21913 76TH AVE W.PDFiiiiiiiiiiiiii
15124
21913 76TH AVE W
City of Edmonds
Critical Areas Checklist
The Critical Areas Checklist contained on
this form is to be filled out by any person
Preparing a Development Permit
Application for the City of Edmonds prior
to his/her submittal ofa. development permit
to the City_
The purpose of the C%ddist is to enable
(Sty staff to determine whether any potential
Critical Ards arc or may be present on the
subject PmPcdy. The information needed to
complete the C haddist should be easily
table from observations of the site or
..a. available at City Hall (Critical Areas
inventories, maps, or soil surveys).
An applicant, or his/her representative, must
fill out the chocidist, sign and date it, and
submit it to the City. The City will review
the checddist; malaa a precursory sory site visit,
and maloe a detammation of the subsequent
steps ncccssazy to complete a development
permit application -
With a signed copy of this form, the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
parccl(s). Ter addition, the applicant is
encouraged to include any other pertinent
information or stddics in conjunction with
this C heeldist to assist staff in completing
their preliminary assessment of the site.
I have completed the attached Critical Area Cheeldist and attest that the answers providedare
factual, to the best of my knowledge (fill out the appropriate column below).
Owner/ Applicant:
M
Name
&N W, .
Tide
617 � A,
Street Address
? n-TrLf kJA 3
G ,Mate. ZIP Phone
Applicant Representative:
Name
Title
Street Address
City, State, ZIP Phone
Signature Date Signature Date
- w'V •`yam• �
Critical Areas Checklist -
Site Informatiome
Project Name: 6A.Permit Number. 'a .
Site Location: 761A MVPropertyTax Account Number: —�. co
Approximate Site Size (acres or square feet):%
Have you filled out a Critical Areas Cheddist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged? Date of most recent action:
Soils / Topography A, QeP lXZ N
2. In the Snohomish County Soil Survey, what is the mapped soil typc(s)? LANV Z- y
3. 'Describe the general site topography. Check all that apply.
Flat less than 5 feet elevation change over entire site.
LRolling: slopes on scte generally less than 15% (a vortical rise of 10 feet over a
horizontal distance of 66 feet)
Hilly: slopes present on site of more than 15% and less than 30°/4 ( a vertical rise
of 10 feet of horizontal distance.)
Steep: grades of greater than 300/6 present on site.
comments -
Hydrology/Vegetation
4. Site contains areas of year-round standing water: _*40
5. Site contains area of seasonal standing water: Approx Depth:
6. Site is in the floodway • floodplain of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? Y-n—flo.ws
are year-round? Flows are seasonal?
uca1 areasswdyis:notrequired
Deterniibauon Number: ��'�_l��"" �'�" ReG�ewer' �� '•
.:L-' Planner =Oafe
Rey '327/92
DEC - a..►
PLANNING 0&'i.
City of Edmonds
Critical Areas, Checklist
The Critical Areas Checklist contained on
this form is to be filled out byany person
pmpuing a Development Permit
Appiirdtioa for the City of Edmonds prior
to bisiher submittal of a development
permit to the city.
the purpose of the Checklist is to enable
City staff to determine whether any
potcadal Critical Areas arc or may be .
present on the subject•pro1ieriy. The
infonnnation needed to complete the
Checklist should be easily available from
observations of the site or data avai-able at
(Sty Hall (Critical Areas inventories. maps.
or soil surveys).'
An applicant; or his/her reprieseiitative;
must fill out the checklist, sign and date it,
DES
PI AWNING DE.P i'.
and submit it to the City. the (pity will
review the checklist, make a precursory site
visi4 and make a determination of the
• sub�oqucat sbcps .necessary to complete a
development permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map -
or plot plan for individual lots of the parcel
with enough detail that City staffean find
and identify the subject parc el(s). In
addition, the applicant snail include
other pertinent information (eg. site
per, topWaphy map,. etc-) or studies in
conjunction with this Chectclist to assist
staff in completing their preliminary
assenment of the site.
I have completed the attached Cd&d Arei Checklist ind attest dot the answers provided are
factual,. to the best of my lmowledge (fill out the approp&te t*lumn below).
