22004 99TH PL W.PDFlill lill lill
9767
22004 99TH PL W
0
I
srotir Fit&
7t7--W"shington State
DI-HPART E OF
SC�
r I
SO�IAL PH ETLT H
SERVICES
A,dult family Home Licen6e,
777 77-7 7777:7
In compliance with and pursuant to the laws of the State of Washington and the Minimum Licensing Requirements
of the Department of Social and Health Services a license is hereby granted
to PAZ & DOMINADOR CABRALES License Number 31 H 40298400
city of
F—
to conduct and maintain at �,2 2J)10,/� L—.a-.9'9'-T-R--PtAC B - -W
EDMONDS zip code 98020 county of SNOHOMISH
State of Washington, an Adult Family Home for the care and supervision of adults as follows:
24-hour family care for no more than 8'x (6) adults
inimber
This license shall be in force from the 13 th day of MAY 19 96 to and including
13th MAY
the day of 19 97 Subject to revocation for due cause.
Special Terms:
N
ten Lirriis(;r
NOTE: This license is not transferable, and is valid only for use by the individual(s) to whom it is issued and at the location above
described. Issued by Authority of Chapter 172, Laws of 1967, and RCW 70.128.
PS11S Ifl. 17:1 (Rev. 1/91)
CITY OF EDMONDS
USE PERMIT
ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION
ADDRESS Z 2- 6z.-) -1 ?q A Tf
OWNER NAME NAME OF BUSINESS
LEGAL DESCRIPTION CHECK
SUBDIVISION NO.
MAILING ADDRESS (7
a
PUBLIC R16HT OF WAY PER OFFICIAL STRE PIP
md 0
CITY ZIP
-Y, uva!� Va_ 'i 0
LEPHONE NUMBER
;Wk 717L.- i9f.5*4
EXISTING - REQUIRED DEDICATION Street
Inspectio
PROPOSED
NNW
WKI Requireo 0
Use Per.it Req'd 0
Requ,,.d 0
x Required 0
NAME
METER SIZE
LINES1 OF FIXTURES
PRV REQUIRED
YES 0 NO 0
ADDRESS
REMARKS
Z
Z
CITY ZIP
NUM13ER
a
[ELEPHONE
NAME
ADDRESS
ENGINEERI.r D4% R IEWEDBY
0
CITY ZIP
TELEPHONE NU ER T
FIRE MEMO DATE16 FIETI-EWEDBY
.
Z
0
STATE LICENSE NUMBER q% FXPIRATIbN DATE
SIGN AREA
ED PROPOSED
SFPAREVIEW
COMPLETE JEXEMPT
A DB NO,
SHORELINE 0
CZ�
Z
Legal Description of Property - clu 11 Mements
0
EXP
VARIANCE OR cu
PLANNING REVIEW BY
DATE
19 7
NOV
SETBACKS - FEET V
HEIGHT
IT COVERAGE
FRONT SIRE REAR
IL9
Z
Property 6D;tj -ofn- 00/- dlvtv cl
Tax Account
REMARKS
Parcel No.
NEW RESIDENTIAL PLUMBINGAAEC
COMPLIAN E R
ADDITION El COMMERCIAL CHANGE OC UOE
REMODEL AFT BLDG. SIGN.
k-,-( AS A =,fN.A k$t i,, A
..4
-
CHECKED BY
ITYPE OF CONSTRUCTION
0% 1.1 -,
CCUPANT
u R.
REPAIR GRADING
CYCIS I FENCE x _FT)
Z
0
D1M.L1rII WINOSESIOSTOVE SWIM POOL
HOT TUBISPA
GARAGE RETAINING WALL/
CARPORT LJ ROCKERY Ca
(TYXFUS 8 SINES 3 OR ACTIVIT
'I) EX
j
LA(,W/ , IN
SPECIAL INSPECTOR
REQUIRED
13 YE S
ARIA
OCCUPA
LOAD
REMARKS
PROGRESS 41%%MS PER UBC 108
L
9
NUMBER
OF
STORIES
NUMBER OF
1. IN.
WELL
UNITS
RITICAL
AREAS Nj.
ICUMBER
W
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN'
NAL.INSPECTION REQUIRED
ION
FEE
PLAN CHECK FEE
BUILDING
HEAT SOURCE dV 0/0
PLUMBING
Plan Check No. V�l
MECHANICAL
This Permit covers work to be dUne on private property ONLY.
