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1138 3RD AVE S.PDFIIIIIIIIIIII 4942 1138 3RD AVE S ADD /6 / TAX ACCOUNT/PARCEL #: BUILDING PERMIT (NEW STRUCTURE) #: COVENANTS (RECORDED) FOR: CRITICAL AREAS M DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver CRITICAL AREAS #: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORD FOR: PERMITS (OTHER — list permit #'s): PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) M . GEOTECH REPORT DATED: STREET USE/ENCROACHMENT PERMIT M FOR: WATER METER TAP CARD DATED: OTHER: L:\TEMPIDST's\Forms\Jana's Street File Checklist 5-14-08.doc A 4pi. .... 1-1 - 2- ----- --- -- - 311A BUS i� _ ot ool NOVID - 1992 PERMIT COUMTFa 4: � -^'f'�'�4a•i��,a"'it���^�1Ay�Tni'`�'a}„r`'q'"".�"?.,%"1"'ry�`�::r� -` �' �' .'„� ..�o� � 'I%' ' ' �k''p� ' j�c�.:'��'`i«'''�,'Nt+'�'���°YA�t'r''P"•ti�1"�` ' �!y STREFJ­FILE :0 "D (1CiTY OF EDMOND"IVF SIDE SEWER PERMIT APR J '1 1993 8g0.1q"o PUBLIC WORKS DEPT: PERMIT j\J° 3479 Address of Construction: Property Legal Description (Include all easements): Owner and/or Contractor: LAJ �•1 t �_� hi'� 1 Ce2A17 ) State License No. De,46 t 1 .� Building Permit No. ga"Single Family Invasion into City Right -of -Way: RNo ❑ Yes ❑. Multi -Family (No. of Units ) RW Construction Permit No. ❑ Commercial Cross other Private Property: 2-No ❑ Yes ❑ Public Attach legal description and copy of recorded easement I certify that I have read and shall comply with all city requirements as indicated on the back of the Permit Card. --30-4'3 Date * CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION * OFFICE USE ONLY * FOR INSPECTION CALL- PUBLIC WORKS DEPT. © 77�-oaa-d 7/%� Permit Fee: � Issued By Trunk Charge: Date Issued: �7� c/ — 93 Assessment Fee: �� Receipt- No.: �!� � c 2 Lid No.: Partial Inspection: Date Initial Comments Reason Rejected: �� Date Initial Final Inspection Approved: Dates-S' Initia ,- ** PERMIT MUST BE POSTED ON JOB SITE ** White Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 3!90 The City Edmonds of EddSide Sewer Drawing EASEMENT NO x-•----- --- -- -------------------- NEW CONSTRUCTION ❑ REPAIRS � LID NO- ------------------ -ASMT. NO. ------------------ OWNER-------•---------------•-•--------------------------------------------------------------------- CONTRACTOR-------•-------•---••-------•-----------•-------.---•-•-----------------•----------- PERMIT NO. (C- JOB ADDRESS R� --'--- S----------------------- LEGAL DESCRIPTION: LOT NO. -------------------------------------- BLOCK NO.--------------•---------•----••--- 3 •----------- EUMONDS NAME OF ADDITION---•---------------------------------------------------------------------- ���{--PLANT i • coNluar- %oal — a4 1 r. o 2If �rcSSttrc re, 4', ?-V-e- aE°P•V•(. ! I i 14 V—c ..�_ 10 1! Stte0 . !V•:V—lPrcSSA 9r%l40F. t Pujt9 Approved: PWW-0001-11/75 (REV.11178) DATE S - -- -.-�`3 -rb TR-4 7—ioJ. STREET FILE PUBLIC DISCLOSURE REQUEST DATE -OF REQUEST: _ �7-9? 3 NAME: l.