6809 164TH PL SW.PDF887
6809 164TH PL SW
hi
PROJECT REVIEW CHECKLIST
PROJECT NAME:
PROJECT ADDRE'IS:-
PLAN CHECK
RECEIPT DATE:—f-izL---5l'S--*'
JREVIEWrD
BY- (Initial/Dat6
PLAN.
W
WATER
COM'MENTS
FIRE
I BLDG....
SEWERISTREETI.
ENG-...:
Setbacks/Variance/Setback Adjustment
Conditional Use Permit
AD13 Requirements
Other Zoning Re uirements
. ......
Underg ound Widng Required
. . . . . . . . . . . . . . . . . . . . . . . . . . .
Lot Slope 15%
....... - -- ---
SEPA Environmental Checklist/Hydraulics Permit
Tree Cutting Plan
Plat/Subdivision Requirements
Legal Description Verification
. . . . . . . . .
Quit Claim/Street Dedications
...........
.
4
Easements - Public/Private
Engineering Storm Drain Reviewfee '!�3�
Engineerin 2.2 Inspection Fee
Drainage Plan (On -Site)
Setback - Top of Bank, Stream, Water d-ourses
Setback - Storm Drain Line
Open Ditch - Existing
Culvert Required
Cuivert Size
Shoulder Drainage/Shale Open Runoff
'21
Catch Basin Required
:22
23
Driveway Slope & Vehicle Access
#red
Sidewalk R2au
24
Curb & Gutter Required
26"
Curb Cut For Driveway Required
Street Paving Required
M.-I "17 Y
27
Right -Of -Way Construction Permit Required
28
Street Name Sign Required
..... . . ...... . ....
. . . . . . . . . .
29
Other Signing Required
:30
Bond Required For Public Improvements
:31
FEMA Map Check/Water Table
32
Side Sewer Availability
.33
Calculate Sewer Connection Fee If No LID #,9-g>
34
35
Create Street File t,&�f5
Existing Water Main Size
................ ........ ......... . . . . . . . . . . . . . . . .
........ .............. .
:::.36
Water Meter Size
:27
Service Line Size
::..38
Water Meter Charge Required
. 9
Hydrant R"uired
40
A I --L.
Irm.1
Hydrant Size Existing
A
Fire Line Charge Required - Sprinkler
:742,'
Street Cut
.4
Miscellaneous
. ...........
7-
...44
Reviewed By:
FIRE
PLANNING
Y-D*
ENGINEERING
FUbL4GlW0Rt,-
PUBLIC WORKS
tJD 5%'I-P, � t,, , +b ve,,4e,,,3 .
FILEDATA1 23/PROJCKLS.SFN
V-V�
1
21
2
22
3
23
4
24
5
25
6
26
7
27
8
28
RW PERMIT # DATE ISSUED RECEIPT #
9
29
10
30
11
31
12
32
13
PAID $ RECEIPT # DATE
33
SS PERMIT# 870 DATE-ISSUEoV/-3 RECET I I
14
PAID $ RECEIPT 11 DATE
34
15
35
16
36
17
37
METER SIZE4/-/ PAID $ DATE RECEIPT #ZI014'�
18
38
19
39
20
40
NOTICE:
No warranty of accuracy.
The information shown on the attached map(s)
was compiled for use by the City of Edmonds,
its Employees and Consultants. The City of
Edmonds does not warrant the accuracy of
anything set forth on these map(s). Any person
or entity requesting a copy should conduct an
independent inquiry regarding the information
shown on the map(s), including, but not limited
to, the location of any sewer stub shown. Such
sewer stubs may or may not exist and may or
may not exist at the location shown. Neither
the City of Edmonds nor its employees or
officers shall be liable for the information given
on map(s), nor for any one representation
provided based upon said map(s).
Water Service Drawing
The City of Edmonds EASEMENT NO . ........................ ...........
OWNER.................... ................
JOB ADDRESS 1.
... ...............
NEW CONSTRUCTION REPAIRS LID NO . ...... ....... I ... ASMT. NO. - ................
............. I ........ CONTRACTOR ........................................................ ....................... ... PERMIT NO . ....................
.................... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
..................................................................... ........... I .......................................... ...... ......................
NAMEOF ADDITION ....................................................................................... I ...... I ...................
IV
eZ 14/
Approved:
e
PWW-0001-11175 (REV. 11/78) DATE ..... Y.711_lf ................ By
-D,4y5
CITY OF EDMONDS
18 9 0 1 9"Z
Address of Construction:
SIDE SEWER PERMIT
PERMIT �\,'O 87,
il-213 q 016
Property Legal Description (Include all easements): ni a MyORKS DEPT
10T 7- AjAdRwdAle'l�-el
7Y/ coo -CO —Q�?o
L Q�D
Owner and/or Contractor: —(:P, Ax-r'j A)
State License No. h\7 Building Permit No.
2" Sii n
gle Family
Multi -Family. (No. of Units
commercial
Public
Invasion into City Right -of -Way: M No Yes
RW Construction Permit No.
Cross other Private Property- J'�l No Yes
Attach legal description and copy of recorded easement
"I �N
I certify tha`M-.F`av'e read and shall comply with all city requirements
as indicated on the back of the Permit Card.
ail�—,_3 — q Le
Date
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE. USE �.ONLY�
FOR INSPECTION CALL 77140W,-PUBLIC WORKS DEPT.
Permit Fee: Issued By
zq � -96
Trunk Charge: Date Issued:
Assessment F ee: Receipt No.: 2/0
Lid N o.
Partial Inspection: Date-7—Initial
Comments
Reason Rejected: Date —Initial
Final Ins*pection Approved: Date�_-54b lnitial�_/4
PERMIT MUST BE POSTED ON JOB SITE
White Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 3190
The City of Edmonds Side Sewer Drawing EASEMENT NO . ............................................ !-
NEW CONSTRUCTION REPAIRS E] LID NO . .................. . ASMT. NO . ..................
OWNER................................................................................................ CONTRACTOR .................................................................................... PERMIT NO. V.� c?
JOB ADDRESS ......
LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
.................................................................................................................................................................
NAMEOF ADDITION .......................................................................................................................
Y-C CD 11
Dee-P -A De"-,p
F(3 (of
LP
Approved:
PWW-0001-11/75 (REV.11/78) DATE ................ By ............................... ..... ............
890 - 199 -
Ci, t of Edmonds
-Y
RIGHT-rOFMAY CONSTRUCTION
-A PERMIT
Permit Number.
Lssue.Date:
A. Address or Vicinity of C6nstruction: 6809 6811 164 P1 SH
B. Type of Work'(be specific): Tinntall Spry rp- (9 S11574)
1A
C. Contractor: WashIRStoij Natural (;as
Mailing Address: 1122 755St SW Everett
State License #: 98203
D. Building Permit # (if applicable):
Contact:
Phone: 356417500 ext 7596
Liability In!!99ce: Bond: $
Side Sewer Permit # (& applicable):
E. E] Commercial 0 Subdivision El City Project Rj Utility (PUD, GTE, WNG, CABLE, WATER)
Fj Multi -Family [] Single Family E] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut 0 Yes FK]No G. Size of Cut: x H. Chargq_$
APPLICANT TO READ AN0'- SIGN -I(LI
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold , 1)i6�tyofEdmondshar is ftom ir�Wyies, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmo=, or any di itVitcpartntent. or
employees, including or not limited to the defense ofany legalproceeding8 including defense costs, and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
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 diteges shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit will be
availableonst at aalll t*,nes for inspection purposes.
Signature: Date: 4--5=9-6
'Y7ntractor WA��—nt)- /
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
TOR,CITY USE ONLY
10
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
0 NO
I&A a-Armon"
Waft WWII
NaturiilGas
AVMOwKjtcnErrWCcffp-TV
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
4�5\IQ
^ V
\/V
J05 cf(111 1 15-:� 13
it .
j or-!>, 9 4-
1 64- PC
Q
Key .* *
-w- Water
Watermain depth QIAS. -G- Gas
-SS- Sever
-& Water hydrant
L/4- gas main 0 Water valve
Washington Natural Gas Company
1122 75(h Strcet S.W., Everctt, Washington 98203, (206) 355-3331
d
iMMG3S-
A VAYJvxjtcn Erergy Go ni"pmvv
1 (0 5
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
4�5\lv
J C>5 ct(. I 15—:�
i� .
j *9 c-o 1.1 .5 -+ 4-
co
64- PL
SW
Q <C-L�ks
Key:
-W- Water
Vatermain depth -G�- Gas
-SS- Sewer
VAgas main -e, Water hydrant
- 0 Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
K�
M=Gas—
AWW�E--WC-rpevv
1 (0 E) ..
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Marianne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
^V
w
JC>5 cm, I I
it .
j 0 r5 9 4-
(x__11B09 164- PL.
Key:
_W_ Water
Watermain depth Q/A, -G-�- Gas'
_SS_ Sever
-e- Water hydrant
gas main 0 Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
890 . 199-
CITY OF. EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works * Planning * Parks and Recreation e Engineering
Mailed 9/20/95
September 20, 1995
Phil Lund
Andrew Austin Co
9004 - 191 st PI S.W.
