550 HEMLOCK WAY.PDF1111111111 lill
11497
550 HEMLOCK WAY
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:— DETERMINATION: E] Conditional Waiver F] Study Required' figgaiver
DISCRETIONARY PERMIT ft'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:w
SCALED PLOT PLAN DATED: 0 ?,� � Up
SEWER LID FEE $:
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED: ldpdco-�)
SIDE SEWER PERMIT(S.)
GEOTECH REPORT DA
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
LID #:
BLOCK:
LATEMKDS'Ps\Fomis\Street File Checklist.doc
#P20
CA File No:. (0
Critical Areas Checklist
Site Information (soils/ topography/ hydrology/vegetation)
1.. Site Address/ Location: Me-A(6&,
i - 7
2. Property Tax Account Number: 0 C-> "L 0 0 / ? 25'yom I mocco
3. Approximate Site Size (acres or square feet): 0 CSF
4. Is this site currently developed? yes; no.
If yes; how is site developed?..,
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
F
Rolling: slopes on, site generally less than -15% (a vei tical rise of 10-feet over a horizontal
distance of 66-feet).
Hilly: slopes present on site.ofmore 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-fee
Other (please describ e):
6. Site contains areas of year-round stan
,din AppTox.,Depth-
g water:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway AA fl
oodplain vx-o of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-rou nd?
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:
For City Staff Use 0 nly
I Plan Check Number, if applicable? &/A
2. Site is Zoned?. 9S
3. SCS mapped soil type(s)? GL A-0 R7.
4. Critical Areas inventory orC.A. map indicabes Critical Area on site? Erces"(nn -O'X�
�0 M-6-W �� cw\ enr-
5. Site within designated earth subsidence landslide hazard area? Q
4-1-M -on
DETERMINATION
�X*cobes, e\cA
s
e.
Reviewed
I* #�P20
City, of Edmonds
Development Services Department
Plannig 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 thi 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. Theinformation
needed to complete the Checklist should -be easily
available froin observations of the site or data available at
City 'Hill (Critical areas.. inventories, maps, . or soil.
surveyel
0
DateReceived:
City Receipt
Critical Areas File#:
Critical ' Areas Checklist Fee:—_A135.00
Date,Mailedto Applicant.. _511,6166 -
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 checklistmake 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 f6mi 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 preliminary. Assessment of the site.
The undersigned applicant and his/her/its heirs, and. assigns, 'in consideration on the processing of the -application agrees
to release, indemnify, 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 fumished'by the applicant, his/her/its; agen6 or employees.
By my signature, I cer* that theInflormation, and exhibits herewith . submitted'are true andcorrect to the best of my
knowledge and that I am authorized tofill tuhis appli/ation on the behalf of the owner as listed below.
'o
SiGNATuRE oF APPLicANT/AGENT DA '2P0(,
TE
Property Owner's Authorization
By my signature, I certify that I have authonized,the above Applicani/Agent,to apply for the subject land use application,
and grant my permission for thepublic officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and postm*g attendan to this application.
SIGNATURE OF OWNER
DATE
PLEASE PRINT CLEARLY
Owner/Applicant:
C7"
Name.
r'_0GV [+441
Street Address
city State Zip
Telephone:_415 - 14 1 o1q,0
lekl'
Email'address (optional :
.Applicant'.,,. presentative:
Name
Street A(�qqss
C2
City State zip
Telephone:
Email Address (optional): gq e— & e
0 0
PLANNING DATA
NAME: Gjt-n 4 t4e#.iixt,- Owen DATE: &113101, . I
SITE ADDRESS: 5-6 H-e -N I -cje W!�!, PLAN CHK#: OL - 7-4 7-116 LZ 2,% 0
PROJECT DESCRIPTION: ff-^L2q
ge-A'6u,,�
REDUCED SITE PLAN PROVIDED?:AQ/60
11��
MAP PAGE: 153 CORNER LOT: (Yes I FLAG LOT: (Yes
ZONING:— F-5 - 1-" CRITICAL AREAS DETERMINATION M-0 S-L
L3 Study Reouired:
2"Waiver
0 Conditional Waive,
SEPA DETERMINATION:
QFee
Q Checklist
Q APO list w/ notarized form
Ll (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
LdExempt
SETBACKS:
Required Setbacks:
Street: 4o' Left Side: S' Right Side: Rear: )9
Actual Setbacks: h
Street: - -55' Left Side: 2-0' Right Side: '24' Rear: 2-4'
Street map checked for additional setback required? (Qs IWO' / Dt!Aj p /
0 DETACHED STRUCTURES:
L3 ROCKERIES:
Ll FENCESITRELLISES: 6,e,
L3 BAY WINDOWS / PROJECTING MODULATION
n QTA10Q I ncrIve
S kola.'
