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City of Edmonds ---Water Department
TAP CARD
Date........
No............................... P INo.................. .....
..............
.....
Meter Ta/ aQ
� Size.... /..........._ Si2 �......................
Mfgrs. No=- --....... !B-5-.------
...... Style�..S_...............
For �j _ ..............._....--------
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LotNo..........7............................ Blk. No ............ --5 . ..............................
Add- ...........................
Service Location
-----------------------------------------------------------------------------------------------_......._.-------......._..............
Meter Location_a....._a -C �-��0 tLG's.
_.....................
......................................................................................_........................._...------.............
MakeTap........................................................................................._....................
.................................................._.........----....................._................_......._......._......
Pressure -----�0.............lbs. Test .................................... %
SendBills to.........................................................................................................
Date
Guar. Voucher No .......................... ................$------------......................._.....
Remarks: .....
.. `?:. I. � o� 1
..49.......... .................................. _....... ......................... _...........---
OUTGOING Index ........Reg......Route Bk...... _.StenciL..... Card ....._
INCOMING Index ......... Reg ....... Route Bk .... _... StenciL.....Card..._...
Ma&al Chargeable to Installation, MeW
NO.
SIZE
DESCRIPTION
RATE
AMOUNT
••--------•--•
•----•--•-
Meter ......................................
........
.....................
----•--•-----
----------
Meter Box ..............................
------•••.....
.. _
.......... ---------
••---•--•-•-•--
..........
Meter Plate.--•---•............................••.........
-------------•
----------
Check Valve ..........................
..............
--------------
----••---
Pipe, Galv. Screw ..-•--............
..............
__.........
..........
.............
----------
Nipples ....................................
............
----•---------
•--•---•--
Bushings------------••---------••--------
------••-•----•
---•-•-•--
Plain Ells ................................
..............
---.........
..........
...............
-- -
St. Ells ...................................
..............
............
..........
---------- ----
--------------
----•-••------
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•-------•-
--------
Tees ....................................... .
•....................................................
•....................................................
-•---•--•-•-••
...............
--•-----•-•-
I...........
-----•----
..........
Material Chargeable to Taps Connected
NO. , SIZE; DESCRIPTION
RATE
AMOUNT
..............
I... ••-•--
Pipe, Black Screw ..................
......-••--•.
.............
.........
----••---•----
----------
Pipe, Galv. Screw -----------•------
..............
.............
.........
-----••----•--
------•---
Lead Connections ...................
.............
.......-•--.
...........
----------••••
...........
Curb Cocks.•-•...................................•-•
-•----•..._.
.........
..............
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Corp. Cocks ...........................
.............
..............
..........
Unions ....................................
..............
...............--
------
Saddles ................................ --•
..............
............
-•-•----------
..........
Nipples ....................................
•--•--•--------
-------•----
.........
---------------
---------
Bushings ..................................
..............
............
..........
---------------
----------
Plain Ells ................................
-•---•-•----
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.........
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..........
Street Ells--•.............•-----•-.....
-•-------•...
.............
-------•-•
.............
..........
Tees ..........................................
...............
..•--•-....
.....----•
--------------
•---------
Curb Boxes ............................
-•---•------..
.............
----------
..............
-•••--•---
S. O. Extensions ....................
-----••---•---
............
----•--•-•
..------•---•
..........
Gates ------ ..-------------------------------
•------•-----
--- ••-------
•----------
----------•-
..........
Plugs ........................................
.............
.............
•----•--••
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Couplings ................................
..............
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..............
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Gate Boxes ............................
.....................................................
......................................................
. .........................................................
...............
.............
..............
.............
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.........
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...........................................................
•..........................................................
Hours Time —Day Men ---•----
--••--•-----•
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......... --•-
...............
----------•-•
.......................
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Hours Time —Monthly Men ................
............
...........
.........................
Hours Time —Auto ............ ...
..............
....... _...
..........
-
Superintendence
•------.................
--.......
Total
3_C R ROUTING SLIP "T'h0r,5dy
NEW SI R\JCF 1NS'CALLAT LON
ADllRESS: l �'T l/'.�
DATE.:
�CDIAL A DIC#✓7,4Q.5"
I• CREW
I METER SHOP
CIVIL ENGR.
DRAFTSTtAN
TELEPHONE
STREET'FILE
CABLE T.V.
