417 3RD AVE S.PDF111111 lill 11
4976
417 3RD AVE S
ADDRESS: in r, A-U6 Is
.TAXACCOUNT/PARCELM 27D-b2-(o0Q100,5C0
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS DETERMINATION: [-] Conditional Waiver KStudy Required Ej Waiver
CRITICAL AREAS #: DETERMINATION: El Conditional Waiver E] Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #s):
PLANNING DATA CHECKLIST DATED: 311qlos
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED: 2-/,5/7q
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USEIENCROACHMENT PERMIT #:
FOR:
:MATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
PLANNING DATA is
New Commercial I Multi -Family Projects
Name:
5GUA ff/ P
Da te:
Site Address: 414 40 Plan Check #: BLD - 2,.0 r?
Project Description: re*7190(91
Use(s) Proposed:.
Allowed Use: & I NO)
CUP File Number:
To Allow What Uses:
Legal Nonconforming Land Use Determination Issued: (YES I(
Reduced Site Plan Provided.- (YES I
Zoning: leM- 2,
Map Page:
Comp Plan Designation: 01Wr%f0WA wa'�Vll��Txcltd
Corner Lot: (YES /(�9
Flag Lot (YESIO 1q"H"401,W, t474 V'e"
ADB File Number (date waived): Admn Ov
t Area: -7 -7
Plans Match ADB Approved: (YES I NO)'/��
Shoreline Required: (YES I
Critical Areas Determination #: C(-Ift Z0117 of
5-Study Required well-
0 Waiver
SEPA Determination. -
Exempt N1q
Needed (for sites with 500 cubic yards of grading or within 200 feet of Puget Sound or Lake
Ballinger. Requires: (1) Fee, (2) Environmental Checklist, and (3) APO List with notarized form)-
&64uired, So�,tbacks
Street:
Side:
/0
Side-
/0
Rear:
Actual Setbacks
Street-
Z 2-
Side: 1,
1 �0 -f-
Side:
�0
ear:
-
Lot Coverage/FAR Required:
Lot Coverage/FAR Provided:
Lot Coverage/FAR Calculations:
guilding Height fV QV lt.ov (LW-(-Y
Datum Point:
Datum Elevation:
Maximum Height:
Actual Height:
Subdivision:
Lot Aggregation Required:
Landscaping.
Landscaping Matches ADB Approved:
Landscaping Bid Provided:. (YES I NO)
Bond Amount (100% Bid):
Plan Review By.- 0 - e�h ���
VA
PLANNING DATA
New Commercial I Multi -Family Projects
-ki
Commercial Pai
Parking Tenant Rmuired
r,
Business Name Type/Use Parkin
Ratio Area
Total Parking Required.
Total Parking Provided.-
Midtf-Famfly Parking A��.
# Bedrooms per Dwelling Unit
Parking Ratio
# Units
Required
Parking
Studio
1_21D.U_
I Bedroom
1_51D.U.
NO
2 Bedrooms
1.81D.U_
3 + Bedrooms
2.01D.U.
1A
Total Parking Required. -
Total Parking Provided.
Other
IjCtrdi�ICCJ,�_ �Cl(j no(6�W tAllo IWM-f-
5a, 110^ cc) tW
a-t- O/C
X&VOL
A10 eve r
ftq CcAra4lfiny WR-r
f -
Plan Review By:
#P20 CA File No:.
Critical Areas Checklist
Site Infomuflon (soils/ topography/hydrology/vegetation)
1. Site Address/ Locatiom �014nd Illebu qj-f -rhjr,.,(
2_ hvperty Tax Accmmt N=dmr
3. Approx . imate Site Size (acres or square feet)*-.
4. Is this site currently developed? 0y; — no
If yes'- how is site developed? _4_ �IrM, q3 kl,�Idif4L
5. Describe the general site topography.- Check,aJl that apply.
Flat less than 5-feet elevation change over entire site.
rise horizontal
Rolling. slopes on sIte generally less than 15% (a vertical of 10-feet over a
distame of 66-feet).
Hilly: slopes present on site of more thari 15% and less than 30% (a vatical rise of 10-feet.
over. a horizontal distance of 33 to 66-feet)-
Steep: grades of greater than 30% present on site (a vertical rise of 10- feet over a horizontal
dista�nce of less than 33-feet).
V Other (please describe):
a
6. Site contains areas of year-round standing water. -A-6 ; Approx. Depth.
7. Site contains areas of seasonal standing water- _&Q—; Approx. Depth.
What season(s) of the year?
8. Site is in the floodway t-;,& floodplain --P- of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
vU 5 _ Flows are wasonal? _ (What bme of year?
U 4-"t -,,(
meadow shrubs mixed'
10. Site is primarily- forested
urban landscaped (lawn, shrubs etc)
It &I-f recl
11. Obvious wetland is present on site:
For City Staff Use Wy
1. Plan Check Number, if appficable?
2- SiteisZoned? PA'-Lq
S)? Ak&rwoorl Wico, q 22±(4e =LO4 �0 ovl:
3. SCS pped soil
_e
�tff oo
Area on site?
4. Cx#�cal Arlim inventory or CJL map indicates Cxifical
rcv- lk-
5. Site within designated earth subsidence landshde hazard areaT
DKI MM&T—ION
SIMY REQUERED WAMM
Reviewed br. Date:_ f 2-1(9 Lo '7
0 #.P20 .0 . - . .
Ile Critical Areas Checklist conUined on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
liMier submittal� of the application to the City.