GRADINGIFILL
Any construction on the.pu%ic domain (curts, sidewelks,
STATE SURCHARGE
driveways, marquees, etc) wil require separate permission.
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 and
ENO. INSPECTION FEE
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, Its officials,
employees, and agents from any and all claims for damages of
PLAN CHECK DEPOSIT
5
,
whatever nature, arising directly or Indirectly from the issuance
0 f this permit. Issuance of this permit shall not be deemed to
9
0.
modify, waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
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 APPLICAT111 APPROVAL
authorized agent of the owner. I agree to comply with city and THIS PERMIT This application Is not a permit until
:tate laws regulating construction; and in doing the work authoriz- AUTHORIZES
d 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. acknowledged in space provided.
INSPECTION
SIGNATURE (OWNER OR AGENT) SIGNED DEPARTMENT
JDATE
OFFICIAL'S SIGNATURE DATE
CITY OF
A, a,, 3 -9 7 EDMONDS
CALL FOR RELEASED BY' DATE
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A,FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR -0220 ORIGINAL - File YELLOW - I.-P-Cl.,
. CEPT FICATE OC nrr_"0AMr.V 14Aq R9:F:fJ nRANTFn imr. 771
SECTION 109 PINK - Owner GOLD - Assessor
10247 Ae 3-2 �L
8 --jonw— C)
9 0 - 19
City o ' f Edmonds
RIGHT-OF-WAY CONSTRUCTION
�2�. L
PERMIT - 0
EET FILE Permit Number.
Lssu� Date: ?y
A. Address or Vicinity of Construction: 22004 99 Pi W
B. Type of Work (be specific): Repair Main Leak
C. Contractor: —Washington Natural Gas Compa
MailingAddress: 815 Mercer St. Seattle WA
State License #: Miii
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 224-2278
Liability Insurance: Bond:$
Side Sewer Permit # (if applicable):
E. F 1 0 City Project g Utility (PUD, GTE, WNG, CABLE, WATER)
Commercial Subdivision
Multi -Family 0 SingleFarnfly Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: ElYes []No G. Size of Cut: 1 (2 x 6) H. Charg(�_$
APPLICANT TO READ AND,83GN
INDEMNITY.- Applicant understands and by his signature to this application, agrees to h e City ofEdmonds harmless ftom inju ofdamages, or
0161
A
claims of any kind or description whatsoever, foreseen or unforeseen, that maybe ma agqinst the City ofFdmonf-.—.r.,eyefiti!6,;,Apartments or
employees, including or not limited to the defense of any legal proceedings includinff-defense costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS90 PERIOD OF ONE Y9AR"F6LL70,WING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMA TED RESTORA TIONI S,WILL BE HELD UNTH, TH� FINAL(STRrET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TOY4?� � BdANT.
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.
Ihaue read the abouestatements and understand the permit requirements and thepink copyof thepermit willbe
available on site at all time�,�inTpectionn pjzrposes.
Signature: Date: March 25, 1994
(Contractor or Agent)
CALL DTAT,—A—DT(-. PRIOR TO BE GINNINGVORK""J f" c
F�W�
FOR CITY USE ONLY
RIGHT OF WAY DEPOSIT
APPROVED BY A J tn' is_;8
TIME AUTHOItIZED.: VOID AFTER J%Awf.�= DAYS DISRUPTION FEE/FUND Ill:
SPECIAei,,,orz1_T-IONS: Q lk
COMMENTS:
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE:
RECEIPT FEE:
n "
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Commen ts:
I Diagram-:
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
ton
j. -
Nahx 51 d��
AWbftVWnb-OWC-rpWV
Addendum to :
City of Edmonds
Right of Way
Permit Application
Submitted by: Guyla Connors
Engineering Aide
Washington Natural Gas
521-5248
fzlr,o,q,e /720/4�)
"", 6 - cu.
;�Ov i /V C, U T
WNG to window
Water main depth
Key: -w- water
unknown
-9- gas -
gas main
-ss- sewer
-E)- water hydrant
0 water valve
815 Mcrccr St. (PO. Box 1869), Scank, WA 98111 (206) 622-6767
9
W VZT 7 'F
4 0
4 City of Edmonds
STRIMSCMIMF-WAY CONSTRUCTION
-V
8 go - 199
PERMIT
Permit Number.
