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18219 76TH AVE W
CITY OF EDMONDS
EYNEW
1:1 ADDITION
El RETIREMENT
ASSET INFORMATION SHEET
SGMEET FILE
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION DEPTIW
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
*PROJECT NUMBER
PROJECT COMPLETION DATE
COST o
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
G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO.
INITIAL
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STREET FILE
ENGINEERING A PUBLIC WOR)
- 2CITY OF EDMONDS PROJECT REVIE
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-r SINGLE FAMILY RULTIPLE COMMERCIAL CHECK LIS
PROJECT NAME &Z- 7- 'CONTACT NAIIE TELEPHONE NUMBER
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ACCESS SLOPE AND VEHICLE ACCESS
DRAINAGE PLAN
STREET FILE
LEGAL DESCRIPTION VERIFICATION
QUIT CLAIM/DEDICATI.ONS
EASEMENT - PUBLIC/PRIVATE
CALCULATE SEWER CONNECTION IF NO LID i
STREET PAVING REQUIRED
CURB AND GUTTER REQUIRED
SIDEWALK REQUIRED
CURB CUT FOR DRIVEWAY.REQUIRED
RIGHT-OF-WAY CONSTRUCTION PERMIT REQUI
BOND REnUIREn FOR P1101lr TLlDDnvruruTc
STREET NAME SIGN REQUIP
OTHER SIGNING REQUIRED
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(ADDITIONAL COMMENT!
EXISTINCI WATER MAIN SIZE A/
WATER MAIN REQUI REn
SERVICE LINE REQUIRED
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HYDRAUT SIZE EXISTING
HYDRANT REQUIRED PER FIRE C09E AIA SIZE
CROSS CONNECTION INSPECTION
WATER fIrTER CHARSE REQUIRED
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REVIEW BY DATE
(ADDITIONAL COMKx-
SANITARY SEWER OWING NUMBER
FILE ML94BER
SIDE SEWER AVAILABILITY SANITARY SEWER C0111ECTION FEE REQUIRED
OPEN DITCH EXIS71116, f 4�
CULVERT REQUIRED
CATCH BASIN REQUIRED -1
REQUIRED
SIZE
INDICATED ON SITE PLAN
SHOULDER DqAIKAGE MAINTAIN COLLECTI011 ON SHALE OPEN RUNOFF
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RUNDLE REQUIRED 1&410 AJNDICATED 04 SITE PLAN
SOIL COUDITIC104"40UND R FIELD CHECKI'D
ON
REVIEW
DATE (ADDITIONAL COMMENT.
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CITY OF EDMONDS ZONE
CONSTRUCTION PERMIT APPLICATION joB
NAME (OR NAME OF BUSINESS) 1ADDRESS
S7os
PERMIT
NUMBER
ILING ADDRESS
pit- !�i
Y TELEPHONE NI.
Pmblo-S 17742
NAME
ADDRESS
S
TELEPHONE NUMBER
TELEPHONE NUMBER
STATE LICENSE NUMBER . I CITY LICENSE NUMBER
Legal Description of Property - include all easements
(show below or attach four copies)
NEW
EkRESIDENTIAL
1:1 PLUMBING
ADDIALTER
NON-RESIDENTIAL
0 MECHANICAL
REPAIR
RETAINING WALL
F] SIGN
EXCAVATE
1:1 DEMOLISH OR FILL
PRE -MOVE INSPJ
COMPLIANCE INSP.
FENCE
( x _FT)
swim
POOL
50 SIDE SEWER WATER LINE
F]
0
FJ
E]
NUMBER OF STORIES
"2
NUMBEROF
UVVt:LLINki
1 UN11b
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
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D NO.
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
PROPOSED
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED
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STREET USE PERMIT REQUIRED 0
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SEE ENGINEERING MEMO DATED
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SEE PIW DEPT. REVIEW CHECK LIST DATED.
