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20031 MAPLEWOOD DR.PDF11111111111111 12223 20031 MAPLEWOOD DR SEWAGE DISPOSAL PERMIT Septic Tank .............. ...... gals. CITY OF EDMONDS Disp. Field ................ 7' / .... sq. ft. Department of Public Works r% L No. .......... Ler .............................. .................. Name ........... 147 --------- > . .......... .. ...... - -------------------------------------- is hereby authorized to install/ repair sewage disposal system at. �,&Cd .... -Z—� ................................................................... ........... ---------------- Date issued on ................ . .. ....... Permit expires one year from date of issue DO NOT COVER BEFORE APPROVED BY DESIGNER OR SANITARIAN I hereby certify this system was installed under my supervision and control and complies with all provisions of the City of Edmonds Resolutions. Signature of Installer ............................................................................ Date ------------------- ............ - -- -- ---- ------------------ Approved-2 Disapproved [J Date --------- -s ........................ By ........... ............ Remarks: .............. ---------------------------------------------------------------------------------- ------------------------------------------- ..................................................................... SANITARIAN OR DESIGNER ................................................................................................. Date .............................................. This permit shall be posted in a reasonably conspicuous place on the job until inspection has been completed. call 775-2525 for old* sewer inspections BRIFORE covering any portion of the construction Inspection will be provided"wIthift 24 hours aftioi requat., No�.44t., Sun., or holiday inspedions'.) 20031 AUD -LOCAMON OF CGNftSUCMS ....... .......................... . .. . ........... . . .. . ......... . ...... . .. ........... . ..................................... ..... ATTACHED '11110111owl LWAL DIDSORMMON ...................... . ............................................... . . . ... . . . . ... . ...... ....................... . ............................................ ......... V'_' ........................... ....... ............ .......... ................. . ................................ . .................. . ...... ... . .. . ...... . .................. . .................................................. V. J. FLOBERT ........ . ................................... 0 , VVIN Jk"/Ox UTTIUMM ...... ........... . .. ........................................................ OWNER OOMV��R'S NAME & ADDIMMS ................................................................ ...... .............. . ...................... . ...... . .. . .. . ................................................... ....... .... ............ 191�, for nV& and/or 000"Moon of a Side www to the city madtwy wwar %4jj; ..... ..... City of FAMonds ordWanew is CAXA= TO THE FOLLAMING: Mwt Istain, a pormpt L irwhide #o t�. of the.propert:t mew, q a� A I!penapd Side Sewer Cantroator.must be emplaod, to covatklA ��—A"U w"*=pmerlolr=med� In city right-of-way requires an lavz;�Wltaffit if- from the City Engincer's office. NOT* 140. 3—Obtaln 1#4 Information regarding Ordinance 11.18.M and Regulations governing aide sawers When you got permit. NOTWX01. 4—Top of side sewer must have at least 30 inches coveM49& At property line and 12 Inches, Inside property line; minimum grade of 2%. No bonds In graft stuaw theA % will be permitted. NOTS No. 5--Trench" in streetmust be water settled and surface of street restored to original condition. Contracton shall be responsible for failure due to Improper work which may develop within one year of completion. NOTE No. $--It to unlawful to alter or do any other work than In provided for in the Permit, or to do any work on the -alp sewer or Its appurtenances except to in- sert the pipe Into the wye. DISIAPPROV D&U� .. . ........ ..... j .......... 8 . ............... . ....... . ......... ----------------------------- By ................ "PWVM Date.._. . .... . .. ... ...... .... ......... . ..... ............................. ----------------- ... . ............. I ................................... ...... ..... . ......... — .. . .. . .. ..... ...... . "�WnnmD D=l C., wuw P - T T, .Q32. Ir )�� -e-- (Fxts7-4--,a 6,'LA3>c- RECEIVED JUL 2 6 2001 DEVELOPMENT SERVICES CTR. STREET FILE CITY OF EDMONDS tTA MCI 00S,067OD60330 ; 7— /06 Ply �. - / 1� FtIt"C14 b(L111" + 1DZ c to LL Att ,e ST Sfl4A&. /01 A ty 16 Vt nl ;e3imi. D� IV t Y Oj 6 ".j s PA aw 43 opo C, A it E -s ibe o4e, G 4p r- + ot Ac.'r 113 104, (16 S-C %AAI. - 1 -1-11 A +-9.3 1 r, r Lo-r P6 tl V 10 ;U&�cAf,L- ?LAkt.z:0pf&1 COY TO .ST C)IL Ioac �4 paAj" 90 ADD GUTTERS/DOWNSPOUITS "K 300 0/10 AND SPLASHBLO Y live"i9y APPROVED AS NOTED AppROVE 3 By pLM%114G BY ENGI�NPERING &A Date: REcEIVE, Zug JUL 2 6 2001 FRON DEVELOPMENT SERVICES cl CITY OF EDMONDS SIDE REAR 1Q'-- OTHE HEIGHT PLANNING DATA NAMExMA,fqZ - . _)2 ATE: SITE ADDRESS.,2c)OAI 1-4PQQW=L EON ING: PLAN CH K#: 0 1 Lp -7 PROJECT DESCRIPTION: CORNER LOT . (Yes�q FLAG LOT (YesAR� SETBACKS: Required Setbacks: Front: iol LeftSide: in' RightSIde: in' Rear: 10' Actual -Setbacks: I Front: Ha Left Side: 12. Right Side: 2-0 Rear: 80. Street map checked for additional setback required? IA. _(Ye;;Q) LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Yoff LOT COVERAGE: Maximum Allowed: ':z >Sob -------Actual: 109�; BUILDING HEIGHT: . Maximum Allowed: Xt5' -ActualHeight: 11; Datum Point-.7-of-m= D,?A . ---Datum Elevation: QQ ' A.D.U. CREATED?:-, SU CRITICAL AREAS#: C'_N —2.00t - lo I SEPA DETERMINATION:JE&i_� LOT AREA: OTHER: Plan Review By: c.Tt1es\pennit%Ap1andaLdoc DA ZoneD NX 1/4, SEC. 19 T.27N.9 RA E.W.M. 255 w 19401 119407 It "07 IF 1%14019418 19416 iz V41Z JI"Z "o 00 1\1\94 tiAal 'r" PFIL. 74'.3 19419 to 194 1, t9s ii4oS ig4ot 1)155W " ' I 1 -1 19-vt " "X 19601 co ao Cc j I In 19502 SEVEN111 0-9y 9 /95*04 I qT4ERL'VING eE ADvENT 19 4? 3 A ISAr t.3 � :1508 ;-, a Q0 CHURL" to go .2 co 00 cr In cz or Fa, F co A —196 TH - ff- X w s T7 SM 4t W 4 4" A I--*— V, Q MAPLDMOD SI! '-5 v Le 10 m 19619 t.- 1" %0 MANOR 131(b 00 1#424 19612, u% m LA 19702 15706 19705 i9w '7o3 11 710 !�! 1- '0 19709 19,111 vi w NO 19714 f9720 31 19721 198 ST MA PLEWO 00 1 L 19722 197ZI .4 19801 727 Q 19730 TD X PARK 19726 1"05 1997 9801 19804 191730 Icla" Ito Itc, 1"22-� 19610 igoll 11129 19870 19629 ci 19014 lots 0 19905 lg,)O_ 19900 19903 1"02 1 19914 199,4 19911 19911 19910 1"10 cc CN 0 'D 00 00 LA 19915 19918 fAA & c '9qi! "'91 19qa 1991 IX 1"25 19917 19919 F� a — - OF 199" 9927 �A 9928 40 19919 ch K I- �4 — Z 00 19qzf co L19929 200 T" ST S.W dL v 20*10 cc ej W a to KID WSTA 920 2,AOIS to ft 2002 ac )i ? OD cl ?00lq co-op ry. 00 Pyll [b 913 c* wo 910 0o?A 200?A ;Zoo-26 20030 �210�30 FLFjAFPJ'VA Y 20031 903 902 ie 8'2 - 0031 Viol F F 20103 0 r4RPLEWO.0 SCOW 1. too- 1 813 v cu IOID& cc vi =20too,20101 -0j a 201/4 — FOR 6 <( zoizi T146 WANDICAPPLrO 20110 ool S.W. CASCADE In . K 0� r- "I r- ;4 20111 04 !-- 0 a ei SA w% Ln 't Lu a 20 LA 00 m OD 00 M CID 00 > 20//. '20110 20201 20Z(4 ck — 20208 24109 V $020 a 40 S.W 20 2o2c>4 —'105 i—ovb 2o2/7 2 2oZc 'Z*7 20307 2%6 44 20m 2ozor OD %oic 10,311 U, -j t % m 2CI226 2DR27 — 20208 20L79 1 20302 OL31 !A- 10-31 MA (L N b. 20301 0. 10315 2*310 Cc 20119 :t 4m a\ 1% go 00 2DY04 In 3 20310 307 1 20213 '21. 01 20311 am a '*31ERRA Q? I a a ;i c? 12 V '2030-7 31,5 N ST W. 321 91 w ;:116 t. 7 ;310 a, 90322 20-517 20-310 I �a 2 , I . I 1 010 'Z032 2"110 Z0,51 0 2 03 1,, 04 20314 0412. 2 2 0 2 NO — T. S. L;17 [204061 ZNOB 02047" S 20405 PIN 96 x RIDGE' 2041) L0414 ZO 321 7 z ?A RK ('I'D' �2.T2 5 F2 %0 20421 26q20 10 -- 00, 4.a L""26 00 20429 I* APPLICATION -T%e City of Edmonds for EASEMENT NO . .................................... SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS F-] LID NO. ...... ASMT. NO - -- ----------- J OWNER.... ....................................................................... ------------------- CONTRACTOR ............................................................ ....................... PERMIT NO - -------------------- JOB ADDRESS .. .......................... ------- - .. ................................... I ....... Vfft�t DESCRIPTION: LOT NO. t�:"7Tt�tC�AIEIDBLOCK NO - ----------------------------------- --- By T Citv,� of Edmonds APPLICATION for SIDE SEWER PERMIT NEW CONSTRUCTION -Izl-- REPAIRS Ej I EASEMENT NO . ............................................ LID NO. __U- ------ - ASMT. NO . ..... 7�3 OWNERJ .... .......................... ------------------------------- CON MACTOR ------------------------------------------------------------------------------------ PERMIT NO. 7* / RE (v .............................. ]E&O . .................................... JOB ADDRESS LEGAL DESCRIPTION: LOT NO - -------------------------------------- qFj ------------------- .... )6-c, ............................................... JYN-1 ------- 1-gy4 ----------------------------------------- NAMEOF ADDITION ----------------------------------------------------------------------------------------------------------------------- Approved: DATE............................................ By ------------------------------------------------------------ 1974, REAL ESTA"I'li- TAX STATEMFNT SNOHOMISH COUNTY, STATE OF WASHINGTON OF ALL STATE, COUNTY, MUNICIPAL, SCHOOL. AND ROAD TAXES . E D V A L U A T 1 0 N T A X BUILDINGS TOTAL GENERAL SPECIAL ,-'OWING TAX DISTRICTS: OAD/LIB. SCHOOL DISTRICT PORT DISTRICT OTHER SEWER FOREST FIRE DIKE NO. DRAIN FIRST HALF OR ENTIRE SECOND HA TAX UNDEF PROCESS NU MBER F CHECK BOX TO L NO. INDICATE FULL OR H HALF PAYMENT v 1L 7 LEGAL DESCRIPTION OMITTEC NOT INC OMIT ROLL YEAR YEAR TAX AMOI U S !4 ;7 L y p t- r 'AYER Ow in T CHECK M. 0. CASH 4 19730 AIM 19811 — co CC) -19812 co co cli 119847 19818 ,.:1 817 91 19822 q8jo 19810 F- 19905 19900 49903, 10402 8705 86a 19914 8715 8610 199.10, -19916k L.— 1014 19906 19904 1.9912 �8618 19 1 :49 18 9 8718 8710- fill, If A� .,R 8619' 19928 8623:-� 1010 19922 19918 cr. 9'2 .8925, oc '19927,.: 8m 8621 9925 8711 10 cl, 1251 L1231 41 930 8724. vi 920 cli co C14 co C-4 -0 co c4 - co 1230 Z 910 20020 '0 '18620 2 28 LO Ci, 20021 820 903 902 N 20030 20026 2003 1, . of 813 812 20 9 2003 810 C*N 20104 201 87f Co 0) Q co N Q OD 800 801 9211 2010 20101 co co co 20114 2012 F— 718 i= np 20125 8810 9220 CIN 8806 8802 20139. .8i C4r r 2013 8808 8804 V07 co 10 0. 90 626 202ND 2 01 8821 8901 8811 021 9011 8921 202ib8 20209 '8620 614 20210 L 8610 lit 8801 M2 sw 117C. 1%9V City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 Fax: 425.771.0221 The Critical Areas Checklist contained on this form is to be filled out by any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of the application to the City. The purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are, or may be, present on the subject property. The information needed to complete the Checklist should be easily available from observations of the site or data available at City Hall (Critical areas inventories, maps, or soil surveys). Date Received: City Receipt #: Critical Areas File CA - 0 0 Critical Areas Checklist Fee: $45.00 Date Mailed to ADDlicant: A property owner, or his/her authorized representative, must fill out the checklist, sign and date it, and submit it to the City. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. Please submit a vicinity map, along with the signed copy of this form to assist City staff in finding and locating the specific piece of property described on this form. In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assistant staff in completing their preliminary assessment of the site. The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or incomplete information furnished by the applicant, his/her/its agents or employees. By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my knowledge and that I am authorized to file this appqhatlon on the behalf of the owner as listed below. SIGNATURE OF APPLICANVAGEN T DATE Property Owner's Authorization By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject * land use application, and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the purposes of inspection and posting attendant to this application. SIGNATURE OF OWNER DATE -7 A S7- A/ I I PLEASE PRINT CLEARLY Owner/Applicant: Name 'a-o0:JJ t-APi-,--vool Street Address 6— � ru�,,l -,-� S, L-/ 4 9 ro-Lb city State Zip Telephone: 41-5- 6-)-� Applicant Representative: Name Street Address city State Zip Telephone: Email address (optional): Email Address (optional): Critical Areas Check] ist.dorJ3.19.2001 Critical Areas Checklist CAFileNo: bi- 101 Site Information (soils/ topography/ hydrology/ vege'tation) 0 Site Address/ Location: -aoo'i I zDa 2. Property Tax Account Number: 00 SO 6-2 0000 *3 3 0 -2- 3. Approximate Site Size (acres or square feet): 13,900 - f 4. Is this site currently developed? Zyes; _ no.. If yes; how is site developed? , i4 5. Describe the general site topography. Check all that apply. I 14 6 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): Site contains areas of year-round standing water: /VO * Approx. Depth: Site contains areas of seasonal standing water: A?'O Approx. Depth: What season(s) of the year? 8. Site is in the floodway /1 0 floodplain —IfL�---of a water course. Site contains creek or an area where water flows across the grounds surface? Flows are year-round? M Flows. are seasonal? — (What time of year? 10. Site is primarily: forested - ; meadow ;shrubs mixed urban landscaped (lawnshrubs etc) w"- 11. Obvious wetland is present on site: A-0 * Critical Areas Checklist.doc/3.19.2001 V.. 4 CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington SEPTIC TANK INSTALLATION PLAN (Subinit in Triplicate) �r/'40" 1�7 "�' ADDRESS OF PROPERTY ...... ........... ot No ..................... :. Permit No../Yt6 ........ Owner...... ..... ............................................ Builder6z_d _�Jars . . . Address ------ .... .............................. .... .......................... ........................ Address 0) ---- a ............... Phone Designer......... . -- - ---------------- ................................ Address ........................................... ....... ................ Phone ........................ Address............................................. ........ .......... Phone ........................ t ------ 1 .... A�wing is an accurate representa . tion of the system installed at the listed �, �acco=pa,��' I hereb cer i e Ing ra address. I also certify all recommendations and restrictions (concerning plumbing stub elevations, maintenance of grades, fills, surface drains, etc.) listed by me on my 'sewage disposal system permit application dated ................ . ....... .... ......................... ....... have been complied with. ...................... 0�. U_'A ...... ...................... Signature o DaiFi_ Date TO BE FILLED IN BY CITY ENGINEER ONLY Accepted ...... .. ...... ... Date. 91�2 Not Accepted Signature of .9anitw4mL ............ . 7e4 .................. Remarks:... ....................... ............ ..................... ............ .......................................................................................................... INSTRUCTIONS: Use the reverse side of this form for the drawing. Use a scale which will permit the greatest detail and still contain the entire site on one page. ATTENTION HOME OWNER: Your septic tank has limitations! It was designed and installed to care for an average -size fa ' mily. Over- loading the septic tank or disturbance of the drain -field may seriously impair satisfactory operation. Points to remember: — �V 1. Have your tank checked periodically to see if pumping is necessary (2V2-3 years). 2. Do not channel ground water, surface water; footing drains or downspouts into the tank or drainfield. 