22003 100TH AVE W.PDF22003 1 OOTH AVE W
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4
_&-.-TV_0FEDM0N6S
CIVIC 6ENTER — WATER__S Call PROSPect 6-1107 when work
...EVVER -DEPARTMENT
18 ready for inspection. (No I nspec-
Mons Saturday,' Sunday or holidays.) N2' 12
SIDE SEWER PERMIT 14
ADDRESS ................
-1- !!..Avenue ... aQ.ut
............................................................................ ................ ..................
6WNER ...... Pack
........................................................................ CO�TRACTOR ........ Dwiiht ... it ----- F.ack.
............. ........ ......
Per"sSiOn is granted .............. NqrQh_2-2 19.- for
with City:Sewers,'�'i-n."accordaitee with applic6 on on -a ...................... days,, to REPAIR or CONi�;.ECT a side. seWer
ti: 26 nd:
governing ordinances.
ATTENTION
LLE
NOTE No. I—Thd`�� of
o-the tPI.Perty!-may obtain a permit to naruct sewer inside property line.' A licensed Slde_,w Sewer, contrattor must
be.e� - cons - ruct side sewer In street area'.. Do enoot cover a I
NOTE No. 2—Obtaln -full Informatio ny port on of sewer before it,h", beeff lhspect�eg.-
n. regarding Ordinance .030 -and Regul . a tions governing _sl -i sewers 7 when' yq�'
NOTE No. 3—Top-of-side sewer must have at' least 30 Inches -le J.. . . _Fet permjt..�
No bends In griLd& sharper than % will be Perm coverage at property line and 12 inches Inside property line;L
Itted. minimum, grade L of 2%.
NOTE No. 4—Tren6hes In street must be water settled and surface of street restored to original condition. Contr
, failure due to improper work which may develop wit.4in one Year of completion. actors shall be r caponsible for
NOTE No. 5--It Is unlawful to alter or do any other w
.Purteiiances except to Inse L rt the pipe Into ork than Is Provided for in the permit, or to do any work on the
the'�wye maJn sewer or Its ap-
-CITY OF EDMONDS
OFFICE OF
PUBLIC WORKS SUPT. 262
Date X, I
Received of —
For No. I
For No. 2
Amount No. cx,c
Amount No.
k
By—
I
APPLICATION
for
cl " o�n d s STMET FILE SEDE, SEWER PERYaT
The City m
OUTSIDE El INSIDE REPAIRS E]
CARD No . ......
EASEMENT No. /357-kg.��
. :!��L � I I
------------------------------------ fZ� - ---------------------------------- ... CONTRACTOR..
..................
---------- -- ---------------- PERMIT No.
EET
0.
..... ........... AVENUE LOT N . .....
F No. STR
. ..................... ..... --- ----
............ . BLOCK No . ...............................................
6 rJ4 NAME ADD.
.... .. ...................
Date
_TTL WORK ORDER ISSUED ................................... DEPOSIT, $ -------------------------
....................
..........................................
MIAMI
WE
Approved:
DATE.................... By
APPROVIED
M A R 12 '11965
E A S E M E N T
0. 41
For a good and valuable consideration, the grantors
her�b-y
to the owners grant
ie
and t rp, 0
',to
jq
mot
ovdad III- �te'
51 r -C ,' jil
01* 2- 3. o�
04, t
Ir 401�
n ' 37 0,,
1050,
on V)
4 ��16 41 i, A, t"":�zt
011 _*
"I10
0'r "'Arm
mn' t
J4?�
An easement for the installation, operation and maintenance of a sanitary
sewer line over, across, through, under and upon the following described
perty,,,.-S�t4at(O Oh$�)Mj-_h Co),
I StMS qi� o -wit.
to
0 1 r n. to rl*-t
rQ A, or,
W 3
ppat�on Go t:
1- Vol '3"�
"o loci Mot 4 .64,000t; t 4A��7140
el 0 1 - 714
C t .04". 'Ilu
0 10 MP 16 1 ZO 4 w Wvy')* to *0
Q.V 2 '('K-eu Z-1 '�34A
;
t 11,14 aa'ort�'!� oald
DATED* this day of POT-mary
- A
STA6 or WASHINGTON
ss
COUNTY OF SNOHOMISH
personally appeared before me;
and
to me known to be the individuals
des Rbed in and whot-Amocuted the within and foreW*Bgranstrument, and
c
acknowledged that signed the same as free and
voluntary act and deed, fo� the uses and purposes the -rein mentioned.
GIVEN undeitto
ftbr1A%r.V hand and official seal this day of
19
0:0,f4-t�1rq.ovmers gf-
lath ZU 4;;1i". pj'�:'!
tua
-on Vni",
in
n
. 96
a IT
t to
8, ')Int' oil
44 _*1 * � " V
An easement for the installation, operation and maintenance ofa sanitary
sewer line over, across, through, under and upon the following described
-situated
e
-wit-
o
t
C91IMN010
. 'T
0 rib 4
o ('wnlor or Tr 3.
