1242 CORONADO PL S.PDFiiiiiiii iiiiii
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1242 CORONADO
PL S
ADDRESS: / O� T� �o%U�add &116 91,
TAX ACCOUNT/PARCEL NUMBER: 0(35 15Z D w D ()? o o
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA'
SCALED PLOT PLAN DA'
SEWER LID FEE
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED: . III
SIDE SEWER PERMIT(S)
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER tint 'i
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver .
LID #: I I
.LOT: BLOCK:
L:\TEMP\DSTs\Forms\Street File Checklist.doc
RECEIVED
-JA N 1 1 1994
CITY OF EDMONic WORKS DEP" SIDE SEWER PERMIT
890 19a° PERMIT N2 85
Address of Construction: �- COr(�y� U 11�0 o'1 0 l/` S �� 9�ya a
Property Legal Description (Include all easements): % le, L G �lo4 - n
Owner and/or Contractor: \) C h c�0�1
State License No. `1 C - L v �� Building Permit No.
M-Single Family
❑ Multi -Family (No. of Units )
❑ Commercial
❑ Public
4�2, -
Invasion into City Right -of -Way: LJ No ❑ Yes
RW Construction Permit No.
Cross other Private Property: E No ❑ Yes
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.
Date
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
I OFFICE USE ONLY
* FOR INSPECTION CALL 771-3202, PUBLIC WORKS PEPT.
Permit Fee: v v Issued By
Trunk Charge: Date Issued: —
Assessment Fee: Receipt No.: ! 7 E 5- 9
Lid No.
Partial Inspection:
Comments
Date Initial
Reason Rejected: 9 Date Initial
Final Inspection Approved: Date Initial
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
t
Revised 3/90
The City of Edmonds Side Sewer Drawing EASEMENT NO. ___________________________________________F
i
NEW CONSTRUCTION ❑ REPAIRS LID NO_ __________________ ASMT. NO- -- _____-__-__-_--
OWNER------------------------------------------------------------------------------------------------ CONTRACTOR-------------------------.-----------------------.................................. PERMIT NO. -0--------
+
JOB ADDRESS ---- ---._`-�'___:-___ LEGAL DESCRIPTION: LOT NO_ ______________________________________ BLOCK NO. -----------------------------
a PWW-0001-11/75 (REV.11/78)
--------------------------------------------------------------------------------- -----------------------------
NAME OF ADDITION----------------------------------------------------------------------------- TREATMENT PLANT
t
t 1
I
_ T
r eqO,. r
R a' neap.
Lr i
1
ebe of— �
Approved:
DATE 1� 2----------------- BY --- ---
APPUCATION
The City of Edmonds for SIDE SEWER PERMITEASEMENT NO- --------------------------------------------
NEW CONSTRUCTION 0 1 LID NO, 9 4 — ------- - ASMT. NO. — ---------------
OWNER----------------------------------- CONTRACTOR --------------------------------------------------------------------------------- — PERMIT NO. --------------------
JOB ADDRESS ... ---- (2�)-Rc1-Ndk -------------------- I ................ LEGAL DESCRIPTION: LOT NO..------- .................... . BLOCK NO. ------------------------------------
...................................... .................................................................................................................
NAME OF ADDITION.-/\& --- I - V i --- ........... PARK -------------------------------
- I IN C
Approved:
lVa771,e-s,',l DAM ------------------------ - ------------
— - - - ------
S-wM�y�. .:�1l�yi .: / : �f � �;�iyY����•�pTf 'e�t+�W'•F ,s• t�,��•n Y,y�..ir�Y i'a4*r.fiw:.Mi�P a.a7`W.F..• ,:jx .r �:v y..�"i3zxa:.i.:,��'.r��-:. �>..�y 1 Sr
,�.�,;� :� t,H` F>^!i'"'.':tli`xE� S�':.'�'�,,,".;.FA`{+al� '��11�aak t� �i�:'d`tr••r'�r�?'.inKyl'�3�8��iV�.;ji-''w"a��,",��:•srrl`tua: 'al' Y:"o i t.i•.
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT
..� � Permit Number.
Issue Date:
-a
A. Address or Vicinity of Construction: 1242 Corinado Pl . (9322820 )
18
9 0 19 0� B. Type of Work (be specific): Install Nww Service
-
C. Contractor: Washington Nat'l. Gas Co.
Mailing Address: '815 Mercer St.Seattle Wn.
w State License #:
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, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR:'r i
F. Pavement or Concrete Cut : ❑ Yes f�ko G. Size of Cut: x H. Charge $
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to holdthe City of Edmonds harmle_gs;�errt tej ries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be madeoagdinstfthe City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legal proceedings including de �e costs, and attorney fees by re�a,§on oJf grantink this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS A`iPERIOD OF ONE YEAR FOLD W NG THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. EST/MATED RESTORATION FEES WILL RE HELD UNTIL THE FINAL STREET PATCH
/S COMPLETED BY CITY FORCES, AT WHICH TIME DEBIT OR CREDIT WII,L:RF1PROCFISSF.D FOR /SS[.IANCF, To 7fIFIAPPL/CANT.
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 approyed'material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand the permit requirements and thepink copyof theperm"it will be
available on site at all times for inspection purposes.
Signature:
y `Jje,:�:: ' 'Date: August 1-11993 j
��N�F�-.. � -a�
(Contractor or Agent) %+
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY -
APPROVED BY:, CA
RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER — A DAYS
DISRUPTION FEE/F
r
SPECIAL CONDITIONS: 1 A
RESTORATION FEE:
•
PERMIT FEE:
_ f
TOTAL FEE:
COMMENTS:
RECEIPT FEE: "
DATE:
ISSUED; BY:A AiO 4017
NO WORK SHALL BEGIN- PRIOR TO PERMIT ISSUANCE
Engrg. Nv. 1991