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11111111111111 11921 1025 MAIN ST N 0 T I C f� �rj6 TO PERMITTEE AND / OR OWNER `- ` . F u — � ❑ PARTIAL APPROVAL ❑ VIOLATION ❑ CORRECTIONS REQUIRED PERMIT NUMBER JOB ADDRESS Ae" � ❑NO PERMIT — STOP WORK — REMOVE CONSTRUCTION OR OBTAIN PERMIT AND MAKE WORK COMPLY WITH BUILDING LAWS. ❑CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS AND PERMIT — STOP WORK. MAKE EXISTING WORK COMPLY 'WITH APPROVED PLANS AND PERMIT OR REMOVE IT. ❑ STOP WORK — UNTIL AUTHORIZED TO CONTINUE BY INSPECTOR. ❑CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN BE APPROVED. ❑ WORK DESCRIBED BELOW HAS BEEN INSPECTED AND IS APPROVED. CONTACT INSPECTOR AND ❑ RECALL FOR INSPECTION.. ARRANGE FOR APPOINTMENT. ❑ % g5A&;2"6- Z47t4,6 41*'ri,-7Zr v- Z�-rrC log THE A IONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN �% DAYS OR PENALTIES IMPOSED BY LAW MAY BE APPLIED. ���1��d�"'�CJi2�l�u' R INSPECTIONS CALL � I�I�.{// BUILDING DIV. INSPECTOR +���`� LJ PUBLIC WORKS CITY OF DATE ` 9 ❑ FIRE DEPT. EDMONDS El CONDITIONAL USE A conditional use permit is required for all fences PERMIT REQUIRED: and hedges over six feet in height. FEE: $25.00. If a site inspection is required to determine compliance with the Code, the fee is $30.00. Additional plan check fees may be charged if warranted. CODE: Edmonds Community Development Code Chapter 17.30 Uniform Building Code Ordinance #2772 Effective 6/1/90 UPPER CATCH BASIN (vTz�vr ) DETENTION WORKSHEE DETENTION PIPE LENGTH CONTROL CATCH BASIN 7 r— 11 MIN % SLOPE-4- OVTLCT CONTROLR MI 4" 1 Z To OLTLJ (RI PRfaF OR PwNoFr SPREADER ._. SYSTEM CROSS SECTION 2' s 'Z a (o"DEEP, 4� 6" SPALIS (ORcowL) f x 2' Y S' DEEP, '- CRUSHED ROCK F" ET CON-rlkOL RIPRAP OUTLET Y^3HED GRAVEL OUTFLOW TRENCH, MIN 10' LONG, 1 TOP 4 A" PERF PIPE TO BE LI-V¢L FROM 0Vr6ET CON- OL 4' PE.RF PIPS WITH CAPS RUNOFF SPREADER OUTLET STPEWE- FILE FOOTING DRAINS SHALL NOT BE Page 9 of 9 CONNECTED TO THE DRAINAGE SYSTEM STANDARD DRAINAGE PLAN.: ' DETENTION ,SYSTEM for 3.. DEISNGN DATA System Imperm Pipe Pipe Orifice Nimhor Araa DiBm Lenoth Didihetee =mom mmm I NOTES f �f I. Call Engineering Div ;on for prebickfill and n81 ihsppetitlnf:;; 2. Responsibility for 606rfi 0d 'Ad � . filaintenince of drainage tyitikig bk"ZI private property is the .aretodA 6010,1 >. of the. property ownpr(s):.MBteri$1; / a�ccumulal§ted iti the Storage pip! Inuit be flushed out and `removed frIA cetth^ basins to allow proper` 606itiohA •Thd- ; t outlet control orifice must bl kept open at all times. tt COUNTER , CITY OF EC�fVid�' O r '41 DAVID L. NELSON AND ASSOCIATES, INC. ' Consulting Engineering Geology October 25, 1989 Project No. 14689 Page 3 backhoe were quite difficult within this fill, due to the caving to extreme caving conditions. HYDROLOGIC CONDITIONS Ground water was encountered within the areas around 'the base of the existing fill, within the organic deposits, and within the native gravelly sands. As shown on the test pit logs, this ground water appears to occur in conditions ranging from wet to very wet, saturated, water flowing to water bearing. At this time, due to the type of exploration performed, we cannot determine whether this is the true water table, or if these conditions denote perched water conditions. We observed water flowing from within and below the rockery to the west (see location map). Standing water was noted below the rockery in the adjacent property to the west. It is our opinion that these water conditions should be considered chronic, and are based on ground water occurrence. CONCLUDING OPINIONS From a geotechnical viewpoint, we found the site to have conditions which are not conducive to placement of the proposed residence in its present state. The occurrence of the existing fill throughout the site, and its non -uniform, generally loose and uncontrolled condition presents potentially high settlement characteristics and a great potential for future damage to the structure. In addition, the occurrence of the steeply sloping fill along the westerly portion of the site, and the occurrence of outcropping ground water along the existing rockery, create a high potential for slope instability and sliding, particularly during seismic events. It is our opinion that additional geotechnical exploration and evaluation should be performed within the area to more accurately determine,subsurface. conditions, including stratigraphy and ground water, and lateral stability. Unless complete removal and replacement of the unsuitable fill and organic soils within the site area is performed, pile or pier support of the structure iis anticipated. The piling or piers placed to bear into the competent native DAVID L. NELSON AND ASSOCIATES, INC. Consulting Engineering Geology October 25, 1989 Project No. 14689 Page 4 ground would be designed to support proposed structure foundations without future distress due to settlement. Additional explorations should determine the subsurface stratigraphy and ground water tables, and provide information for pile lengths, diameter and loads. Typically, the explorations for determination of pile or pier support consist of exploratory borings. Borings performed within the site would also provide information for design of ' lateral support of the existing fill and organic strata. A slope stability analysis should be performed to determine this design. This lateral support may take the form of piling design suitable for resisting lateral loads, a retaining wall, or a soil buttress fill within the downslope area. We feel that the most feasible alternative for embankment support is to place a buttress fill. To construct a concrete retaining wall within the existing property would require removal of the existing rockery. For the soils information we have, we feel that removal of the rockery could destabilize the existing fill mass, and create a significant failure. This would be further analyzed during the future study. Most likely the lateral pile design would not be economically feasible. However, it should at least be considered in the preliminary stages of design. To construct a buttress, or to build a retaining wall in front of the existing rockery, would require that the neighboring property to the west is either obtained or is allowed to be used for a construction or slope easement. This area should also be explored and evaluated if this option is viable. The explorations in this area would be performed by either backhoe test pits or light boring equipment, or both, depending upon available access and surface ground conditions. ADDITIONAL NOTES We would be pleased to present a proposal for services and estimated costs to perform the additional explorations and evaluations within the site area, once DAVID L. NELSON AND ASSOCIATES, INC. Consulting Engineering Geology October 25, 1989 Project No. 14689 Page 2 LOCATION & SITE DESCRIPTION The investigated site consists of lots 34 and 35 of Block 40, located just west of an existing residence at 1031 Main Street, in Edmonds, Washington. Presently the site area is undeveloped, but has been -the scene of past filling operations. Vegetation within the site consists primarily of grass covering, and the area appears to be used for storage of some firewood. The site is relatively flat lying within most of the area, which -then slopes off steeply to the west, down from a top of fill slope (see location map). This slope extends to near the westerly property line, where a 4 to 8 foot rockery occurs. The height of the fill slope and rockery appears to be on the order of 12 to 18 feet high, above what appears to be native ground and vegetation to the west. SOILS CONDITIONS The subsurface soils conditions can best be seen on the enclosed test pit logs. Geologically the site appears to be underlain at depth by glacial outwash sands and gravels, which is overlain by a considerable thickness of uncontrolled fill. The basal native soils were encountered in TP-1 and TP-2, but not in TP-3, due to extreme caving conditions in TP-3. The basal native soils encountered generally consisted of grey, medium dense, poorly sorted slightly silty sand, with scattered gravel, considered glacial outwash deposits. These native deposits were encountered at depths below about 11 to 16.5 feet below grade in TP-1 and TP-2, respectively. Overlying the granular native basal soils are deposits consisting of black, very soft to loose, organic silty sand, organic silt and peat. These materials were found to range from about 1 to at least 3 feet thick. Overlying these organic deposits is existing fill material. In general we found the fill to range from about 10 to 15 feet thick, and is generally composed of brown, black and grey, very loose to compact, mixed silt, sand, gravel, rubble (concrete & asphalt), debris (wood, construction material, plastic, cans, etc.) and organic material. Excavations with the NFi'S�%h!•a4<wE'WFSY?X.:�A •• =S•�v0_'r '.5' ' Xi*A9CYVll�f1 r•�: �'.S't'-_2'�"_=1175R�:^•':_ ."zY GCyyH'3'+eq.+.`:"•:�.