15828 68TH AVE W.PDF111111111111
5253
15828 68TH AVE W
"r,• ' CITY of EDMONDS
For Inspection Call 771-3202 REET FILE
Address of Construction: IS -2 5
Property Legal Description (Include all easements):
SIDE SEWER PERMIT
PERMIT NO. 07690
71 LYNNWOOD LINE
Owner and/or Builder:
d gk L L ( 4+ t �.A A 743- 7139 -aU k Sf- -SS
Contractor.& License No:
Single Family Residence &,--'
Multi -Family (No. of'Units )
,�EC��YED
B 211987
Commercial (No. of fixture Units ) PUBLIC yuORKS
Invasion into City Right -of -Way: No Yes (If ;Yes, Right -of -Way
Construction Permit required.. : Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property,: No Yes (If Yes, easement required;
attach legal description and county easement number.)
PLEASE REM O THE ITEMS LISTED ON THE BACK
/
cVKti n, XRa.t I have read and shall comply Date
itch the items listed on the back.
p
_ a
Permit Fee: �0.. GDO _ Issued By: /2�7 h
Trunk Charge: ZS• CID Date -Issued: 2�z4/o
Assessment Fee: Receipt No.:
Partial Inspection: � % D� 114 —�
Comments Date Initial
Final Inspection Approved: 2-1 R7
Dateco
Initial
Rejected: y
Reason Date Initial
-n
in
a�
** PERMIT MUST BE POSTED ON JOB SITE **
a�
White Copy - File Green Copy - Inspector Buff Copy = Applicant
a
�.:a.�.v✓'�...,rr...,,r'.,�.,gun•,.-,.,�.�,"i'�\`4Y11�^�.:I4t4c.+�n+r v,"/i^•r�9ri�ru='r'1ra4��rt-YfN4.'�'+,t'y`hr'•f�:li�'"rtf`�k.l-.v,�Tri."..y.✓'o �'-.,},:.:. �y��rrr,..,,....k�:r-�i.�k}.<�,+�r�������4..;,,�w.�vr-•�'����. i':-'2
City of Edmonds -
RIGHT -OF -WAY CONSTRUCTION
ERMIT Permit Number. 3 a
FILE/-��STREET Issue Date
A. Address or Vicinity of Construction: I rA28 68 Av. ►�A. (9327297)
B. T of Work specific): Install New Service
18 9 0 1 9 Type P� )
s
C. Contractor: Washington Nat'l. Gas Co. Contact: Frank Swan
Mailing Address:815 Mercer St.Seattle, Wn. Phone: 224-2278
State License #: 98111 Liability Insurance: Bond: $
D.' Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project R) Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut : ❑ Yes )OVo G. Size of Cut: x H. Charge $
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to t ,City of Edmonds harm i uriea, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be m_ a nst the City of F.dmon a, rits 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 1S RESPONSIBLE FOR WORKMANSHIP AND MATERIAL i6l Ar€'ERIOD OF ONE YlA�h-FOLLOWLVG THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATIOArFEES' WILL BE HELD UNTIL THE FINAL 4TJtEET 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;Aay;
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 purpos
A001101-
Signature: e; Sept. 30, 1993
(Contractor or Agent) A
Y CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
�J FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER 1 1 g& PS —DAYS
SPECIAL CONDITIONS: N A'
COMMENTS:
DISRUPTION FEE/FUND III:
RESTORATION FEE:
PERMIT FEE: ¢ �,
TOTAL FEE: 2
RECEIPT FEE:
,4,
DATE:
ISSUED BY:
NO WORK SHALL BEGIN P�IOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES
Comments:
Diagram
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
(Fund 111 - Route copy to Street Dept.)
t.
❑ YES ❑ NO
Date:
Date:
Addendum to : City of Edmonds
Right of Way
Permit Application
_ Submitted by: Guyla Connors _
Engineering Aide
Washington Natural Gas
521-5248
582C3 �8 Au , arc! .
+
iv WNG to window
1
Water main de;
unknown
gas mairr
I JD Cam, s
II 158 PL . s.
ZN�Y,�ti.�.6 �ti�d
K
ey.
-w-
water
-g-
gas -
-ss-
sewer
$
water hydrant
O
water valve
815 M=cr St. (P.O. Box 1869), Scattk, WA 99111 (206) 622.6767
El
BUILDING DIVISI�
IERMIT APPLICATI06
} NAME (OR NAME OF BUSINESS
L .
W MAILING ADDRESS
z
0 1 `L I I
CITY
N AM-9
U
W ADDRESS
h_
I
U
M CITY
c
NAME
E
O ADDRESS
F
u
a
Q CITY
I-
z
U ate.
z
0
F
a
IC
U
0
W
0
J
a
u
W
J
Ef
�te
PERMIT
A ^ �NUMBEf7
Insi
.EYHONE NUMBE
%y-� 70
ELEPHONE NUMBER
ow Below or
NE NUMBER
ENSE NUMBE
;h Four Copies
jUn
ADDRESS,,
LEGAL DESCRIPTION SUBDIVISION ISHORT SUB NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING
PROPOSED
DEFICIENCY OF RIGHT OF WAY
PUBLIC IMPROVEMENTS REQUIRED
❑
DRAINAGE IMPROVEMENTS REQUIRED
❑
DRAINAGE PLAN REQUIRED
❑
UNDERGROUND WIRING REQUIRED
❑
CONNECTION TO SANITARY SEWER
❑
SEPTIC TANK PERMIT REQ'D ❑
NO.
