGMT PAGE 03/03
SNOHOMISH COUNTY'
Property �Account Summary
Account No.: 00507200002400 Alternate Property Number: 50720000240004
AccountType: Real Property
TCA: 00210
Situs Address: 431 12TH AVE N
EDMONDS WA 98020-2931
Legal: Section 24 Township 27 Range 03 Quarter SE Subdivision MAPLEWOOD VILLAGE NO 4 BLIK 000 D.0c) LOT
24 TGW LOT 25 SO PLAT EXC TH PTN THOF LY NLY FDL - BEG NW COR SD LOT 25 TH SOO-09 06W 23.28FT TO
TPB AFORMND LN TH S83'31 14E 191.38FT TO ELY BOY SD LOT 25 & TERM SD LN
Parties:
Role Name & Address
Owner CHIGARAS JOHN N
431 12TH N
EDMONDS, WA 98020
Taxpayer CHIGARAS JOHN N
431 12TH N
EDMONDS, WA 98020
Prop" Values:
Value Name 2011 1 2010 2009
Taxable Value Regular
$1,128,100
$1,116,600
$1,289,200
Market Total
$1,128,100
$1.116,800
$1,2119,200'
Assessed Value
$1,128,100
$1,11,6,600
$1,289,200
Market Land
$544.500
$540.000
$661.000
Market Improvement
$583,600
$576,600
$628,200
Property Characteristics:
Tax Year Character;stic
Value
2011 Use Coda
111 �Ingle Family Residence - Detached
Unit of Measure
Acre(s)
Size (gross)
Lot sizo (net)
0.43
Exemptions:
(End of Report)
RE,S a a
U13
OCT 12 2010
BUILDING DEPARTMENT
GITY OF EDMONDS
Run: 10/5/2010 9.32:37 AM ASCO037 jAscend30—Prodj Page 1
Critical Areas Checklist'
Site Information
Project Name. - /J mAA1 /Z> eck A&�(�ermit Number
Site Location: 43( Property Tax Account Number.
Approximate Site Size (acres or square feet):
Have you filled out a Critical Areas Checklist for a project on this site before? AJP
General Site Conditions
1. Has the site been cleared or logged? Date of most recent action:
Soils / Tbpdghi
+1 AOLL�
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)?
3. Descn-beth6-g6ner;&;sitetop16"_ Check all that apply.
Ylat: less than .5 feet elevation change over entire site.
V/ -Rolling: slopes on site gencrally.les� than 15% (a vertical rise of 10 feetover a.
horizontal distance of 66 feet.)
011k, slopes' present on site of more than 15% and less than 301/p a vertkal rise
of,10, feet of horizontal distance.)
tccp: grades of greaScr th 30%ptesedt on site.
S an
Comments
Hydrology/Ve''g"etatidn
4. Site contains areas of year-round standing water:
5. Site contains areas of seasonal standing watcr. —Approx. Depth:
6- Site is in the-floodv,�Ly tJ floodplain- of 'a" walet c6urse"'.,:
7. Site contains a creek or an area A�rh�re watet'flo*s ii:ioss ih*eground'ssur1f'ace? AJ'0 flows
are year-round? /40 Flows are seasonal?
8. Site is primarily: forested - meadow shnibs mixed
9. Obvious wetlan.d is present on site- A)O
10. Wetland inventory or map indicates wedand present on site: A)0
11- Critical Areas inventory or map indicates any Critical Area on site: _AS L-"b M-N �-a 4-J—
F-0 r-*-. 0 ty -W e - On'.1
A
89 a 1,9 9
City of Ednid n"&
Critical Areas Checklist
The Critical Areas ChccIdiqt contained on
VV. , � 4, An applicant. or his/her representative.. must
dlis form is to be"filled 0& Wany person fill Out the cliccidist, sign and date, it, arid -
,Preparing i Devel6jm�ni p t_.., Submit it to the City- T'he City will revi -
Application forthe Ci " OW
ty of Edm�n&'pnior th . c cheddist, make a p�ccursory site visit.
