23703 78TH AVE W.PDF15215
23703 78TH AVE W
CITY OF EDMONDS GARY HAAKENSON
MAYOR
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
117 C. 8,),3
March 23, 2000
Home Owner
7729 238" St SW
Edmonds, WA 98026
Re: Address Change
This letter is to inform you that due to the recent subdivision in your area, the City
will need your address changed. All of the new addresses, including yours, are to
be addressed off of 78 1h Ave W per the City Engineer. Your new address will be
23703 781h Ave W. I will inform all City Divisions including Fire, Police, Utility
Billing, Public Works and Building.
It is your responsibility to inform the Post Office and all other interested parties of
this correction. We apologize for the inconvenience this may cause you and greatly
appreciate your cooperation.
Thank you,
Lara Knaak
Development Services
Cc: Fire Department
Police Department
Utility Billing
Public Works
Building Official/Street File
Incorporated August 11, 1890
Sister City - Hekinan, Japan
LEGAL DESCRIPTION:
THE NORTH 98.00 FEET OF THE SOUTH 138.00 FEET OF
THE EAST 109.00 FEET OF THE WEST 119.00 FEET OF THE
NORTHEAST QUARTER OF THE NORTHEAST QUARTER OF
THE SOUTHEAST QUARTER OF SECTION 31, TOWNSHIP 27
NORTH, RANGE 4 EAST W.M.;
TOGETHER WITH
A NON-EXCLUSIVE EASEMENT FOR INGRESS, EGRESS, AND
UTILITY PURPOSES OVER, UNDER, THROUGH, AND UPON
THE SOUTH 40.00 FEET OF THE EAST 109.00 FEET OF THE
WEST 119.00 FEET OF THE NORTHEAST QUARTER OF THE
NORTHEAST QUARTER OF THE SOUTHEAST QUARTER OF
SECTION 31, TOWNSHIP 27, NORTH, RANGE 4 EAST W.M.;
SITUATED IN SNOHOMISH COUNTY, WASHINGTON
ALSO DESCRIBED AS PARCEL A OF SHORT PLAT RECORDED
UNDER RECORDING NO. 9311190021, RECORDS OF
SNOHOMISH COUNTY, STATE OF WASHINGTON.
TAX ACCOUNT # 312704-4-001-0108
ZONING: RS-8
SITE ADDRESS:
7729 - 238TH AVENUE S.W.
EDMONDS, WA. 98020
&_*5 FILE
Tit
HEIGHT CALCULATIONS: w
D
A= + 106.75' z
B= + 107.46'
C= + 107.08' Lu
D= + 108.50' >
AVERAGE GRADE = +107.45'
ACTUAL HEIGHT = +129.35'
MAXIMUM HEIGHT = +132.45'
AVERAGE LOT SLOPE: 9%
MAXIMUM ON SITE GRADING: 40 CU.YDS.
Lu
0
0
Lo
C)
C)
Ono
20.00'—/r/.' 20.83'—/ Z— 14.67'
vZ-- 9.50'
109.00,
9.00, 2.33'
D +108.50' - C +107.081 \J
------------- L - -- — - - - - -
------ 3\4.50 1:
1183'
20.'081 EXISTING ADDITION
GARAGE
3483'
EAVE LINE&-�
1: L -------------- �j
- - - - - - - - - - -
EXISTING HOUSE 20.67'
-------- FDN. LINE--7
I + 106.75'
I A
LJ�
Lu Z_ B +107.46'
Lu 4.83-1 6.83'-7
GTE NW INC.
EASEMENT C:)� 20.00'---j/' Z_ 14.00'- 24.17'—
U) 0) C)
w Cvj: // C)
0 Lo 1/ 65.00'- 7 C6
Z475D ------
C) 7.80'
0 co z
Lu m
Lu /CRUSHED ROC�
Lu DRIVEWAY PARCELA
10,681 S.F.
DATUM POIN /+100.00'
REBAR SUJRVEY CORNER
109.00,
- - - - - - - - - - - -
/46. OF - - -
I/ / RE1-1'.'_EIVED
NON-EXCLUZ(VE AP ROVED BY pLANNING PARCELB
ACCESS EA9JEMENT
C? FOR RCELA J A N' I fjl�,�75 S.F.
