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1007 SPRAGUE ST.PDFiiiiiiiiii lill 13230 1007 SPRAGUE ST • TAX ACCOUNT/PARCEL NUMBERV BUILDING PERMIT (NEW STRUCTURE):/ COVENANTS(RECORDED)FOR: CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: 0 %/_i/'%1111 1111111111 1111111111111111 SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR: WATER METER TAP CARD DATED: L:ITEMP\DSTs\Forms\Street File Checklist.doc J USE PERMIT r a ZDNE ND I , _ v CITY O MONDS 1.0�%�r�J`! f1t{ CONSTRUCTION PERMIT APPLICATION ice S 'rE'"P" OF BUSINESS ADDRESS OWNER NAME/NAME NO LID NO { VT GAYLE AND MILLICENT SALMON LEGAL DESCNIIG10;4 CHECK SUBDW ION Z MAILING ADDRESS 3: 1ESCv 20418 92ND AVE WEST PUBLIC R!GHT OF WAY PER OFFICIAL STREET MAP. APPROVED BY O CITY zip TELEPHONE NUMEXISTING BER REOUIRED DEDICATION EDMONDS, WA 98020 778-6436 PROPOSED — ----' d Z NAME a RIGHT OF WAY CONSTRUCTION PERMIT REOUIREOX i JOH STREFT USE. PERMIT REQUIRED ❑ o -U ADDRESS aEVIEw r = 540C NE NORTHGATE WAY #320 SEE ENGINEERING MEMO DATED —1 131e /6 71� L ZIP T EPHONE NUMBER / CITY SEATTLE WA 98125 361-6190 REMARKS 0 NAME GAYLE D. SALMON //VS r 2 ADDRESS G I- 20418 92ND AVE WEST METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS W 1'EIEPHONE NUMBER CITY ; z EDMONDS WA 98020 778-6436 REMARKS LICENSE NUMBER ADS NO. STATE SIGN AREA ENV. REVIEW i ALLOWED PROPOSED COMPLETE • 7Legal Description of Property -include all easements s.oREUNE• (show below or attach twocoples) CITY OF EDMONDS . c D &E �l/'z VARIANCE OR CU PLANNING REVIEW BY BLK043 D-00- LOTS 36 6 37 � _ HEIGHT LOT COV:R�DA PLUS ADJ S1/2 VAC ALLEY-ORD 516- sF_TBAcics-11 i Z FRONT W SIDE REAR'-5 u J Tax Account Parcel No. t¢3W -O�3 - 03EMARKS M PLUMBING ® ® NEW RESIDENTIAL AOOIALTER COMMERCIAL MECHANICAL ] [O REPAIR APT. BLDG. L_J SIGN HEIGHT CHECKED BY TYPE OF CONSTRU TION CODE r-1 FENCE G DA GRADE FILL , I I—x-_-FT) ' D u❑ DEMOLISH ❑ CARPORT SWIM SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT EJREMODEL GARAGE L REQUIRED GROUP �j LOAD M YES C NO J ❑WOOD STOVE/ RETAINING WALL/ D RENEWAL REMARKS C = INSERT ROCKERY INSPECTIONS PER UBC 305 0 PROGRESS (TYPE 'Ur E• BUSINESS OR ACTIVITY) E%PLAIN: a PERSONAL RESIDENCE Ix NUMBER OF STORIES NUMBER OF o DWELLING Q, UNITS NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) CONSTRUCTION OF A ONE LEVEL FINAL INSPECTION REQUIRED VALUATION FEE RAMBLER RESIDENCE. PLAN CHECK FEE BUILDING PLUMBING Plan Check No. / MECHANICAL This Permit covers workk to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (Curbs, sidewalks, S require separate perrn!SSIOn. STATE SURCHARGE driveways, marquees, etc.) will Permit Application: 180 Days Permit Limit: 1 Year- Provided Work is Started Within 180 Days •'Applicant, on behalf of his or her spouse, heirs, assigns and successohold agrees to ) Washington, feits ofnd ficials, -' rthe s in ICtyeof harmless Edmonds,st, from any and all claims for damages of employees, and agents a whatever nature. arising directly or indirectly from the issuance PLAN CHECK DEPOSIT this permit shall not be deemed to of this permit. Issuance of 9 modify, waive or reduce any requirement of any city ordinance 6X nor limit in any way the City's ability to .IT any ordinance TOTAL AMOUNT DUE • provision." ' I hereby acknowledge that 1 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 -his laws regulating construction; and In doing the work authoriz• AONiOR,MES signed by the Building Official or TE state WORK NOTED Deputy; and lees are paid, and rllcelpl Is ed thereby, no poison will be employed In violation of the Labor Y Code of the State of Washington relating ID Workman's Componsa• acknowledged in space provided. INSPECTION If n InSurance. DAiE STONED DEPARTMENT SIGNATURE (OWNER ON AGEN TI } [ 01FIC L TUPE E 9 CITY 0. f EDMONDS CALL FOR L A D Br DAr ATTENTION INSPECTION 'a o IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771-3202 OR ORIGINAL - File YELLOW -Inspector ECE AN D A ALUBC INSPECTION UNTIL OFOCCU OCCUPANCY HAS BEEN AGRANTED. CERTIFICATE PINK - Owner GOLD -Assessor CHAPTER 3. Iozar ,- - -�-.