23408 76TH AVE W.PDFlill 11111111
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23408 76TH AVE W
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CITY of EDMONDS BUSINESS LICENSE APPLICA �tj�ATE LICENSE NO.
Civic Center - Edmonds, Washington 98020
City Clerk Phone 775-2525 ANNUAL FEES PENALTY AFTER FEB. 15
Pelf
It, if-5 t� HOME OCCUPATION
INSTFIUJCTIONS:
Asms must be completed
or application will not be ac-
cepted.
Sign and return application
with fee. Renewals received
after February 15 must pay
penalty in addition to fee.
NEW BUSINESSES AFTER
CLAS
YEAR
LIC. EFFEC. E-JREASG.
LIC. NO.
SPEC.
RECEIPT NO.
DATE PAID
A-
PRINT'X'
IN SPEC. BOX
FOR ISSUE OF
CORRECTED
FEE PAID
LTY P--
PENA AID
LICENSE WITH
'LC' ACTION.
$10.00 (A)
ADDITIONAL $5.00 0
El SMALL BUSINESS
$15.00 (B)
ADDITIONAL $7.50 0
0 Business with 10 or
more employees
ADDITIONAL $25.00 0
$50.00 (C)
A NEW APPLICATION (LA)
0 RENEWAL
(LB)
0 CHANGE
(LC)
JULY 31, 1/2 FEE. (PLEASE MAKE ANY NECESSARY CHANGES) 0 DELETE (LD)
NAME OF FIRM
BUSIN�SS PHONE
MAILING ADDRESS 3q(--)4
g NATURE OF BUS ESS
j
q �50QO
NO. OF EMPLOYEES
BUSINES9 ADDRESS,a-�;,-'/C)'6 7,czJ---1^,,,-,VJ
INDIVIDUAL
(S)
PARTNERSHIP
=I-(P-)
CORPORATION
P
OWNERS NAME 5073-C)4o570
HOMEADDRESS
Q)- Jll�)
03tlo
Q
HOMEPH
,�NE
DATE OF�IRT ,
PLACE OF B RITH
-P
SOOLIAL S ECURITY NUMBER
EMERGENCY NOTIFICATION:' (1) NAME & TELEPHONE
(PLEASE LIST TWO) (2) NAME & TELEPHON F
-7 4�-
gVSHINGTON STATE TAX NO. APPLICANT'S SIGNATURE
DO NOT WRITE BELOW THIS LINE
J:
STAFF REVIEW: -
FILL IN LAND USE CODE, LIFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR
DISAPPROVAL, DATE, AND SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT"
SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT DATE I'dWAn LAND USE CODE ZONING CODE
APPROVE El DISAPPROVE
SIGNATUR IT 7
E
CONDITIONAL USE PERMIT
COMMENTS
BU!�DING DEPARTMENT
B--APPROVE
DATE
Building
CJ
Hotel/Motel
(L)
11. DISAPPROVE
SIGNATURE
Permit
0
Apt. Bldg.
(A)
0
Office Bldg.
(0)
COMMENTS:
Occupancy
0
Restaurant
(R)
Group
0
Hosp/Nurs; Home
(H)
CAPACITY: (No. UNITS, APTS., OFFICE',
SEATS, BEDS, STUDENTS)
E�
.0,
School
(S)
FIRE DEPARTMENT
DATL
U. F. 1. R.
APPROVE El DISAPPROVE
SIGNATURE
COMMENTS:
AKQp(�E DEPARTMENT
111F��PPROVE CJ DISAPPROVE
DATE
SIGNATURE
COMMENTS:
PUBLIC WORKS DEPARTMENT
0 APPROVE 0 DISAPPROVE DATE SIGNATURE
COMMENTS:
0 1 r: A C, r- r1j r- -r 1 1 r-j N 1 -rr% r% 1 -rt/ r% 1 r- M L/
t,h/*e City of,Edm FLE
onds
APPLICATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS
EASEMENT No . ..........................................
A j c, S/
OWNER ......... W.r-* ....... P
CONTRACTOR ......... I .......... "
...................... .... ............... ....... ............................. ............................. .................. PERMIT N.��,�6
ADDRESS ..... ....... ....... LEGAL DESCRIPTION: LOT No . ............................................. BLOCK No . ......... -----------------
NAME OF ADDITION ........................................ (
ld�-) ............... - ...............................................
(IN
APPROVED.
UCT. 0- 1967
Approved:
DATE................................ By
----------- -
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 Edmonds 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
the 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
employees or officers shall be li-able for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
'A' -
E lol, P
'2
-e
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPARTME . NT Call. FRospect 6-1107 when work
1. ready for Inspection. (No inspec-
tions Saturday, Sunday or holidays.) N? 2468
SIDE SEWER PERMIT
bvADDRESS ........... 2.14-06 - - --- ............................................. . .......................................................................
OWNER ............... Pete Barker ....... CONTRACTOR .... owner ...................
........................................................................ .........................................................
Permission is granted ....... Oc-tob-er .............. 6..' 19-6.7., for ........................ days to REPAIR or CONNECT a side sewer
..... ....... .....
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side sewer Contractor must
be employed to construct side sewer in street area. Do nut cover any portion of sewer before it has been inspected.
'E No. 2--Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
r_�TE 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.
NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to improper work which may develop within one year of completion.
r-TE 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 appur-
tenances except to insert the pipe into the wye.
January 12, 1968
Mr. Peter
23408 - 7f
Edmonds, �
Dear Mr. I
issued by the City of Edmonds on 9dt6ber 5 �J67, for proposed connection
of 23408 - 76th Avenue West EdmQ' /
\n�s , to - anitary sewer; and'to d&te
talld,tion, intps
we have no records of the ins p"ection, and connectiond.F- same,
Concerning indivldu'alho6k��up<�/o -sewers within the City of
Edmonds; the following Nance \i��ve ring this subject quoted
from the general ordinances for the \ �Clty of, Edmonds, Page 96 of the
Edmonds City Code:
Ordinance '10 829, Para�r'��h 2, as amended by Ordinance
No. 88-1-i-May 2�0:�i,961 UTURE CONNECTION —WHEN REQUIRED.
,,,,Must within sixty-di7s Of the completion of any future
t7unk or lateral sewer upon which said homeowner may then
iabut or be wiihin two hundred feet therefrom, must make
�c6nnection td 'said trunk or'lateral pursuant to the regula-
�il on applicable as set forth in Section 11.16,020.
You are-_-Vf6refore requested to execute side sewer permit
No. 2468.
.Yours very truly,
CITY OF EDMONDS
JOHN E. MORAN
Director of Public Works