150 WEST DAYTON ST.PDFIIIIIIIIIIIIII
14192
150 W DAYTON ST
CITY IT®F E® Q� S HARVE H. HARRISON
�r it MAYOR
CIVIC CENTER • EDMONDS. WASHINGTON 98000 (206) 775-2525
COMMUNITY DEVELOPMENT DEPARTMENT
Dick Beselin
Harbor Square Associates
300 Admiral Way
Edmonds, WA 98020
December 6, 1982
STREET FILE
RE: HARBOR SQUARE PROJECT @ 150 W. DAYTON STREET
Dear Dick;
The storm, sanitary sewer, and water systems have been
inspected and approved. Prior to final release of any
performance monies, a maintenance bond must be posted.
Per the City Code (see copy attached) the maintenance
bond amount is to be 15% of the total cost of all site
improvements. Please provide us with a cost breakout of
these improvements prior to bringing in the maintenance
bond. Once this bond has been posted, we will authorize
the release of the performance money being held.
If you have any questions, please contact me.
f�®
Dan Smith, Planning /Engineering
DS/cn Inspector
attachment
cc: Building Division
CITY OF EDMONDS ASSET INFORMATION SHEET
NEW FILE ASSET NO. 00-3412,
❑ ADDITION ADDITION TO ASSET NO.
❑ RETIREMENT
DESCRIPTION
SERIAL NO.
LOCATION DEPT. �Nf 0.
Q
/ 'i'S I D .J .S' O
**PURCHASE ORDER NO. _
PURCHASE ORDER DATE
COST
*PROJECT NUMBER W 2.:! f ' 3
PROJECT COMPLETION DATE / 2 - 3 / & 2-
COST .5-.z 6-, 3 7
B.A.R.S. ACCOUNT NO.o06C
• ESTIMATED LIFE Z S
INITIATED BY DATE APPROVED BY
**SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT _
� -0 G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO.
INITIAL
k fnp
DEPARTMENT FILE
6661 G l
C' mf Edm d
ity on s
CRITYCAL ARWAS 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.
Please submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
locating the specific piece of property described on
this form. In addition, the applicant shall include
other pertinent information (e.g., site plan, topography
map, etc.) or studies in conjunction with this Checklist
to assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
>� ¢ I N
Name
Street Address
City State Zip
Telephone
Si attir
Date
Applicant Representative:
Name
Street Address
City State
Telephone
Signature
Date
Zip
0
c:receptionU anakacl. doc
(over)
C ILE NO.
•
ftcalAreas Checklist
------------------ --------------------------------------
Site Information (soils/topography/hydrology/vegetation)
. 1. Site Address/Location: 16-0
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet): 1 L • �lx u�C2� �
4. Is this site currently developed? _Zyes; no.
If yes; how is site developed?�5"'- `-`-'
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
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 over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: to ; Approx. Depth:
7. Site contains areas of seasonal. standing water: Nam, ; Approx. Depth:
• What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- .
round? Flows are seasonal? (What time of year? ).
10. Site is primarily: forested • meadow : shrubs : mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
-- - - ------ ---- --- —`------- ------For City Staff Use Only ----------------------------- -
1;: :Site is Zoned?,
2. SCS.mapped.so.il..type(s)?.,
3: Wetland inventoryor..C.A...map indicates.wetland.present.on site?...
4. Critical Areas inventory or C.A..map Indicates Critical Area on site?., . A/O.-
5; Site within designate..d earth subsidence landsiide:hazard -area?.:::: .
CITY OF EDMONDS
FOR INSPECTION CALL
PUBLIC WORKS DEPART 0T Permit
SIDE SEWER PERMIT 775-2525 Ext—a ' Issue Date
PERMIT MUST BE POSTED ON JOB SITE
i�
1. Address of Construc`777777 J ;, E
2. Property Legal Description (include all easements) REATMENT PLANT
3. Single Family Residence Multi -Family No. of Units R EC EIV E D_
Commercial u
4. Owner and/or Builder d,al� 1�g 5. Contractor & License No. ; -��� - , , „ �� PUBLIC WORKS
6. Invasion into City Right -of -Way: No Yes (If Yes Right-of-
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 FOLLOWING AND SIGN: �F—D) EET PLE
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.
C. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
e. Side sewer lines must be laid at a minimum grade of 2% (1.150)
and maximum grade of 100% (450).
f. No turn in side sewer greater than 45° (1/8,bend) is0allowed
between cleanout. All 90 turns must be constructed of a 45 (1/•8
bend) and wye with removable,cap.
g. No down spouts, footing.drains or floor drains can be connected
to side sewer, system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors. shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE: -
I certify that I have read
and shall comply with the above
H PERMIT FEE: '� r`7 DISAPPROVED BY: Date:
By:Date:
a CONNECTION FEE:1 APPROVED By• _ Date•
0
* PERMIT MUST BE POSTED ON JOB SITE
d0l
0
0
The City of Edmonds Side Sewer Drawing
EASEMENT NO- ......................
NEW CONSTRUCTION REPAIRS E] LID NO . ................... IASMT. NO . ..................
OWNER .... --------------------------- : .................. CONTRACTOR ... P ..........Wes.- T COY f .................. PERMIT NO.
JOB ADDRESS ..... /4$774 ..... . W ...... . ...................... LEGAL DESCRIPTION: LOT NO . .................. ..................... BLOCK NO. ...... .........................
......................................................... .............................................
NAMEOF ADDITION .................................................................................. EDMONDS -----
'WATMEN7 PLANT
PWW-0001.11/75 (REV.1 1/78)
Approved:
...Z•a//2�.. . . ............. B ...... ................
DATE a.-------
STREET FILETREET USE PERMIT APPLICATION STREET FILE
Date Received:'
Date Issued C--
Permit -No. -e�,—
Name of Applicant or Business:
Mailing Address:�l��5���,E1� ��t� �r�t,r Telephone No:�-��
Address of Public Use:
**********************************************************************
1. DESCRIB>E THE PUBLIC PLACE OR PORTION OF PUBLIC PLACE TO BE UTILIZED:
t i t 1r. �� c'"�' Lz-!t. /E 3r/i GrTf G;'X)G°!/1, 121 /WJtr��
Attach an appropriate plot plan or elevation view.
2. SPECIFY THE TYPE OF USE DESIRED:
3. SPECIFY LENGTH OF TIME FOR USE_%� r5
The issuance of this permit is understood by the applicant to be of a
temporary nature and that no vested right is granted.
INDEMNITY: The 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 applicant or the
City of Edmonds, or any of its departments or employees, including but
not limited to the defense or any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this
permit. In addition the applicant understands that the City shall be
provided a certificate of insurance to indemnity and hold harmless the
City of Edmonds from all claims and/or property damage, and naming the
City of Edmonds as an additional insured.
CODE APPLICATION:
By signing the application below the applicant warrants that s/he has
read or had the opportunity to read Chapter 18 of the Edmonds Community
Development Code, and s/he understands that all terms of that Ordinance
are incorporated herein as if set forth in full and this application
and permit therefore are subject to the terms of that Chapter.
cant Signature ,1 Date
Page 6 of 8 1/89
Street Use Permit Application
Page Two
SIGNATURE OF APPROVAL FROM ABUTTING PROPERTY OWNERS
When applicable; if the street use proposal is for utilization of City
right-of-way that may directly impact any adjacent business or private
property owners, the applicant shall obtain written approval from the
neighbors. (This requirement will be evaluated by the City after
initial submittal of the permit has been made by the applicant.)
SIGNATURE PRINTED NAME ADDRESS DATE
c y,
DO NOT WRITE BELOW THIS LINE FOR CITY USE ONLY
City Council Approval Date ADB Approval Date
Certificate Of Insurance Posted Bond Required
SIGNATURES OF PERMIT APPROVAL FOR ISSUANCE
Fire Department Date2--
Police Department , vx��;
Date
Engineering Dept Date 3 /- 9z—
Building Official �i'.' Date�j��
Public Works �� ?�1��X' Date-;-c,-
REMARKS/COMMENTS: 7e) Gam' fa yf✓ 1.
PERMIT NO. �� ;,� ._ DATE OF ISSUANCE ,7
RELEASED BY {.,.i% ,� RECEIPT NO. 7�5
BUILDING PERMIT NO.
Page 7 of 8
1/89
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24215 Brier Rd.
Brier, Washington 98036
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Contractors Registration Section
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P.O. Box 9689
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DEPARTMENT OF LABOR AND IN RIES
Division of Building and Constru lion
Safety Inspection Services
CONTRACTOR'S REGISTRATION SECTION
P.O. Box 9689
. Olympia, Washington 98504-9689
Registration No.