40.00'
SITE PLAN N 88 33'26" W
SCALE: 1" = 20'
J I City o.f Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT
PermitNumben
Issue Date:
A. Address or Vicinity of Construction: _-7
7 2-
9 0 1 9
B. Type of Work (be specific): 4S44C/_9
__d6�1 oe
C. Contractor:
/Ac Contact:
Mailing Address: .42
101-7 �"WA,49- Phone:
State License #:
.1311NOe Liability Insurance: S
Bond: $
D. Building Permit# (if applicable): Side Sewer Permit-# (if ap
plicable):
E. Commercial 0 Subdivision El City Project [-] Utility (PUD,-,GT,E1',, N ',,CA13L*E', WATER)
Multi -Family 'IV, Single Family E] Other.
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: D Yes JMo G. Size of Cut: X_ H. Chargq�_$
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to holdthe City ofEdmond8 harmless from 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 its departments or
employees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WOR K ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THEFINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL 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 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.
Ihave read the above statements and understand thepermit requirements and thepink copyof thepermit will be
available on site at all times for inspe . n pur oses.
Signature: Date:
(Contractor orAgent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
, , "PROVED BY: I -
TIME AUTHORIZED: VOID AFTER — DAYS
SPECIAL CONDITIONS:
191#JM31D1afL-3
DATE:
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND Ill:
RESTORATION FEE:
PERMIT FEE:
TOTAL FEEtZ ("'2 120 1417
RECEIPT FEE:
ISSUED BY:
NO WORK SHAL,LIBEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994
t
FIELD INSPECTION NOTES (Fund Ill - 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:
j
20.00' 20;83' 1 4.6T
E_ - - - - --- - - - - - - - - - - //
LEGAL DESCRIPTION: 9.w 109.00, 2.33',
THE NORTH 98.00 FEET OF THE SOUTH 138.00 FEET OF rl_Q+108.5a C +107.08'
THE EAST 109.00 FEET OF THE WEST 119.00 FEET OF THE ------- --------- --------------- ------
NORTHEAST QUARTER OF THE NORTHEAST QUARTER OF 34.50' r ------ i i
THE SOUTHEAST QUARTER OF SECTION 31, TOWNSHIP 27
NORTH, RANGE 4 EAST W.M.;
20.)8' EXISTING
ADDITION
TOGETHER WITH GARAGE
A NON-EXCLUSIVE EASEMENT FOR INGRESS,- EGRESS, AND
34.83 EAVE LINE
UTILITY PURPOSES OVER, UNDER, THROUGH, AND UPON L ----------
THE SOUTH 40.00 FEET OF THE EAST 109.00 FEET OF THE
WEST 119.00 FEET OF THE NORTHEAST QUARTER OF THE EXISTING HOUSE 'T
NORTHEAST QUARTER OF THE SOUTHEAST QUARTER OF
SECTION 31, TOWNSHIP 27, NORTH, RANGE 4 EAST W.M.; A +�06.75' ------- FDN. LINE
L------------- 1-
SITUATED IN SNOHOMISH COUNTY, WASHINGTON. L B +107.46
Lu Z_
ALSO DESCRIBED AS PARCEL A OF SHORT PLAT RECORDED Lu GTE NW INC. 4.83! 6.W
LL_
UNDER RECORDING NO. 93111 =1, RECORDS OF EASEMENT
20.0(Y — Z-14.W 24.1 T
SNOHOMISH COUNTY, STATE OF WASHINGTON. U)
C)
0 65.00' 06
TAX ACCOUNT # 312704-4-001 -0108 LL_ 0)
00
ZONING: RS-8 0 �7-__/_
LLJ
Cl 105
C)
w CRUSHED ROCK
SITE ADDRESS: Lo DRIVEWAY PARCEL A-'
a 10'681 S.F.'
CD
7729 - 238TH STREET S.W. z
EDMONDS, WA. 98036
DATUM POINT +100.W
REBAR SU7�!FY CORNER
109.00,
----------------
:�:T07 IT -------
HEIGHT CALCULATIONS:
A= + 106.75'
B= + 107.46
C= + 107.08' Ljj
D= + 108.50' NON-EXCLU PARCELB
ACCESS �2MENT
55),875 S.F*.
FOR �ARCEL A
AVERAGE GRADE = +107.46
ACTUAL HEIGHT = +129.35' cii If
MAXIMUM HEIGHT:= +132.46
AVERAGE LOT SLOPE: 9% 00
MAXIMUM ON SITE GRAIDING: 40 CU.YDS.