Edmonds, Wa. 98026
Re: Johansen SFR at%N09-1�;-,16-4h �,Pl and 6811 - 164th P1
Grading and drainage plans
Dear Phil,
LAURA M. HALL
MAYOR
In the process of reviewing the subject permit applications, I found the grading and
drainage plans to be incomplete. In order for me to verify the grading quantities, the site
plans (drawn by Chuck Lee) need to incorporate the existing contours with the new
contours. The drawings submitted do not allow me to verify the grading quantities. In
addition, please show how the roof tightlines connect to the existing catch basin in the
street.
If you have any questions, please call me at 771-0220, extension 324.
Sincerely,
Wafler
Addison L. Chrisman IV
Engineering Inspector
ALC/sf
JOHANLTR.DOC'
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
RECORDED
UTILITY EASEMENT
'95 NOV 29 P 1 :12
SUB if POILLIGEP ,
r-649H '"IqH
Know all men by these presents:
That we the undersigned owners of the land known as
Meadowdale Heights lot 7 and lot 8 recorded Vol 46
page 124 records Snohomish Co Wa hereby subject a portion
of lot 7 to an easement for the benefit of lot 8 of
said subdivision.
The easement is intended to allow for the positioning
of utilities (gas, water, sewer, power, storm water, etc)
on a.portion of lot 7.
The easement area is more particularly described as a
strip 101 wide on the easterly boundary of lot 7
running adjacent to, and parallel to 164th Pl SW.
.-'rheresa Aldridge.- Date
STATE OF WASHINGTON,
County of
On this day personally appeared before me
7xexlv-sl�
to me known to be the individual. described in and *ho executed the'within and foregoing instrument, and
acknowledged that 5'A e signed the same as free and voluntary act and deed, for the
uses and purposes therein mentioned.
NO EXCISE TAX
REOUIRED '
'qOV 2 9 1995
I -,'IRK[ SIEVERS, SoohomA (ounly Treosm
By KIRKE SIEVERS
GIVEN under my hand and official seal day of /�/a z., e 19 -5'—
J oil
. .........................................................
Notary Publk i
for the 51ate of Muton
00 MMA XBAKER
F. 9226 00 fesidint at
00
10,
(P V*10140 J
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Of- W
PROJECT REVIEW CHECKLIST
PROJECTNAME:- PLAN CHECK #:2��—
PROJECT ADDRESS:
'4z- 1 Is RECEIPT DATE:
COMMENTS
FIRE
PLAN.-
BLDG...
ni iaal/Da
WATER.,
SEWER. STREET.
e)
JENG.....
Setbacks/Variance/Setback Adiustment
Conditional Use Permit
M
AD13 Reguirements
Other Zoning Requirements
Underground Wiring Required
.....................
IV
Lot Slope 15%
XX
SEPA Environmental Checklist/Hydraulics Permit
Tree Cutting Plan
8
Plat/Subdivision Requirements
Legai Description Verification
Quit Claim/Street Dedications
. . . . . . . . . . . . . . . . . . . . .
Easements - Public/Private
Engineering Storm Drain Review Fee
12
Engineering 2.2 Inspection Fee
:.13..
Drainage Plan (On -Site)
Setback - Top of Bank, Stream, Water Courses
Setback - Storm Drain Line
g
Open Ditch - Existing
--
--------- -
. . . . . . . .
Culvert Required
Culvert Size
2 Q
Shoulder Drainage/Shale Open Runoff
21.
Catch Basin Required
22
Driveway Slope & Vehicle Access
23
Sidewalk Required
Curb & Gutter Required
.24.
25
Curb -Cut For Driveway Required
Street Paving Required
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - - - - - - - - - - - - - - - - - - - - - -
..........
26
27
Right-Olf-Way Construction Permit Required
EMN..
28
Street Name Sign Required
. . . . . . . . . . . . . . . .
29
Other Signing Required
. . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . .....
30
Bond Required For Public Improvements
N'
FEMA Map Check/Water Table
. .
31
Side Sewer Avalla
............. .
M-0
....
...........
32
.33
Calculate Sewer Connection Fee If No qDY�a�
Create Street File
WIN-.
1 1:35
�34
1
Existing Water Malin
.............
. . . . . . . .
36
Water Meter Size
WQ
............. . .
Service Line Size
-0M
:-.38
Water Meter Charge Required
N
.
-39
Hydrant Required
40
Hydrant Size Existing
. . . . . . . . . . . . . .
Fire Line Charge Required - Sprinkler
Street Cut
Miscellaneous
Reviewed By:
FIRE
PLANNING
FILE:DATA1 23/PROJCKLS.SFJ$
oTrREET FILE:
ENGINEERING
l`UbLK.;1W0Ri-"
PUBLIC WORKS
V'"e".3 .
V—)ff-n-�
-k . PERMIT APPLICATION REQUIREMENTS
To: Applicant
From: Lyle Chrisman, Engineering litspector
Owner:Aa&� J,4&J. �6AOIW5eW
Address:
Plan Check No: +57., 1 j57 -7
Date. 11124 /-oly
After review of the subject permit application, the following requirements must be met
1. Construction hours are:
WEEKDAYS — 7:00 A.M.40:00 PALWEEKENDS/HOL'IDAYS — 10:00 A.M.-6:00 P.M.
2. A separate RIGHT-OF-WAY CONSTRUCTION PERMIT is required for all work on p ublic property. (ECDC 18.60)
3. Truck haul route plan must be submitted and approved prior to permit issuance.
4. Builder/owner Is responsible for containing all temporary runoff and erosion control on site.
(ECDC 18.30.030d)
NO WORK SHALL BE DONE WITHIN 15 FEET OF STREAMS OR 10 FEET FROM ANY CLOSED DRAINAGE
FACILITY- BUILDERJOWNER IS RESPONSIBLE FOR IDENTIFYING CONDITIONS ON THE DRAWING. (ECDC
1&30.50G)
FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCTIO
(ECDC 18.30) N
INSPECMONS ARE REQUIRED ON STORM DRAINAGE SYSTEMS, TIGHTLINES AND CATCH BASIN
INSTALLATIOM INSPECTIONS ARE REQUIRED PRIOR TO BACKFILLING. (ECDC 18.30)
Repair or replace all defective existing curb, gutter and sidewalk adjacerit to the property. if an Intersection is involved, a handicap ramp
ssuan erm
may be required. Contractor shall meet with the City Engineering staff to determine the extent of rep* prior to L cc of the p 1L.
(ECDC 1&90)
Driveway slope shall not exceed 14% Without a waiver. Every aftempt should be made to keep the slope below 14%. Waiver granted to
0/6. (ECDC I&SO.060D)
Driveways must be paved fiom pro" line to City RIGHT-OF-WAY. A separate permit is required. (E*CDC IU0.060C)
INSPECTIONS ARE REQUIRED ON DRIVEWAYS AND SIDEWALKS PRIOR TO AND AFTER POURING. (ECDC 1830)
No burning of construction r4ise without a permit from the Fire Department
Connection to City water system is required. Them is a separate charge for the WaW I meter.
(ECDC 7.20)
A back water valve Is requimd if downstalm plumbing is below the elevation of upstream manhole.. (ECDC 7.20)
Water and sewer main lines should be separated by 10 fed minimum. (ECDC Ig.10)
Conncc4Pn to the City sanitary system Is required. A
LM# Z4ez7 Fees paid: Yet NO
(ECDC I&IOY
Undergrourtd, wiring is required on all new construction, and for additions, alterwfions, and repairs that exceed 50% of the total assessed
value of the structure. (ECDC 1&90)
1. A FINAL ENGINEERING INSPECMON IS REQUIRED PRIOR TO THE BUILDING DIMON GRANTING OCCUPANCY
OF THE BUILDING OR STRUCTURL (ECDc 1&90)
il-tT"""" A L E
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RECEIVED
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PEW COUNMR
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AGCFp-TAlBLF-t4.12 ADS
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pipe
RA 'ToRovcR '�x.&-
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APPROVED AS NOTED
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LOT 7. MEFA'0owrjA.L_E- t4E-:jr_H-rj
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SPOT EUVARON DISPLAY
PHEL LUND
RUMeDUFFY & ASSOCIATES, INC.
LMD USE CONSULTAP(JS
DATE 8-10-95
DRF.
SCALE: 1" 20'.
Ir ..,RS 0 SMUM 0 PLAMERS 0 UNWAMIT
VmG uf-
JOB 95153
OM MM MM. WASOMOR $5201 (WO M-4438 TAX (206) rA-1616
SIR OF-!—
SITE DEVELOPMENT SERVICES
July 24, 1995
Phil Lund
Andrew Austin Co.
9004 - 191st PI SW
Edmonds, WA 98026
Re: Lots 7 & 8 Plat of Meadowdale Heights
Dear Mr. Lund:
SEP 18 1995
PERMITCOUNTER
',In response to a verbal request by Don Fein at the City of Edmonds, I am herein certifying
that the drainage system for the subject plat has been designed to accommodate the runoff
from the subject lots. The hydraulic calculations done for the plat were divided into three
drainage areas, with the subject lots being in area 2. (See pages 2 and 3 of the
calculations.) This area consists of 2.17 acres, with the other two areas covering the
balance of the 10.6 acre plat.
