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TAX ACCOLTNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STR
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: c�RrAD-761 a:! 'quired
p DETERMINATION: n Conditional Waiver 0 Study Re KWaiver
DISCRETIONARY PERMIT #
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
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SCALED PLOT PLAN DATED: ZO !77
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SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: 7 a,
SIDE SEWER PERMIT(S).#:
GEOTECH REPORT DATED:
STREET USE I ENCROACHMENT PERMIT #:
WATER METER TAP CARD DA
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PEMCO MUTUAL INSURANCE COMPANY
PO BOX 778
SEATTLE WA 98111-0778
MAAPRN1003160027189
RETURN SERVICE REQUESTED
INSURANCE NOTIFICATION
0316200547-EDS014200547=000485:000485-1/1
CITY OF EDMONDS ENGINEERING DIVISIO
121 5TH AVE N
- W-7 EDMONDS WA 98020-3145
THIS NOTIFICATION IS NOT AN INVOICE
RIECMVED
MAR 21.1201a
ENGINEERING DjvjSj0,V
PAGE 1
POL-I-G-Y—NO,:—HO-1-1-01-296— —T-NTER ESTE D -PAR-T-Y—NOII F-I.CAII.ON----. -- 03 I-1A1 20-1-0—
HOMEOWNER POLICY
POLICY EFFECTIVE DATE: 04/30/2010 "INSURER: INSURANCE COMPANY
POLICY EXPIRATION DATE: 04/30/2011 -
POLICY RENEWAL EFFECTIVE AS OF 04/30/2010 LOAN NO:
INTERESTED CITY OF EDMONDS ENGINEERING DIVISIO
INSURED: MADATH FRANCOIS PARTY: 121 5TH AVE N
PROPERTY: 513 2N6 AVE N EDMONDS WA 98020
EDMONDS WA 98020
AGENCY: 00010100 800-467-3626
TOTAL PREMIUM 860.95 S. H. MILLER
DEDUCTIBLE 1 000.00 325 EASTLAKE AVE E.
DWELLING COVERAGE �IMIT. 514 077 SEATTLE WA 98111
OTHER STRUCTURES COVERAGE LIMIT 511,407
Correspondence or inquiries directed to the insurer must include a copy of this notification.
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APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT EASEMENT No . ..........................................
NEW CONSTRUCTION [] REPAIRS 0
113-00300
OWNFCONTRACTOR .... ................. -- .......... ------- ---------------------------- ------------------ PERNaT No . ......................
,R E-s.the.r ... P ...... Collard ............ ....... — ---------------------------
ADDRESS...... 5.13 --- 2nd-,,Ave.,...N . . .......................................... .................
LEGAL DESCRIPTION: LOT No . ................ ....... ..................... BLOCK No - -------- ............................
NAME OF ADDITION ...... ..................... ...... — ........................ ------
Dye Tested On Sewer 1972
Approved:
DATE.................................. ............. By ......................................................................
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City. of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
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 the application to the City. - -
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
a
Date Received:1t*-A- �'.( 31110 -7
City Receipt#:
Critical Areas File #: 6 /2 A Zco -i o i 2�
Critical Areas Checklist Fee: $135.00
Date Mailed to Applicant:
A property owner, or his/her authorized representative,
must fill out the, checklist,. sign and date it, and 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.
Pleasesubmit 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 assistant staff
in completing their prelirminary assessment of the site.
The undersign ed applicant', and his/her/its heirs, and assigns, 'in consideration on the processing of the application agrees
to release, inderrinify, defend and hold the City.of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPLicANT/AGENT DATE -7.
Property Owner"s Authorization
By my signature, I cer* that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public offic.ials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and postig attendant to this apUlication.
SIGNATURE OF OWNER DATE
PLEASE PRINT CLEARLY
Owner/AppHcant.-
AAAN ccn � M
Name I
. 5f3 lfqo 6,eNUIE
Street Address
E,omo-Vn A/A . qea�Lo -
City State Zip
a 57-
Telephone:
Email address (optional): FMW015M@f1rkCqM&-15,caM
AppHeant Representative:
Name
Street Address
City State zip
Telephone:
Email Address (optional):
#P20
Critical Areas Checklist CA File No:Y,4200761,73
Site Information (soils/ topography/ hydrology/vegetation)
1.. Site Address/ Location: 61 5-fj V 4;
2. Property TaxAccount Number: �270314,00-ZG4500-
3. Approximate Site Size (acres or square feet): PT.
4. Is this site currently developed? _Vyes; no.
If yes; how is site developed?. 5 F R
5. Des the general site to ography. Check all that apply.
� � p
Flat less than.5-feet elevation'dia*nge 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: Me .;Approx. Depth:
7. Site contains areas of seasonal standing water: A/(:r ;Approx. De pth:
What season(s) of the year?
