341 3RD AVE S.PDFiiiiiiiiiiii
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341 3RD AVE S
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F-111111:4 -- -
TAX ACCOUNT/PARCEL #:
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: DETERMINATION: El Conditional Waiver El Study Required El Waiver
CRITICAL AREAS #: DETERMINATION: El Conditional Waiver E] Study Required El 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:
BLOCK:
SIDE SEWER AS BUILT DATED: 1-1176-7
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED: J44 Awl
OTHER:
L:\TEMP\DST's\Forrns\Jana's Street File Checklist 5-14-08.doc
01*1
APPLICATION
The City of Edmonds for EASEMENT NO - -------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS F� LID NO. -------- ASMT. NO - ------------------
OWNER .... - ------- 1�,� E-=:) i V--� ��
...................................................... CONTRACTOR ---------- -- ------------ PERMIT
r-= !!
JOB ADDRESS ...... 3HO N'4 ---- LEGAL DESCRIPTION: LOT N075�- ----- BLOCK NO - ------------------------------------
El
0
11� -1 .11'r m
N I -
PIT N11
`07
7
TERMIT i;,.,0
(qall 7,75�2525 for Bide, sewer. Anspections, BFFORE; �covering'i,�mn�,� �p6rtlon�lof -the construction.
,I w ';be pr d wlthi� 24,_h-o:u;i; a:f,ter �.requst. NO� Saf., S i or S�
Inspc�t on, III ovide 71nspectlon
By
444i
,
R] 3 EOCA-nOY�OF CONSTRUCTION.: 341: and. -34 3 Thira`.Ave.nue South
............................................................................................................. .........................
_�4% 44 -�V.f 17.
RERT�',Y, kEMA"FDESCR1PT1ON.._ .......... SER ... AITA!7 n
............. .......
Hp ................................................................... ............... ..................................
........................................................... ..................... ..................................... ..................... .............................................................
.....................
........... . .
. ............ .�...OWNEA AND/OR BUIII�,DER..MIIRYI.,...A!ET!'T-NA
................................... .................................... ...............................
TWAWTORIS'�NAME�&-ADDREs Lee. Woo-lov,.I,s. Ripe and �,.S6wer,—R&H 220th EdlAo 'd
................................. ........ .............. .............
S ................................ ...........
.............
marrb., 12. -_7
............... ... ................ 19 .. ..... for repair and/oi connection of
a side sewer to the city sanitarW sewee"
NTIO )��!L�'Di.�,�,�THE-1�OLI�'OWING:
0 ri 4
!4 -;oF,;�,jhe;prbperty.,yna,� obtain.a. permit to constrilet sewer, inside property llne� A fi�ensed Side Sewer Contra6toi must be emplo�adf aruct�_:
eat E Lrea. Do not cover any portion of'sewer�b6fore It' lias'lbeen Inip'e6le&-
slMr�sewer,-*ih�sti to r
city right-of-way requir
as an irivaslo'n of Might -of-Wjy Permit -obtaJnabW from the City Engineer's office.
,N6.','��3."—,.',gbtg,inifUll�,inio'iz�'ation��regELiding Ordinance 11'.16.036 aj�& Reigufations' goveinin
9 side iiwi you get permit.
arB when
ity -line,.and.12 I -hes',-Jnside property line: minimum grade of 2 'bends,'I
n,-gr a.,
ored to original' cond - Ition. Contractorg' shall be'responsible for falhirer due to Irripr'o,per:
.in the permit, or. to.dc; an; woik on the maJn sewer or Its appurtenances'; except to in-
RYED:', Ey Date� .. . .... .... By ... ..... Date ...... ......... .. By ...................
K.— By ................ Date ...........
C ,, ................
. ..................................... ................................. .......... ......
- Y -
. ......... .................. (Dui) 1 e.''
.............................. IT
.......... .............................................. .........
......................
............... ............. ............. I
............ ... ................... ......... ......... ...... ........
QTH Permi t'Cbpies. MUST Be.:Signed By:Owner of'Firm -Perfor-ming-.6 hs
BOTIT.
