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343 3RD AVE S.PDFIiiiiiiiiiiii 4971 343 3RD AVE S 1--, �qj I * . 0 0 0 9-0-1 10 TAX ACCOUNT/PARCEL #: BUILDING PERMIT (NEW STRUCTURE) #: COVENANTS (RECORDED) FOR: CRITICAL AREAS #: DETERMINATION: Conditional Waiver E] Study Required Waiver CRITICAL AREAS #: DETERMINATION: 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: —[BLOCK: SIDE SEWER AS BUILT DATED: b �J/ SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE/ENCROACHMFNT PERMIT #: FOR: WATER METER TAP CARD DATED: OTHER: L:\TEMP\DST's\Forrns\Jana's Street File Checklist 5-14-08.doc 01, APPLICATION The City of Edmonds for EASEMENT NO - ------------- ----------------------- SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS F� LID NO. ;� -------- ASMT. NO . .................. OWNER .... -------- ............................ CONTRACTOR . Lnp�F= ...... -------------------------- P E R M I T N 0. r-= JOB ADDRESS ...... N'4 --- LEGAL DESCRIPTION: LOT NO'Z-�.. ...... BLOCK NO - ----------------------- - ---------- 40 0 V P EIRIM IT IV? v. Call 7,715�2525 for side sewer Inspections' JIFFORE covering :u 01anyj 'portion, 6 ..the constructl on. 'Suii�, - 0� �o tio i 24� hours after�rcqust. NO SEiC, li�ay'_Inspeci Inspection, will 4be provided withl ns� NSTRUCTION ....................................................... -5-Ayenue -South 3411' and..-34L3 Third .................................................... .......................................... . . . . . . . . ... G RIMON ........... F..%. A T T A Ci 11 P D ................. ....................... ................ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........... ? ....................... .... ... OMWER AND/OR BUILDER..MHPYT,...M J'L�� ............................... ........................................... ............. '_1P 4i.434�;34_ Pii)e and :.Sewer .�` 8810S � 220th S W. Edmond�s- TRNCTOR!S"14'AM,E,,&"AbljRESS,. Lee�. Wool ioy I s .............................................................................. .............................. ......................................... .. bctlbn� 6Ua Side sewer to the t6d for�r P­ - ' M: .. . ...... epair and/or conn 'tteiiA - ........ ... 9: ... 7. dn'c"e"'A'vithl,City"of -Edrnonds ordinances. city sanitary Sew er�, LLED_Tb�TI�E,' FOLLOWING: =Th'Wwne'rs'�of;,ihe�.pr6�erty.mak obtain a.permit to constr t sewer' inside property. line.: A licensed -Side Sewer Contracto�. m" 'ireet area. , D6 not cover any portion, o er befor ust' be employed' to. constrtict' uc a:. 64 w 6 r.,J[ ii,.'s f'sew e it has' been lnspc��ted�' '_riorrned j ln� city* dght-of-way requires an Invasion,of RJght-of- Way'Perindt' obtainable' from the 'City Engime E, iorz�*at Ion -regarding Ordinance 11 16 030 and Regulations governing slde.i" r's office. permit. ,,.'No.k,4t—.TLdp%�of,,'sid'e4'se,,�'e�.��i6st'.have at least 30 inches coverage -at property ers when you get' i, sharp ' e n� ' tba-n-i1A'VwIlP be permitted. line, and 12 inside property,, line; minimum grade of, 251,. Vo bends; in,.ki"el' W, . . . . . . . . . re Muflt be water settled and' surface of street restored to orIgInaJ condition. Con , tractori' shall be responsi . ble. forJallure Aue �o� Iffi within bne year of completl6n. proper.- .............. 0 . . . . . . . . . . S, un a erLor, o,*any 'other work.thaxf is 1.9� . _. ___ 4!�_ , 11�1_o� d prov46d for *in 'the permit, or, to, do' any. work on'the main sewer or its4ppurtenances' 6xceptjo �.In- St�, h6,�51pe I In thewye. 6r. S!1�0, El,,: Date;_.:... ................... ...... Date .... ............ . B .............. Date ............... . ....... y... . ............ -,By ................ 1. ­D, PRONYED* ,- %, ....... By . .... .. ....... . ......................................................................... ............. inar S:� a.s.-iml Q:F .... Pipr of - WAy. t Reqn.i,red. D up O'�� .. .......... ......................... ............................................ ........... ....... .......................................... ............................................................................. ...................................................... ....... .......... ......... . ..................... ................... I..,. 'T m Performi ng., , Q hst' ti '�,e 6o b ---- Sign6d By, �Owlner: 6f,,F.ir B TIH Permit,.Copies MUST Be ruc ion,PRIOR To Request For -Ins c n' . . . .. . ......... .................... .............................. ... hereby certify that ifie.sldetse w*er -installation* constructed- undez­Ahis�perinW, L: r Ing Construction) - ntracting pe. with, all - o ernhig'ordihances, of, the:Cify of Edirionds'. Dated- thi S14 ........... ;-....:..:day .. ................. Of..,! ........ .... I f ErORF, yo,�, k-. or:r Water _tD, 'GaSL []i. �.,Telephone, 1E] Power. [1];� Sewer E:];.*' Other-�;E],,7,Vl r i� c r tA ?z That _ji;Yiion"_of ixe ft1_.C1!t'4 of the SE 1/4 of the SE 1/4 of Section 23, Township 27 N.R.�'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 g 6;e `n�i 0,7, j,7, 6 Fhe P 170 feet; thence East 30 feet to point of begin.ning;'thence continue East 65 feet,;.,�Ithence 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 Edmonds, according to the unrecorded plat thereof.) situate in the County of Snohomish, State of Washington. APPLICATION for The City of Edmonds SIODE SEWER PER1%HT EASEMENT No - ------ NEW CONSTRUCTION REPAIRS C) OWN -ER ...... ........ //4 CONTRACTOR --n5 ................. ---------- .......... ........... PERMIT No. ADDRESS ............ . ..................... ......................... Y.-I.- LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................ NAMEOF ADDITION .......................................................................................................................................... Approved: DATE................................................ By .................................................................... SHN�� Drawing The City of Edmonds EASEMENT NO - -------------------------------------------- NEW CONSTRUCTION F� REPAIRS rg LID NO - ------------------ IASMT. NO. ---------------- OWNER........ tAU.RlF--l-.JAG;-E)iN.^ ----------------------------------------------- CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO - -------------------- 11. 14ALvr JOB ADDRESS .... 54-1 ------- 3Ro---- DuRt LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------ F�Zql-ll— �--n 7 1 9 PWW-0001 - 11/75 (R EV. 11/78) -��Pn ------------------------------------------------------------------------------------------------------------------------------------------------------------------ NAMEOF ADDITION ------------------------------------------------------------------------------- ---------------------------------- 0 IN Approved: DATEFeZ ... ...... 1593, By ----------------------- 'W*V'", 4f City of Edmon(e REET &T-OF-WAY CONSTRUCTION PERMIT Permit Number. 93-433 "sue Date: L AV A. Address or Vicinity of Construction: 341 1 Ay. 'q. (9-121561) 11 89' 0 B. Type of Work (be specific): Install New Service Z� C. Contractor: -Washington Nat'l. Gas Co. Contact: Frank Swan Mailing Address: 815 MArnAr St..9pattle, Wn. Phone: .224-2278 State License #: 98111 Liability Insurance: Bond:$ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. 0 Commercial [J Subdivision [J City Project XRJ Utility (PUD, GTE, WNG, CABLE, WATER) F1 Multi -Family E] Single Family n Other INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut 0 Yes []No G. Size of Cut: ( 1) 2 x 4 Cu H. Chargq�_$ @ Gas APPLICANT TO READ AND SIGN INDEMNITY. Applicant understands and by his signature to this applicati(=e b:e d the City ofEdmonds har damages, or d claims of any kind or description whatsoever, foreseen or unforeseen, tha il a ainst the City of Edmon or an�ro?itsodeparlments or employees, including or not limited to the defense of any legal proceedings includingd,;e�:f7e* e ci4ts, and attorney fees by reason ofgranting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIAiS FOR A'PERIOD OF ONE YEAR FOLLOWING'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 WILLAE� 1V�CtqSFD FOR ISSUA NCE f0,­TffWP ,,IT 'CA N T. Construction drawing of proposed work required with permit application. -A 24 hour notice is required for inspection; Please call the Engineering Division, 7714220. Work and material is to be inspected during progress and at completion. 4& 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 &Ly; NO EXCEPTIONS. 1haue read the aboue statements and understand thepermit requirements and thepink copyof thepermit willbe duailable on site at all times for inspection purpo,9'e`s. - �Vrb, a Signature: D te: August 10, 1993 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: L,-I �Jl RIGHT OF WAY DEPOSIT TIME AUTHORIZED: VOID AFTER DAYS DISRUPTION FEE/FUND 111:' SPECIAL CONDITIONS: wA, COMMENTS: RESTORATION FEE: PER MIT FEE: r3o, 0 TOTAL FEE: RECEIPT FEE: .1 DATE: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. I)iv. 1991