8. Site is in the floodway &td floodplain Ncr — of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
PC Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped Oawn,, shrubs etc)
11. Obvious wetland is present on site: AW
- ------- —For City Staff Use Only
1. Plan Check Number, if applicable? IVJ
2. Site is Zoned?. RS-6
3. SCS mapped soil type(s)?_C'js,� +k'mc %0q&j (00(ri
4. Critical Areas inventory or C.A. map indicates Critical Area, on site?
5. Site within designated earth subsidence landslide hazard area? _A/0
DETERMINATION
STUDY REQUIRED
Reviewed
I
WAIVER
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PLANNING DATA
SINGLE FAMILY RESIDENTIAL
Name:
D te: t 1 -7 0-7--
Site Address: -5(3 Ave- A)
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Plan Check Z00 —001(o
Project Description:
Reduced Site Plan Provided: C(YES //�O)
zoning:
F
Map Page: 2-
Corner Lot: (YESkP
Flag Lot: (YES
Critical Areas Determination ff: /;7,4 -)eq -3
Study Required
6-Waiver
SEPA Determination:
Vi-Exempt
El Needed (for over 500 cubic yards of grading)
0 Fee El Checklist El APO List with notarized form
RequIred Setbacks
Street:
Side: 15-
Rear:
Actual Setbacks
Street: Side: hAC,
Side:
Rear:
El Detached Structures:
El Rockeries:
El Fences[Trellises:
El Bay Windows/Projecting Modulation:
El Stairs/Deck:
Buildili Height
Datum Point:
Datum Elevation: o
Maximum Height Allowed:
Actual Height:
Other
Parking Required:
Parking Provided:
Lot Area: -Z M-7
1
Maximum Lot Coverage: 35% Proposed: /00 -A
Lot Coverage Calculations: t e k LS ('7 b
ADU Created: (YES / NO)
Subdivision: /,V0
Legal Nonconforming Land Use Determination Issued: (YES
comflients
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Plan Review By:
KanniN Data Form 04-11-06.doc
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CITY OF EDMONDS /--,\TP
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. eAddress or vi I cinity of Construction
-e A),
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0 Owner: '5V PC,/,)
Name C7" 9- /1
��l
Mailing Address
City, State, Zip Code
e Contractor: rkQ n 9—'Y'
Name
Mailing Address
City, State, Zip Code
No. '�? I /to
FkE Issue Date
e Permit Issued To:
/a / Ae
e Type of Work to be Done: b'R iL.- P, t/
e Work in Connection With:
D Sub or Plat El Single Family
El Comml. / Ind. El Apt. Condo.
9 Pavement Cut: El Yes El No
State License Number
_7__7 (' _ 4 9-70
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that rhay be made
against 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 debit or credit will be processed for issuance to the applicant:
Work is to be inspected. Rest'�rauon to be in accordance with City Cod&.Traffic Control to be in accordance with Traffic
Section of City Code. Street to be\kept clean at all times. A 24 -*hour is required for inspection by Engineering.
Call 775-2525, extension 220.
I understand that this permit must be available at the job site for -inspection purposes at all times.
Signa'fure� Date.
_'..Owner or Agent- -
THIS PERMIT MUST BE POSTED AT THE JOB SITE FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: Permit Fee:
Time Authorized: V/011d after —days Security Deposit:
Special Conditions: Receipt No
Fun'&V�Pee:
Ammendments: Stree t Dim'oblns
X
\Nof�s
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
FIELD INSPECTION TNMTES (Fund. 111 - 7ute cony to Street Dent.
or%mm�"+- 0 -
Diagram:
Contractor called for inspection Yes <��
Work Disapproved By: Date: Bv: Date:
Work Approved By: Date: 1p
Inspector:
Ena. Div. December 1978
STREET FINE
PLAN REVIEW CORRECTIONS
PERMIT # - BLD20070910
PROJECT NAME/Address - Madath GAR / 513 2nd Avenue N
Reviewer - Edward Sibrel (Engineering)
CORRECTIONS / CLARIFICATIONS
RESUB
OCT 0 12007
Note on site Plan where side sewer exits house and connects to main
Answer - completed see attached site plan
n Note on site Plan where the water service lies from house to meter
Answer - completed see attached site plan
3) Unable to verify impervious surface calculations. Please include
entire lot coverage, broken out in Rre and post 1977 construction
The impervious calculations are in two sections of the site plan. The pre-1977
construction has 3026 sq.ft. of impervious surface, while post-1977 (current
addition) would add an additional 297 sq.ft. of net impervious surface. Total lot
coverage is 27%.