�.=.tea-•. ,. --- - - -- .. _ . - ,o•-o• e•-r w-,r � � I p�� AT I P 1. IN w s-, �-MEW Q FOR >MDOD t . I j carc. vAno NOT w/,gaD E,w. �A _ _ JpNT5 _ _ f21e.76'I { I I I '� I I rMM xm I I n Ia-�' -- -- -- -- -- !LE I I I �Tes• I . r ED 4. i� ••...w+ I of I � •: �_ .i - I to z II I I II ... Z. IAGMEOATE I , PAD I �pONO. WALK-WAYo. SLOPE • QNC}CE I . .II•• 1D, OtWE-WAY I , II • ALRXt6 PROP 1 I LYfE { I I HE,GNT CALL — — — RE—D I C L CTµCLE ACK _ �-SFTHLINE I - , o I i 2Y-0- K msso ---- N89' 54' VT W 75 .00" LEGAL DESd6PT,ON: LOTSLOT COVERAGE CALCULATION: NOTE: FOR GRADL40 PLAN, NO NEW BLOC se AND Y OF ED 37. AND MORE EAST CORDMALD< RLL MLL BE NMED, EOSTINO ORADE THE P N• On K EDM01g3. ACCOROMO T TOTAL LOT SO. FOOTAGE B,808 SO. FT. CON muRS WL, REMAIN As R% DQSTIMo THE PLAT R»m M vIS t OF Puri-' WAW TOTAL IMPERVIOUS SURFACES m 3,896.5 SO. FT SITE DRAINAGE WILL NOT 04AHM W/TME 3e-THEIRRECORDS °F HE SOUTH A4FC01Of ACAT EXCEPTION OF ROOF DRAIN RISERS T�TMa 1MTN THE M IIA17 a VACAT LOT AREA COVERAGE = 44. R DRIVEWAY SLOPE NO GREATER THAN AD IACD1r 1NEAtiD Or - 1e: Y i a Z O W U a O rJ..w CITY OF EDMONDS COMMUNITY SERVICES DEPARTMENT RIGHT-OF-WAY CONSTRUCTION PERMIT Permit No. Cy n— sa 9 Issue Date 1 I _ 19 — 9 0 A. • Owner: U N L E SPrLM ON B. • Contractor: V Name Name P.Q. 80X G-� ZIo18 }-tq Mailing Address Mailing Address L,4WNwo0t] WA CIW3(. LyWNWeoi) 1.t.1A g8036 City State Zip City State Zip V- l2T M A WT-1 W & 70 - 3'Z:O7 State License Number Telephone Number C. • Address or Vicinity of Construction: tOCi�1 Sfl��Vy� ST' Type of Work to be Done: 1 NST ArLL 311 PVL G-ON Ov %T ow fc x i ST 1 Al ly P O 4L PLX C..1✓ R4C-'T yN fQG V LPt R Q C D ESTA S_ AT' . PROP D. • Work in Connection With: ❑ Sub or Plat ❑ Commercial Lingle Family ❑ City. Projects ❑ Multifamily D Utility - E. • Pavement Cut: ❑ Y EW F. • Size of Cut: X APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, that may be made against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal proceedings including defense costs, court col%ar�¢'at Vey fe ,by pela 2nYFOOR ranting this permit. E FOR WORK CNSHIP A D MATEI A PERIOD OF ONE THE CONTRACTOR IS RESPONSIBLE O lVi�1 �I YEAR FOLLOWING. THE FINAL INSPECTION AND ACCEPTANCE OFITH'E W RK. Estimated restoration fees will be held until the final street patch is completed by City forces, at which time a debit or credit will be processed for issuance to the applicant. • A 24 hour notice is required for inspection; Please call Engineering: 7��"3202 • Work is to be inspected during progress and at completion. • Restoration to be in accordance with City Code..:/ RF��- c • Street to be kept clean at all times. • Traffic Control to be in accordance with City regulations. • All street -cut ditches must be patched with asphalt or City approved material prior to end of working day; NO EXCEPTIONS. I understand the above and that this permit must be available at the job site for inspection purposes at all times. Signature* r Date: ' O — IS — 1 c) • Owner or Contractor This Permit Must be Posted at the Job Site For Inspection Purposes Call DIAL=A-DIG Prior to Beginning Work APPROVED BY: PERMIT FEE: -L .tom? �rtQQo �1 Time Authorized: Void after) days. Restoration Fee: Special Conditions: Receipt No.: III SPEI:TbK LYL4=_ L. Fund I II Fee: Street Cut Dimensions: x = $ RELEASED BY: Date (°�� INSPECTED BY Date NO WORK TO,PEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. March 1989 FIELD INSPECTION Comments: Diagram: I I I - Route copy *to