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18236 ANDOVER ST.PDFIIIIIIIIIIIIII 10179 18236 ANDOVER ST P District City of Edmonds — Water Department TAP CARD Reading: (000 Date I o-)- ' /I No. No.' -!� ti Meter { Size Tap { Size Mfgrs. No!. Style .-)qL4)SR Purchaser: 1!� k t'-9— 14 Serv. Add. le�_-,sLo AL631,�,, Grx_uk Lot No. Add. Residential: Other: Blk. No. Meter Location / 0 "W, OF �W- ERO,61 FPq DOOR OA17 Service Material: Pressure4�5 lbs. Test % Date of Work 121p,)IRA ce_C,22�� Foreman Guar. Voucher. No. $ Proj. No: Remarks: OUTGOING Inclex- Reg. -Route Bk. ' Stencil -Card INCOMING inclex- Reg. -Route Bk. & Stcncil-Card 0 ROUllNG SUP NEW SERVICE INSTAUATIONO ADDRESS: l6a5�. L�6uj,(-- aaa±. DATE: tc�-/t 4 /e e DIAL A DIG # P.U.D. TELEPHONE STREtT FILE CABLE T.V. GAS FOREMAN STORM SEw�Ou"ll" OTHER FUTURt SERVICE INSTL: YES NO BORE: CUT: LOCK CREW DATE: INITIAL: UNLOCK ,DATE: )a--,/aJ44TNITIAL: METER SHOP ACCOUNT NUMBER: 3 3 3 SUPPLIER: PrLD Oe//-� TREATMENT PLANT FOREMAN E B OL T FOREMAN INITIAL: DATE: TAP CARD METER SHEET APPLICATION/ UTILITY DISPATCH I BILLING 7/76 TAX ACCOUNT/PARCEL NUMBER: 2-7 0 41 S 0016-21 DO BUILDING PERMIT (NEW STRUCTURE): _1(AgV01-NeFP,) COVENANTS (RECORDED) FOR: CRITICAL AREAS DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: M 3 PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED:—Q I I � I � SEWER LID FEE DETERMINATION: Ej Conditional Waiver E] Study Required [] Waiver LID #: 131. SHORT PLAT FILES - z - &%� LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: GEOTECH REPORT DA STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DATED: - I LATEMP\DSTs\Forms\Street File Checklist.doc 5 1 T.F -P L Jt�, N . ICe—T -. I-- ZOLO H,I,E Cr H T C A. L..0 15 C-Iry osr ejD%4q:)tAv5 + 'o. dr Wk. uj Th to-z 4- 0. AD LL- c3. FcwRT,,NT R) OCg *;Z'F. T2 5 URI Lij lu AV It Pao" co CO -1. L- c, Lvw,�*c -1 go .2 a. a (D I 1 4 1 .1. -1 1 13, z I I A t A +0. 15' -L Cb 40 + Al 4Z.. <, &S STOARD DRAINAGE PLAN' DETENTION SYSTEM PAGE I OF -2 for qt=4 lotation4wiftle1j" 40 plat) by j4p phone./—CJ Z—.3le 01 IF dat - DESIGN DATA ,.System -Imperm -Pipe Pipe �Orifice­ Number c:Area' Diam Length Diameter - - , -, , � 1 1 A , /I 1 41, / . I I �kr.fflr__Iasm NOTES 1. Call Engineering Division (7.71-3202). jor prebackfill and final inspections. 2. Responsibility for operation -and'. - maintenance of drainage systems on. private*property is the resDonsibility 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 op�n.at 11 Wmes. to 3 ss 4 �'CITY OF EDMONDS 51TE 'PLP-,N 0, LOT 3 .. ...... CiTY H I E G'H c + yb* to -3 c 4- 0. T ]D + 0. t -ro *r Ab + U CrWT AT rb IOCrW GA ;ZY W re.TvrA Pr AV r. far."