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642 ELM ST.PDF642 ELM ST APPROVED BY PLANNING qz- Adoa JUN 15 1995 PERIWITCOUNTER ELM STREET EXISTWO CLL-OE-SAC SITE PLAN Le A S. (.0 Avow. 40-- f 9g.b-5" gq.,v Ar-'W" f4r -- 11 Moobl' +49.ir Ao-w— #+r i zq.03, rr Date: Octob*r_lp 1968 to: John E. Noran Director of Public Works From: Leif R. Larson City Engineer Subject: Sewer Connection Charges Legal Description: That portion of Sec. 259 T27l R.3E W.M. described as follows: Beg. at t�a NE cor. of E 1/20 NE 1/4, NW 1/4, SW 1/4; thencis S 1009030"W 20 ft.; thence N 88 10030" W 30 ft, to POB, thence con. N 8801813011W 150.78 ft.; thence S 101105011 W 97 ft.; thence E 150.78 ft. less the East 75.39 ft. of said described property. Commonly Known as: 642 Elm Street Owner: E.G.M. Erikeson Z.F.F. Calculation: (66.35 ) Z.F.F. x ( $5.50 $ 364.93 Connection Fee � .1 ) Unit x ( $25.00 ) le $ 25.00 Trunk Charge $ 10.00 Permit $ 399.93 TOTAL City Engineer The City of Edmonds �11F WIN 01, ujv,/, .j 40000 U. Lu ul cl) APPLICATION for SIDE SEWER FERAM BASEMENT No. NEW CONSTRUCTION 0 REPAIRS Cl CONTRACTOR'Z4/ LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ..... NAME OF ADDITION ......... a -------------- ....................... .4 00 Approved: DATE ... ........ By .............. P Date: October 1, 1968 t'lemo to: John 1, Mloran Director of Public Works From: Leif R. Larson City Engineer Subject: Sewer Connection Charges Legal Description: That portion of See. 25, T27, R3E W.M. described as follows: Beg. at t 8 e NE cor. of E 1/2, NE 1/4, NW 1/4, SW 1/4; thence S 100913011W 20 ft.; thence N 88 1023011 W 30 ft. to POB, thence con. N 8801813011W 150.78 ft.; thence S 101115011 W 97 ft.; thence E 150.78 ft. less the East 75.39 ft. of said described property. Commonly Known as: 642 Elm Street Owner: E.G.M. Eriksson Z.F.F. Calculation: (66.35 ) Z.F.F. x ( $5.50 $ 364.93 Connection Fee ( 1 ) Unit x lc to $25.00 $ 25.00 Trunk Charge 10.00 Permit 399.937 TOTAL City Engineer IC C ''OF EDMONDS ITY­. Can- PRospect 6-1107 when work .CIVlC--_CENTER,-WATER-SEWER DEPARTMENT Is ready for Inspection. (No Inspe!, lions Saturday, Sunday or holidays.) 3133 N2 SIDE. SEWER'PERMIT ADDRESS....... �Y�J�1.m ... S.t.r.e.e.t ............................................................................................. . ............................................................ P ............ B...q.M.4 ... Erdk;a8.Qn .......................................... CONTRACTOR ........ VQ.Q.19Y'j��..Rip ft.j� ... �.Qvpr ................ Perixils'sioft- Is granted .......... O.c.t.o.b-er ........ 10..., 19.68.., for ........................ days. to REPArR or CONNECT a side sewer -.'*Ith, City..Sewers In accordance with application on file and -governing ordinances. ATTENTION ISCALLED TO THE FOLLOWING: ]�OTE, No.. 1—The, owners of the property*may obtain a permit to construct sewer inside property line A licensed Side Sewer Contra r must ­:, � , - eto be employed to construct side.sewer in street area. Do not cover any Portion of -sewer bef*ore it has been Inspected. .—NOTE No. 2—Obtaln' full. Information regaxding Ordinance 11.16.030 and Re'gulations governing side sewers when you get permit. 0TE No. 3�Top of side'smer must have at least 30 Inches coverage at property line and 12 Inches de Property line; minimum grade of 2%. No.bends in grade sharper than % will be permitted Insf NOTE No. 4­�Treroches in Street must be water settled and surface of street restored to orl I ginal condition. Contractors shall be responsible for failure du6.to Improper work :which may develop within one year of completion. NOTE No. 6�lt Is unlawful,to alter or do any other work than is provided for in the permit, or -to do any work on the main sewer or Its appur- tenances except to Insert the pipe Into the wye. 0 STREET FILE Date: October 1. 