Street Dept.) CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. July 1985 iPUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY 1476 REV. 7/57 LOCATION NOQ-7 S?Qr-\(, ST SO ' POLE NO. 5L 1/4 S Z4 T R 3 DATE 1p -2s-9 o W.0. NO. LQ AREA 3Z REASON FOR WORK PQOVtOE LICr SE RV (C- ENGINEER MRRTt►J DWG. No. OB9 zco FOR CAP, S-ALMO►J DRAFTER U.G. NO. --� -"— SCALE t = 1 OQ,' DATE WORK COMPLETED FOREMAN APPROVED DATE PRINTED - ENVIRONMENTAL ANALYSIS FEES REQ'D ® EXEMPTOT ❑ TEM EXECMPT r YES ❑ NO PARA. 18 PRIMARY OVERHEAD ❑ RESIDENTIAL O.H. U.G. COND. KV O COMMERCIAL ADD CKT. FT. PH LEO# REM CKT. FT. PH NET CKT. FT. SECONDARY OVERf fEAD O.H. U.G. COND_ KV BASIC EE $ ADD CKT. FT. PH REM CKT. FT. PH METER/CONV. POL $ NET CKT. FT. PRIMARY UNDERGROUND PERMITS (DATE GRANTED) ❑ RESIDENTIAL ❑ TREE TRIM ❑ COMMERCIAL ❑ STATE BASIC, f EE $ ❑ COUNTY LEU# ® CITY CDmowo5 SECONDARY UNDERGROUND BASIC FEE $ -+00 rEASEMENTS OUIRED 11 NOT REOUIRED UNDERGROUND-. PL T.._. - . DATE RELEASED -" .............:. - BASIC f EE.$ AFT.®$ .. : _.� FOREIGN CONT CTS - .. _....- ._..._ ._ STREET- LIGHTING _ ❑ GTNW JPN# - AFT. ®$ - ❑ CATV JPN# _. ❑ JOINT TRENCH G NW & CATV WORK -:IN -RIGHT 0 WAY ❑ JOINT BORE GTN N & CATV .: ❑ PRIMARY- --..::... ❑ ❑ SECONADARY POLE STENCILI G FT. ®$— _ $ FROM 10 . .MISCELLANEOUS .FEES TAKE OFF POLE VAULT $ PRE-CONSTR. REQUIREMENTS EDr11CtOS PERMIT $ 3C7 ' ❑ TREE TRIM ❑ PUD LOCATOR - $ ❑ BACKHOE ❑ $ 19 ONE CALL DATE TOTAL DUE $ S 7 Q INDEX I POLES I IPLAT DATE PAID_ LOGS IXFMR U-MAP RECEIPT# - C-MAP NEW SVCE APPLICATION# 1-? 7 S S % 'LOCATION MAP PAGE _Sg - Z SUBSTATION ' CIRCUIT NO. PHASE r I •I s 11j- 0- 3Z Pi AcE REc_�A►Jc,v�a� s�cor�oa�.f p�0EsT-A� AT PRoPERT�j c_oRNE� A-S STfRKL-1) S�tZ TO (Lv� so �}10 oa oow►J R- I '^J - - # 3 r (Zv rJ too' F2n"n PE--DC-c TA t_ TO GUST MT'2 6ti-Sc- � SST S L7t f} L. tJ S YN t" l -1 S G-7 1c-c>7 G-AS - ;<;CITY OF EDMONDS ' P-it No. COMMUNITY SERVICES DEPARTMENT RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date �� A. • Owner: �� ' / o � / / Z B. • Contractor: Name �oQor 9J Name Mailing Address/—/7t,,, wood Mailing Address . City State Zip City State Zip 3,2 y ak :�21r 7 State License Number Telephone Number C. • Address or Vicinity of Construction: Type of Work to be Done: C__vX,a tlot D. • Work in Connection With: ❑ Sub or Plat *-Single Family ❑ City Projects ❑ Commercial ❑ Multifamily ❑ Utility E. • Pavement Cut: ❑ Y ® N F. • Size of Cut: X APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and .by his signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, that may be made against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal proceedings including defense costs, court costs, and attorney fees by reason of granting this permit. 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 time a debit or credit will be processed for issuance to the applicant. • A 24 hour notice is required for inspection; Please call Engineering: 771-3202 • Work is to be inspected during progress and -at completion.., • Restoration to be in accordance with City Code. • Street to be kept clean at all times. • Traffic Control to be in accordance with City regulations. � I fwL • All street -cut ditches must be patched with asphalt or City approved mat r o day; NO EXCEPTIONS. I understand the above and that this permit must be available t the job site for inspection purposes at all times. Signature: ,�'E��" Date: — Owner or Contracto This Permit Must be Posted at the Job Site For Inspection Purposes Call DIAL -A -DIG Prior to Beginning Work APPROVED BY: 1-61 Time Authorized: Void after —days Special Conditions: PERMIT FEE: Restoration Fee: Receipt No.: Fund III Fee: Street' Cut Dimensions: x RELEASED BY: A& Date / v INSPECTED BY ^� Date NO WORK TO' BEGIN PRIOR TO PERMIT ISSUANCE . Erig. Div. March 1989 FIELD INSPECTION RES '(Fund I I I - Route copy to Street Dept.) Comments: Diagram: CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Dater Eng. Div. July 1985 a�''�rv..'' `_'f�✓�'�0+r�'�k; 4��11�'`�"'�.'Yno�+d�'�++{'�if^ WiSi.