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203 3RD AVE S.PDFIIIIIIIIIIII 4917 203 3RD AVE S City.of Edmonds RIGHT-OF-WAY CONSTRUCTION,. PERMIT - Permit Number. 95 t Issue Date: 5 A. Address or Vicinity of Construction: 7-0 3 3 k P /-\V E -S B. Type of Work (be specific): 0- P LAC-E- D AMA 6 IL 0 C TV r-ARLE if T8 9 0 3CFC ATTAC-14C6 1)P_ALd1WC C. Conti -actor: 04AMG9kS1S1JJ9Ce_109- CA Contact: Td kk AN P ER-50 &I Wiling Address: 5-33 KA(M1977 Phone: 7 74- 5746 SiateLicense#: SUPreR-CC-10161A Liability Insurance: Bond: $ D. Building Pernut # (if applicable):. Side Sewer Permit #..(if applicable): E. [] Commercial []Subdivision 'M-WATER) 0 City Project 6k Utility (PUD, GTE, WNG rAb F1 Multi -Family El Single Family Other -------- I INSPECTOR: I14SPECTOR: kkj�4, F. Pavement or Concrete Cut 0 Yes JRNo. 6. Size of Cut: Ix H. Charp�_$ APPLICANT TO READ AN IGN INDEMNITY. Applicant understands and by his signature to this application, agrees to hold th� Cit� ofEdmondg harmless from injuries,tilamages, or "C" ' f Edmondk , any of its depciAments or claims of any kind or description whatsoever, foreseen or unforeseen, that may be idin.t ih. City a or employees, including or not limited to the defense of any legalproceedings including defense costs, and attorney fees by reason ofgran'ting this permit. 16 THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS.FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL �E�69 WILL BE HELD uNrILITHE FINNI, STREET PATCH INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION IS COMPLETEO B Y CIT Y FORCES, A T WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and material is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. 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 City approved material prior to the end'of the working day; NO EXCEPTIONS. Ihave read the abo�e statements and understand thepermit requirements and thepink copy of thepermit will be available on sl . t all t* for inspection purposes. Signature: Date: ILI - _T1 - ? 5- (Contrac or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: RIGHT OFMAY DEPOSIT TIME AUTHORIZED: VOID AFTER DAYS DISRUPTION FEE/FUND Ill: SPECIAL CONDITIONS: RESTORATION FEE: PERMIT -FEE: COMMENTS: DATE: TOTAL FEE: RECEIPT FEE- ISSUED,BY: Z/, NO WORK SHALL BEGIN PRIOR TO PgRr4iT &SUANCE Eng. Div. 1994 FIELD INSPECTION 'NOTES (Fund 111 - Route copy to Street Dept.) Comments: Diaaram CONTRACTOR CALLED FOR INSPECTION El YES El NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.) Comments: I Diagram CONTRACTOR CALLED FOR INSPECTION F-1 YES El NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: 2-0 . -3--- 3E-I� A'VE s lz P A I I i i -?, r\i r. -rr -A Dp \/-TOO 5T. -SPL/4,9' A�r-LJ 69&E 7o trrmAc,,5D 0!�Ee eA-t!LE - E)oSA jArro IPLUAir A-hip-PEL), - 890 -041 City of Edmonds Critical Areas -.Checklist I he Chucat Areas unecl= cohWned on and submit it to dw City. The City will this form is to be filled out byiny person review the Checklist., malm a precursory site prqMing a Devdopmcat Permit visit, and make a ddm.6=ficn of the Application for the City of Edmonds prior subsequent steps necessary to complete a -to his/her submittal of a "Op devc1opment permit application. permit to the City. 