The purpose of the Checklist is to enable City staff -to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
A propmty owner, or. bisther authorized repeseaWtive,
must fill out the checklist, sip and date it, and submit it
to the City. The City will review the checklisi, make a
precursory sft visit, and make a deter -_ on- of the -
subsequent steps necessary to complete a development
permit application.
plea submit a vicinity map, along with tile signed copy
of this form to assist City staff in finding and locating the
specific piece of property descnl)ed on this form. In
addition, the applicant shall include other pertment
information (e.& site plan, topography map, etc-) or
stimfies in conjunction with this Checklist to assistant staff
in completing their prelinunary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the 7wessing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attomey,s fees, arising fi-om any action or infiraction based in whole or part upon false$ misleading, inaccurate or
incomplete information fin-nished by the applicant, histherfits agents or employees -
By my Signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPUCANTIAGENT 'd� — DATE 190(o-07
7_
Property Ownees Authorization
By my signature, I certify that I have authorized the above ApplicantlAgent to apply for the subject land use appheation,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
lien =7
purposes of inspection end polap-1 I to lication.
SIGNATURE OF 0 DATE _L 4, o&_ - 0 -7
Owner/Applicant: Appucant Representative:
Sown 8 V I e-w L - L - C_ C:3kInn HVIddhl
Naxne
Narn6
W
I a Ce 2 5- _ L4_'�'-Auenue. WU 11). S 'Ic
Stred Address Street Address
Puesr,4 - Puny* .
City State ZIP
city - State zip
Telephme: 5) gq 0- pAgg Telepbone: W25) QQ3-05q3
Email address (optional): Email Add= (optional): Qlann@'inanco. Oyq
J J
CITY OF EDMONDS
CRITICAL AREAS RECONNAISSANCE REPORT
Site Location: 417 3d Avenue S Tax Acct. Number: 27032600100300
Determination: Study Required Determination #: CRA-2007-0163
Applicant: Glenn Hyldahl Owner: Olympic & Sound View LLC
CRITICAL AREAS RECONNAISSANCE REPORT: STUDY REQUIRED
During review and inspection of the subject parcel, it was found that the site contains and/or is
adjacent to critical areas including Geologically Hazardous Areas and Fish and Wildlife Habitat
Conservation Areas, pursuant to Chapters 23.40 and 23.80 of the Edmonds Community
Development Code (ECDC).
Specifically, a segment of Shellabarger Creek runs east -west in a steep ravine between the
subject parcel and the adjacent parcel to the south. The ravine has fairly steep walls which
certainly qualify it as an erosion hazard and possibly as landslide hazard (greater than 40% slope).
GENERAL CRITICAL AREAS REPORT REQUIREMENTS
Critical Areas Reports identify, classify, and delineate any areas on or adjacent to the subject
property that may qualify as critical areas. They also assess these areas and identify any potential
impacts resulting from your specific development proposal. If a specific development proposal
results in an alteration to a critical area, the critical areas report will also contain a mitigation plan.
You have the option of completing the portion of the study that classifies and delineates the critical
areas and waiting until you have a specific development proposal to complete the study. You may
also choose to submit the entire study with your specific development application.
Please review the minimum report requirements for all types of Critical Areas that are listed
in ECDC 23.40.090.D. There are additional report requirements for different types of
critical areas (see below).
Note that it is important for the report to be prepared by a qualified professional as defined
in the ordinance. There are options on how to complete a critical areas study, and there is
an approved list of consultants that you may choose from. You may contact the Planning
Division for more information.
General Mitigation Requirements for all Critical Areas are discussed in ECDC 23.40.110
through 23.40.140.
STUDY REQUIREMENT — EROSION HAZARD AREA
It appears that this property contains or is adjacent to an Erosion Hazard Area. Erosion Hazard
Areas include:
0 Those areas with Alderwood and Everett series soils on slopes of 15 percent or greater.
Any area with slopes of 15 percent or greater and impermeable soils interbedded with
granular soils and springs or ground water seepage.
Areas with significant visible evidence of ground water seepage, and which also include
existing landslide deposits regardless of slope.
DEVELOPMENT PROPOSALS ASSOCIATED WITH EROSION HAZARD AREAS
Development within an Erosion Hazard Area must meet additional criteria.
For erosion hazard areas with suitable slope stability, the only critical area study needed is
an erosion and sediment control plan prepared in compliance with the requirements set
forth in Chapter 18.30 ECDC as part of the construction documents. This option is at the
director's discretion, per Edmonds Community Development Code section 20.80.050.G.
In areas where the slope stability is not suitable, projects within Erosion Hazard Areas will
require a report by a licensed Geotechnical Engineer or other qualified professional. Note
that it is important for the report to be prepared by a qualified professional as defined in the
ordinance.
Report requirements are given in ECDC 23.80.050, and more generally in ECDC
23.40.090.D.
0 Development standards are given in ECDC 23.80.060 and 23.80.070.
STUDY REQUIREMENT — LANDSLIDE HAZARD AREA
It appears that this property contains or is adjacent to a Landslide Hazard Area.
A Landslide Hazard Area is any area with a slope of forty percent (40%) or steeper and
with a vertical relief of ten (10) or more feet (except areas composed of consolidated
bedrock).
* Landslide Hazard Areas are further defined and illustrated in ECDC 23.80.020.B.
In addition to the general requirements for Critical Areas reports referenced above, specific
Critical Area report requirements for Landslide Hazard Areas are provided in ECDC
23.80.050.
DEVELOPMENT PROPOSALS ASSOCIATED WITH LANDSLIDE HAZARD AREAS
Development is restricted within a Landslide Hazard Area and its buffer.
Projects that will intrude into these areas will require a report by a licensed Geotechnical
Engineer.
