20630 82ND AVE W.PDF111111111111
7560
20630 82ND AVE W
NOTICE:
N�owarranty of accuracy.
The -information on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edrn.onds does not warrant the
accuracy of anything set forth on these
map(�_). 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 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 kc--ity of Edmonds nor its
e m p-'I- o-y e e-s o -r o ff I C e,r s s h. a 1. 1 b e 111 a. b'Fe f o r +L h e
information given on -this map(s), nor for
ion provided based
any one representat'
upon . said map(s).
APPLICATION
for
Tho City of Edmonds FU SWE SEWER P100W
STRMTNEW CONSTRUCTION 21' REPAIRS
FjTjRE:AAT7MEE!N'T PLANT
EASEMENT No. — ....................... ..............
........ ............ ---- CONTRACTOR Al
........ ....... ---- ....................... ... 4� ......................... PER.11IT
- --------------------------------------------------------------
ADDRESS .............. LEGAL DESCRIPTION: LOT No . .............................................. BIA)CK No . ............. . ff
NAMEOF ADDITION � .........................................................................................
2_
FZ'!� Aue�
MAR 2 8 i 972
M
Approved:
DATE ... ....... .. ..... ........
]BY;--,; -- - ------ --- ----------- — -------
d-
-'PER "If
N
CITY OF: 'EUMWO
V TR, ZM Tj
-AT-ER-SF,�W,-ER�,DEPA�RTM;EN,T,�!-,
Y-12;
-P M
EMIT,
ov -,'Is'
"(Cill" T-7011071 Ior':,slde s'eiv�'i
eifing n portj�n, e -ecmsiru�fion,
-No
bliday "inspect
t lon�.
Inspection, - 'will��bel.pr6vididl,.wi.t�in,:i�,,Iib�u�s �qter,;i�ques
I(CIONSTRUC,
ADDRESS L OCAMY(00 T_1�14_ 2,06 3 0 32-hd'A��'n`
................ ... .....
..................................................................................... ............ .......
........................... ..... ....
"JiPROPhRTY 1LEGAL_,,DESCR11�TTi* ............. i� ........................................................ Vf 7, Lot:3:. � �ft�
..................................................... ................................... .......... .......
L:
Q]
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.......................... .............. ...... ............ ...... ....................
........................................ . .....
.....................
d.
IEWAINWOR, IBUILDER.-:�_W....
......................................................... ...... T t` &H
. ...... ....... ; .. ............ . ............................ ..........................
,coN,TnA4bToR,,s',,NAME &ADDRESS
z .............. 7 ........ M .............................. ......
.... ................. .......... ................. I ........
t
0al"Ch '201 ....... 72, fbr,��pAi _'Q'qn�16f Side selve t�,,44e�ky.'
.......................... ........ ........ ..... . r,an or:lconnec r sani ary sewer
systellyrAnt.accordance with,.Uty;of Edmoiids,ordinairices�.
NTIOM IS! CA-LLED�'TO THE'FOLLOWING:
censed�Side- Sewer: Confrac ruct"
v I IM No..X---�The.,ownern,,:of thei.property �rnay. obtain a,permit Ao.l.construct, sewer inside ic�r; must �15�,t�iifc�ycdtl
side sewer In- street,area. Do; not coyer:any A16n.Tof,sew6r-Ii6fbm li,Has�;beenAnspecfed' e
NOTW.N& 2�A,11, work �performed� In'.,city right- of -way )requir' v
' 11 *..,aw�Ifi
NOM No. 3—Obtain, fullftin formation: regaxding Oi Inaii6q, l�l�'161030.'andi'-hegii]Ati'o�ns!-,,,g6v�i,�i'nk,�
sj$61�s�w.ers wh mlyou'g�t, permit.'
NOTE, No. 4 ide�-SeWer,must
!n�C4��!,eoye rage,,,at property.,,Iine�,,and! 12,�inches� inside�`,1�6�prty line;�
el
_T �j
.h7r,2r"!than, �/s Will, Lbe permittedL.
