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G, I I �1 I PERMIT EXPIRES
CITY OF EDMONDS us NE/25 �/)�V PERMIT
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THIS PERMIT AUTHOR' LY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading Recording Fee
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE 1
SEPARATE PERMISSION. Engr. Review City Surcharge
PER IT APPLICATION: Use DAYS
PERMIT...' YEAR n c Inspection State Surcharge
B; PROVID 0 WORK IS STARTED WITHIN IN DAYS
SEEMK PINK PERMIT FOR MORE INFORMATION 1190— Izf I —Q
-1110ANr ON.aHALF`.1.IS a.S..POUSE, HEIRS. ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND 11 LD HARMLESS THE CITY 01 -7— 1
EGUION111, HINGTON, ITS OIFIOIAII, EMPLOYE S. AND AGENTS FROM ANY AND Fire Review Receipt #
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ALL LAJMSWFA0S11 DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE action Total Amount Duo jjk
DEEMED TO MODIFY. You E OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANC� Fire Insp
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NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
Landscapainsp. R .. Ipt 11 k21444-1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATKIN� THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, 08 THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CON%MUC- CALL This application Is not a Ferrell until signed by the
TION; AND IN DOING THE WORK AUTHORIZED TH REBY, NO PERSON WILL BE EMPLOYED 0 B.IldFg Official or hisithe, Berney; and F .. ... pold,lon!
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTI N a,.Ipl Is acknowledged I-p— P—Id.d.
WORKMENe IN URANCE AND RCW 18.27.
IIGNATU& DATE/
TIATION
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DATE M.E. (425) , & 0.
771-0220 REL SE
AYTENInON EXT 1333
T7;ik1110— /11
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 2L
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINA -FJ�U- YELLOW. lN4ECTORt
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 FAX PINK'OW . GOLD,ASSESSOR
10101
GUTTERS)DOWNS13M]ITS
TO CONNECT TO EXIST. SYST.
APPROVED AS NOTED
BY ENGINEERING
----------
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Date: giv �07,
OOFRICWMCTOR is RE"SIM FOR FLeA LDOITIOQ 46. 6
umm CWROL AND DRAINAGE
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JUN 1 1 2002.
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BUILDING DEPT,
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NOTICE: IF THE DOCUMENT IN THIS FRAME IS LESS CLEAR THAN THIS NOTICE
IT IS DUE TO THE QUALITY OF THE DOCUMENT.
MR
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June 6, 2002 0�' Z
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City of Edmonds 'R,
Development Services Dept.
Attn. Steve Bullock
121 Sth Avenue North
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Edmonds, WA 98026
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Subject: Critical Areas Conditional Waiver Request CL
Le Residence
7025 Lake Ballinger Way, Edmonds 98026 c— In
Tax #004888-008-009-02 jo
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We request a conditional waiver for the proposed building permit (Residential 0
Remodel/Addition/Alteration) submitted for the residence noted above.
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The proposed addition, we feel, would not impact the Critical Areas located on or adjacent to the
F, (see project site
site. The addition will be approximately 154 feet from the lakeside boundary M
plan), which will be well clear of property setbacks and buffers. The proposed addition win also
not extend beyond an exterior deck the currently exists on the property.
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Attached are photos of the site. We greatly appreciate your consideration.
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Sincerely, H"
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Royal Dumo
Chermak Construction, Inc. In
RECEIVED
JUN 1 1 2032
(425) 776-1367 FAX: (425) 774-4993 BUILDING DEPT
7526 Olympic View Drive, Suite C
Edmonds, WA 98026 CHERM C1 11 ONU www.chermak.com
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Sent By: LSA; 425 872 7998; Doo-5-03 2*40PM; Page 2/5
own/aMM/Raw/fORWORMOSM
Dccember7,2003
Dang'f. Ngqm
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C16 Huy, TA
7025 IAAC flaingOrWay
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Edmondo, WA 98026
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(206)365-7957
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Rw, Proposal ior Flood inamoweEtevationeadfieft for the property located at 7025 Lake Bellinger
to,
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Way, Edmonds, WA. Also knownas Parcel AofCity ofEdmonds Short Plat rcoorded under
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A.F.N. 7811020203.