(Must be given for renewal of
registration)
49TATg
e x BONE AR
CONTRACTOR'S SURETY BOND
Required by the Contractor's Registration Act
Chapter 77, Laws of 1963, RCW 18.27
BOND NO. YL I 221055
AAA MASONRY RESTORATION CO., INC., doing business as AAA MASONRY RESTORATION CO.. INC.
as Principal, and OLD REPUBLIC INSURANCE COMPANY a corporation organized and
existing under the laws of the State of PENNSYLVANIA and authorized to
transact surety business in the State of Washington, as Surety, by this bond bind ourselves and our heirs, executors,
administrators, successors, and assigns, jointly and severally, to pay the State of Washington Six tholisard
dollars lawful money of the United States of America.
The Principal has applied for a Certificate of Registration, from the Contractor's Registration Section of the Washing-
ton State Department of Labor and Industries, to carry on the business of a contractor in the State of Washington.
The Principal is required by chapter 18.27 of the Revised Code of Washington (RCW) to furnish a bond in the penal
sum of Six dollars with good and sufficient surety. The bond must be conditioned as required by RCW
18.27.040.
If the Principal, in compliance with the provisions of chapter 18.27 RCW, pays all (1) wages and benefits to persons
furnishing labor to the Principal, (2) amounts that are adjudged against the Principal because of negligent or improper
work or breach of contractor that arise in its conduct of the contracting business, (3) persons who furnish labor and
•materials or rent or supply equipment to the Principal, and (4) taxes and contributions due to the State of Washington,
the obligation of the Principal and the Surety shall be null and void. If the Principal does not pay the above claims, the
bond shall remain in full force and effect. In no case shall the Surety be liable for any claim not included in RCW
18.27.040.
Any person that has a claim against the Principal, arising from the failure of the Principal to pay any of the four items
referred to in paragraph 3, may bring suit upon this bond in the superior court of the county in which the work was
done, or of any county in which the court has jurisdiction over the Principal. The suit must be brought within the time
and in the manner required by RCW 18.27.040.
The aggregate liability of the Surety under this bond for claims against this bond shall not exceed the penal sum of
this bond. No extension by continuation certificate, reinstatement, reissue, or renewal of this bond shall increase the
liability of the Surety. If the claims against the bond that are pending at any one time exceed the remainder of the
aggregate liability minus the amounts previously paid by the Surety because of other claims against this bond, the
claims shall be satisfied in accordance with the provisions of RCW 18.27.040.
This bond shall become effective NOVEMBER 20th, 1991 and shall remain
in force until (1) NOVEMBER 20th, 1992 or (2) the date the Principal's
Certificate of Registration expires, whichever is earlier, unless the Surety sooner cancels the bond. This bond may be
continued for additional periods by continuation certificate at the discretion of the Surety.
If the Surety cancels this bond, the Surety shall notify the Contractor's Registration Section at least thirty days
before the effective date of the cancellation.
THIS BOND SHALL BE VOID IF THE PRINCIPAL DOES NOT FILE THIS BOND WITH THE CONTRACTOR REGIS-
TRATION SECTION WITHIN THIRTY DAYS OF THE DATE THE BOND WAS EFFECTIVE OR ISSUED.
IN WITNESS OF THIS CONTRACT, The Principal and Surety have affixed their hands
and seals this 26th day of — NOVTMBER 19 91
Q D REftkLIC IIGJRAIU =AW
• Principal's Name AAA W� RESIORMIM OD., DE. Surety Name FO IM 4627 EMIAM OR 97208
By
F625.003-000 Surely Bond (3/66) O% A-246
1 E*-T N, PIMMY IN FtCT „ 3
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OLD REPUBLIC INSURANCE COMPANY
��- POWER OF ATTORNEY
VFKNOWALL MEN BYTHESE PRESENTS: That OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania stock insurance corporation, does
e, constitute and appoint:
Roxanne J.. Samhan, Portland, OR
Its true and lawful Attorney(s)-in-Fact, with full power and authority for and on behalf of the company as surety, to execute and deliver and affix the
seal of the company thereto (if a seal is required), bonds, undertakings, recognizances or other written obligations In the nature thereof, as follows:
All written instruments in an amountl.not to. exceed :an aggregate of Fifty thousand ($50,000.00)
DOLLARS for any single obligation, regardless of the number of instruments issued for the
obligation.
and to bind OLD REPUBLIC INSURANCE COMPANY thereby, and all of the acts of said Attorneys -in -Fact, pursuant to these presents, are ratified
and confirmed. This appointment is made under and by authority of the board of directors at a special meeting held on May 29,1986.This Power
of Attorney Is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of the
OLD REPUBLIC INSURANCE COMPANY on May 29, 1986.