'Me With a signo copy of this form; the purpose of the Chedkiist is to &able, applicant should also submit a map City staff to determine; whether any or ploR plan for indiAdual loft of the parcel potential Critical Areas we or may b6- with -enough detail that City staff can find present on the suWject praperty., The and identify the sWject parc*s). In' inforruatibn needIed to complete additio:4 the applieW shall indude Checklist should be easily available fiam Ptherperfineat Thformation (eg. site observations of the siteor data available at pht4 topograpby . qh 40 erstudMes in City Hall (Critical Aims invenwrks. maps, cOniumfian v4M " Chedkft to assist or sod' survcp).,_, Staff in conqfiethM their Ip -pr An applicant. or Ids&w must fill ("Vie checiffist, sW and date it. I have completed the aftadied OfficalArez- a=Hist and-=cst datV are. gc.(fiu out wner, I Appeaca Applikant Name Sft"Mtves� .... .... fted Ad&-= City, Stato; 7" Phwe MP, Sil:112" �z, CA FILE NO. C fiffical Areas Checklist Site Information..(Sd*&Itopography/hydrology/vegetaflon) 1. Site AddressnAcatim-,,. ��0:3 — S PC> AAA=_ e�yj Ut�j F 2. PEOPertY Tax Account Number. 3. Approximate Site Size (acres or square feet): 1_250 4. Is this site currently developed.? __k:��es; no. If yes; how is site developed7. 5. Describe the general site topognphy."'Check all dw apply. Flat . less than Sfeetelevation change� eyer entire site. Rollinr slopes on ift generally less dim 15% (a vertical f 10-f 04 rise 6 eet ei a horizontal distance of 66-feet). Hilly: slopes presentan skeof worediai'15%miml lessdiaa3O% (iverticalriiiei'_ of 10-feet over.a horizontal distanw of 33 to 6"bet). SteW gaides afgreater dtaa 30% present on site (a vertical gise of 104bet over a hoeizontal distince of less dtan 33�&q). Otfur (please 6. Site contains areas of yeamund stauft watw. /,,to Approx. DepdL­.*':.t 7. Site contain am of seasonal so Vater. ;'Appror_.Depdr_" What season(s) of die yen? 8. Site is in the floodwa dood$ ofawatercotume.— y— t,10 9. Site cOutdo a atek Orain am wbecivaw'Gam across the gmunds surfice? Flov�iwe . YeW6 90 (Whattimeofyed 10. Sift is prituadly: &vested 0.20eadow urban landscaped QawnAuvbs 11. _Obvious wedand is present on -.00-numd 0 -14. Rwlyalr MUMEW C.Al tarth mbddeawl lar 54-6 --ad dcannie'atill' Sin itfiin-Mm z _M ;4QUIR �7 Plaw `1_3 CA FRE.— Critical Areas Checklist Site Infonmation,.(Sd"topography/hydrology/vegetation) 1. Site Add'=M=afim-,,.�XO�3 -3Pf> d4lu're 2. Property Tax Acoount Number.- ;L-ba-] 3. eet) Approximate Site Size (acres or square f 4. Is this site currently developed.? es; no. If yes; how is site developed7_1-Q UgL:_:j[:L 5. Describe the general site topograph�.` Check all that 2pply. ,-"'--'Flat: less than 54eet.el a change over entire site, evatio Rolling: slopes on ske generally less than 15% (a vertical rise of 104eet'ovir a - horizontal distance of 66-feet). Mir. slopes Present on ske of more than 15% aind less than 30% (a vertical r"Uri".. oflO-(eaover.ahochoaWd'm=of33to6"ed). Steep,.-. grades of greater than 30% present on she (a vertical rise of 10-feet over a hoemontal distance of Iess than 33-fed). Other (Please 6. Site contains arm of year-wwW stauTw4g water. go .�;Appw_D.qAc--*­, 7. Site, contains areas of seasonal sta walec Appm�. Depft- What season(s) of the. year? 'A S. Sitels in ific goodway podplaim Mn� 9. S-ftcogit"actv&or'snamubeii'!.W&'W'Gmamn*eVoundswrhoO Flaiii-i areyear6 Mn (What C. ofyd IL 10. Site is pdmargy: forested "eadowl wban landscaped QawnAhrubs CM) llo-.Obvimwedand-ispresemonske:�-,-..