7026 156TH ST SW.PDF11 ill I I 111
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7026 156TH ST
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ADDRESS: ?Oato f�L SO
TAX ACCOUNT/PARCEL Mon 2Z
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS(RECORDED)FOR:
CRITICAL AREAS #: DETERMINATION: 0 Conditional Waiver F1 Study Required 0 Waiver
CRITICAL AREAS #: DETERMINATION: El Conditional Waiver El Study Required El Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #'s):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:91D
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED: [ a-/ jrq I
SIDE SEWER PERMIT(S) #:7�,Oq
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
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CITY of E D N D S REC EIVED 91DE SEWER E R M I T
4,
For Inspection Call 771-3202 OCT 1984 PERMIT NO. 7299
PUBLIC WORKS K
Address of Construction: .2 StIt
Property Legal Description (Include all easements): 6 04.
V I
LYNNWOOD LINE
Owner and/or Builder: Atf floci V el A --tr
Contractor & License No:
Singl:e Family Residence ye <'>
Multi -Family (No. of Units
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No Yes (If Yes, Right -of -Way
C.onstruction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No —Z Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
I certify that I have read and shall comply Date
with the items listed on the back.
Permit Fee: 30, 0 0
Trunk Charge: .2,(:-,o6
Assessment Fee:
Partial Inspection:
Issued By- �ava -
Date Issued: z 9 / gV
Receipt No.: :?C) �tLj
Comments Date Initial
Final Inspection Approved: A
Date injiti
Rejected: Reason _ffa- t _e 7 n i —ti a I
PERMIT MUST BE POSTED ON JOB SITE
White Copy - File Green Copy - Inspector Buff Copy - A pp 1 i can t
CVP-
EXHIBIT A
..........
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o Tract 22, MEADOWDALE BEACH SUPPLEMENTAL PLAT,
0
I'Aco r lat thereof recorded in Volume 5 of Plats, Page
oinish County, Washington, described as follows:
4 2 1, 1:
hoh
Northeast corner o
i rf�if, -4p Be g i pq f.said Tract 22;
I. 'R XNCO.1
g the North line thereof for 300.25 feet to the
01
ginning;
IT 35102" West 142.5 feet;
-OU Oi*2i'41" East 137.75 feet to the Southwest corner
TMMCE S
-T . .. - *1,w,
0 ubendorf
�thait Aii�'Tract previously conveyed to Keith D
and Shirle
his wife, by instrument recorded August 27,
1968 Una$ tding No. 2050220;
THENCZ' ort,:2026108" East along the West line of said Dubendorf
"142'1:47 feet to the North line of said Tract 22;
Tract�
THENCE West.1along the North line thereof to point of beginning;
f Edmonds,
EXCEPT the"North 5 feet thereof.conveyed to the City o
under,:Recordifig No. 1988544.
Situate in the County of Snohomish, State of Washington.
y.
r
4 4
of
The City of Edmonds Side Sewer Drawing EASEMENT NO - --------------------------------------------
MEAD - Co m tA -
NEW CONSTRUCTION 0 REPAIRS F� LID NO. 9
----- - ASMT. NO - ------------------
T '7
OWNER -PAQ-LA-GRAL - ----- A0-L).VeNll;;R ------------------- CONTRACTOR --------- �C04M-SMA- ---------- -------- .. PERMIT NO. -- -
---- --- -LIKE
JOB ADDRESS ---- 702eG ------- 1,5(o- T-"----ST:-S� ------------ LEGAL DESCRIPTION: LOT NO - --------- -- ------------------------- BLOCK NO. LYNNWOOD
----------------------------------------------- ------------------------------------------- --------- --------- -------------------------------------- -----------
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4-5,M
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PPW-0001-11/75 (REV.11178)
'310
NAMEOF ADDITION ---------------------------------------------------------- ------------
E%ISTIUG LINE C-OHNECT10"
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24'
VDIR. c-0-cRP 1:Dp
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Approved:
DATE (OCIL 30 SO ------ By L4 ------ --- ......... ----------
---- - ---- -
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NOTICE:
No warranty of accuracy.
The information shown on the attached map(s)
was compiled for use by the City of Edmonds,
its Employees and Consultants. The City of
Edmonds does not warrant the accuracy of
anything set forth on these map(s). Any person
or entity requesting a copy should conduct an
independent inquiry regarding the information
shown on the map(s), including, but not limited
to, the location of any sewer stub shown. Such
sewer stubs may or may not exist and may or
may not exist at the location shown. Neither
the City of Edmonds nor its employees or
officers shall be liable for the information given
on map(s), nor for any one representation
provided based upon said map(s).
CITY OF EDMONDS Permit No.
COMMUNITY SERVICES DEPARTMENT Issue Date
RIGHT-OF-WAY CONSTRUCTION PERMISIM FILE.
A. 0 Owner: Washinaf-on Natynal-anaq B. 0 Contractor: ,;aTnp
Name Name
805-156 AV NE
Mailing Address Mailing Address
Be! 3ax.3nip, DIA 98097
City State Zip City State Zip
447-0700
State License Number Telephone Number
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e Addressor Vicinity of C0_r
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Type of Work to be Done:
Work in Connection With
-2�O�A - 156 ST SW /lg
acfion.
New '�as service installation
Pavement Cut: 0 Y 0 N
APPLICANT TO READ AND SIGN
0 Sub or Plat El Single Family E) City Projects
0 Commercial -�E]--Multifarriilyr - - - * 10' Utility
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, forseen or unforseen, 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.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed
by City forces, at which time a,debit or,credit,ivill.be processed for issuance to the applicant.
• A 24 hour notice is required.for inspection; -Please call Public Works: 771-3202
• Work is to be inspected during progress and at completion.
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
*-All street -cut ditches must be patched'with asphalt or City approved material prior to end of working day;
no exceptions.
I -understand the abovTd-,44iat, this
t,� be available at the iob site for, inspection purposes at all times.
Sign; Date: 11-2 3— 8 R
d6ner or Contractor
This Permit Must Be Posted at the Job Site For Inspection Purposes
Call DIAL -DIG Prior To Beginning Work
ISSUED BY: -S
Time Authorized: VoidCa7fter 30 days.
Special Conditions:
Amendments:
0
PERMIT FEE:
Security Deposit:
Receipt No.:
Fund I I I Fee:
Streei Cut Dimensions:
X
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
tng. ijiv. juiy iyn
FIELD INSPECTION NOTES
Comments:
Diagram:
7
(Fund I I I - Route copy to Street 6ept.)
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 198
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