+iL'"c"_rh wP.y�. October 25, 1989 Project No. 14689 DAVID L. NELSON AND ASSOCIATES, INC. Consulting Engineering Geology 206/788-5612 13424 Chain Lake Road Monroe, Washington 98272 206/794-4332 G R1:.4'.0i"i 1V NOV 1 H & H Company 17526 - 36th Avenue West PERMIT COUNTER Lynnwood, Washington 98037 Reference: Preliminary Geotechnical Evaluation Proposed Residence at Lots 34 & 35, Block 40 Edmonds, Washington Gentlemen; This is to serve as a report of preliminary geotechnical exploration and evaluation services performed within the above referenced project site, as requested by you. INTRODUCTION The purpose of this report is to present our findings, opinions, conclusions and recommendations for further study and site development to date within the subject site area. Proposed development is to consist of a single family residence. The scope of services included performance of three (3) exploratory backhoe (test) pits within the site area. Observation in and around the site area, and review of available soils and geologic maps of the area was also performed. The location of the site area and proposed layout, and the approximate locations of the test pits are shown on the enclosed location map. ' All elevations mentioned in this report refer to existing grade and to information shown on a site plan prepared by Chenoweth & Associates, Inc., dated September 1989. Proposed residence placement is based on a drawing prepared by you. �l -rz L APPfln)L TCQ / or- F:iLL SLOP& MAW S-REPT LOCAT100 MAP TEsi YiTs N 11 DAVID L. NELSON AND ASSOCIATES, INC. Consulting Engineering Geology 2o6'88 W2 13424 Chain Like Road - Momoe, WA 98272 206 "yJ 4132 Proposed Residence Lots 34 & 35, Block 40 Edmonds, Washington SCALE_ 111 = 201 PROJ. NO. 14689 DATE_10/25189 SHEET M-1 DAVID L. NELSON AND ASSOCIATES, INC. Consulting Engineering Geology October 25, 1989 Project No. 14689 Page 5 you have determined your desires for structure placement, and the availability of the westerly neighboring property. Thank you for the opportunity to be of service. If you have any questions, feel free to call on us at any time. Sincerely, DAVID L. NELSON & ASSOCIATES, INC. David L. Nelson, PG Professional Engineering Geologist (I�Z4 i Charles P. Couvrette, PE Consulting Geotechnical Engineer DLN:kmn HONG WEST & ASSOCIATES ' Geotechnical Engineering • Hydrogeology • Materials Testing • Construction Inspection • September 18, 1991 STREET FILE ftcuivuD_ Mr. Joe Wagner OCT a 1 1..991 114 Second Avenue South coU Edmonds, Washington 98020 ft Subject: Foundation for a residential house on Main Street Edmonds, Washington HWA Project Number 91088 Dear Mr. Wagner: Per your request, Hong West & Associates (HWA) has completed a foundation study for the above referenced project. The project site is underlain by approximately 10 to 12 feet of loose, uncontrolled fill, which is in turn underlain by alluvium and/or outwash sand (please see HWA borings BH-1 to BH-4, 07/17/91). It is our understanding that the existing fill was. placed on a ravine decades ago. A foundation constructed on the existing fill material is likely to experience significant settlement, which could damage the house. To assure that no excessive settlement will occur, the building loads should be transfered to the native soil below the existing fill. This can be accomplished by means of replacing the fill soil at the footing location with lean concrete or structural i:ill, or by using a pile foundation. The pile foundation is considerably more expensive. Removal and Replacement This involves removing the fill soil directly below the footing location to expose the i 1 native grade. The opened pit will then be filled with lean concrete or compacted structural fill. Footing can then be constructed on the lean concrete or compacted fill. For this alternative to be successful, the sides of the trench must be capable of standing vertically, at least temporarily, without collapsing or caving in. ❑ P.O. Box 596 ❑ 157 Yesler Way Lynnwood, WA 98046 Suite 505, Seattle, WA 98104 t(206) 774-0106 (206) 622-7698 ' On September 5, 1991, geotechnical engineers of HWA supervised the excavation of four test pits at the project site. The sides of -three test pits collapsed immediately after the old creek bed, which is approximately 10 feet below the existing grade, was exposed. ' The sides of the first test pit did not collapse. However, the first test pit was not excavated deep enough to reach the old creek bed. Based on our observation during the ' test pit excavation, we ruled out the use of this alternative. Auger -Cast Piles We recommend that auger -cast piles be used. The construction of auger -cast piles ' requires drilling with hollow stem auger to facilitate grouting. After the drilling is terminated at a pre -determined depth, grout is injected at high pressure as the auger is ' smoothly withdrawn. "Necking" of the pile may occur if the auger is withdrawn too fast. Reinforcing steel cage is then placed in the grout -filled hole after the auger is completely withdrawn. I J 1 i� 1 We recommend that the tip of auger -cast pile should be extended to at least 25 feet below the existing ground surface. When a 16 inch diameter pile is used, an allowable axial compression load of 20 tons may be used in the design. All piles should be reinforced with steel cage. We appreciate the opportunity to provide this geotechnical service to you. If you have any questions, please call me. Sincerely, HONG WEST & ASSOCIATES 6i,q, Sa H. Hong, P.E. President Ir I APPENDIX A SOIL BORING LOGS HONG WEST & ASSOCIATES 1 1 1 1 1 1 t -- Bore Holes 1"=20' Site Plan Map Joe Wagner Property A44t0'•U $t.l�' aee4 BH-1 BH-2 -- BH-3- BH-4 Main Street f N Existing Home I 1031 Main Street I I I Dona WEST & AssociATes LEGEND OF TERMS USED ON EXPLORATION SOIL LOGS The classification of soils in these logs is based on visual field and laboratory observations, based o;:t ASTM D 2488. Soil descriptions con- sist of the following: Density/consistency, color, modifier, MAJOR CONSTITUENT, minor constituents, wetness, soil structures, additional remarks. Density/Consistency Soil density/consistency in test borings is usually based on the SPT, the standard penetration test or resistance, ASTM D1586. The test result is the sum of the of the blow counts for the last 12 inches of sampler drive. Non -Cohesive Soil Standard Cohesive Soil Standard Unconfined Density Penetration Consistancy Penetration Compressive Resistance Resistance Strength in TSF (Blows/foot) (Blows/foot) Very Loose 0-4 Very Soft 0-2 <0.25 Loose 4 - 10 Soft 2-4 0.25 - 0.5 Medium Dense 10 - 30 Medium Stiff 4-8 0.5 - 1.0 Dense 30 - 50 Stiff 8 - 15 1.0 - 2.0 Very Dense > 50 Very Stiff 15 - 30 2.0 - 4.0 Hard > 30 > 4.0 Wetness Minor Constituents Dry Little perceptible moisture Damp Some perceptible moisture probably below optimum Moist probably near optimum moisture content Wet Much perceptible moisture probably above optimum Terms Describing Soil Structures Trace Some Modifier (sandy, silty, etc.) very plus modifier Estimated Percentage 0-5 5-12 12-30 30-50 laminated composed of thin pess than 1 cm.) layers of varying color and texture. bedded composed of laminations greater than 1 cm in thickness of varying color and texture. interbedded composed of alternating beds of different soil types. well graded having a wide range of grain sizes, with substantial amounts of all intermediate particle sizes. poorly graded predominantly one grain size, or having a range of sizes with some intermediate sizes missing. fissured containing shrinkage cracks, frequently filled with fine sand or silt, usually more or less vertical. slickensided having inclined planes of weakness that are slick and glossy in appearance. calcareous containing appreciable quantities of calcium carbonate. HONG WEST & ASSOCIATES 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 LEGEND OF SYMBOLS APPEARING ON THE SOIL LOGS GRAPHICAL SYMBOLS FOR SOIL TYPES NON -COHESIVE SOILS (<50% passing the 200 sieve) well graded gravel and gravel/sand mix poorly graded gravel, gravel/sand mix silty gravels, gravel/sand/silt mix clayey gravels, gravel/sand/clay mix well graded sands, gravelly sands poorly graded sands, few fines silty sands, sand/silt mix clayey sands, sand/clay mix COHESIVE SOILS (>50% passing 200 sieve) inorganic silts and very fine sands inorganic, low plastic clay mixes organic, low plastic clays, silt/clay mix inorganic, micaceous silts, silt/sand mix inorganic, high plastic clays organic, medium to high plastic clays peat and other highly organic soil Note: The graphical symbols used for the v; based on the symbols recommendated ii Classification system. Graphical log; jective field indentification of soi. data where available. Letter designai the basis of laboratory data and call SAMPLE TYPE SYMBOLS BOREHOLE SAMPLES ® 2.0' iOD Split Spoon (SPT) IShelby Tube a3.0' iOD Split Spoon with Brass Rings aGrab 'Samples (cuttings) mCore Run TEST IDIT SAMPLES Bag (bulk sample) OGrab (small volumn) IShelby Tube HAND BORING SAMPLES Non-standard penetration (40 lb. hammer with 12 inch drop) 0 Grab Sample (post hole) IShelby Tube ROTARY BOREHOLE SAMPLES mContinuous Core Samples irious soil types are i the Unified Soil s are based on sub- .s, and laboratory :ions are assigned on :ulations. GROUNDWATER INSTALLATIONS AND OBSERVATIONS tonite Seal out Backfill oo. oo. Cuttings Backfill or Caved Hole iezometer Casing Groundwater Level (noted during drilling) i Groundwater Level (measured in piezometer after water level stabilized) Slotted Piezometer Tip d Backfill ATTERBERG LIMITS PL ILL HONG