to his/her submittal of a develop' Permit and in�kz a d ation of the ` * '
to the City- subsequent
The Purpose Of the Chccldist is to 6tiable
City staff to determine whether any potential
Critical Areas are or may be present on the - -
subject Pr0PCrtY-'ThC informition needed to
COMPletc the Checklist should be easily
a 'lablc f
val 110111 observations -of the site or
data available at City Hall (Critical Areas
inventories, maps, or soil'surveys).
stelis necessary to complete a de-,iel6p* ment
permit application-
W-ith a signed copy of this form� the
applicant should also'iubmit I a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject-
Parcel(s). In addition, the applicant is
.-encouraged to include any other pertinent
information or stLidies in conjunction with
this Checkl-
Ist to assist start in completing
i -r iminary assessment of the site
thel . prql
I have completed the attached Critical
I I . AreaChecklist and attest that the answ"eirs providedare
factual, to the best of my knowledge (fill out the app'ro'pn- co
ate, lumn below) -
Owner/ Applicant:
Applicant Representative:
Name
Narne
kjlt
Title
Title
Street Address
Street Address
City, State, Zip Thone City, Stat ZIP
e
Phone
Signature Si
DateJ! gnature
bate
CITY OF EDMONDS
CRITICAL AREAS RECONNAISSANCE REPORT
Site Location: 431 — 12th Ave. N Tax Acct. Number: 00507200002400
Determination: Study Required Determination #: CRA19930181
Applicant: Doug Herman Owner: John Chigaras
NOTE: THE ORIGINAL RECONNAISSANCE CONDUCTED FOR THIS PROPERTY ON JUNE 29,
1993 DETERMINED THAT THE PROPERTY DID NOT CONTAIN ANY CRITICAL AREAS AND A
"WAIVER" FROM THE REQUIREMENT TO CONDUCT A STUDY WAS ISSUED. HOWEVER, SINCE
THE TIME OF THE ORIGINAL RECONNAISSANCE, IT WAS DETERMINED THAT THE PROPERTY
CONTAINS AND IS ADJACENT TO SLOPES THAT ARE STEEP ENOUGH TO BE CONSIDERED
LANDSLIDE HAZARD AND EROSION HAZARD AREAS. THEREFORE, THE ORIGINAL
RECONNAISSANCE HAS BEEN CHANGED, AND THE CURRENT CRITICALARtAS
DETERMINATION FOR THE PROPERTY IS "STUDY REQUIRED" DUE TO THE PRESENCE OF
LANDSLIDE HAZARD AND EROSION HAZARD AREAS.
CRITICAL AREAS RECONNAISSANCE REPORT: STUDY REQUIRED
During review and inspection of the subject site, it was found that the site may either contain or be
adjacent to critical areas, including Landslide Hazard and Erosion Hazard Areas, pursuant to Chapters
23.40 and 23.80 of the Edmonds Community Development Code (ECDC).
GENERAL CRITICAL AREAS REPORT REQUIREMENTS
Critical Areas Reports identify, classify, and delineate any areas on or adjacent to the subject property
that may qualify as critical areas. They also assess these areas and identify any potential impacts
resulting from your specific development proposal. If a specific development proposal results in an
alteration to a critical area, the critical areas report will also contain a mitigation plan. You have the
option of completing the portion of the study that classifies and delineates the critical areas and waiting
until you have a specific development proposal to complete the study. You may also choose to submit
the entire study with your specific development application.
• Please review the minimum report requirements for all types of Critical Areas that are listed in
ECDC 23.40.090.D. There are additional report requirements for different types of critical areas
(see below).
• Note that it is impor tant for the report to be prepared by a qualified professional as defined in the
ordinance. There are options on how to complete a critical areas study, and there is an approved
list of consultants that you may choose from. You may contact the Planning Division for more
information.
General Mitigation Requirements for all Critical Areas are discussed in ECDC 23.40.110 through
23.40.140.