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Dear Hay:
In accordance vA% our recent conversation and information provided, we have agreed to providelthe
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SINV"Ing for the above captioxied project as outlined below:
1. Establish the vertical elevation and other field measurerneing as required under the Federal
Emergency Management Agency Elevation Certificate.
2. Completion ofElevation Certificate f0m
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litradred and Seventeen Hundred Dollars ($1,500.00-$1,700-00).
Them fees do not included any recording fees and/or -production cost and do not milect MY cost
&"mawdvil&qpnqm=tLnpan&orprVwabonofapplicabonF, Wewincommenoeworkinanoduftly
upon receiving a signed copy ofthe enclosed contact
Lmelt-5gucriond 8. A
V4003WAVC.W,.,%UIIC200, VdwA-Ad,WA95036 425-M[591
Sent By: LSA;
425 872 76198; Dec-5-03 2:41PM, Page 4/5
LAA File No, Ref:
KROLL
This somarnent Is rnsdo and entered at Lynnimood. Washington this_ day of—, 2003,
by and bm~ LOVELL-SAUERLAND & ASSOCIATES, INC. (hersirtafter called the 'CONFAJLTANTI and:
Deng T. Nguyen Work ordered By; Huy Le
7025 Lake Ballinger Way
Edmonds, WA 98026 Tel. (200) 365-7067
Fax:
(Hereinafter callmd the 'CUENT')
AUTHORIZATION
The undersigned has mod this agreement, accepts the terms and conditions thereof, warrants that
he/she owns the described property or acts as the authorized agent of the owner, and he/she (and
hiather principal If the undersigned acts as aWt) Promises to pay the charges provided for herein
together with Interest an past due sunns and all reasonable attomWs fees and litigation expenses
should this agreement be placed in the hands of an attomey to collect the sums due to Lovell-
Sauerland G Associates, Inc.
Signed
Work Type: — Engineering _X_ Surveying Planning _ Other
Fee: Time & Materials Estimate JMK 1: J1,5OQMtZQQM
Retainer
Required: In the Sum of INS)
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WORK DESCRIPTION:
PROPOSAL OF PROFESSIONAL SURVEYING PER ATTACHED LETTER SIGNED BY
JOHN K. SLAKE AND DATED DECEMBER 7, 2003.
Page 1 of 2
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Sent By: LSA;
426 672 7998; Doo-5-03 2,42PM; Page 515
LIM'!
GENERAL TERMS AND CONDITIONS
A) The foregoing Is a confirmation ofthe work ordered to be performed. if any information shown
hereon le not In accordance with your understanding,please advise our office Immediately.
We will not be responsible for Strom or misunderstandings which may arise from lack of
proper notification.
B) In the event additional professional services work Is requested or changes made other then
that of the original contract all charges shall be paid by the client as extra work.
Q In the event that any staking is destroyed by an act of God or parties other than consultant
the cost of re -staking shall be paid by the client as extra work.
D) AM few and other charges will be billed monthly and shall be due and payable within ton days
of presentation unless otherwise Specified In this agreement. fleimbuirsable expenses will be
billed at I 10%. If payment is not recaNscl within 30 days of billing, a late payment (finance
charge) of 1.5% per mornh, which Is an annual rate of 18%, shall be applied to any unpaid
balance, commencing.30 days after the date of the original invoice.
E) If, after 30 days, payment Is not received, the consultant has the right to suspend work until
payment Is made,
F) A lion will be recorded within ninety (90) days of the last day worked, unless the account Is
paid In full, or prior arrangements have been made, Any charges for the filing of Such a lion
and the subsequent filing of the lion release, all In addition to any other charges made, shall
be paid by cliord.
0) Should this agreement be placed in the hands of an attorney for collection, all reasonable
attorneys fees and litigation expenses shall be paid by client.