0 The criteria that are applied depend on the amount that the buffer is reduced.
The buffer can be reduced to a minimum of ten (10) feet (with an additional 15' building
setback per ECDC 23.40.280) if a report is prepared that meets the standards listed in
ECDC 23.80.050. The alteration must also meet the requirements listed in ECDC
23.80,060.
In addition, proposals to reduce the buffer to less than ten (10) feet must comply with the
design standards listed in ECDC 23.80.070.A.3.
STUDY REQUIREMENT — FISH AND WILDLIFE HABITAT CONSERVATION AREAS
Since the site is located within a mapped fish and wildlife habitat conservation area, the City would
like to preserve as much of the native vegetation as possible.
,F)
0 0
DEVELOPMENT PROPOSALS ON A SITE WITH FISH AND WILDLIFE HABITAT
CONSERVATION AREAS
The applicant must submit development plans that meet the requirements defined in ECDC
23.90.030 and 23.90.040.
ALLOWED ACTIVITIES
Certain activities are allowed in or near critical area buffers as specified in ECDC 23.40.20. If you
have any questions about whether your proposed development qualifies as an allowed activity,
please contact a Planner for more information.
EXEMPT DEVELOPMENT PROPOSALS
Certain development proposals may be exempt from Critical Areas Requirements (ECDC
23.40.230). If you think that a specific development proposal may be exempt, contact a Planner
for more information. I
Michael Clugst
Name
Planner
Sig
December 13. 2007
Date
NOTE: Cited sections of the Edmonds Community Development Code (ECDC) can be found on
the City of Edmonds website at www.ci.edmonds.wa.us.
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303 HOWELL WAY BUILDING DEPAR-17494-7.
EDMONDS, WA 98020-4113 Wn
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This is the only Monument Sign to be
at the address shown. Any existing
signage to be removed.
vq u6ning in this permit appro
in v� process &hall
terpret'd Is �10wijig -or oermIttIng the
maintenance ot
nonconformi tig a),ny- ('u rrL. n tly existifi� illegal,
or site conditj.-,,_, unpei nnktid building, struct,
hl*ch is Outaidp he scope of tf.
t application, r%,
=uild *' ',aHles-R Of whether such
I ing StrueWre or condition is shown on the
Site P11fi or drawing. Such building structure 01
condition may be the sub'ect f
0 a separate
Propofidd=hRKtDfton
and Landscape Bed.
Landscape bed is double 4173rdAveS.
the size of the monument
1 _Vr P Property Driveway
=and-OvAll consist of
existing landscaping.
Existing Fence was fabricated by some entity
other than Artco Sign Co. We are not responsible
for any necessary permits. F".P— noN
Ande.— Fer.-,A-,
New sign (which was approved for install)
cannot go any further back due to underground piping.
q'c�
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MCON7R4(%*TOR IS R PONSIBLE FOR
EROsION CONTROL A D [)RAINACeperty line
20.5'
ALL Exposm suRFACE$ TO,
13E COVERED WITHIN 2 DAYSI!.
CL
3rd Ave S.
all damage to
utliRm or worixage impruvw1ligs, s- 111 W..y
rjaht.01.w0y per City standards that is caused
or mum during the pwmftd project.
108 S. BRANDON ST
SEATME, WA 98108
206-622-5262 Phone
206-622-0746 Fax
SIGN
CLIENT. SOUND VIEW APTS
DATE: 9/09/08
FILE NAMEFSI:
SOUND VIEW SN
igO IMSIOW VIEW &T
SOUND V
,� .0 1 X E Itt%
CLIE 11 li
NT APPRO �
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SPECIFICS: 5VV of
- SINGLE -FACED 48"w x 30"t x 3/16"
ALUMINUM SIGN PANEL W/ 3" RETURNS
COLOR: OYSTER W/ TBD BROWN
BORDER AND WHITE TRIM LINE
- NAME: .5" SINTRA PVC
COLOR: D.MAHOGANY W/ WHITE
OUTLINE AND REVEAL.
WATERMARK/SHADE COLOR: SOFT BEIGE*
- ALL OTHER LETTERING IS VINYL
COLOR: AS NOTED TO LEFT
- LOGOS: VINYL
COLOR: AS NOTED TO LEFT
MONUMENT STRUCTURE
VERTICALS: 4" x 6" CEDAR
COLOR: OYSTER
HORIZONTALS: .625" MDO
COLOR: OYSTER
of Artco, ri can not be dupticated without expressed consent.
QUANTITY: ONE (1) SINGLE -SIDED SIGN
SQUARE FEET- TEN (10) 0alowl hKe wAVAC Amendments
SCALE: 1 1' pLANNNG 11006 Edition IBC w1WAC Amendments
APPFIOVED By [32006 Edition UPC xv/WAC Amendments
and Appendices A, B, Q I
E32006Edition 11VIC w/WACAmendments
[32006 Edition IFGC w/WAC Amendments
[32006 Edition 1FC w/WAC Amendments
[32006 Edition VIAQ WAC 51-13
[32006 Edition WSEC WAC 5 14 1
59.2 in
48 in
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FINISHED GRADE
NTBD BROWN 1:1 OYSTER ED. MAHOGANY
(MAHOGANY TINT) . BROWN
NSOFT BEIGE
aq of Edmonds Buffling Dwrhnent
PLOAli art work generated by A tco Signs,
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OWHITE OUTLINE 0 INTENSE BLUE
OCT 3 12008
BUILDING DEPARiMENT
CITY OF EDMONDS
; the sote ownership of Artco, & can not be duplicated without expressed consent.