PARKING: Required: Actual: 2- 112.9 "'—
LOTAREA: SZ3�117 3�,o` /636o
LOT COVERAGE HA&.2-6 i0b.
Calculations: �,Z9 3 j,'f
BUILDING HEIGHT:
Datum Point: WW4`1 fox+Lr Datum Elevation: 0Z
Maximum Allowed: 2 t.') Actual Height:
A.D.U. CREATED?: (4g/ S)
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes /A)
OTHER:
Plan Review By._
("P
NewB PPlanningDataForm. DOC
The City of Edmonds
57—
,,OWNER ............ ... ......... Z---
HOUSE No . ..... :5 ..... ..... ----------
APPLICATION- CARD No . ......................................
for
SIDE SEWER PERIVHT
EASEMENT No - -------------------------- ----------
OUTSIDE, El JNSIDE F1 REPAIRS
PERMIT No.
CONTRACTOR ... ------------ ....
--------------
STREET
No. BIAD�CK No . ...............................................
---- ------------------------------ AVENUE WT
NAMEADD . ..............................................................................................................................................................
I�ate Approved:
BACKFILL.-WO.RK,6RDER ISSUED ................................... DEPOSIT, $ ............ .......................
SEVVER WORK WIDER ISSUED ........... ...... ...... DATE
A Of
Eb,i,,_
CITY OF EDMONDS SIDE SEWER AS-BUILTI
A
c) ADDRESSi
550 HEMLOCK WY
CONTRACTORi HOMEOWNERi
xxxxx OWEN
DATE INSPECTEI)i INSPECTED BYi
08-16-2006 JH 7
PERMIT
NO. ENG20060341
NTS
TE DRAWNi DRAWN BYi
08-08-07 1 J.TRIEU
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HEMLOCK WAY
CITY OF EDMONDS WATERLINE AS -BUILT
ADDRESS, PERMIT
550 HEMLOCK WAY No- 2006-0957
CONTRACTOR: HOMEOWNER1 SCALE;
PAUL PERRIGO I OWEN I NTS
DATE INSPECTED1 INSPECTED BY: DATE DRAWN: DRAWN BY:
8/17/06 1 E. SIBREL 1 8/21 /C 1 1. ABILA
Z
0
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0
0
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
550 Hcmlock Way
0 Owner: Washington Natural Gas
Name
805 156th Ave. N.E.
Mailing Address
Bellevue, Wa. 98007
City, . State, Zip Code
0 Contractor: Same as above
Name
Mailing Address
11nit No. 8) D
Issue Date
0 Permit Issued To: U) 0� G
0 Type of Work to be Done: see attachne sb-nt
9 Work in Connection With -
El Sub or Plat Ysingle Family
El Comml. �0141. El Apt. Condo.
Pavement C4JJ'L!1,._E1 Yes El No
State License Number
City, State, Zip Code Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
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 whanoever, foreseen or unforeseen, that may 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. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be' kept clean at all times. A 24 - hour notice is required for inspection by Engineering.
Call 775-2525, extension 220.
I understand that this permit ilable IL;bz4ob sit- for inspection purposes at all times.
Signature Date 8-.16-83
Owner or Agent
THIS PERMIT MUST BE POSTED A� TH E JOB SI TE FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Vold after /0 0 -days
Special Conditions:
Ammendments:
Permit Fee: W30, 00
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
� X
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. Decembcr 1978
FIELD INSPECTION OTES
(Fund 111 - .91te cony to Street , Dent.
r^mm,-� " +- a -
Diagram:
Contractor called for inspection
Work DisaPproved By:
Work ApDroved By:
Inspector:
Date:
Y es
Date:
By: Date
Enq. Div. December 1978
iton
NakwfiblGas
AVAW-910n&WWC-VffV
City of Edmonds
Public Works Department
Right - of - Way Construction Permit
Gentlemen:
Washington Natural Gas Company hereby applies for permission to:
Permission is requested to install a 2" plastic gas main in
Hemlock Way from 185' to 190' West of the center line of 6th Av.