G,AS
#0 62 s
STORM SEWER
OTHER
IFUTURE SERVICE INSTL: YES NO
BORE:
SURCHARGE:
LOCK
nnmr..
YES
INITIAL:
'CTNLOCK ��®®
DATE: �� INITIAL: L '
ACCOUNT NUMBER: ID']—y 0 5� 3 O
SUPPLIER: SSA s
TREATMENT PLANT SIDE —SEWER PERMIT,
0 B ' L T #
SUPERINTENDENT INITIAL: DATE:
TAP CARD MUTER SHEET APPLICATION/,
UTILITY DISPATCH
BTLLI Nt;
7 7n
ADDRESS:1 �UKJ
TAX ACCOUNT/PARCEL NUMBER: D �lP6�b b
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S: V —
DRAINAGE PLAN DATED: 4�'1-1 J" 1
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
it
IM 10 EWAN, VILA- M103,
m 0
PLANNING DATA CHECKLIST DATED: rh
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE: f) --n —q7 LOT:
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
"I
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
LID #:
0
BLOCK:
L:\TEMP\DST's\Fomu\Street File Checklist.doc
STREET FILE
4
1 N v P,,t�,
STREET FILE*
IMPORTANT! Press Firmly While Writing Application!
Applicant Fill I PERMIT
Building Relocation Permit Li Inside Heavy nes NUMBER M
Ow R' NAME NEW SITE A15DRESS
w.re rr.rur_ a nn
91 / '1X1��_101V_ - 1;71_ e1
CIT & ZONE 1 TEL. NO.
CONTRACTOR'S
STATE CITY BUSINESS
LICENSE NO. LICENSE NO.
SITE DESCRIPTION
ADDRESS OF PRESENT BUILPING SITE
J60 S ,� � i� s1 6
gal Description of Present Bldg. Site — (Show below or attach four co
Ion of New Bida. Site — (Show below or
MOVING
Power Company
Telephone .Company n
I hereby acknowledge that I have read this application; that
the information given is correct; and that I am the owner, a
duly licensed moving contractor, or the authorized agent of one
of these. I agree to comply with city and state laws regulating
building relocation; and in doing this work, no person will be
employed in violation of the Labor Code, State of Washington
relating to Workmen's Compensation Insurance.
'r1�
Signature of Owner,
Contractor, orlL �G}}
Authorized Agent .
Signer's / + Phone �tyj a
Address No. ... .. ................. No....7..,1....0�
city � c..L........ i'0 Q''l�"(-........
Date...........................................................................................................
EDMONDS PRE -MOVE
INSPECTION
PERMIT NO:FIRE BLDG. PERMIT
ZONE 1 2 3 NO.
I AT NEWSITE��
MOVE CONTRACTOR'S INSURANCE COVERAGE
NAME OF SURETY
� j / n���� � C\
PROVIDING P.L. & /1 \�\ y` p \`�\ y`(_i
P.D. COVERAGE
a / 0
BUILDING DESCRIPTION
DESCRIBE BASIC CONSTRUCTION & PRESENT USE OF BUILDING:
OVERALL LENGTH OF BUILDING: LJ �1 FT.
[EIGHT AS LOADED IWIDTHS LOADED BLDG. AREA
FT.AA`.7 F,. I SQ. FT.
POLICED T. 7x...
F MOVING RO T DATE
By. - U
Time 'to Commen Moving: 16
G
Time to Finish Moving: .. /... Q. 9............_..
FIRE DEPARTMENT CLEARANCE OF ROUTING DATE
BY:
ENGINEERING C E ANCE DATE
w
G
Y A 11
RELOCATION 1 1
PERMIT ll
FEE i
I RECEIPT NO.'
ATTENTION:
PERMIT APPROVAL
THIS PERMIT
THIS PERMIT DOES NOT BECOME
AUTHORIZES
VALID UNTIL SIGNED BY THE
ONLY THE
BUILDING OFFICIAL OR HIS DEPU-
TY, THE FEES ARE PAID, AND RE-
CEIPT IS ACKNOWLEDGED IN THE
OF THE
SPACE PROVIDED
BUILDING
NOTED
By..............................•--••---..............................
Director's Signature
BUILDING
INSPECTION
DEPARTMENT
Date
CITY OF
EDMONDS
DISTRIBUTION OF COPIES
PR 6-1107
WHITE — File (Bldg. Dept.)
YELLOW — Move Inspector
GREEN — Assessor
GOLDENROD — Police Dept.
