BLD20160848#Z{) CA File No:
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location 16„
2-Property Tax Account Number: I i tit � f.rs� 9 7
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? _ es; no.
If yes; how is site developed?'� "
5. Describe the general site topography- Check all that apply -
Flat less than 5-feet elevation change over entire site.
Rolling -
slopes on site generally less than 15% (a vertical rise of 1Q-feet over a horizontal
distance of 66-feet).
"---< Hi r slopes present on site of more than 15% and less than 30% (a vertical rise of 10-feet
over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal
distance of less than 33-feet)-
other (please describe):
6. Site contains areas of year-round standing wager- —Jqd2--- Approx- Depth:
7. Site contains areas of seasonal standing water: —Y=— ; Approx- Depth:
What season(s)-of the year? IO
8. Site is in the floodwayQ_ floodplain of a water course.
9. Site co tams a creek or an area where water flows across the grounds surface? Flows are year-round?
Rows are seasonal? (What time of year. ).
10. Site is primarily: forested ; meadow_ shrubs : mixed
urban landscaped (lawn, shrubs etc) -
11. obvious wetland is present on site: -
For City Staff Use Oaiy
1. plan Check Number, if app %?
2 Site is Zoned? �S
3. SCS mapped so�T iype(s)?
,11
4 Critical Areas inventory or CA. map indicates CIItical Area on site?
eim 5—
S. Site witiun designated earth subsidence landslide hazard area?
✓ SITED
STUDY RE WAIVER {
Reviewed -
c' Date:
Page 2 of2
Revised on 12118112
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-Critical Area Map
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Development Services Department
--=
Planning Division
Phone: 425.771.0220
Fax: 425.7710221
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
Date Received-
City Receipt#:
Critical Areas File #:C2A2
Critical Areas Checklist Fee
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. - The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition, the applicant - shall include other pertinent
information (eg. site plan, topography map, etc.) or
studies in cbnjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/herrits heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, hisiberri s agents or employees.
lay my signature, I certify that the information and exhibits h submitted are true and correct to the best of my
knowledge and that I am authorized to file �uJ �'yli°� on t of the owner as listed below:
Property Owner's Authorization t
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my percussion for the public officials and the staff of the City of Edmonds to enter the subject property far the
purposes of inspection and posting attendant to this application��
SIGNATURE OF
Owner/Applicant:
Name
, �.
Street Address
City State ZIP
Telephone:�?�
Email address:
3— tom —
Applicant Representative:
ZkA - - Lie
Name
Street Address
City State Zip
Telephone: g-2&
Email Address• a/�!� C•��5'3�'! —
Revised on 1211&12
P20- OWc d Areas ChecHirs
Page I of 2
CITY OF EDMONDS
1215" Avenue North, Edmonds WA 98020
Phone: 425.771.0220 - Fax: 425.771.0221- Web: www.edmondswa.9ov_
DEVELOPMENT SERVICES DEPARTMENT - PLAIR41NG DIVISION
1
Areas s Reconnaissance Report
Critical Areas File Number
Determination
-Site Locdtlon
Tax Account Number
- ' Property Owner
Applicant
Critical Areas Present
Le Descripbi n
'CW01500z0
Study Required
16 04 = 750 Place-fll &t
00513100009002 and 00513109700100
- Rodger li/lay - -
Derek Abbott ACH NW -LLC
0 Geologically Hazardous Areas:
0. Erosion Hazard Areas- - -
H Landslide Hazard Areas _
During review and inspection of the subject site, it was found that the site may contain (or be adjacent to) critical
areas, including Geologically Hazardous Areas (Erosion Hazard Area or Landslide Hazard Area), pursuant to
Chapters 23.40 and 23.80 of the Edmonds Community Development Code (ECDC). Geologically hazardous areas
include areas susceptible to erosion, land sliding, earthquake, or other geological events. They pose a threat to the
health and safety of citizens when incompatible development is sited in areas of significant hazard. Such .
incompatible development may not only place itself at risk, but also may increase the hazard to surrounding
development and use. Cited sections of the Edmonds Community Development Code (ECDC) can be- found on the
City of Edmonds website at www_edmondswa.eov.