WEST 6 ASSOCIATES o - Natural Moisture PL - Plastic Limit LL - Liquid Limit HONG WEST, ASSOCIATES BORING LOG SPT RESISTANCE/MOISTURE % z • MOISTURE % ? cc 1 SPT (blows/foot) C, Cn DESCRIPTION w a J m � CD N 0 80a r = w cn cn cO a A 5 10 t l 83 ► 72/6": 20 <.....:....,....:. a w o . va c o o o Fill Loose, brown and dark gray, silty SAND, some gravel, some organics, fine to medium sand, trace coarse sand, moist. (Fill) SP Medium dense, brown, gravelly SAND, trace silt, gravel clasts to 1.5", fine to medium sand, moist to saturated. (Colluvium/Alluvium) Very dense, gray, gravelly SAND, trace silt to silty, SSL fine to coarse sand, saturated. (Glacial Outwash) Bottom of hole at 22.5 feet PROJECT NAME: Joe Wagner Property LOCATION: Main Street, Edmonds, WA PROJECT NUMBER: 91088 LOGGED BY: Buck Smith k A BORING BH-1 DATE DRILLED: 7/17/91 SURF/SCE ELEVATION: 200 ft. TOTAL_ DEPTH: 22.5 ft. CU W a w 0 HONG WEST & ASSOCIATE:3' BORING LOG SPT RESISTANCE/MOISTURE X z • MOISTURE % oc w SPT (blows/foot) W J DESCRIPTION LU a m CD CD N 0 80 Q C= rWr CD a A i � I i 50 - 50/5.5" cQ Fill Loose, brown and black, mixture of silt, sand, gravel a o and asphalt, some organics, moist„ o (Fill) bQ ' 'ao•. bQ a. oa oQ 'Very Sm loose, dark gray, gravelly organic SAND, some silt, saturated. SP (Original Topsoil) Dense to very dense, gray, fine to coarse SAND, trace gravel to gravelly, saturated. (Glacial Outwash) Bottom of hole at 23.4 feet PROJECT NAME: Joe Wagner Property LOCATION: Main Street, Edmonds, WA PROJECT NUMBER: 91088 LOGGED BY: Buck Smith E'j BORING BH-2 DATE DRILLED: 7/17/91 SURFACE ELEVATION: 200 ft. TOTAL DEPTH: 23.4 ft. �I E HONG WEST & ASSOCIATES BORING LOG LJI SPT RESISTANCE/MOISTURE % • MOISTURE % I SPT (blows/foot) 'n L9 Uj DESCRIPTION LU W i CD M cl- 0M = r1q 0 80 >- x C) LU C= Ln (n LD 50/4": 4 z 9q Fill Loose, brown, silty SAND, some gravel, trace to some organics, fine to medium sand, moist to wet. 00 (Fill) SM Very loose, gray, organic silty SAND, some gravel, saturated (Original Topsoil) �'� SP Medium dense, gray, fine to medium SAND, scattered gravel, trace silt, saturated. (Alluvium) .... SID Dense to very dense, gray, fine to coarse SAND, trace gravel to gravelly, trace silt, saturated. (Glacial Outwash) q Bottom of hole at 33.3 feet Note: Temporary piezometer installed at 19.0 feet. Can be removed during construction phase. PROJECT NAME: Joe Wagner Property LOCATION: Main Street, Edmonds, WA PROJECT NUMBER: 91088 LOGGED BY: Buck Smith BORING BH-3 DATE (DRILLED: 7/17/91 SURFACE ELEVATION: 200 ft. TOTAL DEPTH: 33.3 ft. I , I HONG WEST & ASSOCIATES BORING LOG SPT RESISTANCE/MOISTURE % • MOISTURE % LU I SPT (blows/foot) LO DESCRIPTION U, CL. C) a- M ME CD 0 80 < 0= LU Ln Ln LD ca Fill Medium dense, gray and brown, gravelly silty SAND, trace organics, fine to medium sand, moist. (Fill) Loose, dark brown, organic fine to medium SAND, SM trace to some silt, considerable amount of wood fragments and organics, wet to saturated. SP (Original Topsoil) Very dense, gray, fine to coarse SANO, some gravel to gravelly, trace silt, saturated. .... (Glacial Outwash) Bottom of hole at 19.0 feet PROJECT NAME: Joe Wagner Property LOCATION: Main Street, Edmonds, WA PROJECT NUMBER: 91088 LOGGED BY: Buck Smith VA BORING BH-4 DATE DRILLED: 7/17/91 SURFACE ELEVATION: 200 ft. TOTAL DEPTH: 19.0 ft. M E M O R A N D U M DT: June 24, 1991 TO: Doug Herman FM: Dick Mumma, Building Official d0ll� SB: Preliminary review of soil report on lots 3.4 & 35 Block 40 * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * At you request I have reviewed the soils report (October 25, 1989) and Conceptual Reinforced Soil Embankment report (June 25, 1990). These reports point out problems with that site. 1. The site exploration revealed a large amount of fill on site. 2. The fill would not support a building or would it withstand a seismic event. 3. The site was saturated with water. 4. Additional exploration is necessary before any design could be developed to overcome the problems uncovered. No permits would be issued until the conditions uncovered in these reports were adequately addressed. S. E. 1/4., SEC. 24, T. 27 N.j R. 3 E. W. M. 1" 200 --ISO kUt 44 6 3 14. , .0 Z.- .. Q4 Z, on 12, 15 04 r' 00 ST 04 in It N 4b J., 16- Pz LL, 44 9-V 7— 41; L P R'A"G &j 6 20 r -19 woc 4 f4� ic ST; E:p ONDS C4 I!$ co 0, /0 VIL AGE, NO.' (50 L Lm C4 _V1711 i 1-o '-'.26 25 lo� Ilo ak) kfl aW, I MER ST 100A LLS OR ' 1111- a I FV!, I I OMNI rom ltJ Iq 04 110:1 , 0 w a Ell In 11 'I'll' IG 37 A -4 7 '-ST 7 M 7 zp- " W-1 5"A E le I t; � I ") iln'. u9a aster 4 v GF- - "t - —s N MIR- n o F �iHD z IP F..,-tz ago O Nil t wn� 01. to I U. 1-�511 M 77 ltJ Iq 04 110:1 , 0 w a Ell In 11 'I'll' IG 37 A -4 7 '-ST 7 M 7 zp- " W-1 5"A E le I t; � I ") iln'. u9a aster 4 v GF- - "t - —s N MIR- n o F �iHD z IP F..,-tz ago O Nil t wn� 01. to I U. 1-�511 M 77 '-ST 7 M 7 zp- " W-1 5"A E le I t; � I ") iln'. u9a aster 4 v GF- - "t - —s N MIR- n o F �iHD z IP F..,-tz ago O Nil t wn� 01. to I U. 1-�511 M 77 7 M 7 zp- " W-1 5"A E le I t; � I ") iln'. u9a aster 4 v GF- - "t - —s N MIR- n o F �iHD z IP F..,-tz ago O Nil t wn� 01. to I U. 1-�511 M 77 4 v GF- - "t - —s N MIR- n o F �iHD z IP F..,-tz ago O Nil t wn� 01. to I U. 1-�511 M 77 ago O Nil t wn� 01. to I U. 1-�511 M 77 U. 1-�511 M 77 USE � e ET FILE CITY OF EDMONDS R NUMBER SGO2 �J CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS ,DB SUITE/APT ADDRESS lO I MAILING ADDRESS Z LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID NCO _? /�_�� ass O I L' CITY IP TELEPHONE NUMBER PUBLIC RIGH F WAY PER OFFICIAL STREET AP. TESCP Approved D RW Permit IleQuired Q 7 EXISTING REQUIRED DEDICAT RE ION Stleet Use Permit Rep•d D NAME PROPOSED �!J Inspection rtequlred Sidewalk Rtquired D11 t7 `M— REMARKS w ADDRESS 71,:�IM117e. /WS/_9 U I'f c>`_' CI Y ZIP TELEPHONE NUMBER l • NAME ENGINEERING MEMO DATED // REVIEW BY ADDRESS ,1 U(�A �Z METER IZEfI BUILDING SUPPLY SIZE NO. OF FIXTURE �� CITY ZIP TELEPHONE NUMBER tc w pL VOL) O 83�3 REMA 3 STATE LICENSE NUMBER EXPIRATION DATE � SIGN AREA SEPA REVIEW ADB NO. Legal Description of Property - include all easements ALLOWED PROPOSED COMPLETE EXEMPT EXP ���.. VARIANCE OR CU LAN NING EVIEW BY )DATE 0 SETBACKS — FEET HEIGHT LOT COVERAGE i z w Property FRONT SIOEjgS' REAR 5-35 P y Tex Account ` 'S Parcel No. 13 Q REMARKS KNEW RESIDENTIAL PLUMBING , ,K O ADDITION COMMERCIAL MECHANICAL OREMODEL O APT. BLDG. El SIGN O GRADING ❑ FEI NCE CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT REPAIR CYDS. x—rn C NSERTOODSTOVE ❑ swimHOT POUEISPA DEMOLISH ElGARAGE SPECIAL INSPECTOR AREA 0 CUPANCY OOCACUUPANT RETAINING WALL/ REQUIRED YES — CARPORT ROCKERY RENEWAL EMARKS o (TYPE OF USE, BUSINES OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 305 Z t NUMBER -OF STORIES NUMBER OF ,,[�JJ'� �ajr'(TL� fuL /Q /�/ w��=G, m a I / DWELLING ' I( to 1►— UNITS DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) FINAL INSPECTION REQUIRED /OV VALUATION FEE /! / #11/037 l�ddA PLAN CHECK FEE 9�? HEAT SOURCE: GLAZING BUILDING' /O/ 1'"--� 65 11 IN, PLUMBING /' /�f Plan Check No. / Opr lii CJ MECHANICAL s+ I This Permit Coversyvork to be done on private property ONLY. GRADINGIFILL � 4r"Ir I Any construction on the public domain (Curbs, sidewalks, ry' driveways, marquees, etc.) will require Separate permission. STATE SURCHARGE 7 a 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 y successors in interest, agrees to indemnify, defend and hold w harmless the City of Edmonds, Washington, its officials, s employees, and agents from any and all claims for damages of < whatever nature, arising directly or indirectly from the issuance = of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT �j EaA J modify, 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 provision." (J acknowledge that 1 have read this application; that the ion given is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL ed agent of the owner. I agree to comply with city and s regulating construction; and in doing the work authoriz- THIS PERMIT AUTHORIZES This application is not a permit until by, no person will be employed In violation of the Labor ONLY THE signed by the Building Official or his/herthe Linay State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, anti receipt is r nce. INSPECTION acknowledged in space providsd. (OWNER OR AGENT( SIGNED DEPARTMENT OFF I L'S SIGNATURE DATE JDATE 1. tm 3/ay�2� CITY OF EDMONDS Zi ATTENTION CALL FOR RELEA BY: DATE INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771-0220 UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW -- InsDector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC CHAPTER 3. PINK — Owner GOLD — <ssessor tosaT ;9+• '�v loo, 001 lit too 1ut.i i I I i I I n IM iv I u ! yr I , , u 21•0 ' '. t' i - Z SCw :QQAPYLUb I 1vWv� O 1 N j 2z I N ' _ 1 I � r it r ' 1 I laa.�s�f100.s.140 Est �Lo-12Eoti_ �i _ 2S Zo s j - lol.0` i t,&y f�• F r l I _ 2S.1SWe �� S.�• i;�uc�, �eluru�a j � � Kue(� O.li, 2oD t•f. i tlL _ I 1 i lao I lot l0'1,55 IDe.00l 00 6 vow thin-la lAU . F G' M k I I 'I IVI '.1 14 iN, I tk .1 4-1 1 I ks zo I T. 10 f i-- eov L 4v WAVIM=4w�o." ca 6 A� `Y90 199- City of Edmonds RIGHT-OF-WAY CONSTRUCTION PERMIT Permit Number: 95? F Issue Date: A. Address or Vicinity of Construction: MAtN 57 B. Type of Work (be specific): iN57AC. L ;5Z D N Dgej o AC4oSS MM"i S'T 4 i'a' UG CAylvDC_X— sw C. Contractor: CN662s C,4�SciRPoeIo�e L°,r� Contact: �k G+G4 4 WON t_ Mailing Address: 5-3 3 IAA l ty Phone: % 7 4.. '>7 ¢ State License #: yuRtEe C , lot Q A. Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project El Utility (PUD, GTE, WNG,(CAL WATER) ❑ Multi -Family ❑ Single Family ❑ Other INSPECTOR: INSPECTOR: Mi ITLU-1� F. Pavement or Concrete Cut : ❑ Yes FNo G. Size of Cut: x H. Charge $ f APPLICANT TO READ ANI ,, IGN INDEMNITY. Applicant understands and by his signature to this application, agrees1to,:ehold the'Chy of &!monJs harmless from injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeen, that may 1e made against the City of Edmonds, or any of its departments or employ- ees, including or. not limited to the defense of any legal proceedings including defi a costs, and attorney fees by reason of granting this permit. _. COMMENTS::. TE ISSUED BY:: 44 W444 i4a' Q, w IN PRIOR TO PERMIT IS Engrg. Div. 1991 FIELD INSPECTION NOTES Comments• Diagram: (Fund I I I - Route copy to Street Dept.) CONTRACTOR CALLED FOR INSPECTION 0 YES D NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. July M.AI�1 ST I �G-G oW CA I I I City of Edmonds S FT Fn P: RIGHT-OF-WAY CONSTRUCTION PERMIT � 6 Permit Number: � Issue Date: A. Address or Vicinity of Construction: 1025 MFlin St•. B. Type of Work (be specifie):Ins t. 2" PE IP Main in Main St. from 5151E c/1 61 go . 1 9 y of 9 Av. S. to 8651E c/1 9 Av. S. Per Attached Drawing: 920665 (IR #6043-3)(2) au C. Contractor: Wash. Nat'l Gas. Co. Contact: Frank Suran Mailing Address: 815 Mercer St. Seattle, Wn Phone: 224-2278 State License #: 98111 Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. ' ❑ Commercial El Subdivision❑ City Project A2j{. Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ® Single Family ❑ Other INSPECTOR: INSPECTOR: gvv F. Pavement or Concrete Cut : Yes []No to G. Size of Cut: q x i H. Charge $ APPLICANT TO READ AND/SIGN,/ INDEMNITY: Applicant understands and by his signature to this application, agrees to.hoWe City of F,ilmonds harmless from injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeen, that may be made agairist,tthe City of Edmonds, or any of id departments or employ- ee's, including or not limited to the defense of any legal proceedings including defense costs; and attorney fees by reason of gran`ttng ihts permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECITON J AND 'ACCEPTANCE OF THE WORK. ES77MA7ED RESTORA7TON FEES WILL BE HELD UN77L THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUA'NeE TO THE APPLICANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Department- 771.-3202. Work is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City. regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. ti I have read the above statements and ut derstandthe permit, requirements and the pink copy of the permit will be available on site at all times for inspection pooId._ `' 41 Signature: Date: June 12, 1992 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK A NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 FIELD INSPECTION NOTES (Fund II I - Route copy to Street Dept.) Comments• Diagram: CONTRACTOR CALLED FOR INSPECTION O YES O NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng..Div. Jul CitY of EdmondsY RIGHT-OF-WAY CONSTRIUCTION PERMIT Permit Number: Issue Date: A. Address or Vicinity of Construction: 10;)S /iAi►•1 Sr B. Type of Work (be specific): IkKTQI.I <ZCr hLIhAe_V 171<E12 ON EXISMtYn 'y 9 0 - 1 9 -PoL.19, SET 'PEDESTArL. AT ljgDT�eTy <.oR.lJ112.- op- C. tJ�s= i�l2i Contractor: -P, LA .—L> Contact: DAL,30 LL_ HoWAgP Mailing Address: 21 LA!S 44WNI 199 Phone: (00 _ 25aOS State License #: Liability Insurance: __ Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project ❑ Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family Single Family ❑ Other INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut : ❑ Yes PkNo G. Size of Cut: x H. Charge $ APPLICANT TO READ AND SIGN INDEMNITY. Applicant understands and by his signature to this application, agrees t h 6 the City of Edmonds hatmle from injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeen, that may be madagd�nst the City of Edmonds, or ar ofYtepar(merLor employ- ees, including or not limited to the defense of any legal proceedings including decosts, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD •Of ONE HEAR FOLLOWING THE FINAL' INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORA77ON FEES WILL' BE HELD UN77L THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Department- 771-3202. Work is to be inspected during pro mess and at completion. Restoration is'to be in accordance kith City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regtilations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the.working day; NO EXCEPTIONS. I have read the above statements and understand the permit requirements and the pink copy of the permit will be available on site at all times for inspection purposes4LWd Signature: / / 1 . Date: a�] —C'j p�- (Contractor or Agent) CALL DIAL. A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY:: � , ::::: .:;RIGHT:.OF,WAY: DE'. TWE;AUTHORIZED: VOID AFTER ' DAYS'DISRUPTION: FEE/F .SPECIAL CONDITIONS;_;.. _ :RESTORAT __ .. PERMIT. COMMENTS - :,RECEIPT;NO —_ M DATE ISSUED BY:.; w , _�Ct{ 6. RK SHALL Engrg. Div. 1991 FIELD INSPECTION NOTES (Fund III - Route copy to Street Dept.) Comments: Diagram: .:I-'_. . CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P. W.: Work Disapproved By: I Date: FINAL APPROVAL BY: % Date: Eng. Div. July __.�'�( 'q}� ., �'.Tm." ,, _;. ,�s-, r,.. .�,''S+'h , � �y •'�;,,i i. _ y�. �. ��,;,: lw�l("'�.--'�'-^"r-'--(-T�-rP^--,.--T--.: _.HT Fill 4F Y .1 C ClLy Of Edmonds RIGHT-OF-WAY CONSTRIUCTION 9 v PERMIT Permit Number:- /69 Issue Date: A. Address or Vicinity of Construction: B. Type of Work (be specific): t-- 9 0 1 9 y r�I— .r10 Contractor: C,1, y- �p.y ,s gele i p P SF�ra ontact: Mailing Address: 2 `7 // / �R� .✓t� S4-a . ,WgoPhone: S` — Ci `J? 7/ State License #: CZ-T FZ- Q 100l-- Liability Insurance: Bond: $ D. :Building Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ Multi -Family Single Family INSPECTOR:fNr4 Side Sewer Permit # (if applicable): ❑ City Project ❑ Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Other INSPECTOR: F. Pavement or Concrete Cut : k]t Yes []No G. Size of Cut: -/x 34D H. Charge APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeen, that may be made against the City of Edmonds, or any of its departments or employ- ees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE ZE41? FOLLOWING THE FINAL INSPEC77ON AND ACCEPTANCE OF 771E WORK. ES77MAYED RESTORA77ON FEES WILL BE HELD UN77L THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Departme Work is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. I have read the above statements and understand the permit requirements and the pink i7opy of the permit will be available on site at all times for inspection purposes. Signature: Date: 61-1 -'" (Contractor or Agen CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY: USE ONLY APPROVED B.,..... RIGHT OF WAY DEPOSIT: , TIMEAUTHORIZED'VOID'AFTER.. " v DAYS DISRUPTION FEE/FUND I.I.I. SPECIAL CONDITIONS:.: - -- ' RESTORATION. F... `i'r"- ..... _ _ .: PERMrr. FEE: ..... ...... TOTAL FEE�6 /5777 ....COMMENTS::...... RECEIPT:NO.: ........ DATE::;: ISSUED BY;, NO. WORK SHALL Engrg. Div. 1991 FIELD INSPECTION NOTES (Fund I II - 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: Date: Eng. Div. July •'"` w-r'„'..' t: _•c. �.•i-...r ,•�,i:,�.-.Jv 1-�7^� -.. � ...,.�- �•�✓e�.r•—+�'�113••'K 4ti•tSl,-�yro�,,.�/4�i'n'p'�`p'`c"'y�i���} �Yty�',��..ryr+at,r a�yt,�. , +� r��lP`a"MKr'. - -^'"�. z$ RLE CITY OF EDMONDS SI[IE SEWER PERMIT. l890 19°° PERMIT 3392 Address of Construction: Property Legal Description (Include all easements): -3 S A�G/S - 4U Toc. �DMDNDS Owner and/or Contractor:���� iV� State License No.1�� ��Building Permit No. Single Family Invasion into City Right -of -Way: ❑ No J Yes ❑ Multi -Family (No. of -Units-) RW Construction Permit No. ❑ Commercial ❑ Public �� _- _ ,_ �•.. a / 1, Cross other Private Property: ❑ No ❑ Yes Attach legal descri Dtion and copy of recorded easement I certify that I h�ve read Qyd sharl comply with all city requirements as indicated on the back of the Permit Card. 4•-'�'-7z Date * CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION y * FOR INSPECTION CALL 771-3202, PUBLIC WORKS DEPT. Permit Fee: ' �%U Issued Byc Trunk Charge: Date Issued: 9a Assessment Fee: Aj� Receipt No.: > %- Lid No.: Partial Inspection: Date Initial. Comments Reason Rejected: Date Initial Final Inspection Approved: Date '10 "Initial ,4' ** PERMIT MUST BE POSTED ON JOB SITE ** White Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 3!90 The City of Edmonds Side Sewer Drawing EASEMENT NO_ ____________________________________________ NEW CONSTRUCTION [✓� REPAIRS ❑ LID NO_ __________________ _ASMT. NO. --____-_- t 2 pp OWNER \\ CONTRACTOR ---- - ---------------- PERMIT NO. J__1_--------- C. fl 0�,;"O��-\'P----- BLOCK NO. ------------------------------ AJOB ADDRESS._�------------------�-----------------------------------------.................. LEGAL DESCRIPTION: LOT NO. _ -- ----------------------------------------------------------- ja!