STUDY REQUIREMENT — LANDSLIDE HAZARD AREA
It appears that this property contains or is adjacent to a Landslide Hazard Area.
A Landslide Hazard Area is any area with a slope of forty percent (40%) or steeper and with a
vertical relief of ten (10) or more feet (except areas composed of consolidated bedrock).
0 Landslide Hazard Areas are further defined and illustrated in ECDC 23.80.020.B.
In addition to the general requirements for Critical Areas reports referenced above, specific
Critical Area report requirements for Landslide Hazard Areas are provided in ECDC 23.80.050.
DEVELOPMENT PROPOSALS ASSOCIATED WITH LANDSLIDE HAZARD AREAS
Development is restricted within a Landslide Hazard Area and its buffer.
• Projects that will intrude into these areas will require a report by a licensed Geotechnical
Engineer.
• The criteria that are applied depend on the amount that the buffer is reduced.
The buffer can be reduced to a minimum of ten (10) feet (with an additional 15' building setback
per ECDC 23.40.280) if a report is prepared that meets the standards listed in ECDC 23.80.050.
The alteration must also meet the requirements listed in ECDC 23.80.060. .
In addition, proposals to reduce the buffer to less than ten (10) feet must comply with the design
standards listed in ECDC 23.80.070.A.3.
STUDY REQUIREMENT — EROSION HAZARD AREA
It appears that this property contains or is adjacent to an Erosion Hazard Area. Erosion Hazard Areas
include:
0 Those areas with Alderwood and Everett series soils on slopes of 15 percent or greater.
• Any area with slopes of 15 percent or greater and impermeable soils interbedded with granular
soils and springs or ground water seepage. -
• Areas with significant visible evidence of ground water seepage, and which also include existing
landslide deposits regardless of slope.
DEVELOPMENT PROPOSALS ASSOCIATED WITH EROSION HAZARD AREAS
Development within an Erosion Hazard Area must meet additional criteria.
• For erosion hazard areas with suitable slope stability, the only critical area study needed is an
erosion and sediment control plan prepared in compliance with the requirements set forth in
Chapter 18.30 ECDC as part of the construction documents. This option is at the director's
discretion, per Edmonds Community Development Code section 20.80.050.G.
• In areas where the slope stability is not suitable, projects within Erosion Hazard Areas will require
a report by a licensed Geotechnical Engineer or other qualified professional. Note that it is
important for the report to be prepared by a qualified professional as defined in the ordinance.
• Report requirements are given in ECDC 23.80.050, and more generally in ECDC 23.40.090.D.
• Development standards are given in ECDC 23.80.060 and 23.80.070.
ALLOWED ACTIVITIES
Certain activities are allowed in or near critical area buffers as specified in ECDC 23.40.20. If you have
any questions about whether your proposed development qualifies as an allowed activity, please contact
a Planner for more information.
2
EXEMPT DEVELOPMENT PROPOSALS
Certain development proposals may be exempt from Critical Areas Requirements (ECDC 23.40.230). If
you think that a specific development proposal may be exempt, contact a Planner for more information.
Name S
October 20. 20
Date
NOTE: Cited sections of the Edmonds Community Development Code (ECDC) can be found on the City
of Edmonds website at www.ci.edmonds.wa.us.