The subject property is located on the west side of 75u' Place west between the road and the BNSE railroad right-
of-way. The property slopes down to the west from 75�1 Place at approximately 20% according to the chys UDAR
information: Soils on the property are identified as Alderwood gravelly sand foams 15 — 25% slopes and
Alderwood gravelly sand loams 25 — 70 % slopes. The soils together with the slopes also classify the site as a
potential erosion hazard area. The property is also located within the North Edmonds Earth Subsidence Landslide.
Hazard Area which also classifies the site as a potential landslide hazard.
Certain activities are allowed in or near critical area buffers as specified in ECDC 23.40.220. Similarly, certain
development proposals may be exempt from Critical Areas -requirements (ECDC 23.40.230). if you have any
questions about whether your proposed development qualms as an allowed or exempt activity, please contact
a planner for more information.
!i.
ltWIoLttiQtl
l s MECHANICAL,
SERVICES
_ PLUNIBIl�TMECHANICAL, TANK, &DEMOLITION
PERMIT APPLICATION
121 5t' Avenue N. Edmonds, WA 98020
City off Edmonds �sPhone 425.771.0220 I! Fax 425.771.0221
PLEASE REFER TO THE PLWaING & MECHAWC.4L CHECKLIST FOR SUBAff7TAL REQUIREMENTS
V, Y
PROJECT ADDRESS (Street, Suite.#, City State, Zip):
Parcel #: ((2" 7Q 0 0 0 9 00'
JV '��1•
4++VM}N �7
y
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes No �
sso
Associated Permit #:
APPLICANT: n r, 4
Phone:
Fax: Alm
Address (Street, City, $date, p): /
`N 1,
E-Mail Address:
%12t
PR PENYMR:
D
Phone: Fax:
Ad (Street, te, Zi ):
E-Mail Address:
o'er J
LENDIN GENCY:
Phone:
Fax:
A,I ess (Street, City, State, Zip):.
E-Mail Address:
CONTRACTOR:* A ? J
Phone: ��a�
Fax:
Address (Street C�ijlate, p : n /
E-Mail clieps
t
*Contractor must have a valid City of Edmonds business license prior to doing work
WA State License #f/Exp. Date:
* a 1 j - fO B
in the City. Contact the City Clerk's Office at 425. 775.2525
City Business License #/Exp. Date:
o •,
PLUMBING MECHANICAL U TANK LDEMOLITION
DETAIL THE SCOPE OF WORK: E 141
K-L-5AkXW-1kU, � U{. W(M'
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I declare under penalty of perjury laws that the information I have provided on this fornr/upplication is true, correct and complete,
and that I ant theproperty owner or duly authorized agent of the property owner to submit apermit application to the City of
Edmonds.
Print Name:` Owner ❑ Aent/Other t4 (specify):
Si -nature: Date: L , 9 ✓
FORM C L:1Buildin2 New Folder 201000NE & x-ferred to L-Building-New driveTorm C 2014.docx Updated: 1/17/2014
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Development is restricted within a landslide Hazard Area and its buffer. Projects that will intrude into these areas
will require a report by a licensed Geotechnical Engineer. Geologically hazardous areas include areas susceptible
to erosion, land sliding, earthquake, or other geological events. They pose a threat to the health and safety of
citizens when incompatible development is sited in areas of significant hazard. Such incompatible development
may not only place itself at risk, but also may increase the hazard to surrounding development and use.
The criteria that are applied depend on the amount that the buffer is reduced. The buffer can be:reduced to a
minimum of ten (10) feet (with an additional IV building setback per ECDC 23.40.280) if a report is prepared that
meets the standards listed in ECDC 23.80.050). The alteration must also meet the requirements listed ECDC
23.80.060. in addition, proposals to reduce the buffer to less than ten (10) feet must comply with the design
standards listed in ECDC 23.80.070A3. Development is restricted within a landslide Hazard Area and its buffer.
Additionally, becausethissite is located in or near the North Edmonds Earth'Subsidence and landslide Hazard Area
(landau Associates, 2007), any development on this site will be required to comply with the provisions of
Chapter 19.10 ECDC.
This review applies to the entire subject parwL Depending on the locution and project proposed relative to the
identified critical areas, certain studies and reports miry he raequired. Please contact the Planning tlivislon at
425.77L0220 if and when you have a specific development proposal far this site in order to diswss the various
permits that will be required. Please note that tree removal on sites cotriaining critical areas may first require a
tree cutting permit, and the illegal removal of trees may result in penalties and steep fines (ECDC 1&45 070,
ordinance #3828).
