19504 84TH AVE W.PDF11 lill lill 11
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19504 84TH AVE W
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NOTICE,
a.�c.c u r�a-cy. - -
N'o ... w a r-r a n-tyOf e attached
The -information shown on th
map(s) was compiled for use by the City Of
Edmonds, its Employees and Consultants.
T e city of �Edmonds does not warrant the
h
accuracy of anything set for * th on these
map(s-). 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 loc'ation 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
e m p]- oy e e-s o r o f-fi C e r-,--) -s- h. @. I- I b e I. i a. f o r t h e
information given on this map(s), nor for
ion' provided based
any one representat'
upon said map(s).
I*
0
APPLICATION CARD No . ......................................
for
9 116
The City of EdmondsSTREE7 E SEDE SEWER PERMT
OUTSIDE INSIDE REPAIRS EASEMENT No . ......................................
.........................
............................................. CONTRACTOR ............. rO A., I
OWNER .......... / ..... l7r .............. :': ..................... PERMIT No . ....................... .
< STREET
HOUSENo - ----------- .................................................... . ................... AVENUE LOT No . ...................................................................... BLOCK No . ...............................................
NAMEADD . .................................................................................... --- -------
- " C /- '-V r-1 -7 A I 'ej "'- Z- �
BACKFILL WORK ORDER ISSUED ........
SEWER WORK ORDER ISSUED ...............
/'7
S S ;70
C6OoV- e c,.,o ef""e. c')
IL
00-
T
APPROVED
SEP
'q G/ 'I 'q '), ';�-) -
Date Approved:
........................ DEPOSIT, $ .............................................
........................ DATE ... 2 ........ A I ...... na...... —9 ............
Z
CITY OF EDMONDS
Call PRospect 6-1107 when work
CITEC CENTtE.—WATER-SEWER DEPARTMENT Is ready for inspection. (No Inspec.
tions Saturday, SundaY or holidays.) N2 q-':".J,_ 1[ 1
SIDE SEWER PERMIT
19504 ..84th ... A.ve.n.u.e .... WA s.t ................................................................................................... .........................
ADDRESS.............................. .........
Tucker Const.
OWNER ............... B-i- 11 --- Pe - t - e - r - s - on ...... ... ........ ..................... CONTRACTOR ................................................................................
Pernt's-sion is glunted .......... SepAtle mhe r ........ 9, for ........................ dtys to REPAIR or CONNECT a side sevver
with City Servers in accordance With '. I ipplicatioll oil file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING: construct sewer inside property line. A licei sed Side Sewer Contractor must
NOTE No. i—The owners of the property may obtain a permit to I
be employed to construct side sewer in street area. Do not cover any portion of sewer before It has been inspected.
NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 aild Regulations governing side sewers when you get permit.
NOTE No. 3—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 than ',� will be permitted.
NOTE No. 4—Trenches in street must lie water settled and surface of street restored to original condition. Contractors shall be responsible for
. . . failure due to Improper work which may develop within one year of completion. ny work on the main sewer or its appur-
NIOTE No. 5—It Is unlawful to alter or do any other work than is provided for in the permit, or to do a
tenances except to insert the pipe into the wye.
C1 . Ty OF EDMONDS Can rRospect 6.1107 -hen work
—WAT-ER-SEWER DEPARTMENT is ready for inspection. (No &Pec-
n 38qj`
Clj,,IC CENTER lions saturday, SondaY or holidays.)
SIDE SEWER PERUMV01T
...................................... ...........
ADDRESS ............... ........... ... .... �!0i ... A OE..SERVICE
BOB A LIN..B CK.H ...... .........................
WILLIAM PETERSON ........................................... CONTRACTOR ............... ..... )� ........ ... P
.OWNER .......................... ................. PAIR or CONNECT a side sewer
19 ... 79, f or ........................ days to RE
Pern-tission is gr"tllte-(' cordance With application on file and governing ordinances.
,v,%4th City sewer,, in ac
ATTENTION IS CALLED TO THE FOLLOWING: line. A licensed Side sewer Contractor must
, obtain a permit to construct sewer inside property '
NOTE No. 1—The.owners of the property Malwer in street area. Do not cover any portion of sewer before it has been inspected.
be mployed to construct side se 6.030 and Regulations governing side sewers when You get permit
NOTE No. 2—Obtain full information regairding ordinance 11.1verage at property line and 12 inches inside property line; minimum grade of 21/.*
,. 3—TOP Of side sewer Must have at least 30 inches cO
NOTE N, No bends in grade sharper than i/s will be permitted. to original condition. Contractors shall be responsible for
,er settled and surface of street restored
NOTE No. 4—Trenches intstreet must be wat lop within one year of completion.
failure due 0 improper work which may deve is provided for in the permit, or to do any work on the main sewer or its appur-
N(,-- No. 5—It is unlawful to alter or do ajoy other work than
tenances except to insert the pipe into the wye.