Although the calculations don't specifically outke the limits of each area, the acreage's
with their related detention volumes account for the entire plat area. T11us, if the
developed areas of lots 7 and 8 are connected to the drainage system in 165th Pl., the
detention system there will accommodate the runoff and provide the required detention.
The above statements in no way certify that adequate fall exists from the proposed house
sites on lots 7 & 8 and that the overflow elevation in the detention systemAill not result in
a back up onto the lots. T11e elevation of the overflow in the flow restrictor and the pipe
invert in the catch basin to which the house sites will be connected should be verified prior
to construction.
David C. Dougherty, P.E.
'I
rL L W c 0 v. ( ��,
0 k C,
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ti a i I REET FILE
310 - 208th S.E. Bothell, Washington 98012 (206) 481-9687
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GEOSCIENCES INC.
POSt Office Box 6966
Bellevue, WA 98008-0966
Telephone (206) 867-3297
Focsimile (206) 881-864V
DODDS GEOSCIENCES
Srj��O'
Philip Lund
c/o The Prudential Preferred Properties
20115 - 44th Avenue West, Suite 101
Lynnwood, WA 98036
Subject: Geotechnical Engineering Report
2 Lots: 68XX - 164th Place Southwest
Edmonds, Washington
Dear Nk. Lund:
PAGE 02
11 Twii! 7 C 0' FrR � Y
Pk Job Number 5086
September 7, 1995
We are pleased to present this Geotechnical Engineering Report for the proposed single-family
residences to be constructed on the vacant lots (Lots 7 and 8) at 68XX - 164th Place Southwest
in Edmonds, Washington. The purposes of our work were to professionally evaluate subsurface
soil and groundwater conditions, recommend general procedures for the grading and underslab
treatment under the buildings, provide a reasonable foundation method with design guidelines,
and recommend design earth pressures for basement and/or retaining walk The scope of our
services included:
1) Logging and sampling four test pits excavated to a maximum depth of 4.0 feet below
existing grades. Test pits were generally located in such a manner to provide broad
poverage of the proposed building lots. Test pits were excavated with a mbber-tired
backhoe and logged by the undersigned engineer. Selected samples were taken of
sub�urfkce soils.
2) Reviewing collected soil samples in our office and assigning appropriate laboratory
tests consisting of moisture contents. At the conclusion of the testing program,
laboratory results were analyzed and compared with field notes and logs.
3) Preparation of this summary report in accordance with our understanding of project
requirements and generally recognized ?eotechnical engineering practices. We have
attempted to meet current City of Edmonds requirements in the preparation of this report.
No other warranty is expressed or implied. Plate 1, attached, provides the guidelines in
the use of this report.
Proiect Understandings
T'his office was provided with an 8 1/2 x 14 inch copy of a portion of a topographic survey which
described existing conditions at the time of the survey. The approximate location of the two
Proposed residences were drawn onto the plan. Our knowledge of this project is generally
limited to the information contained on this plan copy and descriptions of the project by Mr.
Philip Lund. Ihe new structures will be a multiple -storied and wood -framed,. with possibly a
daylight basement for the upper lot. We anticipate finish grades will remain near existing
grades.
zub8818641 VuDub bLUbUW14L;Lb HA6L UJ
2 LOTS: 68XX - 164TH PLACE SOUTHWEST
September 7,1995
General Site Conditions - Surface
Job Number 5086
Page 2
The proposed new structures will be located on the two lots at 68XX - 164fli Place Southwest in
Edmonds, Washington. The Vicinity NIap, Plate 2, shows the general vicinity of the property.
At the time of our fieldwork, the site was covered with a moderate growth of brush and small
trees. There were some larger evergreen trees on Lot 8. The surrounding area consists of a
school building and suburban dwellings.
Overall vertical relief ftom east to west across the building site for the two lots was visually
estimated to be around six feet. Ile lots generally slope down to the west after rising sHghtly
from the paved road. We noted no evidence of recent slope instability on the site.
Subsufface Exploration and Descrimion
Four test pits were excavated with a rubber -tired backhoe to a maximum depth of 4.0 feet below
existing grades at the locations shown on the Site Plan, Plate 3. no test pits were logged and
sampled by the undersigned civil engineer during the excavation process. Ile test pit logs are
attached to Us report. Recovered soil samples were subjected to selected laboratory testing
including moisture contents. Test results and field density information are summarized on the
test pit logs.
Although there may very well be some variation in the subsurface and/or conditions not readily
apparent from the ground surface, we expect the following subsurface interpretation to be
essentially correct:
Most of the site is overlain with a variable thickness (±0.1 to ±1.5 feet) of
gravelly sandy silty fill. Under these fill soils, a medium -dense to dense
gray/brown gravelly silty sand was encountered. Ilds underlying. native sandy
soil got denser with depth. No groun�water seepage was noted into the test pits
during excavation activities.
IMe final test pit logs attached to this report represent our interpretation of the field data and
laboratory tests. The relative densities and moisture descriptions on the logs are interpretive
descil tions based on observed conditions during excavation. The logs should be reviewed for
speci c subsurface information at each location tested.
__# 2068818641 DODDS GEO$UIENUES HAUE U4
2 LOTS: 68XX - 164TH PLACE SOUTHWEST
September 7,1995
Conclusions and Recommendations
General
Job Number 5086
Page 3
The following general geotechnical conclusions can be drawn from our field and laboratory test
data:
1) Foundations should be supported on competent dense native gravelly silty sandy soils
or on structural fill built up from native soil. Ile structure design should utilize a
foundation bearing pressure of 2000 pounds per square foot (psf). Ihe floor slab may be
supported on competent native soils or on structural fill.
2) Ile site appears stable, and we expect it to remain so, as long as the recommendations
in this report are followed. Fill should not be placed on, or near, the existing slope crest.
Foundations adjacent to the slope should beat on dense competent native soils in a
manner which would not promote slope instability.
3) Maximum permanent slope gradients should not exceed 2:1 (Horizontal:Vertical)
Foundations
The proposed new single-family residences may be supported on conventional continuous and
spread footings bearing on competent, native, medium -dense gravelly silty sandy soils under the
looser surficial soils and/or existing fill, or on compacted structural fill or crushed rock built up
from competent. undisturbed native soils. All foundations should bear at a minimum depth of
eighteen (18) inches below the adjacent outside finish grade. A bearing pressure of two thousand
(2000) pounds per square foot (psf) may be utilized for foundations bearing as described above.
The design bearing . pressure may be increased by one-third to accommodate short term wind and
seismic loads. To provide protection against shear failure, we recommend continuous and spread
footings have minimum widths of sixteen (16) inches and twenty4our (24) inches, respectively.
Any structural fill that is placed under footings should extend out beyond the edges of the
footings a distance at least equal to one-half of the fill depth. For example, if two feet of
structural fill is placed below a sixteen -inch -wide -continuous footing, the total minimum width
of the fill (and the excavation) would be forty inches.
We estimate that shallow spread foundations bearing on medium -dense native gravelly sandy
soils will settle one-half inch.; Estimated settlements for foundations bearing on properly
compacted structural fill or crushed rock placed atop competent native medium -dense sandy soils
are also approximately one-half inch between building comers.
2068818641
2 LOTS: 68XX - 164TH PLACE SOUTHWEST Job Number 5086
September 7,1995 Page 4
IAteral loads such as wind and seismic forces are accommodated by friction between the
foundation elements and the bearing soils and/or by passive earth pressure against the
foundations. However, passive earthpressum is only available if structural fill is used to backfill
against the foundation, or the foundation is poured against the existing soil. A coefficient of 0.40
may be used between the foundation elements and sauporting soiJs. The passive resistance of
undisturbed native soils and structural fill may be en to be an equivalent fluid having the
density of three hundred fifty (350) pounds per cubic foot (pcf). Ihese recommendations take
into account a one in one -hundred -year seismic event.
Footing drains should be anticipated for the all uphill exterior sides of the structure and along
any daylight basement walls, if constructed. The footing drain should consist of a slotted four -
inch -diameter PVC pipe bedded in, and covered with a minimum of six inches of drain rock.,
The invert of the pipe should b6 placed below the, bottom of the floor slab. A non -woven
geotextile fabric (Mirafi 140N, Suplac �4NP or equivalent) should be wrapped around the outside
of the drainrock. 17he PVC pipe should be sloped to drain, and may be connected to the roof and
surface water discharge pipe down -gradient and away from the structure.
Slabs -on -Grade
Reinforced slab -on -grade floors are ft - ted for the new structures. Slabs -on -grade may be
supported on a minimum of four inches free -draining sand or gravel placed above competent
soils. AU loose soft zones should be i ed prior to placement of the subsIab fill which should
re"a"'
meet the requirements for structural fill —detaikd below. A vapor barrier such as a sheet of a 6-
mil plastic membrane should be placed beneath the slab.
Site Drainaite
17he site should be graded so that surface water is directed away from the construction area.
Water should not be allowed to stand in any area where the foundations, pavements, or slabs am
to be constructed. Filter fabric fence is required downslope from all construction activities.
Final. site grades adjacent to the buildings should be sloped away from the structures for a
distance of ten feet. Roof, surface water drains, and footing drains should discharge to an
appropriate facility in a manner which does not cause erosion or instability.