PINK — Moving Contractor
•.
B U I L Y I N V U `• ^ ^' M
Applicant Fill
ZONE •. "UMBE Ft J�
PERMIT APPLICATI
Inside Heavy Lines
JOB
ADDRESS
/
NAME (OR NAME OF BUSINESS)
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LEGAL LOT
PLAT NAME
SUBDIVISION NO.
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❑YES ❑NO
MAILING ADDRESS
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PUBLIC RIGHT OF WAY PER ORDINANCE NO.
CITY /
TELEPHONE NUMBER
/
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EXISTING RIGHT OF WAY
u/cis_''-GL•JLI
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PROPOSED RIGHT OF WAY.
NAME
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DEFICIENCY OF RIGHT OF WAY
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ADDRESS
STREET/UTILITY WORK REQUIRED ❑YES ONO
•I
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PERMIT FOR WORK IN PUBLIC R/W OYES El NO
0
3
CITY
TELEPHONE NUMBER
(Y
Q
UNDERGROUND WIRING REQUIRED ❑YES ❑NO
U_
DYES ❑NO CONNECTION TO SANITARY SEWER
SEPTIC TANK PERMIT REQUIRED OYES ❑No
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NAME
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SEPTIC TANK PERMIT NO.
0
ADDRESS L/
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SEE MEMO DATED
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CITY
TELEPHONE NUMBER
REMARKS
o
i7/9/va12
- %z
U
TATE LICENSE NUMBER
CITY ICENSE NUMBER
CHECKED BY
Legal Description of Property (Show Below Or Attach Four Copies)
METER SIZE BUILDING SUPPLY SIZE
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('.Aira- l.; ic-
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SIGN AREA
ENV. REVIEW
A DB NO.
ALLOWED PROPOSED
COMPLETE EXEMPT
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SHORELINE
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REMARKS .,../-•G �./�v IJ /`JCC 130-
i i. 3 -z C T CCU 1�c = .
VARIANCE OR CU
PLANNING REVIEW BY
DATE
YARDS
FRONT SIDE REAR
ILOT.COVERAGE
���77�III
NEW RESIDENTIAL El GAS
LINE
FIRE ZONE
TYPE OF CONS/TRUCTION �
CODE HEIGHT
NON-RESIDENTIAL ❑ SIGN
❑ ADD
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1776
RETAINING
❑ DEMOLISH
SPECIAL INSPECTOR
AREA
OCCUPANCY OCCUPANT
❑❑ WALL
ALTER EXCAVATE FENCE
REQUIRED
❑ YES NO
GROUP LOAD
OR FILL ❑ ( X Fr)
❑
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
❑ REPAIR PRE -MOVE SWIM
INSP. a POOL
NUMBER OF STORIES
NUMBER OF
REMARKS / '1 / y
� ���(.1
O
UNITS
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NATURE OF WORK TO BE DONE
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PLAN CHECK FE
VALUATION
FEE
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PROPOSED USE
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PLOr PLAN INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
BUILDING
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"Applicant, on behalf of his or her spouse, heirs, assigns and
SIGN
j
successors in interest, agrees to indemnify, defend and hold harmless
i
i
the Cily of Edmonds, Washington, Its Officials, employees, and
RETAINING WALL
�
0
M
Q
agents from any and all claims for damages of whatever nature,
U
_
I
arlsiq directly or indlrccily from the issuance of this permit. I-ssu-
SWIMMING POOL
0
ance of this permit shall not be deemed to modify, waive or. reduce
i
OJ
any requirement of any city ordinance nor limit in any way the
"�r
I
Oily', .Ilnlil�• t,� rnl',.I, • .lily wdin.otri pn,vision."
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STREET F
CITY OF EDMONDS - ENGI'NEERING DEPT.
Examined bYSJE;
Date
Remarks
Cl 7 _4A V 4
?,&Rovg- GX I 5TI U Cu
it CSuL_Vozr;
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APPLICATION V''
The City of Edmonds for EASEMENT NO. _........
SIDE SEWER PERMIT A-
NEW CONSTRUCTION REPAIRS ❑ LID NO .................. ASMT. NO... ...
OWNER ...... ..M-�-vl ........................ CONTRACTOR ......' ......... `�T....( ��.3S
.I. .!. L� .. PERMIT NO. . `r.'. ..
