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21323 80TH AVE W
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CITY of EDMONDS SS LICENSE. APPLICATION CENSE NO.
.:!o; rl
Civic Center Edmonds, Washing
city clerk Phone 775-2525
mcip
ANNUAL FEES
PENALTY AFTER FEB. 15
0 HOME OCCUPATION
4STRUCTIONS:
CLA ',1YIEAR
F [TATE JREASG.
LIC. NO.ISPEC.1
"�J().Q�
$ (A)
NAL
ADDITIO 00 0
All items must be completed
0 SMALL BU Qs
or application will not be ac-
RECEIPT NOA
DATE PAID
RINT X'
$15.00 DITIONAL $
� ITIONI
ADD 7.50 0
cepted.
511 JAA1' I
IN SPEC Box
0 Busines S With- 10 or
Sign and return application
FEE PAIO
PENALTY PAID
FO R ISSUE OF
CORRECTED
more emOi6yees
ADDI
ADD AL $25.00 0
With fee. Renewals received
L I
LICENSE WITH
'LC'ACTION.
"-$60.00 (C)
after February 15 must payl
0 NEW APPLICATION (LA)
penalty in addition to te6.-
0 RENEWAL
(LB)
NEW BUSINESSES AFTER
0 CHANGE
(LC)
JULY 31, 1/2 FEE.
(PLEASE MAKE ANY NECESSARY CHANGES)
0 DELETE
(LD)
NAME OF FIRM BUSINESS PHONE 0. OF EMPLOYEES
MAILING ADDRESS NATURE OF BUSINESS
e,
-BUSINESS ADDRESS
, (o 0 0 --C)Lq 9:5_0
INDIVIDUAL
PARTNERSHIP CORPORATION
/'?LA
S)
(P) (C)
OWNERS NA ME
HOME ADDRESS
/:Z
HOMrPH ONE
—2 -2 /0 5, q-f)
DATE OF BIRTH
---r/4 IV J �5:'. T '7'
PLACE OF BIRTH
SOCIAL SECURITY NUMBER
EMERGENCY NOTIFICATIO1q: _(1) NAME & TELEPHONE
(PLEASE LIST TWO) (2) NAME & TELEPHONE
ftyj "M I I= 10111 = itelyiym 1: 1601
STAFF REVIEW: FILL IN LAND USE CODE, UFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR
DISAPPROVAL, DATE, AND SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT"
SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT
�'Z-c
9L APPROVE 0 DISAPPROVE
DATE fir I.,
LAND USE CODE
ZONING CO DE
SIGNATUREA6W
CONDITIONAL
USE PERMIT
COMMENTS
BUILDING DEPARTMENT
&--APPROVE O.DISAPPROVE
DATE
Building El
Hotel/Motel
(L)
SIGNATURE
Permit 0
Apt. Bldg.
(A)
F7 I I I 1 0
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 7- �zz_g/
U. F. 1. R.
APPROVE . 0 DISAPPROVE SIGNATURE
COMMENTS:
PO�ICE DEPARTMENT
DATE SIGNATURE
APPROVE 11 DISAPPROVE ':
COMMENTS:
PUBLIC WORKS DEPARTMENT
0 APPROVE 0 DISAPPROVE 1 DATE —Z— 3 0 - SIGNATURE
COMMENTS:
PLEASE RETURN TO CITY CLERK
Z
U
U
0
0
CITT OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION
A. oAddress or vicinity of Construction
-, ; -�l � .
0 Owner: Villa Den Apts
NarnerPloyd r-raima:c*�'�
2132.1
(3 -n Lie) Mailing Address
3dmonds, Wash. 96020
City, State, Zip Code
'Wit No. R I — 1 �42,
Issue Date -7/
r=
EET HLE
• Permit Issued To:
dba i,�chs
• Type of Work to be Done:CISPhalt
• Work in Connection With:
0 Sub or Plat El Single Family
El Comml. /Ind. 0 Apt. Condo.
• Pavement Cut: El Yes 0 No
0 Contractor: Wdv- 01,%pnP,!,- 1;�—
Name
2 � 0 - Box ISO 2 2 3 0 1 01 DS C 3 1
Mailing Address State License Number
�vmnuinnA YfnvCh c!,qn-AG 779 3121,
City, State, Zip Code Telephone N�mber
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
INDEMITY: 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
proc eedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
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
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permi�,n�usrb� availa,Ble at the job site for inspection purposes at all times.