° r14.'Or9'"•'*`ulA4'�;+"'^^!n'�^.'r}��`!�"ai!�(I''lY'�CRuR7'+�^�9^vn=Cr��k�iA+'V4'1'7'�(''f'lny�R'�}h,��'Y, rZgrn�i�w}i�y3A"14^iV'T+�at^`r�, W Z O W E- U O W. �$ QGZ' Permit No. CI. -TV, OF EDMONDS__L{ 5Ci COMMUNITY SERVICES DEPARTMENT P/1�1. y0V IS RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date 9 '110 A. • Owner: Washington Natural Gas Company ` g • Con t,ractor: Name Name 815 Mercer Street Yailtr .e ddress WA 98111 Mailing Address City State Zip STREET' FIL State Zip State License Number Telephone Number C. • Address or Vicinity of Construction: 1007 Sprague Street Type of Work to be Done: Install New Service R W 2 4/ 'ID D. • Work in Connection With: ❑ Sub or Plat ❑ Single Family ❑ City Projects ❑ CommerN❑ Multifamily XX Utility E. • Pavement Cut: ® Y . ❑ N F. et tS z� of Cut: 2 X 4 (1) @ H2O APPLICANT TO READ AND SIGN v INDEMNITY: Applicant understands and by his signature to'this applireds to hold the City of Edmonds harmless from any injuries, damages, or claims of any/1Cip3�oYaescriptio tia so��e``�der,afseen or unforseen, that may be made against the City of Edmonds, or any of its departments or epiployees, including or not limited to the defense of any legal proceedings including defense costs, cour o'ts, and affPn s by reason of granting this permit. U 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 time a debit or credit will be processed for issuance to the applicant. • A 24 hour notice is required for inspection; Please call Engigef ring: 771-320.2 • Work is to be inspected during progress and at com;l &.ii5n. • Restoration to be in accordance with City Code. • Street to be kept clean at all times. • Traffic Control to be in accordance with. City regulations. • All street -cut ditches must be patched with asphalt or City approved material prior to end of working day; NO EXCEPTIONS. I understand the above and that this permit must be available at the job site for inspection purposes at all times. Signature: ' " - Date: September 199 1990 Owner or Contractor This Permit Must be Posted at the Job Site For Inspection Purposes Call DIAL -A -DIG Prior to Beginning Work APPROVED BY: &rK W Time Authorized: Void after Nv^. Special Conditions: W,A PERMIT FEE-,% : Restoration Fee: Receipt No.:� Fund III Fee: Street Cut Dimensions: RELEASED BY:1A �UrAkdd Date 9 -a C 1D INSPECTED BY NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE. Eng. Div. Maren 1969 FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.) 4 Comments: Diagram: CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. July 1985 Addendum to: ,. City of Edmonds Permit Application Engineering Aide Kerry Walsh Washington Natural Gas 622-6767 x 2588 I (c&X4iG� 470 KEY: -ss- sanitary sewer -s- storms -w- water 0 water valve •-�• N89' •54 01'► W 75�00 •—�• 33 0 •��•-��- 10'-0" ng� 6 r • I � 1 5'.50" 5'-0" O.W. IDEYARD. 6" FND. W SETBACK V FND. WALE_ _ r " - - R.I. FOR I I3 50 HOT TUB I CONC. PATIO ie .— — — I I PLANTER 00 I •_6 T ROOF I I • MAXIMI LOCATI II I I . FENCE --,,,,,I I .ST OF • - - - - - - - - - - Y LINE I I I I ��•�MAX." ( � I - - - - - - - I - - -/ - -- -- - I - -;- - - ---- - - - 3 - - .50 (p (.0 . 0 -" I . 0 PAD ' O, � O Z 4" EXPOSED AGGREGATE ICONC. WALK -WAY SLOPE GAR GE 220 TO DRIVE WAY W 4• 1 I I MAX I �AI 1 I I I LII I i I I 5'_ • 0 IDEYARD 218 . . . . . . . . . . . . . . . . N I SETBACK � W QQZ i 22'-0" BRUSHED NC. NVEWAT- 216 ............ " ASSUME 0'.00" ELEI N 8 9' 5 4' 01 " W LEGAL DESCRIPTION: LOT COVERAGE CALCULATION: LOTS 36 AND 37, AND THE EAST BLOCK 43, CITY OF. EDMONDS, ;AC TOTAL LOT SQ. FOOTAGE = 8,806 SQ. FT. THE PLAT, RECORDED IN VOL2 •.0 TOTAL IMPERVIOUS SURFACES = 4,165 . SQ. FT. TO RECORDS OF E' O THI.tSHCOU TOGETHER WITH THE SOUTH HALF LOT AREA COVERAGE = 47.3% ALLEY. ADJACENT THERETO' ROOF AREA - 3,314 SQ. FT. NOTE: FOR GRADING PLAN, NC CONC. PATIO 256.5 SO. FT. BEYOND ROOF) FILL: WILL BE NEEDED, EXISTIN( DRIVEWAY + WALKWAY m 595 SO. FT. CONTOURS WILL REMAIN AS IS ,a� SITE DRAINAGE WILL NOT CHAI 5/90 TO: Permit Coordinator, Building Division FROM: %9a4-Sa4-0, E n g i n e e r i ng in&pe.c#nr_ ADDRESS: DATE: OWNER: PLAN CK# 175 After review of the subject building permit application, we have the following comments: ✓!. Construction hours are: WEEKDAYS.......... 7:00 a.m. - 10:00 p.m. (ECC 5.30.110) WEEKENDS/HOLIDAYS..10:00 a.m. - 6:00 p.m. —2. A separate Right -of -Way Construction Permit is required for any work on City property.- (ECDC 18.60) `j3. Connection to City water system required. Separate water meter charge required. (ECDC 7.30) ,'-4. Connection to City sanitary sewer system required; obtain separate permit. LID #- 107 Fees paid: Yes ✓ No Charge $ 30 pDpD (ECDC 18,10) --S. .Water and sewer lines should be separated by 10 feet minimum. (ECDC 18.10) "6. Driveways must be paved a minimum of 20 feet back from City right-of-way; separate permit required. (ECDC 18.80.060C) ` 1. Driveway slope not to exceed 14%. Waiver granted to (ECDC 18.80.060D) 18. Back water valve required if downstairs plumbing is below elevation of upstream manhole. (ECC 7.20) --9. Builder/Owner responsible for containing all temporary runoff and erosion control on site. (ECDC 18.30.030D) ✓10. No burning of construction refuse without permit from Fire Department. ,Al. Street to be kept clean of debris, dirt, mud, and construction materials. Contractor responsible for dust control. (ECDC 18.30) -12. Inspection required on drainage system, catch basin installation, driveways, and sidewalks. A final engineering inspection is required prior to the building division granting occupancy. (ECDC 18.30, 18.80) V13. Repair or replace all defective existing curb, gutter, and sidewalk. If intersection is involved, installation of wheelchair access may be required. (ECDC 18.90) -14. Underground wiring required on all new construction. Also, if the proposed addition, alteration or repairs exceeds 50% of the total assessed valuation of the existing structure. (ECDC 18.05.010) wu�l ¢/ 6 ..S - a 7 = S * iVo G�iS<u:�Q�� "V� � STREET city of edmonds development information .Environmental Checklist Purpose of Checklist: 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. The purposes 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. Instructions for 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 known, 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 expert. 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 zoning, 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. The 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 significant adverse impact. MAY 8 - 199M Complete this checklist for nonproject proposals, even though questions may be answeretffooI� COUNTER not apply". IN ADDITION, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part 0 For nonproject actions, the references in the checklist to the words "project," "applicant," and "property or site" should be read as "proposal," "proposer," and "affected geographic area." resaectively. A. BACKGROUND 1. Name of proposed project, if applicable: (H0Mr--) 2. Name of applicant: GAVLE AND MILLIGEaJTT SHLH0AJ 3. Address and phone number of applicant and contact person: .20 1fi.9 9aND /4L)jE WEST Gb M 0 U D S� Lk) 4Sr-1I A)GTOri g8o3.o 4. Date checklist prepared: M A `; Q, M o 5. Agency requesting checklist: -PLANNIfuC DIVI SIoN CITY o F EOMo1uDs 6. Proposed timing or schedule (including phasing, if applicable): UAJD-e -Fe 2MI/UED A'TTHIS T-/H6 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. NO 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. 