JOB ADDRESS ------ '. j -r....---•....... -•--------- LEGAL DESCRIPTION: LOT NO- ...................................... BLOCK NO. ------------------- ----------------
TrnS?cC-tiaVt. Tee
G.0 • C4:,Z d ee�� �� �- 22 •�.
r N
� I
1 -22
.............................. --------------------------------------------------------•-----------------•-•----••-----------------------•........------.........
NAMEOF ADDITION----------------------------------------------------------------------------------------------------------------- ----
¢:' f-U-C- Side Sewer•
2% 3 C •p, (6"sleep)
n 5
3' t
3" stvib
,A` Ave.
Approved:
DATE BYC= (�La. T1js 1 L11/75
�- -
jiJ
, CITY
PUBLIC WORKS DEPAR
SIDE SEWER PERMIT
FOR INSPECTION CALL"
775-.2525 Ext. 2.2O-
Permit
Issue Date
PERMIT - MUST
BE POSTED ON JOB SITE
1.
Address of Construction
/f of -- jq A)<f �►
(�7-0
2.
Property.Legal Description (include all easements)
3.
Single Family Residence
Multi -Family No.
of Units
Commercial
c v*c .�
4.
Owner and�r B-u"der
P� ,p
0 U 1 X &1 �.
�'
5. Contractor & License No.
C-V
Invasion into City Right -
way Construction Permit Required
- Call Dial Dig (342-5344) before
excavation).
7. Cross other private property: Yes No Easement required -
attach legal description and county easement number.
READ THE FOLLOWZ.NG AND SIGN:
a. Property owners must obtain a permit to install side sewers on
their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year. I
c. Commercial establishment requir s" " in m o �di����ir - (6') ---
side sewer line. ;, v Hoy s
d. Side sewers may not be installe
to any structure.
e. Side sewer lines must be laid a .m' r ey G .15 )
and maximum grade of 100% (450). I
f. No turn in side sewer greater th n / e I
between cleanout. All 90 turns must be q
bend) and wye with removable cap. 5I'IITrCOOR INATIN6COUNC11
g. No down spouts, footing drains o nnected 1
to side sewer system. 1
h. Pea gravel is required for bedding when installing sewer lines 1
through other than granular soil. 1
i. Cleanouts are required at 30"-60" from each plumbing exit line 1
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original 1
conditions. Contractors shall be_responsible for right-of-way failure 1
due to poor compaction of fill. 1
k.. Side sewer must be left uncovered until inspected and approved
by the City. 1
1. Inspection during normal working hours only. Two (�) working
days notice required.
DATE: 7 `,zZk A
I cc�ti y t at I have read 1
and shall comply with the above
PERMIT FEE:
CONNECTION FEE:
* PERMIT MUST BE
DISAPPROVED By: Date:
B : Date:
APPROVED By : _Date
POSTED ON JOB SIT *
_„�.. ".'"�:.�� ;:.,�.�;-...�;°�.r,."yeR�„�r.^"'-"'a:w?•nip.;r�-n:�dggfi;r'l��w�;,.raa��-r��.,'F,:4�;?�m. �,: ;re' .t"` ,
'• CrN off' Edmon
GHT-OF-WAY CONS T CTION
PE,]R MIT Permit Number. t
> r`: Issue Date:
A. Address or Vicinity of Construction: 1015 'A' Avenue South
lip
8
9 p C) 0 B. Type of Work (be specific): GTE to pl ace telephone service wire in east R.O.W. 1331.
- 1 9
Please see attached sketch.
GTE Northwest Incorpoerated 1628 -
C. Contractor: Mary Bower, Permit Coordinator Contact: Mary 206/488-999A
Mailing Address: 22118 20th Av SE, Suite 130 Phone: Mike Ward 206/771-9111 or mobile 954-0774
State License #: Bothell WA 98021 Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. ❑ Commercial
❑ Subdivision
❑ City Project
ki Utility (PUD, TE, WNG, CABLE, WATER)
❑ Multi -Family
U Single Family
❑ Other
INSPECTOR:
INSPECTOR: „
��;.� W' 'j # 2100-9P001 DB 242310
F. Pavement or Concrete Cut: [')Yes 61No G. Size of Cut: 0 x H. Charge $
APPLICANT TO READ AND SI
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmlessfrarn injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the -City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
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 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 copy of the permit will be
available on site a ll ti or ection purposes.
