1020 EDMONDS ST.PDF1020 EDMONDS ST
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ADDRESS: 1 OZ l J MC)rgds��IRe�
TAX ACCOUNT/PARCEL NUMBER: m4�2,04I opE3. o
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: r� r� DETERMINATION: []Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S: Clu ItD I
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DA'
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER-i q�
LID #: LOT: BLOCK: 41
LATEMP\DSTs\Forms\Street File Checklist.doc
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CITY co, oMOt o4, WASNINGTO N -- DEPARTMENI.OF BUILDINGS
BUILDING PERMIT
hereby certifies that's plot, plan, drawings, and sufficient desatls to indiate
oIi to fu1611 all reyuirenents of this code are attached here:.'a.
ryis. herebyj�,a�c for�et�lit to. do,t�ollowing work:
...
EEL`.................................. ............».........._................................................_...._.........._
~ ��........._..................................... ...... _.......... _..... ..... ........... ..... ...... ............ _... _...
.C......................................... .._......
..... . ..... :/J ....
cumber or lot acid bloekuot�yen nb)
1. Building dimensions are .... .J� ..........x.....? ...................
2. Lotdimensions are .........a.4. .. .......X....,.. .............. ..........
Building will be .......... / ..............stortu in height.
4. Number of basements... ...... I.........
7. occupancy -of building will be... ,.✓a'4rd--ram.•-•••
6. Buildin wil from adjoining lot liiie.
7. Owner.... ................ ..... .... ......................
8. Owners adt. 'f
..................•..............
......................................................
9. Builder........... ..�....�
10. Builders Address............ ..... . .....................................................
11. Architect or gineer............................................... ....._.... '.................
...
gate... _.... ......... ............ .......
Applicant's .ngrlatu C.
'`�� pavaer or his :seat)
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a'� ,v—o
Estimated cost 3.,•-L_d 4?_V ........�—
Group No..�.._..r...
We of perinit._--......_......—
due
Plans filed: 60 No O
--o
Permission is hereby granted to do the work descr.l)cd hereon, according to the approved plans and spedficad -ns pertail*l81avto,
subject to compliance with the ordinances of the City of Edmonds. This copy is your receipt for the following fees:
oa
I--
1. Building permit fee...--_ :.-_-.•--....._. $••.._..- ....._........_...
2. Sewer perinit fef.............................................................
3. Inspection and supervision fee .......................... $.................. ..-------- _........
4. Te tal, ...... ............................ _....................................................... .............._........-_.._. $•-.� Z. o ~ .'....
Receircd�
(tusks 081m)
Dgoartmeot of Bwldmp
PERMIT N� 400 City a Belem&
t. The baIldU.a permit fee wbleh applicant Para when petmit is issued shall be based on estimated caw Of the ptopt+•.d tnta'mre. at tte rota tir "AD tar each
11000,00 a! cost. If the actual that of the structure
vrhen finally detetnined, exceeds the estimated cost by more than 5% appikk%t &WM to Pa! am �dOmd tee
Of $2.00 for each $1000.00 of Such e%etss cost. (n Such event no use permit shall be Issued until Sucre "dbuepaeq ire" Is Paid.
2. Whenever a contras for cormructlon Is owcuted for any structure costing mate thin $1000.0tn for ,-hick a licensed uddtect me w4imet b eat"hbY
the Building Code of the City of Edmonds. the appiituion lot a builtlino peewit shall be accompanied tie a cape of eb.e eanaia amd a ct" Or
_ ` `a VA
s �31Piiorn a�Q oylas as abo or eoilimencin8 le�fi.`nat(f!� �� dal Inwtantro Ohisiao idle amnrtt of Labor anu :bdnarfa. l - 11e
II matte atoahy redo of Mrrofls. Fttll Iastrostow." be obtahwd ftoei� w •1x tfrpansaHtt ., trtaa+ tmd Rndnauits AdH!►
the Payro sore who In turn sboWd dbtitn release •racist aU 1Wb•t0W*,mes• Tb* rdaaas �reelb 1�
"'payment, the owner -hould obtain a release from the geoeraf iremead the G„�, �umial Insaneee Ala. .
by the Departmeat of "lint and' leduuriaL -t b aboer' D otea are tease sn'
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT EASEMENT No .........................................
NEW CONSTRUCTION O REPAIRS ❑
118-02200
OWNER.--........Charles...D.---MCNli-l-len................................................ CONTRACTOR..-•--------•---------•--•--.-.....-•----.....--•--•--•---------.....-------------------•--------- PERMIT No. - .................
ADDRESS ....... 1OZO... E—d.mOn_dS...St........................................................... LEGAL DESCRIPTION: LOT No............................................... BLACK No.............................................
•
•
•
NAMEOF ADDITION.............................................................................•-........................... ........................
Dye Tested On Sewer 1972
Approved:
DATE................................................ By......................................................................
The City of Edmonds Side Sewer Drawing EASEMENT NO- --------------------------------------------
218-02200 NEW CONSTRUCTION [] REPAIRS ❑ LID NO ................... ASMT. NO. -------.-.----.-.-
OWNER.... .CHARLES--D.-?`M(TULLENt-------------------------------------------- CONTRACTOR............................................................ ....................... PERMIT NO. --------------------
JOB ADDRESS ..... 1020--EDT_ ONDS.-ST----------------------------------- ------ LEGAL DESCRIPTION: LOT NO. -------------------------------------- BLOCK NO. .............. ...................... .
------------------------------------------------------------------------------------------------------------------------------------------------------------------ '
NAMEOF ADDITION-----------------------------------------------------------------------------------------------------------------------
•
•
DYE TESTED ON SEWER
Approved:
n
�I
1]
PWW-0001-11/75 (REV.11178) DATE ............................................ BY ....... ......................................... ----------
89p-199_
City of Edmonds
Ah
HT -OF -WAY CONSTINCTION
..PER Mff permit Number:
Issue Date:
A. Address or Vicinity of Construction: 1010 & 1020 Edmonds St.
B. Type of Work (be specific): Install 1k" PE IP ' Main in Edmonds St fr&m
41t) W to bib
C. Contractor. Washington Natural Gas Company
Mailing Address:] 815 Mercer St Seattle WA
State License #: 98111
D. Building Permit # (if applicable):
'W centerline of Olympic Av. per job & Dwgv 941092•
Contact: Frank Swan
Phone. 224-2278
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project ® Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR: � r A;,6;6�
F. Pavement or Concrete Cut: ❑ Yes ®No G. Size of Cut: x H. Charge_$
APPLICANT TO READ AND SIGN
e- ;uINDEMNITY: Applicant understands and by his signature to this application, agrees to hold t1'City of Edmonds harmie� rtl ,,,gig ea, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made agai,raf the City of Edmonds, or any'.,nj its ' tments or
employees, including or not limited to the defense o f any legal proceedings including defense costa, 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, WIhL BE HELD UNTIL THF,,FINAL STj?EET PATCH
IS COMPLETED BYCITYFORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCES§EO FOR ISSUANCE TO THkAPOL ICr1NT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material 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 regl lations 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 tlm inspectir purposes.
Signature: ��� '� �"�`
`''v`'' Date: May 2,, ,1994
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
USE ONLY
RIGHT OF WAY DEPOSIT.
DISRUPTION FEE/FUND 111:
RESTORATION FEE:
PERMIT FEE: jr
TOTAL FEE:
RECEIPT FEE. r ry .e.": x �, �ti .4K.3t < ` {L,e ^•'T
*ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991