Owner I Applicant: Applicant Representative:
t5R-J A-R. -DIVE c, T �.
Name
Street Address
VS F-u_I--,$t-- �%kit& g8527-L
4aty. Ste. ZIP Phone
t 130 �t�{
s natm Date
tTe- f- McAZILO I COIL
Name
foS-4,: avf- (J
city. sb�p, ZIP Phone
36
Sigaatune D
Site laforaatioa (sodsftopography/hydrology/v hoa)
.1_ Site Address/Location: 219 l-3 A• , 21 e-.l -7(0-lam V E
2. Property Tax Account Number. 4 45 - 0oZ - o=z
3. Approximate Site Size (awes of square feet): 2 (,, -tow sr- } 2.(--, �cc = S3 qms
4 Is this site currently developed? des; no -
If yes; how is site developed? �� �x--�� • +_ �-� 1�us� -
S. Describe the general site topography. Check an that apply. _
Flat:•. less than 54eet elevation change over eaf re site.
Roping: slopes on site generally less than IS% (a verfical rise of 104oet over, a
horizontal distance of 664cet).
MUy: slopes present on site of more (had-15% and less than 30% (a vortical fise
of 10-feet over a horizontal distance of 33 W 66-feet).
Steep: grades of gmater than 30% F esent on site (a vertical rue of 10-feet over a
horimoacd distance of less than 33-feet)_
Odrer (please desar'be): .
6. Site contains area of year -acrid sta wmg water: 1J0 ; Approx. Depth:
7. Site contains arras of seasonal Standing water: o ' App
What season(s) of the yeaO. N Cyr AW? pis t,&- t �
8. Sits is in the floodway� floodpWm N O of a water course.
9....Site contains a ccwt or an area where water flows accost the grounds surfaW Flows are year-
round? N a flows are seasonal? Aso (What time of yeah . A
10. Site is primarily_ -forested ; meadow shrubs ; mixed
urban landscaped -Qawn shrubs etc) '
;•
11. Obvious wetland is present on sites
ItRaQ02Wy1
STREET
FILE t
Critical Areas Checklist
Site Informat"
Project Name: is . RM 61A.Permit Number.
Site Location: 3 761AV Property Tax Account Number_ — '-Wj oD
Approximate Site Size (acres or square feet): 6w
Have you filled out a Critical Areas Checldist for a project on this site before?
General Site Conditions
1. Has the site been cleared or logged?
Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soil typc(s)? L-Atq D Z -
3. Describe the general site topography. Check all that apply.
Flat.lcss than 5 feet elevation change over entire site_
LRolling: slopes on site generally less than 15%.(a vertical rise of 10 feet over a
horizontal distance of 66 feet)
Hilly: slopes present on site of more than 15% and less than 30°/p ( a vertical rise
of 10 feet of horizontal distance.)
Sleep: grades of greater than 30% present on site. .
Comments
City Of Edmonds
Critical Areas Checklist
The Critical Areas Checklist contained on
Bus form is to be filled out by any person
preparing a Development permit
Application for 8hc City of Edmonds prior
to his/her submittal of a development permit
to the city_
The, purpose of the Checklist is to enable
City sUffto determine whether any potential
Critical Areas arc or may be present on the
sabjea property_ The information needed to
complete the Choddist should be easily
available from observations of the site or
data available at City Hall (Critical Areas
inventories, maps, or soil surveys).
An applicant, or his/her representative, must
fill out the checklist, sign and date it, and
submit it to the City_ The City Will review
the choddist, make a precursory site visit,
and make a determination of the subsequent
steps necessary to complete a development
pennit application_
With a signed copyof this form, the
applicant should also submit a vicinity map
Of the parcel with enough dcbul that City
staff can find and identify the subject
paroel(s)- In addition, the applicant is
encouraged to include any other pertinent
information or sWdics in conjunction with
this Chcckiist to assist staff in completing
their preliminary assessment of the site_
I have completed the attached Critical Area Checklist and attest that the answers providedare
fachUL to the best of my knowledge (fill out the appropriate column below).