�-i��ko 7-­ . y3tafn V C7 %yer, JaMic 4 Co 40, *WCURRY =4 CMW Ater z 5 QL 0 dslidaWacdvied. Mat se 1171, 10-0 FIELD INSPECTION NOTES (Fund 111 - Route cony to Street Dent.) Diagram: I Contractor called for inspection Yes NO Work Disa.T.3proved By: Date: By: Date: Work Approved By:—. -Date: Inspector:, Encf. Div. December 1978 FIELD INSPECTION NOTES (Fund 111 - Route conv to Street Dept.)j Comments: Diagram: Contractor called for inspection Work Disapproved By: Work Approved By: Inspector: Yes Date: NO Bv: Date: U 0 U 0 .0 W IV) 0 CITY OF EDMONDS S T R E El' PUBLIC WORKS DEPARTMENT RIGHT - OF - WAY CONSTRUCTION PERMIT A. *Address or vicinity of Conslitruction C> 'A 6 9' Owner: , M Name ,,10 -�) Mailing Address EA/V"0L(5Y\A_4-"- City,' State, Zip Code e Contractor: _rmit No. 31 -7 Issue Date 0 Permit Issued To: • Type of Work to be Done- • Wol in Connectl)n With: 0 Sub or Plat El Single Family 0 Corriml. / Ind. Apt. Condo. • Pavement Cut: 0 Yes 0 No Name 0 , k , 0. C Mailing Address City, S ta te, Zip Code NO WORK TO BEGIN PRIOR B. APPLICANT TO READ AND SIGN -'PL- I C7 State License Number Telephone Number TO PERMIT ISSUANCE I INDEMIT'Y: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be' made against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any: legal proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit. I Upon issuance of this permit, the contractor is responsible for workmanship and materials for period of one year I following the final inspection and acceptance of the restoration by the Engineering Division. Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at which time a debit or credit will be processed for issuance to the applicant. Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic Call Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engincerini. 775-2525, extension 220. I understand that this permit must be available at th b site for inspection purposes at all times. Signature: P&a:nn&,& ate Owner or Agent THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSE/* CALL DIAL - DIG PRIOR TO BEGINNINGwbRK C. issued By: Permit Fee: );�:2 tle Time Authorized: Vold after S,3!Q —days, ��O Security Deposit: Special Conditions: Receipt No.: V .0 11C VJ 004-u nd I Fee Arnmendments, Street Cut Dimensions X NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. Decembu 1978 2L -7 1.1y 0 CITY of EDMONDS BUSINESS RRE 4. LICEN to NJ' ST 't TE LICENSE NO. Civic Center Edmonds, Washington 98020 City Clerk Phone 775-2525 A AL FEES PENALTY AFTER FEB. 15 0 HOME 0 QUPATION INSTRUCTIONS: CLASS YEAR LIC. EFFEC. DATE LIC. NO.JSPEC 0 $10. (A) ADDIT l,t �$5. 0 0 0 • All items must be completed & , � � IREASG. 0 SMALL Bus.. or application will not be ac- cepted. RECEIPT NO. OAT A- PRINT X IN SPEC. Box $15.00 �E;)� DT'ONAL $7*10 DITIONAL $7.50 0 3 J 0 B u,� r iness ilK 10' 0 • Sign and return application FEE PAID PENA LTY PAID FO R ISSUE OF CORRECTED r e0l C more.e ployees ADDITIONA 00 0 with fee. Renewals received LICENSE WITH 'LC' ACTION. 50.00 (C) after February 15 must pay 0 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) ,'R-. , - NAME OF FIRM Iq 0/� 7,J 7- BUSINESS PHONE NO.OF EMPLOYEES MAILING ADDRESS NATURE OF BUSINESS JACK E. and MARY K. WILLIAMS Apartments 219 N, Underwood BUSINESS ADDRESS 202�`- :- - 1' INDIVIDUAL PARTNERSHIP CORPORATION -"-- 11 - )0k Q� (S) (P) P 203-209 Third So., Edmonds, WA OWNERS NAME HOME ADDRESS JACK E. and MARY K. WILLIAMS 219 N. Underwood, Kennewic'k, WA 99336 HOME PHONE DATE OF BIRTH PLACE OF BIRTH SOCIAL SECURITY NUMBER 509/783-8843 8-8-17 Centernnint.. diA d qiA-n7-qqI`;4 -Ind i A EMERGENCY NOTIFICATION: (1) NAME& TELEPHONE -Ei Fie—r .1)D-Quse (Jack or -Ma K) (PLEASE LIST TWO) (2) NAME & TELEPHONE Mrs. Blanche E. Jones 206.1776-4374 Emp-1 —.Seq-q-ri-ty-Aqct—.82-80955 -teU "C'� e WASHINGTON STA - — 1!5.