3. Do not excavate, fill, place a structure, driveway or.patio in, on, or over the drainfield. 4. Limit toilet fixture disposal to sanitary wastes and toilet tissue. 5. Detergents and bleaches used in normal household quantities will not harin the action of the septic tank and disposal field. 0 . 9 A-1 Al 9 CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250 Fifth Avenue North, Edmonds, Washington SEPTIC TANK INSTALLATION PLAN (Subriat in Triplicate) No ............. ! ......... Permit No ... 016 ADDRESS OF PROPERTY ...... .......... Owner...... ..... ............. ....... . Addrdss ........ ....... ........... .............. Phone ........................ Buildera... 0j -wa Address a .,*"ne: ........ Designer......... . . .. .......... .. .. ............... .. Address_ --- .. ..................................... I ..................... Phone ........................ AdqUess - ------------_-------- .............. ...................... Phone ........................ Installer... I herebvcei� �-f , &I 4ea2wti-ng is an aCCUratC representation of the system installed at the listed rac-c = p = y'! g so address. I so certify all recommendations and restrictions (concerning g plumbing stub elevations, maintenance of grades, fills, Surface drains, etc.) listed by me on my sewage disposal system permit application dated ....... -------- .... .... ............. ................... have been complied with. 12, 7 ............................ -) e2*61"l e�_' i ...................... _i4 . Z. Signature of LUzk=W Date TO BE FILLED IN BY CITY ENGINEER ONLY Accepted ...... . Date ..... .. .............. .............. 1�1 /1? - - - Not Accepted ................. ....... . ..... . .......... Date .. . .... Signature of _Saaitar4aa ............. ........................ I Remarks.......................................................... ; .......................................................... I .................................................................. ............................. .............................................. ................................................ ............................ .................................... INSTRUCTIONS: Use the reverse side of this form for the drawing. Use a scale which will permit the greatest detail and still contain the entire site on one page. ATTENTION HOME OWNER: Your septic tank has limitations! It was designed and installed to care for an average -size family. Over- loading the septic tank or disturbance of the drain -field may seriously impair satisfactory operation. Points to remember: is necessary (2V2-3 years). 1. Have your tank checked periodically to see if,pur#ng 2. Do not channel ground water, surface I water, footing drains or downspouts into the tank or drainfield. 3. Do not excavate, fill, place a structure, driveway or.patio in, on, or ove'r the drainfield. 4. Limit toilet fixture disposal to sanitary wastes and toilet tissue. 5. Detergents and bleaches used in normal household quantities will not harin the action of the*septic tank and disposal field. .001 Pi lt� t#A)VZfl'o,odD Dirt v5 0 SNOHOMISH HEALTH DISTRICT DIVISION OF SANITATION 3011 Rockefeller Avenue, Everett, Washington APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT (Submit 3 Copies) Permitto be issued to: ......... .............................................................. ............................... ................. For installation at: (street address). ------------ 4 _6 _&Z ........ Addition or Subdivision ..... The --- East --- 17-P.,Z ... f ee t --- of --- the --- Xorhhi Tr 33 Ct --------------- U � ------------ Mmocrood Hills Type of Building: New ..... I-,.- Existing ------------ Single family residence ----- X_ ------ Number of bedrooms ........ 3 -------_--- _ Other: (specify type or use) ..................................................................................................... --------------------------------------------- I ...... Builder ------ A.