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1016 DALEY ST.PDF1016 DALEY ST ADDRESS: TAX ACCOUNT/PARCEL NUMBER: O D' 4-5 4 2-0 4?2 0 O BUILDING PERMIT (NEW STRUCTURE): 1 L 540-3 % Lp(bEg) COVENANTS(RECORDED)FOR: CRITICAL AREAS: vl ZJI Z1 22 2 DETERMINATION:❑ Conditional Waiver ❑ Study Required Waiver / DISCRETIONARY PERMIT #'S:V. �7' 3 V ' DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): _ !�y 1 l' Q.I 1 a 7 `'t' D z-q 7-06 6 (Ad A� A92-CRLH (WL� nus7ol'-s4imiur) PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: f/ SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: bm Q �-ca of (Q l Z SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DATED: OTHER: l.d W - I Z� l I irl 7►'ta 1 Y� P,UJ SQNV I �Q) LATEMP\DSTs\Forms\.Street File Checklist.doc L A CITY OF EDMOh%,, WASH INGTQ N DEPARTMEW06F BUILDINGS — BUILDING PERMIT". hereby� certifies :hat a plot, plan, drawings, and sufficient details to indicate J- entention to fulfill all requirements of this code are attazhed hereto. .2 .;;,"lication is here ':VZ�e for peipinit t, do the following work: b i ..... . .......................................... . ......... 0 C�y ............ 2. .............................. ....... > r z ................................... ..... . ............................................... .................................................... ua .......... ................................................ *11 ............. . .........& >0. tol . ..... ............ ........... ........... .... ........... . .... . .... . .......... .............................. ........................ ... C C . ........................................................... ... ­­ ............... ..... ..................................................... . ......... ............ .................................... ............................................. ........................ ........... . .... . . A ....................................... . ....................................................... T a. 0 -ZI it Pq .............................................. ...... .. ..................... In Z. 0 ...... .......................... ......... In , - 5. -C at ......... (Street number 0 914 C611. X. P. cn 1. Building dimensions are ........ :744 - ------------ ---- ------ —0 Z 2. Lot dimensions are.__. a ............. .......... ... . ....... 3., Building will be ....... :_e .............. stories in height 0 - o 6 E 0 Z. 4. Number of basements -..-A ... ...... S. Occupancy of building vA4- be.. .. ..... ... .... V ---- ---- — --- ----------------------------- 6. Building w feet fro rest dj!olot line- .99 -7 .......... ...... 7. Owner .................. .... ............ ........................... Enintated cost $ R. Own cad....... .................................................... . ..................... 9. Builder ........................ __2 .. ... .... . .................................... Group No. ..... ...... ................ ...... ........... 10. tuilder's Addr-ss .............................................. . .... . ..................................................... r. 7. 11. Architect or engineer .......................... ................. ................... ... Life of permit.... Date ....... ........ 4 Plans filed: Applicant's Signature ......................... ... ................ yes 0 13 ..... . .. li PeL-mission is hereby granted to do the work described hereon, according to the approved plans and specifications pertainiii herit6, 97 s copy b your rcccipt for the following fees. compliance with the ordinances of the City of Edmonds. This subject to com . ..... 1. Building permit fee ........... ........... ........... ................... $ ........ ................. 2. Sewer permit fee ....................... ............................ . ..... $ 3. Inspection and supervision fee_--_ ------------- .......... .................. ...... ......... S ----------- - " Z 4. Total .... . ................. ........................... ............ .............. ...... ..... ...... $ ..... N . .... Received I Dep.�ent of,-Buildiii PERMIT N? 376 City of •-Edmonds I. The building permit fee -hi,l, applicant par, when permit is issued shall be based on -tim, of the proposed structure. at the r2ft of St.00 for each •q $1000.00 of coax. If the .—A re,st of the srtr,t_. when fut.11y.detertnined. eareeds the eteiumrted — by more than 5%. applicant agrees tc pay an -dd;:imal fea of $2.00 for each $1000.00 of such "cen, roar. In such event no uae,pT!it !!.o!ll beAssucil until such **di%=p-=cy fre" is paid. copy *Is am required. by Whenever a comma for mnstrualon is exetuted for any strucrure crafting meremerethan 111000.01) for which a licensed archttect or engla — 'Nldios Code or the Ury of Edmonds, the applimim for a building permit shall be accompanied by . copy of the --a ,d If of the detailed .p!.y. commencing wont, notify tbe; !ndtx%tri-!Llr!mrrance Di,rhioo of &.e P!p Labor and led 7" of 41-11• - ii��Ilty;.11 make � thly'repom f. p-ly lls. Full,injisructions %hould W obtildbd, fl�e. he nearat ii1ce SW an %..y labor ,%c.no!,Z t 1 :7 eparoutent, of =7;=uao"eJ. Before • payment, the owner thould obtain a release from die -general IFbarrictora,u-bo'll tur.'ahould bW;,Txe1e.1i:fr&; JI sub—trata... Th. 