Signature:— Date 7 41-)g R1
Owner orALye-nt--"-
THIS PERMIT MQ�T BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Void after days
Special Conditions:
Ammendments:
Permit Fee: /) 00
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
X
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. December 1978
FIELD INSPECTIONOTES
(Fund 111 Ite conv to Street T4
rf-IMMn'" +-a -
Diagram:
Contractor called for inspection Yes No
T By: Date:
,Alork DisaPproved By: Date:
Work Anoroved By: Date:
Inspector:
Eng. Div. December 1979
jll�
LIDS OLYMPIC INC
LYNNWOOD 0 FACE SEATTLE OFFICE
P.O. BOX 1813*� OPERATING ECH'S PAVING 34M STONE WAY N.
LYNNVVOOD, WA .99036 EATTLE. WA 98103
HEATING OILS e ASPHALT PAVING 632;9!�
HEATINGX AIR CONDITIONING
PROPOSAL SUBMITTED TO
Villa non Apts
PHONE of c. 771 4580
ras - 774 69R4
L 1 u 8 1
S I HLE I ADDIIEW attn: Floyd Fraimark
21321 Roth wARt .
JOB LOCATION
21321 80tb West
CITY, STATF_ ZIP
Edmonds, Wash 98020
-
asphalt work.
Patch areas as shown on enclosed drawing, remove grass
and shrubs as indicated and haul debris away, apply
weed killer to paving areas, fine grade and gravel as
required, all paving to be a c&ass "B" asphalt mat to
211 depth, compacted. In -stall speed bump as shown. $ 22410.00
ALL PRICES PLUS TAX
PAYMENT DUE 15 DAYS FOLLOWING STATEMENT DATE
A late payment charge may be made on any past due balance, which the law calls
a "FINANCE CHARGE:' and it is computed at a monthly rate of 1% (ANNUAL
AUTHORIZED rl
PERCENTAGE RATE OF TWELVE PERCENT). It is agreed that in case suit is
SIGNATURE ( I 111� 7_Ak_e�
THIS PROPOSAL MAY BE WITHDRAWN BY US IF NOT ACCEPTED
instituted to collect amount due on this contract or any portion thereof, reason-
able attorneys fees and court costs maybe added to this contract.
WITHIN 30 DAYS
Permits, if required, will be the ownerjs responsibility.
We shall not be liable for damage to or breakage of septic tanks, underground pipes, and or conduits not visible from the surface of the ground nor for any
damage to approaches (including sidewalks) from the street to the property line.
We cannot be responsible for sub grade failures or settling of subgrade material which was not installed under the above agreement.
Soil sterilization (weed killeo, it included in contract, will be applied at rates specified by manufacturer. Olds Olympic Inc. will noi be responsible forany subse-
quent growths of horsetail weed, morning glory, deep rooted ferns, or perennials, which have not reached maturity prior to application.
All material is guaranteed as specified. All work to be completed in a workman -like manner according to standard practices.
Olds Olympic Inc. accepts no responsibility for any work other than that specifically described above. Any additionsto or alterations of the above work -will De
executed only upon written orders and may become an additional charge.
All agreements are contingent on strikes, accidents, delays of carriers, and other delays unavoidable or beyond our control.
ACCEPTANCE —YOUR SIGNATURE ON ONE COPY, RETURNED TO US;
WILL MAKE THIS A LEGAL CONTRACT PENDING ACCEPTABLE
CREDIT APPROVAL ACCEPTANCE BY DATE
55372
t -
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elle
1pi�
The City of Edmonds
T1 .
Koo 'g,
APPLICATION
for
SWE SEWER PERYaT
FILEOUTSIDE [:] INSIDE [:] REPAIRS 0
CARD No . ......................................
EASEMENT No . ......................................
&*'.+�ONTRACTOR ..... . ............................
..........
OWNER ...... '�L'w... PERMIT No..(/
'5114dkl) J I STREET
HOUSE No—r ........ ...... tr .... . 11.45alA&W(S AVENUE LOT No . .................................................... ................. ]BLOCK No . ................................ ...... ........