.09( 40.00' 1
SITE PLAN N 88 3326" W
H
SCALE: 1 20'
0
CITY OF EDMONDS
USE
ZONE PERMIT 9 4 C', 4 EF,
&<, - NUMBER
CONSTRUCTION PERMIT APPLICATION
G. SUITE?APT
ADDRESS --7 -7 C
OWNER NAME NAME OF BUSINESS
L3rlo?\ rY10CI)ev �%., e ;-j y 4? f- eu " t
LEGAL DESCRIPTION CHECKI
SUBDIVISION NO
1ID 110
Z Z
0
MAILING ADDRESS
v� 7
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — REOUIRED DEDICATION —
PROPOSED
TESCP Approved 0
RW Pe -it Requ.,ed 0
Streal Use Permd Roo d 0
Inspeclion Requ,ed 0
Sce.81k Req..Ied 0
�CITY zip
ELEPHONE NUMBER
�. L, ", t I
NAME
S A- PNr.�-
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REOUIRED
YES 0 NO0_
ADDRESS
REMARKS
§
z
M.
z
CITY Z7--76LEP"ONE
NUMBER
NAME
ADDRESS C
0
U
as
ENGINEERING MEMO DATED REVIEWED BY
CITY ZIP
TELEPHONE NUMBER
FIRE MEMO DATED REVIEWED BY
z
STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
ALLOWED PROPOSED
44
SERA REVIEW
COMPLETE JEXEMPT
EXP
ADS NO.
�N,
SHORELJNE a
E
Re
Legal Description of Property - include all easements
4":,21"(1 �66
1.
q 3111 ��2
VARIANCE OR CU
L
P/IN�jNG R V
74 /4
BY 0 T
h?)
Property
Tax Account 7 0 V
Parcel No.
-
SETBACKS - FEET I HEIGHT
FRONT SIDE :z V-zEAR—j_2_r-�Ij
I LOT COVERAQt
ti
z
HtMAHKb
-i
L
NEW RESIDENTIAL PLUMBING
'�9ADDITION COMMERCIAL MECHANICAL
REMODEL APT.SLDG. SIGN
(^Y)o
CHECKED TYPE OF CONSTRUC�ION CODE
il�� By
OCCUPANT
GROUP
FENCE
REPAIR CYDS. El I X _ Fn
DEMOLISH WOODSTOVE sw OOL
INSERT HOITMTUB/SPA
GARAGE RETAINING WALL/
CARPORT 11 ROCKERY E] RENEWAL
a INSPECTOR JAREA
RP%C1'1tLED
. E3 YES
OCCUPANT
LOAD
MARKS
0
W
0
(TYPE OF USE, BUSINESS OR ACTIVIZI X.PLAIN:
;C
PROGRESS INSPECTIONS PER UBC 305
Zk* ft-,Oelf 7/fS Mee-' �a6 V1 fi Q '(0tile
NUMBER
OF
STORIES
NUMBER
OWELLIN
UNITS
CRITICAL
AREAS
NUMBER
DESCRIBE WORK TO BE DONE JATTJ P��
r . "
FINAL INSPECTION REQUIRED
-
: VALUATION
FEE
PLAN CHECK FEE
20-5-
BUILDING
HEAT SOURCE:
GLAZING
PLUMBING
Plan Check No.
ZO
MECHANICAL
This er�ltrriit Covers work to be gone on Private property ONLY.
GRADINGIFILL
A6f
y conitructl6n on the public domain (Curt$, sidewplks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
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
successors in interest, agrees to indemnify. defend and hold
ENO. INSPECTION FEE
X
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatever nature. arising directly or Indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
-
dX
modify, waive or reduce any requirement of any city ordinance
nor limit In any way the City's ability to enforce any ordinance
provision."
6"'
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 APPLICATION APPROVAL
:thorized agent of the owner. I agree to comply with city and THIS FERMI
tuate laws regulating construction; and In doing the work aulho riz- AUTHORIZES This application is not a permit until
ad 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. INSPECTION acknowledged in space provided.
SIGNATYP45,OWNEA OR AGENT), DATE SIGNED DEPARTMENT OFFICIAL S SIGNATURE DATE
CITY OF
EDMONDS
CALL FOR AELE A§V6y.V DATE
ATTENTION INSPECTION 7-
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNITIL A FINAi !m,�PECTION HAS 13EEN MADE AND APPROVAL OR 771-0220 ORIGINAL - Foe YELLOW - Inspector
OCCUPANCY HAS BEEN GRANTED. USC
A?4e- CZ/V
J4,V 14 11�*b
ft,94flr 1094
EXEMPTION FROM CONTRACTOR REGISTRATION 00,14171
VERIFICATION FORM e19
The undersigned property owner or contractor has applied for a building permit from the
City of Edmonds and claims that he/she/it are exem . pt from providing contractor registration in
accordance with the provisions of RCW 18.27. The property owner, by their signature below
hereby verifies to the City of Edmonds that:
Value of work under $500.00. The aggregate contract price of labor and
materials and all other items required for the project is less than $500.00 and
is not part of.a larger operation to be undertaken on the property. The
person employed to do this work has not 'advertised nor otherwise put
himself forward to the permittee to be a contractor or qualified to engage in
the business of a contract. RCW 18.27.090(9).
