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5154
1020 5TH AVE S
APPLICATION
for
The City af Edmomb s FILE SIDE SEWER PERMIT
I OUTSIDE 0 INSIDE 0 REPAIRS E3
CARD No . . . . ........ - --- -, -
EASEMENT No. .............................
"AM r-,e u,0A1Jl-.
........ CONTRACTOR ........... ......... ................................................................................... PERMIT No. .,KI-57YJI
STREET 7- \L��z
........ AVENUE LOT No . .......... .... ;?l .................... BLOCK No...... ... I ......... .. ....................
..... ..... ........ .. .....
NAMEADD ..................................... .................................................. ...... .............................. ......................
Date
]BACKPILL WORK ORDER ISSUED............................................
...... ...... ............ DEPOSIT, $ ...... .............................
SEWER WORK ORDER ISSUED ................................................
Approved:
DATE... ............................. BY
V
-141�1
r.
.... V.r
V
STREET FILE
COMPLAINTS MUST BE WRITTEN: NO VERBAL COMPLAINTS WILL BE ACCEPTED.
R E C F.I V E D THIS FORM MUST BE COMPI ETE . p./
OCT2 7 1g�� DATE /01,-2 7D
ENGINEERING CITY OF EDMONDS
COMPLAINT RECORD
COMPLAINT SUBMITTEDt BY: p r-'
Nam: � , 4, 1 Ac c� 1 � Phone: % 7p - 7 J � /
Address: 1/0 / T/�I4E- 1 -)4/10(o
ADDRESS OF PROPERTY TO BE INVESTIGATED: l D o2 O ^ S 4ye < �; o
Name of Owner:
Address: Phone:
DESCRIPTION OF COMPLAINT: Sc) P-PACE%r LvJaTZr�- S
0�07-0 t �; �/� r� i Y l L"2oSi-Par
BLXXS C,- 77 9
DO NOT WRITE BELOW THIS LINE - FOR'.CITY USE ONLY
CODE SECTION VIOLATION: ` F o
TYPE OF ACTION EXPECTED : 7 Gw7u 0 ` lJ ��D�'�� 010 /30 P-T4 5 � OE
TIME REQUIRED TO INVESTIGATE / ACT ON COMPLAINT:
RESULT OF INVESTIGATION: DATE:
11
TIME REQUIRED:
INVESTIGATED BY:
-�`
CITY Of EDMON DS B ESS LICENSE APP T O L
Civic center• EdmO0E5. WasRIn010
LICENSE NO.
City Clerk phone 7752525 STREET
TYPE OF BUSINESS ANNUAL FEE
AFTER FEB. 15
CWS
YEAR
�. UG EFFEC: DATE gFA6G.
LIQ N0.5PEe.
❑
N HOME OCCUPATION $15.00
$ 22.50
JSTRUCTIONS:
:
IS(.
(6) BUSINESS WITH $20.00
$ 30.00
All items must be Completed
RECEIPT
NO.j PATE PAID
1TO 3 EMPLOYEES
or application will not be aC
PAINT'x'
IN SPEC. BOX
❑
BUSINESS WITH
(CI $2200
$ 33.00
cepted.
FOR ISSUE OF
eT09 EMPLOYEES
Sign and return application
'FEE PAIp
ENALTY PAID
pp AA zCTED
LICENSE WITH
❑
IDI BUSINESS WITH IO $75.00
OR MORE IPLOYEES
$ 112.50
with fee. Renewals received
'LC'ACTION.
after February 15 must pay
NEW APPLICATION
142NEWAL
(LA)
penalty in addition to fee.
❑
(LB)
NEW BUSINESSES AFTER
❑ CHANGE
(LC)
JULY 31, 112 FEE.