Ir
_�od818641
DODDS GEOSCIENCES
HAUE Ub
2 LOTS: 68XX - 164TH PLACE SOUTHWEST
September 7, 1995
Foundation Walls
Job Number 5086
Page 5
Foundation walls must be designed to support the lateral earth pressures which abutting soils will
impose. Ile following recommendations am for foundation walls which are less than eight feet
high supporting level backfill, where equivalent fluid pressures are appropriate:
Parameter
Design
Value
Active Earth Pttwm*
30 pcf
At -Rest Earth Pressure
55 pcf
Passive Earth Pressure
350 pcf
Unit Weight of Soil
125 pcf
Coefficient of Friction
0.40
*Tbe active earth pressure recommended assumes the wall can deflect at least
0.002 times the wall height. If this assumption is incorrect, the at -rest earth
pressures should be used to design the wall.
IMe values recommended above are ultimate values, and should be reduced by an appropriate
safety factor. As a guideline, we recommend a minimum factor of safety of 1.5 for overturning
and sliding. The resultant force from the soil (neglecting the passive pressure force) can be
calculated by taking moments about the.toe of the wall. The resultant force should pass through
the middle third of the footing.
The above design values do not include hydrostatic pressures behind the walls and assume that
no surcharge slopes or loads am placed above, or near the walls. Design values can also be
exceeded if heavy construction equipment is allowed within a prism defined by a 1: 1 (H: V) line
extending up to the soil surface from the back end of the -retaining wall footing. If any of these
conditions exist, then the above design values should be augmented by appropriate additional
pressures. If walls higher than eight feet or sloping wall backfills are reqi I iired for this project,
please contact our office for supplemental recommendations.
Foundation walls adjacent to living areas should be positively waterproofed. All walls should
be backfilled with clean compacted, free -draining granular soil. This will prevent the buildup of
hydrostatic pressures. Ihe wall bacIdUl should contain no more than five percent silt or clay, no
organics, and no cobbles greater in diameter than four inches. Ile percentage of sand (From the
#4 sieve to the, #200 sieve) should.range from 25 to 75 percent. This free-drainin blackfill
should be allowed to seep into the foundation drain. During compaction of wall ZI-111, care
should betaken to not damage the wall. The top one to two feet of wall backfill should consist
of a relatively impermeable soil or topsoil.
_,adiB641
DUDDb OLUbUlt(AULb
2 LOTS: 68XX - 164TH PLACE SOUTHWEST
September 7,1995
Excavations and S12M
Job Number 5086
Page 6
Tempotary and permanent excavations and slopes for this project must meet all applicable
government safety regulations. Temporary cuts to a depth of four feet may be attempted vertical,
although they will probably not hold for extended periods of time. Excavation slopes greater
than four feet in depth should be cut no steeper than 1:1 (H:V) through the medium -dense sandy
soils. Flatter slopes may be required depending upon local variations in soil conditions. All
contractors worldng in excavations should anticipate caving of the side slopes.
Permanent cut and fill slopes should not exceed 2:1 (H:V). water should not be allowed to flow
uncontrolled over the top of any slope. All permanently exposed slopes should be seeded with
appropriate vegetation 6 reduce erosion and improve stability of the surficial soil.
General Earthwork and Structural Fill
Site construction should begin by stripping and clearing the building arm of all vegetation,
existing fill, and any other deleterious material. Stripped materials may have to be removed
from the site. Even though groundwater seepage was not noted during excavation of the test pits,
the contractor should anticipate, and be prepared to accommodate some seepage into the
excavations.
Structural fill is defined as any fill placed below structures, including slabs, where the fill soils
would need to support loads without racceptable deflections or shearing. Structural fill should
be placed above unyielding site soils in maximum eight -inch -thick loose lift and compacted to a
minimum of 95 percent of Modified Proctor (ASTM D-1557). During wet weather or under wet
conditions, structural fill should consist of a granular soil having less that five percent silt or clay
(measured on that portion which �esses the 3/4-inch sieve).' During drier weather, water may
have to be added to the soils to achieve the required compacted density.
Closure
It is recommended we be retained to review the final development plans to verify site specific
subsurface requirements have been met.
It is also recommended that we be retained to provide professional geotechnical consultation,
and observation services during design and construction. This allows us to: 1) confirm. that
design conforms to specific subsurface requirements; 2) confirm that subsurface conditions
exposed during construction are consistent with those indicated by this report; 3) evaluate
whether earthwork and foundation construction activities conform to the intent of the contract
specifications and plans, and; 4) provide recommendations for design changes in the event of
changed conditions. While on the site during construction, we will not direct or supervise the
contractor or the work, not we will be responsible for maintaining or providing for on -site safety
during construction activities. Also, we will not be res'ponsible for dimensional measurements
during construction.
DUVVb ULUt)k-;ILINULZD
2 LOTS: 68XX - 164TH PLACE SOUTHWEST
September 7,1995
Job Number 5086
Page 7
It has been- a. pleasure providing you with our professional services. If there are any questions,
please call me directly at (206) 867-3297.
Sincerely:
DODDS Geosciences Inc.
K' D
41
96 * 22SO8
EXPIRES
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Enclosures: 5 Plates
SITE PL)&,�,J
LOT 7. MEFAlDowQA.L-E' wEic,"T-5
CITY OF=
ZWOHOM113V4 CO., Wk.
HEIGHT CALC'S
A.
C 14.51
43 10 -1. G F,
:)r)*.I- 400,tFai —' .4 100.1-3T 145AN
+ ZT.000 —
. 12.T.13T N40-141
RECEIVED
SEP 1 1 1995
PERWCOUNTER
co
0.1 000
5
'S C A,�L E I C �- '30 L 0
PLANNING DATA
SITE ADDRESS: 690q 1&1141'92— 51,2 DATE:
ZONING-fE'2 -0-- -V,-- PLAN CHK#.: 'L - 1 -5-1--
PROJECT DESCRIPTION: 15-f zz
SETBACKS:
Required Setbacks: I
Front: Y,< Left Side: (0 Right Side: )0 Rear:
Actual Setbacks:
Front: *2,5- Left Side: 1--7 Right Side: Rear: 69
CORNERLOT �0
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED �0-r-
LOT COVERAGE:
Maximum Allowed: 6a(o?-F.:5 -65�o Actual: 65,
BUILDING HEIGHT:
Maximum Allowed: Actual Height:
SUBDIVISION: &4=&A2kb-;f; t66a+82'5 L CTr
I
CRITICALAREAS#: stotaer2 -P-0 Acq— -&X69�� -Yo% jxlez Trpz) 5,,,.Rnjnr4>
SEPA DETERMINATION:
LOT AREA: /9, 13 K
OTHER:
Plan Review By:
CITY OF EDMONDS
250 5TH AVENUE NORTH, EDMONDS, WA 98020 (206) 771-0220
RCW 197-11-970 Determination of Nonsignificance (DNS)
DETERMINATION OF NONSIGNIFICANCE
Description of proposal: Construct new single-family residence totaling approximately 2,600 sq.ft. (City
of Edmonds Building Permit Application # 95-157).
Proponent: Andrew Austin Company, Inc.
Location of proposal, including street address if any: 6809 164th Place SW, Edmonds, Washington
Lead agency: CITY OF EDMONDS
The lead agency for this proposal has determined that it does not have a probable significant adverse impact on the
environment. An environmental impact statement is not required under RCW 43.21.030(2)(c). This decision was
made after review ' of a completed environmental checklist and other information on file with the lead agency. This
information is available to the public on request.
XX There is no comment period for this DNS.
This DNS is issued under 197-11-340(2); the lead agency will not act on this proposal for 15 days
from the date below. Comments must be submitted by .1995.
Responsible Official: Jeffrey S. Wilson
Position/Title: Current Planning Supervisor, Department of Community Services - Planning Division
Phone: 771-0220
Address: City of Edmonds, 250 5th Avenue North, 5 n s, 91020
r
Date: I uxw v 5— Signatu
XX You may appeal this determination to Robert Ch e Planning Manager, at 250 5th Avenue North,
Edmonds, WA 98020, no later than I i _I 1995, by filing a written appeal
citing the reasons.
You should be prepared to make specific factual objections. Contact Jeffrey S. Wilson to read or ask about the
procedures for SEPA appeals.
XX Posted on 1013) 9S 1995, at the Edmonds Public Library, Edmonds Community
Services Building, and the Edmonds Post Office.
XX Distribute to "Checked" Agencies on the reverse side of this form, along with a copy of the
Checklist.
Mailed to the following along with the Environmental Checklist:
XX Department of Ecology
Environmental Review Section
P.O. Box 47703
Olympia, WA 98504-7703
XX Andrew Austin Company, Inc.
9004 191 st Place SW
Edmonds, WA 98026
Attachments:
Critical Areas Determination # CA-94-126
Environmental Checklist
PC: SEPA Notebook
Robert Chave, Planning Manager
R. Page 1 of 2
MEMORANDUM
CITY OF EDMONDS
PLANNING DIVISION
250 5TH AVENUE NORTH, EDMONDS, WASHINGTON 98020
TO: BUILDING PERMIT PLAN CHECK # 95-157
FROM: Ann Bullis, Code Enforcement Technician.