PLANNING DATA
SINGLE FAMILY RESIDENTIAL
STREET=FILE
Name:
Date:
Site Address:
Tax Parcel
Project Description:
Plan Check #: SLbDko� C) 0.5-q-1
Reduced Site Plan Provided: NO)
Zoning:
Map Page:
Corner Lot: (YESC�—)
Flag Lot: (YES
Critical Areas Determination #: -C
Study Required wl oc,;b-Ned o �Vzide. C�v
waiver
SEPA Determination: 9EX
Exempt
Needed (for over 500 cubic yards of grading)
0 Fee 0 Checklist 0 APO List with notarized form
Required Setbacks
Street:
(E:�)
Side:
0
Side:
L—C�)
Rear:
Actual Setbacks
Street:
Sid
Side:
Rear:
Ac,pILQ;s�,
S---- e-- ,
El 'detached Structures:
CNN
Rockeries: )�l
,Is
El Fences/Trellises:
El Bay Windows/Projecting Modulation:
Stairs/Deck:
Height
Datum Point: &I Ix
Datum Elevation:
4 3 aver- o
Maximum Height Allowed:
Actual Height: ?er 0"
Other
Parking Required:
Parking Provided:
cz -9-
Lot Area:
Maximum Lot Coverage: 35% P14osed:
Noc\,�,qcke-
\14
Lot Coverage Calculatio
e
ADU Created: (YES
Subdivision: Cxs",A=,e pe-, to/sAto tiwier-
Legal Nonconforming Land Use Determination Issued: (YES/Agp
Comments
Plan Review By:
Planning Data Form 07-1+09
Critical Areas Checklist'
Site Information STREET p/L.E,
Project Name-,Z;_� /b ec (�ermit Number
con..
Site Location: 4,;( K1. -Property Tax Account Number. I
Approximate Site Size (acres or square feet):
Have you filled out a Critical Areas Checklist for a project on this site before? IJO
General Site Conditions
1. Has the site been cleared or logged? Date of most recent action:
Soils / Topogri''A"
phly
2- In the Sno.homish County Soil Survey, what is the mapped soil type(T
3. Describe the ginerA's ite to-pogii-&'_y. � C-he*c"k'alil, 'th.'at apply.
Ylat: less than 5 feet elevation change over entire site.
-Rolling: slopes on site generally les's than 15% (a vertical,rise of 10 feet.over a,
horizontal distance of 66 feet.)
Jully: slopes present on site of more than 15% and less than 30'Vp a vcrtii:al rise
of 10 feet of horizontal distance.)
Steep: grades of greAter than 30% pte'seht on site.
Comments
Hydrology/Vegetation.
4. Site contains areas of year�-round standing w�a'ter: ''t� 0
S. Site contains areas of seasonal standing water. --Approx. Depth:
6. Site is in the floodway floodplain- P,32 ofa'watdr 'urse.,
7- Site contains a creek or an area whei� watet"fli iow�'s;i'b'ios'.'s'th'e"gro'u'n'ds surface? 101 flows -
are year-round? /JO Flows are seasonal?
8- Site is primarily: forested meadow ;shrubs mixed
9. Obvious wetland is present on site: A� 0
10. Wetland inventory or map indicates wetland present on site: AJO
11- Critical Areas inventory or map indicates any Critical Area on site:J��S �-O
F6r,Gty.Ui
NN %
,9s,a -199
City of Edmd�jds
Critical Areas Chec'�Iist
Pr;f;,"I A
%I&jLqddi4 contained on
this form is to b�'fit ,
Y any person
.preparing a'Dc*el m6dt P t
Application for"the City" of Fdru�nds'pnor
to his/her submittal of a development permit
to the City.
Ibc Purpose of the Checklist is to enable
City staff to determine 'whether any potential
Critical Areas are or may be present on the
wbica prI0PcrtY � The information needed to
'complete the Chccidist should be casily
allabic fi'0M observations of the site or
data available at City Hall (Critical Areas
inventories, maps. . or soil surveys).
An applicant� or his/her represcptatiye. must
fill out the checidist, sign and date it, and'
submit it to the City_ Ihe City will review
the Checklist. make a precursory site visit,
and mike a d of the subsequent
-steps necessary to complete a' development
Permit application.
