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304 DALEY ST.PDF11111111111111 13917 304 DALEY ST 0-0 (-he4.a&. J 4, S1:0 TAX ACCOLTNT/PARCEL NUMBER F BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) CRITICAL AREAS DETERMINATION: E] Conditional Waiver E] Study Required E] Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PERMITS PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: SHORT PLAT FILE: SIDE SEWER AS BUILT DATED: - SIDE SEWER PERMIT(S) GEOTECH REPORT DA STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DATED: LID #: LOT: logo 3004 BLOCK: *NOTATION ON ADRESSES 304,310&312 DALEY STREET Parcel #0043202600101 consists of a Duplex (310/312) and a single family (304). The assessor considers this property a "triplex" and has assigned one parcel number. LVFEMP\DSTs\Fonns\Street File Checklist.doc This jurisdiction has opted to assign each dwelling its own address. P.,terial Chargeable to Installation 11 ters NO. ZE DES IpTION .. ...... Meter RATE AMOUNT -- ---------- Meter iox ..... .............. I J �� ...... ........................... ............... .......... Meter Plate ................. .... * ------------- ........ *"*'** ... * ...... * ------- 1---1 -- ---------- Check Valve ........................ --- -------------- .. . ......... .......... .............. ......... Pipe, Galv. Screw - ----------- .. .......... .... .............. ...... .......... Nipples ... -------------- ............. .......... ........................ ........ I ..... .......... Bushings .... ............ .............. . . ......... .......... ............... ........ - Plain Ells ................................ ... * ---------- ------------- ---------- .............. .......... ------------- St. Ells ..... --------------............. .......... ............. .......... Tees ................. .............. ------------ --- --- ------------ ) ........ . 4 ...... .... --- - -------- ---- ? ....... . ............ ---------- *1 -- ------------ ---------- .............. ...... - -------- .................... - .............. ........ .............. .......... ..... --- '4L:%a ................. .... ......... ---------------------------------- .......... ............... - ---------- ---------------------- ........................ .............. --------------. . ......... .............. ......... .................. ........... ......... .................................... .............. J. I .......... ........... Material Chargeabl e to Taps Connected 'NO. SIZE DESCRIPTION -------- . ....... Pipe, Black Screw RATE OUNT -------------- ---------- Pipe, Galv. Screw ............ .......... ......... ........ .. .............. .......... Lead Connections ............. ........ .............. Curb Cocks ....... ...... ........... . ......... Corp. Cocks ........ ................... Unions .......... ...... ------- .............. ...... .... ................... .. ....... ............... ............... Saddles ............. .......... .............. .......... Nipples .......... ................ ' --- --------- ....................... * .... ....... .. . . ........ .. ............... ---------------- --------- Bushings .................................. ............ ......... .............. --------- I'll .. .......... Plain Ells ........... .......... .............. ........ Street Ells .......... ........... ............. .......... ............... __ -------------- -------- Tees ... ............. . ......... . . .......... .................. .......... -------------- ---------- Curb Boxes .... ......... — I .......... S. 0. Extensions .................. ......... ............ .......... .............. ............... .......... Gates ....... ............ .......... -----------Plugs ........... ..................... .. .............. e. Couplings --- I ............ ............... ............ ........... ........ .......... Gate Boxes ..... .............. .......... ......... ............ . . . ............. . ............ ..................... ........ .............. ............. .......... ................. . ............ -- ................. .... .......... -, .......... ........................................................... .............. I ....... . .......... ............................................... .... I..,:: ::: --------- ---------- -- - ---------------------------------- .............. ........... ............................................................ .......... -**It5� .. ....... ....... .............. .......... . . ... ............................. .............................. ............. .............. . ........ ................................................... .............. .......... ............ I ........................... ............... .................. ............... .......... ........................ .................................. ............... .. .... . .......... ............ .......... .............. .............. .......... .......................................................... ............... ......... Hours Time —Day Men ........ . ............ .......... ............ .......... ...... Hours Time —Monthly Men..... ...... ......... Hours Time —Auto ............ .. ---- Superintendence ... ......... ...... . .. ....... .. ...... * ....... . ............. z Total .............. "7' PAIIJ AFK - 0 19WA ................... . ....... District CitY Of Edmonds --- Water Department TAP CARD E) il, "' R - �, I Date......... . ... ..................... NO.................. Meter I Size .............................. Tap No ........................... . ............ Size................. ...................... FMfgrs. ....... ............... ...... e or .... ? ............... ti ............................ %�� .. :� ................... . ... . . . .......... . .. . .... ...... . .............. ....... .................. ................................................................... . ....... ......... ....... . . ... . ..... . ... LotNo ........................................... Blk. No .................. Add. ........................................ / ........ ............... Service Location . ...... A�� . ........... -:�Zh ................. ........................ Meter Location .................... .......................................................................... MakeTap ............................................... ..................... . ....... . ...................... . ... ...................................................................................... . ................ . ....... Pressure .............................. lbs. Test .... Send Bills to .............................................. ....... . ............................... ....... ..... ..... Date of Work ...... ......................... I ..................... . ......................................... Foreman Guar. Voucher No ........................................... $ Remarks: ......... . ................................................................................................. ..... ......................................................................................................... ....... . ............ ............................................................................................... . ....... . ....... . . .. . . . .......... ...................................................................................... . ....... . ........ ....... . . . . . . .......... ........................................................... . 6T----R . ... HEE .. . ............ - .................................................................................................................. . ....... . .......... - OUTGOING Index .......... Reg ....... Route Bk ......... StenciL ..... C4rd...— INCOMING Index .......... Reg ....... Route Bk ......... Stencl...-Card...-.- 00 1 09 j APPUCATION """BUILDING PERMIT.. Appl. No. ...... Uff OF EDMONDS Building Depa"mont Permit limit, one year AP?UCATION is hereby mada for a permit to, construct the. following work, in accordance with, the accq,m1--..,-. panying plans and specifications. Two sets are submitted herewith for approval. Off -St. new alter (.C-,) Z,�_e,�. Work acidn repair ....... .............................................. arking ...................... ............................... Occupancy ................................ Const. type ................................ Use zone ..... 4 , 2'� ............. q ..... Fire zone ................. ...... Address ..... ....... 4 , . ........... BI .......... 9: Addn ... ................... Lot frontag .. ........................................ Are 4�.s, ... .. ��L�17Septic tank ........... . ... . .............. 'de ..................... . 1. si& ....... -backs front ........... r ...... .... ... i Bldg. set s. ...... ..................... Aear ................................ . Tel. No .... f= Z, . .............. Address .... e . ....... .................... ... ... Owner, Z-11. -:`�J.Z ........... Addr................................................. . Tel. No .................... P ms by... ............................................................... Address ............ ....................................... Tel. No..'. ....................... .. A Remarks....... �d ..... ........ ............................................................................................................. ................................................................................................................................................................................................ J lawi r L tinj I" - The above is a correct statement, and I agree to coraply_v�ith all applicable -Codes and State: egu a work. Signed Owner/Agen 4- J, .... Address ........ .................................... PERMIT for the above wort- is,hereby approved, subject to the above conditions, and to, comipfianc,�,wiith. the a'' p-. ent notations thereon. proved plans and specifications,.. and Building Departm it e ........ .. ..... Valuation .................................................... Perm fe ....................... Reed. by .... ....... 7 Building. Department. By .... .................. ......... ..... e ------ Date ........... ........................................ ------ NOTE This permit does -not cover plumbing,. �ewer, or elcctrical installations, nor does it permit a -ay -work t6 be i do-ne in the Right of Way areas. Driv.eways a -ad walkways must,be planned tb meet the official gra�es of street�'�.'. and alleys, and plans for future sidewalk development. CITY OF EDMOA,�.i, WASHINIGTOW— DEPARTMENt OF BUILDINGS BUILDING PERPUT Applicant hereby certifies that a plot, plan, drawings, and sufficicrit details to indicate intention to fulfill all requirements of this code are a=clicd hereto. npplication is hereby made for permit to do the following work: C ........................ ....... ...... ................................ ............. 0. 11. > z ,z� ................................... 3, .................... . _e. r, ............. ............................. ..... U. W a .............. ........... a .. ...... ....... ...... ............. ................... Cn ............................................................. ........................................................ ....................... A4 0 r� <! ............................ ..................................................... a ............................................................. U J .................................................................................... C: 0 0 ............................................................. U U�, ............................................................................ ................................................................... -C Q C C . .......................................... .......... r ...... ....................................................................... at......................................... .......... I ............ . ............. 0 U W .�, >, - C , , . . (Street number cr lot and bi�/Lb__e_r_s--) 1 .2 CW n4 : E " '. i 0 LQ IL 0 Cie 1. Building dimensions are ........................... ...... X ....................................... tn W Z Lot dimensions are ........... ...................... X .............................................. > V) 4 0 Bading 'will be ............................ stories in height. r. 0 W ��g > 0 4. Number of basements .................................. W,2 Z. 5: Occupancy of building will be ...................................................................................... 6. B-ailding wi!1 bf . ................... feet from nearest adjoining lot line. —7- 7. (Ywncr .............................................. -------------------------------------------------------------------- Estima'ted cost $ ... .............................. . . 8.� Owner's Address ........... ............................................... ....................... ......................... J :1. Bader .................................................................... ................................................. I ........ Group No . .................................. ...... V?. -Duilder's- Address. ........ ......... .......................................... ............................................. I i., Architect or engineer ................ ....... ............................................................................ Life of permit. ............. a. t . e; ........................ 4 Date ...... ..................................... 19 ......... Plans filed: Y 4 A�plicant's- Siglldtuilre_�-_?_ nt) ........... P e rding to h plans and specificationsper— rrrdssion is hereby. granted to do the work clescrib6d, hereon, acco. t C subject to compliance with the ordfnances of the City of Edmonds.. This. copy is your receipt for the following -Fi;` L. Building permit fm ............................................... .... .. .......... ......... ................... 2. Sewer permit fee ............................................................ $ ...... ............................... 3. Inspection and supervision fee ........ ............................ $ ...................................... 4. Total ......... .. .............................. M ...................................... ......... .......................... . ........ ...................................... . Received by ........................................ . .......... . ......... (issuing officer), Departri�ent* of Buildini� PEROMWIT N? 378 iCity *of Edraonds, I. The brUing permit fee,which applicant pays when,permit is issued shall be based on estimated cost of the proposed structure, at the rate of si.00 for, each -ost. app sl000xo of If the aCtU21 �COZt Of the structure, when finally determined, exceeds the estimated Cost by OlOte� than 5%, liC2nt agrees to pij',an additional fee'. . of $1.0 for each $1000.tO of such exqess cost. In such venr no use, permit shall be. imed until such "discrepancy fee" is paid. 2. whenever a 'cohtrvc� for cont!z�u5s�lon is executid - for , ;ry structurc1.c\6v!in#; more than $,000.,00 to., Which a licensed architect or- englni-w is'n,or req-tred'by., the Building Ci)de of the City of Eddionds, th, e application for a building pirmit shall be accompanitti by . cn!-; of the contract and a copy 'of the -detailed,- 5 cations Z=7-. a� P,;Of. to irnploy;n r or,corandeddog wo&,,n�iify the-l�dusthal Insurance Division of the Department of Labor and Tndustri gi�i g, es n an.ethriate o t 'Voll iostru�do�s should be 'o'lbt , ained from the. nearest office of the D;Partent of* Labcr and Industries. 1 Bef 05M, he payrol;.2nd make monthly reports of payrolls final payment. the owner should Obtain a release from ihe'ge'oer�l Tontrictofs wb6"in'turn should obtain relense.fro�n vN sub-contractors.-Zhe,releases sh6 d he' ul IFtisted by t�c, E�parunenr of Labor and Industries. �The 2bove�rrofedures are requirements of the State' Industrial Ins::rance AcE. - TL The City of Edmonds APPLICATION for SIDE SEWER FERY[IT NEW CONSTRUCTION (3 REPAIRS E] EASEMENT No . ............................. OWNER..................................... .................................... CONTRACTOR .................................................................................................. PERMIT No. CD .... ADDRESS ...... :;ZV..Y .............. 07. ?,A. A'4tl.wl7 ........................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................ NAMEOF ADDITION ........................................... ............................................................................................. .ao-v j- eL.%.o i—w— &, DATE.. ..... By ................................. APPLICATION for The City of Edmonds SEDE SEWER PERNaT EASEMENT No . .......................................... NEW CONSTRUCTION [] REPAIRS 0 113-07600 OWNER ........... ��enda M. Schauss .................. .................................................... .................... CONTRACTOR .................................................................................................. PERMIT No . ................... ADDRESS ....... 3.0.4 .... Daley --- S-t . . .......................................................... LEGAL DESCRIPTION: LOT No . ................ ............................. BLOCK No . ............................................ -0 NAMEOF ADDITION ......................................................................................................................................... Dye Tested On Sewer 1972 Approved: DATE.................................... ......... -,By.— .................................................................. C� dc CIL -k i L "I OIYN &S JUL Cl I Y OF -EDMOi'�;DS BY4�4-- )kLeC,. if ----------- ----- A FRO,'vl. TIC P, a a moo D Ro f & JIM EASTER OWNER INVOICE L D. S 5TH AVE. SO. 117 EDMONDS, WA. 98020 N 1897 24 HOUR QUALITY SERVICE FORDER NO. DATE ORDER&D BILL TO: PHONE ADDRESS DATE PROMLSED CITY JOB NAME AND LOCATION 7UZ QUAN. DESCRIPTION TOTAL HOURS LABOR AMOUNT TOTAL MATERIALS MECHANICS @ I HELPERS @ TOTAL LABOR Y I rHIRPEI ACKNOWLEDGE THE SATISFACTORY OM L ' TOTAL LABOR ETION OF THE ABOVE DESCRIBED WORK] X DATE TOTAL r� PLUMBING SUPPLIES REPAIRING REMODELING 0 FREE ESTIMATES�* -� FR{IA4 WO y� 7_ A[i [77' TF �;,�. aw CLAIM FUR DAMAGES NOTICE Claim MUST be presented to the City Council and filed with the City Clerk within 120 days from the date of Accident or Accrual of Damages. TO THE CITY COUNCIL OF THE CITY OF EDMONDS: PLEASE TAKE NOTICE, THAT j1Z_ (if married, give-hilsband's name) WHO NOW RESIDES AT 4,2 (State present actual address by bt.�eet, number and city) AND WHO FOR SIX MONTHS PRIOR TO DATE OF ACCIDENT HAS RESIDED AT 0 �L - (Give residence by street, number and city) CLAIM DAMAGES OF AND FROM THE CITY OF EDMONDS IN THE SUM OF arising out of the following circumstances: Describe Claim, giving DATE and TIME injury or damage occurred, PLACE and full particulars. Accurately locate and describe defects caus- ing injury or damage and all acts of negli- gence claimed. Accurately describe injuries or damage ME 122 gm:'4411' ffwfn"�Wmb d F MUM 7 � �e %4 �JA - �A State items of damage claimed. Itemize all. I-A-.4 -;b expenses and losses. U V V V I 01 Ls" Aag U0 cz, a.;LA&, o" 'C' 4 ilk._t V V (claim must be sworn to by claimant) SUBSCRIBED AND SWORN 6 before me this '/ Z Z: day of ZL A ^4.CJ4C,of6to — 7Signature of Claimant) - It "o ary Public in and fo Washington, residing at. 74 19jo—.