19401 82ND PL W.PDF111111111111
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19401 82ND PL W
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ADDRESS: W/ az-
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: [] Conditional Waiver [] Study Required [] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
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) #-
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DA
OTHER:
LATEMP\Dsrs\Forms\Sftwt File Checklist.doc
Also see
19400
19401
19402
194.03
0
NOTICE:
Nb--warranty of a ' ccuracy. e a'ttached
The -information shown on th
map(s) was compiled for use bytheCity of
Edmonds, its Employees and Consultants.
The City of �Edm.onds does not warrant the
accuracy of anything set for.th on these-
map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
-map(s), including, but not limited to,
th-e lociation of any sewer stub shown. Such
sewer stubs may or may- not exist and may
or may not exist at the location sh own.
Neither the City of Edmonds nor its
emp-l-o-yees or offiCers -shalrl be 1.1-a-b-1--e for the
information given on this map(s), nor for
ion provided based
any one representat'
upon said map(s).
'Cr� 112
CITY OF EDMONDS. SIDE., SEWER PERMIT
WATER-SEWEAj DEPART KENT
Urri
PERMIT
4414
coverI4 any portion of the con:truction.)
(Call 7,76-1107 for side sewer Inspections REF01]BIE N6 S&L., Sun., or holiday in pections.
Ijispection will be provided within 24 hours afteij request.
est
ADDRESS LOCATION OF CONSTRUCTIO� 19403! - ......... ............................ . ......................................... .............
W
lewj�� ........... ........
Lot Map . .................................................. . ...................................... . .........
PROPERTY LEGAL DESCRIPTION ------------------------------------------------ —1 ....... 11,—,
............. . .................................. . ..................................................
............................................. .................... ... . ..............
............. �: ..................................... . ............
..... ................. .................................................
................ .......
...... OWNER AND/OR BUILDER ...... ..........
................. * ---------- ........ ewer` Meadowdale Road
Rus.s..John.s..wi ... $* ...& ... Nqrt� .......... .............................................
CONTRACTOR'S NAME & ADDRESS -----
73 wer
July Is 19 .. ...... for repair suWar connection of a side sewer to the city sanitary se
Permission Is granted -------------------------- .............. .................
"stem in accordance with City of Edmonds ordinances.
N
FOT,LOWINr,:
_11rENTION IS CALLED TO THE to construct
NOTE No. I —The owners o the property may obtain a permit to construct sewer 'inside property line. A licensed Side Sewer Contractor must be employed
I f inspected. I � . I
side sewer n street area. Do not cover any portion of sewer before it.; has been y Engineer's office.
NOTE No. 2—All work performed in city right-of-way requires an Inv:dsion ofjUght-of-W&Y Permit obtaInable from the Cit
0
N TE No . 3—Obtain full information regarding Ordinance 11.16.030 & Regulations governing side sewers when you get permit. No bends in grade
NOTE No. 4—Top of side sewer must haveat least 30 inches coverage at property ;line azxd lVinches inside property line; minimum grade of 2%.
harper than % will be perm tted. to original condition. Contractors shall be responsible for failure due to improper
NOTE No. 5�—Ire.�hes in street must be water settled and surface of street restored
work which may develop within one year of completion. any work on the main sewer or its appurtenances except to in -
NOTE No. 6--It is unlawful to alter or do any other work than is provided for In the permit, do
Pert the pipe into the wye.
...............
y ----- Date ............... . ........... ....... By.
DAPPROVED f:] Date .............. ........................ By ................ Date..� ............ .. .....
IS
............ B . . .............................................................. I .............. ......
APPROVED E] Date.— ...
.. ..................................................... . .........................................
Remarks: ............ .................................................................... .................... I . " I .
.......................... . ....................................................... .
.............. ........................
. . ....... ............... ...... e ----- \— ---------- ............ -------------------
............ .....
BOT I
wasins ed in
virit C ies Be Signed By Owner of Firm �Performil
---- ---------------- ... ....... ... hereby Fertify th
r o aing Firm Grming Cons tion)
e with nances of the Cit�, of Edmt
Dated itils .... I ------
Check BEFORE you dig for: Water E], Gas
Construction PRIOR To Request For Inspection
the side sewer installation construfted under this permit
S.
19 .........
............ day of ...........................................................
:Power Sewer 0, Other,
CA FILE NO.
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: /7-YOa Fa?2 P1. W. 5,qo-2(.