With a signed 'copy of this form, the
applicant should also -submit avicifiitymap
of the parcel with. enough debuil, am City
�taff can find and identify the subicct-
parcel(s)- In addition. the applicant is
-encouraged to include any other pertinent
information or studies in conjunction -�,nfth
this Checklist to assist staff in"c'O''mp'leting
i inary assessment of the site-
i,their,prei rn
I have completed the attached Critical Area Checklist " attest that the ans"w''eirs providedare
I and
factual, to the best of my knowledge, (fill out the app'ro' co
priate. lumn below) -
Owner/ Applicant:
Applican' t Representative:
Name Name
Title
Title
4k,
Street Address
Street Address
City, State, Zip ,Phone City, Stat Zip
e
Phone
Signature
Date)." Signature .7
Date
I
CITY OF EDMONDS
CRITICAL AREAS RECONNAISSANCE REPORT
Site Location: 431 — 12t' Ave. N Tax Acct. Number: 00507200002400
Determination: Study Required Determination #: CRA19930181
Applicant: Doug Herman Owner: John Chigaras
NOTE: THE ORIGINAL RECONNAISSANCE CONDUCTED FOR THIS PROPERTY ON JUNE 29,
1993 DETERMINED THAT THE PROPERTY DID NOT CONTAIN ANY CRITICAL AREAS AND A
"WAIVER" FROM THE REQUIREMENT TO CONDUCT A STUDY WAS ISSUED. HOWEVER, SINCE
THE TIME OF THE ORIGINAL RECONNAISSANCE, IT WAS DETERMINED THAT THE PROPERTY
CONTAINS AND IS ADJACENT TO SLOPES THAT ARE STEEP ENOUGH TO BE CONSIDERED
LANDSLIDE HAZARD AND EROSION HAZARD AREAS. THEREFORE, THE ORIGINAL
RECON*NAISSANCE HAS BEEN CHANGED, AND THE CURRENT CRITICALARtAS
DETERMINATION FOR THE PROPERTY IS "STUDY REQUIRED" DUE TO THE PRESENCE OF
LANDSLIDE HAZARD AND EROSION HAZARD AREAS.
CRITICAL AREAS RECONNAISSANCE REPORT: STUDY REQUIRED
During review and inspection of the subject site, it was found that the site may either contain or be
adjacent to critical areas, including Landslide Hazard and Erosion Hazard Areas, pursuant to Chapters
23.40 and 23.80 of the Edmonds Community Development Code (ECDC).
GENERAL CRITICAL AREAS REPORT REQUIREMENTS
Critical Areas Reports identify, classify, and delineate any areas on or adjacent to the subject property
that may qualify as critical areas, They also assess these areas and identify any potential impacts
resulting from your specific development proposal. If a specific development proposal results in an
alteration to a critical area, the critical areas report will also contain a mitigation plan. You have the
option of completing the portion of the study that classifies and delineates the critical areas and waiting
until you have a specific development proposal to complete the study. You may also choose to submit
the entire study with your specific development application.
• Please review the minimum report requirements for all types of Critical Areas that are listed in
ECDC 23.40.090.D. There are additional report requirements for different types of critical areas
(see below).
• Note that it is important for the report to be prepared by a qualified professional as defined in the
ordinance. There are options on how to complete a critical areas study, and there is an approved
list of consultants that you may choose from. You may contact the Planning Division for more
information.
General Mitigation Requirements for all Critical Areas are discussed in ECDC 23.40.110 through
23.40.140.
STUDY REQUIREMENT — LANDSLIDE HAZARD AREA
It appears that this property contains or is adjacent to a Landslide Hazard Area.
A Landslide Hazard Area is any area with a slope of forty percent (40%) or steeper and with a
vertical relief of ten (10) or more feet (except areas composed of consolidated bedrock).
0 Landslide Hazard Areas are further defined and illustrated in ECDC 23.80.020.B.
In addition to the general requirements for Critical Areas reports referenced above, specific
Critical Area report requirements for Landslide Hazard Areas are provided in ECDC 23.80.050.
DEVELOPMENT PROPOSALS ASSOCIATED WITH LANDSLIDE HAZARD AREAS
Development is restricted within a Landslide Hazard Area and its buffer.
• Projects that will intrude into these areas will require a report by a licensed Geotechnical
Engineer.