ohn H. Stewart
Signature: 0 rns Su v-OSP En r9. Date: August 23, 1995
(G§fiff%1 *r Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
-- -FOR CITY USE ONLY
APPROVED BY: IAA 7 4 C-I)h RIGHT OF WAY,,DEPOSIT
TIME AUTHORIZED: VOID AFTER NOv (I DAYS DISRUPTION FEE/FUND 111:
SPECIAL CONDITIONS: IJ A • RESTORATION FEE:
PERMIT FEE:
TOTAL FEE: - OG
COMMENTS: RECEIPT FEE: I : zg
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
IJ
LEGEND
IT
OD
I -
z
PERMIT SUBMITTED BY
GTE
m
PEGS
POLES 0
ROAD BORES
OVERHEAD LINES
1A UTILITY POTHOLE C7
UG TRENCHING —UCT
POD
D"'�& fib prF
Ll. •f of . r •
'' _- -- EOP
• -1 Ae 66 t 0,6 w 13
AV C. 50, da
--,,-.4T1E0, IA EAST-aP -Eo1' - _ _._ - - _ -•------------------------------- . --
09071
14
V
ti
ti
Lo
`� CUTS,
F tC E t v E e Cif, of Edmond STREET
FILE
„ Ai
y 1991 RIGHT-OF-WAY CONSTRUCTION
F-r-nrlNu PERMIT _ a
Permit Number:
Issue Date: /n _Z a —C� I
A. Address or Vicinity of Construction: 1015 A Avenue ”
a
B. Type of Work (be specific): Install 2" PE IP Main from 237' South to 182'
8 9 0 -1 9 9 v South centerline Pine Street. Per Attached Drawing: 920-036
(IR 6043-30 (20
C. Contractor: Washington Natural Gas Company Contact: Gary Swanson
Mailing Address: 815 Mercer Street, Phone: 224-2080
State License #: Seattle, WA 98111 Liability Insurance: Bond: $
D. Building Permit # (if applicable):
U0
Side Sewer Permit # (if applicable.
E. ❑ Commercial ❑ Subdivision ❑ City Project ® Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR: VV
F. Pavement or Concrete Cut : ❑ Yes ®No G. Size of Cut: x H. Charge $
APPLICANT TO READ AND SIGN `'
INDEMNITY: Applicant understands and by his signature to this application, agrees to hol�ltthe City ofEdmondsharmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that may,,�be m6 against the 60 of fonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings includin' defense costsl and aitTIey fees by reason of granting this permit.
poi ) ) 1
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MA TERFA7 S FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC77ON
AND ACCEPTANCE OF THE WORK. ES77MA7ED RESTORATION 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 76 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.
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 purposes.
Signature: Date: October 15, 1991
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
..... .
FOR CITY USE ONLY
..........
APPROVED BY;:::: RIGHT OF. WAY. DEPOSIT:::....::
,A 1Z-.
TIM AUTHORIZED., VOID AFTER DAY&' DISRUPTION`FEE/FUND 111
.,....
S PE CIAL CONDITIONS;.LaZRESTORATION:,FEE;:
PERMIT. FEE::
............................
_..... ......... TOTALTEE::.
Q
BY:<
WORK SHALL BEGIN PRIOR TO PERMIT
Engrg. Div. 1991
FIELD INSPECTION
I II - Route copy to Street Depf)'.
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P. W.:
Work Disapproved By:
FINAL APPROVAL BY:
❑ YES
Date:
Date:
❑ NO
tng. urv. Jury lye.)
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Date 10116121 To • LOY WHI T c 0T !
From Lawrence Hirsch
Subject Jobs 9Z0 -- 03 6
REFERENCE: (Contract No. or I.R. No.) Address: 101_5 A Ay
Your assistance in expediting this permit application would be
greatly appreciated.
Thank You
v 622-6767 ext 2588
9 STREET FILE 0 -
CITY OF EDMONDS CHRON
250 - 5TH AVE. N. • EDMONDS. WA 98020 • (206) 771.3202
COMMUNITY SERVICES:
Public Works • Planning • Parks and Recreation • Engineering
890 19C�-.
August 22, 1989
Alexander Uraquhart
1015 "A" Avenue
Edmonds, WA 9B020
Dear Mr. Uraquhart:
CO
PY- NAUGHTEN
C V 11 MAYOR
PETER E. HAHN
DIRECTOR
This is to inform you that shrubbery extends over your water meter
which interferes with accurate reading and maintenance of the meter.