DATE: SEPTEMBER 27,1995
SUBJECT: ENVIRONMENTAL DETERMINATION TO CONSTRUCT A NEW SINGLE
FAMILY RESIDENCE APPROXIMATELY 2,600 SQFT. IN SIZE AT 6809
164TH PLACE SW, EDMONDS, WASHINGTON. APPLICANT: ANDREW
AUSTIN COMPANY, INC.
During a site visit on September 27, 1995, 1 found that the site slopes steeply, but does not
exceed 40% as verified by a topography submitted by the applicant with -the building permit
application. The requirements of ECDC 19.05 and Title 18 enforced by the Building Department
and Engineering Department respectively, appear to address possible e'rosion/geotechnical
concerns for which they were established.
I have had the opportunity to visit the subject site, review the environmental checklist, and
Critical Areas Determination, a copy of which are filed in the official file for this permit. Based
on my review of all available information and adopted policies of the City, I recommend that a
determination of nonsignificance, be issued.
Review by Responsible Official:
Iconcur
I do not concur
Comments:
Jeffrey S. Wilson, AICP Date
Responsible Official
Attachments
PC: FILE NO. 95-157,
Robert Chave, Planning Manager
Page 2 of
(((FILE #))) EN/ (((DATE))). SEPA
51TE PL,&,�,l
LOT 7. MEAlDO\VraALE- WSIC,1475
CITY OP 9"Z)&JGWVt
zwoHomit" CO., L4),k..
HEIOH'r CALC'S
A� c 1 C3 6-34
14.lrl
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+
RECSIVED
SEP I 1 1995
PEW COUNTER
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City of Edmonds
Critical Areas Determination,
Applicant: I Phil Lund Determination #: I CA-95-126 I
Project Name: Permit Number:
Site Location: I 68xx 164th Pl. SW Property Tax Acct. #: 1 7412-000-008-00 1
Project Description:
Non -Project Specific
Determination: Study May Be Required
Due to the slopes on the subject property, a study may be required. The purpose of this study would
be to identify the extents and steepness of the slope and analyze the impact of development on the
slope. With the information submitted and the site inspection conducted it is, as yet, impossible to
determine if the slope is significant enough to require a study.
With the submittal of your building permit, you will need to submit a topography map that indicates
where slopes of more than 40% exist on or adjacent to the property and delineates the top of the
slope. If their are no slopes greater than 40% on or adjacent to the property, your only obligation
will be to comply with whatever requirements the Building Official applies to the project from
ECDC Chapter 19.05. If there are slopes with and inclination of 40% or greater you must maintain
a 50 foot buffer and a 15 building setback unless you enter into a three party contract with the City
and a geotechnical consultant to determine whether you may reduce the buffer down to 10 feet.
Stephen Bullock June 28, 1995
4)ature Date -
Name Si
NO
CAFILE Gtco
Critical Areas Checklist
Site Information (soils/topo�raphy/hydrol(��/vpgetation)
1. Site Address/Location: Z�
0�
7 jcxf)
2. Property Tax Account Number: M/2-00(2>00 90005 %1--q
3.* Approximate Site Size (acres or square feet): -i�44_ alace
4. Is this site currently developed? Xyes; — no. /U0 /43r�
If -yes; how is site developed?
5. Describe the general site topography. Check all that apply.
-feet elevation change over entire site.� rT5 1�
te... COPTUR
Flat: less than 5
.-Rolling,--slopes on site generally less than 15%-(averfical'rksie�o 10-feet over'a
horizontal distance of 66-feet).
Hilir,-: slo"p*eie; present on site of more than 15% �nd less' thad 30% i'verticalAse
. ..... 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
-feet).
horizontal distance of less than 33
Other.(please describe):
6. Site contains areas of year-round standing water. IVO Approx. Depth:
7. Site contains areas of seasonal standing water: eop Approx. Depth:
What season(s) of the year?.
8. Site is in the floodway - IVO floodplain of a water course.
9. Site'contams a,cr or,�n area where water flows across the grounds surface? Flows-areyear-
round? A Flows airies''ea'sonal? _ eNhatfimeof year?..
w
10. Site is primarily: forested meado ;s��:.. ;.mixed'
urban landscaped (lawn,shrubs etc)
11. Obvious" i�etlan�d is present on sitez.
itectes!gnm�ae xnemvmmmmmiyacnmuve.-jtrmmapr.;-.-LL%2/:-.-.---)Ctg
Da
F .04
9 9
City of Edmon&
Critical., Areas: Checklist
Ile Critical Areas Checklist contained on
this form is to be filled out by any person..
preparing a Development Permit
Applicat ion for the City of Edmond ' sprior
to histher 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 invento*ries, maps,
or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and dateitl'
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'.
With a signed copy of this 6��, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
-other pertinent infonnation (e.g. site
Plan, topography map, etc.) or studies in
conjunction with this Checklist to assist
staff in completing their prelintinary
assessment of the site
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).
Owner / Applicant: resentative:
Name
Street Address
City, State, ZIP C
Signature
Date
P
Date
viz.
1: 1� A-
690 -199-
Purpose of Checklist.
CITY OF EDMONDS
ENVIRONMENTAL CHECKLIST RECEIVED
SEP 12 1995
PERMITCOUNMH_
The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all governmental agencies to consider the
environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be prepared for all
proposals with probable significant adverse impacts on the quality of the environment. Ile purpose of this checklist is to provide
information to help you and the agency identify impacts from your proposal (and to reduce or avoid impacts from the proposal, if it
can be done) and to help the agency decide whether an EIS is required.
Instructionsfor Applicants.
This environmental checklist asks you to describe some basic information about your proposal. Governmental agencies use this
checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer
the questions briefly, with the most precise information kpown, or give the best description' you can.
You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you should be able to
answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the
answer, or if a question does not apply to your proposal, write *do not know" or does not apply". complete answers to the
questions now may avoid unnecessary delays later.
Some questions ask about governmental regulations, such as zonin ' g, shoreline, and landmark designations. Answer these questions
if you can. If you have problems, the governmental agencies can assist you.
The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or on different parcels
of land. Attach any additional information that will help describe your proposal or its environmental effects. 'Me agency to which
you submit this checklist may ask you to explain your answers or provide additional information reasonably related to determining
if there may be signi fi c*ant adverse impact.
Use of checklistfor nonproject proposa&
Complete this checklist for nonprcject proposals, even though questions may be answered "does not apply." IN ADDITION,
complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D).
For nonproject actions, the references in the checklist to the words "project," "applicant," and "property or site" should be read as
.proposer," and "affected geographic area," respectively.
A. BACKGROUND
1. Name of proposed project, if applicable:
2. Name of applicant:
4.
I
-- A-2
40S /I �J (�o /Vc
Page I of 221
CHMV10-25-91MASTER
5. Agency requesting checklist: City of Edmonds.
Prdposed.timiing or schedule (including phasing, if applicable):_
(STAFF COMMENTS)
7. Do you have any plans for future additions, expansion, or further activity related to or connected with this
proposal? If y% e�plairyj - 0 r— /7
8.
(STAFF COMMENTS)
List any environmental information you know about that has been prepared, or will be prepared, directly
(STAFF COMMENTS)
11�
9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting
the property covered by your proposal? If yes, explain.
IL16 A.
(STAFF COMMENTS)
10. List any government approvals or permits that will he needed for your proposal, if known.
() J)r&O QAJ
(STAFF COMMENTS)
Pne 2 of 22
CHKLT/10-25-93.MASTU
11.
12.
Give brief, complete description of your proposal, including the proposed uses and size of the project and site.'
There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You
do not need to repeat those answers on d14 page. I -
(STAFF COMMENTS)
Location of the proposal. Give sufficient information for a person to understand the precise location of your
proposed project, including a street address, if any, and section, township, and range, if known. If a proposal
would occur over a range of area, provide range or boundaries of the site(s). Provide legal description, site
plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required
by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications
(STAFF COMMENTS)
TO BE COMPLETED BY APPLICANT
B. ENVIRONMENTAL ELEMENTS
1. Earth
a. General description of the (ci Flat, rolling, hilly, steep slopes, mountainous, other:
(STAFF COMMENTS)
b. What is the vAeepest slope on the site (approximate percent slope ek-
f
-2�
(STAFF 90MMIENTS)
C. What general types of soils are found on the site (for example, clay, sand, gravel, peat, muck)? If you
know the classification of agricultural soils, specify them a d te any prime farmland.
Page 3 of 22
CHKLT/10-25-93.MASrER
(STAFF COMMENTS)
d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe.
kD
(STAFF COMMENTS)
e. Describe the purpose, type and approximate quantities of any filling or grading proposed. Indicate source
I
(STAFF COMMENTS)
Could �rl�ion occidAs axes t of clearing, construction, or use'.) Ifso, generally
(STAFF COMMENTS)
� M / M I
g. About what percent of the site will be covered with impervious surfaces after project construction (for
example, asphalt or buildings,,)? ,
(STAFF COMMENTS)
Page 4 of 22
CHKLT/10-25-93.MASTER
h. Proposed meqpy�es to reduce o��ontrol erosion, or other impacts to the earth, if anyi
(STAFF COMMENTS)
2. AIR
a. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors,
industrial wood smoke) during construction and when the project is completed? If any, generally describe
and give approximate quantities if known. .1WA)e
(STAFF COMMENTS)
b. Are there any off -site sources of emissions or odor that may effect your proposal? If so, generally
describe.