• The criteria that are applied depend on the amount that the buffer is reduced.
0 The buffer can be reduced to a minimum of ten (10) feet (with an additional 15' building setback
per ECDC 23.40.280) if a report is prepared that meets the standards listed in ECDC 23.80.050.
The alteration must also meet the requirements listed in ECDC 23.80.060. .
In addition, proposals to reduce the buffer to less than ten (10) feet must comply with the design
standards listed in ECDC 23.80.070.A.3.
STUDY REQUIREMENT — EROSION HAZARD AREA
It appears that this property contains or is adjacent to an Erosion Hazard Area. Erosion Hazard Areas
include:
0 Those areas with Alderwood and Everett series soils on slopes of 15 percent or greater.
• Any area with slopes of 15 percent or greater and impermeable soils interbedded with granular
soils and springs or ground water seepage. -
• Areas with significant visible evidence of ground water seepage, and which also include existing
landslide deposits regardless of slope.
DEVELOPMENT PROPOSALS ASSOCIATED WITH EROSION HAZARD AREAS
Development within an Erosion Hazard Area must meet additional criteria.
• For erosion hazard areas with suitable slope stability, the only critical area study needed is an
erosion and sediment control plan prepared in compliance with the requirements set forth in
Chapter 18.30 ECDC as part of the construction documents. This option is at the director's
discretion, per Edmonds Community Development Code section 20.80.050.G.
• In areas where the slope stability is not suitable, projects within Erosion Hazard Areas will require
a report by a licensed G i eotechnical Engineer or other qualified professional. Note that it is
important for the report to be prepared by a qualified professional as defined in the ordinance.
• Report requirements are given in ECDC 23.80.050, and more generally in ECDC 23.40.090.D.
• Development standards are given in ECDC 23.80.060 and 23.80.070.
ALLOWED ACTIVITIES
Certain activities are allowed in or near critical area buffers as specified in ECDC 23.40.20. If you have
any questions about whether your proposed development qualifies as an allowed activity, please contact
a Planner for more information.
4
EXEMPT DEVELOPMENT PROPOSALS
Certain development proposals may be exempt from Critical Areas Requirements (ECDC 23.40.230). If
you think that a specific development proposal may be exempt, contact a Planner for more information.
NOTE: Cited sections of the Edmonds Community Development Code (ECDC) can be found on the City
of Edmonds website at www.ci.edmonds.wa.us.
3
STREET FILE
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS. WA 98020 - (206) 774-0220 FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works * Planninn a Parks and Recreation o En ine-rin
89 0.- .19 C)
LEI -MR OF TRANSAUffAL
Date: June 30, 1993
To:
John Chigaras.
431 12th Ave. N�
Edmonds WA 98020
Subject CRITICAL AREAS CHECKLIST
Transmitting: CA-93-181
For your information:
As you requested:
For your file:
Comment and return:
Note attachments:
Comments:
**YOU MUST BRING A COPY OF YOUR CRITICAL
AREAS CHECKLIST WHEN YOU SUBMIT YOUR,
BUILDING PERMIT APPLICATION"
Planning Division
Cindi.,Cruz, Planning.Secretary
LAURA M. HALL
MAYOR
0 Incorporated August 11, 1890 e
Sister Cities International — Hekinan, Japan
C)
City Of Edinon'&
Critical Areas Chec' Mist
'MC- Critical Amu ChwMist -
this f contained on
onn,s to be fined out by any person
-preparing a Development Permit
Application for the CitY Of Edmonds prior
to his&er sUbMittal of a development Permit
to the City�
Ile Puqx= Ofthe Checklist is to amble
CitY staff to determinc whether any potential
Critical Areas amor may be present on the
'bicct PIOPcrtY- Ihe information needed to
complete the Checklist should beeasily
available from Obscmd'Ons of the site or
data available at City Hall (Critical Areas
inventories. maps, or soil surveys).