Work performed personally on own properiy. The undersigned verifies
that all work done under this permit will be done by the permittee personally
on his/her own property and that the improvements constructed on the
property are not being undertaken with the intention and purpose of selling
the improved property.
El Commercial property exemption. The permittee is the owner of
commercial property and the owner's own employees will perform all
maintenance, repair and alteration work on the property ' No work will be
done by contract under the permit. RCW 18.27.090(13).
13 Licensed architect, engineer, electrician or plumber. All work performed
under this permit will be performed by an architect, civil or professional
engineer, licensed electrician or licensed plumber operating within the scope
of his or -her license. RCW 18.27.090(14).
THE UNDERSIGNED PROPERTY OWNER HEREBY VERIFIES THAT ALL
INFORMATION PROVIDED ON THIS FORM IS TRUE AND ACCURATE TO THE BEST
OF HIS OR HER KNOWLEDGE AND ACKNOWLEDGES THAT IF ANY OF THE
INFORMATION PROVIDED ON THIS FORM IS FALSE, HE OR SHE UNDERSTANDS
THAT THE BUILDING PERMIT WILL BE IMMEDIATELY REVOKED AND ALL FEES
PAID FORFEITED.
DATED this 11A day of J—a", os= /
-, rv—r�. / P�Y
PROPERTY OWNER/PERMITTEE
,2
WITNESS:
I
SEN� BY:EVERETT OFFICE 3-23-e4 13:37 STEWART TITLE CO. 20V7102214 1/ 5
WAR TITLE COMPANY
OF SNOOOMISH COUNTY
FACTIMME MNSMZS�
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FROM.
comwNm
FAX#. (206) 252-7j7j
-IF YOU HAVEANYQ��IONSREGARDING THly MNSMISVION, PLFASK
CAM (206) 258-6450L
SENTI BY:EVERETT OFFICE 3-25-94 ; 15:37 STEWART TITLE CO.
W TIM COWARY
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2067710 221;# 2/
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ow I Gan--w -- DeFft
Donald A4 VRVWft, AttOrneY
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ro
ran
TW MUMR. 12ing H. LOW=. as bar amparate ONUS
w mad m --midmom it Tan Dollars and Other Valuable: 0DWLderation
in b"d pma � m mo md P4�- VMCRM PACIFIC TRUCT, IT"tod, for R.P.T.
wD.
ea howw" "now No am NNW 0 Pa C400 a two *I woo&"".
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is at S*Awmish County# State of WaShLootcm.
Mmmmm Uzi% a ace-ewlusLve eamemmint tW L99MIJ AM 69ma
over &M mms the Smth'40 feet of tho Wast 109.01 foomet Of
pazVol a of Ohort Plot recorded -ad r maeota"W go- 9311190021p,_-r'�
recorft of I I =hozh county, State at Wa2h1nqtm.
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(2) My*miU, amAt4m, roSdICUM, MMWM, Micatimst
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SF-.NT.BY:EVERETT OFFICE ; 3-25-94 ; 15:38 ; STEWART TITLE CO. -4
2067710221;# 3/ 5
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TOGETHER WrTM, a am -exclusive essusest for InSweso and *gress
7 �
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remas at ancTooish Cmmty, StaLta
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This Dbod of "t wh1ch in Becurlty for a cartain ftooLvacry.ft
of even data SWI be assumable by a new buyer of the proDer
excapt that tim minanclary herein ma# appcove or tim qxw4itty
n . Wo
ess of any f"u" buyer(D), sald aPPrcval my Wt, hawovar# be
unreasonably withhold.
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SENT.BY:EVERETT OFFICE 3-25-94 ; 15:39 ; STEWART TITLE CO. 2067710221;# 4/
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Critical Areas Checklist RECF--11,
Site Information JAN 14 1994
LOWELL SHORT
Pro
je4CtNaMe: - SUBDIVISION Permit Number.