Please prune or remove these shrubs to permit free access to the entire
meter cover, which is in accordance with the City Ordinance quoted
below:
7.10.050 Access to curb cocks and meter -covers.
----------------------------------------------
The Water Division shall have free access to curb cocks and water
meter covers. All persons are prohibited from piling rubbish,
building, or other materials thereon. (Ord. 413, Par. 20;
February 5, 1929).
We will again inspect your meter in sixty (60) days. If, at that time,
the meter is still obstructed, we will be required to have this work
done by City personnel and the costs billed to you.
Thank you advance for your cooperation.
Sincerely,
^4ewa--
Archie Brena
Water/Sewer Supervisor
AB/lk
URQUHART/TXTWATER
• Incorporated August 11, 1890 •
Sister Cities International — Hekinan, Japan
A. *Address or vicinity of Construction
f a
• Owner:— t t t ?- ►
Name
)� t
Miling Address
City, State, Zip Code «�
• Permit Issued To: Ilk, L '_` 1 "s tt. §
• Type of Work to be Done: x
• Work in Connection With::
❑ Sub or Plat Single ly
❑ Comml. I Ind. ❑ Apt. Condo.
• Pavement Cut: ❑ Yes No
• Contractor: .'L._.j 41 ; ,t .:,1.. F-t A, t'
1
Name gyp, tlryq �g/[,'$ ({
..yia A „ f/�..1
Mailing Address` State License Number
�.. t bit XUJq#Ay, 1 AJidt W 19 7. 4 -,74z
dCity, State, Zip Code Telephone Number
U
a * * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
a
d, B. APPLICANT TO READ AND SIGN
Gl INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
2 proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
O
wUpon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
O
Funds held from the Security Deposit (estimated restoration fee),vdill be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit muse Ile avanable at the ob st a fo�r¢inspection purposes at all times
Signature: V+r: ' Ewa' ,mow w �, C �D'ate
Owns 'or Agent
* * THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: ' I
a Time Authorized: Void after days
Z Special Conditions:
Ammendments:
CJ
x
w
Permit Fee: —
Se curity Deposit:
Receipt No.: 4
Fund 111 Fee:
Street Cut Dimensions
X=
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
M �
Eng. Div. December
78
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Constru tion
• Owner: I-6 . 1 t,'1 all) , l
Name 4
Mailing Address
City, State, Zip Code
• Contractor: a 14 f it2
Name /
Mailin ddrless
• Permit Issued
• Type of Work to be Done:
• Work in Connection With:
❑ Sub or Plat .L�'Single,,Family
❑ Comml. / Ind. ❑ Aptt Condo.
• Pavement Cut: ❑ Yes ` ❑ No
[{�� 'l"%9 _ f�jTj j♦f) 12y'�"� )// {t State License N/umk,-,-
�d3 City, + State, Zip Code Te ep one Number
1 4?
�t NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
wa
A INDEMITY: Applicant understands and by his signature to this application a
from any injuries, damages, or claims of any kind o w oev, 4- - , resee
against the City of Edmonds, or any of it's depart ti%br a yees, cl IWAl IAM0 : e to th
proceedings including defense, costs, court costs, an attorn r o of gti�t is p mit.
O
BE-: RE
ua Upon issuance of this permit, the contractor is bl wor an hip(OW "a for
following the final inspection and acceptance of the s a ' in ton.
Funds held from the Security Deposit (estimated
which time a debit or credit will be processed for
M1
f Edmonds harmless
that may be made
defense of any legal
period of one year
is completed, at
Work is to be inspected. Restoration to be in accord wieh-E'ity'C#5i C. trai is Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220. \`-
I understand that this perm rv6st
Signature:,
site for inspection purposes at all times.
--�
wrier or Agent
it THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL DIG PRIOR TO BEGINNING WORK
C. Issued By: ---4,-,. 4-t*=1
Time Authorized: Void after 2 days
Special Conditions:
Ammendments:
Permit Fee: `•- -�
Security Deposit:
Receipt No..
Fund 1 i 1 Fee:
Street Cut Dimensions
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANC * ,k
Eng.� Div, December 1978
. ... - ..
FIELD INSPECTI0AW)TES (Fund. 111 -Wute cony to Street Dept.