Owner/ Applicant_
f�
Name
OW H
Title
1114--111-7
Street Address
City, State, ZIP Phone
Applicant Representative:
Namc
Title
Street Address
City, State, ZIP
Phone
Signature Date Signature
Date
January 22, 1990
TO: Larry Naughten
Mayor
FROM: Bobby Mills
Public Works Superintendent
SUBJECT: WATER DAMAGE AT 21913 - 76TH AVENUE WEST +
----------------------------------------
After review of what happened at the above address it looks like the
damage was caused by the owner and not any fault by the City. Lee
Willieksen did as one should. When.he noticed the water running longer
than normal he again turned off the meter. The owner then was notified.
Attached is the Memo for Record regarding this account. Since we were
instructed to turn on the water it became the owners responsibility for
what happened inside the home. What would you like me to do about this
account?
BM/lk
Attachment
Account turned off and locked for nonpayment several days with daily
check for damage to lock or meter. On Friday, December 15, 1989, found
meter still off and locked. Upon further investigation noticed a
garden hose strung from next door house at 21901 - 76th Ave. West
leading to 21913 - 76th Ave. West at the rear or east side of the
house. I disconnected the hose and notified person residing at 21901 -
76th about the illegal hook-up. He said he did not know anything about
it. I explained to him to watch and please disconnect the hose if
found hooked up.
On December 19, 1989, a radio call requested a turn -on at 21913 - 76th
Ave. West and that the account was paid in full. At approximately 3:00
PM I unlocked the meter and turned the water on. The meter was
indicating water was running somewhere on the property. I called Ilene
Larson, Utility Billing Clerk, on the radio to ask her to call on this
account as to whether to leave the water on or off. She answered after
about three (3 minutes) to leave it off and to meet with customer at
8:00 AM an December 20, 1989.
I turned the meter off, but did not lock it and left. On December 20,
1989, I waited at the house from 8:00 AM to 8:20 AM. No one showed
up. I radioed my supervisor, Archie Brena, to alert him in case anyone
called for service at this address and left. Later phone conversation
with Leanne at 774-8615 indicated a faucet was on inside the house and
sink drain was plugged causing water to overflow onto the floor. I
passed the information on to my supervisor, Scott Highland.
/ R --2G 99
L Wi ieksen Date
#451125/TXTWATER
Professional
Realty
Options
Mayor Larry Naughten
Civic Center
505 Bell
Edmonds, Wa. 98020
Dear Sir,
RECEIVED
JOIN 10 WO
MUC..JUORKS
4210 198th St. S.W., Suite 103
Lynnwood, WA 98036
(206) 774-8615
January 6, 1990
Re: Water damage claim.
I am writing you in regard to the water damage at the home
located at 21913 76th Ave-W. This is. the problem I discussed
with you by telephone on January 5th of this month.
This office received a call from the Edmonds Utility office on
December 19th at approx. 3:00 pm. We were informed that the
field worker was going to restore water service but when he
turned on the water, he could here water running, consequently
he turned it back off and called his office. The girl at his
office contacted us of this situation and it was agreed that
the water would be turned on the following morning at approx./
8:00 am.
I sent my secretary to the home that evening of December 19th
at approx. 4:30pm to go in the house and make sure all faucets
and valves were closed.(The home was vacant.) She entered the
home to find that the faucett on the bathroom sink was open and
there was 2-3 inches of water on the bathroom, bedroom, and
hallway floor.
I called the water department and spoke with the supervisor,
Archie Brenna, explaining the situation. He checked and informed
me that his field man had turned the water off; and he had to
beleive his employee. I am sure that was his intent, but the
water was not turned off. It was less than 1, hours after he
was there that my secretary was there.
We had to have carpet cleaning firm come with a water vaccume
and the carpet has to be replaced in the hall and one bedroom.
It is old carpet but the labor and material to replace it will
probably amount to $300.00. The carpet cleaner assessed us $50.00
and I think that $150.00 toward the carpet expense would be a
fair amount. This a total of $200.00. Would you please do what
you can, to see that this amount is sent to us as soon as
possible.
Thank you for your immediate attention to this matter.
�yIzz
Gene Sylte
Broker/Owner
113�
REALTOR
Sales • Listings • Property Management • Market Analysis • Notary Service
mum —
I 1 I E. H. "SHORTY" INGRAM
District Manager .
C,�_J��
Lc _ Di S core NBC �C.