7705 AND 7729 - PE.RMILOGWITER
SiteLocation: '939TH ST_ S.W. Property Tax Account Number. 3 19704-4-001-0108 AND
312704-4-001-0009
Approximate Site Size (acres or square feet): 68636 SO. FT.
Have you filled out a Critical Areas Cheeldist for a project on this site before? NO
General Site Conditions
1. Has the site been cleared or logged? PARTIALLY -Date of most recent action: UNKN
Soils / Topography ALDERWOOD-URBAN
LAND COMPLEX (2-8 AND 8-15%
2- In the Snohomish County Soil Survey, what is the mapped soil type(s)?
SLOPE
3. Describe the general site topography. Check all that apply.
Fl less than 5 feet elevation change over entire site-
X -Rolling: slopes on site generally less than 15% (a ve rtical rise of 10 feet over a
horizontal distance of 66 feet.)
X _11illy: slopes present on site of more than 15% and less than 30*/,o (. a vertical rise
of 10 feet of horizontal distance.)
-Steep: grades of gmter than 30% pre sent on site.
Comments NO EXCAVATION, GRADING, � OR SITE ALTERATION OF ANY KIND WILL OCCUR IN
CONNECTION WITH THIS PROPOSAL.
Hydrology/Vegetation
41
City of Edmonds
Critical Areas Determination
Applicant: I Irene Lowell Determination #: I CA 93-155
Project Name: Lowell Short Plat Permit Number: N/A'
Site Location: 7705 and 7729 238th St. Property Tax Acct #: 312704-4-001-0108
SW and'312704-4-001-
0609
Project Description:
The critical areas assessment covers two properties, including a
generally square shaped 10,682 s.f. parcel located at 7705 238th
St. S.W. and a larger recta ngu lar-shaped 55, 875 s.f. parcel,
which encompasses the smaller lot, and is located at 7729 238th St.
S.W. Both properties contain a significant amount of mature
vegetation.
Waiver Criteria (all criteria must be found to apply):
xx There will be no alteration of the Critical Area or its required buffers;
xx The development proposal will not impact the Critical Area in a manner contrary to
the goals, purposes, objectives and requirements of the Critical Areas ordinance; .
xx The development. proposal meets the minimum standards of the Critical Areas
ordinance;
XX— The above findings are based on the following conditions of approval:
N
1. The proponent shall prepare a tree preservation plan and coordinate the
preservation plan with the site grading plan for submittal with the subdivision
application. Tree cutting shall be limited to building pad areas, driveways, and
reasonable yard areas.
CA93155.DOC
CA-9S-'155
June 21, 1993
Page 2
Based on the above findings and conditions, the requirement for a Critical Areas Study
associated wi ' th this development permit is hereby Waived, as authorized by Chapter
20.15B. 150 (B) of the Edmonds Community Development Code.
Wame ignature AcZate
, � 5 � �- I �-7 L; �---
PLANNING DATA
SITE ADDRESS:. 7-T7-5 zFo4- ki-eSO DATE: I / A P) I lei 4
ZONING: PERMIT#:
PROJECT DESCRIPTION: Z�MjT-7D6.)-
SETBACKS:
Reauired Setbacks:
Front: ��Left Side: Right Side: Rear:
Actual Setbacks: I
Fr1ont: 3 15 ' Left eide: I Right Side:j,8
FLOOR AREA: 15'5G, Z 4-/--fQ1,-1 -- 1-7 61, 10
LOT COVERAGE:
Maximum Allowed:, VO 3-73'34ctual: 1�4 �/Q IqQ�a�
BUILDING HEIGHT:
Maximum Allowed Actual Height:
SUBDIVISION: 115 - q 3 — / ---j/ /
CRITICAL AREAS #:
SEPA DETERMINATION:
LOT AREA: / U ) (�2 1) /
OTHER: -Z -7 04� - CkD I ' . G, 4:� p.
I t,-/ C-j
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 lia-ble for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
�
The City of Edmonds
APPLICATION VIA MUMOM
for L 4 "' tSTA tTM
mEDmSEWmR PERAM
NEW CONSTRUCTIONO REPAIRS [] ---------'- ------------
OWNER
_________________ _ ~~^,^^~~~^~~^............ ................................................. ................................... P000ulIr»mx --
ADnRESa ....... —�—.��.��—..��................ ��.�1..�[���—.��—............. LEGAL DESCRIPTION: LOT »ru.......................... ................... BzI»mK No--_______'.____.
