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7113 176TH PL SW
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C F OF EDMONDS -
COIVI1VhNITY SERVICES. DEPARTMENT
RIGHT-OF-WAY CONSTRUCTION PERMIT
A. • Owner:
Mailing Address
4=-
Permit No
�1 FC�I `Issue Date 3 — 4 ---9 1
B. • CotttRapI: T.i �nlc CIA(�)k.i=
RNGJI VEFRJN S .
C7 Mailing Address
City State Zip City State Zip
State License Number �2ephone Number
C. • Address or Vicinity of Construction:
Type of Work to be Done A U= LA-:) ^� =rN-' o ►-)
D. • Work in Connection With: ❑ Sub or Plat ❑ Single Family ❑ City Projects
❑ Commercial ❑ Multifamily Utility
E. • Pavement Cut: ❑ Y P "` F. • Size of Cut: X
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, 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:�crro��sts, 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.
Estimated restoration fees will be held until the final street patch is completed by City forces, at which time a debit or credit will be
processed for issuance to the applicant.
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• A 24 hour notice is required for inspection; Please call Engineering: 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
Signature:
this permit rpusf be available at the job site for inspection purposes at all times.
Date: z-
Owner or
Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY:
Time Authorized: Void after I yfeAl? r days.
Special Conditions:
PERMIT FEE:
i�1 r 1 r , •
Restoration Fee:
Receipt No.:
Fund 111:. Fee: �
m
Street Cut Dimensions:+I$
RELEASED BY: Date3 INSPECTED BY Date
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div: March 1989
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept)'''
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1985
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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).
pq low— IN
RE
APPLICATION ZXf Lo - Z- 14)( for
The City of Edmonds SIDE SEWER PERMIT BASEMENT Nw-,7----)
NEW CONSTRUCTION [:] REPAIRS o I fG Lt
CONTRACTOR ......
OWNER ...... &AL?��x ----- ......... �- ........ 0)14ja. PERMIT �Xo
................ ----------------- ......................... .......... .........................
ADDRESS ... 7111...... ...
-------------- ................ Z ...... y -*Ah 0-5 LEGAL DESCRIPTION: LOT No . ..... ------------ ............... BLOCK ....
NAME OF ADDITION .......................................
.. ... ................................ .......... ..................
APPROVED
JUN 1 ej 1970
ApprovW-
I /� /Pl,
DATE'......... ......... ------------------------ By ............ -------- ----------- ---------------- -- -----
s A L. JASON &ASSOCIATES
THE PRUDENTIAL STANLEY ANLEY S. SHUMLICK
Insurance Company of
America 6727 SUNSET BOULEVARD
HOLLYWOOD, CALIFORNIA 90026
BUSINESS: 465-1 101
RESIDENCE: 246-2702
i[
LIFE INSURANCE HEALTH INSURANCE ANNUITIES GROUP INSURANCE GROUP PENSIONS
i�
' CITY OF EDMONDS
Call' PRospect 0-1107 when work
"CIVIC CENTER — WATER -SEWER (DEPARTMENT is ready for inspection. (No inspec• d� T 0 � � � cD
56®E SEER PER11�1i dons Saturday, Sunday or holidays.) 1® �,
ADDRESS ...................... XY$X-XXXX(KV(XR...-----...7113 - 176th Place S. W.
...................................................
OWNER. ........ Dahl. y... L •... S tee le CONTRACTOR.....-.. Owne r
.............................................................
Perinission is granted.....s.W.1e...1.6...................... 19..7.0. , for ........................ days to REPAIR or CONNECT a side sewer
With City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must
be employed to construct side sewer in street area. Do not cover any portion of sewer before it has been Inspected.
NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. % '-
NOTE No. 3—Top of side sewer must have at least 30 Inches coverage at property line and 12 inches inside property line; minimum grade of 2q,.
No bends in grade sharper than 1/s will be permitted. i
NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors, shall be responsible for
failure due to improper work which may develop within one year of completion.
NOTE No. 5—It 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.
OFFICE OF THE
SNOHOMISH COUNTY ASSESSOR
COURT HOUSE EVERETT, WASHINGTON 98201
TAXPAYER
?0- oc, - 6,363
qri G
-
SEC -LOT ITWP•BLKI RGE I LEVY CODE.'.
3 �,67 0230
SEA L ;pie ACRESS
LOT 3
NO.07429
Assessor's Notice of Change of Value Chapter 146, Section 10, Laws of 1967 Ex. Snohomish County, Everett,
Washington JAM-b9 19
You are hereby notified that the true and fair full value of the real property hereon described and subject to
assessment in the year, 19 6 9 for taxes payable in 19 70 has been changed, the property is now ap-
praised at: 1 $,1. 2 0
Information concerning this value may be obtained at the Snohomish County Assessors Office, or you may
request by petition a hearing before the County Board of Equalization.
The July Board of Equalization will convene on the first Monday in July in the Assessors office at Everett,
Washington, and will continue in session for a period of two weeks, and shall be in session not less than
three days during this lapsed time. The Board of Equalization is to review and equalize the assessments for
the current assessment year for taxes payable the following year.
This notice may refer to your total property, or only a portion of your property. The description given will
correspond to your tax statement for this parcel. C, L. BARLOW
SNOHOMISH COUNTY ASSESSOR