18107 88TH AVE W.PDF111111111111
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18107 88TH AVE W
-Oc�'s t . 18 9 \-)
CITY OF EDMONDS.
250 5TH AVENUE NORTH - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works e Planning 9 Parks and Recreation 9 Engineering
Date: November 14, 1996
Project No.;
To: . Kenneth L. and Carol A. Johnson
18107 - 88th Ave. W.
Edmonds, WA 98020
Re: Quit Claim Deed
Transmitting: Quit Claim Deed and Real Estate Excise Tax Affidavit
As you requested For your file
For your information For posting in public place
As we discussed For signature and return x
For appropriate action x
BARBARA FAHEY
MAYOR
Remarks: Please sign the attached Quit Claim Deed and have it notarized. Also,
sign the attached Real Estate Excise Tax Affidavit. Return both forms to
this office. If you have any guestions. contact Gordy Hyde, extension 325.
TRNSMTL.DOC
Signature
Sharon Fain, Administrative Secretary for the
Printed Name and Title Engineering Division
Incorporated August 11, 1890
Sister Cities International — Hekinan, Japan
QUIT CLAIM DEED
THE GRANTOR, Kenneth L. Johnson and Carol A. Johnson, husband and wife for and
in consideration of mutual benefits to be derived by the establishment of a public right7of-way, convey
and quit claim to the CITY OF EDMONDS, the following described real estate, situated in the County
of Snohomish, State of Washington, including any interest therein that grantor may hereafter acquire:
That portion of Lot 7, Lawrence Addition, as recorded in Volume 19 of Plats, Page 92,
records of Snohomish County, Washington; lying Southerly and Westerly of the following
described line:
Commencing at a point 5.00 perpendicular feet West of the Northwest corner of said lot;
thence South 0*45'50" West, parallel with the West line of said lot a distance of 85.14 feet
to a point of tangency of a curve to the left and the point of beginning of the line described
herein; thence Southeasterly along said curve having a radius of 40.00 feet and consuming
a central angle of 89*46'2611 for a distance of 62.67 feet to a point of tangency on the South
line of said lot that lies 51.73 feet Westerly of the Southeast corner of said lot and the
terminus of described line.
together with the right to make all necessary cut or fill slopes on the land of grantors adjacent to the
above -described real property in connection with the construction, maintenance or improvement of the
above-desdribed real property for purposes of a public roadway.
DATED THIS - DAY OF
Husband
Wife
STATE OF WASHINGTON)
COUNTY OF
19
On this day personally appeared before me to me known to be the
individual described in and who executed the within and foregoing instrument and acknowledged that
signed the same as free and voluntary act and deed, for
the uses and purposes therein mentioned.
UNDER MY HAND AND OFFICIAL SEAL THIS DAY OF
NOTARY PUBLIC in and for the
State of Washington, residing at
JOHNSONK.DOC
C
PLEASE TYPE OR PRINT REAL ESTATE EXCISE TAX A"IDAVIT This fonn is your receipt when stamped
PLEASE SEE REVERSE by cashier.
form No. 54 Mum
CHAPTER 82.45 RCW - CHAPTER 458-61 WAC
For Use at Count
.y Treasurer's Office
(Use'Form No. 84-=113 for Reporting Transfers of Controlling Interest of Entity Ownership to the Department of Revenue)
TIUS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS 1-7 ARE FULLY COMIPLLTED
UIName Kenneth L. and Carol A. Johnson I a IName City of Edmonds
9 99 Ix M
gi Street 18107 — 88th Ave. W. gi
rA 0 city Edmonds, . State WA Zip 98026 00
ADDRESS TO SEND ALL PROPERTY TAX RELATED CORRESPONDENCE
Name City of Edmonds 1-11
Street 250 — 5th Ave. N.
Street 250 — 5th Ave. N.
City Edmonds State WA Zip 98020
TAX PARCEL NUM
City/State Edmonds, WA Zip
— __18020
LEGAL DESCRIPTION OF PROPERrY SITUATED IN 0 UNINCORPORATED COUNTY KI OR IN CITY OF EDMONDS
Street Address (if property is improved): N/A
SEE ATTACHED LEGAL
Is this property currently: YES NO
Classified or designated as forest land?