N6T-E:-No:. &:—TrenchesAn, street. must,be watertsettledi and surfac' �of!streef*
e restored-._7to,,orl glnal;icondltion'� ,,C6ntractois.'sh ELI L:.be� riesirsible, for 491 lure,-. d �eei. ol,,improper,
'work Whichi may (develop wItfiin one'yqa�, of completion., . .. .., . I - I �. I . , . * I .. I . I ;r " _ '. , , i
NOTE'No. 6--it,%Is uniawfaito alt�r'or�,do,�ank, oth6r, work tha'nJlds pro.vided',4fon"Im �,th�e perrnit-,:,or1,to,;do;An its; 'a;P U
'Sert�thel,�ipe,�intos,�the.,wye..' Y.work,.;o�L,the maln,%sewer-ar P iie'riince'siiexc6nt�'toj4n-'
7
6"
B0TH1�ermit,CbpieA,M1U5W-1 �e y_2�,'qwner�,,ofj -,.Firm C nstxuCt.,'�rt,,�jtj6
R.'To, Request For,:1ft9pec'jon1L —
j3
Con ......... .......... ....................... ere- b rtif thel.side) Sew -stall*gtiori,,construdt.e'(V,,.uiider,*3thisi;p,ermii.
....... i� 11 ce ylhat;� er,in
06wnew (C
r n racting F�l m Pl�erfibb'rrmng Constructionp- .
it
XA,rts installed,4n ac okdancei wa Vall� -governing �ordina.'ricesl,dt'ith& City"O'Edniond's,..
C
Atedtlhis 19.. z
. . . . . . . . . . . . . . .
D
....... . .... XL ......
'Che6k BEFORE yowldfj, f6r':pWa`te`r,':E];I 0 01 Pr,lbwe
�Sewer;[]-,
R F-C F. IV ED
City of Edmonds J U N 0 2 1998
PLANNING DEPT.
-'QW CRITICAL AREAS CHECKLIST
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 a development
permit 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 Axeas inventories,
maps, or soil surveys).
An applicant, or his/her 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 determinatiori of the
subsequent ste*ps 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 assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
,)C)LA-)D4 48RA&�5
Name
D
Street Address
VA 0 V1 Ct
City State Zip
HaS -�-7(., ?ciO';,
Telephone
941ature
�' - �'
Date
Applican%TXSativoe: PY
Name
Street Address
city State Zip
Telephone
Signature
Date
mceptionkJanakaddoc
(over)
I
CA FILE NO. 15 Z_
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soil s/topography/hydrology/vegetation)
I Site Address/Location: 92" RL)E— Lki,
2. Property Tax Account Number: DI
3. Approximate Site Size (acres or square feet): t
4. Is this site currently developed?,2�_ yes; —no.
If yes; how is site developed?
�_j _j
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-feet over a
horizontal distance of 66-feet).
X Hilly: slopes present on site of more than 15% and less than 30% a vertical rise of
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: N o Approx. Depth:
7. Site contains areas of seasonal standing water: fi D Approx. Depth:
What season(s) of the year?
8. Site is in the floodway Al L-) floodplain .4 D of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? — (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc) X
11. Obvious wetland is present on site:
--------------
For Cftv Staff Use. Only --------------------------- --------
.777 --- 7---.
.1 8 ite i's Zoned?
............
2 mappdd soil We(s)? &j,/nL.J- S
Vetland inventory -or CA.- rniap'itidicates w*eItid pfelsen't on site?
kl�
'Crft*Jcai Areas inveniory or C.A.*M* ap indicates Critical Area on site?
5
5. within designated earth subsidence landslide hazard a rea?
Y�Site designated on the Environ6entally Sentitive Areas*Map.
DEVEAMINATION
CITY OF EDMONDS
USE
ZONE
PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
OB
ADDRESS S-LAd SUITE/APT
Zap 0
#
36 I'JIM361 Re>fAYIA 45
LEGAL DESCRIPTION CHICKI
SUBDIVISION NU.
LIU NO..
cr
ui
Z
MAILING ADDRESS
AVf-.
o,
pLitu,2lin _gay,� 1,&
PUBLIC RIGHT OF WAY PER
OFFICIAL STREET MAP.