'
Kerner Lien, Senior Planner March iS, 2015
Name, Title
Date
PaV13
Approved Transaction
RECEIVED
Page 1 of 1
psclean air.org
Puget Sound Clean Air Agency
Notification Case #: 201603073
JUN 27 2016
DEVELOPMENTCTR.
CITY OF EDMONDS
This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for
inspection at all times at the asbestos project or demolition site (Reg III, 4.03(a)(6)).
Fee Amount Paid $275.00
Credit Card Transaction # ATOFE84E3ADD
Transaction Date
06/24/16
Owner's Name
Derek Abbott Phone (206) 423-3209
Project Street Address 16404 75th PI W
City
Edmonds Zip 98026
Contact Person
Derek Abbott Phone (206) 423-3209
Mailing Address
221 185th PI SW
Bothell, WA 98012
This project includes asbestos removal.
Project Size linear feet / 500 square feet
Project Start Date 07/05/16 Completion Date 07/08/16
Asbestos will be removed by a licensed asbestos abatement contractor
Contractor wrecking ball demolition Contractor Job #
Contact Cody Chestnut Phone (425) 339-3111
Mailing Address 3310 Chestnut St
Everett, WA 98201
This project includes a demolition.
Demolition Start Date 07/11/16 Completion Date 07/30/16
Demolition will be completed by a demolition contractor
Demo Contractor wrecking ball demolition Contractor Job #
Contact Cody Chestnut Phone (425) 339-3111
Mailing Address 3310 Chestnut St
Everett, WA 98201
(1) I certify that the information I have provided is to the best of my knowledge true and accurate.
(2) I understand that I must file an Amendment to this Notification if:
• The type of project has changed. The project types are asbestos and demolition.
• The quantity of friable asbestos to be removed meets a larger project category.
• The projects start or completion date has changed.
(3) I understand one Notification must be filed for each structure. The only exception is for
a single-family residence that includes multiple ancillary structures, such as a detached
garage or other outbuildings having the same street address. If there is no street address, I
have used a building number.
(4) I understand the fees for this Notification are nonrefundable.
Create Another Notification View History
If you have questions, contact us at asbestos@pscleanair.org or 206.689.4058.
Loa Out
https://secure.pscleanair.org/Asbestos/Approved.aspx 6/24/2016
`.Qc 199V
DAVE EARLING
MAYOR
C= OF FMMONDIS
121 5M AVENUE NORTH - EDMONDS. WA 98020 - 425.771.0220 • FAX 425.771.0221
Website: www.edmondswa.gov
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building —
PUBLIC WORKS - Engineering
DEREK ABBOTI' ACHNW LLC JUN 2 7 2016
221 185TH PL SW. DEVELOPMENT SERVICES CTR.
BOTHELL WA 98012 . CITY OF EDMONDS
Subject Determination regarding Critical Areas Checklist: CRA 2015.0020
Dear Applicant/Owner,
.Enclosed please find a copy of the Critical Areas Checklist you submitted.
The 'DETERMINATION" reached by the City is located on the reverse side of the form (bottom of
page). It is very important for you to retain a copy of this critical areas "determination" for your
records.
Please examine this Determination; for additional requirements. You may need to submit
additional information such as an Environmental Checklist or Critical Areas Study.
The Determination for the Critical Areas Checklist you submitted is a site -specific determination,
not a project -specific determination.
YOU MUST SUBMIT A COPY OF THE CRITICAL AREAS CHECKLIST and DETERMINATION WITH
ALL PERMIT APPLICATIONS OR YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
• Building Permits
• Conditional Use Permits
e Subdivisions
® Variances
• Applications to the ADO; Land Use Applications
• Any other development permit applications.
*Architectural Design Board
Enc.
Thank you.
Planning Secretary
InevrporatedAHgust 11,190 -
Sister City - Hekinan, Japan
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Type of structure to be demolished (e.g. house, shed, garage, etc.): tTY_
Floor area of structure to be demolished: sq. ft t U{�
Critical Areas Determination: Study Required Conditional Waiver ❑ Waiver ❑,
PSCAA Case N . lz*( ' obf10
AHERA Survey done? (required)
Additional comme ts:
�2�1(Q le30�3
FORM C L:1Buildina New Folder 20101DONE B_ x-(erred to L-Buildine-New driveTorm C 2014.doex Updated: 1/17/2014