Z� jqr%V.1�0 �
0 nl4t
lea 1- 6 6 A
tmo pc":1n,44 0 nh 00 vsaj�'ql nr_'?t0:n0
tuell . '# _# 410" B." kxlovj� th I
Ino Or
ozll�y oald
rtuo "",a- x*
Cif bor
Vr
.44
Vr)A
77
DATED this day of
STAVE OF WASHINGTON
ss
COUNTY OF SNOHOMISH
t�&"ay personally appeared before m
and e,
to me known'TZ; be the i n d 3'. UK a —Is
thin and fore
descRibed in ;nd whoi�,axwuted the wi
mbft�nstrument, and
acknowledged that signed the same as free and
voluntary act and deed, for �he uses and purpose—s �therein mentioned.
A1',-ron-rZqjGIVEN undeltnp hand and official seal this day of
19
4��SUldfary Pu or the
tate of Wa residing
at
7777777
%J
This sketch shows location and boundaries of the property covered by the mortgage
identified in Schedule A of policy and the. approximate general location of
improvements as appears on inspection without actual survey and measurements of the
improvements. The street number of said property is
QTDCCT C11, C
WTI Co. 2
NOTICE:
W C
No— "a-r-ran Yt acc-cFr . . . . . . .
The information shown on the attached
Hed for use by the City 01
map(s) was com ' p]
Edmonds, its Empl-oyees and Consultants.
Th,..e City of. Edm.onds does. not. warrant the
accuracy of anything set for.th on these
M a P (s`). A n . y person or entity -requesting a
copy should conduct an independent
i n shown- c
inquiry regarding the rmati o
tFe -Map(s), including, but not hm'ted to,
the c ion of any sew-er stub shown. Su(
lo' at'
sewer stubs may or may- not e.xlst and ma\
he location shown,
or may not exist at t
,�'ty of Ec.1 mbnCIS nor its
N ei t- h e Ir t h e
for th
i a. b-1
employee-s o.r office-rs -shal] be 1`
n is map(5), nor for
on th
Information g ve
'ded based
any one representation Provi
upon said map(s)�
STREET FILE-,..�
J.
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWWNE NAME /NAME OF BUSINESS
J� /,�� -� / -/
Cc / /- i Iq M 0 4 IJ 7-0 AJ
LLJ MAILING ADDRESS
Z
0
CITY ZIP TELEPHONE NUMBER
/? -9 a V 0 s- If'r j a
NAME
V
ow ADDRESS
7
CITY ZIP TELEPHONE NUMBER
0 7_61 eL- Z_
Cr ADDRESS
0
< CITY ZIP TELEPHONE NUMBER
X
Z
0
U STATE LICENSE NUMBER
Legal Description of Property - include all easements
Tax Account Parcel No.
NEW
1:1 RESIDENTIAL
PLUMBING
ADDIALTER
El COMMERCIAL
MECHANICAL
REPAIR
APT. BLDG.
El
SIGN
GRADING
1:1
FENCE
DEMOLISH
— CYDS.
FT)
CARPORT
swim
REMODEL
GARAGE
El
POOL
WOOD STOVE I
r7 RETAINING WALL/
INSERT
" ROCKERY
RENEWAL
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
to*
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
DES�R�SE WORK TO BE DONE (ATTACH PLOT PLAN)
ZONE
PERMIT
9,� (!j 1! 18
NUMBER
JOB
ADDRESS
17 &n
<- 4o su ITE/APT
LEGAL DESCRIPTION CHECKI
SUBDIVISION NO.
LID NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved 0
RW Permit Required 0
EXISTING
REQUIRED DEDICATION
Street Use Permit Req'd 0
PROPOSED
Inspection Required 0
Sidewalk Required 0
REMARKS
a:
u,
W
Z
Z
Lu
ENGINEERING MEMO DATED
3 -tb . q12
, ytl
METER SIZE UILDING SUPPLY Si F FIXT'URES
cc
7
REMARKS
SIGN AREA SEPA REVIEW ADS NO.
ALLOWED PROPOSED COMPLETE EXEMPT
EXP SHORELINE
VARIANCE OR CU PLANNII, DATE
SETBACKS — FEET HEIGHT I LOT COVERAGE ?
Z
Z
FRONT SIDE REAR
REMARKS
'HECKED BY
TYPE OF CONSTRUCTION
CODE
HEIGHT
SPECIAL INSPECTOR
AREA
OCCUPANCY
OCCUPANT
REQUIRED
13
GROUP
-A
LOAD
YES
REMARKS
PROGRESS INSPECTIONS
PER UBC 305
FINAL INSPECTION REQUIRED
PLAN CHECK FEE
/47 6 '6�-
BUILDING
PLUMBING
Plan Check No.
MECHANICAL
GRADING/FILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewolks,
driveways, marquees, etc.) will require separate permission.
STATESURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
5
employees, and agents from any and all claims for damages of
a:
<
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
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
information given is correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner. I agree to comply with city and
THI S PERMIT
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
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
tion Insuranc
INSPECTION
SIGNATURE (OWNER OR AGENT) DATE SIGNED
DEPARTMENT
CITY OF
2—
L
EDMONDS
CALLFOR
ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
GM
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
771-V-20
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his/her
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
OFF194t' GVAT4RE DATE
. �Sl �
RELEASED BY: DATE
ORIGINAL — File YELLOW — inspector
PINK — Owner GOLD — Assessor