Parcel "All: N 2101 of s 1/2 of W 1/2 of W 1/2 of NE 1/4 of NE 1/4
2- 80 rw Afe. NAME ADD. of .-Sec.-w ... 30-v --- TWP ---- 2-7 .. N-67--Ran-ge--4 ... EW-M-j --- EXCEPT --- W --- 180-1 ---- thereofjj....
Parcel "B": N 1101 of W 1801 of S 1/2 of W 1/2 of W 1/2 of NE 1/4
of NE, 114- of,. Se-c. 30. TWP27N---Ra-gp-4. F-WM, rXCER3; 1; @946-fe City Rd.
fiM
0
Ll
0
0
— -------- 7--' 7
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
SEWER WORK ORDER ISSUED .......................................... DATE ......... By ... ..... ...............
APPLICATION'
CARD No . .......................................
'h * e C#y�of E dmonds
for
SEDE SEWER PERMT
OUTSIDE 0 INSIDE 0 RE�AIRS 11
EASEMENT No . ..................................
OWNER
;
PERMIT No
flousEeNo .. ............. ...... ....
.4okONTRACTOR .......
STREET
0—' d/Oft AVENUE LOT ............ -------
..... No.
-- --- ----- 441::!5
--------- **"* -------------- ....................
................... . .........................
BLOCK No . ...... * ----------------- ----------
Parcel "A": N 2109
of s 1/2 of W 1/2
of W 1/2 of NE 1/4 of NE 1/4
NAME ADD. -of ... se' ---30-ii
--- TWP--2-7---N-jj --- Riange-A-E-W-M-i
--- EXCEPT`41 --- 1801'---themofii---
Parcel "B": N 1101
of W 1800 of S 1/2
of W 1/2 of W 1/2 of NE 1/4
DEPOSIT, $ .................. I ------
...........
DATE................................................. By ...................................................................
y Rd. �
NOTICE:
No warranty of accuracy.
The information 'shown on the attached
map(s) was compiled for use by the City of
Edmonds,, its Employees and Consultants.
The City of Umonds does not warrant the
accuracy of anything set forth on these
map(s-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
----fh-e -map(s), including, but not limited to,
the location 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
emp-l-o-yees or officers, Shall be liab-11--e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS
CIVIC CENTER —WATER-SEWER DEPARTMENT Call ""PeCt 6-1107 when work
is ready for inspection. (No Inspee-
tions Saturday, Sunday or holidays.)
SIDE SEWER PERMIT N2 1220
ADDRESS
--- 21sl ... Ammg-aggth
OWNER ................. Bill ... B�Onrxell
............ ............ _ CONTRACTOR ......
Permission is granted __� ..... M.arch ... 39 ............... 19.6.5— for ...........................
with City Sewers in accordance with appHeation to REPAIR or CONNECT a side sewer
On file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners Of the Property May obt I ain & Permit to construct sewer Inside property line. A licensed Side Sewer Contractor must
be employed to construct side sewer in street area. DO not cover any Portion of sewer before it has been inspected.
NOTE No. 2—Obtairi full Information regarding Ordinance 11-16-030 and 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.
NO. 4—Trenches In street must be Water settled and surface of street restored to original condition. Contractors shall
failure due to Improper work which May develop within one Year of Completion. be responsible for
NOTE No. 5—It Is unlawful to alter or do any other work than Is provided for In the Permit, Or to do any work on the main sewer or its ap-
Purtenances except to insert the Pipe into the wye.
- M
'�tj%jplrK ow
F APPLICATION CARD No . ........ ----------------------------
for
City -"of Edm4 S11DE SE'VVER PERlVM
ond
'EASEMENT No - --------------------------------------
OUTSIDE INSIDE F -AIRS
RE!
--- ------------
.............. ................................. PERMIT No - ----- 1110)
CONTRACTOR --------- — ------------------------------------
-OVVNER --------------------------------------------------------------------------------
- ----------------------
STREET
AVENUELOT No . ........................... ....................... .................. BLOCK No - ------------------------------- ---------------
dOjSE No . ............................................................................... ............................
------------------- .........
NAME ADD . ................................................................................................................................
7
A/ -
Date Approved:
............................. --------------------------------------
SSUED --- DEPOSIT, $ -------
AlirDATE ........................................
.. ..........................
.......................................................
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