2. Property Tax Account Number: 6 -3 q? - 6D (D - 009- 00 0,9 RECEIVEE)
3. Approximate Site Size (acres or square feet): 14,375 P�2-
4. Is this site currently developed? v*' yes; — no. MAR 2 3 1995
If yes; how is site developed? LkQ I e-Y, PERMIT COUNTER
'4
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise
of 10-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
Rev 09rNM3
S SIDE S*EWER PERMIT
CITY OF EDMOND
YATER-SEWEJ�,, DEPAR MENT
PERM
'IT
4414:
Call 7.76-1107 for side sewer Inspections BEFO - RE coverI4 any portion of the construction.N
Iflspection will be provided within 24 hours afteii request. N
0 Sat., Sun., or holiday inspections.1
ucno� West
ADDRESS LOCATION OF CONSTR jC .. �1949 D .e .................. ..... act
. ......................................................... .............................................
Ma A
PROPERTY LEGAL DESCRIPTION ........ 1-.,).t ........... M.a.p .... ewo.o.,.
. .. .. . ....... .. ..... ................ ....................................................................
................................ I ..........
.................. ...... * ......... ...... ................. .... . ................................................................................
......................
.......................................
......................... OWNER AND/OR BUILDER ...... 9-i.o rd H
............. qws ........................................... ................................................
CONTRACTOR'S NAME & ADDRESS ...... Q115.$ ... North Meadowdale Road
....................................... I ..........................................
July IS 73
Permission Is granted ............................................................ 19 ...... .., for repair and4or connection of a side sewer to the city sanitary sewer
:,,�tem in accordance with City of Edmonds ordinances.
.,TENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—Th ' owners of the property may obtain a permit to construct sewer 'inaide propeity line. A licensed Side Sewer Contractor must be employed to construc 0 1
aid's sewer in street area. Do not cover any portion of sewer before It has been inspected.
NOTE No. 2—All work performed In city right-of-way requires an Invazion ofWght-of-Way Fermit obtaInable from the City Engineer's office.
NOTE No. 3—Obtaln full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE. No. 4—Top of side sewer must have at least 30 Inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends In grade
sharper tha'n 1/s w 1 11 be perm I tte d
NOTE No. .5—Trenches in street must be water settled amd surface of street restored to original condition. Contractore shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE No. 6—It Is unlawful to alter or do any other work them is provided for in the permit, or
sert the pipe Into the wye. to do any work on the main sewer or its appurtenances except to In -
DISAPPROVED 0 Dat ................ By.... Date...
..... . .... .... ........ .......... ;0,% 'BY ..... ...... Date .................................... By .................
APPROVED Da
..................................................................................
Remarks: ........... .......................................
tl.----
. ........................
.......... .. . ..................... _--.7 ..................................................................................
............... .. ......
.................. ...........................................................................................................
............ ...... ...... .......... .......
BOT I P it C ies Be Signed By Owner of Firm Performijg Construction PRIOR To Request For Inspection
7 1
..... ................ .... ....... ... I hereby :r-ertify th
W' 4t the side sewer installation constructed under' this permit
er of n cting Firm Grming Cons tion)
.�as in
S ed in ac a e with inances of the M3� of EdMohds.
DatedjhIs ........... ................ day of ..................................
..............................
q.,V Check BEFORE you dig for: Water Gas "'Telephone Ej, Power
Sewer, 0, Other 0
APPLICATION
mm 0 for f.
The City of Edmoni'd' SIDE SEWER PERMIT
OsT RRIEET, FU EASEMENTNo'�'V.Z�_.'.
NEW CONSTRUCTION gj REPAIRS
ACTOR
OWNER ........................... .......................... ......................... ..................... --- CONTR 1 _26
................................. --PER-MIT-No, . ......................
-BLA),CK'No:
LEGAL -DESCRIPTION: LOT No . .......... ........... w
ADDRESS _ K�!)AicnNkc_�.__ -
.................................. ................... ............ .. ........................... ....
NAME OF ADDITION ... .... L-tSST .... PF M- W�
............ .......................... ................................................................
kj
-\,WEST
, v
Approved:
DATE By_',
zt,
LO-T*
....... sil�l
';el ITT a %
CITY of EDMONDS
B S LICENSE APPLICATION LICENSE NO.