NAME OF ADDITION
Approved,
�
The City of Edmonds
-jr
OWNER ...... /I.Fjo-Ze...
HOUSE No . ....... 77,
1.0
APPLICATION
for
SIDE SEWER PERM
OUTSIDE 0 INSIDE REPAIRS 0
........................................ .............
............. zlyie .............
CONTRACTOR ........... .... I lle� A � C., *, - �- ..
d�?p ' i
CARD No . ............... . ... .. ... ... —
EASEMENT No . ........ ............
/ (") � 0,7
......... ..... ............... PERMIT No.
STREET
AVENUELOT No . .............................................................................. BLOCK No . ................................... ......
NAME ADT)
#4
........................ ................ ................... ................. ........... ....................
/V �l , "
zo I?
47
VIQ
�gv
Date Approved:
BACKFILL WORK OR DER ISSUED ............................................ DEPOSIT, $� ........................... ........ ................
SEWER WORK ORDER ISSUED ................................................ DATE. ... ....... BY ... ...... .. .... ... . .. .... .. ........... ...................
-� �- /; Z/S. --/ -�-
Q.
NA"I"I
L5
Chfof tftoW,
:�.'..:.'.,,-RIG11T-0E-WAY CONSTRIJCTION:
PERMrr 05 7
1&we Date: h-1/9
�XAV. TvkC W\N-Y,4,
Address or vloiixitY of Construction: 'Z 9 2 3,E�L'l SO �X S
B. Type of Work (be speciffq),2_tLQLCQkQQ N 'POLE (XA C IT (� -T
. .. F ')Vkr_ M-FlAkt.01 - P_Zkc.
C. COMIA11111 NO -Contact-. kv:.��
MaUin,gAddreai: klLj*-( 99 Phoce: (6-70 - 32--oS
State I jesuse 01160 Z' * Liability Imranoe: Road: $
D. 13wlaNj Petinit # (if applicable): Sido., Sewer Permit# ff applicable):
E_ El co—momw Subdivision C3 cityproject [3 Utility (PTJD, am, Wxo,- CA331-E, WA'rER)
Ci Multi -Family Single Family Cj Other
I N S P E C~TO'% RL --d INSPEcTOR:
F. Pavement or Concreie Cut - Yes No G. Size of Cut: H. Cbatgt�,$
x -AMI.
APPLICANT T _GN Pz_�
I,VDEA&ar..4p,plicaoitundeo-itan*amd by his signaiv.�4 lo thir qpp�lwt F
[pail 1. to d; ho f jas om Wuries, d&;nqp.F, or daimi of any
kind or dc.scropitan whatsoever, foreseen or unforeseer(,4<0 %4A01 ag i cigojf monds. 'cor any qf'lis departments or
gn oftm ofany '[pK attor res by remon ofirraming ihispermn.
'pd"se, Inelsoding ap mai lim iied to rho d*f _joga 4
TH.6 CONTRACTOR IS REVONSIBLE FOR 4112AD MA R—J-PERIOD OP6NE YE.4,R FOLLOWIYG TWE FIN.44 INSM,
T(ONAND A CCEPTANCZ OF THE WO �J! R STOR"LA . . . . . . HELDUN77L THE FINAL STREUP.,(TCHIS COMPLZ740
B r cny PoRcgs, A r WKICK TIME A J JT CReDIT WILL BE F UANCE TO WE APPLICANT
Two asts of construction dmwin'gxof p posed r with permit application.
A 24 hour notice is required for, inspecti . eausz r. I -c Engineering Division, 771-0220...,
Work and material is * to be inspected duri C53 and at completion. JUN 2 9 199'
Restoration is to be in accordance with V odes.
Street shall be kept clean at all times.
Traffic Contml and Public Safety shall be in accordance with City regulations as requirehy�Vkifii�,Fkftjaeer,
All street cut trench work shall be patChad with asplialt or C Ity approved material p ' 1:04he end -of the working day-,
NO BXCEPTIONS.
I have read the, above statements and understand thepermit reqgirements dnd the pink c6py of the permit will be
available At all timesfor inspyctpn purposes.
'9� n
_e V �;� _. Date: Cli
(�vn*
.Ator orAgeni)
CALL DLAI,-A-DIG PRIOR TO BEGINNING WORK
-"AVA I
FOR C17Y,
1- .11
WAY FEE:21"I'+.
. . . . . . ....
x
R- 0 i'AW."A
Ak
Or
'4K
?
&h..
4.