'deatses Aoulrl'be ,uzeiird by the Zparurteot of Labor\=d Industries. 'Me above procedure 'arajeqiti—ta of the State Idu,721 Insurance Art,: 1r, ^l r_ FV MJJAGr.-, AFu6 ��maz•-;IZtti� rsT' I•tvaG �IDi�••INI�`7 ISI7 s�A.r-r. 13q 5�I A'f46 u W rry ZAHS rent' F^a 55 ' t IIL I.3' d Kf. �... _ - - t 1011 +ley KET'^lW;LIG WAA' +.1v4 k3' �" _----- k r-rt i 1_194rJSV,v IJ1.lJ. 35 ,' S,75 -- -. 128 . � :S�Firl�Y-t dL 104 I l , Ni.W 900v 0. H. 19, T'r'f' --` ' P�'Dr'eiW PWITIOF.1 f 1-71 7- 4 IOq I SHE ; I � AeoRx�y , 'Ryfis•i: (�20F LIB c'.OuIJ lY \v �• I . p, et o C �claifi►..IG ! �! Nou�� � . o - ! •� rn N I' rn cj d =11•. I�ir'iNG;RrbFG H -•S rJF'l rv. rf • , �. �- ' • •.3 •fail sa yv ..y.n '.F'�^'�� .�papf�p�t�q"1Rw +.�.tr.�o.....3.:.-�w:rt�a.-�+�.;.�A�9Ca,.:,�i .aiw•w.<,.,•,-Y•v�R`9M1�' %"°�-'Rey`a�,.`+:...y'.':.��5'. ti r.ti �, �r�: City of Edmo =1 _- 9t- 890 199v RIGHT-OF-WAY CONSTRUCTION f PERMIT Permit Number: Issue Date: A. Address or Vicinity of Construction: 1016 Daley Street ' B. Type of Work (be specific): Install New Service C. Contractor: Washington Natural Gas Company Mailing Address: 815 Mercer Street, State License #: Seattle, WA '98111 D. Building Permit # (if applicable): Contact: Frank Swan Phone: 224-2278 Liability Insurance: -Bond: $ Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project Utility (PUD, GTE, MING, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other INSPECTOR: INSPECTOR: iN �4l T LV1 "7 r. ravement or Concrete Cut.: LN x es vivo \L I ti..oize or g_ut: _ -$ x 4 ti. Lnarge Z f R APPLICANT TO READ INDEMNITY. Applicant understands and by his signature to this application, agre ld the City of Edmonds hatmlE�s %r%h iuVe� damage's, or claims of any kind or description whatsoever, foreseen or unforeen; that may betmade against the City of Edmonds, or any of its departments or en oy- ees, including or not limited to the defense of any legal proceedings including defense costs, and_a(torney fees by reason of granting thtpptmit. . '..: t ...,.w'sr � i' s ; 7 ��,,.... • :fir . THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INS ON AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORA77ON FEES WILL BE HELD, 6fN,7 s,THE FINAL STREET PAfiH7S _6 ETE 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 Work is to be inspected during progress and at completion. +n Restoration is to be in accordance with City Codes. 77l-0220 r 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 stateme nd understand und ers and the permit requirements and the pink copy of the permit will be available on site at all times for ection Signature:' Date: October 20, 1992 (Contractor or Agent) CALL DIA] .................................................................... rA=DIG:PRIQQR.�TQ4BEGENNING WORK ............................................ �:. ......... zn Z DATE::::- - : : ISSUED BY NO WORK SHALL BEGIN.PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 FIELD INSPECTION NOT (FunMI - Route copy to Street D;it:) Comments: Diagram: • 3 ' d CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection. by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. Jul) M ..a,.��_ "a^�w AVVb9vV n&MrgVCmpa rV DI& pAICY s-- WNG to window --,- Water main depth unknown 2 " gas main to City of Edmonds Right of Way Permit Application Submitted by: RIc.N� aP� Ftit.i,gQ) Engineering Aide Washington Natural Gas 622-6767 x2761 Pager 9(09 s� P . IG A Key: -w- water -g- gas -ss- sewer $ water hydrant O water valve 815 M=W St. (P.O, Box 1869), Seaak, WA 98111(206) 622-6767 .u. A, Critical Areas Checklist Site Information Project Name: Aeo,,max,, /e,'c5& c,,/r. Permit Number: Site Location: 1U/Co 4oeC- Y Property Tax Account Number. Approximate Site Size (acres or square feet): Have you filled out a Critical Areas Checklist for a project on this site before? General Site Conditions 1. Has the site been cleared or logged? V3</Z-- 0q3 -6o S -00 Date of most recent action: Soils / Topography 2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? . /JGG�2Guvo�� Ci,�iia�uy 3. Describe the general site topography. Check all that apply. S.oA-1-tly G" i°M r /S rb ZS S40116 Flat: less than 5 feet elevation change over entire site. jZ _Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a horizontal distance of 66 feet.) Hilly. slopes present on site of more than 15% and less than 30% ( a vertical rise of 10 feet of horizontal distance.) Steep: grades of greater than 30% present on site. Commentsex&na,,J QE SIZE Hydrology/Vegetation 4. Site contains areas of year-round standing water: //i), 5. Site contains areas of seasonal standing water. r1110 Approx. Depth: 6. Site is in the floodway ) D floodplainA)of a water course. 7. Site contains a creek or an area where water flows across the grounds surface? &_flows are year-round? Flows are seasonal? N..