19410 82ND PL W.PDF11111111111111
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19410 82ND PL W
ADDRESS: IRV — 4-71ID
TAX ACCOLTNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: F1 Conditional Waiver [] Study Required E] 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:
SIDE SEWER AS BUILT DATED: �3113JZ3 rap,
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERM[IT
WATER METER TAP CARD DA
OTHER:
LOT: BLOCK:
SIDE SEWER PERMIT(S) #:
LAT'EMP\DSTs\Forms\Shwt File Checklistdoc
I I
^TREET FILF APPLICATION
for
The City of Edmoinds SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS 0 EASEMENT No . ...........................................
t. . . . .................................. 441 V
O`WNER—.—. _U .......... t PEI:tlk,=No..
............................................................
.....................
ae2wo PIL -LEGAL- IDE ON.,.IOT No . .. ...................................... B1,OCK No .. .............................................
.................................................................................. SCRIPTI
NAME OF ADDITION ................................
ZA
'O',F'':E�DMON,DS,,,,,,t�,S,l�DE'��S�EW;Ek," PERMIt"
'4
yt,
CIT
_7 "�l
WATER -SEWER, DitP
TREET FILE,
'PE,RMIT 441
ng, sAy portion,,, of a constru'441ot'L,
i; t at)l 44.1 t Onji 1330FORS, I-OoVerl
t6
un.", r -lospecti
P It 11, be d1d �ns
*oVI hin' 24 boUrsliiftei request 94t.,, 18 h6liday�
o� jj0 & 19408, 82nd Place Watt
ADDRESS LOCAMON OF CONSTRUM
.................................. . ................... ... ............ . ... .................... ....... ......
PROPE 6, . Maplew6dd,
RTY LEGAL DESOLYI�Iiox.: .... . MR-W ............................. .................. . . ..... . ........... ...........
7,17
4A,
................ ............. OWNER A.ND/6R. BU, ... ...... . ......... .......... ...... ......
: '.., . 1., 1. � , �§. er'&,PlUmbihg� � 1000�'- North': M�aa,� "aile, �Rdad
NAME ADD iSS ..... ......... ........... . ............ T .......... ... ............ 4 .................... ....
. . ..............
-18 19.i ......... f9r repair, -and/or:
k�rniisslon I Ju,ly
.. ....... .......... A ....... connection, of, a -side sewer.* to th y se!Fer,,
s�FstenJi In accordance withAMy ofEdifion0g, ordinahces..
t
`o:'A 'The owners �i'jthe tpropertk ms�y'obtaln at.,j�errnit` tb"cp'ns't'r'uc't`bewer Ansids,propetty I us. :A:, ifie6abd,,�lae'Oev�ei.:Cohtractor must be. einployeT o construct
aide' sewer in, streef area� Do not cover - axy�. po I rtion Of. sewer before It' hii been. inspected.
NDTE. No. 2—AIL work'perform , ed. in cit . y ri I ghf-of-way requires, an Inva'sion, o . f Right -of I -Way . Per . mit-obtairmble fi, I om .the dity Eng . in6drle office.
si e.. sewers when you get permi.
NQTM No. 3—_Ob�aln fulf-information regarding OrdinaAce MiS.03d and.Regulatioili governii, di
14 - . 1, and"12 Inches - Inside -fine; minlinum' grade'6
OTE No'�� 4—Top of.side sewer miist least" 30 inches coverage at"property Zoo f, 2%�: No bends in grade
shar�er thah'I/S. will' be'permitt��.
fnal.c6nditlon., C6ntrszt9rs 9 all be respoilsible f6i taiiiire -.due Ao improper,
Nq!r3il Nq.,b-!�Tr�n6hes in strek;m"t,�e,,water s�ttled aind'Afirface of,ati6pt- ri`4ors�d�'i..'�rlg
:�Iwork,vifiich maj d�velop *,Ithin'6ne year'oficompletioni
t
N011k " s ��nia"wf�i.�6 � he�,',Ii�6rl� thdn�,:Js provide4`,for,, In' -the k or its
X7
OVED Date ... . ... .......
DIISAPPR . ....................... :,B .......... .........
"te B .. t-,Dxte. ... ... . "By.
'Y ..... ...... Y
)%&Cni'0�Dattee.' 777
"PROVED t ...... Z5 .......... ........ .... . .. .. ........... .............. . ................ ... * .....
...... ... ........ ....
. ............. .........
`Q
.................. ....... .... .. . ..................................................
BOTIkfern copi�76mtr B�e Sij*6d'By O*Aer ni I ' Perfortnfiig' C ' At.upt'i6n PRIOR Td 1�eques�t.F6r Inspee'tion
7n 9n
.. ... .... I ..... . ....... . hereby. certify #iat t;he side sewer Instal- lation -constructed under ihis'pe*�rnit,*
of t g Pi ction)
alle in c r an all �g6iiernin b in, ei 6f the.City, of tdrAdAft,.
0'.
hibid . ......... 4day ........... �;e ... ....
'Gas T4 [j Po e I w Other'[:] -
V 4 Check BE]fQRE'*oxt dig. iojr:-�'W.aier wer, S er. [3,
ppho no.
