20515 80TH AVE W.PDF11111111 lill
7134
20515 80TH AVE W
NOTICE:
No warranty of accuracy.
The -information shown on the attached
map(s) was compiled fo' use by the City of
171
Edmonds, its Employees'and Consultants.
The City of Eclim.onds does not warrant the
accuracy of anything setl forth on these
map(�_). Any person or ehtity-reque'sting a
copy should conduct an'independent
inquiry regarding the informa tion shown on
includin it not limited to,
-t-Ke -m a p (s) g, b u
the location of any sewer stub shown. Such
sewer stubs may or may�. not exist and may
or may not exist at the lo'cation shown.
Neither the City of Edmonds nor it's
-s o-r off ice r---) sh all be liable for the
empio-yee
information given on this map(s), nor for
any one representation I provided based
upon'said map(s).
APPLICATION
for
The City of'Edmona,)s LF SEDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS 0 EASEMENT No . ..........................................
OVVNER ............... .......... ........... ...... ...... ................................... CONTRACTOR ....... qc="F= PERMIT No . ......................
...........................................
ADDRESS .......................................................................... LEGAL DESCRIPTION: LOT No . ..........
............................ BIA>CK No . ....................
.... . ................
" 4=6-av I "
...........................................................................
3Y.... .....
"t'? --.5 .......................
APPLICATION
The City of Edmonds for
SME SEWER
NEW CONSTRUCTION REPAIRS EASEMENT No . ..........................................
L ID /.aq
OWNER ---
y ..........................................
ADDRESS ....... - — -----
... ............ ...........
CONTRACTOR 7'
------------ PERMIT No. �,3,9.6
LEGAL DESCRIPTION: LOT No . ..... .................................. BIA)CK No . .............................
NAME OF ADDITION -Z
..........................................................................
— -5—Z / —
Approved:
DA7W......... - ...... ........................... _ By ..................
JUN 2 8 1973
ITTY, OF EDM011 05 .,Sli it
R-�SEW IRTMENT
W�iTE ER DEPA
IRM
PE,
43 9'6
-7 6-4107; .46r Is Ide, sewer,.�Insaai.n., �coiv e i I tj it, joy, �'port I ciw'�-,d f �'-_Ahe�
Conkrucciont
Inspectlon7. wlilI�b�,PrIOVIdedk withino.2�(,hourslafter- request., Inspe
-OF"CONSTRU -80n,',�-vt-nue Wes t
�kDDRES& LOCATION CTION ............ ........ ... ..............................
...........
.....................
.............. ............ ..............
RIF NI. I .............
PROPERTY LEGANL! DESC M ..... Pt QAOet ........................
............. ...........
...................... .........................................................................
..............
.................................................. ....... ....... ...... ..................... .............................. . . . ..................... ....
......... .... .......... ......... .........
................... . ...... .................... k. -Admes"
........................... :...
............. ......................... ...........
.... ........
COXTRA4bT-OR,S1'NM1JE1 & ADDRESS' xcavators.,S, �30302',SbUtly 384-th Puy'all -hlis 483�7
...... ------- 7'� ............................................ 7 ......................................... MNp . ..............................
. .... ............
rzfiteid,: ........ ......
........... ...... ............... y:.s1kA ar
S1,91- :'-` 73 onne�t Qf�f� sid it
T_�ds4onl Uni? M
1,9!.- * , �%.,,�for,.,repair,,andViD�.!"C fozi� 6 sewer
y/,�sewer,
ordinances.
7NTIONi 18''CAILEEDItTO'THE� FOLLOW NG:
imu
li_The�,owneis,,of the may obtain, 'a,,"p'erifiit,to,6on"9'truct,..W'�lil.-I.�i'i�e pr' e'rty'.-Iffie., 'A' licensed; Side Sewer'.,Cont ", st P
pp i.ctor ibeem loy�d �'I;Q;construct
sift'sewer.Am'street area:. Aoinot,cover,iny Portion �of.sewer,before�4t. has been ins
NOTI�f No. pdFtedi,
.2L�Allll work �peiiformedin-.clty, -right-of-way.,rpquir�es�.an,,Iiivasioii,,of..'-RJ*ght-of-Way Perinit, abieji�m,,the 'City'�Engineerls;,,*6ffic6,.�,:,;,-
�obtaih
''NO ti ' .1mgarding �Ordln
T-E. -'T—'Obtaln,l full Anforma Ion ance 11.46.030: and -Regulations; ;g�v��ning.:sl�e,"seweral..%�hen"you igqt,PermiG.