108 S. BRANDON ST
SEATTLE, WA 98108
206-622-5262 Phone
Z06-622-0746 Fax
SIGN
CLIENT: SOUND VIEW APTS
DATE: 9/09/08
FILE NAMEFS1:
SOUND VIEW SNOHOMISH \ SOUND VIEW PERMIT
SOUND VIEW PERMIT FILE
CLIENT APPROVAL:
SPECIFICS:
SINGLE -FACED 48"W x: 30"t x 3/16"
ALUMINUM SIGN PANEL W/ 3" RETURNS
COLOR: OYSTER W/ TBD BROWN
BORDER AND WHITE TRIM LINE
- NAME: .5" SINTRA PVC
COLOR: D.MAHOGANY W/ WHITE
OUTLINE AND REVEAL.
WATERMARK/SHADE COLOR: SOFT BEIGE
- ALL OTHER LETTERING IS VINYL
COLOR: AS NOTED TO LEFT
- LOGOS: VINYL
COLOR: AS NOTED TO LEFT
MONUMENT STRUCTURE
VERTICALS: 4" x 6" CEDAR
COLOR: OYSTER
- HORIZONTALS: .625" MDO
COLOR: OYSTER
SCALE: I" = I'
0
18 in
.0
Dimensional Lette'rifg
mounts to signface
via D/F VHB tape
and Adhesive Silicon
Posts cemented into ground
i 18 in
Base mounts to posts through
the returns via .375" x 1.5"
woodscrews
Sign mounts to posts through
the returns via .375" x 2.5" tags
18 in
Go
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108 S. BRANDON ST.
SEATTLE, WA 98108
206-622-5262 Phone
206-622-0746 Fax
SIGN
CLIENT. SOUND VIEW APTS
DATE: 9/09/08
FILE NAMEFSI:
SOUND VIEW SNOHOMISH \ SOUND VIEW PERMIT
SOUND VIEW PERMIT FILE
CLIENT APPROVAL:
SPECIFICS: .
SINGLE -FACED 48"W x 30"t x 3/16"
ALUMINUM SIGN PANEL W/ 3 " RETURNS
COLOR: OYSTER W1 TBD BROWN
BORDER AND WHITE TRIM LINE
- NAME: .5" SINTRA PVC
COLOR: D.MAHOGANY W/ WHITE
OUTLINE AND REVEAL.
WATERMARK/SHADE COLOR: SOFT BEIGE
ALL OTHER LETTERING IS VINYL
COLOR: AS NOTED TO LEFT
LOGOS: VINYL
COLOR: AS NOTED TO LEFT
MONUMENT STRUCTURE
VERTICALS: 4" x 6" CEDAR
COLOR: OYSTER
- HORIZONTALS: .625" MDO
COLOR: OYSTER
All art work generated by Artco Signs, is the sole ownership of Artco, ft can not be duplicated without expressed consent.
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CITY OF EDMONDS
BWMWQ DEPARTMENT
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BLDG. OFFICIAL'-
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ADDRESS 4_/
NAME (OR NAME OF BUSINESS)
L.EGAL �OT
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PLAT SUBDIVISION
No.
W
I ING ADDRESS
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PUBLIC RIGHT OF WAY PER ORDINANCE NO.
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CITY
TELEPHONE NUMBER
EXISTING RIGHT OF WAY
PROPOSED RIGHT'OF WAY
NAME
DEFICIENCY OF RIGHT OF WAY
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In
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ADDRESS
STREET/UTILITY WORK REQUIRED C1 YES 0
PERMIT FOR WORK IN PUBLIC R/W 11^ E S Cl No
0
3:
CITY
TELEPHONE NUMBER
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UNDERGROUND WIRING REQUIRED YES NO
U
CONNECTION TO SANITARY SEWER OVES No
SEPTIC TANK PERMIT REQUIRED OYES N 0
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CL
NAME
SEPTIC TANK PERMIT NO.
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ADDRESS
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SEE MEMO DATED e4- L-�
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CITY
TELEPHONE NUMBER
REMARKS
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
CHECKED BY
METER SIZE BUILDING SUPPLY SIZE
Legal Description of Property (Show Below or Attach Four Co�ies)
m
W
REMARKS
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SIGN AREA
ENV. REVIEW
ADB NO.
ALLOWED PROPOSED
COMPLET EXEMPT
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SHORELINE
W
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REMARKS
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VARIANCE OR CU
LANNING REVIEW BY
DATE
YARDS
LOT COVERAGE
RE GAS
NEW SIDENTIAL OLINE
FRONT SIDE REAR
FIRE ZONE
TYPE OF CONSTRUCTION
HEIGHT
FADD NON-RESIDENTIAL F SIGN
ICODE
DEMOLISH RETAINING
WALL
SPECIAL INSPECTOR
REQUIRED
AREA
OCCUPANCY
OCCUPANT
El ALTER EXCAVATE
E) YES 11 No
GROUP
LOAD
[:]FENCE
OR FILL X FT)
P N CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
F1 REPAIR PRE -MOVE swim
INSP. POOL
z
NUMBER OF STORIES
NUMB ER OF
REMARKS.