RESOLVED FURTHER, that the chairman, president or any vice-president of the Company's surety division, in conjunction with the secretary
or any assistant secretary of the Company, be and hereby are authorized and directed to execute and deliver, to such persons as such
officers of the Company may deem appropriate, Powers of Attorney in the form presented to and attached to the minutes of this meeting,
authorizing such persons to execute and deliver and affix the seal of the Company to bonds, undertakings, recognizances, and suretyship
obligations of all kinds.The said officers may revoke any Powerof Attorney previously granted to any such person. The authority of any Power.
of Attorney granted by any such officer of the Company as aforesaid shall not exceed five million dollars ($5,000,000.00), except (a) bonds
required to be filed as open penalty bonds, and (b) bonds filed with any court or governmental authority requiring an unlimited penalty in
bonds filed in that court.
RESOLVED FURTHER, that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company
(1) when signed by the chairman, president or any vice president of the Company's surety division and attested and sealed (if a seal be
required) by any secretary or assistant secretary; or
(ii) when signed by a duly authorized attorney -in -fact and sealed with the seal of the Company.
RESOLVED FURTHER, that the signature of any officer designated above, and the seal of the Company, may be affixed by facsimile to any
oPowerof Attorney orcertification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or othersuretyship
bligation of the Company, and such signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, OLD REPUBLIC INSURANCE COMPANY has caused these presents to be signed by its proper officer, and its
corporate seal to be affixed this l l th day of June , 19 91
\1\\Illlbll/I/
OLD REPUBLIC INSURANCE COMPANY
frF '
Asst Secretary o EMMsy �`�° Vice President
'""llllllllllll\\.\"
STATE OF WISCONSIN, COUNTY OF WAUKESH — SS
On this llth day of June , 19 _91_, personally came before me, Jess J. Wadle
and Patricia A. MortaR to me known to be the Individuals and officers of the OLD REPUBLIC INSURANCE COMPANY
who executed the above instrument, and they each acknowledged the execution of the same, and being by me duly sworn, did severally depose
and say, that theyare the said officers of the corporation aforesaid, and that the seal affixed to the above instrument is the seal of the corporation,
and that said corporate seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority of the
board of directors of said organization.
.............+"-
/%'
' \ •� 'uellt 1 =r
\nor w\s;° ` Notary Public
My commission expires: 1 /31 /93
CERTIFICATE
I, the undersigned, assistant secretary of the OLD REPUBLIC INSURANCE COMPANY, a Pennsylvania corporation, CERTIFY that the
foregoing and attached power of attorney remains in full force and has not been revoked; and furthermore, that the Resolutions of the board of
directors set forth in the Power of Attorney, are now in force.
`co G i•--+\F;%yam
• r ,Irolur o �s
Signed and sealed at the City of Brookfield this 26th d y o N VEMBER , 1g 91
Assistant Secretary
ORSC 11008 (6.86)
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USE PERMIT
ZONE NUMBE 620337
1 CITY OF rC`NDS
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CONSTRUCTION PEIT APPLICATION
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I,/OR/� NAME OF BUSINESSI
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LEGAL DESCRIPTION CHECK
SUBUIVIS:GN NO.
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This Permit covers work to be done on orivate property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
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driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
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Permit Limit: t Year • Provided Work is Started Within 180 Days
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"Applicant, On behalf of his or her spouse, heirs, assigns and
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successors in interest, agrees to indemnify, defend and hold
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harmless the City of Edmonds, Washington, its officials.)t.•i'.1''
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employees, and agents from any and all claims for damages of
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wha!ever nature, arising directly or indirectly from the Issuance
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of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
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nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
0,0
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provision.-
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I hereby acknowledge that I have read this application; that the
Information given IS correct; acd that I am the owner, or the duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
slate laws regulating construction; and in doing the work authoriz-
AUTHORIZES
This application is not a permit until
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ed thereby, no person will be employed in violation of the Labor
ONLY T-E
signed by the Building Official or his
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Code of the State of Washington elating to Workmen's Compensa
'•YORK NOTED
Deputy: and fees are paid, and receipt is
tion Ins anc .
R �]/�/ D TF SIGNED
INSPECTION
acknowledged in space provlded.
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SIGNATI c O AGE.Y
DEPARTMENT
CITY OF
OFFICIAL S SIGNATURE
1
,
THIS SITE IS LOCATED IN THE CITY EDMONDS
OF EDMONDS. LOCAL SALES TAX
775.2525
DATE
!
ATTENTION SHOULD BE CODED 31.04.
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUGTJRE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL
OR ORIGINAL — File YELLOW — Inspector
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' A.CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
10278
PINK — Owner GOLD - Assessor
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PLUMBINGUnderground �.
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Water, service...
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WALLBOARD.
FINAL
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