Diagram:
0
Contractor called .for inspection Yes (-o
Work Disapproved Fay • -Date: By : L Date:
Work Approved By: Date
Inspector: _
Fna. Div. December 197E
m
A V,
IN
I go f
N o Ki-lti
a
-[),q L2qJ79
tv
H
STREET FILE
CITY OF EDMONDS
BOARD OF ADJUSTMENT
APPLICATION FOR VARIANCE
DATE '7 �`� '" d >9 - -
FEE !
RECT #
APO' S t�
HEARING DATE:
APPLICANT t:j ,��7e;r�t� /��'�7/s�>,� ADDRESS I/J,��7L5 _->'�' �lt✓
CITY &r52/vi,,I PHONE � !� / 12
INDICATE TYPE OR DEGREE OF INTEREST IN PROPERTY r r(,lVe i'
LOCATION OR ADDRESS OF PROPERTY
� � I
LEGAL DESCRIPTION OF PROPERTY !ro7`' s174
VARIANCE REQUESTED :/QGi/-,',r7 l i2 C C) f= i lz? If, 014 /?r cr ryc'e , t-IX!,C /SZ(l
/-7-7 rt', or'> % S f� h'J 5 C .CJ.t' /�' /� c� v % c* r r /✓ - //%✓5 J` c'Lfi Cy t)!�
r
/ 5 f /%r'' /�v 7 A -5.mac" e= ri C r , .o e, ( /, ii �?,, 7✓ e i v
-3v / FOR OFFICE USE ONLY
USE ZONE ONE: - (C,
ZONING ORDINANCE REQUIREMENT:
STATE OF WASHINGTON) ss..
COUNTY OF SNOHOMISH)
`Tc
7
Signature of Applicant,Owner, or
Representative
On this date, before me, the undersigned, a Notary Public in and for the State
of Washington, duly commissioned and sworn, personally appeared�r�,n ,
who, being duly sworn, on his/her oath deposes and says that (s}he Was prepared
and read the attached statements and has acknowledged to me that the recititations
contained therein are true, and has signed this instrument as his/her free and
voluntary act and deed for the purposes therein
entioned.
Subscribed and sworn to before me this ,2 V C day of I�. 19_.
Notar VPublic��7i`n 1and for the State of Washington
}
0
DECLARATIONS OF APPLICANT
Please answer all questions
1. What are the physical characteristics, (i.e. topography, shape
of lot, etc.) which create a hardship for you in regard to
development of your property?
A10 r✓e.
2. How does your property differ from other property in the same
vicinity?
3. Will this variance be detrimental to the public or damaging to
other property or improvements in the vicinity?
4. What
hardships will result to you if the variance
is not
granted?
Will
c,
these hardships have been caused�by your own
Uv ,v /-c'✓'m om 0"' tl �11. CY e C'L/i�lL t c7�
action?
/77 c «�✓
N%
> rt'
/ ( G O l` �' C C' CL 7'�c7 r /✓ CL
/,�i�%S/
fC� `�ji:-
G ! w
Al' r /� 4y (S r 14, �' C✓� t L L ,`,�i c,
�Z—
` I.ZC ,y 1
! C « s C {�:� °.z �.,`�c(
c4.yz� lam'/} ► r
/
C/ /a �^C r'✓
/
/A,"
/��/l /'C� , e Cj�4
O I �+
..L�'-7t//7-�
A / ! L LY l �"�' {l V A Z 1 Ae O G' �' i/'�' / (2 /``
`' d +lit ,C
";4
5. Can
you make reasonable use of your property without the
variance?
sdNce- �z''_ ��d'
N
STREET
Mayor Harve H. Harrison
Memhers of the City Council
Edmonds Civic Center
Edmonds,. Washington 98020
640 Pine St.
Edmonds, Washington 98020
March I, 1979
Dear Mr. Mayor and Members of the City Council:
"AG.,, -; 197g
I am the property owner at 640.Pine St., and there is a proposal to move
a house on to the lot in back of us. The lot in question is in an environ-
mentally sensitive zone because it is bisected by Shellabarger Creek.
The neighbors are very concerned about this action resulting in severe
drainage problems, view blockage and loss of privacy. The proposal includes
the culverting of the stream and we feel the environmental assessment was
inadequate.
The building official is set to issue the permits on March 7, 11?79. 1
believe additional conditions should be attached to the permits before they
are granted.
I would like to ask for a hearing before the City Council to appeal the
decision of the building official and ask that no permits be issued until
that time.
An answer to this request would be apnreciated before March 7,,I07?. 1 will
be attending the Council meeting on lurch C. 1979 to discuss this matter
further.