(J • 2- � 4660 7 , ADDRESS: —A, , 1-3 �zD PHONE: % ` D GI 1,7v—.6- Signature (Staff Use Only) (0 - 5 COPIES FREE) L. Non-profit organization @ .10 per page: Charge: pages @ .10 per page = $ 2. General public @ .25 per page: Charge: pages @ .25 per page = S a S TOTAL = S . DOCUMENTS PROVIDED: Date: Mailed: Pick-up: f ile: word\data\disclo sr CITY OF EDMONDS CIVIC CENTER • EDMONDS, WA 98020 • (206( 775-2525 J -"-SMNNPW— O 8919°� 0 LETTER OF TRANSMITTAL Date: October 21, 1992 To: W.L. Abbott 1138 3rd Ave. S. Edmonds WA 98020 Subject: Critical Areas Checklist Transmitting: For your information: As you requested - For your file: Comment and return: Note attachments: Comments: STREET FILE LAURA M. HALL MAYOR Planning Division T` Diane. Cunningham, Planning Secretary • Incorporated August 11, 1890 • Sister Cities International Hekinan, Japan 690.199- City of Edmonds Critical Are as 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 S Street Address 97r �S %0 Zy City, State, ZIP Phone Applicant Representative: Name Title Street Address City, State, ZIP Phone Signature bate Signature Date Critical Areas Checklist Site Information M 1/Project Name: Permit Number: 5005 00t O V Site Location: //3 r S w4S . Property Tax Account Number: Approximate Site Size (acres or square feet): G 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? � Date of most recent action: Soils / Topography 2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? K rvII ? 3. Describe the general site topography. Check all that apply. M 4 0— 4— / Flat: less than 5 feet elevation change over entire site. NO 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. Comments HydrologyNegetation 4. Site contains areas of year-round standing water: 5. Site contains areas of seasonal standing water: �Approx. Depth: 6. Site is in the floodway A& floodplainNo —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? 8. Site is primarily: forested ; meadow ; shrubs ; mixed. 9. Obvious wetland is present on site: 10. Wetland inventory or map indicates wetland present on site: A2 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:Criticai areas-studynot required if specified conditions satisfied: WAIVER: Critical areas study is not required. Determination Number.4-cm49/S Reviewer > f l 9(/ Planner ate Rev 3127/92 Building Permit Application Information Application #.. 920925BLDG Date... 10/22/92 Site Address.... 1138 3rd Ave S' ,lob Name....... W. L. Abbott `tame .......... W L Abbott Address....... 1138 3rd_. 7ity/St/Zip... Edmonds WA Owner Information Ave -S • STR"'EET FILE Permit.,. # P-920925BLDG Unit #..... ATA# 5820 003 008 02 `98020 come Phone.... Work. -Phone... ''`Contractor' Information Name ........... Corit # . OWNER address....... 'ity/St/Zip. g 'ontact....... 4 �Plione, .. . "Architect.Jnformatxon Tame ........... Arch # 'address....... 'ity/St/Zip... �. .ontact....... ',-.Phone... 776. 3444. --- Engineer Information !ame.......... P .. Engr # > Adress......., \ 'ity/St/Zip... m , 'ontact ....... " Phone ' eW. X Addition ..... Alteration Repair._ Heat. ature of Work.. 600 1. ;Sq: Ft.:.' Detached Heated 'Workshop " uilding Type code ". SFR ,UN'" Cost/$gFt :. $ 6512 Building=Area ' Basement........ First Story: 600 Second Story.... • } Third Story = C_. Over 3 Stories .. Decks.......... Shell Only �N Total Square Footage.: Build ing„,Valuation.......... $ t:->.3.9 072.00 Building" Permit Fee $ 30'870" Plan Review"Fee........ 200.66 . Total Fees............ $ M 509.36 1.q • CITY OFOEOMONDS CIVIC CENTER • EDMONDS, WASHINGTON 98020 • (20645.265 , 4 PURCHASE REQUEST INVENTORY REQUEST 'E N D 0 R VENDOR, NO. aCON ATION ORD WORK REQUEST SHIP PREPAID TO REC IVEi? IS WOO&USTAPPEAR ON`ALL INVOICES, irpf BILLS O.F LADING A NDENCE. SERVICE LOCATION) DATE REQUIRED SHIP VIA DOCUMENT NO. ORDER DATE BATCH NUMBER d�3 VED PLEASE FURNISH THE Vol LOWING ITEMS: N .UANTIT UNdT CATALOG NUMBER 'DESCRIPTION UNIT COST TOTAL COST ESTIMATED ACTUAL �COC s-- on YO �.� SUBTOTAL TAX TOTAL AMOUNT W .J 1 CODE PROJECT AMOUNT ESTIMATE ACTUAL 2 3 4 5 6 71 9 10 12 NO) TOTAL AMOUNT .k • ORDINANCE -V1035 • UTILITY CUT f,EPAIR, STRI-J.T DIVISION Permit i et t No 82-295 e D 1 ece i ved 11/5/82 Issue Date 11/5/82 '—__ Dato ---------- Proces,,ed­ 1/31/83 Date Completed 1/22/83 Asphalt Tvj)e of Repair: ASIA),11t Rbadwxl 6mx . I k x� .1 ­­­_ Conc. Curb Total Area Rej)air - 5 Ft. X 24 i t. , 1'o ta 1 13.78 Sq. Ms. /Ln. Ft. Total Cost Summary: 2 Sq.Yds./Ln.Ft. Minimum Charge @ 72.00 = $ 72.00 11. 78 Sq.Yds./Ln.Ft. Additional (1) 7.-.50 83.35 Sq.Yds. Additional Base Lift @ $ —0— Yds. Additional Base Aggreate 0 Total Cost 160.35 ....................... Fund #111 Dej)osit Fee .......................................... $ 225.00 Total Reimbursement ...................................... 64.65 Total J'kddlitional [.,xlwnst . ................ I ...................... —0— This ill f 0111410 On is LO b(2 Vi I ed W'I 01 01"i (J'i I I,1 I IWI-111 it.. C 0111M E N I S in January 31, 1983 MEMO TO: Art Housler, Director Finance Department FROM: John B. Mitchell Superintendent of Public Works SUBJECT: REIMBURSEMENT OF STREET CUT SECURITY DEPOSIT - ORDINANCE #1935 R/W CONSTR. PERMIT NO.: 82-295 DATE ISSUED: 11/5/82 LOCATION OF WORK: 1138 3rd Ave. S. SECURITY DEPOSIT AMOUNT: $225.00 RECEIPT NO. & DATE: #2440 11/5 82 COMPLETION DT. OF REPAIR: 1/22/83 Please prepare a Treasurer's Check in the amount of $ 64.65 made payable to the following; Darlene Landry 1138 3rd Ave. S. Edmonds, Wa. 98020 The balance of the deposit in the amount of $ 160.35- is to remain in Street Division Revenue Fund 111-000-000-383.0.0. 1 mph NO: :DATE.: STREET FILE.TI �AE LJREIC , WOI�KS DEPARTM�N1' SPECIAL N551STANCF REQLAE ST. NNME-:: i Tt ME : � hDD ITI ON t��... CONtMEI�I TS 11 i 4 i • w l a ✓�i ty of Edmonc:_j TREET FILE INTER -OFFICE CORRESPONDEEINCE3 TO -- CC__S ,5 F/ l e FROM IDATE 52 R SUBJECT SOF Aco 7� I The City of Edmonds Side Sewer Drawing EASEMENT NO. ............................................ ) / NEW CONSTRUCTION �Z REPAIRS ❑ LID NO. _1 ._...ASMT. NO ................... OWNER ._..1---a r CONTRACTOR ------ �GI�YIC�✓ PERMIT NO. �_F�1, yd JOB ADDRESS ._1f��.. -- - •'---�o-•=------------ LEGAL DESCRIPTION: LOT NO. .................... BLOCK„NO.------------------------------------ F�4 P/ PWW-0W1-11/75 (REV.11/78) 37 NAME OF ADDITION �n of c6 --.m om --------•----•--•-- --------------------------------------_------------------- EDt�4pNpS 7'REA-f►Vltfd7 PL4N7 c Approved: DATE .�ea.T/1� ---------- B ` lG