(PLEASE MAKE ANY NECESSARY CHANGES)
❑ DELETE
(LD1
MAILING ADDRESS NATURE OF BUSINESS
ao
BUSINESS ADOflESS-. --- IDUAL PARTNERSHIP CORPORATION
%Dao-S77/" _04vF_ a (S) O(P) / O(C)
OW, ERS NAME / HOMEADDRESS UNAS
�(j O20
HOME HONE /BIRTH 7- ___F_4-inrPnFRIRT14e
J ro C'
EMERGENCY NOTIFICATION A_-v (I) NAME BTELEPHONe""
(PLEASE LIST TWO) (2) NAME& TELEPHONE
WASHINGTON STATE TAX NO. APPLICANT'S SIGNATURE �-.—_
DO NOT WRITE BELOW THIS LINE
STAFF REVIEW: FILL IN LAND USE CODE, UFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR DISAPPROVAL. DATE. AND
SIGN, IF DISAPPROVAL, PLEASE COMPLETE "COMMENT" SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT
B IS
CIS APPROVE ❑ DISAPPROVE
DATE
Bl
LAND USE CODE
ZONING CODE
SIGNATURE
CONDITIONAL
USE PERMIT
COMMENTS
m
®
m
BUILDING DEPARTMENT
DATE-23-�'(
Buildin
f�PPROVE ❑ DISAPPROVE
SIGNATURE H�.
9er VKs
9 ❑
Permlt ❑
Apt. Bldg.
pp(. Slog.
(L)
(A)
® ❑
Office Bldg.
(0)
COMMENTS:
Occupancy ❑
Restaurant
(A)
Group ❑
Hosp/Nurs Home
(H)
® CAPACITY: (NO. UNITS, APTS. OFFICES, SEATS, BEDS, STUDENTS)
® ❑
School
(S)
DEPARTMENT
DATE
--z-
U.F.I.R.
�F./IRE
OCAPPROVE ❑ DISAPPROVE
SIGNATURE
S
ITT' o1
® Q �j
COMMENTS:
POLI PARTMENT -Z.l —rrY�
PPROVE ❑ DISAPPROVE DATE SIGNATURE
PUBLIC WORKS DEPARTMENT
❑ APPROVE ❑ DISAPPROVE DATE - .F- d SIGNATURE
_PLEASE RETURN TO CITY CLERK
• STREET FILE *
CITY OF EDMONDS
200 DAYTON ST. • EDMONDS. WASHINGTON 98020 • (206) 775-2525
DEPARTMENT OF PUBLIC WORKS
4 October 31 1979
Dear Resident,
SUBJECT: Fifth Avenue Sidewalks
HARVE H. HARRISON
MAYOR
It would be appreciated if you would park your
vehicles on the street prior to 7:00 a.m., Thursday, November
1, 1979. Construction of driveways and sidewalks has been
scheduled for that time in your area.
Thank you for your consideration and cooperation
in this instance.
FRED F. H
Director/
rks
(� SHEET 2 OF 15 SHEETS �j Q
5 t h A V E N_U E CONDOMINIUMS
-
IN -SE, 1%4 NE 1 /4 OF SECTION 26, T.27N., R.3E., W.M. �� Qs J
- CITY OF EDMONDS, SNOHOMISH COUNTY, WASHINGTON Vj Q Q O
i .. . .. -- _ - - - - - - -- - - - - - - — 2 O
Ica
_ _ - -- _%
— - - — 4th AVENUE SOUTH
- -
LOT 3 LOT. 2 LOT ; i (J
\ V)
u L _ °-------------N — — — — — — — — — —
1
E 5(uEni i0R 0,0 ! �'..Sr m,vPOSES ,i..0.1736999 �I I
— n,.P 10. •Sfi• 1 —• o / r./CM ti0. 'S6 — — — — — — C)
_ .E.. -EPEE'S . 6' v0E 40E SEER E.YuENT 4ECCADED UNOEG °i.n0. 1532169 ^+ 0 `
OKR .r Uu015CLOSED POPPO, OF r =vOPERTY .LONG �T'E LwE AS CONSTRUCTED i I VV