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of
Phone —
Area Code Number Extension
TELEPHONED PLEASE CALL
CALLED M SEE YOU WILL CALL AGAIN
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Professional
Realty
Options
Mayor Larry Naughten
Civic Center
505 Bell
Edmonds, Wa. 98020
Dear Sir,
4210 198th St. S.W., Suite 103
Lynnwood, WA 98036
(206) 774-8615
RECEIVED
JAN 1.0 IJ90 REAUOR
January 6, 1990
EUB-M-WORKS
Re: Water damage claim.
I am writing you in regard to the water damage at the home
located at 21913 76th Ave W. This is the problem I discussed
with you by telephone on January 5th of this month.
This office received a call from the Edmonds Utility office on
December 19th at approx. 3:00 pm. We were informed that the
field worker was going to restore water service but when he
turned on the water, he could here water running, consequently
he turned it back off and called his office. The girl at his
office contacted us of this situation and it was agreed that
the water would be turned on the following morning at approx.
8:00 am.
I sent my secretary to the home that evening of December 19th
at approx. 4:30pm to go in the house and make sure all faucets
and valves were closed.(The home was vacant.) She entered the
home to find that the faucett on the bathroom sink was open and
there was 2-3 inches of water on the bathroom, bedroom, and
hallway floor.
I called the water department and spoke with the supervisor,
Archie Brenna, explaining the situation. He checked and informed
me that his field man had turned the water off; and he had to
beleive his employee. I am sure that was his intent, but the
water was not turned off. It was less than i, hours after he
was there that my secretary was there.
We had to have carpet cleaning firm come with a water vaccume
and the carpet has to be replaced in the hall and one bedroom.
it is old carpet but the labor and material to replace it will
probably amount to $300.00. The carpet cleaner assessed us $50.00
and I think that $150.00 toward the carpet expense would be a
fair amount. This a total of $200.00. Would you please do what
you can, to see that this amount is sent to us as soon as
possible.
Thank you for your immediate attention to this matter.
Gene Sylte.
Broker/Owner
Sales • Listings • Property Management • Market Analysis • Notary Service
MEMO FOR RECORD
December 20, 1989
SUBJECT: 21913 - 76th Ave. W. - Account W451125
Account turned off and locked for nonpayment several days with daily
check for damage to lock or meter. On Friday, December 15, 1989, found
meter still off and locked. Upon further investigation noticed a
garden hose strung from next door house at 21901 - 76th Ave. West
leading to 21913 - 76th Ave. West at the rear or east side of the
house. I disconnected the hose and notified person residing at 21901 -
76th about the illegal hook-up. He said he did not know anything about
it. I explained to him to watch and please disconnect the hose if
found hooked up.
On December 19, 1989, a radio call requested a turn -on at 21913,- 76th
Ave. West and that the account was paid in full. At approximately 3:00
PM I unlocked the meter and turned the water on. The meter was
indicating water was running somewhere on the property. I called Ilene
Larson, Utility Billing Clerk, on the radio to ask her to call on this
account as to whether to leave the water on or off. She answered after
about three (3 minutes) to leave it off and to meet with customer at
8:00 AM an December 20, 1989.
I turned the meter off, but did not lock it and left. On December 20,
1989, I waited at the house from 8:00 AM to 8:20 AM. No one showed
up. I radioed my supervisor, Archie Brena, to alert him in case anyone
called for service at this address and left. Later phone conversation
with Leanne at 774-8615 indicated a faucet was on inside the house and
sink drain was plugged causing water to overflow onto the floor. I
passed the information on to my supervisor, Scott Highland.
LW Willieksen Date
#451125JTXTWATER
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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 this map(s), nor for
any one representation provided based
upon said map(s).