1968 Heino to: John r— �L'Iloran Director of Public Works From: Leif R. Larson City Engineer Subject: Sewer Connection Charges Legal Description: That portion of Sec. 25, T270 ME W.M. described as follows; Beg. at the NE cor. of E 1/29 NE 1/4, NW 1/4, SW 1/4; thence S 100913011W 20 ft.; thence N 88'1013011 W 30 ft. to POB, thence con. N 8801813011W 150.78 ft.; thence S 101115011 W 97 ft,; thence E-150.78 ft. less the East 75.39 ft. of said described property. Commonly Known as: 642 Elm Street Owner: E*G.M. Eriksaon Z.F.F. Calculation: (66.35 ) Z.F.F. x ( $5.50 $ 364.93 Connection Fee Unit x $25.00 $ 25e00 Trunk Charge 10-00 Permit $ 399-93 TOTAL le City Engineer e7 ZI- -Ile It It P:7PT. C.U7, LIST L trce t Pir Existin MOD Access Eascinmits Exi-�tinp 9 r5r- Utility Eascinont Existing RED!) Lot Por Su�)div4sjon5— Assessor Plat Sitc Plan nic-c!:ed for Accuracy u), Uncicraround !1cod. RON, tu., . Uv !)atc t;?A L'atcr :"ain .—ircd Hv(11-an" .)I Z(' nctectnr ("Ice: '"C', tor P.Ccl"i"Cr! r-jr,c ........... .. C 'I"aill: S,,�ptj.c Iny"it Pcouil-od o sidc Sm dlabi -er Corn -Co 1,10(mirc(I cction Culvort Pool 0 Catch DIF�in Oufmi rod -Ch P 1-0 v, 11,11,11,11c, required 41 ition soil Co d1l"Op ---- lbtc cnni 11ro.i File '.'o. S S ize n n It -i a c 111dica ;1-01111(1 1-�'ater Hold (1oc,x(I --Rite rn M- -n m mw S trce I.1ving, 1"Cquircd ftirb wid (',,i-Ltcr i i i. rc Sida'alk Pcouired Cur`b nut for Privc,_,av Rcquired rcd Pinlit-ol-Wav Construct i Oil I ­11't Reold Bond Rcquirc(l_'Si�- �11)iic Improw-,ents T. 1 (2 Sion Rcmlircd O'licr Si-1 iri, R nui 3 c! 'C C, I)rc --it Sitc Inspcction nocic oil itc ;2i SCwC. U It Water St-rcet spocj�!!. PC";I;iroi-,cnts listed in me-.') to T)ate 4 1 A-11 itc;�ls filled in oil JIC',-,,yjjt �pnlj.CItion P"Itc 22-1 C; mndi ".btations By nat(� r_ r_ PCIMIT)IRCIA STREET FILE CITY OF EDMONDS HARVE H. HARRISON MAYOR 200 DAYTON ST. o EDMONDS, WASHINGTON 98020 * (206) 771-3202 OFFICE OF THE CITY ENGINEER March 10, 1982 Mr. Wayne Tanaka Ogden, Ogden & Murphy 2300 Westin Building 2001 - 6th Ave. Seattle, Wa. 98121 Dear Wayne: SUBJECT: PROPERTY LINE DISPUTE 638 ELM STREET The attached letter was received last June, and it appears that we never answered it. Please advise. Sincerely, *A-'--�� , P. E�.� i S E. AD P. E. y V Engineer JEA/st Attachment 4okd�a­MaochA Dt W 0 Ms. Mary Lou Block Director of Planning City of Edmonds 505 Bell Street Edmonds, WA 98020 Dear Ms. Block: 0 638 Elm Street Edmonds, WA 98020 May 21, 1981 L D JUN 8 1981 Dir. Of PuWic Works This letter regards the placement of a rockery/fence at the east side of my property. The properties involved are: My own, at 638 Elm Street ("638"); and that of my neighbor immediately to the east of me, at 642 Elm Street ("64211). It is clearly visible that the rockery, which begins near the street, veers to the west (into my yard) as it progresses south. At a point at right angle to the front of the neigh- bor's garage, the rockery joins the fence (cyclone). The rock- ery and fence were place there in early 1979 by the previous owner of 642, Mr. Blowers. Mr. Blowers and I discussed the fact that the rockery/fence did not follow a true course south, so he was aware of my disagreement with it as the property line. I have today spoken with the present owner of 642, ('Vic') stating my disagreement with the rockery/fence as the property line, and told him of writing a letter to that effect to the City of Edmonds. Until such time that I, or the owner of 642 (which is again for sale) choose to have an accurate survey made, I do not wish the rockery/fence to be removed, nor to change the manner in which our adjacent yards are being used; only to place on file with you a formal record that I do not recognize the rockery/fence between 638 and 642 as the true property line. cc:Owner,642 Rainier Mortgage Snohomish County Very truly yours, Clarann Lasic Ballard 4 CITY OF,EDMONDS PUBLIC WORKS EMINEERING, STREET ACTION REPORT 1.929 - SUSPENSE DATE: Date: .5 Time: File # PHONE: REQUEST RECEIVED BY: TELEPHONE CONTACT IN OFFICE r RECEIVED BY: Pni]TF Tf)- smw�M �MMMM sm MM uw����MMMM arTTnN. All Concerned Notified w. Action Completed/File GFr-, 0 0ECENED STREET FILE CITY OF EDMONDS CIVIC CENTER * EDMONDS, WASHINGTON 98020 - (206) 775-2525 CITY AT`TORNEY Ms. Clarann Lasic Ballard 623 Elm Street Edmonds, Washington 98020 Dear Ms. Ballard: March 24, 1982 MAR 2 5 1982 Dir. Of Pbblic W00NARVE H. HARRISON MAYOR Re: Prcperty Tine Dispnte w.ith 642 Elm Street After some time your letter of May 21, 1981 has wound its way through the Planning and Public Works Department to my desk in the City Attorney's office. Your letter describes a property line dispute with your neighbors, the owners of 642 Elm Street. . You very clearly state that the true property line is not rep- resented by the rockery which veers into your yard and does not follow the true property line. I understand that your purpose of writing was to formally register your belief that the rockery is misplaced and that it does not represent that true property line. The City of Edmonds acknow- ledges receipt of your letter, however, I would point out that Edmonds is not entrusted with the task of keeping property lines straight and titles clear. This is a job which has been delegated by state law to the Snohomish County Auditor. I notice that a copy, of your letter went to Snohomish County, however, to make your record a permanent one you should be careful that your notice of disagreement is filed with the County Auditor and attached to all other documents pertaining to the property located at 642 Elm Street., If this.is properly done, a subsequent purchaser will have notice of the disputed property line before he or she purchases that lot. If you have further questions regarding the necessary steps to preserve your rights I would advise that you consult a private attorney. MAE/ka cc: Mary Lou Block, Jim Adams, City Very truly yours, OFFICE OF THE CITY ATTORNEY z ":" e��4z�� Mark A. Eames Director of Planning Engineer .11. -� - I � 4. CY 9 0 - 1 9 4 - City of Edmonds STREET FILE W6WX%QWAY CONSTRUCTION j A% 2 4 1992 PERMIT ENGINEERING Permit Number: - oaz,.. I ssue Date: f- A. Address or Vicinity of Construction: - 642 Elm Street B. Type of Work (be specific): Install NEw Service C. Contractor: -Washington- Natural Gas Company Mailing Address: 815 Mercer.Street, State License #: Seattle, WA 98111 D. Building Permit # (if applicable): Contact: Frank Swan Phone: 224-2278 Liability Insurance: Bond: $ Side Sewer Permit # (if applicable): E. 'r! Commercial El Subdivision F-1 City Project FX] Utility (PUD, GTE, WNG, CABLE, WATER) F1 Multi-Fan-ffly F] SingleFamily F� Other JNSPECTOR: INSPECTOR: is V\J F. Pavement or Concrete Cut [I Yes FK]No G. Size of Cut- x H. Charge$ APPLICANT TO READ SIGN INDEMNITY. Applicant understands and by his signature to this application, agrees t o the City of Edmonds harmlessfro4 injuries, damages, 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 attorneyfees by reason of granting this permit. THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP AND MA TERIALS FOR ARERIOD OF ONE YEAR FOLLO WINP TrFIN AL INSPEC17ON AND ACCEPTANCE OF THE WORK ES77MATED RESTORA 77ON FEES WILL BE HELD UN77L THE FINAL STREET I rCH COMP28TEDBY CITY FORCES, AT 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- 771-3202. 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 SaWy —shal'10e in accordance with City regulations as required by4he City Engineer. All street cut ditches shall be patcIM117with 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 copy of the permit will be available on site at all timesfor inspection purposes. Signature: M 1514A&OAA Date: January 20, 1992 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK 0 NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 FIELD INSPECTION NOTES (F und I I I - Route copy to Street Dept.) 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. Div. July 1985 1. , W WashlngtLn Natural s' AVMI-gton5-WG-X-TV 04-z eLm si- WNG to window Water main depth unknown 12- 11 gas main--- Addendum to City of Edmonds Right of Way Permit Application Submitted by: Kerry Walsh Engineering Aide Washington Natural Gas 622-6767 x2761 pager 969-1686 N �jo ct�- TS Key: 121-� �NA -w- water -g- gas -ss- sewer water hydrant 815 Mercer St. (P.O. Box 1869), Seattle, WA 98111 (206) 622-6767 DESCRIPTIONz That portion of the East half of the Northeast quarter of the Northwest quarter of the Southwest quarter of Section P-3, Township P-7 Northq Range 3 East, W.M., in Snohomish County, Washington, described as followst Beginning at the Nor * theast corner of the East half of the Northeast quarter of the Northwest quarter o ' f the Southwest quarter; THENCE South 1009130" West for 20 feetl THENCE North*881018130" West 30 feet to a point of beginning-, THENCE continue North 88018130" West 150-76 feet; THENCE South101115011 West 97 feeti THENCE East 150,'78 feet to a point which bears South 1009130" West from the true point of beginning; THENCE North 1009130"East to the true pointof beginning; EXCEPT the East 73-36 feet thereof; AND EXCEPT the North 10 feet conveyed to City of Edmonds under Auditor's File - No. 2027837. Situate in the County of SNOHOMISH, State of Washington. 0 CA FILE NO._E4 - / 3'8 Critical Areas Checklist RECOVED Site Informaflon (soils/topography/hydrology/vegetation) JUN 0 9 1995 1. Site Address/Location: &42 ELI-i !STMT 2. Property Tax Account Number: 25'Z70�1-3-001-0-0o4- JUN 2 7 1994 3. Approximate Site Size (acres or square feet): &657to 4SIFi PER 4. Is this site currently developed? -K yes; — no. "T COUNTER If yes; how is site develODed? PLE'SIDEP'nAL - ttOUSE + 42-646— S. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 66-feet). Hilly: slopes present on site of more than 15% and less than 30% ( a vertical 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 distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: Approx. Depth: 7. Site contains areas of seasonal standing water: t%10 Approx. Depth: What season(s) of the year? 8. Site is in the floodway 00 floodplain 0 0 of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- round? I*A 0 Flows are seasonal? f4O (What time of year? 10. Site is primarily: forested ; meadow _; shrubs mixed urban landscaped (lawn,shrubs etc) >< 11. Obvious wetland is present on site: RcY011M4 9 City of Edmonds Critical Areas Checklist The Critical. Areas, Checklist contained on this form is to be filled out by any person preparing a Development Permit Application for the City of Edmondsprior to his/her submittal of a development permit 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). An applicant, or his/her representative, must fill out the checklist, sign and date it, and submit it to the City. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. With a signed copy of this form, the applicant should also submit a vicinity map or plot plan for individual lots of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assist staff in completing their preliminary assessment of the site. I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner / Applicant: -SAL-u� -Yo Me-609-r-LiE Name 642- ELrl S-ra&-T Street Address E�DH040sf WA- C5AO'ZO -7 City, State, ZIP Phone Applicant Representative: Name &4z.. ari --�:-,TeaEr Street Address '60"00!6 VA.1919026 -779-3c,0(o City, State, ZIP Phone 4Signatdr-eZZ �'//V* .--VatWe Signature Date CA FILE NO.-,74 — / 3 6 Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: &42 ELm, -sTmT 2. Property Tax Account Number: 2.G a10-; - 3 - 00-) - 0 Oo4- JUN 2 7 1994 3. Approximate Site Size (acres or square feet): - &66-4.0 "S-Fi PERNiq 4. Isthis site currently developed? --K yes; —no. COUNTER If yes; how is site developed? PLESIDERT1AL - ttOLKE 5. Describe the general site topography. Check all that apply. Flat: less than 5-feet elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance of 66-feet). Hilly: slopes present on site of more than 15% and less than 30% ( a vertical 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 distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: Approx. Depth: 7. Site contains areas of seasonal standing water: PO Approx. Depth: What season(s) of the yearl 8. Site is in the floodway floodplain W 0 of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- round? �A 0 Flows are seasonal? 1�1 0 (What time of year? 10. Site is primarily: forested ;meadow _;shrubs mixed urban landscaped (lawn,shrubs etc) >< 11. Obvious wetland is present on site: Rev0~4 &90 -199- City of Edmon& Critical Areas Checklist The Critical Areas Checklist contained on this form is to be filled out by any person preparing a Development Permit Application for the City of Edmondsprior to his/her submittal of a development permit 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). An applicant, or his/her representative, must fill out the checklist, sign and date it, and submit it to the City. The City will review the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. With a signed copy of this form, the applicant should also submit a vicinity map or plot plan for individual lots of the parcel with enough detail that City staff can find and identify the subject parcel(s). in addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) or studies in coWunction with this Checklist to assist staff in completing their preliminary assessment of the site. I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner / Applicant: -SAL-L.%< 'Yo Me-6op-LI-LE Name 642- F- L" S-rUET Street Address Applicant Representative: Name &4 -7, F-Lri --c-,TwEr Street Address V:DH0t4K3S1WA-0)A0'*Z0 -7 QAUo0!AW4.q13Q26 -779-3c,6Xo City, State, ZIP Phone City, State, ZIP Phone ��� Xii7g—n— Signatdr-e I'// bate ature Date CITY OF EDMONDS USE PERMIT ZONE 11 — � NUMBER CONSTRUCTION PERMIT APPLICATION OB SUITE,APT a ADDRESS <_ OWNER NAME NAME OF BUSINESS 1�� 4 L L. All e LEGAL DESCRIPTION CHECKI SUBDIVISION NO LID NO MAILING ADORESS Z 0 L I -A PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved 0 AW Permit Required 0 CITY ZIP TELEPHONE NUMBER .7 EXISTING —REQUIRED DEDICATION — Street Use Permit ReQ'd 0 /v Inspection ROPOSED Required 0 Sidewalk Required 0 NAME 't) L W METER SIZE LINE SIZE NO. OF FIXTURES PFIV REQUIRED < YES 0 NO 0 ADDRESS ULJ) j. REMARKS cc < W W Z CITY zip TELEPHONE NUMBER Z NAME -rq L L,`c- L1,71 L ADDRESS ENGINEERING MEMO DATED 0 REVIEWED BY Cr CITY zip TELEPHONE NUMBER FIRE MEMO DATED REVIEWED BY W Z 7"1 7 5 0 LJ 4��' ­� cc STATE LICENSE NUMBER EXPIRATION DATE SIGN AREA ALLOWED SEPA RE IEW COMPLETE ADB )4Q (///1- Legal Description of Property - include all easements Z S3 4�FIOPOSED JEXEMPT 7 S H 0 VFot WE 0 EXP,, , VARIANCE U N I BY 'D a: 4nEW AN� 0 �Alj e b 7- SETBACKS FEET HEipHT 11.0� Lu V) FROf T DIE REAR �7 Z Z Property REMARKS Tax Account 7- 1. 61 4� Parcel No. NEW RESIDENTIAL PLUMBING tuh, ­,nn Ls ADDITION COMMERCIAL MECHANICAL MREMODEL El APT. BLDG. N= I SIGN CHECKED BY TYPE OF CONSTRUCTION CODE OCCUPANT GRO , P GRADING FENCE EIREPAIR CYDS. x _FT) 71 WOODSTOVE SWIM POOL E] DEMOLISH El INSERT E] HOT TUB/SPA SPECIAL INSPECTOR- AREA OCCUPANT REQUIRED C3 LOAD GARAGE RETAINING WALL/ RENEWAL REMARKS CARPORT ROCKERY 0 PROGRESS INSPECTIONS PER UBC 305 Z (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: NUMBER OF 1 NUMBER OF DWELLING CRITICAL AREAS INUMBER Vi'/ - 3,5 W 0 STORIES DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) FINAL INSPE CTION REQUIRED -11 4,14 VALUATION FEE PLAN CHECK FEE -FAZING BUILDING 7&1&0 HEAT SOURCE: PLUMBING Plan Check No. MECHANICAL GRADING/FILL This Permit covers work to be done on private property ONL Any construction on the public domain (curbs, sidewpiks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Permit Application: 180 Days Permit Limit: 1 Year - Provided Work Is Started Within 180 Days . STORM DRAINAGE FEE ENG. INSPECTION FEE "Applicant, on behalf of his or her spouse,. heirs, assigns and successors I n 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 M 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 0 :r nor.limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE -Ij ?p �7[1 /?a provision." I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL Information glven is correct; and that I am the owner, or the duly authorized agent of the owner. I agree to comply with city and THIS PERMIT T his application is not a permit until state laws regulating construction; and In doing the work authoriz- AUTHORIZES . THE signed by the Building Official or his/her ed thereby, no person will be employed in violation of the Labor ONLY Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is ion Insurance and RCW 18.27. INSPECTION acknowledged in space provided. IGNATURE (OWNER 0 AGENT) Nto. DEPARTMENT DATE IAL" NAIIe CITY OF 6h EDMONDS CALL Fw' 0 .1! ATTENTION INSPECTION 1 16' IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. PINK — Owner GOLD — Assessor