* --- G.,---Ward ------------------------------------------------------ Address --- 20105 --- Maplewood --- Dr. -- ------ Edmonds-,- Wn, Designer ---- Address ---- P-B4O ....... BGX ---- 14D-9 ------ Seattle --- Heights-, Wn. Soil Log Hole No. 1 --- 0 ?I_M5__1 ---- f-oreat ... 1-itter.y --- 5y_aW� --- Ald erwGod --- sandy --- gravelly --- ---------- ... fina..aand .. with ... a.-small.--amaunt --- Df --- alay . . ...................................... SoilLog Hole No. 2 --------- Same --- as__.SL--,_j ----------------------------------------------------------------------------------------------------------------- .......................................................................................................................................................................................................... Elevation of Water Table, if encountered. (Distance from ground surface) ---_-------- ------- None ----------------------------------- Corrections to control surface water if needed _----------- Suf fi-cient --- slo-pe ------------------------------------------------------------- Specify if any removing or grading of topsoil in field area ----- Approximately ... J&!! of --- topsoil --- to ------ ---------------- be ... plaaed ... over ... the --- draInfi-el&-area ... from--basement-.�exzavati.on-, ------------ Percolation: Test Hole No. I —Average Rate -------- 5 .. Min/in ------- ------- _ ------ .-(Fall in minutes/inch-bottom 6" test hole) Test Hole No. 2—Average Rate ........ 8 --- min./in ......................... (Fall in minutes/inch-bottom 6" test hole) Test Hole No. 3—Average Rate ----- 5L;2Lm1n/i.n ------------------------- (Fall in minutes/inch-bottom 6" test hole) Average percolation rate on which to base drain field design ...... 7...min/in ---------------------------------------- Septic tank requirements based on present rules and regulations: Septic Tank Size -------- 9GO ------------ gallons. Amount of Square Feet of Disposal Field -------- 423 ------------ Signature — Designer--- ----------------------------- Date ------- 13 --- Mar --- 6.3 --------- ---- DO NOT WRITE BELOW THIS LINE (To'be completed by Issuing Agency) , /K 63 Permit issued (date) ---------------- 3 - ------------------------------------------ Permit Number ----------- O_A� ----------- Remarks:. -------- - ------------- ----------- ----------------- .. . .. 11'111�111111'e 7r BROWN auto n, z�,S: 11;4, $Wpo 1w, W, lN Von ARNW, IQW, 7 My W- -"M". W� M, 01 lb--- N-11- If 1-k Qn%f 510! of w 6-4 A la"W" IA P, 4 .ti 77%7 QN �A`Ml W4 AW, 1 it A-" 11 Ill 1 10 - . i 4-i h sq, WAIN, TO REGARDING: 20031 �laplewood Drive .Taiddress) R E C 0 R D 0 F C 0 N T A C T S DATE NAME, PHONE NO., & COMMENTS ADDRESS of CALLER 5/1/74 James Flobert. Certified Letter No. 406346.sent n p requiring hook-up within 60 days. 5/24/74 Resent Certified Letter No. 406450 I requiring hook-up within 60 days. L L �/7/74 Came in and obtained permit #484S. L_ 6/27/74. Connection completed. ACTION TAKEN Letter returned uncldimed. Letter received. INITULS TE Igo TE TE RECEIPT FOR CERTIFIED MAIL-300jplus postage) 422-066,20 % %P ARK I �E OSN OR D E FLOBERT, JAMES Q:zr 7020 GREENWOOD AVE. N. SEATTLE, WASH. 98 103\,. "'K auu .. u"AL t"' SERVICES FOR ADDITIONAL FEES RETURN 11 Sh s to whom and date delivered ow a to . es ss 0 ly RECEIPT With delivery to add, e see only 65d 2. Shows to whom, date and where delivered 35e r SERVICES i y to r ss . ly W th delivery to addressee, nly . ........ 85,t 7 10 ADDRESSEE ONLY .... .. .. .. 50d SPECIAL DELIVERY (extra fee required) P" PIP PS Form 3800 NO INSURANCE COVERAGE PROVIDED— (See other side) Apr. 1971 NOT FOR INTERNATIONAL MAIL GPO; 1970 0-397-458 k.i N #WiO i '-SIGNATURE r., U 7 A t .,.is K,,URE�:OF'.'ADDRESSEEIS,,A(iFNI'.