USE PERMIT 9� (y�'
CITY OF EDMONDS ZONE
NUMBER J
7MAILINGADDRESS
TION PERMIT APPLICATION a,B SUITE/A
E OF BUSINESS ADDRESS 12 `5 t,� { -
LEGAL DESCRIPTION CHECK SUBDIVISION NO.-n` LID No.
w
j O (✓-u \mili�
PUSLIC'PIGHT OF WAY PER OFFICIAL STREET MAP. TESCPApproved
SEXISTING REQUIRED DEDICATION RW
Inspection
PROPOSED
❑
Permit Required ❑
Veel Use Permit Rep'O O
Required ❑
Required ❑
CITY ,` - -- ZIP
Iset-ut.JL-^4�PrriA �i>3Z
TELEPHO-rNE�N-0 UMBER 17-
7IL7fa 1R7
NAME
Sidewalk
METER SIZE I
LINE SIZE
I NO, OF FIXTURES
PRY REQUIRED
YES ❑ NO ❑
ADDRESS
REMARKS
OITY ZIP
TELEPHONE NUMBER
,!5 ✓ �h
NAME
ADDRESS
it 1 t 4;7 Q I,v T IAJG trtil t.
ENGINEERING MEMO DATED REVIEWED BY
CITY ZIP
gu21-r1.1G TC�+3 1[3-2
TELEPHONE NUMBER
Z4`-75% 2'37�
iREMEMOOATEQ R IEW DB
STATE LICENSE NUMBER EXPIRATION DATE
r•—IG n I -r L 10 M 1 a '7-.'2I -95
SIGN AREA
ALLOWED PROPOSED
SEPAREVIEW
COMPLETE EXEMPT
E%P
ADS NO.
Legal Description of Property - include all easements
Lot' 2 �l c.r ac 2 f \IJ�n �AoJ� �+` �D.
SHORELINE
5, I
1_C..
VARIANCE OR CU
PLANNING REVIEW BY
DATE
O CW t1
W
SETBACKS - FEET
,FRONT SIDE 'REAR
HEIGHT
LOT COVERAGE
Property
Tar Account d _ G. �+� .,,.� ,-
Parcel No.
REMARKS
NEW El RESIDENTIAL PLUMBING
ADDITION COMMERCIAL MECHANICAL
El REMODEL APT. BLDG. El SIGN
GRADING FENCE
. REPAIR CYDS. El (x_FT}
DEMOLISH WOODSTOVE SWIM POOL
INSERT HOTTUB/SPA
OGARAGE RETAINING WALL! RENEWAL
CARPORT ROCKERY
/TYPFnFUSE B09INESS OR ACTIVITY) EXPLAIN:
CHECKED BY
TYPE OF CONSTRUCTION
4�&LL
CODEE�
7
OCCUPPANT
j/ 3®
SPECIAL INSPECTOR AREA
REQUIRED
❑ ES
Y
O/C`+CUPANT
LOAD
MARKS
PROGRESS INSPECTIONS PER UBC 305.
NUMBER w.
NUMBER OF
CRITICAL
OF
DWELLING
AREAS
STORIES
UNITS
NUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
Q L_ 1 of
i sT IAx
FINAL INSPECTION REQUIRED
PLAN CHECK FEE
BUILDING
a�
HEAT SOURCE:
GLAZING
PLUMBING
Plan Check No.
MECHANICAL
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,
STATE SURCHARGE
Permit Application;180 Days
Permit Limit:1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her Spouse, heirs, assigns and
ENO. INSPECTION FEE
successors in Interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
Qemployees, 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
Q
In odify, waive or reduce any requirement of any city ordinance
i nor limit in any way the City's ability to enforce any Ordinance
TOTAL AMOUNT DUE
I
�l
provision."
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 agree to comply with city and
THIS PERMIT
This application is not a permit until
state laws regulating construction; and in doing the work authoriz•
AUTHORIZES
THE
signed by the Building Official or his/her
ed thereby, no person will be employed in violation of the Labor
ONLY
WORK NOTED
Deputy; and fees are paid, and receipt is
Code of the State of Washington relating to Workmen's Compensa•
acknowledged in space provided.
tion Insurance and RCW 18.27.
INSPECTION
SIGNA RE (OWNER OR AGENTI SIGNED
DEPARTMENT
" E DATE
J.ATE
t / /
`6rtvt, KAv-dLe�)rc K- Il a�ltV1 `7`'1
CITY OF
EDMONDS
V 1,41 - %mil
CALL FOR
RELEAS a DATE
ATTENTION
INSPECTION
d
ITNTIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
��� r.LL OwAo
ORIGINAL - File YELLOW- Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK - Owner GOLD - Assessor