South and from 5' to 15' South of monument line of Hemlock Way.
To serve the address of 550 Hemlock Way.
P.A.D. 833-203
Reference "Verbal Permit" #83-211 dated 8-16-83
We would like to begin construction about August '83_ and will require
approximately - 60 days to complete the work. If we have your
approval to proceed, please sign and return the original of this form.
(Please enter any special conditions.)
Application Date 8-16-83
WASHINGTON NATURAL GAS CO.
Tony P. Tessitore
Distribution Engineer
Eastern Division
Washington Natural Gas is hereby authorized to perform the work
described above in accordance with their franchise responsibilities
and are further subject to all applicable federal, state, county and/
or municipal ordinances and specifications.
Approval Date kv
805-156th Avenue North East, Bellevue, WasMngton 98M Telephone (206) 2M4101
CITY OF WHONDS0%
City InSineer's Office
COMPLAINT REPORT
Report No. 72-10
Referred to for Action William Nims Time2:15 pm - Dato---3/6/72
Received By _ Bbada Eonch TimejL.3o In Date 31§Z72
Made BY Mr. r.A. Keserve Address 550 Hemlock Way. Tel, 776-2543
Aow Received: Letter Telephone In Person xx
4ature of Complainp Draiparg -diverts ftK= Sgamont Wne -9"o hj§ pgaerty tbXMh
ime
ngineer
)escribe Act
VT �
Completed:
!'ime Date Completed
�ocstion Sketch:
ZQ
50
1, �--4 ?,"Ll WE �/O 1�-Mhlt-07-
77
i,7+4 AVE-
"w
0
4
I-
.1
is!'CULVEZI
9
0
0
Z,
NEVISW
2 NTS
Nw view
NT
HEMLOCK STREET
EXST.
11"Tw
MEMR
PAM*
100.0
CORNER
EL.= 100.0' T
0
15ST5K 0
t�ep Coue-fZ61>
NE kRY
ADDITW ENT
ION Tk
FIR
A _ ST NEW CONC.
ADDITION AT FIR
F rLOOR LUALKWAY
LOOR
POINT A
EL,= 101.0
POINT C I
rzL,= 101.0'
CORNER I
EL.= 102.0'
m
EX6T.r-ENCET0
REMAKTYP.
site 101an
r-10-0
EXISTING
DRN/EWAY
il "GOOR000w7m I wNriwWWWA
SITE PLAN NOTES:
BUILDING HEIGHT CALCULATION:
- POINT A = 101"
- POINT 5 = 101'
-POINT C = 101'
-POINT D = 101'
AVERAGE GRADE = 404/4 = 101'
MA><IMUM HEIGHT = 12ro'
ACTUAL HEIGHT = 123.2'
GLEN 4 HEATHER oLUEN
4TACT PERS09-
ERIC: GEDNEY I ARC141TECT
206-5271-4TI28
(n
V) LF-CiAL DESCIRIFM09.