Chapter 84.33 RCW
Classified as current use land (open space, farm FK)
and agricultural, or timber)? Chapter 84.34 RCW
Exempt from property tax as a nonprofit 0
organization? Chapter 84.36 RCW
Seller's Exempt Reg. No -- — — — — — — — —
Receiving special valuation as historic
property under? Chapter 84.25 RCW
Property Type: 0 land only 0 land with new building
0 land with previously used building 0 land with mobile home
0 timber only 0 building only
Principal Use: 0 Apt. (4 + unit) 0 residential
0 timber 0 agricultural 0 commercial/industrial
M other Piihl ic right—of—way
(1) NOTICE OF CONTINUANCE (RCW 84.33 or RCW 84.34)
if the new owncr(s) of land that is classified or designated as current use
or forest land wish to continue the classification or designation of such
land, the new owner(s) must sign below. If the new owner(s) do not desire
to continue such classification or designation, all compensating or additional
tax calculated pursuant to RCW 84.33.120 and 140 or RCW 84.34.108 shall
be due and payable by the seller or transferor at the time of sale. The county
assessor must determine if the land transferred qualifies to continue
classification or designation and must so indicate below. Signatures do
not necessarily mean the land will remain in classification or designation.
If it no longer qualifies, it will be removed and the compensating taxes
will be applied. All new owners must sign.
This land 0 does 0 does not qualify for continuance.
Date
DEPUTY ASSESSOR
(2) NOTICE OF COMPLIANCE (Chapter 84.26 RCW)
If the new owner(s) of prop�rty with special valuation as historic property
wish to continue this special valuation the new owner(s) must sign below.
If the new owner(s) do not desire to continue such special valuation, all
additional tax calculated pursuant to Chapter 84.26 RCW, shall be due
and payable by the seller or transferor at the time of sale.
(3) OWNER(S) SIGNATURE
Description of tangible personal property if included in sale (furniture,
appliances, etc.)
NIA
If exemption claimed, list WAC number and explanation.
WAC No. (Sec/Sub) WAC 458-61-420 (1-1)
Explanation Government� transfer — development
of public right—of—way
Type of Document Quit claim deed
Date of Document
Gross Sale Price $
— 0 —
Personal Property (deduct) $
— 0 —
Taxable Sale Price $
— 0 —
Excise Tax State $
— 0 —
Local $
— 0 —
Delinquent Interest: State $
— 0 —
Local $
— 0 —
Delinquent Penalty: State $
— 0 —
Total Due $
— 0
THERE IS A $2.00 FEE FOR PROCESSING THIS FORM IF NO TAX IS DUE
0 AFFIDAVIT
I certify under penalty of perjury under the laws of the state of
Washington that the foregoing Is true and correct.
Signature of
Grantor/ALyent
Name (print)
Date & Place
Signature of
Grantee/Agei
Name (print)
Vate Place or bigning
PERJURY. PetJury is a class C felony which is punishable by imprisonment in a state correctional institution for a maximum
term of not more than five years, or by a fine in an amount fixed by the court of not more than five thousand dollars ($5,000.00),
or by both imprisonment and fine (RCW 9A.20.020 (IQ.
FOR TREASUREWS USE ONLY
FORM REV 84 0001A (12-93) (PD 12-17-93) COUNTY TREASURER
That portion of Lot 7, Lawrence Addition, as recorded in Volume 19 of Plats, Page 92,
r ecords of Snohomish County, Washington; lying Southerly and.Westerly of the following
described line:
Commencing at a point 5.00 perpendicular feet West of the Northwest corner of said lot;
thence South 004515011 West, parallel with the West line of said lot a distance of 85.14 feet
to a point of tangency of 'a curve to the left and the point of beginning of the line described
herein; thence Southeasterly along said curve having a radius of 40.00 feet and consuming
a central angle of 8904612611 for a distance of 62.67 feet to a point of tangency on the South
line of said lot that lies 51.73 feet Westerly of the Southeast corner of said lot and the
terminus of described line.
CITY OF EDMONDb I nCF..