ELEVATION OF PROPERTY CORNERS
❑
& FOOTINGS REQ'D
n
SEE ENGINEERING MEMO DATED
CHECKED BY l
ILDING SUPPLY SIZE
SIGN AREA I ENV. REVIEW
Al LOWED I PROPOSED COMPLETEI EXEMPT
REMARKS
VARIANCE OR CU IPLANNING REVIEW BY
n
YARDS
CNEW
E ADD
❑ ALTER
ElREPAIR
�[%�'
L_J RESIDENTIAL GAS
❑ LINE
SIGN
NON-RESIDENTIAL11:1
a DEMOLISH 'RETAINING
ALL
❑ EXCAVATEOR FILL a i ENCE x--�)
D PRE -MOVE SWIM
INSP, POOL
FRONT
FIRE ZONE
T�
SPECIAL INSPECTOR
REQUIRED
❑ YES ❑ NO
PLAN CHECKED BY
Z NUMBER OF STORIES
NIUMBER OP
REMARKS
O
DWELLING
f
UNITS
E
a NATUR OF WORK TO BE DONEIn
-
W
0
, PLOT PLAN
PLAN CHECK FEE
BUILDING
-��
PLUMBING
MECHANICAL
FENCE
In "Applicant, on behalf of his or her spouse, heirs, assigns and
� successors in interest, agrees to indemnify, defend and hold harmless
i the City of Edmonds, Washington, its officials, employees, and
< agents from any and all claims for damages of whatever nature,
a
z arising directly or indirectly from the issuance of this permit. issu-
SIGN
RETAINING WALL
SWIMMING POOL
0 ance of this permit shall not be deemed to modify, waive or reduce
rt anv requirement of anv city ordinance nor limit in anv w:,v thr
ADD NO,
DR ELINE
DATE
COVERAGE
SIDE REAR
F CONSTRUCTION I CODE HEIGHT
AREA OCCUPANCY OCCUPAI
GROUP LOAD
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
VALUATION I FEE
If
I-
z
W
f
a
IL
W
0
F
z
W
F
a
O
J
W
W
O
I-
z
7
F
F
0
U
y
DATE:
t 11:,,lo 'ro : fill i l d
i nfi, Di v i.s i.cln
(:onullurliLy Dcveloj)ment -Department
FROM; En„i.neeri.ng Division
Public Works Department
SUBJECT:
After review of the subject building permit application, tae have -
the following comments : .
M
N
e
0
E
.0
Uj
0
CJ
s
w
Z.
J .
Ln o
:Z
z
J
F-�
w
O
W z.
U
0
GQ
Z
2
0 p
z
0. o
Ln
p. O
o U
U Q
F-
z
0
NORT H-
1N :
F
s
r
00
\19
00
4
Ln
ro
R
Hy
ea > R Wa
c a iV anQo
aa°� Q M q;�0
�CqJost
r"
t1
a: Q
o� a
N
NOTICE- NO WARRANTY OF ACCURACY The information shown on the
attached map was compiled for uze by the. City of Edmc=''3, i.a ern-, Icyces
anc! consultan's. Tho QN of Edmonds dogs not v.arrant tho aee_ c,y of
anyqlring scr forth on the map. Any person or entity reqF,.':: a copy
sh_ - 6 conduct, an independent inquiry regarding the Infor tratic;l cn
the map, including, but not limited to, the location of any sc�:--r stub
shuviii. Such sevrer stubs may or may not exist and may or may rot c;,`--t at
the location shown, Neither the City of Edmonds nor its a rlcy,_3 cr
c"'r?rs shah be liable for the information given on this map, nor for sny ord.
rc..— �--'ation provided based upon said map
G 8 TK AV E— W. .
U
W
r d
a�Qo
0qj,
In J o..
w
�
Ln
o
0
1s
a
0
SANITARY SEWER EASEMENT 4'QosA
' good and valuable consideration, the grantors
For a g Gerald R. Lee
hereby grant to the owners arre F. and Paula C. Alkema
and to future owner of:
MEADOWDALE BEACH
SDKTR037DTH1S02*59 OOE3ALGASDCEM NE COR
LN 89.40 FT TH W PLW N LN SD TR 37 FOR
165 FT NO2*59 OOW PLW E LN SE TR
89.40 FT TH E PLW N LN SD TR 165 FT TO TPB
An ease%ent for the installation, operation and maintenance
of a sanitary sewer line over, across, through, under and
upon the following described property, situated in Snohomish
County State of Washington, to -wit.
MEADOWDALE BEACH
BLK 000 D-04IN
THOFN208 5 FT TRPOB TH CONT SLY37 TH SLY ALDELY 20 FT
TH WLY PLL NLY IN SD TR 165 FT TH SLY
DATED this day of " 11- 9-7 , 1987
Marald R. Lee
STATE OF WASHINGTON
NO EXCITE TAX
z
< :K
a rA
sa I
F
COUNTY OF SNOHOMISH a
c �
On this day personally appeared before me Gerald N
to me known to be the individual described n ana
executed the within and foregoing instrument, and acknowl-
edged that he signed the same as his free and voluntary
act and deep for the uses and purposes therein mentioned.
Given under my hand and official seal this // day of
"P11— tA— , 1987
AotarftSffit�ean or t
State of WashiI on residing
at
v
0
0
O
v
VOL. 2041PA6E2168
S,'t)32'70424
0