— 8. Site is primarily: forested ; meadow ;shrubs ; mixed r' M 9. Obvious wetland is present on site: /U� M �� 10. Wetland inventory or map indicates wetland present on site: --� °U 11. Critical Areas inventory or map indicates any Critical Area on site: -- ----------�� _ For City Use Only STUDY REQUIRED:.Critical areas study.is required. CONDITIONAL WAIVER: Critical areas study not required if specified conditions satisfied. WAIVER: Critical areas study is not required. Determination. Number_. CA..-G,L-- 12,77.. Reviewer Planner Date' Rcv 3/27/92 ar9a _199- City of Edmonds Critical Areas Checklist The Critical Areas Checklist contained on this form is to be filled.out by any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of a development permit to the City. The purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are or may be present on the subject property. The information needed to complete the Checklist should be easily available from observations of the site or data available at City Hall (Critical Areas inventories, maps, or soil surveys). An applicant, or his/her representative, must fill out the checklist, sign and date it, and submit it to the City. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. With a signed copy of this form, the applicant should also submit a vicinity map of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant is encouraged to include any other pertinent information or studies in conjunction with this Checklist to assist staff in completing their preliminary assessment of the site. I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner / Applicant: Name Title .i. —0/4; Street Address Applicant Representative: Name Title Street Address City, State, ZIP Phone City, State, ZIP Phone Signature Date Signature %/1f7_ Date 3 3 APKICATION The CRY of Edmonds fcw, EASEMENT NO. ------------- -- --------------------------- SIDE SEWER PatMIT NEW CONSTRUCTION REPAIRS n LID NO ................... . ASMT. NO. OWNER- ....................................... ....................................................... CONTRACTOR .................. .................................. --------------- -- ..... PERMIT NO. -------------------- JOB ADDRESS ....I A. f- c...... bl.kj ------- 54X--eg-.-i ............. LEGAL DESCRIPTION: LOT NO. ---------- --------------------------- BLOCK NO- ------------------- ---------------- ................................................................ ...................................................................................... .......... NAMEOF ADDITION ............................................................... ....................................................... Approved: DATE-------------------------------------------- By ------------------------ ------------------------ ................---District ?o 196 4 City of Edmonds ---Water Departmenf4l& TAP CARD Date. ...... ......... MeterNo ............................... Tap No...........---------...................... Size.............................. -Size....................................._. Mf9rs. N ..... .. ... . I�..... ........ ................ Style---........ . . ....................................................... . .. For ... . ..... IZ..... �. ...... ......................................................................................................... Lot No------------------------------------- ---- Blk. .No .................................................... Add. ..................................L2� ..... ....................................................... Service Location .4.. ......... . .... ................................ .................................................................................... .................................................... Meter- Location ................................................................................................ .................................................. Make Tap ....................... ................................................................................................................... Pressure.............................. lbs. Test........---....._................... % SendBills to .................................................................................. .................................................................... . ............................... Dateof Work .................. 7 .. ..... ................................. ...................................... 2) . .... a .... .................................................... Foreman Guar. Voucher No ........................................... $ .......................................... Remarks: ........................................................... ............................................... ................................................ ............. ....... ........ ............................................. ........ ..... .... ........... .. VV . ... .. ..................................................................... ............... .... . . ................. . .................................................................................... ................ .... ................ .......... . ....... STREET .... F ................................................ .............. I ...................................... IM"""' ................. OUTGOING Index .......... Reg ....... Route Bk ......... Stencil ...... Card ........ INCOMING Index .......... Reg ....... Route Bk ......... Stencil ...... Card ........ Material Chargeable to Installation M-effers NO, SIZE .... ..... DESCRIPTION RATE AMOUNT Meter ....... */ ... .......... Meter io'x... . ............... .......... Meter Plate ............................ .... .............. .......... Check Valve ........................ .............. ......... Pipe, Galv. Screw .................. .............. . . ......... .......... .............. .......... Nipples . .................................... .............. ....................... .............. .......... Bushings .................................. .............. ............. .......... .........................I Pla"' Ells ................................ .............. ............... ......... St. Ells ....... ............................ .............. ............ .......... .......... . ... .............. .............. .......... ............... ............... ............... .............. .......... .......... I ........ . .......... .......... .......... ......... ...... ... Tees ......................................... . .................................................... ...... .............................................. ...................................................... .................. ............. ..................... ...................................................... ....................... I ........................... ................................................ ..... ............... .............. .............. .............. ............... .............. .............. .............. .. . ........ ............ ............. ............. ........... ......... .. --- - - ............ I .......... .......... ......... ..... .......... .......... ----------- .......... Material Chargeable to Taps Connected NO. SIZE DESCRIPTION RATE AMOUNT .............. ......... — Pipe, Black Screw .................. ............. ............. ......... .............. .......... Pipe, Galv. Screw .... __ .......... ............... ...................... -------------- Lead Connections .................. CurbCocks .............. ............ ......... ............................ Corp. Cocks ..... ..................... ............... .............. ....... ........ ;�. .............. .......... Unions .................................... ......... .... ............. ......... ........... — .......... Saddles ................................ ... .............. ............ . ........ .............. .......... Nipples .................................... ............... ........... ......... ............... . ....... Bushings .................................. .............. ............ .......... ............... .......... Plain Ells ................................ ............ ............. .......... ........ ..... .......... Street Ells ---I........... ... ............ I ............. .......... ............. .............. .......... .......... Tees ............ "­­'"­­ ----------------- ------ ---------­---- Curb Boxes '* ­­ ---_--------- ...... ........... ........... . ...... .......... ........................ S. 0. Extens ions .................... .............. ............ .......... .............. .......... Gates ........................ ................ ................ ............ ........... ................. .......... �V Plugs .......... ........................ Couplings ............ _ .......... ............... ..... . ...... ..... .............. .......... Gate Boxes ............................ ............... ............. ..... .. rW..A� .. o- ........................ .... ........ ... ..... &A .. ...... .. .. .. — .............. — ............ .......... .............. .............. .......... ......... ........ I .................... � ............ 7 ............ ........................................................ .......... .... f ......... .... .............. . ........ ........................................................... ..' ........... ............. . ....... .............. .............. ........... .......... .......... ......................................................... . ........................................................... ....................................................... . . ............ . ............... ............... ............. ..: ..... ;­ ............. . ........ ­ ... ­ .......... ... .......... I—. .......... .' - . .. ............. ........ ..... ........ .. ....... ............... .......... .............. Hours Time—......................... ­* ....... * ...... Day Men ........ ............... ............... ..... ....... ...................I.'-- Hours Time —Monthly Men...-------_..... ........ . 2g; .............. .......... Hours Time —Auto ............................. ................ ........................ Superintendence .................... .............. .......... Total .................. .............