18909 78TH AVE W.PDF111111111
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18909 78TH AVE W
41
CY 9 0 . 1 9 4 -
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT
STREET FILE
A. Address or Vicinity of Con�truction:
Permit Number:91 - 397
Issue Date: 5
18909 78 Avenue West
B. Type of Work (be specific): Ins tall New Service, -GEWED
RC
N 0 V 0 S 1001
C. Contractor: Washington Natural Gas Company Contact: Gary Swanson
Mailing Address: 815 Mercer Street, Phone: 224-2080 ENGINEERINO
State License #: Seattle, WA 98111 Liability Insurance: Bond:$
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. _- F1 Commercial
E]
Subdivision
M City Project R] Utility (PUD, GTE, WNG, CABLE, WATER)
F-1 Multi -Family
F1
Singfe Family
F] Other
INSPECTOR:
INSPECTOR:
F. Pavement or Concrete Cut : El Yes [flNo G. Size of Cut: — � x — H. Charge$
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the Chy of Edmonds harnilessftom injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen,.tkat may be made against the City of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including d�fense costs, and attorneyfees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLEFOR WORKMANSHIPAND MATEeALS FORA PERIOD OF OAE YEAR FOLLOWING THEFINAL INSPEC77ON
AND ACCEPTANCE OF THE WORK ES77MA TED RESTORA77ON FEES'WILL BE HELD UN77L THE f1AArS7REET PATCH IS COMPLEYED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLJCANT,1
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call. the Engineering Department- 771-32W
Work is to be inspected during progress and at comple"tiod—.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
le" 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'(ify approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit re'quirements and the pink copy of the permit will be available
on site at all timesfor inspection purposes.
Signature: mehtaewad./ .; _' _" Date: October 22, 1991
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.)
Comments:
Diagram:
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
V&shkx on
jt_
Nabxa Ga�
AVAShr�&-WC-C-y
Addendum to :
Submitted by:
� E)q oq .-I e) kv V
qA WNG to window
NAWater main depth
unknown
2- 11 gas main
City of Edmonds
Right of Way
Permit Application
Kerry Walsh
Engineering Aide
Washington Natural Gas
622-6767 x2761
pager 995-6914
Key:
-w-
water
-g-
gas
-ss-
sewer
-E)--
water hydrant
0
water valve
815 Marcer St. (P.O. Box 1869), Seank, WA 98111 (206) 622-6767
P, - j
a
'00<
I
RECEIVED
A U G 2 9
4n_-1/
Et"wREET FILI::�" MR DMAGES Eamnds Ctty Clerk
NOTICE
Claim MUST be presented to the City Council and filed with the City Clerk within 120 day s R E C E I V E D
from the date of Accident or Accrual of Damiages.
P I M- 01, 9 lcm'-�
70 THE CITY COUNCIL OF THE CI77 OF EEMONDS:
PUBLIC k'40R'15
PLEASE TAU WYTICE, TMAT I _ I
(if married, give hu bandfs came)
WED I" RESIDES AT
TState present actual address by street, number and city)
AND WHO FOR SIX 14ONTHS PRIOR TID DATE OF ACCIDENT HAS RESIDED AT
(Give residence by street, number and city) 'I�A T /04. 17A
CIALKS DAKAGES OF AND I" THE CITY OF EDMONDS IN THE SUM OF ti-t- . — ?3 , '7
i L
&rising out of the following circu-stancea:
Describe Claim, giving
DA7E and TIKE iiijury or
damage occurred, PLACE
and full particulars.
Accurately locate and
describe defects caus-
ing injury or dazage
and all acts of negli-
gence claimed.
Accurately deace*be
i.nJuri*s or doAuLge
V
State items of A--& e
claimed. Itemize an (:=X-
axpenses and losses.
2tL�
(Claim must be asorn to by claimant)
tgigziature of Claimnt)
bafciv UT 1phisl;�V_ day of vi9Z2 6
C� fo t* a
-Ma;pu �ro
tAX7 PU lic for tato of
Maahington, rvaidaing
53
"JUST LIKE UPTOWN ONLY BETTER"
MAPLEWOOD AUTO REBUILD
E30DY AND FENDER - FRAME WORK - PAINTING
GORDON VAN MERE DEL DERN
3413 196 S.W. 778-5197 EDIVIONJOS,
',AEMORANDUM BY
t.::RTIMATE OF REPAIR COSTS 0_0_�
WASH. 9BO20
-,,WNER
ADDRESS
PHONE
AKE MODEL
LICENSE NO.
MILEAGE
DA E
.�F_W
RE-
PAIR
DESCRIPTION OF LABOR OR MATERIAL
PARTS
LABOR
SUBLET
a 4
7"
f
"I above Is an estimate based on our Inspection and does not cover additional parts or labor which may be required after the wort
."Ll been opened up. Parts prices based on standard catalog procurement. Price lists subject to change without notice. Procure-
.,-..ent charges may be added on Items not available locally.
1 OTICE: We use factory formula mixed paints but cannot guarantee a perfect match on all colors. There is an extra charge for
oting and blending. %
!�i�fore or while your car Is being repaired, we suggest that you take care of the necessary details to assure proper settlement. One
'i i the following conditions must be met:
1) Payment in full when Job Is completed
2) Collision Loss: Deductible amount of the policy paid AND insurance check properly endorsed, or proof of loss proper
2) signed. ly
3) Liability Claim: Insurance check properly endorsed, OR release papers properly signed with directions to pay Maplewood
3) Auto Rebuild.
PARTS
NET
LABOR
TOWING
TOTAL
TAX
TOTAL
tz,il OWNER
lot M&CO""',
r
iii " 19306 Highway 99 - Lynnwood, WA 98036
776-0221 - 776-3363 Dafe
1-7-7,1
Owner Address Phone
Year Make Model Body Style No. Serial No Business
pair
Re-
place
Description
Parts
@Lisi
Labor
Hrs.
Refinisti
Hrs
Maierials
& Nei Items
UC/
-7//Z
I he above is an estimate based on our inspection and does not cover additional parts or labor which
,nay be required after , he work has been opened up Paris prices based on standard catalog pro-
,uremeni. PRICE LISTS SUBJECT TO CHANGE WITHOUT NOTICE. Procurement charges
-may be added on items not availa ble locally
Flefofeor whileyour car isbe,ng repaired we suggest that you take Cate of the necessary details to
,issure pioper settlement One of the following conditions MLIl he Met
1 ) Payment in full when job is completed
2) Collision Loss Cledticlible arnotint of the policy paid AND insurance check properly en
clorsed, or proof of loss properly signed
31 Liability Claim Insurance check properly endorsed. OR release papers properiv signed
with directions to pay Lynnwood Body Shop
BY OWNER
LABOR HRS
REF HRS
TOTAL > - PER
LA B 0 R H R S X $2-;K- HR = ,
PARTS Cq, LIST S
MATERIALS & NET ITEMS S
MISC
SLIBTOIAL
SALESIAX
TOTAL REPAIR