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
19 G_ 'At V4 (9 0 L9 11-k �P_S
MAILING ADDRESS
7 W # Z
CITY TELEPHONE NUMBER
Fl- b 11.4 O-S 1-779-734
NAME �?_ � C-5. t-V AJ S 6
ADDRESS
'L q 4.
CITY TELEPHONE NUMBER
NAME
ADDRESS
CITY I TELEPHONE NUMBER
STATE LICENSE NUMBER
S ak_\44n):� I I
Legal Description of Property -- include all easements
(show below or attach four copies)
s "T, 6 \)q 4E-
4_1� Z__� NN L-)- 1 11�7 &<3 D e_ —
1- 44- L1 -5 't (n- 0 0 o - 0 0,Ei - 0 14 07
NEW
F�Z]
RESIDENTIAL
PLUMBING
ADDIALTER
COMMERCIAL
MECHANICAL
E] REPAIR
RETAINING WALL
El SIGN
F1 DEMOLISH
EXCAVATE
OR FILL
FENCE
REMODEL
PRE -MOVE INSPJ
COMPLIANCE
I— x _FT)
swim
ETPOOL
_INSP.
WOOD STOVEI
INS APT.BLDG
RENEWAL
i NUMBER OF STORIES NUMBEROF
DWELLING
UNITS A
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
Z
PERMIT
NUMBER
JOB
ADDRESS
[EGAL DE CRIPT41N_CHECK SUBOIVI'SION NO. LID NO.
TESCP
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. APPROVED BY
EXISTiNG_��__ REQUIRED DEDICATION
PROPOSED—,r
:7_LC)__
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED. .
STREET USE PERMIT REQUIRED:
SEE ENGINEERING MEMO DATE
RE
&*2#.�, I,/ f -1 -_
a, P 7 1/f 7 �-,W av -W,
METER SIZE IBUILDING SUPPIA SIZE IFIXTURE
REMARKS
SIGN AREA ENV. REVIEW
ALLOWED I PROPOSED I COMPLETE # EXEMPT
: B
AD : N:O. :
IQ RE LINE.
Cr
Z
0
Z
W
VARIANCE OR CU PLANNING REVIEW BY ATE
YARDS IGHT LOT COVERAGE Z
Z
FRONT SIDE Z
I <
REMARKS . a!
CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
SPECIAL INSPECTOR AREA OCCUPANT
REQUIRED GROUP LOAD
El YES NO I A
_ JOCCUPANCY
REMARKS
PROGRESS INSPECTIONS PER UBC 305 Z
k
PLAN CHECK FEE
Y A BUILDING
J) PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
GRADING/FILL
STATE SURCHARGE
ENERGY CODE
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
2
employees, and agents from any and all claims for damages of
<
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
0
modify, waive or reduce any requirement of any city ordinance
nor I . imit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
information given is,correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and in doing the work authoriz-
THIS PERMIT
AUTHORIZES
ed thereby, no p�rson will be employed in violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
-tion Insvrance. __ /-N 1-11
1 NSPECTION
SIGNATU+ (OWNER OR AGEN DA�Tq SIGN D
DEPARTMENT
17L
CITY OF
EDMONDS
VALUATION I FEE
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his
Deputy; and fees arepaid, and receipt is
acknowledged in space provided.
OFFICIAL'S SIGNATURE DATE
ATTENTION 771-3202
RELEASED BY:
DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3. PINK — Owner GOLD — Assessor
102-87
too
A,
&LOY.
7
AM
7� any
"IT
AM
lot
. IF
Sol
DATE
4r(OpIj
As
rV
MIA,
2 act
12
to
STANDARD DRAINAGE PLAN
Ljppt=-R
CA'Tr-14
SAS%N DETENTION PIPE LENGTH COVTrROL CATCH
BASIN
I' MIN, 2'.MAX covEk
OLrTLrLT
Cowlkoi.!
% SLOPE-4- -1 -1 1 -?— 4"
'TO OUTLET
(N PRA-P OR
RUNOFF
S'PP.EADrV,)
SYSTEM CROSS SECTION
* SEE PAGE 3 FOR OUTLET CONTROL DETAIL
21 . 2, Deep, At.&" SP^LLS 6 WGU^L.)