0
0
13
--- - ---- - -
----------
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Chelck Wake,
777�
�pi'
P�p ---------------- - ---
..... .
....... . _-
_Bumipgs
Thki - EW,.
_L S
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---
T lies
-777!_.
..
..........
.....
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Er-
- ---- - -
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....... ..
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..... - ----- ----
-,. -. 7.,. . -
- . �, Z" I �, �
---- . . .... . .... . ........
1', , - j'.
7 �'
_77�
7 77-
Maierial G�..al�g
7 7 .
SIZE!.'�,- DESCRIPTION
-RATE-
-Pip*e Bhitk'S�criw,
p 1pe Screw
Edv
--------- - --
.. ....
------- -
...
777,777
.0
lli�id b ons 7 7777-
Curb C66h -------
rp. ..... . ... -------
ru PAS
Saddles
----
..... . .... .
......
.... . ....
.... . ...
---- — - ----- ..
BliAirig's
........
ain-:
. . .........
...
CiA' %kes
-S' --o.*-E ......
.........
...
:C0460
Gaw 136xes ---- - - - ------
----
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'� --------
e ITT or,�,
CITY of EDMONDS BUS' SS
LICENSE APPLICATION Dt- Aii(* i-5 /7? LICENSE NO.
Civic Center - Edmonds, Washi. . .... ..
City Clerk Phone 775-2525
qw
ANNUAL FEES PENALTY AFTER FEB. 15
PI:P:T
F11
F 'R HOME OCCUPATION
INSTRUCTIONS:
CLASSjy"A
LIC.EFWeUNMTW
$10.00 (A) ADDITIONAL $5.00 0
• All items must be completed
/3
IRFAS6.11919.0ft.11SPEC
0 SMALL BUSINESS
or application will not. be ac-
RECEIPT No.
DATE PAID
PRINT.X.
$15.00 (B) ADDITIONAL $7.50 El
cepted.
1A 4
Z IN SPEC. BOX
4 FOR ISSUE OF
0 Business with 10 or
• Sign and return application
FEE PAID
PENALTY PAID
CORRECTED
more employees ADDITIONAL $25.00 0
with fee. Renewals received
LICENSE WITH
LC' ACTION.
$50.00 (C)
after February 15 must pay
NEW APPLICATION (LA)
penalty in addition to fee.
0 RENEWAL (LB)
NEW BUSINESSES AFTER
0 CHANGE (LC)
JULY 31, 1/2 FEE. (PLEASE MAKE ANY NECESSARY CHANGES) 0 DELETE (LD)
NAME OF FIRM
BUSINESS PHONE
NO. OF EMPLOYEES
-!5. 7 cn - j-- i - -� P - , !S
..3 el- 2
MAILING ADDRESS NATURE OF BUSINESS
L L
:��SINESS ADDRESS INDIVIDUAL PARTNERSHIP
ir
(S) F>a(P)
HOME PHONt JPATg OF 1311
;7- tf -;I- F1 -3A
EMERGENCY NOTIFICATION:
(PLEASE LIST TWO)
HOME ADDRESS
Ive.
ITK. PLACE OF BIRTH
(1) NAME & TELEPHONE
(2) NAME & TELEPHONE
CORPORATION
= P
SOCIAL SECURITY NUMBER
— I I
-7 (-,;w.
WASHINGTON STATETAX NO.— APPLICANT'S SIGNATURE
7o
.00,
DO NOT WRITE BELOW THis LINE
STAFF REVIEW: FILLIN LAND USE CODE, UFIR 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 LAND USE CODE ZONING CODE
B`_APPROVE. 0 DISAPPROVE _55_1 I I
SIGNATURE (f d-kAQJ�L&_ Ft 2
CONDITIONAL USE PERMIT
COMMENTS
BUJeDING DEPARTMENT DATE 3
PAPPROVE 0 DISAPPROVE
Building
Per it
m
0
Hotel/Motel
(L)
SIGNATURE 4h h4��
Apt. Bldg.
Office Bldg.
(A)
7
(0)
COMMENTS: /��
Occupancy
0
Restaurant
(R)
GroUD
0
Hosp/Nurs Home
(H)
CAPACITY: (NO. UNITS, APTS., OFFICES, SEATS, BEDS, STUDENTS)
0
School
(S)
F�RE DEPARTMENT DATE j ZZ
U.F.I.R.
J9 APPROVE 0 DISAPPROVE SIGNATURE 271,&
COMMENTS:
P:K
.�CE DEPARTMENT DATE
JU. PPROVE 0 DISAPPROVE
COMMENTS:
SIGNATURE
PUPWC WORKS DEPARTMENT
31
Zll[::l 9
eAPPROVE Q DISAPPROVE DATE I _2,,_ SIGNATURE_
COMMENTS:
PI.C:AQC 011=711111KI Tn r%ITV 1'%l MMV
NOTICE:
N'o ... wa rra nty ... of aocuracy.
The information . shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edm.qnds 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
tFe -map(s), including, but not hm'ted 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 shown.
Neither the City of Edmonds nor its
. h a. I I b e l-`1 a. b-.11--e f o r t h e
ernp]-o-yee-s o-r offiCe,rS S) i
information given on this map(s), nor for
ation provided based
any one represent
upon said map(s).