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18403 90TH AVE W.PDFlill 11111111 8753 18403 90TH AVE W ADDRESS: IE4�)3 `?0-P' AVC-- W TAX ACCOUNT/PARCEL #: On&38900001600 BUILDING PERMIT (NEW STRUCTURE) #: COVENANTS (RECORDED) FOR: CRITICAL AREAS #: DETERMINATION: 0 Conditional Waiver El Study Required 0 Waiver CRITICAL AREAS #: DETERMINATION: 0 Conditional Waiver Study Required E] Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORD FOR: PERMITS (OTHER — list permit #'s): PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID#: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: ',7 GEOTECH REPORT DATED: STREET USE/ENCROACHMENT PERMIT #: FOR: WATER METER TAP CARD DATED: OTHER: LATEMP\DST'skForms\Jana's Street File Checklist 5-14-08-doc Corner—tFlag—N BY NNING Zone A OVED 4BY Nom-rH Setba k A�--R Uir d ct al Ll Sides� G.. 0 I A ul Rear M A - Ul Other I 7-k 91 lLe& 1�y vi <— reO I CAtxy Ll WE 0s F r> P M9, Z", �K- Ab 01 A, A rn o -"n 0o L UJ CL 10 vol rn RECEIVE:r) MAY 0 7 2009 DEVELOPMENT SEFJvICE� CTFI. CITY OF EDMONDS 94Y. 0, RA P v_rr-T Ir LWIL t> 3(5f FmzrX Prz-opvzTr\� L-INIZ —to cvAj*rFiz OP 0 PLANNING DATA* Ls—TREET FILE --I SINGLE FAMILY RESIDENTIAL Name: Date: 0 Site Address: tBqd Plan Check 0 Project Description: )4 Reduced Site Plan Provided: NO) Zoning: Map Page: Corner Lot: E /NO) Flag Lot: (YES kN11 Critical Areas Determination #: CT-A-)�c)61 Study Required W . �waiver SEPA D�.termination: Exempt Needed (for over 500 cubic yards of grading) 0 Fee El Checklist 0 APO List with notarized form Required cks Street: Side:.!> 1 Side: C 01' 1 Rear: A ctual Setbacks StreeY- kil %Z/ ga Sid Side: cr� o El Detached StrJctures: 11 Rockeries: El Fences/Trellises: El Bay Windows/Projecting Modulation, WStairs/Deck: Dulluin Height Datum Point: Datum Elevation: Maximum Height Allowed: Actual Height: Other Parking Required: Parking Provided: Lot Area: Maximum Lot Coverage: 35% Proposed: Lot Coverage Calculations: ADU Created: (YES / NO) Subdivision: Legal Nonconforming Land Use Determination Issued: (YES / NO) Comments Plan Review By: Planning Data Form 04-11-061oc NOTICE: The -information on the attached map(s) was com ' piled for use by the City of Edmonds/ its Empl.oyees and Consultants. Th...e City of*Edm.onds does. not. warrant the n these accuracy of anything set for.th o M entity *requesting a ap(� Any person or copy should conduct an -independent inquiry regarding th*e info'rm,*at1on shown- or tFT�2 -map(s), including, but not limited to, -er stub shown. Suc the lotation of any sew t and may sewer stubs may or may* not e.xis. or may not exist at the location shown. Neither the city of Edmonds nor its ernpl-o-yee-s o-r office-rs -shal-1 be I-Jab-[e for the information given on this map(5), nor for ided based any one representation provi upon said map(s). APPLICATION The City of Edmonds for EASEMENT NO - - -------------------- -------------- SIDE SEWER PERMIT ASMT. NO. -NEW CONSTRUCTION REPAIRS 0 LID NO. ------- OWNER ........ H-(�-t,AFE .... ------- .......... CONTRACTOR - -------------- ..... .................... PERMIT NO - -------------------- JOB ADDRESS .... ------- LEGAL DESCRIPTION: LOT NO - ------------- ------------------- BLOCK NO - ----------------------- - E---f —�!�-T- -------------------------------------------------------------- I ----------------- --------------------------------------------------------------------- ----------- TL�l� -13 NAME OF ADDITION --- -------- F= t P c-- ......................................................... ----------------------------- 0 0 EWE1Z*,PERM1T­.. %i NON' - 71TY �'(GF -,,EPiM DS- SIDE S WATEWSEWER.11)kPARTMENT: 1z �i PERMIT, V.;i- Z., :,7 it P. hsp 1 0 -BEFORE -co��ring, any�.6-jrtion.,of thc cons ruc. on,N, t f6r si&. *s �ver.