A)
(STAFF COMMENTS)
C. Proposed measures to reduce or control emissions or other impacts to the, if any:
(STAFF COMMENTS)
3. WATER
a. Surface:
(1) Is there any surface water body on or in the immediate vicinity of the site (including year-round
and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide names.
If appropriate, state what stream or river it flows into.
(STAFF COMMENTS)
Pa.ge -5 of 22
CHKLT/10-25-93.MASTER
(2) Will the prq�lect require any work over, in, or adjacent to (within 200 feet) the described waters? If
yes, please describe and attach available plans.
(STAFF COMMENTS)
(3) Estimate the amount of rill and dredge material that would be placed in or removed from surface
water or wetlands and indicate the area of the site that would be affected. Indicate the source of rill
material.
(STAFF COMMENTS)
(4) Will the proposal require surface water withdrawals or diversions? Give general description,
purpose, and approximate quantities if known.
(STAFF COMMENTS)
(5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan.
(STAFF COMMENTS)
(6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the
type of waste and anticipated volume of discharge
(STAFF COMMENTS)
Pagt 6 of 22
CHKLT/10-25-93.MASTER
b. Ground:
(1) Will ground water he withdrawn, or w ' ill water be discharged to ground water?. Give
general description, purpose, and approximate quantities if known.
4 -J-0
(STAFF COMMENTS)
(2) Describe waste material that will be discharged into the ground from septic tanks or
other sources, if any (for example: Domestic sewage; industrial, containing the
following chemicals ... ; agricultural; etc.). Describe the general size of the system, the
number of such systems , the number of houses to be served (if applicable), or the
number of. animals or humans the system(s) xp t d to serve.
(STAFF COM MENTS)
C. Water Runoff (including storm water):
(1) Describe the source of runoff (including storm water) and method of collection and
disposal, if a'ny (include quantities, if known). Where will this water flow? Will this
(STAFF COMMENTS)
(2) Could waste materials ent r ground or surface waters? If so, generally describe.
(STAFF COMMENTS)
Page 7 of 21
CHKLT/10-25-93.MASTER
d.
(STAFF COMMENTS)
4. Plants
a. Check or circle types of vegetation found on the site:
deciduous tree: alder, inaple, aspen, other:
evergreen tree: fir, cedar, pine, other:
shrubs
grass
pasture
crop or grain
wet soil plants: cattail, buttercup, bulrush, skunk cabbage, other:
water plants: water lily, eelgrass, milfoil, other:
other typeq of vegetation:
(STAFF COMMENTS)
b.
V. 2-
(STAFF COMMENTS)
C. List threatened or endangered species kno,.vn_!g,be on or near the site.
(STAFF COMMENTS)
d. Proposed landscaping, use of nati� I =iLs or,other materl Is to preserve or enhance YeLretation on the
site, if any: Z5�-'T ` I
Pa-C 8 of 22
CHKLT/10-25-93.MASTER
(STAFF COMMENTS)
5. Animals
a. Check or circle any birds and animals which have been ed on or near the site or are known to be on
or near the site: &0
birds: hawk, heron, eagle, songbirds, other:
mammals: deer, bear, elk, beaver, other:
fish: b.tss, salmon, trout, herring, shellfish, other:
(STAFF COMMENTS)
b. List any threatened or endangered specie; known to" or near the site.
A) 0 -'Ot,&
(STAFF COMMENTS)
C. Is the site part of a migration route9 If so, explain.
(STAFF COMMENTS)
d. Proposed measures to preserve or enhance wildli , if agy:
(STAFF COMMENTS)
6. Energy and Natural Resources
Page 9 of 22
CHKLT/10-25-93.MASTER
a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet the completed
project's energy needs? Describe whether itwill be used for heating, manufacturing, etc.
(STAFF COMMENTS)
b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally
describe.
/fl-10
(STAFF COMMENTS)
C. What kinds of energy conservation features are included in the plans of this proposal? List other
proposed!,me,tsures to red ce or control energy impacts, if any:
(STAFF COMMENTS)
7. Environmental Health
a. Are there any environmental health hazards, including* exposure to toxic chemicals, risk of fire and
explosion, spill, or hwairdous -waste, that could occur as a result of this proposal? If so describe.
(STAFF COMMENTS)
Page 10 of 22
CHMT110-25-93MASTER
(1) Describe special emergency
&m
(STAFF COMMENTS)
might be required.
(2) Proposed measures to reduce or control epvir
(STAFF COMMENTS)
health ha7ards, if any:
b. Noise
(1) What types of noise exist in the area which may affect your pr(kiect (for example: traffic,
equipment, operation, other)?
./t) or 14
(STAFF COMMENTS)
(2) What types and levels of noise would he created by or associated with the project on a short-term or
a long-term basis (for example: traffic, construction, operation, other)? Indicate what hours noise
would come from the site. r �� # — - A -
(STAFF COMMENTS)
(3) Proposed measures to reduce 2r-aantrol noise impacts, if any:
(STAFF COMMENTS)
P a.-e I I of 22
CHKLT/10-25-93.MASrER
8. Land and Shoreline Use
a. What is the current use of the site and adjacf9t properties?
&10('�—Voev '�-T
moo�— / V 0"-
(STAFF COMMENTS)
b. Has the site been used for ag-riculture? ir so, describe.
(STAFF COMMENTS)
C. Describe any structures on the site.
(STAFF COMMENTS)
d. Will any structures he demolished? If so, what?
4,0
(STAFF COMMENTS)
e. What is the current wning classification of the site9
?A 0 - - -
(STAFF COMMENTS)
Page 12 of 22
ClIKU/10-25-91MASrER
f. What is the current
(STAFF COMMENTS)
ive plan dL-%ignation of the site?
g. If applicable, what is the current shoreline master plan d!!mnation o9he site9,
(STAFF COMMENTS)
h. Has rt r tl e site been chuLsified as an "environmentally sensitive" area? If so, specify.
(STAFF.CONINIENTS)
i. Approximately how many people wou!gjeside or work in thewanpleted
(STAFF COMMENTS)
j. Approximately how many people would the completed proJect displace?
(STAFF COMMENTS)
k
CHMT/10-25-93.MAnER
Page 13 of 22
k. Proposed measures to avoid or reduce displacement impacts, if any:
hA i A -
(STAFF COMMENTS)
1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans,
if any: r__Oy"� 64A
(STAFF COMMENTS)
9. Housing
a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income
housing.
— 94
(STAFF COMMENTS)
q
b. Approximately how many units, if a would he eliminated? Indicate whether high, middle, or low-
income housing. a
(STAFF COMMENTS)
C. Proposed measures to d r control housing impacts if any:
/1J 6 T__ ,
(STAFF COMMENTS)
Page 14 of 22
CHKLT/10-25-93.MA-STER
10. Aesthetics
a. . What is the tallest height of any proposed structure(s), not including antennas; what is the principle
exterior building material(s) proposed?
2,
(STAFF COMMENTS)
b. What views in the immediate vicinity %V(!Od he altered or obstructed?
/t) 6 U Lt
(STAFF CONMENITS)
C. Proposed measui-L-s to redu )r
(STAFF COMMENTS)
aesthetic impacts, if any:
Light and Glare
a. What type of light or gl e WIII the proposal produce? What time of day would it mainly occur?
(STAFF COMMENTS)
b. Could light or glare from the finished project be a safety ha7ard or interfere with views?
(STAFF COMMENTS)
Pa.-e 1 -5 of 22
CHKLT/10-25-93.MASTCR
C. What existing off -site sources offigi or glare may affect your proposal?
4) A)T
(STAFF COMMENTS)
d. Proposed measures to reduce or control light and glare a s, if any:
I z
01
(STAFF COMMENTS)
1.2. Recreation
a. What designatedand infimnal recreational opportu t* in the immediate vicinity?
(STAFF COMMENTS)
b. Would the proposed pro.ject displaceany existing recreation uses? If so, describe.
(STAFF COMMENTS)
C. Proposed measures to reduce or control impacts (in recreation, including recreation opportunities to be
provided by the project or applicant, ifany:
(STAFF COMMENTS)
Page 16 of 22
CHKLT/10-25-93.MASTER
13. Historic and Cultural Preservation
a. Are there any places or obJects listed on, or proposed for, national, state, or local pres6Tation registers
known to he on or next to the site? If so, generally describe.
426
(STAFF COMMENTS)
b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural
importance known to he on or next o t ie s . t
(STAFF COMMENTS)
C. Proposed measures to reduce or control�l�acts, if any:
11Y,9 1
(STAFF COMMENTS)
14. Transportation
a. Identify public streets and highways serving the R*te, anddescribe proposed access to the existing street
system. Show on s te pla , U�� ;1-C -
7- iio
(STAFF COMMENTS)
b. Is site currently served by public transit? If no what is the approximate distance to the nearest transit,
stop'! WO �
Page 17 of 22)
alKLT/10-25-93.MASTER
(STAFF COMMENTS)
C. How many parking spaces woulA the completedproject have? How many would the project eliminate?
(STAFF COMMENTS)
d. Will the proposal require any new roads or streets, or improvements to existing roads or streets, not
including driveways? If so, generally describe (indicate whether public or private).
(STAFF COMMENTS)
e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so,
generally describe.