Issue Date:
A" Add'ress or_Vi6i�ity of Construction: j. '7Z-6 7 17(. 'r H S-r 5 w
B. Type -of Work (be specific): kao0L_Are_rr,_ pA1AA1!fap_o r>,e,,jp
C. Contractor: C_ J-�AA4 13 IFZS /3 U P6_4.1 O/Z C-Ar Contact: �7-ejA4 1+AJ0A54','5aAJ
Mailing Address: <- Phone: 71117-4-- S-1 4 41
State License#: S (JPF,,2 C_ r__ 10 1 Q A Liability Insurance: Bond:$
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. F1 Commercial [J Subdivision El City Project [;a Utility (PUD, GTE, WNG, WATER)
n Multi -Family EJ Single Family [_1 Other
INSPECTOR:, INSPECTOR:
F. Pavement or Concrete Cut Yes allo ) G. Size of Cut: x H. Chargq�_$___
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to'li ds harmle.
ma, e o(dlhe City ofEdmom damages, or,
ma, e
e
claims of any kind or des ription whatsoever, foreseen or unforeseen, that may be ma 9, rJ inst the City of J of s epartments o
employees, including or n'oct limited to the defense of any legal proceedings ine =utng deft e 9sts, and attorney fees by reason ofgranting this permit.
113 - 2 5 . 9 11
7
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATER L FOFA PERIOD OF ONE YEAR FOLLOI(ING THE FINAL
INSPECTIONAND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION, FEES)WILL BE HELD UNTIL TH�, Fg�,L _TREET PATCIT
A
IS COMPLETEO BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL A��ROVC-ES4ED FOR ISS17ANCF NPA*,ANT.
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 Cit regulations as required by, the City ELigineer.
'y
All Street cut ditches shall be patched with asphalt or City appro�ed -inaterial prior to the -end 4 trie'w"�or_�ing day;
NO EXCEPTIONS.
Ihaue read the above statements and understand the permit requirements and thepink copy of thepermit willbe
available on jsOia-it all tz I mes� inspection purposes.,
e'*� , "-j? /( Date: 3 12- 4/9 4—
Signature:
(Contra'ctor'or'A'ge_nt)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: NOID AFTER E A A— DAYS
SPECIAL CONDITIONS:
COMMENTS:
,DISRUPTION FEE/FVND. 111:_
RESTORATION FEE:
PERMIT FEE:
rrllrl�
TOTAL FEE:
RECEIPT FEE:
DATE: - ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
'f Fngrg. Div. 1991
FIELD INSPECTION NOTES (Fund .14,1, Route Copy to S.treei'Dept.)-
Comments:
Diaaram
CONTRACTOR CALLED FOR INSPECTION El YES M NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
C11-11AMBEPS
CABLE
7ZD7 17&TP:�-TS W
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3-2-14 -94- TEA
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HOME
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5:33 MAIN STPES7 . =-r-Mr-Nr-S.'JVAS�-lr'JG -Ir--N SSC2C (2CS1
-i 1. -
If - � I
D /OR OWNER
STREET. K&TN'CE
El PARTIAL APPROVAL
El VIOLATION
'Ea CORRECTIONS REQUIRED
PERMIT
NUMBER
JOB ADDRESS 2,lz- 17
NO PERMIT - STOP WORK - REMOVE CONSTRUCTION OR OBTAIN
PERMIT AND MAKE WORK COMPLY WITH BUILDING LAWS.
CONSTRUCTION IS NOT IN ACCORDANCE WITH "PROVED PLANS
D AND PERMIT - STOP WORK. MAKE EXISTING WORK COMPLY WITH
APPROVED PLANS AND PERMIT OR REMOVE IT.
STOP WORK - UNTIL AUTHORIZED TO CONTINUE BY INSPECTOR.
CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN
BE APPROVED.
El WORK DESCRIBED BELOW HAS BEEN INSPECTED AND IS APPROVED.
CONTACT INSPECTOR AND RECALL FOR INSPECTION.
ARRANGE FOR APPOINTMENT.
A -.,)P 7 - 7
THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN
DAYS OR PENALTIES IMPOSED BY LAW MAY BE APPLIED.
FOR INSPECTIONS CAL%W&�� -
771-02= BUILDING DIV.
INSPECTOR PUBLIC WORKS
FIRE DEPT.