i (�
�OyEvnANO 0'. ,r. • 2-1C0v5 —efff OF
40
LLJ
23 33' ES' Jd.65' <
1� y Q O Q
S STORY at;'__r:v :G CLU0D:0 aaSENEUT WATER DEf ARTMENT i o
1020 5:- A'.£'tUU� r E $Oo, - .�
tL CROSS CONNECTION ONTR C
"•PE° la g #ter ith hazes, insafieonxfawfpre
- a 6r S P • `"'`"�w improved on condition 1e following'a+sf, sysfartn 2
C.D:ETE •ALK ON 1rt r0pp ! OCD' w 7na iLOCR L.,. , 1a �y._f:.• j At
-- ti - \ 'bp i ✓ _agtEA .l ' V-tl pr! f is rwAded:
NON
ID
P_r•.'EP C. .—
DRIVEWAY C.A. ,!L—^ M 1 AIR
AP; .I REDtICE PRESSURE
�PARYwO $TA!�j 1 ® 'I ru ICE
T Ft•
1 ---r---------ns les' ins
s'�e.5• e.s;es as' e.s••eA ,n3' es'!es' �p -
. I ;CARPORT : NPR!: � (\
ASSE\!J N O-TP-2 P-]'P-d'P-5'P-6P-]�P_O;P-9;P-T0; P-11P-,1.P-1]:P-1ai� I B
1 / C.A.LC.I.LC.&!LCAiLC.AILC.A.'LC.A..L.C.A'LC.A.'LC A.•Lc A.! LC.A.'LCA' LG.!. 1 ' 1 t„
30*
C P . . 184, - .`5ET LEAD PLut
... ,/CAP O. iCN' �� °. .R ® ✓ ® %' ♦ TAIX
S.E. COPE. K 7I.E. COA. OF CARPMT
1 0.05' r t 3.5N. OF 3.7' w. • 21:3' i OF
S.E. PROPERTY CORNEA r,L PROPERTY CORgR S
F` )_12•75- // ilA[ '.+DRANT A BENCH uARM 9012.75 9012'15'
I
- IL P1Ad - - - - SET T,C• n( ;��A±OaRAss CAP .o:,. .�OlLD7a _
SE � o
5th AVENUE SOUTH FiA AL- (95PEC7700 �-
v) V
I
�'�p��• .i' `y 1- 77 t_
``77
�Iw VEMENT SKETCHF'ORc :tOONALQ-A. JANGARD .
Ti�E -WAST'HALF OF •LOTS 1 ANO' 2y BLOCK 1, SOUTH PARK ADO{TION TO EOMONO$:f ACCORDhNQ TO Pi,'f THEREOF RECORE
IN VOLUME 8' OF PLATS, PAS. 13, RECORDS Of SNOHOMISH COUNTY. WASH'INaTONj. LESS UE NORTH 87.00 PEST OF 9AI
LOT i.
F
SiJBCiECT TO AN EASEMENT :FOR INaRES3 ANC.&81RE38 AND FOR UTILITY PURPOSES OVER AND' UPON THE WEST 1O.00 FEET THEREOF.
TOGEIkER W.I iH AN EASEMENT FOR. IWO AND UTILITY •PURPOSESp OVER- THE WEST 10.00 • FEET OF THE NORTH 87.00 FEET OF THE
EAST. HALF OF SAID- LOT 1, 'BLOC i, UUTH PAJtK-Aa&I TI,ON- TO EGMONOSv AND OVER THE EAST 10.00 FEET OF THE WEST HALF
OF SAJD LOTS 1 AND 2, BLOCK SOUTH PARK ACDITION•
(SEPTEMBER 21 1962
CAALLL 1" a�_SO .FEET', .
(-` Pinc Styr(fet
40
0
-
I
o, I'**"-- ...
Ic
i
i
I �
{
f
I
125.00
I HEREBY CERTIFY THAT THIS SKETCH SHOWS THE ACTUAL
LOCATION OF ALL IMPROVEMENTS ON THE PROPERTY ABOVE
DESCRIBED AND THAT THERE ARE NO ENCROACHMENTS.
30'
N
STREET FILE r
Joe.No. 2341
FB 67/20
REID, MIDDLETON & ASSOCIATES
Consulting Engineers&Land Surveyor3
324 Main St PR 8.1171
EDMONDS, WASHINGTON
STA IF'
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