� --------------------------------------------------------------------------------------- 1AME OF ADDITION ___________ .°?.i/e, moo. fflvl� Y3 .S l Approved: DATE--------------- � Y------------------------------------------------------------ PWW-0001-11/75 (REV.11/78) �s lv�ati s+ 4 STREET FILE DETERMINATION OF NONSIGNIFICANCE Description of proposal Construction of a foundation for a relocated house Proponent Joe Wagner 114 2nd Ave S., Edmonds, WA 98020 Location of proposal, including street address, if any 1025 Main St., Edmonds, WA 98020 Lead Agency Edmonds Planning Division FILE# N/A The lead agency for this proposal has determined that it does not have a probable -significant adverse impact on the environment. An environmental impact statement (EIS) is not required under RCW 43.21C.030(2)(c). This decision was made after review of a completed environmental checklist and other information on Ifile with the lead agency. This information is available to the public on request. X There is no comment period for this DNS. _ This DNS is issued under 197-11-340(2); the lead agency will not act on this proposal for 15 days from the date below. Comments must be submitted by Responsible Official Jeffrey S. Wilson Position/Title Current Planning Supervisor Phone 771-3202 Address 250 5th Ave. N., Edmonds WA 98020 Date jjg6/4f Signatur , .,& Cx-9--L— X You may appeal this determination of nonsignificance to Hearing Examiner at 250 5th Ave. North, Edmonds, WA 98020 no later than December 7, 1991 by filing a written appeal citing reasons..'..,. . You should be prepared -to make specific factual objections. Contact John Bissel-l- to read or ask about the procedures for SEPA appeals. There is no agency appeal. R4%lb-Ai; lIVkzb CITY OF EDMONDS X 1 3 1 1991 ENVIRONMENTAL CHECKLIST MMlt COUNM A. BACKGROUND 1. Name of proposed project, if applicable: l�1et. 2. Name of applicant: �DG>>Qk:� LNEb2. 3. Address and `phone number of applicant and contact pcerson: �otF �u�i2t },�bu•tES� I�l� - d7ycxi 04 9'W -1-9.4t,Qs 4. Date checklist prepared: C) S. Agency requesting checklist: City of Edmonds. 6. Proposed timing or schedule (including phasing, if applicable): A-S /a—r (STAFF COMMENTS) 7. Do you have any plans for future' additions, expansion, or further activity related to or connected with this proposal? If yes, explain. .Y yV . (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 1 of 26 S. List any environmental information you know about that has prepared, or will be prepared, directly related to this proposal. ::.... i�✓1�..G✓�-•-r wa. s �c CG'EO �j t-� r" (STAFF COMMENTS) been 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.`` /00 (STAFF COMMENTS) 10. List any government approvals or permits that will be needed for your approval, if known. (STAFF COMMENTS) 11. Give brief, complete description of your proposal, including the proposed uses and size of the project and site. There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not need t4,3 repeatthose answers on this page. �;� s,TyLv[� T" Fo-rlh �a�•4-no-,c� FU✓� h�in�� � �� itro✓/� a�t� ��� °vs e --v r.'b-I2ct t %i L '�rsrt2�c •c Yor/�L vv( .Pa I�Ic��—w— (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 2 of 26 12. Location of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, and section, township, and range, if known. If a proposal would occur over a range of area, pn3vide range or boundaries of the site(s). Provide legal description, site plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not requi.Lred to duplicate maps or detailed plans submitted with any permit applications related to this checklist. 1 U ZS 1M1�-�h 1 ' • �11�Yy��,+�� (STAFF COMMENTS) TO BE COMPLETED BY APPLICANT B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous, other: (STAFF COMMENTS) TY(7 (171-'P�7y /s err L�OI,�� OT fNL i-!GL L S ) b. What is the steepest slope on the site (approximate percent slope)? (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 3 of 26 _f 1 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. f 1D�i mac Gs � �,y�2GV�d�' (STAFF COMMENTS) d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. (STAFF COMMENTS) e. Describe the purpose, type and approximate quantities of any filling or grrading proposed. Indicate source of fill. (STAFF COMMENTS) f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. Ah,7 ( STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 4 of 26 g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? (STAFF COMMENTS) h. Proposed measures to reduce or control erosion, or other impacts to the earth. if anv: (STAFF COMMENTS) 2. AIR a. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities if known. ( STAFF COMMENTS) b. Are there any off -site sources of emissions or odor that may effect your proposal? If so, generally describe. (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 5 of 26 C. Proposed measures to reduce or control emissions or other impacts to the, if any: (STAFF COMMENTS) 3. WATER a. Surface: (1) Is there any surface water body on or in the immediate vicinity of the site (including year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide names. If appropriate, state what stream or river it flows into. (STAFF COMMENTS) (2 ) Will the project require any work over, in, or adj a ent to (within 200 feet) the described waters? If yes, please describe available plans. (3) ( STAFF COMMENTS) 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. /A I CHKLT/10-8-91.MASTER Page 6 of 26 (STAFF COMMENTS) (4) Will the proposal require surfaces water withdrawals or diversions. Give general description, purpose, and approximate quantities if known. (STAFF COMMENTS) (5) Does the proposal lie within a 100-year floodplain? If so, note location on the site plan. (STAFF COMMENTS) (6) Does the proposal involve any discliarges of waste materials to surface waters? If so, descril,)e the type of waste and anticipated volume of discharge. )O ( STAFF COMMENTS) b. Ground: (1) Will ground water be withdrawn, or will water be discharged to ground water? Give general dlescription, propose, and approximate quantities wif rr known. CHKLT/10-8-91.MASTER Page 7 of 26 (STAFF COMMENTS) (2) Describe waste material that will be discharged into the ground from septic tanks or other sources, if any (for example: Domestic sewage; industrial, containing the following chemicals...; agricultural; etc.). Describe the general size of the system, the number of such systems, the number of houses to be served (if applicable), or the number of animals or humans the system(s) 8lre expected to serve. (STAFF COMMENTS) C. Water Runoff (including storm water): (1) Describe the source of runoff (including storm water) and method of collection and disposal, if any (including quantities, if known). Will this water flow into other (STAFF COMMENTS) (2) Could waste materials enter ground or surface waters? If so, generally describe. � 9 I ve) (STAFF COMMENTS) CHKLTl10-8-91.MASTER Page 8 of 26 d. Proposed measures to reduce or control suicface, ground, and runoff water impacts, if any: (STAFF COMMENTS) 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 ,x—grass pasture crop or grain wet soil plants: cabbage, other:_ cattail, buttercup, bulrush, skunk water plants: water lily, eelgrass, milfoil, other: other types of vegetation: (STAFF COMMENTS) b. What kind and amount of vegetation will be remove or altered? CH KLT/ 10-8-91.MASTER Page 9 of 26 (STAFF COMMENTS) C. List threatened or endangered species known to be on or near the site. (STAFF COMMENTS) d. Proposed landscaping, use of native plants, or other materials to preserve or enhance veget� f `tion on the sit: f any: / ,, /,()J,C .., .0 vLD'l t' aiT ,�A- O�r�z �� �,� �.t � �lJ e!^-C (STAFF COMMENTS) S. Animals a. Check or 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, songbirds, other: mammals: deer, bear, elk, beaver, other: fish: bass, salmon,•:trout, herring, shellfish, other: (STAFF COMMENTS) CH KLT/10-8-91.MASTER ;Page 10.