H) In the event that client Institutes a suit agahm consultant because of any failure or alleged
failure to perform, error, omission or negligence, and If such suit is not successfully
prossmited, cliem agrees to pay consuftent any and all cost of defense,
1) In the went all or any portion of the work prepared or partially prepared by the consultant be
Suspended, abandoned, orierminffted, client shall paytho consultant forall few, charges, and
services Incurred to date of termination.
A In the event either client or consultant files suit, it is agreed by both parties that the proper
place for such suit shall be Snohomish County Superior Court, State of Washingm.
K) All original papers and documents, and copies thersof� produced as a result of this contract,
except documents which are required to be filed with public agencies, shall remain the
property of the consultant.
Q Lovell-Sauerbrid & Associates, Inc. will diligently pursue the above described work and
complete the some within a reasonable time unless delayed by circumstance beyond its
control, If a fixed lee Is specified above, It Is understood and agreed that said fee is predicated
upon conditions and availability of closest existing survey control points according to public
records which are Subject to field verification. If any such points, records. or conditions are
found to be missing, In error or changed, Lovell-Sauerland & Associates, Inc, will Inform the
client as to any fee Increase which will be required as a result, In that event the client may
terminate the job and will reimburse Lovell-Seuerland & Associates, Inc. for charges incurred
to that date.
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SINGLE-FAMILY RESIDENTIAL
SHORELINE SUBSTANTIAL DEVELOPMENT PERMIT
EXEMPTION
Project Location: 7025 Lake Ballinger Way, Edmonds
Applicants: Royal Dumo or Chermak Construction for owner Huy. Le'
Project Description: Addition of 213 square feet to the first floor and 292 square feet to the
second floor of the north side of existing Single Family Residence.
See Attached: 10 Site Plan 0 Elevation
-02-285
Plan Check Number: PC
Date Issued: July 25, 2002
SEPA I Determination: Determination of Nonsignificance issued on July 25, 2002
Issued by: Star Campbell, Assistant Planner
The above project has been determined to be exempt from the requirement to obtain a Shoreline
Substantial Development Permit under WAC 173-27-040(2)(g), which states:
Construction on shorelands by an owner, lessee or contract purchaser of a single-family
residence for their own use or for the use of their family, which residence does not exceed
a height of thirty-five feet above average grade level and which meets all requirements of
"Single-family
the state agency or local government having jurisdiction thereof.
residence" means a detached dwelling designed for and occupied by one family including
those structures and developments within a contiguous ownership which are a normal
appurtenance. An "appurtenance" is necessarily connected to the use and enjoyment of a
high water m rk and the
single-family residence and is located landward of the ordinary a
perimeter of a wetland. On a state-wide basis, normal appurtenances include a garage;
ading
deck; driveway; utilities; fences; installation of a septic tank and drainfield and gr
which does not exceed two hundred fifty cubic yards and which does not involve
Local
placement of fill in any wetland or waterward of the ordinary high water mark
circumstances may dictate additional interpretations of normal appurtenances which sha I
be set forth and regulated within the applicable master program. Construction authorized
under this exemption shall be located landward of the ordinary high water mark;
Robert Fritzen, Shoreline Planner with the Department of Ecology, has stated that this has been
interpreted to include additions and remodels to existing single-family houses, provided that they
are normal appurtenances to single-family dwellings.
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This exemption is not being sent to the Department of Ecology because it appears to City staff
that it is not subject to U.S. Army Corps of Engineers section 10,permit under the Rivers and
Harbors Act of1899 (the provisions ofsection 10 ofthe Rivers and Harbors Act generallyapply
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to any project occurring on or over navigable waters. Specific applicability information should
be obtained from the Corps of Engineers.) Nor does the project appear to City staff to require a
section 404 permit under the Federal Water Pollution Control Act of 1972. (The provisions of
section 404 of the Federal Water Pollution Control Act generally apply to any project which may
involve discharge of dredge or fill material to any water or wetland area. Specific applicability
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information should be obtained from the Corps of Engineers.) Robert Fritzen has advised us that
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per WAC 173-27-050, no letter is required to be sent to Department ofEcolo gy
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While this letter provides an exemption from the need to obtain a Shoreline Substantial
Development Permit from the City of Edmonds, it does not evaluate whether other State and
Federal approvals are required and leaves that responsibility to the applicants.