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. 10. List any government approvals or permits that will be needed for your proposal, if known. $UIL.DitiG �PEI2MIT �}EMoLiTIoN-Pe'2Mt1 ll. Give brief, complete description of your proposal, including the proposed uses and the 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 this page. (Lead agencies may modify this form to include additional specific information on project description.) S InJGLE F/aMiLY DL,-) 1AJG— APPieoXIMqTE a000 s a 49�F— Fool H O M E RECEIVED M AY g 12. Location of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street PERMIT CO!!N'i A address, if any, and section, township, and range, if known. If a proposal would occur over a range of area, provide the range or boundaries of the site(s). Provide a 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 related to this checklist. I(.Do7 5P2AGu6 STP`eT f—=DMo"D5, Wi5H IAJGTO&) TO BE COMPLETED BY APPLICANT EVALUATION FOR. .... AGENCY USE --ONLY B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous, other F-L A -r b. What is the steepest slope on the site (approximate percent slope)? NoluE 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 and note any prime farmland. d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. N 0 e. Describe the purpose, type, and approximate quantities of any filling or grading proposed. Indicate source of fill. 6 2A D r U G To A cGo M 0 D/+TE Fou �J fDATt o ti F-oP NCbu f-to"E, No FIt_L f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. N O g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? AP'P2uxI'M/a-T(5 ✓-66 SQvgrLE FET GorucMGTE 3)21VEuuAY h. Proposed measures to reduce or control erosion, or other impacts to the earth, if any: • • 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. No /V E b. Are there any off -site sources of emissions or odor that may affect your proposal? If so, generally describe. /VONE c. Proposed measures to reduce or control emissions or other impacts to :air, if any: 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. NO 2) Will the project require any work over, in or adjacent to (within 200 feet) the described waters? If yes, please describe and attach available plans. /V D 3) Estimate the amount of fill 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 fill material. /vo N E 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities if known. No 5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. No 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. ND b. Ground: 1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, purpose, and approximate quantities if known. ND • 0 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) are expected to serve. 1VONC c. Water Runoff (including storm water): 1) Describe the source of runoff (including storm water) and method of collection and disposal, if any (include quantities, if known). Where will this water flow? Will this water flow into other waters? If so, describe. SU(Z.FAGE W(+TE2 FLOWS INTO 510g-Aq F1HI1U7-AiNtjD i' THE- CIT- of ED,CoaJDS, 2) Could waste materials enter ground or surface waters? If so, generally describe. NO d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: -D2A1 AjA GF sY3re m A-5 RffaUi P-ED '3(7, THC CITY OF Ek)"O )Ds- 4. Plants a. Check or circle types of vegetation found on the site: deciduous tree: alder, maple, aspen, other evergreen tree: fir, cedar, pine, other shrubs grass _ pasture _ crop or grain wet soil plants: cattail, buttercup, bullrush, skunk cabbage, other