CITY OF DATE
EDMONDS
STREET FILE
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-3202
COMMUNITY SERVICES:
Public Works * Planning * Parks and Recreation e Engineering
, 890 . 199 -
August 6, 1991
Robert France/Janet Goad
22004 - 99th Pl. W.
Edmonds, WA 98020
Dear Mr. France and Ms. Goad,
LARRY S. NAUGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
I have been receiving calls from people indicating that shrubbery at
the intersection of 220th St. S.W. and 100th Ave. W. is impairing
visibility. I recognize that there are instances where home owners
install plantings within the public right-of-way. These plantings
sometimes become overgrown and create a sight distance hazard.
Before I request City crews trim the public right-of-way, I would like
to enlist your cooperation.
I will be directing City crews to do the necessary pruning on August
19, 1991. If you desire to have the plants trimmed in a particular
manner, please do so prior to that date.
Enclosed is a copy of the section of the City Code that pertains to
height restrictions at corners. Because of the volume and speeds of
the vehicles at this intersection, I would request your cooperation in
upgrading the sight lines on your property. I would like to meet you
at your convenience to discuss the possibilities.
Thank you in advance for your cooperation.
Sincerely,
/GORDON C. HYDE
Engineering Coordinator
GCH/sdt
Enclosure
FRNCGOAD/TXTST530
llrce?lllz� /?/
Incorporated August 11, 1890 *
Siste: Cities International — Hekinan, Japan
17.30
CHAPTER 17.30
FENCES AND HEDGES
17.30.000 GENERAL HEIGHT RESTRICTION
A. The height of a fence shall not be more than six (6)
feet -unless a conditional use permit is first
obtained. The height of a particular section of fence
shall be measured from the lowest finished grade at that
section of the fence.
When a retaining wall three (3) feet in height or
greater is contiguous -to and below a proposed fencel the
proposed fence may be constructed for the purposes of
safety not -greater than four (4) feet above the top of
the.retaining wall or the finished grade, whichever is
less, without the necessity for a conditional use
permit.
B. The height of a hedge shall not be more than six (6)
feet unless a conditional use permit is first obtained.
(Ord. 2772 §1, 1990.)
17.30.010 SPECIAL HEIGHT RESTRICTIONS
A. Streets and Corners..- Height shall normally be limited
to three feet within ten feet of any street or access
easement, and within 30 feet of any corner as shown in
Figure 17-1, unless an exception is approved.
B. Exception. If the Building Official finds thatho
hazard to users of the street or to nearby property will
be created, he or she may approve a fence or hedge of up
to six feet in height.
C. Hazard. No fence or hedge may be.constructed or
maintained if it creates a hazard to users of the street
or to nearby property (See Section 18.85.060).
(07/31/90) 122
'C I T Y 0 F E D M 0 N D S
STREETFILE - SEWER DEPARDIENT
STOPPAGE OF SANITARY SEWER MAIN REPORT
DATE: �A&-( 5, iC)-7-7 TIME CALL RECEIVED:
LOCATION OF STOPPAGE: 5EF—=
TIM� OF ARRIVAL ON THE JOB SITE: 4�0 p - �-A -
TIME NORMAL FLOW OF SANITARY SEWER REESTABLISHFD:
CAUSE OF STOPPAGE: 6E-F— "E�-kt) RDe.,� fZECjQ2--D t=CZ -
.6,D'D i ri C) L--J A-L- t LJ cDL-i P-E-GCm2-D t t.-J G
ACTION REQUIRED TO CLEAR MAIN AND/OR LATERAL:
CITY CREW ON STOPPAGE. CALL OUT (Personnel Involved): ILA J(a�-35EA-J
LZA2-�--f Cc—l—rl—
LOCATION OF RESIDENCE AFFECTED: '2-2-0 0 4 - C-4C) L W.
NAME, ADDRESS, AND PHONE NUMBER OF PROPERTY OWNER: V,
b, L-0 Vi I Li - 02-'2-0 c') -P L LJ -
C> �S'
DESCRIBE DAMAGE TO PRIVATE PROPERTY:
e- ��� c-z;-ri
REMARKS: "akAo OF:- 2 F�- C_CV-Z W I I I PQ-C�, i D E---
T114 Ic-D S-rop p NL�' iLr.
8/75
0
MEMO FOR RECORD
May 6, 1977
SUBJECT: PLUGGED SEWER '- 22004 99TH PLACE WEST - R. BALDWIN
On Tuesday, May 3, 1977, at 3:30 p.m., I was informed of
a plugged sewer at 22004 99th Place West, owned by Raymond K.