Civic Center - Edmonds, Washing
City Clerk ton92O
Phone 775-2525 RTPFFT
ANNUAL FEES PENALTY AFTER FEB. 15
F11
1:E1
HOME OCCUPATION
INSTRUCTIONS:
CLASSIYEAR
LIC. F
17 LIC.wNO
SW
. w $10..00 (A) ADDITIONAL $5.00 0
• All items must be completed
-
1 11
7 -Ja--S LL BUSNESS
t$15.00
or application will not be ac-
RECEIPT NO.
DATE PAID
I A
PRINT 'X' — 00 (B) ADDITIONAL $7.50 1-]
cepted.
/I qvola 11 'n
9
IN SPEC. BOX
E) rus—ine-ss wwith 10 or
• Sign and return application
FEE PAID
PENALTY P ID
FOR ISSUE OF
CORRECTED
more employees ADDITIONAL $25.00 0
with fee. Renewals received
I.
I Aoorl �11
I I I
LICENSE WITH
'LC' ACTION.
$50.00 (C)
after February 15 must pay
6�'_NEW APPLICATION (LA)
penalty in addition to fee.
—n-RENEWAL (LB)
NEW BUSINESSES AFTER
D CHANGE (LC)
JULY 31, 1/2 FEE.
(PLEASE MAKE ANY NECESSARY CHANGES) El DELETE (LD)
9F F.IRM
BUSINESS PHONE
NO. OF EMPLOYEES
=E _ tivv—%
4 L4
MAILING ADDRESS NATURE OF BUSINESS
�IY7
BUSINESS ADDREV le? V.�ql - F2 I�IA.
INDI UAL
PARTNERSHIP CORPORAI
(P)
P
OWNERS NAME
4 f9 ell' I 6_7
HOME ADDRE�S
OY I-)
HOrD,�TE
,,PHONE
—zz V#
OF B IRTH
P4ACE OF.BIRTH
SOCIAL SECURITY NUI
0i f-J
��33
-1 -7 S F
EMERGIENCY NOTIFICATION: (1)
NAME & TELEPHOHE
(PLEASE LIST TWO) (2)
. L)
NAME &. TELEPHONE
WASHINGTON STATE TAX NO
APPLICANT'S SIGNATURE
STAFF REVIEW:
BER
DO NOT WRITE BELOW THIS LINE ---) 1� t , ,
FILL IN LAND USE CODE, LIFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR
DISAPPROVAL, DATE, AND SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT"
SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT DATE 3-12-22 LAND USE CODE ZONING CODE
&--APPROVE E, DISAPPROVE
SIGNATURE 0 IR ID I I
CONDITIONAL USE PERMIT
COMMENTS
DEPARTMENT 'Z> A9 -
DATE
Vr"ILDING
APPROVE EJ DISAPPROVE SIGNATURE I
Building
Perm it
0 Hotel/Motel
TXApt. Bldg.
(L)
(A)
�&a
Occupancy
0 Office Bldg.
0 Restaurant
(0)
(R)
COMMENTS:
Group
0 Hosp/Nurs Home
(H)
E==:) CAPACITY: (NO. UNITS, APTS., OFFICES, tSEAT'S, BEDS, STUDENTS)
School
(S)
FIRE DEPARTMENT DATE 2 - 6 - 7 U. F. 1. R.
APPROVE 0 DISAPPROVE SIGNATURE e�
COMMENTS:
PO E7'DEPARTMENT S.
L DATE IGNATU
1�- tPPROVE 0 DISAPPROVE RE
PL�&IC WORKS DEPARTMENT
Z APPROVE Ij DISAPPROVE DATE SIGNATURE 29-2
COMMENTS:
P1 FASF RETURN TO CITY D FRK
ME S WER PERMIT
CITY OF. EDMO,ND.S
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Owner :Kaivo Ophelia E 7t I Tq7 23 A� f Parcel :6349 000 009 00
Site :19401-V2Nd Pl W Edmonds 98026 Xf ered :11/13/1992
Mail :3711 164Th St SW #W191 Lynnwood Wa 98037 Price :$200,000 Full
Use :12102 Res,Two Family Res,1 Struct,Duplex Phone
Bedrm :4 Bath :4.00TotRm : YB1973 Pool BldgSF:2,046 Ac : .33
0 � 0 5- -4-- -7
Information compiledfrom various sources. First American Real Estate Solutions, L.P. makes no representations
or warranties as to the accuracy or completeness ofinformation contained in this report.