-" qO 0 CD* 1 .1 . . -j , 90 L co Z-: L AL C. ID 21 C 1 -1 T Y o . f E . D M '10 S SIS SEWEIR For Inspection : Call 771-3202 STREET FILE PERMIT NO. Address of Construction: P E R M I T 0 Property Legal Description (Include all easements): La -3 11�s a-252) Owner and/or Builder; Contractor & License No: Single Family Residence �-.L) M 0 N D S 'A�TPMENT PLANT Multi -Family (No. of Units =� Commercial (No. of fixture Units Invasion into City Right -of -Way: No V0'0' 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,-6,asement required, attach legal description and county easement number.) PLEASE READ THE ITEMS LISTED ON THE BACK L) DEC 151988 Iz-4 02) 1 ce tify that I haN -s-F-a-l17 comply Date wi't the items listed on the back. PUBLIC WORKS r Permit Fee: ;fIssued BY: Trunk Charge: tDate Issued: Assessment Fee': Receipt No.: 740 Partial Inspection: Comments Date Initial Final Inspection Approved: Date Initial 00 Rejected: b S CD Reason V tial _�a_ t _e n -i PERMIT MUST BE POSTED ON JOB SITE Wh-ite Copy Fi l.e Green Copy -'Inspector Buff Copy Applicant City of Edmonds Side Sewer Drawing NEW CONSTRUCTION [0 OWNER------------------ ---------------------------------------------------------------------------- JOB ADDRESS .11A.3te ....... -------- S� EASEMENT NO. REPAIRS [3 LID NO - ------------------ ASMT. NO - ------------------ CONTRACTOR .... --------------------- PERMIT No. LEGAL DESCRIPTION: LOT NO - ---------- 13 -------- --------------- BLOCK NO. - - ---- - -- ------------ ---------- -- ELD,"v10 DS -------------------------------------------------------------------------------------------------------------------------- E-T-R-E-ATMENT !-.PLANRT — _0 NAME OF ADDITION -------------------------------------------------------------------------------------------------------- ------------------- CAP CDP. 2. 3 Co isbe t T4. F- 0 I.; 5.5 0 P. 1 5 P, MP VAfJL.T RUM. I 'P.U.b 0.1 WCA ISZ132- I',' ID 0 -\/ F— 8"Xfbo SA0014 CONN Approved: PWW-000 1 - 11/75 (R EV. 11178) DATE ... L-2-6-7.89 ............. By 01 6. 9' F/14VO. It- of: Q I MY MON ONDS LA-St-0, -795- - , �NE W ADDITION RETIREMENT STREET Fl�gjoj . NFORMATION SHEET ASSET NO. 6--7 ADDITION TO ASSET NO. DESCRIPTION SERIAL NO. LOCATION DfiPT. NO 1s:=p,34- /061y PURCHASE ORDER NO. PURCHASE ORDER DATE rl kyp) COST PROJECT NUMBER' Z, e, /p, --o /. c > PROJECT COMPLETION DATE COST glp, ,� B.A.R.S. ACCOUNT NO. ESTIMATED LIFE INITIATED BY DATE APPROVED BY **SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY F�DEPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT G.L. ENTRY REFERENCE DATE INITIAL DEPARTMENT FILE �4L VERIFIED BY PROCESSED BATCH NO. IT�tDF EDMONDS W loc. , Wit No. /L9 COMMUNITY SERVICES DEPARTMENT STREET FILE Issue Date RIGHT-OF-WAY CONSTRUCTION PERMIT A. 0 Owner: c­�;,,ve lholltOlroll &a Ilee �/. 4y, Oddress &no City StatC Zip Address or Vicinity of C tru ti Type of Work to be Done- B. e Contractor: <*04 e__ Name Mailing Address City State Zip 516 V'F1_16Z0y111111 State License Number Telephone Number I/ - Work in Connection With: El Sub or Plat X Single Family 0 City Projects El Commercial El Multifamily 0 Utility Z < Pavement Cut: k El N U APPLICANT TO READ AND SIGN a4 a4 < 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 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 ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. 