Baldwin. At approximately 3:40 p'.m., Jim Jensen and I arrived
at their residence.
We were met by Mr. Baldwin and a Roto Rooter man, who ex-
plained that they had been derooting the sewer line for two
hours and found no evidence of a blockage. They pulled the rod
out and.placed it on top of the ground and stretched it out to
the City main.
At this point, we rodded the 8-inch sewer main some 150
feet to the south from the clean out and found no obstructions.
We then checked the manhole which Mr. Baldwin's line flows into
and found the flow to be normal. On January,26, 1977, we were
called by Mr. Baldwin informing us he had a plugged sewer, but
the problem was on his side of the property. On that date, we
rodded the 8-inch main serving the property and found no obstruc-
tions at that time.
Q
I informed Mr. Baldwin I would return in the morning to
dig up the lateral on the City's side to see if perhaps there was
a grade problem. He agreed.
On Tuesday, May 3, 1977, the Sewer Division crew dug up the
lateral serving Mr. Baldwin's property. After exposing three
sections of 6-inch clay sewer tile and the "t" connection in the
8-inch sewer main, we found the grade to be normal. We then
punched a hole in the '-top- of 1 section of 8-inch sewer pipe to
see if perhaps there might be excess cement in the bottom of the
tile where it connected to the 8-inch pipe. After finding no
evidence of blockage, we then used the Vactor jet and rodded the
main. Again, there was no evidence of obstructions other than
a somewhat larger amount of grit than usual. Mrs. Baldwin said
that her toilets and drains were working alright at this point.
We repaired tI.e 8-inch tile, backfilled, and cleaned up the area.
My own thought.isthat their grade to the 8-inch main has just
enough fall to keep it flowing. However, due to the lack of use
and since their house is the last service on the 8-inch main,
problems may occur.
continued
Memo For Record
Page Two
May 6, 1977
We are now going to maintain that line on a monthly basis
for a period of six months to see if the situation improves.
However, I suspect a Claim for Damages will be filed by the
Baldwins.
Eq W�mw � �eo �- � �
LDO: j t
Attachments
MEMO TO TELEPHONE CONVERSATION
June 1, 1977
BETWEEN: Lani Cogan
St. Paul Insurance Co.
AND: Larry Ogle
Sewer Leadman
SUBJECT: RAYMOND K. BALDWIN CLAIM FOR DAMAGES
On Friday, May 27, 1977, at approximately 2:30 p.m., I
called Ms. Lani Cogan, Claims Agent for St. Paul Insurance
Co., to explain the Public Works Department Sewer Division's
findings on a recent claim.submitted by Raymond K. Baldwin,
22004 99th Place, regarding a sewer stoppage at his residence
on May 3, 1977. (see attached memo for record and stoppage
report for additional backup) Ms. Cogan asked if I would give
a recorded statement explaining our findings, and I agreed
and did so. After the recording, Ms. Cogan asked me if I
thought the problem was the fault of the City. I said no,
but it would be hard to explain that to the Baldwins.
I explained also that we were going to perform on a
monthly basis, a routine maintenance and inspection of the main
serving the Baldwin property to possibly prevent problems of
this kind in the future.
She mentioned that she would suggest that St. Paul pay
the Baldwin claim.
LDO: lee
STREff FILEO
C I T Y 0 F E D M 0 N D S
- SEWER DEPARTW_NT
STOPPAGE OF SANITARY SEWER MAIN REPORT
DATE: J&t'� - Z�=j lq-1-7 —TIME CALL RECEIVED: (qAo t-\.tv\.