V, -
W
CUA.-W-S All
Y
RIGHT' OF -WAY CONSTRUCTION,
98-osi
PERMIT Permit Number.
f 1�'.e Date:
0& A. Address or Vicinity of Construction: -77 2. cl 2 3 P\'r
It7c. B. Type of Work (be specific)ZQQL�..� N va-C bur- Vc� TVAZ
_F
C. Contractor:
eLIOContact: 9.,\C\A
(n7 0 - 3 2- 0 6
Mailing Address: 2- k 0\ Phone:
State License #: F=016LINOS 9b(3z\oLiability Insurance: Bond: $
D. kbfil�t`nj'Pe t # (if applicable): Side 'Sewer Permit # (if applicable):
E. C] Commercial Subdivision
n Multi -Family Single Family
INSPECTOR: A" A Z(
F. Pavement or Concrete Cut : El Yes
0 city Project
F1 Other
INSPECTOR:
G. Size of Cut
,�'H;ty (PUD, GTE, WNG, CABLE, WATER)
X_ H. Charit
- . APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessfrom injuries, damages, or claims ofany
kind or description whatsoever, fore�een or unforeseen, that may be made against the City of Edmonds, or any of its departments or
40.1yees, including or not limited to the'defense of any legal proceedings including defense costs and anorneyfees by reason of granting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED
BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR*ISSUANCE TO THE APPLICANT
Two sets of -construction drawings of proposed work required with permit application.
A 24 hou'r notice is required for inspection. Please call the Engineering Division, 771-022
Work and material i1s.t6 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 trench work shall be patched with asphalt or City approved material 4he-end-of the working day;
EXCEPTIONS.
I have read t above statements and understand the permit req�irements a"nd the pink 'of �he permit will be
OPY,
f . I
available o sv_e�at all times 0 t. purposes.
SiknaturP -0 Date: C�
(�ontVtor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY FEE:
TIMEAUTHORIZED: VOrDAFTER M - aY* 9!9 DAYS DISRUPTION FEE/FU`ND I 11:
SPECIAL CONDITIONS:kAoWi(k S LJQUAJ k::e - RESTORATION FEE:
�_,% War. ITTEWM
T OTAL FEE:
RECEIPT NO.:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Commen'tsv",
. I
Diagram
A
CONTRACTOR CALLED FOR INSPECTION 0 YES E-1 NO
Partial Work Inspection by P.W.:
Work Disapproved By: Dat e: .
FINAL AIIJ�ROVAL. BY: Date:
Public Ublity District No. I of Snohomish C60hty
1K76-W FleVALW
tocaforr 23627 78TH AV W EDMONDS 98026 SO CTY - Area
lPbleNc.: ]r: 27 N R: 4 E S: 1 31 SE114 �Date:- 2111/98 W.*O. No.: 31445AI20
ReasDn ForWedc RELOCATE -POLE FOR MICHEL CONST AND Engineer AFDEM, RICH Dwg. No.: 123631
REPLACE DEP POLE Drafter U.G. No.:
Scale:
jWateWotk0o=qAeted: Approved: Date Pdnted
iree,tReifd: E[Yes []No
Wkinary Ovedw2d
EIResidentiall . OCommercial
No-:
*I@ r =$ 0.00
123cmdary Overhead
Basic Fee $0.00
T =$ 0.00
WetedConv. ftle $0.00
Primary Undeaground
DResidentiall DCommercial
Basic Fee $0.00
1EU No.:
'4@ =$ 0.00
Swondaty Ubderground
Basic Fee $0.00
=$ 0.00
4kulargroundl4lat
Basic Fee $0.00
r =$ 0.00
areet Ughfift
---f =$ 0.00
Zorkin'RigWelf Way
rlpriirtary
C-ft@ =$ 0.00
3KsceI22neo,u&Fees
Vault $0.00
Pel"it $0.00
CONrMCTAW 9 093
$0.00
Total Due: $ 9,4X(
Ode Paid:
4—bcept M.:
Environmental Analysis
[]Exempt ONot Exempt
Para. - Item
O.H. U.G. Cond. 7.2 KV
ADD CKT.FT. PH
REM CKT.FT. PH
NET CKT.FT.
O.H. U.G. Cond. KV
ADD CKT.FT. PH'
REM CKT.FT. PH
NET CKT.FT.