TESCP Approved 0
cli ZIP
14,245
TELEPHONE NUMBER
^719P '7'10.A
EXISTING — REQUIRED DEDICATION —
RW Permit Required 0
Street use Permit Req'd 13
v,,% tDVN C) gwakfa
Inspection Required 0
PROPOSED
NAME
Sidewalk Required 0
5 AAA I- A s A ia ov
METER S IZE
LINE S17E
NO. OF FIXTURES
PRV REQUIRED
cc
LOU
ADDRESS
YES 0 NO 0
REMARKS
L)
cc
<
qTY ZIP
TELEPHONE NUMBER
a:
W
uj
Z
Z
i4AME
SArv\e AS A"Iopye- &..Oa_kvc�
cc
ADDRESS
0
ENGINEERING MEMO DATED
REVIEWED BY
L)
t
a:
CITY ZIP
TELEPHONE NUMBER
l`_
Z
FIRE MEMO DATED
REVIEWED BY
0
0
STATE LICENSE NUMBER EXPIRATION DATE
I
VARIANCE OR CU
ADB#
SHOREUX64A.—
Legal Description of Property - include all easements
Z
BL - Q1 S 1/2, bt LA
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PBW
HEIGHT
0
r )D 1)
I D
ALLOWED, PROP07
EXP
I
I 17
a:
L e e-, 1-1 -3 1.
—C.
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT.)
W
ALLOWED
PROPOSED
-fl—
FRONT SIDE REAR
FRONT UR SIDE REAR
P14+
J. Ac_re'
I-Pef,
tP S %
�
Z
'i
3W
Z
Z
Property
Ta Account
Irc
Pax el No. IDD13 004 ho 3, r7l, I
LOT AREA
PLANNING �IgVIEW Y
AS
rTE
E]
PLUMBINGIMECH
REM ARKS
NEW
RESIDENTIAL
1.7.1 ADDITION
COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
po. 1,� 1,
APT. BLDG.
REMODEL
SIGN
GRADING FENCE
REPAIR CYOS. L_ x —FT)
CHECKED BY
TYPEq
CONSTRUCTIO
CK:- 1
&�
'4,
4
0
GCWr
WOODSTOVE SWIM POOL
DEMOLISH F JINSERT HOT TUB/SPA
SPECIAL INSPECTOR
AREA "01
OCCUPANT
REQUIRED
LOAD
FGARAGE RETAINING WALL/
� CARPORT RENEWAL
REMARKS
Z
0—
ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
PROGRESS INSPECTIONS
PER UBC 108
XCkWIA
D
NUMBEFtJ le
4111MBER OF
CRITICA
WS
0
OF
DWELLING
AREAS
Cc
0
STORIES'
UNITS
NUMBE
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
PlrAA Rqwi 46 Reakzl
FINAL INSPECTION REQUIRED
VALUATION
FEE
FEE
ROM& Legave, j2r-kb1V\In1 ROA TA P6,0_
PLAN CHECK FEE
GLAZING
BUILDING
HEAT SOURCE:
NAA-virial Cog
PLUMBING
Plan Check NO.
Ul C
MECHANICAL
This Permit covers work to be done on private property ONLY
GRADINGWILL
Any construction on the public domain (curbs, sidewpiks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns an d
ENG. INSPECTION FEE
,n
successors in interest, agrees to indemnify, defend and hold
'.n
harmless the City of Edmonds, Washington, its officials,
'E"
2
employees, and agents from any and all claims for damages of
15
cc(
whatever nature, arising directly or indirectly from the issuance
M
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
9
modify ' �waive or reduce any requirement of any city ordinance
0
nor Ilimlifin any way the Cily'is ability to enforce any ordinance
1
TOTAL AMOUNT DUE
provision.:'
I hereby acknowledge thlat I Aave(read this appli6dtjo'n;� thatthe
information given is correct; i_6d that I am the owner, or this duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and in doing the Work authoriz-
AUTHORIZES
T his application is not a permit until
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 aria RCW 18.27.
INSPECTION
acknowledged in space provided.
SIGNATURE (OWNER OR AGENT) DATE SIGNED
DEPARTMENT
CITY OF
E
OFFICI ' IGN 'R-A>11
EDMONDS
ATTENTION
CALL FOR
INSPECTION
'RELE4SE'D BY: DATE(
6
I -a Z
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. USC
—
SECTION 109
PINK — Owner GOLD — Assessor
'.�' C�'
CA FILE NO. 0— 15z-
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soil s/topography/hydrology/vegetation)
1� (—) t -41
1 Site Address/Location: RI)E_
2. Property Tax Account Number: 4�01 6)b:!, D-1- Q�
3. Approximate Site Size (acres or square feet): C'�Dpcj t
4. Is this site currently developed?,X,_ yes; no.
If yes; how is site developed?
�_j _j
5. Describe the general site topography. Check all that apply,
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 1 0-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
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: . grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: /)t D _; Approx. Depth:
7.
8.
9.
10,
11.
Site contains areas of seasonal standing water: fi D ; Approx. Depth:
What season(s) of the year?