An applicant. or his&cr representative. must
-fill out the chccldis4-sign and date it, and
submit it to the City. ne City Will review
the cheddist. m a precursory site visit,
and make a Act=Mination of the subsequent
steps U00CSSMY to complete a development
Permit application.
With a signed copyof this form. the
applicant Should also submit avicinity m2ap,
ofthe parcel with enough dc&n that City
staff can find and identify the. subject
parcel(s)- In addition. the applicant is
encouraged to include any other pertinent
information or sttidics in conjunction with
this Checklist to assist staff in completing
their preliminary assessment of -the site.
I have completed the attached Critical Area Checklist and attest that the answers providedare
facuml, to the best of my knowledge (fill out the appropriate column below).
Owner/ Applicant:
Applicant Representative:
Name
Title
Name
Title
Street Address Street Address
City. State, Zip
Phone City, iiate. ZIP
Phone
Signature Date
Date
REcEIV
E: D
Critical Areas Checklist' JUL - 9 1993
Site Information PERMIT COUNTER
Project Name.%,z L-W 144 lbee-k "t Number:
Site Location: 431 t7,V,4,- d, Property Tax Account Number:
Approximate Site Size (acres or square feet):
Have you filled out a Critical Areas Chedidist for a project on this site before?
General Site Conditions
1. Has the site bow cleared or logged?
�J 0
/J 0
Date of most recent action:
Soils / Topography g-tktQ%
2- In the Snohomish County Soil Survey, what is the mapped soil type(s)?
3- Describe the general site topography. Check all that apply.
less than 5 feet elevation change over entire site-
V/ Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a
horizontal distance of 66 feet.)
Hill3r. slopes present on site of more than 15% and less than 30Yp ( a vertical rise
of 10 feet of horizontal distanm)
Steep: grades of greaW than 301% present an site.
C�mmcnts
Hydrology/Vegetation.
4. Site contains areas of year-round standing water. t�
5. Site contains areas of seasonal standing water- —Approx. Depth:
6. Site is in the floodway tJl�l floodplain of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? A31 flows
are year-round? /JO Flows are seasonal?
8. Site is'primanly: forested meadow shrubs mixed
9- Obvious wetland -is present on.site: A)O
10. Wetland inventory or map indicates wctland present on site: A)c)
11. Critical Areas inventory or map indicates any Critical Area on site: _AS L-�,�
tb r, G ty -U s* e - On ly,
CITY OF EDMONDS
WORK PERMIT JOB CARD
(POST AT JOB SITE)
R
Permit No.
TYPE OF JOB
43 Zf�i Ae- N-
CONSTRUCTION: A&C ADDRESS
OWNER PERMIT EXPIRES
19
ISSUED BY DATEISSUED
INSPECTIONS ARE MANDATORY. A 24-HOUR NOTICE IS REQUIRED. HAVE CITY APPROVED PLANS ON JOB
FOR ALL INSPECTIONS. POST THIS CARD FOR INSPECTOR'S NOTATION FOR CITY INSPECTIONS CALL
771-3202 AND ASK FOR APPROPRIATE DEPARTMENT. ALL ELECTRICAL INSPECTIONS ARE THROUGH THE
DEPARTMENT OF LABOR AND INDUSTRIES.
DEPT INSPECTION ITEM APPROVED BY DATE COMMENTS
Setbacks
Foundation
Z
z
Plumbing
Underground
z
Rough -in
a.