:2f - 2* 3r IDGEP., V4*- LRUS14ED ROCY,
FPCIM
OLMLET
CON-rROL.
RIPRAP OUTLET
WA314ED &P.XVE*L-) (-OUTFLOW TRENCH, Mkti 10' LONG,
-rOP 4 A- PE-FLF PIPE -170 BE L-P-VeL-
IL
FROM
0 Lr ri. ET
CONTROL
� PERF P%Pr= WITH C4P.5
RUNOFF SPREADER OUTLET
I
NOV 14
DETENTION SYSTEM
PAGE I OF 2
for 5ga L,�) 106 & 0 0 Wke-5 _TKC�-
location Z(t '4uly"t- VIC"i L)r(I
plan by WRAU)&"�D
phone- '77R� -7.;(,.a
date //- L6�- 7
DESIGN DATA
System Imperm Pipe Pipe Orifice
Number Area Diam Length Diameter
NOTES
1. Call Engineering� Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the resvonsibility
of the property owner(s). Material
accumulated in the storage pipe must
be flushed out and removed from catch
basins to allow proper operation. The
outlet control orifice must be kept
open at all times.
Y, Z4
Table 2'- Detention Pipe Len'ths
9
Pipe Diameter
impermeable Required
Area Sq. Ft. Vol. Cu. Ft.
15"
levy
2411
3011
2000 50
40
28,
16
10
2500 62
-�k�50
35
20
13
3000 75
60
42
15
3500 87
70
49
28
18
4000 100
80
56
32
21
45-M- 112
90
63
36
23
5000
100
710
0
25
Table 3 - Outlet Orifice Sizes
Impermeable
Outlet
I
Orifice Diameter�
A rea
Inches
Sq. Feet
2000
5/8
2500
5/8
3000
3/4
3500
3/4
4000
7/8
4500
7/8
C--- �5O 0 �O
i V
NOVI 4
>-Required
pipe
length,
feet
DATE:
MEMO TO: Permit Coordinator, Building Division
FROM: Dan Smith, Engineering Inspector
ADDRESS:
OWNER:
After review of the subject building permit application, we have the
following comments:
1) Construction hours are: WEEKDAYS 7:00am to 10:00pm
WEEKEN.DS/HOLIDAYS 10:00am to 6:00pm
2) A Right -of -Way construction permit is required for any -work on
City property.
3) Conne*ction-to City water system required.
4) Connection to City sanitary sewer system required; obtain separate
permit.
5) Water and sewer lines to be separated by 10 foot minimum.
6) Driveway must be paved a minimum of 20 feet back from City
right-of-way; separate permit required.
7) Driveway slope not to exceed 14%.
1
8) Back water valve required if downstairs plumbing is below
elevation of upstream manhole. I
9) Builder/Owner. responsible for conta'ining all temporary runoff and
erosion control on site. Construction may not impact neighboring
properties in any way.
10) No burning of construction refuse without approval from Fire Dept.
11) Street to be kept clean of debris, dirt, mud, and construction
materials. Contractor responsible for dust control.
12) Inspection required on drainage system, catch basin installation,
driveways, and sidewalks. A final engineering inspection is
�4' -,,O-.,,PrWBCT, MaEW C1MMMXST
PrOJECT' ADDRESS:
Fzo
PLIC-ATION PB=P`ri
CDMMEMS
Revieued
by: (initiaT17
-d-al,
FIRE
PLANNING
WrR/SWR
STRM-
0� G
BUILDING
/MMT=/C0f4ERC
sn=E AMILY IAL - (Circle one)
ACKS, CHJXKED,--, Plannin 9
7TT=T—fT7=
VARIANCE/SErRACK ADJ.