•of'25 b. List any threatened or endangered species known to be on or near the site. ( STAFF COMMENTS) C. Is the site part of a migration route? If so, explain. ( STAFF COMMENTS) d. Proposed measures to preserve or enhance wildlife, if any: ( STAFF COMMENTS) � �L 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 a used for heating, manufacturing, et 14- (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 11 of 26 b. Would your project• affect the .potential use of solar energy by adjacent properties? If so, generally describe. Nd (STAFF COMMENTS) C. What kinds of energy conservation features are included in the plans of this proposal / (STAFF COMMENTS) 7. Environmental Health 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. (STAFF COMMENTS) (1) Describe special emergency services; that might be required. A- --- (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 12 of 26 (2) Proposed measures to reduce or control environmental health hazards, if any: (STAFF COMMENTS) b. Noise (1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? ( STAFF COMMENTS) (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. R1o�2h�t A l GUI / S '� (ZA4AA GlJl �lt , 4ev-` � /1Fr/lylE (STAFF COMMENTS) (3) Proposed measures to reduce or control noise impacts, if any: ( STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 13 of 26 8. Land and Shoreline Use a. What is the current use of s1i/te and o'djacent properties? em- /the ( STAFF COMMENTS) b. Has the site been used for agriculture? If so, describe. ( STAFF COMMENTS) C. Describe any structures on the site. (STAFF COMMENTS) d. Will any structures be demolished? If so, what? ( STAFF COMMENTS) e. What is the current zoning classification of they si CHKLT/10-8-91.MASTER Page 14 of 26 f. (STAFF COMMENTS) What is the current comprehensive plan designation of the site? ( STAFF COMMENTS) nor S"j &62e2 �D� g. If applicable, what is the current shoreline master plan designation of the site? ( STAFF COMMENTS) h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. n ete if A,� ( STAFF COMMENTS) i. Approximately how many people would reside or work in the completed project? (STAFF COMMENTS) CHKIT/10-8-91.MASTER Page 15 of 26 d c¢ j. Approximately how many people would the completed project displace? (STAFF COMMENTS) k. Proposed measures to avoid or re uce displacement impacts, if any: % 7A- ( STAFF COMMENTS) 1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plalis, if any , 11 (STAFF COMMENTS) 9. Housing a. Approximately how many units would be provided, if* any? Indicate whether high, mi�Jd//d�le, or low-income housi,ng,,.. (A Y^- (STAFF COMMENTS) CHKIT/10-8-91.MASTER Page 16 of 26 l b. Approximately how many units, if any would be eliminated? Indicate whether high, middle``, or low-income housing. A/� D-P ( STAFF COMMENTS) 00 r 1 U lM r.jrw firs Proposed measures to reduce or control housing impacts, if any: (STAFF COMMENTS) 10. Aesthetics a. What is the tallest height of any proposed structure(s), not including antennas; what is the principle exterior building material(s) proposed? (STAFF COMMENTS) b. What views in the immediate vicinity would be altered or obstructed? (STAFF COMMENTS) cj�" CHKLT/10-8-91.MASTER Page 17 of 26 C. Proposed measures I�to reduce or control aesthe is/impacts, if any: (STAFF COMMENTS) 11. Light and Glare a. What type of light or glare will the proposal produce? What time of day woul it mainly occur? (STAFF COMMENTS) b. Could light or glare from the finished project be a safety hazard or interfere with views? ( STAFF COMMENTS) C. What existing off -site sources of light or glare may affect your proposal? ( STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 18 of 26 d. Proposed measures to reduce or control light and glare impacts, if any: (STAFF COMMENTS) 12. Recreation a. What designated and informal recreational opportunities are in the (STAFF COMMENTS) b. Would the proposed project displace any existing recreation uses? If so, describe. Y to (STAFF COMMENTS) C. Proposed measures to reduce or control. impacts on recreation, including recreation opportunities to bet provided by the project or applicant, if any: AA nn /jelll� (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 19 of 26 r 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. Wa (STAFF COMMENTS) b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural .importance known to be on or next to the site. (STAFF COMMENTS) C. Proposed measures to reduce or control impacts, if any: (STAFF COMMENTS) 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. (STAFF COMMENTS) CHUT/10-8-91 WASTER Page 20 of 26 b. Is site currently served by public transit? If no, what is the approximate distance to the nearest transit stop? ( STAFF COMMENTS) C. How many parking spaces would the completed project have? How many would the project eliminate? (STAFF COMMENTS) d. Will the proposal require any new roads or street, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether pub;Lic or private). Y-Je (STAFF COMMENTS) e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. Nr (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 21 of 26 + _L f. How many vehicular trips per day would be generated by the completed project? If known, indicate when peak volumes would occur. (STAFF COMMENTS) g. Proposed measures to reduce or control transportation impacts, if any: ( STAFF COMMENTS) 15. Public Services a. Would the project result in an increased need for public services (for example: fire protection, police protection, health care, schools, other)? If so, generally describe. (STAFF COMMENTS) b. Proposed measures to reduce or control direct impacts on public services, if any: 99 (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 22 of 26 16. Utilities a. Circle utilitieurre tly availab at the site: �eteccriciLyy . <. natural gases water refuse service telephone, sanitary sewer septic system, other: �5 ��ton ( STAFF COMMENTS) b. Describe. the utilities that are proposed for the project, the utility providing the service, and t]ie general construction activities on the site or in the immediati3 vicinity which might be needed. (STAFF COMMENTS) C. SIGNATURE The above answers are true and complete to the b6st of my knowledge. I understand that the lead agency is relying on them to make its decision. Signature of Proponent Date Submitted CHKLT/10-8-91.MASTER Page 23 of 26 4 :' I i D. SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (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? war feAi � iZo ' Drzcu N a Ike 7 Dr/sQ� 2. Proposal measures to avoid or reduce such increisesfare: t n) n _k.t A . f [��t.t.+�- U�Yf S.O Q (t — How would the proposal be likely to affect plants, animals, fish, or Proposed measures to protect or conserve plaints, animals, fish, or marine life are: , 3. How would the proposal be likely to deplete energy or natural resources? CHKLT/10-8-91.MASTER Page 24 of 26 Proposed measures to protect or conserve energy and natural resources are: - WX How would the roposal be likely to use or affect environmentally sensitive area de 'gnated (or eligible or under study) for governmental protection; such s parks, wilderness, wild and scenic rivers, threatened or endang ed species habitat, historic or cultural sites, ftnndnleins - r nrime farmlands? Proposed measures to protect such resources or to avoid or reduce S. 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? f A 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? es- I d� wtav 4&e� -i CHKLT/10-8-91.MASTER Page 25 of 26 4 to • Proposed measures to reduce or respond to such demand(s))are: 7. Identify, if possible, whether the proposal nay conflict with local, state, or federal laws or requirements for the protection of the environment. CHUT/10-8-91 WASTER Page 26 of 26 J... as Ste, CITY -COPY DETERMINATION OF NONSIGNIFICANCE Description of proposal Construction of a foundation for a relocated house Proponent Joe Wagner 114 2nd Ave S., Edmonds, WA 98020 Location of proposal, including street address, if any 1025 Main St., Edmonds, WA 98020 Lead Agency Edmonds Planning Division ,I,571FEET PILE The lead agency for this proposal has determined that it does not have a probable significant adverse impact on the environment. An environmental impact statement (EIS) is not required under RCW 43.21C.030(2)(c). This decision was made after review of a completed environmental checklist and other information on file with the lead agency. This information is available to the public on request. X There is no comment period for this DNS. _ This DNS is issued under 197-11-340(2); the lead agency will not act on this proposal for 15 days from the date below. Comments must be submitted by Responsible Official Jeffrey S. Wilson Position/Title Current Planning Supervisor Phone 771-3202 Address 250 5th Ave. N., Edmonds WA 98020 Date itL26ll4! Signatures• X You may appeal this determination of nonsignificance to Hearing Examiner at 250 5th Ave. North, Edmonds, WA 98020 no later than December 7, 1991 ..by filing a written appeal citing reasons. You should be prepared to make specific factual objections. Contact John Bissell to read or ask about the procedures for SEPA appeals. There is no agency appeal. a CITY OF EDMONDS O U T ENVIRONMENTAL CHECKLIST POW MHU A. BACKGROUND 1. Name of proposed project, if applicable: tj&v.� 2. Name of applicant: 04-4ly Z 3. Address and phone number of applicant and contact person: . o F L04! r A)t-7i2 I ILA -7 7 & ,23St ?JAWift- l— 6—mc-S, 4. Date checklist prepared: lU -30 5. Agency requesting checklist: City of Edmonds. 6. Proposed timing or schedule (including phasing, if applicable): (STAFF COMMENTS) 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. (STAFF COMMENTS) CHKIT/10-8-91.MASTER Page 1 of 26 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. r?:c,` ✓ j WA-S FZ CC, D C.AiLS D LcSE. ( STAFF COMMENTS) 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. (STAFF COMMENTS) 10. List any government approvals or permits that will be needed for your approval, if known. -r (STAFF COMMENTS) 11. Give brief, complete description of your proposal, including the proposed uses and size of the project and site. There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not need to repeat those answers on this page. Ca•I S7-WL e/o a/?;:� Mgioes e --v r,t�itta- ;L.