,w APPLICAT16N
for
The City of Edmonds 6STRE&Flt SIDE SEWER PERrMT
NEW 9NSTRUCTION [:] REPAIRS
. .. ... ... .. .....
OWNER ........ 6-1 /V I ... . . ..........................................
....................................
7--/l,
................
ADDRESS .............. l..'74C.11 .... ....... '41 .4-V6 . .... . .....
Z- )U k!C
EASEMENT No . ...........................
Z--1119 0
CONTRACTOR ... ......................... ...... Sl-l-(d-C6 PERMIT N
LEGAL DESCRIPTION: LOT No . ............ 7 ------------ ------ * ...... BLOCK No . ............................................
F�l 41C c-1 .5. 74 A/. wy,2o / o F F S. JF- '/// 0, F -7 4 e
NAME OF ADDITION ..... A.�� ... ..... - /,Ff � 7
.................................... ... . ............ ; ............
eSS 4,,, 136 ' fF Jess Ac.
S iv o,4 4
I r r, / I
DATE .......... By ,� ...... ............
Ty
1w 11!TION
CITY of EDMONDS
BUS[ DATE LICENSE NO.
r1L
gton 9802SIAMT
=r Civic Center - Edmonds, Washin ANNUAL FEES
City Clerk Phone 775-2525 PENALTY AFTER FEB. 15
0 JJOME OC CUPATION
4STRUCTIONS:
CLASSIYEAR
C. EFFEC. DATE
LIC. NO.JSPEC.
0 (A) ADDIT L $5.00 0
All items must be completea
JREASG.
11 SMALL BU
or application will not be ac-
RECEIPT NO.
DATE PAID
PRINT'X'
L
$15.00 DDITIONAL $7.50 0
$ 0
cepted.
ell,
/ AAP'y
IN SPEC. BOX
FOR ISSUE OF
si
0 Busine ith 10 or
Sign and return application
FEE PAID
ENALTY PAID
CORRECTED
m employees ADDITIONALC-$25.00. 0
with fee. Renewals received
I& e4
LICENSE WITH
'LC' ACTION.
;n n jr�
$50.00n (C)
after February 15 must pay
�k NEW APPLICATION (LA)
penalty in addition to fee.
0 RENEWAL (LB)
NEW BUSINESSES AFTER
0 CHANGE (LC)
JULY 31, 112 FEE.
(PLEASE MAKE ANY NECESSARY CHANGES) 0 DELETE (LD)
NAME OF FIRM
olwool
BUSINESS PHONE
NO. OF EMPLOYEES
C
MAILING ADDRESS
NATURE OF BUSINESS
.310 5 - i cq3 5 7- Apartment
03
BUSINESS ADDRESS cao 0 - 0 3cloo INDIVIDUAL PARTNERSHIP CORPORATION
19504 84th West Edmonds, WA '98020 (S) (P) (C)
OWNERS NAME HOME ADDRESS
ID a r-4 tv" CA M, b S -39 c) s - C53 5 T 5 VY'
HOME PHONE DATE� OF BIRTH PLACE OF PIRTH SOCIAL SECURITY NUMBER
17 5 - .-� .1� /- �- -if-- C 4 A Y7e-,0v -S 6.S - 4 `A - (� 2- t d,
EMERGI�NCY NOTIFICATION: (1) NAME & TELEPHONE �a-42bGFIL -655-33-
(PLEASE LIST TWO) .(2) NAME & TELEPHONE -7 78 -,3-(SL5
WASHINGTON STATE TAX NO. APPLICANT'S SIGNATURE
DO NOT WRITE BELOW THIS LINE
STAFF REVIEW: 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
.7
ig-APPROVE 0 DISAPPROVE
DATE
SIGNATURE -
LAND USE CODE
ZONING CODE
CONDITIONAL
USE PERMIT
COMMENTS
E=
BUILDING DEPARTMENT
DATE
Building
g-APPROVE 11 DISAPPROVE
SIGNATURE A
0
Permit 0
Hotel/Motel (L)
Apt. Bldo. (A)
M I I I J 0 Office Bldg.
(0)
COMMENTS:
Occupancy 0 Restaurant
Group 0 Hosp/Nurs Home
(R)
(H)
CAPACITY: (NO. UNITS, APTS.,
OFFICES, SEATS, BEDS, STUDENTS)
0 School
(S)
FIRE DEPARTMENT
DATE 7-�22-gl
U. F. 1. R.
.0 APPROVE 0 DISAPPROVE SIGNATURE
lo
- I/ T1
COMMENTS:
POLICt DEPARTMENT
DATE ki
P--APPROVE El DISAPPROVE
SIGNATURE
L
COMMENTS:
PUBLIC WORKS DEPARTMENT
0 APPROVE 0 DISAPPROVE
DATE ---7-.30- SIGNATURE
COMMENTS:
PLEASE RETURN TO CITY. CLERK