ENP2022-0011 STREET USE PERMITSTREET USE
PROJECT NUMBER
City of Edmonds
- N, Edmonds WA 98020 ENP2022-0011
www.cityofedmonds-gov
IL
Description: MOVING POD ON 3RD AVE S MARCH 25-27TH Approved: 3/22/2022 12:00:00 AM
Address: 337 3RD AVE S 101 EDMONDS, WA 98020-3579 Parcel: 00670500010100
CONTACTS
MR
NAME TYPE
NAME
ADDRESS
PHONE
APPLICANT
JANA DOMBROWSKI
337 THIRD AVE S 101
4152909402
CONTACT
JANA DOMBROWSKI
508 2ND AVE N
14152909402
CONTRACTOR
OWNER
OWNER
JANA DOMBROWSKI
337 THIRD AVE S
14152909402
CONDITIONS
INSPECTION SCHEDULING: WWW.MYBUILDINGPERMIT.COM OR CALL 425-771-0220
IN
INSPECTION TYPE DATE COMPLETED RESULT NOTES
E-7 TRAFFIC CTRL
X-2 ENGINEERING FINAL"
The applicant has signed an application which states he/she agrees to hold the City of Edmonds harmless from any injuries, damages or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the applicant or the City of Edmonds,
or any of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs, court
costs, and attorney fees by reason of granting this permit.
ENGINEERING DIVISION
"DTED
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TRAKiT
CITY OF EDMONDS M BuildingPermit.com
Right -of -Way Application #1111331 - 337 Third Ave S MOVE
Applicant
First Name Last Name Company Name
Jana Dombrowski
Number Street Apartment or Suite Number E-mail Address
337 Third Ave S 101 jana_dombrowski@hotmail.com
City State Zip Phone Number Extension
Edmonds WA 98020 4152909402
Contractor
Company Name
Owner
Number Street Apartment or Suite Number
City State Zip Phone Number Extension
State License Number License Expiration Date UBI # E-mail Address
Project Location
Number Street Floor Number Suite or Room Number
337 3RD AVE S 101
City Zip Code County Parcel Number
EDMONDS 98020 00670500010100
Associated Building Permit Number Tenant Name
Donna Mann
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Jana Dombrowski
Number Street Apartment or Suite Number
337 Third Ave S
City State Zip
Edmonds WA 98020
Certification Statement - The applicant states:
I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and
authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I
have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work
requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
Date Submitted: 3/21/2022 Submitted By: Jana Dombrowski
Page 1 of 2
CITY OF EDMONDS MyBuildingPermit.com
Right -of -Way Application #1111331 - 337 Third Ave S MOVE
Project Contact
Company Name:
Name:
Address:
Jana Dombrowski
508 2nd Ave N
Edmonds WA 98020
Email: jana_dombrowski@hotmail.com
Phone #: 14152909402
Project Type Activity Type Scope of Work
Multifamily Residential Street Use Objects Temporary in Nature
Project Name: 337 Third Ave S MOVE
Description of Work: Moving pod to be parked on street and unloaded
Project Details
Project Information
Other
Page 2 of 2
Google Earth
POD CAN TAKE NO MORE THAN 3 PARKING SPACES AND
SHALL BE PARKED FOR NO MORE THAN 72 HOURS.
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Applicant shall repair/replace all
damage to utilities or frontage
improvements in City right-of-way
per city standards that is caused or
occurs during the permitted project.
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
ENGINEERING DIVISION
,DTED
13/22/2022