�,�, (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 2 of 26 12. Location of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, and section, township, and range, if known. If a proposal would occur over a range of area, provide range or boundaries of the site(s). Provide legal description, site plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications related to this checklist. IU ZS ? I� Imo- --��� 6' (STAFF COMMENTS) TO BE COMPLETED BY APPLICANT B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous, other: (STAFF COMMENTS) I r b. What is the steepest slope on the site (approximate percent slope)? l s�/a aYl E,4 1 to 5` bo' C� -rl �.v d_ b l� LCE- (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 3 of 26 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. �L- him c G's v►�t �„� 2-i.V�CdJ' (STAFF COMMENTS) d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. L (STAFF COMMENTS) e. Describe the purpose, type and approximate quantities of any filling or grading proposed. Indicate source of fill. �1 , /fit 1 e (STAFF COMMENTS) f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. AA% (STAFF COMMENTS) CHUT/10-8-91.MASTER Page 4 of 26 g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? 32�e (STAFF COMMENTS) h. Proposed measures to reduce or. control erosion, or other impacts to the earth, if any: (STAFF COMMENTS) 2. AIR a. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities if known. (STAFF COMMENTS) b. Are there any off -site sources of emissions or odor that may effect your proposal? If so, generally describe. // (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 5 of 26 c. Proposed measures to reduce or control emissions or other impacts to the, if any: (STAFF COMMENTS) 3. WATER a. Surface: (1) Is there any surface water body on or in the immediate vicinity of the site (including year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide names. If appropriate, state what stream or river it flows into. (STAFF COMMENTS) (2) Will the project require any work over, in, or adjacent to (within 200 feet) the described waters? If yes, please describe available plans. / MY7NL_ S2 4- V�IA4 t- (STAFF COMMENTS) (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. T"A;� n++hd- Cn22vP.P_ of f711 1NA+P_YIAI - CHKLT/10-8-91.MASTER Page 6 of 26 (STAFF COMMENTS) (4) Will the proposal require surface water withdrawals or diversions. Give general description, purpose, and approximate quantities if known. (STAFF COMMENTS) (5) Does the proposal lie within a 100-;gear floodplain? If so, note location on the site plan. (STAFF COMMENTS) (6) Does the proposal involve any discharges of waste materials to surface waters? If so, describe the type of waste. and anticipated volume of discharge. I .)© (STAFF COMMENTS) b. Ground: (1) Will ground water be withdrawn, or will water be discharged to ground water? Give general description, propose, and approximate quantities if known. CHKLT/10-8-91.MASTER Page 7 of 26 (STAFF COMMENTS) (2) Describe waste material that will be discharged into the ground from septic tanks or other sources, if any (for example: Domestic sewage; industrial, containing the following chemicals...; agricultural; etc.). Describe the general size of the system, the number of such systems, the number of houses to be served (if applicable), or the number of animals or hu(m`a'ns the system(s) are expected �to serve. ,'9 (STAFF COMMENTS) t. C. Water Runoff (including storm water): (1) Describe the source of runoff (including storm water) and method of collection and disposal, if any (including quantities, if known). Will this water flow into other (STAFF COMMENTS) (2) Could waste materials enter ground or surface waters? If so, generally describe. ZV—I-) (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 8 of 26 d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: / A 'Ltk/� %mil%•; ' A, (STAFF COMMENTS) 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 _,,Z_gra s s vasture crop or grain wet soil plants: cabbage, other:_ cattail, buttercup, bulrush, skunk water plants: water lily, eelgrass, milfoil, other: other types of vegetation: (STAFF COMMENTS) b. What kind and amount of veget tion will be remove or altered? CHKLT/10-8-91.MASTER Page 9 of 26 (STAFF COMMENTS) C. List threatened or endangered species known to be on or near the site. (STAFF COMMENTS) d. Proposed landscaping, use of native plants, or other materials to preserve or enhance veget tion on the sit , f any. (STAFF COMMENTS) 5. Animals a. Check or 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, songbirds, other: mammals: deer, bear, elk, beaver, other: fish: bass, salmon, trout, herring, shellfish, other: (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 10 of 26 b. List any threatened or endangered species; known to be on or near the site. (STAFF COMMENTS) C. Is the site part of a migration route? If: so, explain. (STAFF COMMENTS) d. Proposed measures to preserve or enhance wildlife, if any: (STAFF COMMENTS)�L 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 a used for heating, manufacturing, et ti 4ev (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 11 of 26 b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally describe. (STAFF COMMENTS) C. What kinds of energy conservation features are included in the plans of this proposal J (STAFF COMMENTS) 7. Environmental Health 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. 7 A (STAFF COMMENTS) (1) Describe special emergency services that might be required. (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 12 of 26 (2) Proposed measures to reduce or control environmental health hazards, if any: �1O7J!ri (STAFF COMMENTS) b. Noise (1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? (STAFF COMMENTS) 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 Frould come from the site. (STAFF COMMENTS) (3) Proposed measures to reduce or control noise impacts, if any: %Lk.17UE (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 13 of 26 a. Land and Shoreline Use a. What is the current use of the site and adjacent properties? ,e�sI S c 4,iJ. M-4d)� 1�11..� iJq C ( STAFF COMMENTS) SuA340t-r -s 17Z As VAe,w c b. Has the site been used.for agriculture? If so, describe. (STAFF COMMENTS) C. Describe any structures on the site. (STAFF COMMENTS) d. Will any structures be demolished? If so, what? (STAFF COMMENTS) e. What is the current zoning classification of t 1, site? CHKLT/10-8-91.MASTER Page 14 of 26 (STAFF COMMENTS) f. What is the current comprehensive plan designation of the site? ( STAFF COMMENTS) r 7-771:Z - g. If applicable, what is the current shoreline master plan designation of the site? (STAFF COMMENTS) h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. (STAFF COMMENTS) i. Approximately how many people would reside or work in the completed project? (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 15 of 26 j. Approximately how many people would the completed project displace? (STAFF COMMENTS) k. Proposed measures to avoid or re7uce displacement impacts, if any: (STAFF COMMENTS) 1. Proposed measures to ensure the proposal is compatible with existing and projected land uses and plans, if any: igC � (STAFF COMMENTS) 25 - �v r� �'s,rs�-L ram' �.�'!ti► ��,/ 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, middle, or low-income housing. I �- lGLl.�? e'Zte L �/ (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 16 of 26 b. Approximately how many units, if any would be eliminated? Indicate whether high, middle, or low-income housing. 14- NP ( STAFF COMMENTS) _120 r cry c crc_ it LZ1 /�'� (STAFF COMMENTS) Proposed measures to reduce or control,housing impacts, if any: 10. Aesthetics a. What is the tallest height of any proposed structure(s), not including antennas; what is the principle exterior building materials) proposed? ^ �r C rm (STAFF COMMENTS) b. What views in the immediate vicinity would be altered or obstructed? (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 17 of 26 r � C. Proposed measures to reduce or control aesthe is impacts, if any: �- L� f (STAFF COMMENTS) 11. Light and Glare a. What type of light or glare will the proposal produce? What time of day woul it mainly occur? �] f --6-e,, L�n (STAFF COMMENTS) 6W b. Could light or glare from the finished project be a safety hazard or interfere with views? _J AJIi7 (STAFF COMMENTS) C. What existing off -site sources of light or glare may affect your proposal? (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 18 of 26 r d. Proposed measures to reduce or control light and glare impacts, if any: i)II /J (STAFF COMMENTS) 12. Recreation a. What designated and informal recreational opportunities are in the (STAFF COMMENTS) b. Would the proposed project displace any existing recreation uses? If so, describe. r (STAFF COMMENTS) C. Proposed measures to reduce or control impacts on recreation, including recreation opportunities to be provided by the project or applicant, if any: N� (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 19 of 26 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. t.)a (STAFF COMMENTS) b. Generally describe any landmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. (STAFF COMMENTS) C. Proposed measures to reduce or control impacts, if any: (STAFF COMMENTS) 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. :5-11t 1�2er-Am Alv�iv (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 20 of 26 b. Is site currently served by public transit? If no, what is the approximate distance to the nearest transit stop? 1 ( STAFF COMMENTS) C. How many parking