NOTE No: 4'.—T6��,of;si�e;:�e�ver'mtist. have at' least Is ajidl-12, 'nche
I �: ., - , 30 inches _coverage, at �property lin I." Bt,:Inaide�,properLy�line;;.rritnim�m,'.grad�.,oi,'
sharpeikhaj0A, wlll�be,,' rm'ttted�
pe
NOTE, No% _5—Tiienches�iirl:stre6t must �,be water �settle�d`&ndsurfsc6,of street restored� to',,cr'IgIn lA n� ac
al �o ition, �6ontr_'_torsishalll bei:responslille"'ior f.1'ju['re,1d6e1jtc,fJmpr�per
work, wfflch,-m&y,develbp, Within-,one,:year;of,,'
completiom ,
NOT.R No;,,r>�—It Is, unlawfull,to-Ialter lo'r-,do, any other work� thaj�,.Isl provided for Jn. tbe!,I�eimit,,,!6�7,to,,do,a�y'-w6rk on,the:.Maiff -se*'er!�,6r,�it's"�a�purte�ancei�l�x'�6pf*'jt6, jn`-�
wy
sert Us p!pe, Intol the e.,,
DIS"PROVER) IE]!�: Datet;.:� ... ................. Didife"
BY: ...... ... ....... . B ..............
. , - iii- . .................
71'.:;,W . ............ Y, ........
AP P R OVE D'
............. .......... ............ .... ..
Rbinar ... ...
.......... ..................... ...... . ........... ........ .
................................... ......................... .................... ............
............................... ....... ......... .....................
.............................................. ...............
�.B T PJerinif'lCbpi'ei;i,MqST'Be, -S� ed!,BY �Gx�,Ii&,O? J�i erforming; IConsltru�tionl T'RIOR. TbI:Request,"Fo�,! lnspectibm
All
"1Aibn'�iConst*`
-certify (t-49VAthe;
... .... ...... ...... .. V ........ 'hereby* er er-mit
ruct0l� , ithid ithisrip
...........
d'A
� z7l' ...........
M, 7
;(Own lr�Fof Conit�actlng"Flr - Performink C nstructiow)
-EdrA
Ihstalled4maccordance,wa -alligovern �ordiri wices lot .the, Zftyyof bridi
S
......... 19.7.
batedi,this ............ t7it.
7�
C k, BEFORE' y6u,,dig i(or:'W—ater T,
hec, elephonei.1g, -pow r,;E3:: Sewer: i[],,. 0ther, �Ey
4 -
City of Edmonds
]01"T -O.F-WAY CONSTRUCTION
JL
Permit Number.
Issue Date:—
"7
Err
A. Address or Vicinity ofConstruction:
9 0 1 9() B. Type of Work (be specific):— Re v.IAC- 9 -3-Z'
C. Contractor: Contact: "a Y��
Mailing Address: 20 & Aye 4) Phone: '7 -7/1 <?R 0
State License #: Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. E] Commercial E] Subdivision n City Project E] Utility (PUD, GTE, WNG, CABLE, WATER)
F] Multi -Family JA Single Family F] Other
INSPECTOR: C1-"6MAr4 INSPECTOR:
F. Pavement or Concrete Cut: D Yes 0No G. Size of Cut: x H. Chargq,,$
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds harmless from 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 its departments or
employees, including or not limited to the defense ofany legal proceedings including defense costs, and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT 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
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 asrequired 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 abouestatements and understand thepermit requirements and thepink copyof thepermit will be
available on site at all times fo:r�7insp tzo,�n3urposes.
Signature: 2�"e I _4� - . Date:
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY'USE ONLY
APPROVED BY: RIGHT'OF'WAY DEPOSIT LA.4 b, >
TIME AUTHORIZED: VOID AFTER DAYS, DISRUPTION FEE/FUNDf 111:,
SPECIAL CONDITIONS: RESTORATION FEE:,
4F
;RP'fa&�d= PERMIT,FEE:,
TOTAL FEE:
COMMENTS: RECEIPT FEE:,,
DATE: jSS,UED, BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund 111 Route copy to Street Dept.)