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Shoreline Permit Exemption File
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WE=
FEDERAL EMERGENCY MANAGEMENT AGENCY
NATIONAL FLOOD INSURANCE PROGRAM
ELEVATION CERTIFICATE
Irnoortant! Read the Instruclions on oanes 1 .7.
O.M.B. No. 3(
Expires Decei
BUILDING STREET ADDRESS (including Apt., Unit, Suite, and/or SkIg. No.) OR P.O. ROUTE AND BOX NO. company NAIG Number
7025 LAKE BALLINGER WAY
CITY STATE ZIP CODE
Edmonds WA _98026
PROPERTY DESCRIPTION (Lot and Block Number, Tax Parcel Number, Legal UeScriptron, etc.)
LAKE BALLINGER LANDCO SUBDIV I BUK 008 1 Lots 8 & 9 Parcel Number 03488800800802
BUILDING USE (e.g., Residential, Non4eSki Addition, Accessory, a
Residential
ILATITUDEILONGRUDE (OPTIONAL) HORIZONTAL DATUM: �jo_j RCE: 171 GPS (Type):
#1P 49 -##.##' or #ff###W ONAD1927 ONAD19M 0 USGS Quad Map 0 Other
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
NFPCOMNITYRAKE COWUNITYNUMBER B2. COUNTY NAM - STA-
E.'dmmds530163 SnolhorrMindepanxIedaty 11A
L B9. BASE
BE:: E\ASED KFLOODZCNE(S) goneX
B4,MAPANDPANE B7.FIRMPANEL
NUIRER 111RIX 11111)i) EFFECTIVEIR FT==S)
MW315 E low 110% A 282S
B10.1ndicatethesou"ce ofthe Base Flood Elevation (SHE) dataor baseffood depth entered in t39.
0 FIS Pdre n FIRM 0 Community Determined El Other (Describe):
Bll. Indicate theelvalion datum used for the BFE in B9., 0 NGVD 1929 CINAVD1988 00ther(Desaffee):_
B12. Is ithei located in aCoastail Barrier Resources (CBRS) area or0therMse Protected Area (OPA)? E]Yes ONo Designati
Cl. Building elevations are based on: 0 Consauction DraMngs* Lj Building UnderConstnuclon' IN hn'sneo tonstrucuon
new i Certificate tMil be required when construction of the building is conniplete.
C2. Building Diagram NumbLr8 (Select the bulding cliagram most simliarto the building forwhich thiscafficate is being completed -seepages 6 and 7. 11
accurately represents the building, provide a sketch or photograph.)
C3. i — Zones Al-A30, AE, AH, A (with BFi VE, V1430, V (Wth SFE), AR, ARA, ARIAE, AR/Al -A30, APJAH, APJAO
r—lop. lt� C.1 -n4 belm acoordina to the buildina diacram specified in Item C2, State the datum used. ff the dam Is cifferent from the datum used for the BFE in
T;Is . ..,re �.wi I rriri�oepurri�hable by fine or jmp�sonmerd under 18 U.S. Code, t'loh 101.
CERTIFIERS NAME RobartGreale 1111TENUMBER29539
TITLEOWNER COMPANY NAME GREENE LAND SURVEYING
790619P
SIGNATURE
FEMA Form 81-31, January 200:
i WA 9wzd
DATE TELEPHONE
01107r,lDG4 42569T66M
reverse side for continuation, Replaces all prevl7us
Copy both skies ofthlis Elevation Cefficatefor (1) community official, (2) insurance agentloompany, and (3) building owner,
COMMENTS
A Base good Elevation of28260feet NGVD 29 was Estabhshed perthe Cftyd Mountlake Terrace with theffood event Dec, 19%
El Check here 9 attachments
SECTION E - BUILDING ELEVATION INFORMATION LSURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WHOUT SFE)
For Zone AD and ZoneA (without BFE), complete [terns ElthroughE4, 9 the Elevation Calicate Is intended for use as supporting Information for a LOMA or LOMR-F,
Section C must be completed.