Please see site plan for calculations.
4) Show how erosion control is to be addressed durin-q construction
Answer - completed see attached site plan
Note - Subject lot is relatively level and stockpiles will be covered with two days
Thank you
Francois Madath
425-985-1867
Francoism(a)arcreports.com
0
City of Edmonds
1215 TH AVENUE NORTH - EDMONDS,
WA 98020 - (425) 771-0220 FAX(425) 771-0221
Website: www.ei.edmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
Permit#: BLD20070910
Plan Review Coffections
Date: September 26, 2007
Project Name/Addres S*: Madath GAR / 513 - 2 Ave N
Contact Person/Address/Fax:
Francois Madath / francoism@arcreports.com
Reviewer: Edward Sibrel
Division: Engineering
During review of the subject submittal it was found that the following information, corrections, or
clarifications will need to be addressed:
1. Note on site plan where side sewer exits house and connects to main.
2. Note on site plan where the water service lies from house to meter.
3. Unable to verify impervious surface calculations. Please include the entire lot coverage, broken
out in pre- and post 1977 construction. A handout to aid you in this is available at:
hftp://www.ci.edmonds.wa.us/CityDepartments/EngrDept/E72-Erosion—Sedimentation_Control.pdf
4. Show how erosion control is to be addressed during construction.
Please resubmit three copies of the revised plans/documents to a Development Services Coordinator. You
may contact me at 425-771-0220 if you have specific questions regarding these plan corrections.
DATE mafled/faxed/emafled
PAGE —OF
nnwv-&—q�
April 2, 2008
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
Website: www.d.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning ! Building - Engineering
Ms. Donna Madath
513-2nd Ave N.
Edmonds, WA 98020
Dear Ms. Madath:
GARY HAAKENSON
MAYOR
To follow up on our conversation on March 6, 2008, your building improvements as issued
under City building permit #BLD 200709 10 have encroached onto an existing City utility
easement for a sanitary and/or storm sewer pipeline across your property. Enclosed is a City
encroachment permit application for you to execute prior to the final acceptance of your building
permit.
In the remote event that the City would need to excavate in order to access the pipeline under
your building, the City would require you to remove a portion of your garage. As we discussed,
if options exist to avoid having to remove the garage in order to make repairs or renovations to
the pipeline, the City will evaluate those options first. This is with the understanding that the
City does not incur costs in excess of the cost to reconstruct the sewer line in its current/original
location.
Sincerely,
NOEL F. I
Public Works Director
cc: Dave Gebert, P.E., City Engineer
Ed Sibrel, Engineering Technician
Street Address File"
Enclosure
2 Me N - 513—Madath_Encroachment.doc 0 Incorporated August 11, 1890
E
T FILE EASE-MENT
IN, CONSI]YbRATION of beriefits to accrue to the grantQrii herein b7
reaso� of the construction .%md estab h-shment el a sewer syst-em, the uncleralpeci
FLOYD R. PRICE
513 SECOND Avc. NORTH
EDMONDS, WASHINGTON
hereby grant to the CITY OF EDMONDS, a municipal corpovation, an 14-'AUMENT,
feet in width, e�eaending feet on efther side of the fol3lowing cle-
pribed centerline, fox, the insta:11, atf.on, operatign and maintpaance cyZ a sanitary and/or
storm sewer line over, across,, through and below the foUlowingdescribed property,
located in the Countw of, Sncihornish, State af' Washingt on, to -witz,
THE NORTH 701 OF THE EAST 35' AS MEASURED FROM THE NORTH AND EAST LINES THEREOF
OF THE FOLLOWING DESCRIBED PROPERTY CONVEYED To FLOYD-R. PRICE:
BEG)NNING AT THE N,W. CORNER Or 3RD & EDMONDS STREETS THENCE N 29018' E
854.9'j,l THENCE N 89057,1. W 359.322 TO THE WEST SIDE OF' SECOND STREET EXTENDED:1.V
THENCE N 31('27140" E 124.16.��,//`THENCE S 57048' E 8.72l/T&HENCE N �32-12" E 55.0 ' O-i
THENCE N 570481 W 110.00', THENCE N 32012' E 80.00' TO THE TRUE POINT OF"'BEGINNING,
THENCE N 320121 E 20.001, THENCE N 57048t W 20.001.,� THENCE E 180.00' MORE OR LESS
TO THE WEST LINE OF SECOND STREET, THENCE SOUTHWESTERLY ALONG SECOND STREET 116.00'
MORE OR LESS TO A POINT WHICH is 5 570481 E OF THE TRUE POINT OF BEGINNING, THENCE
N 57*481 W 139.00' To TRUE POINT OF BEGINNING PLUS A PORTION OF VACATED SECOND
STREET.