ITIML USE PERMIT
2
111117--l-17-111-TI-7
ADB REQUIREMEMS CEECKED
3
77777777
aIMM ZCNING REQUIRRMM
11111k11
4
EWIRMMEt"AL FEATURES
ACCESS SLOPF & VEHICLE ACCESS
77777777
6
777777
DRAINAGE PLAN (on site)
777777777777777777777
STRErr FILE
8
LEGAL DESCRTMON VFRIFICATION
777777
//////
1111111IT"111111111
/////////
/////////
IT77777T
////////
9
QUIT CIAIM/DEDICATIONS e)q -----77TTIT7TTTf7TIT
777777777-77777777
10
EASEMWr - PUBLIC/PRIVATE
11
CAMTLATE SEWER CON14ECTION IF NO LID#
11"7T
12
PLAT/SURDIVISION RE)QUIRFIIEWS
13
RIGIM-OF-WAY CONSTRUMON PERMIT REr-D
14
BOND REQD FOR PUBLIC IMPROVEMNIS
15
SOILS CONDITIaIS & GROUND
////-/7-/77777T/7777T///R-
WATER FIELD CHECKED
/////////
/////////
///////
16
/////////'777/-/7777
n"
SIREET PAVING REOUTRED
/////////
/////////
17
11177-1
-RT/-7/-T/7
CURB AND GLTITER REQUIRED
//////
/////////
18
777777-77777777T
SIDEWMLK REQUIRED
/////////
19
-
111111111177T77TIW
1771111111
CURB CLYr FOR DRIVEWAY RECO
/////////
/////////
20
-
7777�77//
1111777777
M?JXf NAME SIGN REQD
21
777T17T17
OTIEM SIGNING RECO
/////////
22
777-777
7TR11111
SIDE SEWER AVAILA13ILITY
23
EXISTING tMIM MATN SIZE
TITTITr=TIV
///Y/////
24
-
17TI77TFI
777777T/7
W%TER �� SIZE
25
-
1111IT777771711
//T/7T/7
77777.77777
SERVICE LINE SIZE
26
HYDRAMr REQUIRED
7 7 7 7 7 7 7 7
777T/TIT
777TT=
27
--17T17T
I-ITTI-17T
7 7 7 7 7 7 7 7
-
HYDRANr SIZE EXISTING
//////
28
CROSS CXMECTION INSPECTION REQD
T/ TF1 T
/ TTI TTT1 T
2 9
[11177771-1-1-7
11171111777-1-71-17'
VATER MMIER a 1ARGE REM
/////////
////////
30
77/7777.1/
-177T17Tr1-7
-
FIRE LINE CMRGE REQD - SPRINKLER
111171111
31
STREET cur
32
OPEN DITCH EXISTING
33
T17TIT
7TI177TIT
REOD
/////////
34
777T/T77///////
171-Flll—ll
7
CULVERr REQD
35
SIZE
36
CA'Mf BASIN REQD
77777T
//////
1-117-11111'777TRTIT
/////////
/////////
37
777771
77777771-
INDICATED ON SITE PLAN
//////
/////////
38
SHOULDER DPAIMGE MAIMMIN
777777
T/7777777
7771-1 /7
SHALE OPEN RUNOFF
//////
/////////
/////////
39
11111111T
-//77T/77T-A-
MISC:
40
im.
NORKS
REVIEWED BY:
PLANNING tCR. ENGINEERING MGR.
PUBLIC WORKS MGR.
B. 0 Contractor
Permit No. Ty J ? ( !
Issue Date Z/C)
. S&vy\e--
R-arrie
Mailing Address
City State Zip
Ck V-) a �-
, ts? C-0 ?jt 7 3(,oq
State License Number Telephone Numbei
60Y, OF EDMONDS
COMMUNITY SERVICES DEPARTMENT c%-OrREET FILE
RIGHT - OF - WAY CONSTRUCTION PERM19 I
A. 9 Owner -
Name
r7s-�)o _a I a 'so
M a Vg
ili Addyss
A4 % L L
City"' - State Zip
C. 9 Address or Vicinity of Construction:
I I-—
Type of Work to be Doqef4_4-,ff,_4a
D. * Work in Connection With: 0 Sub or Plat Single Family F1 City Projects
Y"
El Commercial El Multifamily El Utility
E. 0 Pavement Cut: 0 Y VN F. 0 Size of Cut: — X'
APPLICANT TO READ AND SIGN
INDEMNITY: 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, forseen or unforseen, that may
be made against the City of Edmonds, or any of its departments or employees, including or not limited to the defense
I
of any legal proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF,QNE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Estimated restoration fees will be,held'until the final street patch is completed by City forces, at which time a debit or credit will be
processed for issuance to the appilcant.
e A 24 hour notice is required for inspbcti6n; PY'ase call Engineering: 771-3202
is Work ig,to be inspected during progress and at completion.
