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639 ELM PL
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
HOMELAND HOMES, INC.
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LU MAILING
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I ELEP11 H �CNE NUMBER
CITY 0
EDMONDS ::�75 - 2 0 3 3
NAME
DESIGN CONSULTANTS
Ow ADDRESS
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903-10th STREET
TELEPHONE NUMBER
ITY --L���7 47�
4C MUKILTEO -656�9;�
NAME
HOMELAND HOMES, INC.
ADDRESS
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0 221 JAMES STREET
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4 TELEPHO R
NE NUMBE
CITY
775-2033
z ED�MONDS
S s T s
TATE �LICENSE NUMBER
HO ME LHI-*174KE
FTL,,egal Descwrlptlon of Property - include all easements
,. elo (
-qhg,ow below or attach four copies)
Lot 21, PlaT OF ELM PLACE
ZONE
DIP
ADDRESS
639
LEGAL DESCRIPTION CHECK SUBDIVISION NO. ID
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING EQUIRED DEDICATION
PROPOSED
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
STREET USE PERMIT REQUIRED D
R
SEE ENGINEERING MEMO DATED
'ej
REMARKS xj
Y SIZE IFIXTURE UNITS
REMARKS
SIGN AREA ENV. REVIEW ADB NO.
ALLOWED PROPOSED COMPLETE I EXEMPT g_
HORELINE
VARIANCE OR Cu PLANNINU KtVit" 0� DATE
- I I 1� il�,�� �I 71 1
YARDS - :: :I III LOT COVERAGE
FRONT SIDE REAR=
NEW
rv-1
i��J RESIDENTIAL
ING
PLUMBING
PL U M B
ADDIALTER
El
COMMERCIAL
0
HA NCAL
MECHANICAL
M E C
REPAIR
DEMOUSH
El
11
RETAINING WALL
EXCAVATE
OR FILL
SIGN
FENCE
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CHECKED BY
C
REMODEL
WOOD STOVE/ R
INSERT
INSPJ
APT.BLDG
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swim
L
W L
RENEWAL
SPECIAL INSPECTOR
IRED
REQUIRED
0 YES 0 NO
REMARKS
NUMBER OF STORIES MBER OF
I DWELLING Single
Two UNITS
==::M::
NATURE OF WORK TO BE DONE (
Construct single family dwelling
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work t e done on pr vate property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
d ivew ys m rate permission. STATE SURCHARGE
riveways, marquees, etc.) will require sepa
Permit Applica tion: 180 Days ENERGY CODE
Permit Limit: I Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns an6
successors In interest, agrees to Indemnify, defend and hold
harmless the city of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
—i.i— m,antiv nr Indirectiv from the issuance
OCCUPANCY OCCUPANT
GROUP ILOAD
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'FIR S T
ELM PLACE
A PLANNED RESIDENTIAL DEVELOPMENT
POR. OF NW 1/4 SW 1/4 SEC. 25, T. 27 N., R. 3 E.,W. M
DEDICATED AS R/W EDMONDS, WASHINGTON
7_ ----------- NE CORnEk
m S r
Is
NE 1,/4. t 1/4.
201 84 0
so /4
so To
4.4 TRACT 102 'o
$4.4 2000. id
A 3.94
20
21
X C
PTJON
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29 22
a ad-J.'ar" IT
18 150 r.
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TRACT 102 16
bu
7 NOTES:
Ila PHU ARE AS DEPICTCD IN THE
L CASEmENTS AFFECTING THIS
DIECLARATIUN OF COVENANTS, CC"DITIONS AND RESTkCTiOuS
o A L C 50
Sc
AS FILED UNDER A.F NO.-
3a SETBACKS HAVE BEEN SPECIFICALLY DETERMINED AS 10 FEET
2.
-I_; Soecalrf FRONIYARD AND ZERO FEET SIDE AND REAR YARDS WITH THE
11)"ONDS.
APPRO\AL Of P.R.D. NO, 1-83 111 1111 CITY OF
E 1� c p T I D 114
c, n SAN , SWR.