EX5T. TELEPHONE
TPOLE SEC, 25 TWF 21 RGE 03 RT-14,4-3) BEG SW COR 5WI/4 NWI/4 NWI/4 TH NAL6
50 SUB 3e&FT TH E 312.e8f:TTO TP5 TH CONT E &OFT TH N II-IFT TO .5 LN
4 HEMLOCK ST TH W 6OFT TH, 5 II-1FT TO TP5
ZI LM.INFORMATI09-
I CORNER
41
0 V) EL.= 100.01 PARCEL NUMBER 21032500210200
M V_ V)
ZONING Re-ro
LOT SIZE- 133roo .5F
MAX. LOT COVERAGE (35%) 3,216 SF
POINT 13
5
EL-= 101 -c
1. F" -011
SIDE
-
=^1%.71 INIL3 LoLo;Y =MAkQ;t:
NEW ENTRY ADDITIONAL COVERAGE
1125 Sr-
513 55
YARD
,SET5KI
TOTAL LOT COVERAGE-
1,16*1 SF
R-VK)-IJS SURPACrE CAL-CALAIM-
EXISTING HOUSE (PRE-Ic3l-D
2,OF,4 5F
EXISTING DRIVEWAY (PRE-jej-D
I'Ma 5F
TOTAL EXISTING IMPERVIOUS SURFACE
3,232 5F
mu
3 6
10
I M-1
V
d)
PROPOSED HOUSE ADDITIONAL COVERAGE: 32
T L PROP08ED IMPERVIOUSSURFACE: 3,264 5F
QLAZING CAL-CMLAnOR,
GLAZEDAREA IN WINDOWS: 3,15.11 5F
GLAZEDAREA IN DOOR& 53.33 5F
TOTAL GLAZED AREA: 425.44 5F
TOTAL HEATED FLOOR AREA. 2,30ro 5F
%' OF GLAZING TO FLOOR A REA 1&.5910
LI$T OF
A-101 SITE PLAN PROJECT INFO.
A-102 DEMOLITION PLANS
A-103 STRUCTURAL DETAILS
ki'104 FOUNDATION PLAN, NOTES
A-;)O5 FIRST FLOOR PLAN W/ STRUCT,
A-�O(b SECOND FLOOR PLAN W1 STRUCT.
A-201 EXTERIOR ELEVATIONS
A-�301 BUILDING SECTION, INT. ELEVATION
A-0 ELECTRICAL PLANS
CIM4ERAL NOTE-&
ALL WORK UNDER THIS CONTRACT SHALL Cb�`IPL-T- WITH TH;=
CURRENT EDITIONS OF THE U�41FOIRH BUILDING cdor= AS AMENDED
BY LOCAL JURSIDICTION, THE UNIFORM PLUMBING CODE,
NOATIONAL ELECTRIC CODE ANS, WA STATE DEPT. OF LABOR AND
INDUSTRIES REGULATIONS
2. GENERAL CONTRACTOR SHALL VERIFY,4ND COORDINATE ALL
EXISTING AND NEU) SITE CONDITIONS BEFORE AND DURING
CONSTRUCTION AND INFORM THE ARCHITECT OF VARIATIONS
BETWEEN THE CONTRACT DOCUMENTS AND EXISTING CONDITIONS.
3, 20 N07'6CA4EZ;'i'P�,4_W1Nra6. VERIFYALL DIMENSIONS ON SITE,
7- 1 CORNER
4. DIMENSIONS SHOWNARE TO FACE 05 CONCRETE OR MASONRY,
NORT14
FACE OF FRAMING MATERIAL OR CENTERLINE OF POSTS OR
0 51 10, 20 1
INTERIOR PARTITIONS UNLESS OTHERWISE NOTED.
VERTICAL DIMENSIONS ARE TO TOP OF SU5FLOOR AND TOP OF
PLATES UNLESS NOTED OTHERWISE.
DOORS ARE DIMENSIONED TO PANEL SIZE AND WINDOWS ARE
OWNEWCONTRACTOR IS RESPONSIBLE
DIMENSIONED TO OUT51DE OF FRAME, U.N.O. CONTRACTOR 15
RESPONSIBLE TO CALCULATE NET SIZES BEFORE FRAMING AND
FOR EROSION CONTROL AND DAMAGE
ORDERING,
CONTRACTOR TO UNDERSTAND AND ACCOMMODATE FOR ALL
IMPLICATIONS OF GALVANIC REACTION BETWEEN PRESSURE
TREATED MATERIALS ANDA55OCIATED CONNECTORS TO AVOID
CORROSION.
ADD GUTTERS /DOWNSPOUTS
AND SPLASHBLOCKS
A1*Pn1(*1A,'E'L) AS NOTED
BY EqGINEERI
Date:
APPROVED BY PLANNING
Zone 9-S-& Corner Flag_
Setbacks RegWred
Front 2.0-
Sides 4'— 201-:24—
Rear 11;
Other
Vewht 2 1. 2 [12 3 �2')
RECEIVED
REET FILE MAY 2 3 2006
BUILDING DEPARTMEN7
CITY OF EDMONDS
6530 � REGI�TERED
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