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The Grantors herein,, HENRY S-TRUDIVIM, HEDGES and,
�IZZIE HtDGE 9.
htsband-and, Wi�e, their heirs j 'administrators,
executors and assigns, for and in consideration of OkE'HtN
DRED
($100.00), DOLLARS in hand paid 7� 'the, receipt of which is here,-
by-vackn.OWI-e49,jqd,,and. other yaluable, considerations do
..hdreby
g�ve and grant 'unto the CITY'O)F 2DMONDS, State of �.Washingtoh,
In
for the use of the public forever�,, the following easement,,
to -Witt
;The right tq�'construct, recon�truct� 41,ter�,- maintain
and bperate-a,trunk.sewer along and upon the following right-
of-way., to -wit:
A strip of' 'land. 15. feet inwidth being 7* feet.on',
each side of tfie'folldwing�desc
Oibed center-Iine:
Beginningat the intersection of the center 11iie -A
Of S6cond Street and Lidm6nds Stiteet in said City of.'Edmonds
Snoliomish County Washington; thence Southeasterly along.the
cente'V��jft,bl for 10 fee . t hence -No�tfti . gbtet-�--
feet eaaterly of ihe' cent lin6 of
ly parallel to :and .10�
Second,Str6et for 730 97: Pr
�of the Grantors' r e et morO.-ot less,.to the Pouth.line
land; the true pOint" of beginning .:thencQ'�
c
Pntinuing along: same course for 369 fee,
lin fess to
tha North e of, the Grantors I land.
Th,e Grantors herein,
their heirs,, AdminiAt,rAtors
execut.orsi Orfecessors and assigns retain the� right of use and
pos�session. of the property'herein bove described subject'how-
ever to su-ch -use and
Possession as may be nO!ded or req#Ired
f.br the construction, reconstruction, alteration, operation6r
maintenance of said'Tru 'S'Pwer.
DATED 'this-_/__
day of 'DE C-zNfBE,'P, , 1939.
Y
*14K
MAKE REMrrTANCES PAYABL -4.
E -0:
VERNE SIEVER'S F�RST HALF"MUST BE PAID By AP21L
SNOHOMISH COUNTY TREASURER 1971 OR ENTiRE TAX IMCOMES DRN"
SECONO HALF DEI - lNQI_NT AFTER OCT.:v
EVERETT, WASHINGTON 9,3201 REAL ESTATE TAX S'TATEMENT TAX JNDER $I D.00 MU_'T BE PAID IN YIJL�.
SNOHOMISH COUNTY, STATE OF WASH:NGTON
OF ALL STATE, CO!jNTY, &�UN'q�A.L,
SCW'CLI AVD RC'AD TAX-E, TAX MTE I
L E V Y
'7 ASS E S560 VAtlf j�T '10 N DELINQLJEN� O%PE
' ECOID E FMtATE T "i, X
LAND TOTAC GEN-CRAL PROCESS
NUMEER
'ka SFECIAL ACCOUNT NUM
.�YOLPR TAX DOLLAR 7
V0 L L BE C:,TRIBUTED TO TjE r0LLf3VP',C4 -,,!,X D STRICTS:
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ST:ATE Co T, qITY OR
SCHOOL DISTRICT 1971
'6.
T PORT STR,,C:$ GTKER
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PIU�-FIIAL . CHECK BOX Tr_) F
WATER SEWEN FOREST FOkE
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I � . I I I HALF PAYMENT 1 1 HALF TAX
NAME AND ADDRESS LEGAL DESCRIPTI01% I _-, L
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EXAMINE DESCRIPTION OF YOUR PROPERTY
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FIRST HALF MUST BE PAID BY APRIL .30
OR
EVERETT WASHINGTON 98201
EVERETT, WASHINGTON 98207
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REAL ESTATE ST
ENTfRETAX BECOMEr, DEtfNWEW..
SECOND H*F DELINQUENT AFTER OCT-31
TEIMENT
'Cotmr 4
TAX UNDER $10.00MuST BLr PAID IN FULL.
ITAX
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HALF PAYMENT
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PLEASE PR?Nl CHANGE OF TAXPAYER
NOTICE:
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OR CI4ANC-E OF ADDRrSS BEL 0 �*w
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NAME
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ADDRESS
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CITY $TATE_ ZT. P
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DATE OF CHANGE
-------------
EXAMINE DESCRIPTION OF YOUR PROPERTY
CAREFULLY
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