6 6-6,Ction PRIOR To Request For lns'fiecti6n,
—7 1-Y, .0
............... .. :1 hereby certify that the side, sewer -installation constructed under.this�pdri�'itt�
=ncrr.4"6f1bon"tracti�g in, struction) -
Firm, -
�.dince;w.ith� all �'.�d erning. ordinances, of,'the City, of "Edinonds'.,
is n
D c hi . .............
at. d t s*) Aiay:of.::
ErORF t
u,dig.for: Wa MIR,
Yi)
er:[]t
Gas, eleph Pow r 0 h
t�r .94& tFJ;� Sewer
(LC 1A "Z,?
(A
That 6\i�iion Of e" I .
p 1!'. 4 of the S E 1/4 0 f the S E 1/4 o f Section
23, Township 27 PJ.R.j� 3 E.W.M., described as follows:
Beginning at the Southwest corner of said subdivision on the
center line of 3rd Street; thence North on said center line
170 feet; thence East '30 feet to point of beginning;'thence
continue East 65 feet,;.j;..thence North 67.4 feet; thence West.
65 feet; thence South 67.4 feet to point of beginning; (Being
yortion of Lots 20 and 21, Block 2, Olympic View Addition�to
Eanionds, according to the unrecorded plat thereof.)
situate in the County of Snohomish, State of Washington.
S
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS
/D
... ... ......... ........ ---------- ........... PERM
OVINER ...... -------- .... CONTRACTOR .......... IT No.
ADDRESS ...................... 13 ....
....................................... LEGAL DESCRIPTION: LOT No . ......................... .................... BLOCK No . ............................................
NAMEOF ADDITION ..........................................................................................................................................
Approved:
DATE .....
By.................................
Drawing
The City of Edmonds EASEMENT NO . ............................................
NEW CONSTRUCTION REPAIRS [g LID NO - ------------------ - ASMT. NO. - ----------------
OWNER-------- ----------------------------------------------- CONTRACTOR - ---------------------------------------------------------------------------------- PERMIT NO . ....................
(NO.
JOB ADDRESS --- 34] ------- 3RD ... )-- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
PROP.
FA
PWW-0001-1 1/75 (REV. 11178) -?)PM
------------------------------------------------------------------------------------------------------------------------------------------------------------------
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
is
Approved: I
DATEFEZ ... ��S ...... 093. By -Z-LO ---
);19 ------------------------------
lid';
REET96City of Edmon
T_oF_wAy CONSTRUCTION
PERMIT Permit Number.
,Issue Date:
A. Address or Vicinity of Construction: 141 -1 Ay. 'S.* (9321561)
9" 19() B. Type of Work (be specific): Tristall New Service
0 C.
C. Contractor: -Washington Nat'l. Gas Co.
Mailing Address: 815 merrer qt_.spnttJe, wn.
State License #: 98111
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 224-2278
Liability Insurance: Bond:$
Side Sewer Permit # (if applicable):
E. 0 Commercial 0 Subdivision El City Project XU Utility (PUD, GTE, WNG, CABLE, WATER)
n Multi -Family 0 Single Family n Other
INSPECTOR: INSPECTOR: VL,/*
F. Pavement or Concrete Cut: [S] Yes []No G. Size of Cut: ( 1) 2 x 4 Cu H. Charg(�_$
@ Gas
APPLICANT TO READ AND SIGN
I
INDEMNITY. Applicant understands and by his signature to this applicati( the City of Edmonds harm�l�fJ6� i damages, or
6agai ttheCityofEdmond,ora �Piue
claims of any kind or description whatsoever, foreseen or unforeseen, tha=z �imid' n;"oJ it partments or
employees, including or not limited to the defense of any legal proceedings including drftf4e te c s, and attorney fees by reason ofgranting this permit.
C'
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A'PERIOD OF ONE YEAR F&LOWING-THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL CfSSED FOR ISSUANCE fkm NT.
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. A&
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.
f
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working &Ly;
NO EXCEPTIONS.
"Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit willbe
dvailable on site at all times for inspection purpage's.
0.'Om�
te: August 10, 1993
Signature: --va
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK I
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER DAYS DISRUPTION FEE/FUND 111:
SPECIAL CQNDITIONS: wA,
COMMENTS:
RESTORATION FEE:
PERMIT FEE: r3o.-Oo
TOTAL FEE:
RECEIPT PEE:
.1
DATE: ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Nv. 1991