Permits (Date Granted)
NTree Trim
[--]State
[:]County
Ocity
El -
Easements
E]Required E]Not Required
Date Released
Foreign Contacts
NGTNW JPN No.-2b2t%
WCATV JPN No.-282f-Otb
[]Joint Trench GTNW & CATV
DJoint Bore GTNW &CATV
11 -
Pole Stenciling
From TO
Take Off Pole
Pre-Const. Requirem ents
NTree Trim EIPUD Locator
E]Backhoe ElFlagging
(00ne Call Date
No.:
Index Pole Plat
____Logs ____U-Map
_XFMR__C-Map
2bw Seavim 4wilication No: I Location Map Page 475A-2
ER
Circuit No.: 12-261 Phase: I
Eng es. Tel. #
r(425)-670-32K]
Engrs Pager #
1 (425)-787-7522
qAN-- CHARGE TIME TO -REPLACE POLE: 4-28 TO W.O.#20
- TIME TO RELOCATE POLEA-29TO W.O.# 31445A
E
POLE-A-28 SET 45'POLE I'SOUTH OF EXISTING POLE
W DEAD END PRIM NORTH AND SOUTH
REHANG XFMR N-17846 ON'NEW POLE
'20. EATTACH TSEC RISER ON NEW POLE
R
TOPAND ABANDON OLD POLE TO GTE AND CHAMBERS
'POLE 4-29 SET 45'POLE,',9 EAST OF EXISTING POLE
INSTALL 318" DG L-15 SOUTH
DEAD END PRIMARY NORTH AND SOUTH - RUN REDUCED TENSION SPAN SW
31445 REMOVE XFMR DIST# L-11587-X SER#
HANG A 2_5KVA 7200/240/120V XFMR DIST#
SER# SEC'D VOLT------J—
RUN 6'OF 1/0 TRIP TO OLD POLE FOR THE EXISTING SEC UG RISER
TOP OLD POLE TO SEC RISER
X
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WA
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PREW=Y DIM=
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City of Edmon's
RIGY11111LIP-OF-WAY CONSTRUCTION,
rEICV-11 IL Permit Number- C18 - 2GeA
IssueDate:— kn_k4_98_
A.' Address or Vicinity of Construction: 7729 - 238th Place S.W.
ID 'T' IF UT 11 fk. ;1R,Ne 11179 + I "i 0
YF� U — 'k— Je �J! I . . M53JnlaJn A ULIrIAU %f!r Jf�e Wire,
17 c. IS9W= p9le #4851, located at 7728 238th St. S.W., then slouth to a residence at 7729 238th Pl. S.W.
GTE to plow 751, push no driveways -and no roads. R.O.W- fu=39t$ 15 . 1.) Teet.
Contractor: #GTE NORTHWEST INCORPORATED Contact: Linda Price. Permit Coordinatnr. Or./710-41.13
Mailing Address: 2312C West Casino Rd. EgreiftllA Phone: ENGR: Terry.Anderson, 425/771-8683
826 40
State License Liability Emrance: Bond: $
D. Building.Permit #(if applicable):
E. Commercial
M.ulti-Family
iNSPECTOR':
0 Subdivision
Single Fa mily
Side Sewer Permit ff(if applicable):
0 City.Project';g Utiliiy''(PUD,ODWNG,'CA13LE,',WATF, 1�)
E] Other - 1"" � t �' I � - I
-4- -10
GTE '04 2100-9POOlDB 6423.
INSPECTOR:
F. Pavement or Concrete Cut : . 0 Yes JKNo G. Size of Cut: � I " - x . I H.
Please see attached sketch/drawing.
. APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by,his signature to this application to hold the City. of Edmonds harmlessfrom injuries, damages, or claims ofany
kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, includingornot limitedto the defense ofany legal proceedings including defense costs and attorneyfees byreason of granting 'this permit.
THE�CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED
BY CITY FORCES, AT WHICH TIME ADEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Two sets of construction drawings 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 str eet cut trench work shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have, read the a"bove statements and understand the permit.requiremeii.ts and the pink copy of the permit will be
available on site at all timesJor inspx ion pur
Signature: Adftk Date: 10-06-98
DAVE Hawkins, gr_dj%ec%Qs 'Design
CALL DIAL -A -DIG PRIOR. TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY. gc,, RIGHT OF WAY FEE:
TIME AUTHORIZED: VOID AFTER 12-0 DAYS DISRUPTION FEE/FUND I It:
SPECIAL CONDITIONS:.... RESTORATION, FEE:
T OTAL FEE:
RECEIPT NO.:
ISSUED
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE .-Eng. Div 1997
FIELD INSPECTION NOTES
Comments:
Diaoram
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES 11 NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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