LOCATION OF STOPPAGE:
TIME OF ARRIVAL ON THE JOB SITE: 150 A., - r*-A
TIME NORMAL FLOW OF SA NITARY SEWER REESTABLISHED: C)'. eo A\ - [%A -
CAUSE OF STOPPAGE: QC_C_A,)Q D ZE r\ aE sJ
5%AC)\N Ev. DZNA NJ LK-1 C_LXACN-, Q
CLSS-rQPAeQ,S PC)"E_ p" W5 PgppEQ.T---(
ACTION REQUIRED TO CLEAR MAIN AND/OR LATERAL:
CITY CREIV ON STOPPAGE CALL OUT (Personnel Involved):
Ck�__E/ 'It. -A je�Asr-_S4
LOCATION OF RESIDENCE AFFECTED: 2.7.cc4 - c)q�� -'R-
MA,NM P ADDRESS, AND PHONE NUMBER OF PROPERTY OWNER:
V,. 2)1S.LDW1&_A
DESCRIBE DAMAGE TO PRIVATE PROPERTY:
:51Ac)wF_q_ pg_.&.kkA pf.'rrc %K1
REmAm: 4r_LvSTc)v_AC-AL At�V_aD A1.SGCx.)T
I:Lust�oec) -nAE" -nAe_wrr_w L-L
MEMO FOR RECORD
February 17, 1977
SUBJECT: CLAIM FOR DAMAGES - RAYMOND K. BALDWIN
At 12:05 p.m., February 8, 1977, Mr. Lloyd Hagen, Claims
Adjuster for Pemco Insurance Company of Seattle, met with me
to discuss a claim for damages submitted by Raymond K. Baldwin
of 22004 99th Place West, Edmonds.
In our conversation, Mr. Hagen asked if there was any
possibility that the problem/blockage was in the City sewer
main. I said no, and.that in my opinion, there was no evidence
of any materials, grease, �-rags, etc. that would have caused
a blockage. I also stated that after we rodded the main, we
found nothing indicating a stoppage. Mr. Hagen said the
Baldwin's called Roto Rooter to rod their line, and no evidence
of a blockage was found either.
Mr. Hagen asked for copies of my Stoppage Report and Truck
Report illustrating the City's action. At this point, Mr.
Hagen said he would investigate further and keep me informed
on this situation.
From my point of view, it appears the City might be facing
another problem with the Baldwins on this Claim for Damages.
A detailed report will be written to further explain the City's
involvement in this matter.
Ifthr.-I 10
CE qn-Mn�jrw�M � ME/
LDO: j t
MEMO OF TELEPHONE CONVERSATION
January 31, 1977
BETWEEN: Lloyd Hagen, Claims Adjuster
Pemco Insurance Company
AND: Larry Ogle
Sewer Leadman
SUBJECT: SEWER STOPPAGE AT 22004 99TH PLACE WEST
At -approximately 4:45 p.m., I received a telephone call
from Lloyd Hagen, Claims Adjuster for Pemco Insurance Company
of Seattle. Mr. Hagen called in reference to a plugged sewer
claim submitted by Raymond K. Baldwin of 22004 99th Place
West, Edmonds.
Mr. Hagen asked if our sewer main was plugged. I replied
no and that we had rodded the main to verify there was no
blockage. He asked if I had been present while Roto Rooter
was there; and if so, what the results were. I informed Mr.
Hagen I arrived shortly after Roto Rooter had begun derooting
the line, and that I was not aware of the location or cause
of the blockage.
Mr. Hagen informed me he would have to investigate Mr.
Baldwin's claim further but, at this point, the City had no
involvement.
LDO: j t
APPLICATION
rn for
�E T,
FILE-'- SEDE SEWER PERbHT
The City of EdmonclssTlq, EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS 0
400-06200
OWNER........... ---------------------------------------------------------------- CONTRACTOR -------------------------------------------------------------------------------------------------- PERMIT No . ......................
ADDRESS ....... 220.04-99th ... Place ... W - ------------------------------------------------ LEGAL DESCRIPTION: LOT No . .............................................. BL0CK No . ............................................
NAMEOF ADDITION .... ....................................................................................................................................
0
Dye Tested On Sewer 1972
Approved:
DATE................................................ By ......................................................................
NOTICE:*
n' 0 -. - �-a--. cc u rary
No-w -a r-r a
Theinfor I matlon*shown on the attached
for use by the City 01
map(s) was cOm ' Piled d Consultants.
Edmondsi its Empl-oyees an nt the
Th,.e City of *Edm.onds does. not. warra
y of anything set forth on these
accurac
M a p (s). A n . V person or entity -requesting a
copy should conduct an independent
orm'ation shown-c
Inquiry regarding the inf'
tF�� -Map(s), including, but not Jimited to,
the lotation (Df any sewer stub shown. Su(
sewer stubs may or may- not exist and rna�,
or may not exist at the location shown.
ts
Neitheir the City of Edmond-s' nor i for -1h
e m o'y e e*s 0,r o ff i -c e -r s -s h- a I- I b e 11 a. b-1--e
information given on this map(5), nor for
prese.ntation provided based
3ny one re
upon'said. m a p (5)