DWELLING,
z
UNITS
NATURE OF WORK TO BE DONE
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PLAN CHECK FEE
VALUATION
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PROPOSED USE
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PLOT L 4 (INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
BUILDING
U
0
PLUMBING
W
>
W
0
MECHANICAL
>
FENCE,
z
3
VI
III
"Applicant, on behalf of his or her spouse, heirs, assighs and
SIGN
III
successors in interest, agrees to indemnify, defend and hold harnil ess
_j
2
the City of Edmonds, Washington, its officials, eniployees,. and
FIETAINING WALL
ag ents from any and all claims for damages of whatever nature,
OU
I
arising directly or indirecily from [Ile iSS1IaIICC of this J)efulit. ISSII-
t;WIMMING POOL
rl
un,�o if' th; irniii 111 - o ho d .......... 1 1 " .:;,-,. ,, —.1 ... -
I N T; d I H I, I) I 1,,j j I., I i [-I j J� J\ I I I 1 1, 1 �j
UITY 010 L)NDS
-t F F
PUBLIC -JORKS Dif.-J'ARIT,11
FT), " j I FFLIU.1 If.', 1 1") I-V 1 1. (A I DATE
SUBJECT:
Subdivision
Multiple
Plat
Colmlerci,ll
I I � E 411, i Tj
FRD
Coordination of'. the location or any :�,Lructur(-, w.1ti, t-0 11tiLities, streets, r)ro.r)prtv
lines and driveway F, I
rades is tile -1 0
Of, tjj.-� &)jjj-j,,ct j,.
The ccnstraJ-or is required to keep the abuttltl�r, st"ect or cMit an d debris caused
by the collstruction 7.30.200 Violatioils - Pen-31ties, 7-30.290.
A "Right-OC-Uay Construction Permit" is requirr,
ci fro
In the Dif-Ineei,ing, Division of Public
Works for any work within tile Public riF ;4y or, J)Ublic easement.. 7-39-010 Violations
;ht-of-i
Penalties 7.30.290.
UNDERGROUND PO', -ER
El Under!-,rowid Wiring Recild Ho t Req d
SA14ITARY SEIIER (Fff-C-lIT RLOID)
Connection to Sanita-r Se�er Recild El Baci, i.-late'r Valve, R . eq'd on Side Sewer
.Y
Septic Peimit Rc-n d. Desipi Approval Req'(A
Approved Dt.
P(:!1TILit lJW1-J)Qr
STCIRM SEI.:FE�i SYS'i-E] (1-1:3 CITY coDp
El Draj.nap--�3 F I �m Req I d
Drai.rm.i.f,e Arrroved' Dt.
El Site Drainar4e to be Contained oil :�ite
EJ 'Ate Drai*r],'iFt3 to be Coralected to City System
ROADWAY L--1FJF(J\rE-EiT1'-Q A I FL) I)i I. IV El�-IAY I 3EY)U I Fu-.17-IL-j ft's
Drive -,-jay SIOT)e Not to Lxc—:�d I'll"
Drivel.-ia-� aving Req I d
EJ Vertical Cw-b Recild
Street Favii-Lir
, Req cl.
0 Drj.vei�,,ay Culv�2rt Req'd Size
El
E]
El Bond Recild . for Public Improvements EjSubmit Cost Esti.ma . t e
Note:
Fowidation
Side
&�wer D
-eptic Tank
�Watc:�r Serwice
Fi-re
Protection
Drainage
EJ Site TiTp*roveme�nts
A 24 hour noti.ce is rpquired
for, inspection
h�, Fhgineering, call 7*75-'2525,
extension 220
PJ,..
16
C 1 t,. I lJ1Wi!1-*.t-'
PUBLIC WORKS DEPART,= C1]ECKfT
.4-L4 7? Date..
BUILDING PMaT REVIEW
SPRInKLak SY-,57SM "17 3 &D Address
;71COAI rIE:R, iL4j0SCA&MC- JAIC. .
Street:Right-of-Way Existing LIZ
Access Easements Existing REQD
Utility Ease-nent Existing REQD
Lot per Subdivision Plat Assessor Map
Site.Plan Checked for Accuracy
Underground,14iring Reqd.
Check Accuracy of Legal Descript
Envirorm-entally Sensitive Area
Envirarnental.Checklist Reqd.
Flood.Hazard'Zone
Shoreline Management Area
Slope, Soil, Vegetation \j
Stream, Creek, Drainage Basin
Existing ZoningL Per Code
Amenities Design Board Approval Reqd. ;A�DB # Approval
Board of Adjustment Approval Reqd.
P,eyie-,�.,By: Date:
-Existing 1%1atdr-T%1Ain Size
Water Main Reqd.
.Service Line Reqd.
Hydrant Size Fxis ting,
Hydrant Reqd. Per Fire Code Size
Detector Check Meter.Reqd.
7nvg&,s catscie VWA1,1r
Cross Comection.Inspection �S REQUI/eED Al SY-C-MA-7
'Fire Departinent:Carment's
water'Meter,Gharge..Rcqd.
Rev1 ew b)� .
Septic Tm-�,� Des'ign Approved
Septic Tank Permlt Reqd.
Sanitary Sewer Availability
Drawing No.
Side Sewer Availability
Sanitary Sewer Connection Fee.
Revie%T By
Date:
Permit:No.
-Proj
File No..
Date:
t
q)en Di.tch Existh-ig
Reqd.
Culvert Reqd. size
Catch Basin Reqd.
Indicate on Site Plan
Shoulder c1rainage -niaixi6in�/Con /11 oil swale open, run
off
-6--ul]iole reqd. Indicate oil Site Plan
Soil Conditions (jd.Gr nd I -later Field Cliecked
Do te
I p, re I I -F% 0
Street Paving R.eqd.
Curb and Cutter Reqd.
Sidewalk Reqd..
curb Cut for Driveway R/eqd
.01 P e
Rig)-it-of-I%Iay Construct]-oi P iit e
0
I ok
'I.Its
Bond Reqd.,for Public I ro emc-nts-
Street NmTe Sipl -Re:qd.
Offier Signing Read.
7-A a
Pre Pemit: Site-Inspectiow M`a-de on
0 >
I' )Y:. S.D�.IER.
U
WATER A
SIM- :,T
IG-INEUMIG.
�>'Special Requirei-'�-nts list in 1111W
Buil-ding Division -
BY
y,.D V lopi-a--nt' D&pa'rLiyent,
Date
o �,A.11 itei� filled in on Build Permit Application
)y Date
1 Drawings O)Lmiped and No.tations 1�kide
BY ate
to, - D,
N
by PUbliC 1,7cm.ks DCIMFL-MUlt:
Revised: 1v 10-19 . 17
Side Sewer Drawina
1%,
The City of Edmonds EASEMENT NO - --------------------------------- ----------
NEW CONSTRUCTION REPAIRS E] LID NO . .................. ASMT. NO . ..................
OWNER ------------ CONTRACTOR .............. PERMIT NO.
JOB ADDRESS ..... ........................... LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO . ....................................
..............................................
...............................................................................
..................................
PWW-0001-1 1/75 (REVA 1/78) DATE �Z-.:5.--75K
al, ......... I
---- By�-
a4
E-4
W
�4
P4
z
0
CQ
0
E-4
AC[aress ot construction
2. Property Legal.l�escription (include all easements)
3. Sin-gle Family Residence Multi -Family _)IZL_ No. of Units
Commercial
� Vn LW'1 ds I
4 &,sti
4. Owner and/or Builder q-
5. Contractor & License up.
Rvs'�
6. Invasion into City Right -of -Way: No Yes L-""(If Yes Right-of-
way Construction Permit Requited - Call Dial Dig (342-5344) before
excavation).
7. Cross other private property: . Yes No L-"�_Easement required
attach'legal description and county easement number.
READ THE FOLLOWI,NG AND SIGN:
a. Property owners must obtain a permit to install side sewers on
their property. A licensed side sewer contractor must be employed.to-
construct side sewers in the public right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for.one year *
C. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
d. Side sewers may not be installed closer than thirty inches (30")
to any structure. 0
e. Side sewer lines must be laid at a minimum grade of 2% (1.15
and.maximum grade of 100% (450). 0
f. No turn in side s8wer greater than 45 (1/8-bend) is 0 allowed
between cleanout. All 90 -turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down -spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line Tun.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure.
due to poor compaction of fill.
I k. Side sewer must be left uncovered u L'inspected and approved
by the City.
1. Inspection during normal working o 0 working
days notice required. -
DATE: /.5F- '79
certity thcTt i- nave reaci
and shall comply with'the above
EPERMIT
FEE: 4 1�0 '00 INEr- re'V-SAPPROVED
BY:
Date:
OW
CONNECTION FEE: I uniti
B y -.�__Da'
��Date:
t e
94::)
. I - IrVjjKAPPROVED By:
0
44
7�
PERMIT MUST BE POSTED ON JOB SITE
,j�OPL.LLMION
'k, for
IDE SEWER PER.Mff
SIDE 0 REPAIRS 0
L
F-I
-73
71
PERMIT.No.
*TRACTOR ( .........
TREET .............. .. BLOCK No...,: . ... ..
VENUE LOT'No. .. ....
-ti -I of 110 .59t. quarte.r
That P0. 01 .......... ...... ....... ... I
� I .... .................. c f th e.
1AME ADD . ...... ...... . ............. :
of the nort,heasu. (j'u
theast qiarter 01
of See 26
cli.)arter .9
-th Rangge-.3 east.,
Township 27 no,l
11,T.M.., descrit)ed , as follows:
(,tion
Beginn at t1l.e inter-
0� -t.h north line of said
se��tlon 26 with thi-- east
u he
line of.- Ird Street in t� uth
-inds' thence SO
e Of 3rd Street
�alor,�! easu- 1T.' r,0 feet;
a dI..stance of
stance of 300 ft
t1jence east a di to.the.n.
e nort:r"150 feet;
thet*lr- I iji '
nc,-rth lille of sa Src..tion 26;.
Salo Sec,,L.ion
100 -c.-t ul e
Of
fit
D. Building Permit # (if applicable):
'City of -EdmondW.
AY CONSTRUCTION
ERMIT Permit Number. � 1. 16:-J26"o
Issue Date: —I, -.4-1)17 9".5
Construction: L1117 3"JQ49 �Sr
ific): 1AW74LL 24 ftVarr dizaL
51DERALZ -TO . 12401AAse- ona=-
Contact: -A" ANDaMOA) -
Phone:
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. Commercial F1 - Subdivision 0 City Project Utility (PUD, GTE, WNJ2�LEATER)
Multi -Family E] Single Family Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut 1A Yes []No G. Size of Cut: x H. Chargc�-$
APPLICANT TO READ A
,ND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City ofEdmondg harmless from injuries, damages, or
1. . � " I
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or aqy 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 WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETEO BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BEPROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed Work required with 1�ermit application.
A 24 hour notice is requir%d for inspection; Please call.the Engineering Division, 771-0220.
Work and material is tobe 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 ofthe working day;
NO EXCEPTIONS.
Ihave read the above statements and understand thepermit require;iients and thepink copy of thepermit will be
available on site at all tin^ for inspection purposes.
S 19 '& AKA-5--
nature: 4-C Z4,IL -cewe= &-10 Blate-
?Cc;n-tractor or -Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: A
TIME AUTHORIZED: VOID . AFTER 3L DAYS
SPECIAL CONDITIONS: 1E ReAo'JE CONC4
' K CA 0 -Y) J<e-PLALC A S
A M tAi. -W 15 1-1 A 0 E L
COMMENTS: A V6 -7
RIGHT OF WAY DEPOSIT*
DISRUPTION FEE/FUND Ill:
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE:
RECEIPT FEE:
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT. IS�fUANCE
Eng.'bi�. 1994
FIELD INSPECTION NOTES (Fund 111 Route copy to Street Dept.)
Comxnents-�
Diagram.:
CONTRACTOR CALLED FOR INSPECTION YES NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
w
:> 1
oz
08/07/1995 09:57 7752299 CHAMBERS CABLE PAGE 01
C'] A M B E R S
-2 L E
PAX MESSAGE
DATE:
TO:
COMPANY:
PAX PHONE NUIOER:
CC:
FROM: "'V f
SUBIECT*
OF PAG2S 14CLUDING THIS COVER SHEET)
HESSACE:
er
1p yOTj E)c � (-T RECEIVE ALL PAGES r PLEASE CALL BACK IMMEDIATELY.
VOICE: (2f:6)774-5146
FAX: (206)775-2299
5-T -� ., ;� sS`r=EEl" I Er-,MCNCS. WA&*IN�TUN 98C2C . (2r-81 -/74—T-146
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMITSTREE`;� FILE
Z
1�
U
U
0
A. *Addrqss or.* . cinity of ,on
501�1 C
7 .---3 :��a
e Owner: At�,X�,O�e 4—
Name
Mailing Address
-7,-/ q
City, State, Zip Code
-W 10
Permit No. 1 -7
Issue Date
0 PermitIssuedTo: CIP15K,
0 Type of Work to he Done: Afe -V,;?l
Work n Connection With:
El Sub or Plat El Single Fami ly
El Comml. / Ind. X- Apt. Condo
0 Pavement Cut: 11 Yes VNo
0 Contractor:—O-,,/n A
Name
'700
4
M 'ling Address I State License N��P4.
21 �9 A /I r-1001 7
IPVI
(11ty, State, Zip Code Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT -TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any 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 of any legal
proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering.
Call 775.-2525, extension 220.
I understand that this permit must be available at the job site for inspection purposes at all times.
Signature: I Date
Owner or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SITE FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNINGWORK
C. issued By:
Time Authorized: Vold after 130 days
Special Conditions:
Ammendments:
Permit Fee:—A)U40�0
Security Deposit:
Receipt No.:
Fund ill Fee:
Street Cut Dimensions
X
UC T 0 2 1981
.,NO WORK, TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. December 1,978
FIELD INSPECTION NOTES (Fund 111 - Route cony to Street Dept.
Comments:
Diagram:
Contractor called for inspection Yes No
Work Disapproved BY: —,""-7, Date: Bv: Date:
Work Approved Bv:<� D a t e : 5;� Zrlo ZL
Inspector:
Rna. T)iv. T)Prpmhpr 11)7P
� " z..
CITY OF EDMONDS
U
�:i
0
U
0
0
0
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
9
c' TR E
A. *Address or vicinity of Construction
5-0
0 Owner: 64)16�QAI
Name
Mailing Address
City, S ta te, Zip Code
0 Contractor: L1,J41 /0 — 01 L 50 N
r-) �-kv,4 e—
Mailing Address
owf-
City, State, Zip Code
Fermit No. 79 - /1"
Issue Date --;,--A- lZ<,-
Permit Issued To: Ay-sr-t b —%,
1, A 77X -S R
• Type of Work to be Done: OP I k,/, e J 4,
e-
• Work in Connection With:
El Sub or Plat 0 Single Family
El Comml. / Ind. N. Apt. Condo.
• Pavement Cut: E$AYes 1:1 No
0 D- 3 - u I - H E, P k M o Its- V",
State License Number
1;, (t �) —/ L/ e//
T -�hc�ne Number
ele
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any 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 it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand thaelthis per-Rih-mLi(st be ava'ilable at the job sife for inspection purposes at all times.
-10 6) Z11 JA i"
Sig --Date4
Owner or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: Z"r
Time Authorized: Vold after -
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit:
Receipt No.: /-J 11 A 5<
Fund III Fee:
Street Cut Dimensions
X
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. December 1978
FIELD INSPECTION NOTES (Fund 111 - RMute cony to Street Dept.
rr%MM'-jn*0-
Diagram:
Contractor called for inspection., Yes
T Date:
Work DisaT.Pproved By: Date:
Work Approved Bv:
—Date:
Inspector:
Ena. Div. December 1978
F�
Z
0
0
I—
LU
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTIONPE.RXRE
A. *A1J,y) Q,��cini,,
I I _4 �?�p
is Owner: /!;g
Name
Mailing Address
,5�—
�/p_7qq I _wcU,
City, I State, Zip Code
Wit No.
-7 �0
2 9 1981 Issue Date
q12_1 I k I
�P
IEI
Pubiic �Vorks
9 Permit Issued To: i!
9 Type of Work to �e Done:
Work in Connect] on With:
El Sub or Plat El Single
Family
El Comml. / Ind. X Apt
Condo
Pavement Cut: El Yes'
YNo
0 Contractor:
Name J9 2-27 -3 3 A-2
laailing Address State License Number
J�W ! 7 7 ��W& q -3 &V
C11 —ty State, Zip Code Telephone Number
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any 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 of any legal
proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering.
Call 775-2525, extension 220.
I understand that this permit must be available at the job site for inspection purposes at all times.
Signature: P" 100. Date
Owner or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SITE FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: C. wx4tk��
Time Authorized: Vold after —days
Special Conditions:
Ammendments:
Permit Fee: A)aa�
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
X
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
0 , .