• Restoraeion to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above- nd that is permit must be available at the job site for inspection purposes at all times.
Signature-. lxzZ Date:
Owne o 6ontractor
701
'Oe Posted at the Job Site For Inspection Purposes
This Permit i's
C�g I�L-A-DIG Prior to Beginning Work
APPROVED BY: 71, )')1
Z Time Authorized: Void after 3Q—days.
0
W Special Conditions:
U
:,RELEASED BY:
PERMIT FEE: 30
Restoration Fee:
Receipt No.: 1051(09
Fund I I I Fee:
Street Cut Dimensions: _-7- x - = $
D ate INSPECTED BY
Date
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE.
Eng. Div. March 1989
FIELD INSPECTION NOTES (Fund I I I Route copy to Street Dgf)
Comments:
Diagram:
f
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
r,ng. viv. July .
CITY of EDIVIO
For Inspection Call 77<ee
Address of Construction:
SIVE St WE R P,�E R M I T
PERMIT No.
Property Legal Description (include all easements):
Lo-T- Stavt��o 7r-octs,
Owner and/or Builder: �1_s e-,�tcA—)60 D dn�ln e, <-
Contractor& License No: L,__�6 6(f-
Single Family Residence
Multi -Family (No. of Units
TREANMENT PLANT
Comme,rcial (No. of fixture Units"
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.)
HE ITEMS LISTED ON THE BACK
with the items 1
on the back.
R EG E I V E 1D
JUN 81989
PUBLIC WORKS
Date
Permit Fee:' Issued By: 7�)
Trunk Charge: kate Issued:
Assessment Fee.: Receipt No.:
Partial Inspection:
Comments Date Initial
Final Inspection Approved: dy
-It
co
I— : .. Rejected:
C:)
Ln
White Copy File
'Date' - Tf�itial , .
ason
** PERMIT MUST BE POSTED ON JOB SITE **
Green Copy -'Inspector
Date —T—nitial
Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing EASEMENT NO - --------------------------------------------
# NEW CONSTRUCTION Eg*'� REPAIRS F� LID NO . ............. ---- ASMT. NO - ------------------
'OWNER ... --------------------------------------------------------------------------------------------- CONTRACTOR -��F-As4m--)k ..... Oo. --------------------------------- PERMIT NO.
JOB ADDRESS
-- --------- 6--b ------- .... N e -------- \A--t LEGAL DESCRIPTION: LOT NO . ...... �L� -------------------------- BLOCK NO - ------------------------------------
6k 10 cl Ar T p c) Ic- R T, AV p-
10
iPWW-0001-11/75 (REV.11/78)
---------------------------------------------------------------------- ------------------- ------------------------------ - ------
7 -7,�-
IDS
DAON
NAME OF ADDITION --------------------------------------------------------- P-L6NT,�
--------------
a I
0 b
tq
DATE . .... ........
--- (--3 -------- 1�--? --------- I ---------------------------
f
N
-------------------------
NOTICE:
-N 0---wa rr a
The information shown on the attached of
map(s) was compiled for use by the City
Edmonds/ its Employees and Consultants.
Th,e City of �Edm.onds does not. warrant the
accuracy of anything set for.th on t. ' hese
Map(�-). Any person or entity -requesting a
copy should conduct an independent
0 at'on shown on
inquiry regarding the infi rm I 1m1ted to,
_tFe -map(S)i including, but not J -h
th . e lociation of any sewer stub shown. Suc
sewer stubs may or may, not exist. and may
or may not exist at the location shown.
Neither the 'ity of Edmoind's nor its
emp-1-o-yee-s o-r office-rs -sh-a-I'l be 11a-b-[e for the
information given on this map(5), nor for
any one representation provided based
upon'said map(s),
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