water plants:.water lily, eelgrass, milfoil, other _ other types of vegetation b. What kind and amount of vegetation will be removed or altered? /tJoNE c. List threatened or endangered species known to be on or near the site. No NE d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: /1J02MA-L 7.ESI D�AJ7-1 4L, 1o%ouU.5C/4P/.0 6 • • 5. Animals a. Circle any birds and animals which have been observed on or near the site or are known to be on or near the site: birds: hawk, heron, eagle,Oe;avikitDher: other: ............................. mammals: deer, bear, elk, .. ....................... fish: bass, salmon, trout, herring, shellfish, other : .................... b. List any threatened or endangered species known to be on or near the site. AJaNE c. Is the site part of a migration route? If so, explain. d. Proposed measures to preserve or enhance wildlife, if any: AMa1c 6. Energy and Natural Resources 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 it will be used for heating, manufacturing, etc. /uAiu2.4(. s►5 14E.47jN6 t=Le ,7p,6 LIGt 1uG b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. Na c. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts, if any: 141C,ti t=r-r-4GiENGY. G+s F-(J12rU.4GC- (¢oME Tv P>E -6utL:r T16 CN-CfZ-G`t' GoA1SEfZ-QA-T10t� GODS S I . Iff. DoVBL E 11.1 I IJ1>00JS, 7. Environmental Health 1N 5L)1__4-r1,0 .) a. Are there any environmental health hazards, including exposure to toxic chemicals, risk of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal? If so, describe. /U C) 1) Describe special emergency services that might be required. ILM AJ 2) Proposed measures to reduce or control environmental health hazards, if any: y/otic b. Noise 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? U5UAL Noise✓ L;�v0L, OF g u13uR-$AA) 14+�;=fl 2) What types and levels of noise would be 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. Co A) 5-1-/7-vCT/0,A) -- aM To G PM '6H027- TC-7F-M 3) Proposed measures to reduce or control noise impacts, if any: No ti 6 lvl q 8. Land and Shoreline Use a. What is the current use of the site and adjacent properties? 7�0 S I DEN7/ AL KoME b. Has the site been used for agriculture? If so, describe. No c. Describe any structures on the site. SIA.)6 d. Will any structures be demolished? If so, what? Co H T-L 4 iE OF j5X , 5 Tn /U G 5'T2,j GTU I2_E7 e. What is the current comprehensive plan designation of the site? Sl�iG L-E Ho,-41 h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. N O i. Approximately how many people would reside or work in the completed project? Twa j. Approximately how many people would the completed project displace? /L10 N 6 k. Proposed measures to avoid or reduce displacement impacts, if any: 1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: To E5 No7- 4PPL.Y 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income housing. 'Do E-5 N0T 4.4P¢`-`f b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. a)6es N07- ffPRZ_- c. Proposed measures to reduce or control housing impacts, if any: Xo e_-) I NaT AT)PL, , • 10. Aesthetics a. What is the tallest height of any proposed structure(s), not including antennas; what is the principal exterior building material(s) proposed? Uj (T H I N T-H 4-- POoT HE( G H r P_ESrTrZuC_T(o /)-S or EDMonuD5 DING GaDES. wooD b. What views in the immediate vicinity would be altered or obstructed? /lJ o /U E c. Proposed measures to reduce or control aesthetic impacts, if any: f1/ DNE /M PA CT1✓1) - 11. Light and Glare a. What type of light or glare will the proposal produce? What time of day would it mainly occur? A.)OIl/E b. Could light or glare from the finished project be a safety hazard or interfere with views? Nd c. What existing off -site sources of light or glare may affect your proposal? /UO/VE d. Proposed measures to reduce or control light and glare impacts, if any: NoAu E 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? H UMM IN 6 812D 1�i4�21� — CITY OF E&1-16iU S b. Would the proposed project displace any existing recreational uses? If so, describe. of p c. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: 2)0E 5 N0T' /DPP[-Y 13. Historic and Cultural Preservation a. Are there any places or objects listed on, or proposed for, national, state, or local preservation registers known to be on or next to the site? If so, generally describe. Np b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. /vo,U 6 0 •. c. Proposed measures to reduce or control impacts, if any: VOe5 NnT '4PPL j 14. Transportation a. Identify public streets and highways serving the site, and describe proposed access to the existing street system. Show on site plans, if any. l p o 7 57 Pt2 E CL U E ST (2-1, b. Is site currently served by public transit? If not, what is the approximate distance to the nearest transit stop? -rwo $�0CGle- S c. How many parking spaces would the completed project have? How many would the project eliminate? j)oEs lioT- APPLY 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). /U 0 e. Will the project use (or occur in the immediate vicinity of) water, rail_, or air transportation? If so, generally describe. No f. How many vehicular trips per day would be generated by the completed project? If known, indicate when peak volumes would occur. -Do E 5 iU vT 4PP4-`; g. Proposed measures to reduce or control transportation impacts, if any: :7)o Es No 7- A7-7PL- Y 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. /1/D b. Proposed measures to reduce or control direct impacts on public services, if any. N 0 - 16. Utilities a ircle iesuaijAb-le att► water refuse service tele hon m tar sewe ite:electicitn ptseptic o b. Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity which might be needed. UTILITIe=s 10 -PLACI= • • C. SIGNATURE The above answers are true aild complete to the best of my knowledge. I understand that the lead gene .s rel i g n them t.o make its decision. Signature:..l�.y�ii�.:.. .. ..................`7-Z� Date Submitted:. ..e.. 6Q 4 ............................... J D. Supplemental Sheet for Nonproject Actions (Rezones, Code Changes, Annexations, etc.) -- Do not use this sheet for project actions. Because these questions 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 be likely to increase discharge to water; emissions to air; production, storage, or release of toxic or hazardous substances; or production of noise? , Proposed measures to avoid or reduce such increases are: 2. How would the proposal be likely to affect plants, animals, fish, or marine life? Proposed measures to protect or conserve plants, animals, fish, or marine life are: 3. How would the proposal be likely to deplete energy or natural resources? Proposed measures to protect or conserve energy and natural resources are: 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 cultural sites, wetlands, floodplains, or prime farmlands? Proposed measures to protect such resources or to avoid or reduce impacts are: 5. How would the proposal be likely to affect land and shoreline use, including whether it would allow or encourage land or shoreline uses incompatible with existing plans? Proposed measures to avoid or reduce shoreline and land use impacts are: • 6. How would the proposal be likely to increase demands on transportation or public services and utilities? Proposed measures to reduce or respond to such demand(s) are: 1. Identify, if possible, whether the proposal may conflict with local, state, or federal laws or requirements for the protection of the environment. ENVCHK3/PFORMS