Sincerely,
P+. E. Townsan
cc: Mr. C. Dibble, II.A.A.
Ma
STREET FILE
DATE
CITY OF EDMONDS
COMPLAINT RECORD
Complaint voiced by:
FEB 2 6 1979
Name: U r; 1
Address: (,--)fi )[�V i I~ %I�i�r(yyI)`, �.'/-1�W �.
Property owner: Yes L No 7 /4, � yJ
Where o o P/,1!V li i /=
.; /V u !Z T 1i /I N D o != !���s JR L D ,y ,A A V 1z A11FAR Pi nJC S!.
Address of property
to be investigated:
Name of owner: Pi f i l,11 /;
Address: Vyf n[� rJivF, E' �y(n1ePhone: TV 3
Description
of complaint:
The purpose
of the Manning Commission
is to develop the community according to
a reasonable plan
and to permit neighbors to attend
hearings and to have a voice to express
their
.
When
a developer purchases a 1201 lot
and then uses only 601 of it and later
sells
,
Commission and the
rights and votes of neighbors who
may vote to develop adjoining property
on 12
•
It is
obvious that Mr. Duitsman plans
to crowd his residence on only 60' of the
propez
ty as tha t ts
the way tie 5 taked tt.
I object
to this obvious circumvention
by Mr, Duitsnan of the rights of the
neighI
vxs to attend
W heaftng
se
on a 601 lot. The Planning Commission should look at the long range plans of developers in
cases .
Result of investigation:
Date 0rZC
MEMO TO: Building Division
Community Development Department
FROM
SUBJECT:
Engineering Division
Public Works Department
After review of the subject building permit application, we have the
following comments:
IYT Coordination of the location of any structure with respect to
utilities, streets, property lines and driveway grades is the
responsibility of the contractor.
/5if The contractor is required to keep the abutting streets cleaned
of dirt and debris caused by the construction.
X-7 The "Right -of -Way Construction Permit" is required, from the
Engineering Division of Public Works, for any work within the
Public Right -of -Way or public easement.
N
i7
Driveway slope not to exceed 14%.
Connection to sanitary sewer required.
Septic Tank Permit required, submit design.
Fire hydrant required, submit design.
Site drainage per code #__. See approved plans
Curb /% Sidewalk /=7 Paving required.
Bond required for public improvements. Submit cost estimate.
Underground wiring required.
Approved Engineering Plans required when applicable.
Rev. 7/78
City Engineer
Department of Public Works
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BUMDTNG PENfiT REVIEW
I-Addres.
Street Ri)it-of-Way Existing REQD
Access Easements Existing `Hbt( j READ —
Utility Easement Existing -7-1 0 N r REQD ---
Lot Per Subdivision Plat Assessor Map
Site Plan G1lecked for Acc...... cy Z I t, _-•E Ci
ihuierground Wiring Reqd.
Check Accuracy of- Legal DCLIScri.ption
Environmentally Sensitive Area
Environncntal,-.Checklist Reqd. �((�
Flood Hazard -Zone flu
Shoreline Kmagement Area 7-l0
Slope, Soil, Vegetation
w _Stream, Creek, Drainage Basin �r S
Existing Zoning Per Code
= Amenities Design.Board Approval Reqd. ,-f-JO ADB # Approval
Board of Adjustment Approve 1 Reqd.
�l Review By: Date:
�. �t,�,��,�'�.R.�Yf`�jA1�r'�fi,I\. ...ram. 1.d� rj" >�,. R` �.n•
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Existing Water i?ain Size
Water Main Reqd.
S Service I.<ine Reqd.
Hydrant Size Existing
Hydrant Reqd. Per Fire Code IM Size _
Detector Check meter Reqd. NA RZ�
Cross Connection Inspection
Fire Department Comments
Water Meter Charge Reqd.
Review by: l�'y Date:
J�'�':��: r��'':��►'�:�.f�.lit:�,�t,�.;�.,r'��2:4i�e�'1��.��!:�:�§,�'
Septic 'Tank Msign approved Me:
Septic Tank Permit Reqd. ���t�Permit No.
Sanitary Sewer Availability�r beZ► 1 Proj .. _L� c ,i
Drawing No. �� �� �, n 19 File No. 2 L -1 j_
Side Sewer Availability � �,n,C4
Sanitary Sewer Connection Fee Reqd. C
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