Site is in the floodway AID floodplain N D of a water course.
Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? (What time of year?
Site is primarily: forested meadow shrubs 19 mixed
urban landscaped (lawn,shrubs etc) X
Obvious wetland is present on site:
---------- For City Staff Use Only ------------------ ------ — ------ --------------
------------------ 7 ------------- — ---------
16, . S.ite is Zoned?
SCS ma ped soil type(s)! r Wl� /t
we r
Wetlan.d inventory or C.A. map indicates vvet and present on,site? 9 .
EIJI
'Critical Areas inventory or C;A. m#p indicates Critical'Area on site?
:5. Site Within designated earth subsidencc'landslide hazard area.?:
Site desigrtat6d on the'
Environmeritally.Sensitive Areas Map?
DMIkMINATION
STIODY REQTJIRjED
CONDITIONAL WAIVER
: : - , '' : �. , , I : . a
WAIVER
Aeviewe'cf by:
Planner
Date
RECEIVED
JUN 0 2 1998
City of Edmonds "NNwa DEPT.
"kw CRITICAL AREAS CHECKLIST
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 a development
permit 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).
An applicant, or his/her 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 assist ' staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
�DURADQIV 48RAVvv5
Name
a 0 �' "� D e, al OQ E-
Street Address
av'404-5'
City State Zip
HaS -?-7j� ?cYO';-
Telephone
Q�ature
L - -�,
Date
c: recep tion\janakad.doc
Applicant Representative:
Name
Street Address
C ity State Zip
Telephone
Signature
Date
(over)
117 C . 18 C) "I
June 4, 1998
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
BARBARA FAHEY
MAYOR
COMMUNITY SERVICES DEPARTMENT
Public Works e Planning/ Building * Parks and Recreation - Engineering o Wastewater Treatment Plant
Jourdon Abrams
2063082 nd Ave. West
Edmonds, WA 98026
Subject: Determination regarding Critical Areas Checklist # 98-152
Dear Applicant:
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
IMPORTANT INFORMATION TO BE NOTED:
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CHECKLIS OR CRITICAL AREAS STUDY.
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
You must submit a copy of the CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL AN
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Enc: Critical Areas Determination
* Architectural Design Board
Thank you.
Sharla Graham
Acting Planning Secretary
C:ReceptionUana\CRLTR.doc
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
STREET ADDRESS FILE
CITY OF EDMONDS
7110-210TH ST.S.W. 0 EDMONDS, WA 98026 - (206) 771-0235 - FAX (206) 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION
-61S -� 1-8 ()'3
March 12, 1996
Jourdon Abrams
20630 82nd Ave W
Edmonds, WA 98020
Dear Mr. Abrams
BARBARA FAHEY
MAYOR
I have reviewed your account and will allow a credit for February 1996 in accordance with
our City policy. The policy states that the customer will be billed at the retail rate based
upon the average water consumption for the same period during the previous year. In
addition, the excess water lost from the leak will be billed to customer at the City's
wholesale rate with a 15% surcharge added for administrative cost. Only one leak credit
will be granted in any three year period.
Should you have any additional questions after you receive your new billing, please
contact Ilene Larson, Utility Billing Clerk, at 771-0241.
Sincerely,
A
Ron I �ari
Water/Sewer Supervisor
RH/jh
cc: Ilene Larson
Utility Billing Clerk
wordata\water\credit96\#430075 * Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
Nj
3- 7 - 91 G
Ron Holland,
During the week of 1-20-96 a note was left on my porch from
the Edmonds Water dept stating my water usage was above normal.
Some causes given were leaks. Well, that makes sense. One specific
culprit was given as a the toilet. Mine had been been making hiss noises
and I had replaced the valve and float with a modicum of successf
but was told at the plumbing store that it (the toilet) was old and
probably needed replacement. After getting your note, I decided to repla
toilet and I did. Enclosed find a copy of the receipt. A few weeks
later I got my water bill and was unpleasantly surprised to find
it was three times usual. I contacted your office and explained
my situation. The nice lady I talked with said to send a letter
with explanation and a receipt of parts used to fix problem. I could
then apply for a "water credit". I am therefore applying for said
credit. Thankyou for any help you can give in this matter.
Jourdon Abrams
20630 82nd ave w. Edmonds Wa.