- It AI�T,�"j�: �7 A f ire'qi d REq:,, �rj 4cste .aM'ii�qud4'4�P_q�dc). OW.4WHERE P_ J 7 E. N. 98103 Z RECEIPT FOR CERTIFIED MJAIL-300 i c) -James F70bert (Plus POstag Z_ �_ e T EET AND PTSTMA-RX Gre' OR DATE __enwood Av (.b 0., s -enue NOrth 0c.4f, tF CODE CD 7 e 5 atsh - 9 r I ng.ton. OPTIONAL S ;98703 RETURN 1. Sh ERViCES FOR ADDITIONAL F RECEIPT aws to whom EES N With del , and date delivered SERVICES tZ. 2. shows t very to addressee oni With whom, date and rib y ........ DELIVER TO ADDRESSEE deliver- t a s ere delivered SPECIAL DELIVER ONLY ddre Sce only 3 '""' * ..... * .... .. ...... P Form Y (extr, fee req ire '* ............................ 85 Ap.. 197, 380o NO INSU ........................ .... .... ...... 50d RANCE COVERAGE p NOT FOR 'NTERNATIO VIDED_ 0 L AIL (See othe, side) 'Po: 1970 0-397.45a DATE RECEIVED t,. J PERMIT EXPIRES., u4sisse CITY OF EDMONDS USE PERMIT ZONE 0� 4 NUMBER, - CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT ADDRESS A b! 21 OWNER NAME/NAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ 0 r -r r— &k MAILING ADDRESS 20403) M/WL& L_,4%),b b f2 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT TESCP Approved 13 RW Permit Required 0 Street Use Permit Req'd C3 Inspection Required 0 Sidewalk Required 0 Underground Wiring required 0 CITY ZIP TELEPHONE L4 I 6n alij I NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIR D YES 0 NO Z ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE z z (3 z CITY ZIP TELEPHONE NAME v 6r 4�= (L COA�STA44::�TD^.) Tj�� 4 31A I ;ENGINEERING XVIEWED/DATE 1Rx VC 0/it/ /01/ ADDRESS 00 -a OX '-)30 �,FIRE REVIEWED BY DATE S It. CITY zl�'� L 6 C—LL4 f-N TELEPHONE 1 114 50cl o-Al. 7:111 VAR C R CU, ... SHORELINE 09 .,AD i B , # INSPECTION REO'D 0 YES XNO BOND ND 0 4 z z STATE LICENSE NUMBER EXPIRATION DATE _5gF_ VA5_0 711"y yzk L I CHECKEDBY SEPA REVIEW COMPLETE I EXEMPT EXP SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCECNO. 00 506 003302. A -700 'Aj� NEW RESIDENTIAL /MECH EF> AUDITION COMMERCIAL COMPLIANCE OR CHANGE OF USE REMODEL E] APARTMENT SIGN GRADING FENCE REPAIR CYDS 0 X FT) LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT) FRONT SIDE REAR 6 '15ROPOSED SETBACKS (FT.) FRONT-AJR SIDE REAR I - 1" 1/ Fh..� PARKING LOTAREA I PLANNING REVIE ED'BY; IIATE REQ*D I PROVIDE S, r-..jda, 0-1 REMARKS DEMOLISH 0 TANK o OT—HER r. I A2 :kIhh1:tx, 4 JA U ' " GARAGE C@ R ETA' NING WALL RENEWAL CARPORT R CKLI3L (fYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN- CHECKEDBY ITYP!jMCTION TT7_ OCCUPANT GROUP ie 31,4 )�jp4-z- - NUMBER OF STORIES z NUMBER OF DWELLING UNITS CRITICAL`itlIqA01QLP— AREAS NUMBER C) I SPECIAL INSPECTOR' A-REA REQUIRED 0 YES OCCUPANT LOAD -ti DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D Coeavett'r 2_ C-AIX e_A,9jIs0A,7' X --To 00 Sf 4>f _51� t4ee_ 6$-,e1,_t ce;, Ale-, re4c,,`,;,5 W14// or�. 3 &A(DI PtAe_44 Rtd-,,2q4�9 . S"fil-, -side, klCil') /h(Ilkik 'eW904'.- t7nll I NkxD &V:�nr! rllqN VALUATION FEE etjGo P) I PLAN CHECK FE 77—�9, 1 1. V, HEAT SOURCE GLAZING % LOT SLOPE % 'BUILDINM' PLAN CHECK NO: VESTED DATE JPLUMBING 2 MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE GRADING/FILL SEPARATE PERMISSION. STATE SURCHARGE cc W PERMIT APPLICATION: 180 DAYS 0. PERMIT, LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 0 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS 0 ENG. INSPECTION FEE W IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CIT j Y OF LANDSCAPING 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT RECE DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENTOF ANY CITY ORDINANCE 7, 0 NOR LIMITIN ANYWAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- 21 TOTAL AMOUNT DUE R CE71 T -2 I HEREBY ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT, AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid. and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. A — SIGNATU WNER DATE SIGNED OFF �LS SIGNATUR -1 DATE r �,T I'DI-25-0ir (4251 r-11A B 771-02H yll I I z I D B DATE ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL' 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI ORIGINAL FILE x CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX - V _,N1PFCTdC PINK - OWNER - GOLD - ASSESSOR 5198