0 U Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed W by City forces, at which time a debit or credit will be processed for issuance to the applicant. • A 24 hour notice is required for inspection; Please call Public Works: 771-3202 • Work is to be inspected during progress and at completion. • Restoration 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 ve that this permit must be available at the job site for inspection purposes at all times. Signature:, Date: /44/' dc..) Owvner or -'Contractor This Permit Must Be Posted at the Job Site For Inspection Purposes Call DIAL -DIG Prior To Beginning Work Zo >� ISSUED BY: '2h PERMIT FEE: 0_� Z Time Authorized: Void after 30 —days. Security Deposit: 0 W Special Conditions: Receipt No.: — Fund 111 Fee: U Amendments: Street Cut Dimensions* 2-1 2 X 0 4� NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. July 1985 FIELD INSPECTION OS IS I I I - Route copy to Street tept.)J� Comments: Diagram: a CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. July 1985 F_ Z U 0 U W PQ 0 F_ >0 0-4 Z 0 U 1:4 0 44 CITY OF EDMONDS qW Wit No. COMMUNITY SERVICES DEPARTMENT STREET FILEIssue Date RIGHT-OF-WAY CONSTRUCTION PERMIT A. Owner: Washihqton Natural Gas B. .9 Contractor: S ame Name Name 805-156 AXT Mailing Address Mailing Address WA 8�00 7 city State Zip City State Zip 9 Address or Vicinity of Type of Work to be E Work in Connection With Pavement Cut: 0 Y 0 N AA7,07on State License Number Telep'h6he''gumber gas'seY-iFice-installati.on 0 Sub or Plat El Single Family El City Projects 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 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 ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCjEPtANCE`bF THE WORK. Funds held from the Security De posit, (estimated restoration fee) will be held until the final street patch is completed by City forces, at which time a debit or credit -will be processed for issuanceto the applicant. o A 24 hour notice is required.for inspection; Please call Public Works: 7.71-3202 e Work is to be inspected during progress and at completion. 9 Restoration to be in accordance with City Code. * Street to be kept clean at all times. 9 Traffi� Control to be in ac . co.rdance, *ith City regulations. 0 All street -cut ditches must be patched'with, asphalt or City approved material prior to end of working day-, no exceptions. I understand. the _14V,,A�d th t thiUp lkvpla a eTdr'rn tp b �ble at the job site for inspection purposes at all times. Signature-. Date: 11-16-88 Owner or Contractor This Permit Must Be Posted at the Job Site For Inspection Purposes Call DIAL -DIG Prior To Beginning Work ISSUED BY: C-a�). 0�4,g� Time Authorized:. Void after — I \30—days. Special Conditions: Amendments: PERMIT FEE: 0 Q A b(- ZttK& CC, — Security Deposit: Receipt No�: Fund I I Pfee: Street Cut Dimensions: X NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. July 1985 Eng. Div. July 1985 E 0 v8- Sw o 0 PC IP usmrLN 19BI N tilt 300v 1,48fa co 04513r7 Do 3 w 0 Go to -A& N '800 1943 i Q% to- .3 0' PVT RD 8021-8019 774- Pic tp Zow 5 afmr Lm lit 375T OWN cr w > 0 z 181 PL SW 8023 W -P L, S W - - - - - - - Ma; 14 ts .7 I" STW IP t1,r.