El. Building Diagram Number -(Select the building diagram most similar tothe Wildingforwhich this certificate is being completed -see pages6 and 7. Ifirrodiiagramacourately
represents the building. providea sketch or photograph.)
E2. Thetopolthe bottom Poor (including basementor enclosure) of the building is _ft#)_in.(crn) [I aboveor 171 below (check one) the highestadlacent grade. (Use
natural grade, 9 available).
E3. For Building Diagrams 6-8 with openings (seepage 7), the neA higher floDrorelevated floor(elevation b) of the building is _ R.(m)_jn,(cm) above the highest adacent
grade. Cornoetefterns, C3.h and C3.1 onfrontofform.
E4. The top ofthe platforn ofmactinery andlorequipmerit servicing the Wilding is _ft.(m)_in.(cm)F1aWveor M below(check one) the highest adjacent grade. (Use
natural grade, If available),
E5. ForZoneA0 only: If no flood depth number is available, is thetop ofthe bottom floorelevated in accordance with the oommunity'siloodplain marragamentordinarroe?
E]Yes ONo El Unknown, The local official mustoadfly this Information in Section G.
SECTION F - PROPERTY OWNER (OR OWNERS REPRESENTATIVE) CERTIFICATION
The property owner or ownet's aftdzed representative who completes Sections A, B, C (items C3.h and C3,I only), and E for Zone A (without a FEMA4ssued or community -
issued BPE) orZoneA0 must sign hem The statements in Sedii)ns/l, B, Q andEare =red to the bestofrryknowfedge.
PROPERTY OWNERS OR OWNERS AUTHORIZED REPRESENTATIVES NAME
ADDRESS CITY STATE ZIPCODE
SIGNATURE DATE TELEPHONE
Check here ff aWments
4—,
SECTION G . COMMUNITY INFORMATION (OPTIONAL)
Thelocal offical wh6iCs anthorzed by law oradharroe to adirfinister thetommunity's floodlilam managememordinance can complete SectlonsA, 8, C (or E), and G of this Elevation
Cadificate. Complete thdain.plic" ftem(s) and sign below.
Gl,, D Thetriformatkin in Sqdon Qwas taken from other documentation that has been signed and embossed by a licensed surveyor, engineer, or architect who is wthonzed by state
'0rIoMl3wt0oerfl�eleA&lqIbdnabon. (indicate the source and clateof the elevation date in the Comments area below.)
G2,0'Ac&Tvhun4offidaloomOf4��mEfdabuildigbadi��eA(wfthoutaFEM44ssuedor=nmun�/4ssuedBFE)orZDneAO.
G3. 0 T�Ioving informiatim. (Items G�G9) is pmvided for community floodpain management purposes.
DATEIE1111 ISS1111
_364q.:
G7. This permit has been issued for. EINewconstnuction 13SubstantalImprovement
GB. Elevation of as�Wlt lowest floor (including baserrent) ofthe Wilding is: '2 85". 06 ft'(m) Datum:
G9. OFE or(in Zone AD) depth of flooding at the building site is: _fl.(m) Datum:
LOCAL OFFICIALS NAME TITLE 4U14,01,Ve?
COMMUNITY NAME y 01� TELEPHONE -125-77/-OZZO x 122(�
SIGNATURE DATE /&� 0
COMMENTS
FEMA Form 81-31, January 2003 Replaces all previous editions
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FINAL PROJECT APPROVAL FORM
TO.
DATE:
MEMO TO: PERMIT COORDINATOIZ, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE—
U3 1� ENGINEERING DIVISION DATE_L-�
PLANNING DIVISION DATE—
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PERMIT # ( )k4--±—ADB#-----------PATE INSPECTED----�—� �—:—
80
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DESCRIPTION OF WORK TO BE INSPECTED--LLJ h)
A field inspection was conducted to determine final compliance with approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of
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V---G'RANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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u Copy of CONDITIONS given to owner/contractor by inspector
x
(n
z
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0
M
o Copy of CORRECTION NOTICE given to owner/contractorby inspector
1.
2.
3.
RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date_
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