`i cc I ng�­ -be! pro ided"within-2:1- hourW' holl' ay I t Otis Sat.­Su6�,.or. d ns after re,just. NO,, C; d cof 4 - Avr-�. ,OF�GONSTR , UCT: . ..... ION.* ....................................... ....... ............... ...................................................................... .ADDAES&S OCATION1 7 .......... ............... . ..... ,,',PROPEk,T,,�V-�"L'E"l�,DESCRI,PTION- rall ---JI-I's ................ .................................... .................. .......... ............ ....................... ..... ......... . ....... 7.: ........................................... . ............................................ ........... ........................... ....... ..... ......... ................... ........ ..... ....... .................. ------- ......... . ....... ............. ............ OWNER, ANDY.OKBUILDER.' ........................... ........................ . T�T#APT v. n e ad-. Edmonds !.,JA,,,- - Ru,�',s.,J ' ns6h­: I 6JO9 rl 11C'adMqda1' - -Ro' z ................................................................................ : .................. ............ ......... .......... co ................................. 0 onnection .,of., a, side� sewer-Ao the, city Sanitary-, sewer. slonls;,gran J, ......... .. for�repair and/ r -'e "w'danee d !Sys pjYiijn,..Acco -With,,. OtypU Edmonds or inances.-, 'a- IION� M;CA,LLE .1 1 . ,, -... wfN. NO, l,o.��,LThe*'�ow�ers'.'bf-'tlier�pr*operty may obtain a-. permit. to. construct? sewer Inside propertyJlne.:,,,� lioen�ed Side SeNk�er�coxitiactoi'�nust.,be�V.mplo ed-to',c6nstruct -cover-any* porticin' of..�sewer before it :has side, se4erAh�,streiit, area., D`o� nU been inspected. -way quires an, lnvasion� of-ioig�t-rf-'Way.,Pennit;obtEdnable* from the City Ehoneer's, office, WOTF re I.No-22�Alil,w6rk performcd�,Inl ciiy:right-of -rmit. -NOTk' No.-3�ObtEiin.,full'iiiform�ti��, regarding. Ordina:nce' 11.16.030 and Regulations , governing..-sid.e-:sewers,..,%vhen�.you get pL e '-af property line i., ade,. NOTE" sew e�r'm­usCha�y`� -at �;,;i�t 30 inch'es -c rage jand, 12 inches -Anside; property line: minimum_ grade'�of.2%. j:No :beh6 n�.gr sharper. than' 'A 'will be.'permitted. NOTF,,,No! ;5­1,Trenc)ies,,1n�i e,�,, -i�tsf;b`wafer'settl6d f�c6- of-zstrect �cstored� to: originaVicond n; Contractors shall. be-respo��sible,'for,iailure�;due to -,improper ic�- et., e� 'and �sur' iti6 one yea of work which may'develop within r compi etion. any�-�thev`worlc, than is�provldecl for, the­p�rmit,, ior,C6 do -any work.ort the -maAn sewer.ore its, appurtenances'. except;1o.,in, -sert, thelpt e-infc,-*the�wye. .............. 'Date.... DISAPPROVED. Date— .... ...... Y BY ..... .......... ... .. ........... B ......... Date ............ i!� ...... ...... .... ­:�, Date.,-. .......... .................. ........... _7 ..... . ............................ Remarks:,.*-..; ............... ............................ .......................... ....................... .............................. .. ... ......................... .................... .......................... .............. ......... .. ...... ...... .......... ............ ........ .................................................... . it �Copile T, Be:'Sij�med.rBy: Ow n6r, of Firni TerforrnineQoh struction. PRIORT-b.-Request --For 'In I spe,ct', )110� kPe -,ioh % I tal ation icons trcted undenithis!,-permi t. ....... ... ....... he�eb certify t4dt, the- side -sewer . I .... .................. Y.: , , . . -, 1. ; or o upq �ting- Fir Perfrrming Constr 7 e i tallat on',c9m tiction), w t n6rids. "st I i Pn, 4a �c r e. ith �n­ g' rdina:hc6s- 6f' Ch e:.'Ci V of Edi gpye in o, )f -of . . .. .. ..... ................ ...... �­ aitedii this .......... day, 7 ter V:",�CII�ck.-BEFOI�E:.ypu:dig*fcir:':W.ii. Telellhone. �Ey The City of Edmonds APPLICATION for SIDE SEWER PERMIT NEW CONSTRUCTION Er-' REPAIRS F-� EASEMENT NO . .............. ......................... LID NO. ........ ASMT. NO.. OWNER ...... ----- ----------------------------------- CONTRACTOR ---------------------- J.0 --- 7 - ------ .......... PERMIT NO. --- --- ----------- ..<-/ JOB ADDRESS Z-f _4 - ------------------- <� ------ ------ /- -c ------ LEGAL DESCRIPTION: LOT NO. 2��o ........................ .- BLOCK NO - --------------------------- ------- RECEIVEL i 9 1 Q'74 li. � 0 ......................... ------------------------------------------------------------------------------------ --------------------------------------------------- NAME OF ADDITION --- ----------- ............................................................. Approved: DATE........................ ................... By ------------------------ City of Edmc 8 9 0 - 10 - RIGHT-OF-WAY CONSTRUCTION STREETTUIT PermitNumber. Issue Date: A. Address or Vicinity of Construction: - 184()3 go AV W (932R206) B. Type of Work (be specific): Install New Service C. Contractor: -Washington Natural Gas Compapy Mailing Address: 815 Mercer St, Seattle * WA State License #: Y6111 D. Building Permit # (if applicable): Contact: Frank Swan Phone: 224-3278 Liability Insurance: Bond:$ Side Sewer Permit # (if applicable): E. ivision Commercial El Subdi El City Project JR Utility (PUD, GTE,.WNG, CABLE, WATER) Multi -Family 0 Single Family n Other INSPECTOR: INSPECTOR: t F. Pavement or Concrete Cut: D Yes Jallo G. Size of Cut: x H. Chargq,,$ APPLICANT TO READ AN N INDEMNITY. Applicant understands and by his signature to this applieation, agrees to r1he City of Edmonds harm le.4Am 1Wr_ifeZ;1n.ges, or Cit claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or e;�p_loyees, including or not limited to the defense ofany legal proceedings including defenti sts, and attorney te s by reason ofgranting this permit. 110 __6WTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND M, ATERIALS'F PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATIOAr-PEESNWILL BE HELD UNTIL TH'F' FK7AL'41rREET PATCH &COMPLETED BY CITY FORCES, AT WHICH TIMEA 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 regplations as required by %City�Ejngineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working aaly; NO EXCEPTIONS. Ihave read the above statements and understand thepermit requirements and thepinkcopyof thepermit willbe available on site;a:t �alltIm s for inspection -purposes. Signature: 11�4k# It Date: October 12, 1993 traAjr"olrn,�g7n_?�- CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: I obd RIGHT OF WAY DEPOSIT TIME AUTHORIZED': VOID AFTER FA DAYS DISRUPTION FEE/FUND Ill: SPECIAL CONDITIONS: CAt t., 00 �!IMLA—Aboi* RESTORATION FEE: 442;,o Lim S COMMENTS: DATE: PERMIT FEE: TOTAL FEE: RECEIPT FEE: ISSUED BY: q t:a NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. I)iv. 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.) El YES Date- - Date: - E] NO E. r Addendum to City of Edmonds Right of Way U Permit Application a Submitted b Guyla Connors y Engineering Aide Washington Natural Gas 521-5248 3 WNG to window Water zimai n depth ��n�own gas main C.- Key: -w- water -g- gas - -ss- sewer -&- water hydrant 0 water valve 815 Mercer St. (P 0 - BOX 1869). Seattle, WA 98111 (206) 622-6767