(STAFF COMMENTS)
f. How many vehicular trips per daywould be generated by the completed project? IF known, indicate when
peak volumes would occur.
(STAFF COMMENTS)
Pa.-c 18 of 22 1.,
CHKLT/10-25-93.NIASTER
4
g. Proposed measures to reduce or control transportation impacts, if any:
(STAFF COMMENTS)
15. Public Services
a. Would the project result in an increased need for public services (for example: fire protection, police
protection, health care, schools, other)? If so, generally describe.
(STAFF COMMENTS)
b. Proposed mewsures to reduce or control direct impacts on public services, if any:
(STAFF COMMENTS)
16. Utilities
a. ircle utilities c rrently available at the site gelectricit natur- gas wate , 6efuse servi , telepho
L-sanitary sewer, eptic system, other:
(STAFF COMMENTS)
Pagge 19 of 22
CHMT/10-2"IMASTER
b. Describe the utilities that are proposed for the pro.ject, the utility -providing 'the service, and the general
cons!rtVion activities on the site or in the immediate vicinity which might be needed.
-.,- —A I
C. SIGNATURE
The above
to make Wi
(STAFF COMMENTS)
Signature of Proponent
to the best of my knowledge. I understand that the lead agency is relying on them
Date Submitted
Pa.-C 20 of 22
CHKLT/10-25-93.MASTER R,
D. SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS
(do not use this sheetfor project actions)
Bemuse these qu�stions are very general, it may be helpful to read them in conjunction with the list of the elements of the
environment.
When answering these questions, be aware of the extent the proposal, or the types of activities likely to result from the
proposal, would affect the item at a greater intensity or at a faster rate than if the proposal were not implemented. Respond
briefly and in general terms.
1. How would the proposal he likely to increase discharge to water; emissions to air; production, storage, or release of
toxic or hamrdouspbstance
,h; or production of Nise?
measures to avoid o ed ch increasis are: %
—Z:�— �AW"
2. How would the proposal he likely to aft'ectl nts�,.aals, fish, or marine IWO
Proposed measures to protect or curiserve plants, animals fish, or marine life are:
3. How would the proposal he likely to deplete energy 02 natural resoun�es7
Proposed measures to protect or conserve energy and natt ral resources are:
4/
Pagc 21 0(22 1,
CHMT/10-25-91MASrER
4. How would the proposal be likely to use or affect environmentally sensitive areas or areas designated (or eligible or
under study) for governmental protection; such as parks, wilderness, wild and scenic rivers, threatened or endangered
species habitat, historic or cultueal �ites, wetlan4 floodplains, or prime farmlands?
Proposed measures to protect such resources or to avoid or reduce impacts are:
5. How would the proposal he likely to affect land and shoreline use, including whether it would allow or encourage land
or shoreline uses incompatible with existing plansj'
Proposed measures to avoid or reduce shoreline and land use impacts are:
6. How would t e proposal be likely to increase d9t9nds on transportation or ublic services and utilities?
Proposed measurLs to reduce or respond to such demand(s) are:
7. Identify, if possible, whether the proposal flict with local, state, or federal laws or requirements for the
protection of the environment. al— Z; F
Page 22 of 22
CHKLT/10-25-93.MASTER
STREET FILE
CITY OF EDMONDS
XT T f?-N PER
CO RUC MIT APPLICATION
NAME (OR NAME OF B NESS)
Jim E
JUJ MAILING ADDRESS
z
q: 1:2 1111a L �-7fh We�St 0/0 /,/jJ-S TI)6.
CITY 0 ck Uj 14 TELEPHONE NUMBER
t -v rN W C Ar'7 -71 7
NAME
P Tsc
i QW-ADDRESS
Lz -a
9 A V
CITY TELEPHONE NUMBER
E
NAME
hl,0�26 r/bz?
ADDRESS 3 I'd V,!E�- wq-5- 7-
P
ia cl TELEPHONE NUMBER
STATE LICENSE NUMBER
E.5 *rl--? 2 015 /;C�
Legal Description of Property - Include all easements
(show below or attach four copies)
FL
0 C1 a
()I Mpadot.0 ' le 1k*,*cJi1,-\
C(Ii/ (�E jCdincwd 1 5.
j f
NEW [�F ESIDENTIAL EJ PLUMBING
ADDIALTER R COMMERCIAL F MECHANICAL
REPAIR RETAINING WALL SIGN
EXCAVATE FENCE
DEMOLISH OR FILL I x -FT)
PRE -MOVE INSPJ swim
REMODEL COMPLIANCE INSP. POOL
WOOD STOVE/ -1
INSERT I APT. BLDG El RENEWAL
'05 NUMBER OF STORIES NUMBER OF
DWELLING
3 [UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOTPLAN)
ESS
IL
SUBDIVISION NO ID NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING 90 REQUIRED DEDICATION
PROPOSED 3& 0
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED W--1-
STREET USE PERMIT REQUIRED 0
SEE ENGINEERING MEMO DATED
REMARKS
SIZE V BUILDING SUPPLY SIZE FIXTURE UNITS
. \ I I
A VSIGN AREA ENV. REVIEW ADB NO.
LOWED PROPOSED COMPLETE --,EXEMPT
. I �1
VARIANCE OR CU Pj-ANN�NJQ_REVIEW BY DAI
YARDS I S(,.gC7 HEIGHT I LOT COVERA YE
r 3,!�5
/� 26#
FRONT I E`IZ) REAR
REMARKS
A)1-�:,Ior-
CHECKED BY
TYPE OF CONSTRUCTION
CODE
HEIGHT
/
I V *
/192,
Z9,
SPECIAL INSPECTOR
AREA
OCCUPANCY
OCCUPANT
REQUIRED
I
GROUPg_
LOAD
0 YES 0 NO
_g
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY. GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission. STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - ProvidedWork Is Started Within 180 Days
ENERGY CODE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors In Interest, agrees to indemnify, defend and hold
1 12
harmless the City of Edmonds, Washington, its officials,
,2
a:
employees, and agents from any and all claims for damages of
<
whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of, this permit shall not be deemed to
PLAN CHECK DEPOSIT
0
modity,.waive or reduce any requirement of any city ordinance
..x
nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
�j
provision."
il
I hereby scitnowtod9t) that I hwo rwW this application; that the
tj
;1"Buthafted
tntormation ql�m la coffect; w%d that I eirn the owner. or the duty
ATTENTION
Gotni of the oww. I SWW to COMM with city and
THIS PErdar
$We law3 regifaft QW41rodW; OW W dah%s the wark authoft.
AVrrf04UM
ONLY TIHE
LWAIC11140"
WAMNAIT
CffV Of
EDIAONDS
771-3202
. UYV A WALWNG OR STRUCTURE 1-4 &A Ar7
RFMAOADE AND APPROVAL OR
&(AS BEEN C.;RANTEO. LIEC
�.- 1, � I
VALUATION
FEE
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his
Deputy'. aind fees are paid, and receipt Is
acknowledged In space provided.
FXM*S SIGNATURE DATE
RELEASED BY:
DATE
2-
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
a:
Uj
z
Z
0
z
I
C ATC44 5 A3 14:
Amo a I S,30 (OIL
WSUAL.)
N F M = W C a 2.1-M
TRrL NC W L11r NG"rH
21 W
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............................
4: -n C.Wt U W Ir --I
4PIEKF PIPW -,,,o
TEE w/ 4"Low. LEGS
LCVWI- TX�Nc_m
CAY
SYSTEM CROSS—SECTION
MIFZArl 50ox
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Tio LA�YED e
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3/4 WAS 9 E D
GRAVEI
,9�01AM -P'EqF P
. . -- L zo-p, - _�
TRENCH CROSS—SECTION
ON
r4 .
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2
for —MIC.HAC-L 14OUNSI'IELL
location (:�R Oq /,/-14 n EL _5W
b /%,l 0 Al /� S:
plan by 1e*j4A5L_ Re)tjA,/<Hr_ALt
phone- 7111 - z '76
date
DESIGN DATA
Trench Perc LF per Imperm Trench
Number Rate 1000 sq.ft. Area Req.
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at reg lar intervals (at least
twice per ye
4/&�
W
CITY OF EDMONDS
Iji
AT 10 KI
SITE PLAN. SC4LE:
;TE: DO NOT USE INFILTRATION SYSTEM
SLOPES OVER 15 PERCENT (15
)T RISE PER 100 FEET'- HORIZONTAL
PGP-C-1-55T MT
FL L\ �-J
STANDARD DRAINAGE PLAN
INFILTRATION S�STEM
PAGE 2 OF 2
-OWN'
11111111 u0c PERMIT
CITY OF EDMONDS ZONE F�?`V Z NUMBER 950730
CONSTRUCTION PERMIT APPLICATICFN , JOB SUIT)APT a
ADDRESS
OWNER NAME NAME OF BUSINESS 6;P6 5 —,, &,/ )
i
LEGAL DESCRIPTION CHECK[
SUBDIVISION NO
+�o
LID NO
0
MAILING ADPRESS
q 1,.q
T'
Pusgc RIGHT OF WAY
EXISTING U?
PROPOSED
PER OFFICIAL STREET MAP.