Acct number 4-30075
Pec'elveo
MAR
PUBLIC
LAAY-
X- /,) rj
A�
VON,
51
".THE-., HOME CIEPOT 4707
V 1335 Ni 205TH STREET-SEATTLE, WA 98133
STORE MGR-TIM GRACE (106)546-1900
SALE 4707 00013 74339 0112C/96
973 06;32 PM
,038753311937 WAX RING 1.51
026613009049 BRASSCRAFT 3.36
073088058034 TOILET SEA 12.37
'040688073804 TOILET DOW 94.00
.040688077116 TOILET TAN 6i.50
SUBTOTAL 171.24
.173.24 TAX WA 8.200 14.21
TOTAL $187.45
4428680002503113 VISA/MC 187.45
AUTH CODE 085091/4132278 TA
. ORIGINAL RECEIPT REQUIRED FOR REFUND
THANK YOU FOR SHOPPING AT THE HOME DEPOT
WAREHOUSE PRICES - DAY IN, DAY OUT
ON of Edmonds
WdWJ%F WAY CONSTRUCTION
F
TERMIT Permit Number'. — r-,8
IssueDate:
A. Address or Vicinity of Construction: - 20630 82 AV W 9509856
8 --mmm— C) Q5 B. Type of Work (be specific): Tinsitall mpw spryiep-
9 0 - 19
C. Contractor: -Washington Natural Gas Co Contact: Frank Swan
MailingAddress: 1122 75 ST SW Everett Phone: 447-3284
State License #: 98203 Liability Insurance: Bond:$
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. [-] 'Commercial E] Subdivision 0 City Project E] Utility (PUD, GTE, WNG, CABLE, WATER)
E] Multi -Family 0 Single Family F] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: )W Yes []No G. Size of Cut: __�x H. Chargq
(71 J7u t
APPLICANT TO READ A SIGN
_e
INDEMNITY. Applicant understands and by his signature to this application, agreeiiii hold City ofEdmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may, �. ;��l against the City of Fdmond8, or any of its departments or
employees, including or not limited to the defense ofany legalproceedings including tl�fu;hsel costs, and attorney fees by reason ofgranting thi8permit.
%" I I � ?T
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOKAI A& OF ONE YEAR 2iLOWINO 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 TIMEA DEBIT OR CREDIT WIA BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineexi�g Division, 771-0220.
Work and material is to be inspected during progress and at comple�on.
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 approve(kniaterial prior to the en
1 4 of theworking day;
NO EXCEPTIONS. ;�/ I I If -')
Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit will be
available on site at all ti t,
,�U�or in,,Wn purposes.
3p i
��/ & 02-13-95
Signature: _60M Date:
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY, USI�,, ONLY
APPROVED BY. WAYDEPOSIT�
TIME AUTHORIZED: VOID AFTER DAYS
SPECIAL CONDITIONS:
COMMENTS:
DATE:
DISRUPTION FEE/FUND III:
RES TORATION FEE:
PERMIT FE$
E.
30
RECEIPT FEE -
"ISSUED BY,
NO WORK SHALL BEGIN PRIOR TO PERMIT, ISSUANCE Eng. Div. 1994
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Was
AVMlwxjtcn ErerW Ccnxxww
WNG to window
Watermain depth WIA-
4- -- gas main
6. .1
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
j
KI
LA-T-
Key:
-W-
Water
-G-
Gas
-SS-
Sewer
-&
Water hydrant
0
Water valve
-0-
Washington Natural Gas Company
1122 75th Street S.W., Everett. Washington 98203, (206) 355-3331
UP NOR"'
VVGIOIIIIIMVWII
Natuft- I Gas
AVVcYJWXjton Erergy Corypffv
WNG to window'
Watermain depth WIA-
4- -- gas main
f r
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
j
KI
ISOC185(,,
�O
LA -T-
Key:
-W-
Water
-G-
Gas
-SS-
Sewer
-el
Water hydrant
0
Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
NaturblGas��
AVVhIvxjton ErvrW Compem
WNIV, to window
Watermain depth W/16-
4- - gas main
j . I
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
i
ISOCIbs(�-
�O iaz
LA -T-
Key:
-G-
-SS-
0
W
Water
Gas
Sewer
Water hydrant
Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
Moil
29539
L
20
1 370,57
3
0
z
N,
00
A',
New Id
PIV
co, XJ64-
eT T.