- I - - - - - - - - - - - - _a WATER
.3 go___
147QQ UTIL TY
TRACT 103 E
ASEMENT
1, sJ.c.0 SO.- -------------
.'aANTE
-1. CI 0 TO THE
8 4 TY OF EDMOnDS
2 a OLYMPIC VIEW
50,30 5000 -WATER DISTRICT
3 a. 00 . . '. E TRACT 102
4.4, -1
5
A FR A D I SEE
JRVE DATA SURVEYOR'S CERTIFICATE
Ul", WILTS LE1,iGTH CURVE DELT4 RADIUS LENGTH 1. LeRoy F. Mlddl,toh, I
1.11,41 do h."Of
133.43 83.73 23 26*41'56" 17.00 7.92 d' ,o. ., cti.. R), 'i., I
90.00:00- �7.00 26.70 ZS4 2 3'06'23' 44,50 17.95 nen t i m tcen set and lot crncr% %*ed on tht qr,�M
11 t;6. I DO S.C8 2 533:07 44.10 4S1.26 at sho�h hereon.
1:45: 1
9 28 CPO 35 , 08 26 3 0 32 0.00
22* 1 1 54 !03 15 40,14 7 26-41:�11 0.00 .67
00 15 1 4 '.. a 1: 7.00 53
90, 00. 10 , , 71 28 144
11 50 13 w ?1 41*25 55, SO.00 37 9()
i a
M.47 17 , 23 )0 10*50 52* .9"." 18 89 �dj.'tc.. ,,I
.4
90*��'. C.). 0 7 .0 31 26*2 ' 99.711 46 DO Rmi�ter-d LJ 'yor
WS, 33 0 22 46 32 11-15-36- 17.00 22 92
11 , 11
11� Is 33 00 . 011), 455.00 1 g.,
34 3 59 W io.00 24.26
Go: D - 77.50 70 34 35 41 1:32: 7.00 3.3� IIA
1 :5
0 36. 14 36 a " 34 �0.00 1.3
la.w 3,15
LEGEND
,.SQ
1 S. �10 18.12 38 90,00,00, 31,42
1?.00 - *3 19 11:110:04 7.00 2,137 015TING CAS-D MCNj,10�7
W.S. 17. W �11.sl 40 to, 19 1 1: �0.10 �8. h
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PFAWECT REVIEW CH]XTLIST ILI
NAME. PROJECT ADDRESS: zxm wee-
J�
Reviewed by:
(initial/&
cct4mE3m
PrAimn4G
WrR/SWR
SIREET
ENGNMr.'
G
tFIRE,,
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sn4GLE'FAmnY/mmTlPLE/Ca4-fETCT.AL ��(Cir6l:e. One)
BUILDING,
SETILAJCKS CHECKED P ing
7
VARL*=/SMMCK ADJ-
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CONDITIONAL*USE PERMIT Q, f , �,
77T7777/7
ADB REWIRDOM clinc�
47177
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CMER ZaSiING REQUIREMENTS W///
777777/7
i!�RaZ(ENTAL FEAnJRES
77 7 7 P
7T/T/7
77M71
ACCESS SWPF VEHICLE ACCESS
-17TI-I 777
77
7777TR7
DRAINAGE PLAN (On Site)' 1W,44jWlj
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STREET FILE
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LEGAL DESCRIPTICN VFRIFICATION
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QUIT -CLAIM/DEDICATICNS
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CALCULATE iSLWER coNNECTi .IF NO'LID#
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�SOILS.'CCNDITIMIS 4 GROUND.
.WATER FIEfD OW
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STREET - PAVIW, REQUIRED,
7T77
77 TIT17
7777TTIT7
=*/7F/
CURB AND GUTTER REQUIRED
IITITT17T
7777
7T17TF177
TFR77777
SIDEWALK RKOIRED.—
cuRH CUP FOR DRIVEWAY REM
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//////
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S,TREET NAME SIGN REGO
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(MIER STGNTNG REC)D
SIDE SR4ER AVAIWILITY
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EXISTIN�G WIER MAIN SIZE
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WATER METER SIZE
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SERVICE LTNE SIZE
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HYDRANT REOUIRED
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HyDRWr SIZE EXISTING
CFOSS CaqNECTICN INSPE)CTICN REM
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/////////
VaTER METER CHARGE REOD
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FIRE'LINE CHAhGE REM- SPRTNKIJ M
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opEN DITCH EXISTING -
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#2 a2l -744/f,5 ST. szII7-,E /00 E2)JIOAID
EL " PLq CE LOT 21
PO 9) 0 F A-1 W Y4 -- W Y4 X f- C. 2 5-,
T. 2. 7 AJ. ) k -3 C. WA-f
E D "V A).D S 5 w,,Q. 9.? 0 .2 0
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- 7 Z: L-L-T-R--
jr5,/Z,/.k> C A -7
HEIGHT CALCULATIONS
datum= o.o(top of storm C/
east of site)
corner
orig elev.
dat
#1
227
-3
#2
234
3
#3
226
-4
#4
215
-15
Allowable Ht.
— -21.64/4 = -5.41
#3 +25.0
19.59'above dat
SC19L E /0 TO Z� 2210
8 9 0 - 1 9 C) -
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city. , ofl�dm
RIGHT-OF-WAY CONSTRUCTION
'IT
PER Permit Number.
0a
Wue Date:-,/, /3 - 2 &
A. Address or Vicinity of Construction: ---639 Elm St (9607253)
B. Type of Work (be specific): install Seryfte
C. Contractor: -Washington Natural Gas
Mailing Address: 1122 75 St SW Everett
lqtzatp I _ir�-nqp. 98203
D. Building Permit # (if applicable):
Contact: -Mar:Lamne Kingsbury
Phone: 15,6-7500 ext 7596
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. E) Commercial Ej Subdivision El CityProject [0 Utility (PUD, GTE, WNG, CABLE, WATER)
E] Multi -Family El Single Family E] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut 0 Yes [NNo G. Size of Cut: / x H. Charg!�,$
_77
APPL'ICAN-T TO- ]READ ANOSIGN
INDEMNITY: Applicant understands and by his signature to this applilrati,n, agrees to hDl� the City ofFdmondg harmless.frqn�injuries, damages, or
I
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or an; -of its departments or
employees, includingor not limitedto thedefenseofany legalproceedings includingdefc�7 -8ts, andattorneyfees by re—onofgrantingthispermit.
,.% ) 1� I '?- "I el
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 COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construedon 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.
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.
Iha ve read the above statements and understand thepermit requirements and the pink copy of thepermit will be
available on s * e? 11 ',nesforinspectVin urposes.
,Hata �n
Signature: 011, Date: 02-08-96
,_,f0ntractoi?G-r Ag_e?i_tf I
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: 1__', RIGHT OF WAY
TIME AUTHORIZED: VOID'AFTER !JIFAe- 'P
—DAYS DISRUPTION FEE/
SPECIAL CONDITIONS: ty RESTORATION FEE:
NO WORK SHALL BEGIN PRIOR TO'PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES
I Comments:
r
I Diagram
(Fund I I I - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION C1 YES E] NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
M
G-OaA�
AVAzhnglon ErvrWCbnip&v
G39
Vatermain depth
gas main
Addendum to:. City of Edmonds
Right of Way
Permit Application
Submitted by: Mari ' nmne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
Q-
V)
N
LL " '��>-F
960 -/Z 5
15t- �� 67-
0 AJ
Key:
-W- Water
-G- Gas
-SS- Sever
e, Water hydrant
0 Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
1
. 890 . 194
STREET FILE
CITY OF EDMONDS
250 - 5th AVE N. -EDMONDS. WA 98020 - (206) 771-3202
COMMUNITY SERVICES:
Public Works o Planning * Parks and Recreation 9 Engineering
July 21. 1908
Elgin & Helen Cathro
639 Elm Place
Edmonds, WA 98020
SUBJECT: TREE REMOVAL AT 639 ELM PLACE
Dear Helen:
LARRY S. NAUGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
Duane Bowman and I visited t-he right of way aliung Elm and 6th Ave. to
disc-uss removal of the requested trees. The maple you requested to
remove shall not be cut at this time. The other wild cherry may be
removed and replaced by rhododendrons. I will be glad to visit the
site with you and go over what may be removed. Again, if you provide
the necessary information on removal of the fir along your north
property line, we would consider removal approval. from the city.
Although you may have some restriction through your homp owners'
association.
'Sincerely;
Bobby Mills
Public Works Superintendent
BM/sk
'Ff3EEREM/TXTLMK141 0 Incorporated August 11, 1890 *
Sister Cities International — Hekinan, Japan
Ef9in & clValan Catfiw i UL
6 3 9 Efm -"Pfa cE attle Sales Division
Ed(mondti, 98020
TTLE, WASHINGTON 98134
Al
CITYW EDMONDS
Water Department
501 Bell Street
P.O. Box 2008
Edmonds, WA 98020
206 771-0241
RECEWED
J U N 1 0 1996
PUBLIC WORKS DEpI
AFFIDAVIT OF �QUALIFICATIONS FOR A
REDUCTION IN WATER UTILITY BASE
RATE AND SEWER UTILITY RATE FOR
LOW INCOME CITIZENS
I hereby apply for a reduction in Water Utility Base Rate and Sewer Utility Rate as provided
in RCW 74.38.070 and Ordinance No. 2805. This discount will only apply to the period
ending June 30, 1997.
Name
Casf First Middle Initial
A.
Address Telephone No.
B. I own-1,k Rent _ my place of residence.
C. I do Do not reside in Federally subsidized housing.
D. I do Do not file an income tax return (Form 1040).
-IF YOU FILE, PLEASE ATTACH A COPY OF LAST YEAR'S RETURN
E. Household income for the preceding year:
Applicant adjusted gross income $ 7
0 a
Spouse/Co-Tenant adjusted gross income
Total :;z
1 k�-, A k)
Applicant
4'
2.
Spouse/Co-Tenant Security No.
By signing below, I do hereby certify under penalty of perjury that the above information is
true.
. ........ .. 07,
Signdlt'64 Date -
,firApplicant
(SEE REVERSE SIDE FOR INFORMATION AND INSTRUCTIONS)
0 0
INFORMATION AND INSTRUCTIONS
FILING PERIOD: The application for a rate, reduction.,must. be filed. annually with the
Finance Departm-ent'prior'to June 30 of e . ach year..' Any filing after June 30 shall apply only
to those utility statements mailed after the date of filing and shall not be retroactive to June
30 of the year of filing.
ELIGIBLE HOUSING: At the time of filing the application, the person must reside at the
address. Persons in Federally subsidized housing ARE NOT eligible for the discount.
QUALIFICATIONS: "Low income citizen" is defined as a person whose total adjusted
gross income, including that of a spouse or a co -tenant, does not exceed the amount stated
in RCW 84.36.381(5)(b), which is currently $14,000.
Low income citizen RATE REDUCTION (water base rate and sewer rate)
Total combined adjusting gross income: Less than $14,000 30%
Less than $12,000 50%
If you file a tax return, attach a copy of all individual income tax returns (Form 1040), for
those persons whose income is included.
SIGNATURE OF APPLICANT: The application must be signed by the person entitled to the
discount. In the event that person knowingly makes any false or misleading statements in
the application with the intent to secure the discount authorized by RCW 74.38.070 and
Ordinance No. 2805, he or she shall be guilty of a misdemeanor.
If you need assistance, please call Ilene Larson, at 771-0241, Edmonds Utility Billing
Department.
Utility Billing Department
501 Bell Street
P.O. Box 2008
Edmonds, WA. 98.020.
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