324 3RD AVE S.PDF111111111111
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324 3RD AVE S
,ADDRESS: a: 52
TAX ACCOUNT/PARCE L #: g M 521,J), 77j,"J?
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: DETERMINATION: El Conditional Waiver Ej Study Required E] Waiver
CRITICAL AREAS #: DETERMINATION: F1 Conditional Waiver Study Required Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #'s):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
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CITY of EDMONDS B ESS LICENSE APPLICATION D
I Civic Centef - Edmonds, Washington 9
City Clerk Phone 775-2525 ANNUAL FEES
STREFT
LICENSE NO.
HOME-CCCUPATION
INSTRUCTIONS:
, All items must be completed
or application will not be ac-
cepted.
- Sign and return application
with fee. Renewals received
C L.A�S�
YEAR
LIC. EFFEC. DATE
REASG. LIC. NO.JSPEC.
I
RECEIPT NO.
DATE PAI
A —
3
PRINT 'X'
IN SPEC. BOX
FOR ISSUE OF
R R I C T E D
CLI
FEE PAID
PENALTY PAID
� "
n �;,: A
:
COE N S E WITH
I 'LC'
I I, c/1,
I I I
ACTION.
10.0 (A)
0 SMALL BUSINE
$15.00 (13.)
I--] Business w�th-eor
more 01-
_Qm oyees
after February 15 must pay
penalty in addition to fee.
NEW BUSINESSES AFTER
JULY 31, 1/2 FEE. (PLEASE MAKE ANY NECESSARY CH���ES.
NAME OF FIRM
MAILING ADD
M,
PENALTY AFTER FEB. 15
ADDITION6L-$5-00 0
,DDITIONAL 17.50 0
A ITI�
DD 0 25.00 0
0 NEW APPLICATION
0 RENEWAL
0 CHANGE
0 DELETE
BUSINESS PHONE
NATUR� OF BUSINESS
BUSINESS ADDRESS INDIVIDUAL
Ll - ? V 'E� (S)
OWNERS NAME HOME ADDRESS
H Q�M PLACE OF BI
/Y��HOPE DAT F BIRTF�
EMERGENCY NOTIFICATION: (1) NAME & TELEPHdNE 4 A
(PLEASE LIST TWO) (2) NAME& TELEPHONE
WASH I NGTbVSTATE TAX NO. APPLICANT'S SIGNA7
(LA)
(LB)
(LC)
(LD)
NO. OF EMPLOYEES
f
PARTNERSHIP CORPORATION
(P) (C)
SOCIAL SECURITY NUMBER
-7 7X 1-
DO NOT WRITE BELOW THIS LIME./,
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
1/1641
LA APPROVE 0 DISAPPROVE
DATE
LAND USE CODE
ZONING CODE
SIGNATURE
I R IM I LIT
CONDITIONAL
USE PERMIT
COMMENTS
E=
BUILDING DEPARTMENT
DATE --4-63!
El' -APPROVE 0 DISAPPROVE
SIGNATURE
Building 0
Permit 0
Hotel/Motel (L)
Apt. Bldg. (A)
0 Office Bldg. (0)
Occupancy 0 Restaurant (R)
COMMENTS: Group 0 Hosp/Nurs Home (H)
CAPACITY: (NO, UNITS, APTS., OFFICES, SEATS, BEDS, STUDENTS) I P_ 1 0 School (S)
FIRE DEPARTMENT DAT U. F. 1. R.
X�. APPROVE EJ DISAPPROVE SIGNATUR
COMMENTS: /) e? An7--R
P P
,,UCE DEPARTMENT
L"APPROVE 0 DISAPPROVE DATE SIGNATUR
COMMENTS:
PUBLIC WORKS DEPARTMENT
ED APPROVE 0 DISAPPROVE DATE SIGNATURE
COMMENTS: it i DD - 6 9100
PLEASE RETURN TO CITY CLERK
The City of Edmonds Side Sewer Drawing EASEMENT NO . ........................... ..........
NEW CONSTRUCTION M REPAIRS E] LID NO . ........... ...... . ASMT. NO . ..................
OWNER ..... R:C C—r.Q.r.y) --------------------------------------------------------- CONTRACTOR
------------ I ........... ERMIT NO . ....................
JOB ADDRESS 3 LEGAL DESCRIPTION: LOT NO . ....................................... BLOCK NO - ------------------------------------
--------------------------------------------------------------------------------------
---------------------------------------- I .........................................................................................................................
FlU NAME OF ADDITION -----------------------------------------------------------------------------------------------------------------------
_7 1
yt
'Stele Wo�LK
-.--W- -V --.1 - ).-
I trA
Ave -
Approved:
........... ...
PWW-0001-1 1175 (REV.1 1/78) DATE -al 1719 --------- By -------------------------------------
------------ ; ----- -----
APPLICATION
for
The City of Edmonds SIDE SEWER PERrMT
NEW CONSTRUCTION [] REPAIRS EASEMENT No . ..........................................
OVvrNER...... Crutn,.A.AC . ................................................................. CONTRACTOR ............................................................................................... .., PERMIT No.— ...................
ADDRESS Ave-s . . ............................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No..... ........................................
n - it t
oTIRECEE-9-y' FILE
NAME OF ADDITION .......................................... .................................
JU f ) a-, P? 7G)
Dile- -rQ-S+Qd Orl Sd-wc-r
Approved:
DATE................................................ By ......................................................................