0
Heating System
z
<
Framing (Prior to cover)
le
/,
/./d - ,z 1'r",
c"
0
?_�
z V"Wallcovering
ADB Approval (if required)
M
co
jWnporary Occupancy
FINAL APPROVAL
Side Sewer
z
Water Service
a:
W
Drainage
.Lu
R/W Construction
z
Lu
Site Improvements (if required)
FINAL APPROVAL
Hydrants (if required)
z
LU
CL
Fire Protection System
.6
Extinguishers
aui I=
5 E
Addressing Visibility
LU 0
m
Temporary Occupancy
FINAL APPROVAL
NOTE: OCCUPANCY without approval is a violation of Section 305 of the UNIFORM BUILDING CODE.
cd
C L
Lk
71
�T
71
j
Ki
C_ IF
STREET FILE
0-
im 231983
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STREET FILE
C I T Y. 0 F E D M 0 N D S
SEWER DEPARTMENT
STOPPAGE OF SANITARY SEWER M[AIN REPORT
DATE: 7
-2-1 - S
TIME
CALL RECEIVED:
LOCATION OF
STOPPAGE: 'gETwFFt,,t
K/HS 6-124
8-17(o.LASi
TIME OF ARRIVAL ON THE JOB SITE:
TIME NORMAL FLOW OF SANITARY SEWER REESTABLISHED:
CAUSE OF STOPPAGE:
ACTION REQUIRED TO CLEAR MAIN AND/OR LATERAL: R(3r)'LEp .-Tc) CL A
Q
LINE -
CITY CREW ON STOPPAGE CALL OUT (Personnel Involved):
LOCATION OF RESIDENCE AFFECTED:
NAME, ADDRESS, AND PHONE NUMBER OF PROPERTY OWNER:
DESCRIBE DAMAGE TO PRIVATE PROPERTY: 1"�n t-�F—
Th
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STREET FILE
C I T Y, 0 F E D M 0 N D -S-
SEWER DEPARTMENT
STOPPAGE OF SANITARY SEWER MAIN REPORT
DATE: 7 85 TIME CALL RECEIVED: pm
LOCATIONOF STOPPAGE:
TIME OF ARRIVAL ON THE JOB SITE: Ito f)m
TIME NORMAL FLOW OF SANITARY SEWER REESTABLISHED: PfA
CAUSE OF STOPPAGE:
ACTION REQUIRED TO CLEAR MAIN AND/OR LATERAL:
Opf) ET)
M A-4 " S -- 1 f7 7 1' 1r7 A -
CITY CREW ON STOPPAGE CALL OUT (Personnel Involved): tA
LOCATION OF RESIDENCE AFFEC7`ED:
NAME, ADDRESS, AND PHONE NUMBER OF PROPERTY OWNER:
DESCRIBE DAMAGE TO PRIVATE PROPERTY: c- F
� _WpCOE_ \kit
REMARKS: KA� -:"-
%ATAXAM�=&"k rd woraffam of
WAY 1111151111111111
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CITY OF EDMONDS-�Wl*
..PUBLIC WO RKS DEPARTME11T,, ENGINEERING DIVISION
STREET FILELICATION FOR R'IGHT-OF�-WAY -CONSTRUCTI'ON PERMIT
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION -PURPOSES
Applicant to Complete Parts A.and B
A. Permit to be issu6d t'o : Snohomish Count� P.U..P. #1
For Work at:(address or vicinity) "A
/Z
Type of Work to be done,:— 7TVI�,C-Vj -(,'A
(attach drawing when applicable)
Time Required -- Start: 1-day Finish:
Owner: Snohomish County P.U.D. #1
Name
21018 hwy 99
Mailing Address
Lynnwood, IVA 98036 774-2112
City State zip Telephone Number
Contractor: samc as above
Name
Mailing Address
State License Number
City State Zip Teleph�one'Number
J
0
B, INDE11NITY: 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 descriptio'n whatsoever,.foreseen or unforeseen, that may be made.against
the'applic.ant or the City of Edmonds, or any of its 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 d ebit 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 775-2525, ext. 220.
.I understand.that this permit must be available at the job site for inspection
purposes at all -times.
Signature Date:
91tL
Owner for Age-nt�
C , TO BE COMPLETED BY I-SSUING AGENCY:
14Z
Date Issued: 1,�'-7,9 Permit No. Fee:
Security Bond: /J'0�1-
Time Authorized:- L��y
APPROVED BY 'D a t e
I (I -6� 7 7 1 - (-D,. - 4 � - A )