— A 14211 1Y1'GNdW STAFF REVIEW: DO NOT WRITE BELOW THIS LINE 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. i PLANNING DEPARTMENT �kAPPROVE 0 ERSAPPROVE DATE LAND USE CODE ZONING CODE SIGNATURE CONDITIONAL USE PERMIT COMMENTS BUILDING DEPARTMENT DATE :5 -3 Building 2-"A'PPROVE 0 DISAPPROVE SIGNATURE 0 Hotel/Motel Permit 0 Apt. Bldg. (A) ET I I I I 111 Office Bldg. (0) COMMENTS: Occupancy 0 Restaurant (R) Group 0 Hosp/Nurs Home (H) CAPACITY: (NO. UNITS, APTS., OFFICES, SEATS, BEDS, STUDENTS) 0 School (S) FIRE DEPARTMENT DATE U. F. 1. R. APPROVE 0 DISAPPROVE SIGNATURE - �vtaf-,,— COMMENTS: POLICF--DEPARTMENT --11�- / -I— Cj / t,A-rP R 0 V E D AT E SIGNATURE 0 DISAPPROVE COMMENTS: PUBLIC WORKS DEPARTMENT 0 APPROVE 0 DISAPPROVE DATE SIGNATURE COMMENTS: /0/ - 03100 CP /o/ -03AOO COTY 0, 9--- E KJ M 0 j" Ll E. �c HARVE H. HARRISON 200 DAYTON ST. EDMONDS, WASHINGTON 98020 - (,'?OC)) 171, MAYO�z. DEPARTMENT OF PUBLIC WORKS March 16, 1981 I STREET �.­ILE Dear Resident: On February 17, 1981, the Edmonds City Counci"� passed Resolution 488 for construction, reconstruction and -repair of deteriorated sidewalks. A puhlic hearing will be held in the Council Chambers at the"Civic Cent-er on April 21,198.1 at 7:30 P.M. You are ianvite.d to-. a.t-t,-e..nd--,,;, this_ hq_aj��ing—for, discussing!i,repair of portions of deter i oeated-:,sA"de-W­�fk abutting your property. The-,impr . o 11 v i emO'i")'E'of�d�e-walks — i n need of repair at the expense of the abutting property owner is provided by City Ordinance, Chapter 7.20 and'' Revised Code of Washington, Chapter 35.68. The areas needing repair have heen marked in paint on the sidewalk adjoining your proT)erty. Reconstruction and repair of these sidewalks must be Completed on or before September 1, 1981. In the event improvements are not completed within the above specified time, tile city will perform and complete the improvements at the expense'of the abutting property owner. This action is' in response to many citizen requests and pedestrian falling accidents which have been increasing in recent years as a result of sidewalk deterioration� and increased pedestrian traffic. Sincerely, FRED F. HERZBERG Director of'Public 'Works APPLICATION for The City of Edmonds SIDE SEWER PERI$HT NEW CONSTRUCTION [] REPAIRS EASEMENT No. . ....... ................................. OWNER.... .... JaCjk ---- E . .................................... CONTRACTOR .................................................................................................. PERMIT No . ...................... ADDRESS c:209 .... 3 --- r ... d ........ AY-0-A .... SO ........................................ LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................ 1�1 0 0 NAME OF ADDITION ............. 117a -C/ Ta A,�r, l%e/ On Sewe-r DATE................................................ By ...................................................................... APPLICATION for The City of Edmonds SIDE SEWER PERMT NEW CONSTRUCTION 0 REPAIRS 0 EASEMENT No . .......................................... i0l -08 ton OWNER.... JdC-K.-#=-* ......................................... CONTRACTOR .................................................................................................. PERAUT No . ...................... 'd ADDRESS .210.3-3 .. r ........... Ava.....-J ......................................... LEGAL DESCRIPTION: LOT No . .............................................. BL0CK No . ............................................ 0 0 NAME OF ADDITION ................................................ Juna, /97J Jor :td 0 et Tewfad Sewer Approv . DATE................................................ By ...................................................................... , 0�o USE e, ZONE PERMIT CITY OF EDMONDS NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT # OWNER NAME/NAME OF.BUSINESS ADDRESS LEGAL DESCRIPTION CHECK[SUSDIIISION NO. LID NO. f1r,kt,/A07r2 �J L-u MAILING ADDRESS Z 3: 0 17 , 0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved CITY ZIP TELEPHONE NUMBER RW Permit Required XISTING — REOUIRED DEDICATION — Street Use Permit Req'd 13 �A-� I I I - -Z 0& - c� �Vl - Inspection Required 0 :ROPOSED Sidewalk Required 0 NAME cr W METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED LULJ ADDRESS YES 0 NO 0 REMARKS W cc CIT! �Zll NUMBER w Z NAME LC 5.Nv I A.!>A L cc ADDRESS- 0 ENGINEERING REVIEWED BY I'- VF-. t� /,/ 6 k e- (f MEMO DATED < CITY ZIP TELEPHONE NUMBER (r 1'- &2 � FIRE MEMO DATED REVIEWED BY W Z 206, cc 8 U. STATE LICENSE NUMBER' EXPIRATION DATE 67 L. U (�A r2 -51 '7& 7M q !Za. SIGN AREA SEPA REVIEW, ADS NO Legal Description of Property -,include all easements t1t;j ALLOWED PROPOSED COMPLETE JE ti�� I SHORELINE N EXP VARIANCE OR CU �WREVIEW BY Li cc U 7-1 W SETBACKS — FEET* HEIGHT LOT CdVERAG9 Z FRONI SIDE REAR Z Lu I I -j 5 .ti-Account REMARKS ElNEW El RESIDENTIAL El PLUMBING Xz� �314-411 0 ADDITION COMMERCIAL El MECHAN1;.,AL S//z S�7,/Zzt2i ;1 ElREMODEL XAPT. BLDG. El SIGN CHECKED BY TYPE OF CONSTRUC� VIN CODE OCCUPANT GRADING FENCE P 9/ Gr� El RE -PAIR El — CYDS. El 11— x _ F7) WOODSTOVE SWIM POOL SPECIAL INSPECTOR JAREA OCCUPANT DEMOLISH El INSERT D HOT TUB/SPA . REQUIRED LOAD, ES GARAGE RETAINING WALL/ CA ROCKERY RENEWAL REMARKS L) (TYPE OFAJSE...BLJSINE S OR AC:jIVITY). EXPLAIN: PROGRESS INSPECTIONS PER UBC 305 EE A\T2AyTh1i5f-r j KI rr� 5-n NJ&- �S NUMBER UMBER OFP.,- 'CRITICAL uj I .. 1 4 REAS o OF DWELLING (0 _STORIES UNITS 10 UMRFR 0 DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) JZ�MOVC .2- r-A, PvtJ &75 FINAL INSPECTION REOUIRED VALUATION FEE AP2' 5,ato PLAN CHECK FEE BUILDING HEAT SOURCE: GLAZING % PLUMBING Plan Check No. - MECHANICAL 71 This -Permit . covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewelks, — driveways,. marquees, etc.) will require separate permission. STATE SURCHARGE �71 PerrAlt'Application: 180 Days STORM DRAINAGE FEE Permit Limit: 1 Year - Provided Work Is Started Within 180 Days ­A00IicanFpn 'behalf of his or her spouse, heirs, assigns and - ENG. INSPECTION FEE w successors in interest, agrees to indemnify, defend and hold 'Wn harmless the City 'of Edmonds, Washington, its. officials, i employees, and agents from any and all claims for damages of ir , < whatever nature, arising directly or indirectly from the issuance of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT modify, waive or reduce any requirement of any city ordinance 0 x nor limit In any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE provision." I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL information given is,qQ.Frkct; and that I am the owner, or th.9 duly authorized agent of, ihe'owner. I agree to comply With city and THIS PERMIT This application is not a permit until state laws regulating construction; and In.doing the work authoriz- AUTHORIZES ed thereby, no person will be employed In violation of the Labor ONLY THE signed by the Building Official or his/her Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid. and receipt is tion Insurance and RCW 18.27. INSPECTION acknowledged in space provided. SIGNATURj (OWNER OR AGEN,T DATE SIGNED DEPARTMENT GFjFACIA S AT IE DATE CIT I '1� " , I Y OF 2- EDMONDS Ou CALL FOR RELEASED 0 Y: ATTENTION INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220- ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC