628 GILTNER LN.PDFIIIIIIIIIIIIII
14002
628 GILTNER LN
8 9 0 . 199 -
r'1`1- - 10, M'.1 . t . - I, i, � ( - , - -1 I .
C!Tn=CT C11 C
RECEIVED City.of Edmonds
R�%T-OF-WAY CONSTRUCTION
FEB 2 PERMIT
ENGINEERING Permit Number:
Issue Date7
A. Address or Vicinity of Construction: 09 144 V-4 A
B. Type of Work (be specific):
C. Contractor: AML w 'oo Contact:' �_T//V' 40111b! -o
Mailing Address: 91 /F Phone: &7
0= 2--v 40
State License #: ot-0 r- ty 2-0-T- Liability Insurance: Bond: $
D. Building Permit # (if applicable): 4?1(97 of-5 Side Sewer Permit # (if applicable):# F,36 S
E. F-1 Commercial Ej Su��ision 0 City Project 0 Utility (PUD, GTE,WNG, CABLE, WATER)
Fj Multi -Family 29-lingle Family F� Other
INSPECTOR:, INSPECTOR-
F. Pavement or Concrete Cut e-Y—es []No G. Size of Cut: 2 x H. Charge $ /0;6. J90
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harrnlessfrom injuries, damage�, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be made against the City of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP AND MA 7ERIALS FOR A PERIOD OF ONE YF_4R FOLLOWING 7HE FINAL INSPECITON
AAD ACCEPTANCE OF THE WORK ES77MA7ED RESTORA77ON FEES WILL BE HELD UN77L THE FINAL S7REET PATCH IS COMPLE7ED BY
C17Y FORCES, A T WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Department IN
Work is to be 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 accordan& with City regulations as required by the City -Engineer.
All street cut ditches shall be patched with asphalt or."City approved mat . erial prior to the end of the working day;
NO EXCEPTIONS.
Ihave Z!t a o;ve tatemAentsandw erstan the permity'requirements and the pink copy of the permit will be available
!ad '
re 0 spe rtiol
siti tim I'
on i e at times inspectiot u ses.
Signatur Date:
(Contractor or Agent)
.17
CALL DIAL -A -DIG PRIOR TO BEGPQ�ING WORK
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.)
Comments:
IDiagram:
1 6
CONTRACTOR CALLED,FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
tng. mv. j,
to
Ap
MOVAI NOTED
6MMM�Ml
M1wKMKz3jM
FM�EM�M
imp"Iwo ml
ZVI! 1 0 �kr; 0
f
rMhhM� 400 W-A
i'A
-IT -14 kj*'
i 17,V
77
DETENTION WORKSHEET.
STMARD DRAINAGE PLAN
UPPER
CA,-MV4
BASIN
(vr-t4-r)
VETEITT,ioN PIPE LENGTH CONTROL. CATCH
BAS%R
MIN, 2'�M�6Y."C-OTv"u, --,I _
% SLOPE-4-
SYSTEM CROSS SECTION
OLrTLr.T
CONTROC
UTO OUTL-ET
(N P RAP OR
P,UNOFF
51PREADER)
2' - 2' &�'OIMWF, At'(-" SPAL�Ls 6 rc—)
IV' x 2' V�' 10) U E 1P, V4*- CRUSHED ROCY-
FROM
0 rrLE
LfrLE-r
CON-MOL
RIPRAP OUTLET
m
WASHED &V-okVEL M11`4 10' LONC-j,
-rOP 4 4' PEMF PIPE -M BE L-F-VIEL-
r oL)-rFLOw TREN cH,
L-7
'FROM
OVT'&.ET
)L
COt4TKOL
4� PFRF PIPE; WITH CAPS
RUNOFF SPREADER OUTLET
FOOTING DRAINS SHALL NOT BE
DETENTION SYSTEM
for ZA
location k rN
plan by fg. Ate- ZsArIgAf—
phone 1610- 2-ddoq
date
4 7 0 - 2 ev o2 ___j
DESIGN DATA
System imperm
Pipe Pipe
Orifice
Number Area
DIP VT
Diameter
1 1. "
��
I � �- "
NOTES
1. Call Engineering Division (771-32021
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the resDonsibility
of the property owner(s). Material
accumulated in the storage pipe must
be flushed out and removed from catch
basins to allow proper operation. The
outlet control orifice must be kept
open at all times.
AP"O D AS NOTED
MP
CITY OF EDMONDS
Page 9 of 9 CONNECTED TO THE DRAINAGE SYSTEM I I — I
Le
001
City of Edmonds
RIGHT-OF-WAY CONSTRU
PERMIT
C O&P
f%
aTREET FILE
ION
Permit Number:
Issue Date:
A. Address or Vicinity of Construction: 628 Glitner Lane
B. Tvne of Work especific): Install 1 1/4" PE IP Main in 3 Avenue North
9 0 9 from 21' West to 301 East at Glitner Lane. PEr-Attached
Drawing: 920-039 (T-R 60_413-31) (1)
Washington Natural Gas Company L
Contractor: Contact: Gary Swaason
Mailing Address: 815 Mercer Street, Phone: 224-2080 RECEIVED'
Seattle,WA 98111
State License #: Liability Insurance: Bond:,$, fl k
IV W I W %I
Building Permit # (if applicable): Side Sewer Permit # (if applicable). ENGINEERING
E. F1 Commercial El Subdivision E] City Project, [Z Utiliiy� (PUD, GTE, WNG, CABLE, WATER)
Multi -Family EJ Single Family Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut : )M Yes E]No(3) G. Size of cut: - 2 x 4 H. Charge$
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the Chy of Edmonds harmlessfrom injuries, damages, or
claims of any'kin I d or descriptio I n whatsoever, foreseen or unforeen, thal—��akwe,made agaihsi-thl Chy �jhtdmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit.
IRE CON7RACTOR IS RESPONSIBLEFOR WORKMANSHIPAND MATERIALS FOR A PERIOD OF OAE.YEAR FOLLOWING THE FINAL INSPEC77ON
AADACCEPTANCEOF ' kEES I&L BE HELD UtML,
THEWORK ES77MA7ED RESTORATION 4 -1 . _. THE FINAL S7REET PATCH IS COMPLE7ED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE -PROCESSED FOR ISSUAkiE Yl� THEIAPPLICANT,
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Department- 771-3202.
Work is to be inspected during progress and at compl6ptiok
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 day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink �cqpy of the permit will be'available
on site at all timesfor in t' e
SPWP
Si nature: Date:October 24. 1991
Z>
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES
C
'f.
(Fund I I I - Route copy to Street Dep ) ..
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. viv. July m
STREST PLE
7
CITY OF EDMONDS SIDE SEWER PERMIT
8 9 PERMIT I"-1
1-0 8368
Address of Construction: vt_ 10- LAAve-
Property Legal Description (Include all easements):
r__;�nmoNps ITECEIVED
lllnn��EB 2 4 1992
PUBLIC WORKS DEPT.
11. ' -C
Owner and/or Contractor: 6,,. -e C_
State License No. f) A I-Ac- 01 LOOS- Building Permit No.
[I'-S'ingle Family Invasion into City Right -of -Way: El No 2"'re's
13 Multi -Family (No. of Units-) RW Construction Permit No. 9z Z_
El Commercial Cross other Private Property: B-N'0_ El Yes
0 Public Attach legal description and copy of recorded easement
T'certify/at I ha7ve read and shall comply with all city requirements Date
as indi(!ated on the back of the Permit Card.
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
Partial Inspection:
Comments
Date -Initial
Reason Rejected:. Date -Initial
Final Inspection Approved: DateUje& lnitiaz�
. I
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3!90
�he City of Edmonds Side Sewer Drawing EASEMENT NO - --------------------------------------
I NEW CONSTRUCTION R— REPAIRS Fj LID NO . .................. ASMT. NO - ------------------
OWNER------------------------------------- ---------------------------------------------------------- CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO.
JOB ADDRESS --- �0.-Zg ----- LEGAL DESCRIPTION: LOT NO - --------- ---------------------------- BLOCK NO - ------------------ -----------------
- ------------------------------------------------------------------------
PWW-0001-11/75 (REV.11/78)
NAMEOF ADDITION ------------------------------- ---------------------- .......... 0S ---------- ------------------------------
T
PLAN f-
.T
rr YRZ
Ll 301ftc L 1-* 3 1�
+ e-tc 4 c
3o' 'PALO-?. 40
Approved:
Z---
DATE ................. By
- ---------------------------------------------------------
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
i6�
PERMIT
NUMBER
..
ADDRESS
sui
OWNER NAME/NAME OF BUSINESS
DAHL
LEGAL DESCRIPTION CHECKI
SUSDIVjStON NO.
LID NO
MAILING ADDRESS
I
PUBLIC RIGHT OF WAY PER OFFICIAL STREET
XISTING REOUIRED DEDICATION
6 2 !jq
PROPOSED 04)
TE ScP Approiied
RW O.M11 Required
Street Use Permit Rect'd
Inspection Required
510-11, Required
CITYdr,JC"ld ZIPOZ ()I
_S
TELI;1�11NI-. NUMBER
6 76 2<i 01
NAME
0 (\ j 6 �N
REMARKS
. -
ADDRESS
23 A 10 k)
C
ZIP
il? q
41, 17-7
tj�FHIIE NUMBER
i94( _ 22A
ADDRESS
METEEVIZE
BUILDING SUPPLY SIZE
NO. OF FIXTURES
CITY z IF
TELEPHONE NUMBER
REM7
V 'g,
STATE LICENSE NUMBER
OtMil- WE
SIGN ARE4�
ALLOWED PROPOSED
SEPA REVIEW
COMP LETE
EXP
ADS NO.
Legal Description of Property - include all easements
T-(A I-V C- C�
SHOR ELIN E N
Z07- Z
VARIANCE OR CU
— I
PLANNING REVIEW BY
-dlp A --I AJI0
DATE
V7-2,qq /
11::�
r -
SETBAQKS - FlEg HEIGHT LOT
FRONT,�,SIDE REAR
-,:
COVERAGE 3
Tax Account Parcel No�
TEWARK7
P:kom r 9 P--T &A e-k, L:�NX
E4NEW 211 PLUMBING
DADDIALTER MECHANICAL
REPAIR SIGN
FENCE
DEMOLISH GRADING -n CYOS.
CARPORT, swim
REMODEL GARAGE L
POO .
ElWOOD STOVE I RETAINING WALL/
INSERT ROCKERY RENEWAL
R Oq 0. e-r (3,q cL,- Ig
"V' e4 "s 4"' k4 7'crb 11 f Y4 -d 1
1-0 f-Av-
t..EC.El
TYPE70F CONSTRUCTION-
CODE
SPECIAL INSPE TOR
C
REOUIRED OYES
-9MARKS
AREA
JOCCUPANCY
GROUP R3
OCCUPANT
LOAD
PROGRESS INSPECTIONS PER USC 305
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER OF STORIES
—7DWELLING
NUMBER OF
U,
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN�
C0AS+rv4%c,,%. FR
FINAL INSPECTION
REQUIRED
Z -' 67,'�S
6�646111f ZWe7
PLAN CHECK FEE
BUILDING
Z-L RIC
PLUMBING
-43
Plan Check No.
MECHANICAL
2
This Permit covers work to be done on private property ONLY.
ffiQL�121fILL
Z.3
Any construction on the public domain (curl:,s, sidewplks,
STATE SURCHARGE
#1 15 0
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
w
successors in interest, agrees to indemnify, defend and hold
0.
harmless the City of Edmonds, Washington, Its officials,
5
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
X
nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
Information given Is correct; and that I am the owner, or thjs duly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
laws regulating construction; and In doing the work author z.
AUTHORIZES
This application is nqt a
:late
d thereby, no person will be employed in violation of the Labor
ONLY THE
signed by the Building Offic I
. mc
Code of the State of Washi Sting to Workman's Compensa-
WORK NOTED
Deputy; and fees are ps4
tiop4rMurance.
INSPECTION
acknowledged in space provided.
GNAT IOWN:IR; A SIGNED
DEPARTMENT
�®R �Nff JOATE
CITY OF
E DATE
EDMONDS
AT-tNTION
CALL FOR (AELEAdt-0
BY: L-' DATE
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUIL61NG OR STRUCTURE
771-3202
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
ORIGINAL — File YELLOW — inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER . 3.
PINK — Owner GOLD — Assessor
FILE
PROJECT REVIEW CHECKLIST
PROJECT NAME:
PR OJECT ADDRESS:
STEEETFI-LE
PLAN CHECK
RECEIPT DATE:
I
m ia a
e)
PLAN.
W ATER
COMMENTS
FIRE
:.-BLDG.
SEWER
I
STREET
ENG.
Setbacks/Variance/Setback Adjustment
Conditional Use Permit
........
ADB Requirements
Other Zoning Requirements
-------------------- -------------- - - - - - - - - - - - - W
XX
Underground Wiring Required
Lot Slope IS%
it
SEPA Environmental Checklist/Hydraulics Permit
.... .......... ...
Tree Cutting Plan
A -
Plat/Subdivision Requirements
...... ....
Legal Description Verification
Quit Claim/Street Dedications
- - - - - - - - - - - . . . . . .
Easements - Public/Private
Engineering Storm Drain Review Fee
Engineering 2.2 Inspection Fee
.14
Drainage Plan (On -Site)',
, N,;OO*. � . I . . . . . . . . . . . .
Setback - Top of Bank, Stream, Water Courses
Setback - Storm Drain Une
..,l 7,-
Open Ditch - Existing
612 flf
18:.
..........
Culvert Required
Culvert Size
Shoulder Drai�-age/Shale Open Runoff
..............
Catch Basin Required Yej
V--Y
Driveway Slope & Vehicle Access ed-
Sidewalk Required -'A-4--)
El -m 111,71 1
Curb & Gutter Requi - red Ale
Curb Cut For Driveway Required
Street Paving Required
27
Right -Of -Way Construction Permit Required
.2-8-`
Street Name Sign Required
-29
Other Signing Required
... 30--
Bond Required For Public Improvements
31-
FEMAMap Check/Water Table
. . . . . . . . . . ................................. ---------------------------- - - - - - - - - - - - - - - - - - - - - - - ---------------- ----------
32
.
Side Sewer Availability
............
_�3
Calculate Sewer Connection Fee If No LID # 377
Create Street File
. ..... ... .
- - - - - - ----- --------- - ---------------- 14 "Pvc
. . . . . . . . . . .
Existing Water Main Size
Water Meter Size
Service Line Size
Water Meter Charge Required
...........
39
Hydrant Required
Hydrant Size Existing
s
41
Fire Line Charge Required - Sprinkler
;::A2
Street Cut
43
Miscellaneous
LEM,
44
Reviewed By:
I
FIRE
PLANNING..
ENGINEERING PUBLIC WORKS
TREET FILE
COMPLAINTS MUST BE WRITTEN: NO VERBAL COMPLAINTS WILL BE ACCEPTED.
THIS FORM MUST BE COMPLETE.
DATE
CITY OF EDMONDS
COMPLAINT RECORD
COMPLAINT SUBMITI BY:
-2
Name: Ir.. Phone: 7 7,57-SS
Address: ip li?Wl Z4we, STREET FILE
ADDRESS OF PROPERTY TO BE INVESTIGATED:
Narm of Owner:
Address: Phone:
DESCRIPTION OF COMPLAINT:
DO NOT WRITE BELOW THIS. LINE. FOR. CITY USE ONLY
CODE SECTION VIOLATION:
TYPE OF ACTION EXPECTED:
TDIE REQUIRED TO DNESTIGATE / ACT ON COMPLA=: , --5— X'-,
RESULT OF INVESTIGATION: DATE: TIME REQUIRED: ks X
INVESTIGATED BY
APPUCATION
The Qty of Edmonds for
SME MCWIM PrAWT
NEW CONSTRUC77ON [] REPAIRS 0 EASEMENT No . ..........................................
113-06200
Harry Giltner
OWNER........... ............... .................................. ............................................... CONTRACTOR .......................................... ------------------------------------------------------- PERbM No . ...................
ADiDp
628 3rd Ave. N.
................... . .......................... ...................................... .................. LEGAL DESCRIMON: LOT No . ................... .......................... ]BLOCK No . ............................................
NAME OF ADDrrION
-r
AD, 0
&J� ?A;�,
Dye Tested On Sewer 1972
Approved:
DATE................................................
Thg� ';#y of Edmonds
`� IL
SEDIE SEV;�iV-klFjBY01T
OUTSIDE P INSIDE El REPAIRS
OWNER ------- N' CONTRACTOR ...............................
- — ------------------------------------------- I ----------- ---------
STREET
HOUSE No . ..... AVENUE LOT No.
. . .. .......... .... .. .
NAME ADD . ..................................
CARD No . ......
EASEMENT No . ......
........................
-----------------
.................................................... PERMIT No.
------------------------------- BLOCK No . ...............................................
---------------------- ..... . ............................................................................
Date Approved:
BACKFILL WORK ORDER ISSUED ............ ...................... DEPOSIT, $ .............................................
11"?,5-1
..............
SEWER WORK ORDER ISSUED . ----------------------------------------- DATE
DAHI-- HOMRS
Pc>-r--t�:LcD1ri
SEC. 24,127N.,R.M.,W-M.
Zacalio--7 o,,' Walk.- Z.1�7e- SCALE: I U 30 1
/�7 61h�7e-- Z,-.-7-- ,6 N
c/;, yo /0 ATE- 2-4-91
0ry�y 'ecv. . 1)
'5/jz "a, hya.1 f
--7 CA�Aa-Al,,77L olala- 'fev. 4. d.$/ 'dda e-
JV. 72 jW 7-5.) e5177 Y$
1 All)
—W
Owner: Carol Rogers
628 Giltner Lane
Edmonds, WA 98020
Applicant: Dahl Homes
9218 224th St. S.W.
Edmonds, WA 98020
Contact: Rosemary Lowman
Subdivision Services, Inc.
22727 Highway 99, Suite 110
Edmonds, WA 98026
Surveyor: Western Surveyors., Inc.
13000 Highway 99 South
Everett, WA 98201
—T; "Ae7 t"T
ox C Cw/
Giltner ,-vx,9,&m,',56*'w—Lane - -
C-6 0
0 CO. N 'nea. A.A.M0. 4<3. A9
0 -.1
cle
ez, ez/4 7
ia
saelv J0,41,9,4wee
V
-� e
x4s""'
I r'�5"
A J*S6
0 %3
Ile, lk -
TV
�11 D- ev'1'77`1�v
!t4z '1'V z I've
............
4"'r
(ro e.- 'felw-o I "e':2) %
AW �4�ff. 0z
'CX' x X7 2r,
I-C'
07 W /so. 00 '1- J, to
.0-9 0 -1.9 .3e. '0 n'
-dt�rzow'e e)(15711VS 1101-16,6 410 e 15e 0e7A::11L
A/. 7" 5.
AU G '9
Subdivisio
Services . ERMIT MINTER
Incorporated
Zoning: R6
Lot Area: Lot I 6269.square.feet CITY OF EDMONDS
Lot 2 6269 square feet P. W. DEPT. ENGINEERING DIV.
EXAMINED
By om DATE-7- f 1-91
Setbacks established per City of Edmonds
Community Development Code 16.20.040A REMARKS
No foot c MTHIMIZED
FOR RECORDING
CITY OF EDMONDS
22727 Highway 99 - S' tq
778-15551 e
Edmonds, M 020
L �8
RE
0��I,tlH L
0-s
to
I..ejw I I i �;
te
fA L
LOU
� .Ww, I . . .
I
SEC. 249T.27N.jR.3E.,W.M
Ui J01
LL
Jv. 7e ry
.LLJ
55MW
el? AV
Aj ---------
)wner: Carol Rogers
)wner: Carol Rogers
628 Giltner Lane
Edmonds, WA 98020
�pplicant:
Dahl Homes
9218 224th St. s.w.
Edmonds, WA 98020
ontact:
Rosemary Lowman
Subdivision Services, Inc.
22727 Highway 99, Suite 110
Edmonds, WA 98026 -
urveyor:
Western Surveyors, Inc.
13000 Highway 99 South
Everett, WA 98201
! K_ _5� r
Giftler V d119 JF'36 jV W
0 C.O.
7�
r3�7 .'; ...... '0 �W/T
M, I
1h
%
L__7
lts
ZAo'OFZ
106C
COMC. - - - - — -;'- --,5X1,571A1O'O .. e..Je
�Oea<___4 I... ilrode'femw
O64;O=Oez11r
eX15r1oOVG A101-15e
Subdivisioii
Services
In ftf-rhfiff- Carl
aning: R6
'rea: Lot 1 6269 square feet
Lot 2 6269 square feet
ztback-� established per City of *Edmonds
T)1*Vc%1nnm,,nt- rnAP 16.7n.nisnA
Lane
RS F707
AA 1
lex 15 r~6;
Oz AIR 1
4eyrzome -X/57//Va llael6e
Random Elevations shown
r-Na-5- _foot contours exist
I W_o
VC,<
402QW(r'—_
SCALE: 1 30
N
DATE,2-4-91 It
0
O(P 27 WAf. -
i . '9� Go � 5�
'�E 0 0
cle
7 re, V,
Tk 7'
"V
22727 Highway 99 "Suite #110 -Edmonds, WA 98020
778-1556 - FAX 774-5999
'>/ -jo
1. &C A191-0 1rCAA:5rA'C-_ = -5
Max. Z6,14 40perLY&
44C
lit'ZI - , . ///- .4 X ,
STREET FILE
�ITY OF EDMONDS
RECORD OF SHORT SUBDIVISION
This is to certify that the properties as shown on the attached map (Exhibit
"All) and described as follows:
See Exhibit "B"
have been divided under the provisions of the Edmonds Subdivision Ordinance
(Sec.12.10) File No. S-4-91 subject to the following conditions and
requirements:
1. Exhibit "C" Hold Harmless Agreement
2. Connection to City water, sewer, and storm sewer will be required with a
building permit on lots 1 and 2.
3. An on -site detention system, underground wiring and excav
per the UBC, Chapter 70, is re quired with a building per E
P ' VV.47�&Wt I
EXAM114LD
BY
REMARKS_gj�4
I/we verify that I/we are the legal owner(s) of the property described
above. I/we warrant that all representations are true and correct and
understand that in the event of any misrepresentation or failure to comply
with the conditions and regulations set forth herein, the City of Edmonds
shall have the right to declare that subdivision void and record a statement
to that effect in the Grantor -Grantee's Index in the office of the Snohomish
County Auditor.
SIGNE
STATE OF WASHINGTON
ss:
COUNTY OF SNOHOMISH
On this day personally appeared before me
to me known to be thd`-1 ndivi duals described in an
and foregoin$ i.nstrument, and acknowledged that -
same as 16�� free.and voluntary act and
all^ Acac tharain ment oned.
LR
AUG 2 8 In
PERMIT CounTER
aa,,/
wh xecuted the within
I —, signed the
eA, for t uses and
r r
Given under mY hand and official seal this .L�day of 1 gfz.
1 11 C7-
AUTHORIZED
)R RECORDING
Y OF EDMONDS
5 r
Z
.Nota�Y Public In an or the State
.of Washi�g I ton resid Ing t
10
My ComMISSION EXPIRES 3-1-93
STREET FILE
FILE NO.— S-4-91
EXHIBIT "C"
Owners, and all persons having any present or subsequent ownership
interest In these lands, and the successors and assigns of owners or
other parties having any said interest, hereby agree that the City
of Edmonds shall be held harmless In all respects from any and all
claims for damages for injunctive relief which may be occasioned now
or in the future to adjacent land or improvements by reason of the
construction, operation and maintenance of the drainage system and
hereby waive and release the City of Edmonds from any and all claims
for damages, excluding damage caused solely by an act or omission of
said City and injunctive relief which the owners, or their
successors or assigns, may themselves have now or in the future by
reason of the construction, maintenance and operation of said
drainage system.
N.
a
AUTHORIZED
FOR RECORDING
CITY OF EDMONDS
BY
PAGV 2- OF 5
AUG
-PERMIT Coy�ITER
CITY OF EVAONDS
P. W. DEPTI� ENGWIEE17�ING Div.
EXAMINED
BY
REMARKS ----------
STlr-",EET FILE
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STREET FILE
7
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CITY OF EDMONDS
USE
ZON
PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION:
OWNER NAME/NAME OF BUSINESS
JOB
ADDRESS
SUITE/APT
DA H L H on.-\Q
LEGAL D SCRIPTION CHECK _IVISION NO. _0
JSUBD LID
Z
MAILING ADDRES
--
11 V �,2
, *
COW,
J
0
Ealmond3 WA t,
CITY ZIP TELEPHONE NUMBER
PUBLIC RIGHT OF WAY PER OFFICIAL STREET M-AP. TES�,,� App,,�,d [:1
EXISTING Z?_2 REQUIRED DEDICATION RW ermit Required ll�
'>O
Edynond-s 29ozol 6 702<1 0,q
NAME
PROPOSED
Street Use Permit Red d
Inspection R quired
Sidewalk Reqe X,
uired 0
Roe\ j6V\1\50f\
REMARKS
Z
'W1
ADDRESS
W
j9t()j �ji AID Lki
ke
a
ac
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CIT LJ�LEPHONE NUMBER
-1
Z
w
r gZIP 7
_Se 14k 9 /I_ F��41 4 - 2 T
NAME
cc
A A
ADDRESS
ENGINEERING MEMO DATED
REVIEW By
Atd�l
0
METER §IZE IBUILDING SUPPLY SIZE NO. OF FIXTURES
CITY ZIP NE NUMBER
yr I
/ 11 1
cc
w
Z
0
L)
REMAR
'1
STATE LICENSE NUMBER
:22 L R='
nARL_- WE' ftl.0,5'
Legal Description of Property - include all easements
AL SIGN AREA SEPA REVIEW ADS NO.
PROPOSED COMPLETE EXEMPT
k'A-TrA L 14 G [_'�s
SHORELINE #
EXP
Zo
VARIANCE OR CU
PLANNING REVIEW BY DATE
SETBACKS — FE
HEIGHT LOT COVERAGE
FRONT SIDE
FAR
R / _9.(_
Z
Z
Tax Account Parcel No
REMARKS
WQ
[P�NEW [�i�RESIDENTIAL PLUMBING
F_/Z 0AI T- 5,,i= T
RA e-k- /I/,.
D ADDIALTER El COMMERCIAL 17 MECHANICAL
, i
9
—
1:1 APT. BLDG. El
L7 0 f A le yea 7-
Alz
REPAIR SIGN'
GRADING FENCE
CHECKED BY TYPE'OF
CONSTRUCTION CUBE HEIGHT
DEMOLISH CYDS. (-- x _FT)
I =—Al ele 2S_1
CARPORT
GARAGE swim
E] REMODEL POOL
-
ECIAL INSPECTOR
OCCUPANCY
I OCCUPANT
AREA.,
ElWOOD STOVE/ r7 RETAINING WALL/
INSERT RENEWAL
REQUIRED S "I
OYE
GROUP -2 LOAD
Z
0
ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
REMARKS
PROGRESS INSPECTIONS PER UBC 305
uj
NUMBER OF STORIES NUMBER OF
7AheemW
DWELLING
UNITS
0
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
0A FR
'FINAL INSPECTION REQUIRED
VALUATION FEE
67M 61.,f ZW6
PLAN CHECK FEE
BUILDING
dcl
PLUMBING
4-3
Plan Check No
This Permit covers work to be done on private property ONLY.
,.Any
MECHANICAL
GRADING/FILL
2
Z3
construction on the public domain (curbai sidewl?lks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within I 'r 80 , Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
STORM DRAINAGE FEE
ENG. INSPECTION FEE
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
.F
employees, and agents from any and all claims for damagesof
a:
<
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
57�'
modify, waive or reduce any requirement of any city ordinan - c4,
0
:r
nor limfi in'any way the City's ability to enforce any ordinandd.
j AMOUNT DUE
prOVIS ion."
,6,�L
ZL
I hereby acknowledge that I have read this application; that tA
information given is correct; and that I am the owner, or the duly
ATTENTION
APPLICATION APP*ROVAL
authorize'd—aggn/t of the owner. I agree to comply with city and
THIS PERMIT
state ia%Wj�regulating construction; and in doing the work authoriz-
AUTHORIZES
This application is not a permit until
ed thereby, no person will be employed in violation of the Labor
ONLY THE
signed by the Building Official or his/her
Code of the State of Wash' tomelating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
UTance. - - 7 � - .11 * .
INSPECTION
acknowledged in space provided.
IGNAT RE (OWNEI�01,14 DATE SIGNED
R_ R I
DEPARTMENT
OFFI?�IA 'S �SIGNATU E DATE
&EN
CITY OF
EDMONDS
o3 Flo 7.
ATIENTION
CALL FOR
4E: LEA By.
IT IS UNLAWFUL TO USE OR OCCUPY A BUILD.ING OR STRUCTURE
INSPECTION
74e�� c� 7
I
ORIGINAL — File YELLOW — I
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-3202
A CERTIFICATE OF OCCUPANCY' HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK — Owner GOLD — A_q.-n_q_qnr
NOTE-5
I. FIELD LOCATE ALL, UTIUTIF,5
CALL, 1-800-424-5555
48 HOUR5 BEEF0Re0IGGIl-4C-:y
pl. LAY DSTEC�T WARNINO WIRS
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