CAP
S2_2
/q 0 6 Fr
ko
r__j
40 ".,x
FT
ADD GU171511100WNSPOUTS
AND SPLASHBL�CKS
ASPH
ASPH
20
cli
U')
(0 1
40
LEGAL DESCRIPTION
THE NORTH 60 FEET OF THE SOUTH 455 FEET OF LOT 39, WILLOWDALE
GARDENS/ DIVISION NO 1, ACCORDING TO THE PLAT THEREOF RECORDED IN
VOLUME.10 OF PLATS, PAGE 72 RECORDS OF SNOHOMISH COUNTY, WASHINGTON.
SITUATE IN THE COUNTY OF SNOHOMISH STATE OF WASHINGTON.-
B UILDING HQ OHT CALCULATIONS:
A 375.7
B 376.3
C 377.3
D *376. 4
TOTAL 1505.7
MEAN 376.4
PLUS 25 FEET 401.4
tit, 1464— /4114)(
DESIGNED BY
RGG GENERAL NOTES
DRAWN BY
CHECKED BY HORIZONTAL. DATUM:. EAST ALONG THE CENTERLINE OF 208TH STREET ASPER
APPROVED BY PLAT OF ROBERT E. THOMAS, .2ND ADD.
DATE PRINTED 1/18/2008 VERTICAL DATUM: ASSUMED 370.57 ON. SANITARY SEWER RIM AS SHOWN.
SCALE it? 10' .
F.B. NO. PG
WATER & SWER
INSPEaMNS RFWn
CALL 425-77.170220 EXT 1326
24 HR. NOTICE REQ.
F I
OR INSPECTION
k:PP7 KENGINEERING
natal kl;�
1.16,
0.74'
LEGEND
Zone
Comer Flag
5-e—tbacks
3" BRASS CITY SURFACE MONUMENT
d Agtual
Front
FOUND CONCRETE MONUMENT Sides
x
SET TACK IN LEAD.WITH SHINER LS 29539 Rear
------
Other
FOUND CASED MONUMENT
SET 1/2" REBAR WITH. CAP LS 29539
BUILDING FIRE CONNECT
CATCH BASIN
ELECTRIC VAULT/HAND HOLE
X X
CHAINLINK FENCE
WOOD FENCE
FIRE HYDRANT
GAS METER
GAS VALVE
HOSE. BIB
JUNCTION BOX
LIGHT
co
MAIL BOX
MONITOR WELL
ROCKERY
0
SAN. SEWER CLEAN OUT
0
SAN. SEWER MANHOLE
SIGN
SOIL TEST PIT
@
STORM DRAIN MANHOLE
TELEPHONE RISER/BOX
-0-
UTILITY POLE
VALVE
WATER METER
WELL
WET LAND MARKER
<
YARD.LIGHT'
ASPH
ASPHALT
CALC
CALCULATED
DW
DRIVEWAY
E
ELECTRICAL POWER
G,
GAS
IE
INVERT ELEVATION
MB
MAIL BOX
MEAS.
MEASURED
MH
MANHOLE
OHIP
OVERHEAD POWER
OHT
OVERHEAD -TELEPHONE
P
PLAT
PTR
"Nothin this Permit approval process shall be
PLANTER gin
interpreted as alinvving or permitting the
SD
SHD
STORM DRAIN maintenance of any curvmQ� existing illegal,
nonconf6rming or uppermitted building, structure
SHED or site conditiori. ouvolde the scope the STREE"."
FILE
of
germit application, regardless of Whether such
S.
SEWER
uilding, structure or condition is shown on the
site plan or drawing. Stich building, structure or
TW
TOP OF WALL condition may be the subject of a separate
enforcement action,"
UGP.
UNDERGROUND POWER..
W
WATER�,
DECIDUOUS OR ORNAMENTAL EVERGREEN TREE
TRUE EXTENT OF CANOPY NOT SHOWN
CONIFEROUS TREE
TRUECANOPY NOT SHOWN
RECEIVEL41
F r 133 8j 12008
Zone
PER MIT COUNTER
ad4c—ka
Front
Sides >
Rear
Other
RESUBHe
APR.i..03 2008
APPR OVED BY Pi Am i
11LWN
0$1�'n M YENT
ON 8
JOB NO.
BOUNDARYAND TOPOGRAPHIC SURVEY
GREENE LA ND S UR VE YING 0--7 ' 2007.20
OF 0,,o,
DRAWING NO.
EDMOND S, WA SHING TON HOUSE #20625
A FOR
PHONE (206) 498-0979 .. FAX. (425) 697-6604 KURT L ACHER SHEET OF