1 6 Tcf—V
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENTj ENGINEERING DIVISION
STREET FIMUCATIO[I FOR RIGHT-OF41AY CONSTRUCTION PFRMIT
THIS PERMIT.MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PUR,PbS_E'S
Applicant
to COMDlete Parts A ind R
A, Permit to be issued to:
'I For Work at :(address or vic
Type of Work to'be done: SO'e- , C-01
(attach drawing when applicable)
Time Required -- Start:
Owner:�Vc/uag.ic,�-5
name
— 1194 N - 171_"' Sl_
Mailing Ad ress
41 e - - 1-11 98)Sy
.City State Zip
Finish:
5-42 --74-4-1
Telephone Number
Contractor:
qN me "State License Number
FI Mii Address
1�"mj
Cief State Zip Telephone Number
NO WORK TO 13EGIN PRIOR TO PERMIT ISSUANCE
.B. INDEMNITY: Applicant understands and by his signature to this a , pplicationi�,— �ees
to hold the City of Edmonds harmless from any injuries, damages, or claims of any
kind,or description whatsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including or not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance,
of the restoration by the Engineering Division.
FUnds held from the Security Deposit (estimated restoration fee) will be held until
the final street patch is completed, at which time a debit or credit will be
processed for issuance to --the applicant.
Work is subject to inspection and r t tion in accordance with City Code. A
S�!�ora b
24-hour notice is required for in . C ion y Engineering. Call 775-2525, ext. 220.
I understand that this'-per-mlt_� '�e
MU? b, �vailable at the job site for in sp t n
purposes at all times..
Signa . ture4 riz, Date: 771
I AWZ4�_
19F,Vn9V_o-T Ap,'ent-
TO BE COMPLETED BY IS�UING Lk�,ENCY:".
0 0
Fee:
Date Issued Permit No. Ar
Security Bond:' Pv'pjd 1 10 Y. CIO
Time Authorized:
14 cictv.K
APAOVED B Y. lb�VL�
� 4
t I I
4, 4,
po [2- -r 6
et
'T
-"/C— 747, '71
7,
1L) i AJ 6-� ,V7
Ws
51
............
o
..........
3 0
MEMO TO: Art Housler, 'Director
Finance Department
FROM: Leif R. Larson
Director of Public Works
SUBJECT: REIMBURSEMENT OF STREET CUT SECURITY DEPOSIT
ORDINANCE #1935 --
7,8 319.
R/W CONSTR. PERMIT NO. : � — ,, I
DATE ISSUED: 12 -.23 - 78
LOCATION OF WOPK: 417 3rd Ave. So'.
SECURITY DEPOSIT AMOUNT:108.00
RECEIPT NO. & DATE: 4635 1-04-79
COMPLETION DT. OF REPAIR: 3-09-79
Please prepare a Treasurer's Check in the amount of $ 13.50
made payable to the following:
Russ Johnson
16009 No. Meadowdale Road
Edmonds, WA. 98020:
The balance of the deposit in the amount Pf $ 94. 50 is
to remai n in Street Division Revenue Fund 111-000-000-3 9. 0.
StkR-(5t, Supt--/ Dt.
7/31/78
.ACM n.\,.,/ Dt.
CITY OF EDMOND
PUBLIC WORKS DEPARTMENTj ENGIOL RING DIVISION
N,
AP.PLJ.CAT,J.QN FOR Rlr3HT-.OF-IL-Y-COp�ISTRIJ,CTIOtI.PFRMIJ
THIS 'YERMIT MOST BE AVAILABLE AT THE JOB'SITE FOR INSPECTION �PURP -S-E S
.0
ete afts 'A -a'irid -B,
to -Com� 'P,
A Permit to be is,su-ed to.: Snohomish Counity P.B.D. No. 1
SEP 6 1978
For -Work a-t�:(address or vicinity) 417 3rd Avenue South
Mr. Ut Public WOFTS
Type of Work to be done:, inStall
underground power. system to serve the Hen-.
(attachr-drawing�-when-,applic,able)
rilison-Wil-son
Apartment
LU,
Time� Required -Start: Septem*ber
15, 1978
Fi.nish:. 1 day
Owner.:i,,
LL
Name
W.0'. # 886701
Please.return to the
Mailing Address
attention of PIary Bond.
LU
City State
Zip
Telephone Number
Contractor: Sn6hbmi�h Coont'y"p,.U.D.
No. I
Name.
.�State ticense-Number
Y :0. Box �J 10.7
Mailing Address
Everett Washington 98206
258-8415 Grey
City 'State
Zip
Telephone Number E *
nginee.r
7 7-
B1. INDEM , NTI.TY: Applicant understands and..by his signature .,to t-hi . P.application, agrees
to -h )1,d the City of �Edmonds harmless If rom any injuries, damages, or claims of any
kind.or description whatsoever, foreseen or unforeseen, that 0 may b F e mad .1 e against
the applicant..or the City of Edinonds,,or any of its'departments or employees,.
including,or not limited to the defense I of any legal proceedings including defense
costs, court costs� and attorney fees by reason of granting,.this . pe�rmit.
Upon issuance of this permit, the contractor is �responsible 'for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until
the final street patch is completed, at which time a- debit or credit will- be�
,Processed for issuance to the applicant..
Workis subject to inspection and festoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call '7 , 75-2525, ext. 220.
I understand that this erm st be a ilable at the job- site for inspection,
purposes at all times.
ur
Signatur 3—, Date:
Owner or X�ent (A
TO BE CO�IPLETED B� ISSUING AGENCY:—
Date I ssued Permit No.: e
F e
Security'Bond:
Time Authorized: -
APPROVED B
Date