* !4-S S(W [OCEPAVMEWT 67C It 183 7 J. 4 I' SER TEE ,d m*4 t, 3: 9108 00 io I vo IL fn -ST SW (PVT RD) u *er.44's 0(19 liar. 415 /* 1044 182 PL SW -510' VA; S lite -1 to 1965 zo Z cn -j 0-1 F 1,9 7* to (183 STS w E LW 0 0 DI AV %A is !n _!LI'307' 11107 '590*3 lacy cn ki ---VOW" co 1967 0 0 OD soot 41165 A OD w 813+ aliz 0 z O� kjkI P, -Owl 184 0, ST k 1: S w 184 7pq*s 2-srw ip I z's z,,srw ip ws -01SY-AV11- 6 'IV -STW IP &',v cu (e-j LX- 68C otr 66CO37 T PR0= REVIEW CIMMIST . I RD= NAME- PROJBCr ADDRr.SS: ppLICATICv r*=I?r DATE: qhb, ls�k L L r. j I I !�ev �eweE by: (initial/!date) ' COMMM PIAMING FIRE MIMING wrR/swR STREMET 7/////T ENCVRNGj IN= FAm:rLy/,%mT:rPLE/CCNT4ERCIAL - (Circle One) Ul .,TBACKS CIMCKED - Planning VARIANCE/SF.TftACK ADJ. )NDITIONAL USE PMNIT -/F/777/7 -7 -77-7-77 17TRI 7 T7 77 7 M REQUIREMEMS CHOCKED ////// — ///////// //////// 777T/7 7777777777 MER ZONING REQUIRFMEMS \]VIRONNF1?rAJ. FEMURES 77777777 CE:SS Sjjopp & VENICTY, ACCESS 7777=7777T/77--//////// ftkTNACE, PLAN (On Site) Ig' 1111171ITTIT777777'777TI-TI-I fTdMT FILE P,GM, DEscRivrim vrniricwim 1111777,77771111 1 JIT CIAIM/DFDICATIONS ///////// 11111IT1777777TRI PLJBLTC/PRTVAq`E t-jjMATE Sr..WER CoNjqSCTIoN IF NO LID# 71-RII 777—///// f.AT/SUBDrVISICt1 R1T-UIRrMEVM //////// 1 7TRII 77TI-71177 7—////////. IGIrP-OF-WAY CONSTRUCTION PERMIT RFf-)D 06 -77777-T/77 11171-1 r)ND REKo M-R PUBLIC IMPROVE7�� ////// -1-IT177-17T ///////// 011S C(MITTMIS & GROUND NIE'R FIE11) CIMCKIM 77777T -777 7717-1111 7 1-7 T/T/77777 7777777 7 Z// :IfTUMT PAVrNr. REQUIRED 777TFI 7 -//-/7/777 — 7 R7777TI-I AND n�ypfER REXAJTRED .,jM V/777 TF[/7/r/77 ;1DEWALX REMIRED ////// Tfl-I ///////// -17F�IVIR�W7 - 71 777T/ Frl 77 .uRFi Cur M-R DRIVEWAY REOD /-f/7/-/7/7 7 7 . i 111Rwf NAME SIM REOD 77777777— 777T7TIT17 MnM ST(NTNG RECID 777-77 77777T/7T 31DE SEWER AVAILABILITY '////// ///////// MSTI14G WIT-R MATN SIZE 7 7r/7 5 -/ On J1177TIT T/71////// T/ —77 77 !/��J777777777 / 141 7 7 7 7 7777 77T7-/ /-/ F1 ,p\TER �� SIZE /77777/77777 7T 7777 cMIVICE LTNE SIZE ///////// T177TIFIT771111111 777TI77T777T777777' JYMARr RB--XJIRED ///////// ///////// //////// 7TT1777TR' 7TT17 7T/777T/7 ifyDRAM SIZE EXISTING 7T[F/7/7 T/T/77777' MOSS CONNECTICN INSPECTIM RECD T7-777777 IWATER METER CIMRGE REOD 777777 7777T/7/// FIRE LINE CHARGM REM- SPRI14KLER STRM cur 117T17-717-11117MR111111 OPEN DITCH EXISTING ///////// 1; 7717 REQD ///////// TITF77111111 777777777 C[JLVERT REQD ////// ///////// ///////// 111777-TUU1777 SIZE CAMf BASIN REQD /77777 77T77T/77T/77///// INDICATED CN SITE PLAN SHOULDER DIUdMGE MAIMMIN SfiALE OPI-N RLINOFF MISC: ILIC WORKS 7 D 1 2 3 4 5 6 7 9 0 I 12 '3 15 �6 ?7 28 29 30 31 32 33 34 35 36 37 38 39 40 REVIEWED BY: /;" elA� — PD�RNNMNG - MGR. ENGINEE G MGR. PUBUff WORKS MGR.