REQUIRED DEDICATION 41
TESCP Approved
RW Permit Required
Street Use Permit Req'd
Inspection Required
Sidewalk Required No
13
0
0 a:
W
CIT)�_/ Zlp�f
ek"�,4, J(.
TELEPHONE NUMBER
NAME
AA 1.4f'o
ME�ER JIZE
LI IZE
NO. OF FIXTURES
PRV REQUIRED
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NO 0
ADDIJAKS 0
f 2A W i 1 4= 1 —
REMARKS ?
0 . IWO UPIIJ6 Cr
W
W
— —ITELEPHONE NUMBER
cif 7717 e"o. /iw 17 �i /f L K
0
Z
lv� iju &Iul �r-4,1Z?_ -
NAAE
e
ADD SS
cr / ., r pie. ENGINEERING MEMO DATED VIEWED BY
2 ( - /C/
L)
< LIZ
cc CITY TELEPHONE NUMBER
'77 FIRE MEMO DATED REVIEWED BY
Z Lu
S LICEVQ EXPIRATI914 DATE
_7 SIGN AREA SEPA RE IEW ADS N7.
i T VV .7 k
14 A �(f /0 4?A X ALLOWED PROPOSED COMPLETE JXE.MPT
Legal Description of Property lude all easements t
J /A SHOREKI E 0
7n EXP Zill-
IL VARIANCE OR CU PAfslhl�. Rr.IEW BY
?.ATEI
_j SETBACKS'— FEET HEIGHT LOT C,DvltRA�E
Z
NT jJr-_7 SIDE REAR2A 1<
'i Property FRO
Tax Account 7 REMARKS 0.
Parcel No, (./12, 6 7 oc-, u L)
,�2rlEw ' 0 'ErRESIDENTIAL LUMBING
1-1 ADDITION . El COMMERCIAL ;20MECHANICAL
ETREMGDEL APt. BLDG. SIGN
FENCE CHECKED By TYPE OF CONSTRUCTION CODE OCCUPANT
GRO
REPAIR R4"!A5;YDS. X_ FT) -
194 X
WOODiTCfVE SWIM POOL SPECIAL INSPECTOR R OCCUPANT
DEMOLISH INSERT HOT TLIB/SPA REQUIRED LOAD
%RAGE RETA:I . NING/V�LLL,_ E] DYES 7002,
Ror RENEWAL REMARKS
4�R&� . f kERY
Z Z
(TYPE OF. USE. BUSINESS ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 305 0
_j
n
<
NUMBER OF.
0 OF DWELLING AREAS
9 UNITS ; . * NUMBER M� )w ZM 66ff Of-13 VIA
W NUMBER " I CRITICAL &
00 STORIES P' LAN) �iiws
H LO
DESCR WORK TO,BIE OQINE (AT1AC
LA) FINAL INSPECTION R.E.QUIRED
VALUATION FEE
OX-0
�,LAN CHECK FEE
10Y D 74-
BUILDING
HEA_T S.OURCE:
A
GLAZING
%
2&
PLUMBING
Plan Check N Oti '
7
�MECHANICAL.
&.3 E 9.5.
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission,
STATESURCHARGE
Permit Application: 160 Days
Permit Limit: I 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
150
successo!s in interest, agrees to indemnify, defend and hold
ow
harmless the City of Edmonds, Washington. its officials,
m
employees, and agents from any And- all claims for damages of
cc
whatever nature, arising directly or Indirectly from the issuance
mit. Issuance of this"permit shall not be deemed to
PLAN CHECK DEPOSIT
7
0
0 1 -waive or reduce any requirement of any city ordinanc
I
nor. I.imit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision." —1g,
A hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I agrepAo otomply with city and
THIS PERMIT
This application is not a permit until
stat struction; In do)hg the work authoriz-
0 e of the Labor
ey
hereb arson w be c oyadi
AUTHORIZES
ONLY THE
signed by the Building Official or his/her
r , 4iolation
Code o a f Washiqgtp relating Workmen's C mpensa-
WORK NOTED
is
Deputy; and fees are paid, and rodelot—
tion In r e and RCW 1&2q..-7 Z f
INSPECTION
acknowledged in space provided.
IGNAT OWNER OR DATE SIG
DEPARTMENT
0 G TURE DATJ
CITY OF
I —
WAZ
EDMONDS
-5
CALL FOR
KLEASED By: V DATE
AT N
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY ABUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — File YELLOW — inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK — Owner GOLD — Assessor
102-87
CITY OF EDMONDS
ZONEF M_ PERMIT
NUMBER 950730
CONSTRUCTION 'PERMIT -APPLICAT16N
jog APT #
OWNER NAME NAME OF BUSINESS
ADDRESS 9 .5;sn
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LEGAL DESCRIPTION CHECKI
SUBDivISION NO
LID NO
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MAILING A TRESS f�
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F-1-M-4
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NUMBER
CITX_ ZIP�f
PUB61C RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved 0
RW Permit Required'
%... JTLLtHONE
C
EXISTING U REOUIRED DEDICATION
.340
Street Use Permit Req'd 0
PROPOSED
inspection Required
0
NAME
Sidewalk Required 40
cc
W
ME�,ERJIZE I
LIN�IZE.,,,
NO.OFFIXTURES
PAV REOUIRED
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YEah NO 0
REMARKS
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FIRE MEMO DATED REVIEWED BY
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8
ST EXPIRAT19N DATE
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SIGN AREA
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AOB
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ALLOWED
PROPOSED
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Legal, Description of Property clude all easements'
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REMARKS
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ADDITION
COMMERCIAL .
.200MECHANICAL
DREMODEL
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CHECKED BY
TYPE OF CONSTRUCTION
CODE
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OCCUPANT
GRK :3
REPAIR _FT)
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-2
DEMOLIS`1H WOODST6VE SWIM POOL
F INSERT' HOT TUB/SPA
SPECIAL INSPECTOR
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LOAD
RAGE RETA�ININGYV�LLL,,
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13 YES
R MARKS
ROPKERY or
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(TYPE OF USf. BUSINESS ACTIVITY) EXPLAIN:
PROGRESS INSPECTIONS PER UBC 305
NUMBER NUMBER OF... CRITICAL
M 0-0111tiq
leAt &AN W4
to
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0
OF -
DWELLING
AREAS
INUMBER ?S-147
to
0
STORIES
UNITS
Jr
DESC ORK TO -BE DONE (ATTACH PLOFLAN)
ILL) 112
FINAL . INSPECTION
R4,01.111RED
VALUATION
FEE
�,LAN CHECK FEE
8 7
441�40
BUILDING
?1
'OURCE:
HEAT 1)
GLAZING
%
7 —7
PLUMBING
Plan Check N6.
�MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
IdI&
Any construction on the public domain (curbs, sidewpiks,
driveways, marquees, etc.) will require separate permission.
STATESURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started WItlhln 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
00
150
successo�s in interest agrees to indemnify, defend and hold
'Wn
harmless the City oi Edmonds, Washington. its officials,
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employees, and agents from any And. all claims for damages of
Er
4
whatever nature, arising directly or indirectly from the issuance
PLAN CHECK DEPOSIT
L4O
of this permit.. Issuance of thls*permit shall not be deemed to
0
modify; -waive or reduce any requirement of any city ordinance
City's
:r
nor. limit in any way the ability to enforce any ordinance
TOTAL AMOUNT DUE
provision." _1q,
.I hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
Information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I agre " m ply with city and
ction; In "dVoi g the work authoriz-
THIS PERMIT
AUTHORIZES
This application is not a permit until
er I lolation of the Labor
herety son w be a oyed
I Wash' Workmen's C mpensa-
ONLY THE
WORK NOTE D
signed by the Building Official or his/he.r.
Deputy; and fees are paid, and- receipt is
C de e gt relatin
III n I r a and RCW 112 Y f
INSPECTION
acknowledged in space provided.
SIGNATWOWNER OR AGENT DATE SIG
DEPARTMENT
ITURE OATJ
CITY OF
47 —
am
EDMONDS
MW
CALL FOR
__5
WEASED BY- V DATE
AT N
INSPECTION
IT IS UNLAWFUL To USE OR OCCUPY A.BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — Fiie YELLOW — inspector Li
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
CHAPTER 3.
PINK — Owner GOLD — Assessor
A PORTION OF SECTION- 8,_,;TOWNSHIP 27 NORTH, RANGE 4 EAST, W.M.
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SEP I 1 1995
PEPIATT COUNM
A PORTION OF SECTION 8,J9WlV&Hi"7-,NORTH, RANGE 4 EAST, W.M.
SNOHOMI9ff -COUNTY-,-,.. WASRINGTON
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RECEIVED
�,J
SEP I 1 1995
PEMAff COUNTER
LOTS 7 & 8 MEADOMALE HEIGHTS
SPOT ELEVAnON DISPLA)*
PEEM LUND
R.L. McDUFFY & ASSOCIATES, INC. DATE 8-10-95
LAND USE CONSULTANM DWG a,, D.R.F.
EfIGNEEPS * SURVEMRS s PLAIRIERS e MANAGEMEW jog # 95153
3605 COLBY AVENM MZM. WkqMM 9VOI (206) 258-4438 FAX: (2061258-1616 -,HT 1 nF I
#:
STREET FILE
RECEIVED
SEP i t 1995
pgMITCOUNTEft