REMAR S
METER SIZE
UILDING SUPPLY SIZE __TURE
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UNITS
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REMARKS
SIGN AREA
ENV. REVIEW
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ALLOWED I PROPOSED
COMPLETE I EXEMPT
VARIANCE OR CU
NNING REVIEW
YARDS 75F 'I.
LOT COVE
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FRONT SIDE REAR -7,-J? /0
By ITYPE OF
HEIGHT
SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
REQUIRED GROUP LOAD
0 YES f-7. NO I I I
PLA14 CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on p rivate property ONLY.
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
GRADING/FILL
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
o successors in interest, agrees to indemnify defend and hold
3 harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
i whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of this permit shall not be d Berried to
modify,. waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I 'agree to comply with city and
state laws regulating construction; and In doing the work authoriz-
ed thereby, no person will be employed In violation of the Labor
Code of the State of Washington relating to Workmen's Compensa-
tion Insurance. i
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
NSPECTION
DEPARTMENT
CITY OF
C r1% " f'%
WNER ORrIENT)
SI N URE (0 -InATE/G
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ATTCKlTlnKl 771-3202
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 0 UG
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBA
CHAPTER 3.
102-78
VALUATION
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged In space provided.
OFFICIAL's SIGNATURE
DATE
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91984 ORIGINAL — File YELLOW — Inspector Li
PINK — Owner GOLD — Assessor
Kelyo, Pg - E-01o, WA . 175 9494
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CITY OF EDMONDS
71
WWO-DEPT.
CONDITIONAL
WORK --A"
ADDRESS-
OWNE
APPROVED DATE -
BY
BLDG.OFFICIAL
KEE ' P THESE STAMPEI)l
PLANS ON'JOBSITE FOR
ALL INSPECTIONS
PERMIT NO. SHEET
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AUG 91984
G3
MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Publ ic Works Department
SUBJECT: /F21c? 71—`�I,�e
DATE: X
A,//
After review of the subject Building Permit application, we have the following
comments:
1. Connection to City water system required.
2. Connectio - n to City sanitary sewer system required.
3. Right-of-way oermit.required for any work on City property.
4. Driveway slope not to exceed*14%
5.. Backwater - valve required if downstairs plumbing"is below elevation of
upstream manh-o7e.
6. Water and sewer lines to be separated by 10 foot minimum.
BD 6/82
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CITY of EDMONDS
For Inspection Call 77:
I ZMEET FILE
Address of Construction: / 06J, / ( , 7 6
SIDE SEWER PERMIT
PERMIT NO�212 - -----
7 _7NNWOOD LINE
Property Legal Description (Include all easements):
L
Owner and/or'Builder:
Contractor & License No:' C�_
RECEIVED
Singl:e Family Residence
.00T 2 �q 7984
Multi -Family (No. of Units
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No Yes (If Yes, Right -of -Way
Construction Permit required. Call O�e-Call-Cente_r (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 READ THE ITEMS LISTED ON -THE BACK
C�
I —certify that I have read and shall comply Dat6
with the items listed on the back.
Permit Fee: 30,00 Issued By: A41 041"
Trunk Charge: C)C) Date Issued:
Assessment Fee:— Receipt No.:
Partial Inspection:
Comments Date Initial
Final I nspection Approved:
Date InitMl
Rejected: Reason —5—te 7—nitial
PERMIT MUST BE POSTED ON JOB SITE
Wh.ite'Copy File Green Copy - Inspector Buff Copy Applican t4__
The City of Edmonds Side Sewer Drawing EASEMENT NO - ---------------------------------- ---------
NEW CONSTRUCTION REPAIRS 0 LID NO - ---------------- - -ASMT- NO - ------------------
OWNER. ---------------- CONTRACTOR B --- OA ----------------------------------------------------------------- PERMIT No.