spaces would the completed project have? now many would the project eliminate? _ r' (STAFF COMMENTS) d. Will the proposal require any new roads or street, or improvements to existing roads or streets, not including driveways? If so, :generally describe (indicate whether public or private). fie (STAFF COMMENTS) e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally describe. NG (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 21 of 26 . r. 0 f. How many vehicular trips per day would be generated by the completed project? If known, indicate when peak volumes would occur. (STAFF COMMENTS) g. Proposed measures to reduce or control transportation impacts, if any: (STAFF COMMENTS) 15. Public Services a. Would the project result in an increased need for public services (for example: fire protection, police protection, health care, schools, other)? If so, generally describe. %- (STAFF COMMENTS) b. Proposed measures to reduce or control direct impacts on public services, if any: (STAFF COMMENTS) CHKLT/10-8-91.MASTER Page 22 of 26 16. Utilities a. C'rcle utilities, currently availab e. at the smote: __electricity_ natural gas water refuse serviced te:Lephone_,�i sanitary sewer septic system, other: (STAFF COMMENTS) 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. (STAFF COMMENTS) C. SIGNATURE The above answers are true and complete to the best of my knowledge. understand that the lead agency is relying on them to make its decision. Signature of Proponent Date Submitted I CHKLT/1 0-8-9 1. MASTER Page 23 of 26 D. SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (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. 2. 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? Proposal measures to avoid or reduce such increases are: How would the proposal be likely to affect plants, animals, fish, or 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? CHKLT/10-8-91.MASTER Page 24 of 26 4. Proposed measures to protect or conserve energy and natural resources are: _ How would the roposal be likely to use or affect environmentally sensitive area de 'gnated (or eligible or under study) for governmental protection; such s parks, wilderness, wild and scenic rivers, threatened or endanged species habitat, historic or cultural sites, wetlands, floodplains,`pr prime farmlands? Proposed measures to protect such resources or to avoid or reduce 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 p ans? �1` tnhG''Q /w:., ,�G. _t �L'iF' G' 1i � � . � c.. t•.. � .%�C✓t�� 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? / i C CHKLT/10-8-91.MASTER Page 25 of 26 Proposed measures to reduce or respond to such demand(s)) are: / 1 7. Identify, if possible, whether the proposal may conflict with local, state, or federal laws or requirements for the protection of the environment. CHKLTl10-8-91.MASTER Page 26 of 26 RLE CITY OF EDMONDS LASE zo"tE PERMIT CONSTRUCTION PERMIT APPLICATION — NUMBER OWNER NAME NAME O`F�BUSINESS Joe SUITE APT ADDRESSOp e ..- LEGAL DESCRIPTION CHECK SUBDIVISION NO LID NO cc w MAILING ADDRESS Z O // 11: �'} G! J J G Q U� Clir ZtP TELEP►*NENUUBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET, MAP. TESCP Approved ❑ CP20 7 -2 J EXISTING E� REQUIRED JEDICATION< RW Permit Remit R 6. Street Use Permit Req'd ❑ NAME I' PROPOSED Inspection Required ❑ Sidewalk Required rZ z I.i d REMARKS O ADDRESS �3' %✓� ��i i:•(Lr.Lt I�C'�i/,. %7�7(1'TZ//li'�C.:" iti'�i� i L) /��c/ Z CITY ZIP TELEPHONE NUMBER[7.� C w NAME t/a f /Z rt tES itl� ENGINEERING MEMO DATED REVIEW BY i Z/A5 /ki/ 7 a: ADDRESS / S�/ r L L' U S4 "l(� l METER SIZE BUILDING SUPPLY SIZE NO. OF FIXTURES Cr CITY ZIP TELEPHONE NUMBER It G � 202V 7 % a3cj REMARKS 3 U STATE LICENSE NUMBER SIGN AREA SEPA REVIEW ADB NO. MIR Legal Description of Prop y - include all easements ALLOWED PROPOSED COMPLETE EXEMPT O SHORELINE M (/ EXP a U �O _ �CJ _ S iQ, ,' X� VARIANCE OR CU P NN PIEW BY Z ATE N w O '— — SETBACKS -FEET HEIGHT jL6T COVERAGE � `> Z FRONT SIDE t REAR ^`'d Q Tax Account Parcel No. (' + �` ` t '1-2-0�©� s KS a ® NEW RESIDENTIAL PLUMBING ElADDIALTER 0 COMMERCIAL MECHANICAL APT. BLDG. E] REPAIR SIGN ❑ GRADING FENCE CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT DEMOLISH CYDS. I x _FT)CARPOR � REMODEL GARAGET El SWIM POOL, SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT REQUIRED GROUP LOAD ❑ YES WOO INSERTVEI STOWALL/ ❑ 11 RENEWAL REMARKS ROCKERY (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 305 Z 2 NUMBER OF STORIES NUMBER OF D m o / DWELLING m / UNITS O DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) FINAL INSPECTION FIEOUIRED VALUATION FEE PLAN CHECK FEE 472,11 BUILDING 20 f CC - / p PLUMBING Plan Check No. MECHANICAL This Permit covers work to be done on private property ONLY. GRADING/FILL ' Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Permit Application: 180 Days STORM DRAINAGE FEE Permit Limit: 1 Year - Provided Work is Started Within 180 Days "Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE N successors in interest, agrees to indemnify, defend and hold w harmless the City of Edmonds, Washington, its officials, _ /1 1 employees, and agents from any and all claims for damages of a whatever nature, arising directly or indirectly from the issuance M of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT _w. L • omodify, waive or reduce any requirement of any city ordinance = nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE 3 �� 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 signed by the Building Official or s/her ed thereby, no person will be employed in violation of the Lataft Code of the State of Washington relating to Workmen's Compenai orDeputy; and fees arepad,andceipt is e,��T, ti n Insurance. Tio acknowledged n space provl d. SIGNATURE (OWNER OR AGENT) DATE SIGNED DEPARTMENT L' E ATE � J O C S os :. EOInTno R L=ABED BY: CALL FOR ATE ATT NTION INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771_3.ZO.Z UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR O.�IGINAL — •FI YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC ST�lEET F, LF. tz,.?-�r I mom LACCAMJAM 2 ADSAd Eck. Nov A 1 FzJ?�41 PERMIT COUNTER W 'TR RFT s �T (IL 0 i . 1 f TIGHTIINE MATEAIA ) &12 AD �� P D3034j _2p R�,ILA, id. 'if itD NOU - 1 1-9g1 � PERM COUNTER t,LOW tMar.; 3* s y =. T.s �L=j= 1476 PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY REV. 7/87 LOCATION I0Z5 MAIN 51- 501XTH COLkOTY AREA POLE NO. '5e 1/4 S Z4 T 27 R 3 DATE 4- 2(p- 9'1 W.O. N0. _ 4 REASON FOR WORK SEL 1�ED �c��i_�utEP(Z1N'�' I.}( ES ENGINEER kDyJ 9Zl DWG. N0. ()9(orj (FRS _ DRAFTER U.G. NO. -- — — SCALE DATE WORK COMPLETED DATE PRINTED FOREMAN APPROVED EN ' - V1RONMEN 1AL ANALYSIS REQ'D ❑ YES ® ❑ EXECMPT EXEMPTFEES ❑ NO PARA. 18 ITOM PRIMARY OVERHEAD O.H. U.G. COND. KV ❑ RESIDENTIAL ❑ COMMERCIAL ADD C KT. FT. PH LEO# REM C KT. FT. PH /®$ �_$ NET C KT. FT. SECONDARY OVERHEAD O.H. U.G. COND. KV BASIC FEE $ ADD C KT. FT. PH ®$ �_ $ REM KT. FT. PH METER/CONY. POLE $ NET KT. FT. PRIMARY UNDERGROUND PERMITS (DATE GRANTED) ❑ RESIDENTIAL ❑ TREE TRIM ❑ STATE ❑ COMMERCIAL BASIC FEE $ ❑ COUNTY LEU# 0 CITY EDMoQD,< ®$ �_$ ❑ SECONDARY UNDERGROUND EASEMENTS 'P `"CPAL' BASIC FEE $ 4,5Q,f" ❑REQUIRED ®NOT REQUIRED UNDERGROUND PLAT DATE RELEASED BASIC FEE $ FOREIGN CONTACTS STREET LIGHTING FT. ®$ _ $ ❑ CATV JPN# ❑ JOINT TRENCH G NW & CATV WORK IN RIGHT OF WAY ❑ JOINT BORE GTNv & CATV ❑ PRIMARY ❑ ❑ SECONADARY POLE STENCILING t FT. ® $—_ _ $ _ FROM T D_ MISCELLANEOUS FEES TAKE OFF POLE VAULT $ PRE-CONSTR. REQUIREMENTS F-*D tahtT>s PERMIT $ 3D�°a ❑ TREE TRIM ❑ PUD LOCATOR $ ❑ BACKHOE ❑ $ ❑ ONE CALL DATE $ # TOTAL DUE $ INDEX POLES PLAT DATE PAID LOGS U-MAP RECEIPT# _ XFMR C-MAP NEW SVCE APPLICATION# I9830�( LOCATION MAP PAGE 454_H6, SUBSTATION CIRCUIT NO. HASE O 105T 3" SE'L R►Sete pN E)(►SrIp�G� POLE GuT 5' x 5' 5EC."%0N O 51DEWAL< SET PED AT p, C- A 5 5TAKED IZ" 5d OF 4.10 AL 7V_, c PWN POLE 77D p� CoNN AT. ?OL-E -ro EX15TO.J6 1/0 AL TZK r'.E5T0a-P- S10 EwALK , i MA i N ST. IOZ5 ►031 N T0!Xt5TIN6 S1DEVVALK 1/0 P'Lr Tax, N-1-7755 -T V 0 a J O 2° SHOF-T STOPPER I _ MOTE5 I. FIELD LOCATE ALL OTILMES CALL 1-S00-424-5 ,55 4$ HOURS BEFOg i DIGGING 2. LN-Y DETECT WAP-N ,MG WIPE OVER ALL PE DIRECT BUF-lb" PIPE 3. I STALL OWE POUND ANODE FOR E�/ERy 1000' OF L CA M6 WIRE A,. SUAVE\-/ KJOT P-EQblF-ED 5. M IWTAIN A 5' !-tOR� Oh1TAL. 3' VERTICAL CLEARANCE FZONA ALL. CITE/ UTILITI I I; lc. O EN CUTS Af2E HO\NW AS $ OR C7 ( Z� X 4' TYPICAL) I 2"SHOwT C-)TOPPF-P- I D O V_ H 00TE5— I. FIELD LOCATE ALL;UTILITIES CALL I-500-4?_4-5S55 413HOURS BEF0I;_'E!il;DkGGIWGj 2. L_N DETECT VqAP-,M el WIP-E. OVER ALL. PtDIP-Er-T BURIN JPIPE 3. IJSTNLL OWE POUND NWODF_ FOR EVER1,1 1000' OF L CNTIMC-7 WIRE A,. 5U V_\/ E'`4 KIOT REQkjl?_ED 5. MAINTAIN A, 5'h40R4OWTNL 5'j\/ERTICkL CLENQ#,WCE FRON4 ALL- CITE{ UTII—ITIEL5 L....... 4 Id II 4' L R 40r, (10 0 2 3 2!'. CAP O -PE_ IO TEST- LEAD 15 T� _STL_EAC) E30 x Z \AJ I R-E) so - -50-? Zi" TRAUlsl_rlom P:,17 IKIG, 78 500 1 Z'5HORr 5TOPPEMi: \-AX-71010 76 7-43 2. 35d 14 GAUGE OETL:: T WARUIMG WIRE -,b- 1 ?0 SOP--Ik PE PIPE STOCK rlO 4 --- -- tvrbl Gras W" r t SDF?-Il PE IP�, TO 5LRVF- CUSS` 10251 k\ANW caT t) SE 24 - 27- 3 FILAT 01) MAP I(00. GZ AREA- 241 -- --------- TAX COI)F - SFO W) 'W EYT 0 M E E ts"T r- E T 43-3 pn 4- IcI2, ion ClZ0-&&5 T f r _r) I ill G_ Ll Pr7VIS101 NIS I