Comments:
I Diagram.:
CONTRACTOR CALLED FOR INSPECTION El YES NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
-VIEET
0'.
ci 1),.; i
!3 1. ci i n,: I t. Ll C,- -t t i n
ng
Propc;-sccl rz 4) c, r, a t i. c: a i on, 205 lil 10"Oth Ave. W.
A E
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s T T
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- - - -- - a--/1/7-1
r
POSTED ON KRO" MIEPMO-: PERMIT
BUILDING DEPARTMENT
ApplicawntIll1111
NUMBER
PERMIT APPLICA1 Inside
Ileavy )Ardm
Jun ADDItEas
NAMS 4ox AXE 031BUSIRANS)
':� 0 5� /5 —
�"Vicx
BIDE YARD SETBACK
STREET IIET13ACK
RZAR YARD SWELACK
MAILING ADDRESS
a
, j
USE ZONE
LOT AREA
VACANT 8rM
0
CITY
RUFM
1rxL1tPHONz NUM
0 YES 0 No
A
41
HEIOIIT
BUILDING AREA
VARIANCE NUMBER
NAME
o
PLOT PLAN APPROVED
ADDRESS
STREET R/W
CITY
TI1LBPIIONX NUMBER
EXISTING STREET R/W.......rr. DEFICIENCY THIS PROPERTY
CONP PLAN ST. R/W . FT _.PT.
It MARKH
By
s M
ATE YNICENON
METER SIZE SERVICE SIZE CLEARANCE
CHECXED BY
a NUMBER
CITY LICENSE NU HER
REMA"S
Legal Description of Property (Show Belo. .1 AtI.1h 1.lJr 0opl..)
L� eL Of= \)j0Cb\JAkLr—
TYPE CONNECTION
VERIFIED BY
OvrrL-4
PERC. TEST
PERMIT NUMBER
92
REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVKU
11 YES NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
-E-T
A.
El LINE
C3 YES ONO
W
PLAN CHECKED BY
AD
INON-REJUDICNTIAL
HIS I! t IN THFh
q.
[:] RZTAINING
DEMOLISH WALL
REMARKS I b, I 1!t -f)eA:FEO
SALES
CITY OF EDMONDS. LOCAL
ALTzR.' EX AVATE E] FE NCE
jtx 5piotim or: ef)E)EE) 31.94.
ORCr1LL 1 2
REPAIR PRE -MOVE SWIM
11 INHr' El POOL
rollygo
NUMBER OF
WELLING
UNITS
-WA—TU" OF WOnK TO 2§2 D
val"U..
Fee
Rerelpt ND
rt_ cbk
BUILDING
Dole LL I ki q
PLUMBING
PLOT PLAN (IndlCate BUIldIng eetbaekn, ablitting stnete)
HEAT & GAS LIKE
FENCE
SIGN
IfRETAINING
WALL
___zz
N
SWIMIIINO POOL
DEMOLITION
RECEIVED
PRE-KOVE ZNBPEC77ON
MAR 8 1973
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I beNtly fteltnoWledge Met I be" reed Lbb applicittloo; that the in-
formation given Is correct; sod that I = the owner, or the ftly
teed AMIL of the 01,0W. I &Vft to comply with city end AaU W-a regil.
ArrE?MON
APPLICATION APPROVAL
tittles constractJon; and In doms the waft authorb," turelly, to pereon
w1H be mployad to r1ehillon of the Labor Code of the Kate of Wewthington
TM8 r9alm
This application is not a permit until
relaung to workmem-8 clampantloa LarAwce.
AUTHOUSES
@Wed by the Building Official or his Dep-
NOTE; Pe mil UWt One You (Zltaept DZKOLSTIONS whilh
ONLY T=
WORZ NOTED
uty; and fees are paid, and receipt is ac-
#Mll be completed in slasty days; UOVXD.IN SULLDINGIS AMU be cons-
knowledged in apace provided.
pl" In six mooms.)
DATEIUQKMD
69SPEOVON
NAIrtim
1
DEPARTMENT
CITY OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
PH 0-1107
This rermIll coven work to be does " pri-te, V-Perty . ONLF
Any construction as Ch. publis 4.0.1. (cn., drhoways.
am"uses, Ste.) wall ftqnlm "Par&" peethiselew.
FTLE