"-OMF-5 -72
U2
JOB ADDRESS AS J!7 ----- !M ------------------ LEGAL DESCRIPTION: LOT NO. --:i� -------- ------- SP ----- BLOCK NO. � ----------------
LYNNWOOD LINE
----------------------------------------------------------------------- --------- --------------------------- ---------------- —
'72'
E
PVM-0001 -11/75 (REV. 11/78)
NAMEOF ADDITION . --------------------------------- --- -------------------------------
14, 1
is'
161
All- c.ozAP VDP-
To SURFACE
Approved:
DATE--------- BY - -------- -4 -------------------------
94 lqlqq
CONFORMED COPY
Return Address:
City Clerk
City of Edmonds
121 - 5th Ave. N.
Edmonds, WA 98020
n IA -
200011160233
11/16/2000 11:45 AM Snohomish
P-0001 RECORDED County
NO EXCISE TAX
r
179, E D
TEMPORARY CONSTRUCTION EASEMENT
Property Address: 18219 — 76"' Avenue West, Edmonds, WA 98026
Assessor's Property Tax Parcel No.- 3708 003 005 02 06
"'Ov 2000
CUM' 1Y Treaswer
11 A tjL
I �y__
IN CONSIDERATION of benefits to accrue to the grantors herein, the undersigned, Ronald and Helen
Peluso, in exchange for Two Thousand Dollars and No Cents, hereby grants to'the CITY OF EDMONDS, a
Municipal Corporation, from the following described property:
Lot 5, Block 3, Admiralty Acres, according to the plat thereof recorded in Volume 12 of Plats, page 48,
records of Snohomish County, Washington.
EXCEPT the north 89.46 feet; and,
EXCEPT the west 158.00 feet as measured along the so uth line thereof.
SUBJECT TO and TOGETHER WITH the terms and conditions of that certain "Notice of Easement and
Maintenance Agreement" recorded under Auditor's File No. 8403140190, records of Snohomish County,
Washington.
TOGETHER WITH a non-exclusive easement for ingress, egress and utilities over that portion of -Lot 5,
Block 3, Admiralty Acres, according to the plat recorded in Volume 12 of Plats, Page 48, Records of
Snohomish County, Washington.,
a temporary construction easement to be used only during construction of a sanitary sewer main and appurtenances
on adjacent property, togethermith the right of access to the easement at any time for the stated purpose, and the
further right to remove trees, bushes, undergrowth and other obstructions interfering with such access or with the
Construction of said sanitary sewer main apd appurtenances, -said tcm�arary-cascrnent off
the sewer main for maintenance and operation by the CITY. The temporary easement hereby granted is located in
the COUNTY OF SNOHOMISH, STATE OF WASHINGTON, and is more particularly described as follows:
The shaded area of the subject property as indicated on the attached Exhibit 'A', included herein by
reference.
THE CITY agrees to restore to substantially the original condition such improvements as are disturbed
during the construction of said sanitary sewer main and appurtenances, provided the grantors, their heirs, or assigns
shall not construct any permanent structure over, upon, or within the temporary easement during the existence of said
easement, provided hirther that grantors and the City agree that the surface of the temporary construction easement
area shall be covered by the City's contractor with five -eighths to minus crushed rock to a depth of four inches upon
completion of the project, if not sooner, and provided further that such coverage shall not exceed two thousand
square feet.
The right-of-way, during its existence, shall be a covenant running with the land and shall be binding on the
successors, heirs, and assigns.of both of the parties hereto.
DATED THIS DAY OF _2W
STATE OF WASHINGTON)
) ss
COUNTY OF,SNOHOMISH)
On this day personally appeared before me AciA14 io PEL066,4 AID 9,Sl-fAl iD&)-US0 '
to me known to be the individual described idand who executed the within and foregoing instrument and
acknowledged that t%lfll signed the same as .7-14e-lk 'free and
voluntary act and deed, for the uses and purposes therein mentioned.
IR MY HAND AND OFFICIAL, SEAL THIS DAYOF
,2000.
� ,/7
_eip _� _JAtjeT
NOTA#y PUBLI in and for the tq_irr9ik
JANET FLETCHER S eof �shington,rtsi Ig at
3TATE OF WASHINGW't
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