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1035 BELL ST.PDFIIIIIIIIIIIIII 10227 1035 BELL ST W, ADDRESS: TAX ACCOUNT/PARCEL NUMBER: 4067 ly,�6 �,/wlfoo BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) CRITICAL AREAS: DETERMINATION: []Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DA' EASEMENT(S) RECORDED FOR: PERMITS (OTHER): PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: 0 I L1 K SEWER LID FEE $: SHORT PLAT FILE: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DATED: 10111, M LID #: LOT: 19-3O BLOCK:4t L:\TEMP\DSTs\Forms\Street File Checklist.doc I '['IIAT PORTION OF IA•PS 2R, 29 AND 30, BLLJI:I: $1, F iil)•'Or71S, ACWRDINC TO PIl\T j THEREOF RECORDED IN VOI.IIMF. 3 OF PI1�'I'S, PACE 39, :corns oT !UXIONI.SH COIDICY, I•IA311MI'ON, DESCRIBED AS F01.IMS: i BEGINNING AT A POIIT!' 10. 1 Flilil' EAST O? '111E SOLMII ST CORt101 OF 1,01' 30, SAID POT NC BEING ON A FENCE LINE LNI'F.RSECPION; '11I1-.NCE EAST 67.00 FEET TO A POTNP 17.1 FI:EI' EAST OF 1IU: SO171'RP,'S'I' CORNER OF I.01' 23 AND TILE C RNER OF A CONCRIM' MIA.; T111iNCE NOR'I11 NDMC SAID UA.U, I lO FEET; 'f11P.NCL' IJES'P 67.0 FELT; 111ENCF. SOU11T Al",IC A F1,34CE LINE 110 Fi;I'.I' TO TILE 11OLNT OF BEGI. NING; EXCEPT TILE NOR'111 5 FEET i j TIIEREOF. ZgNE ATRACKS: FONT ao New A&d,f,o,/ ;REAR Ay b A 'OTHIER H HCIGHT IL 1 — ' I" I v1 ' A I I a Z• I I S Q� z� c O— I CITY OF cDi.i0ND5I 1 CONDITIONAL PERMIT IWORK- Q'95 ADD I ADDRESS- /OS'S- /344 S OWNER. Soi-0 ieG h� APPROVED DATE - BY BLDG.OFFIC!AL i I KEEP THESE STAMP D PLANS ON JOBSITE R ALL INSPECTIONS! 1 PERMIT NO. I SHEET / I ' I N-1 1 n 1 � I I gddz� s s o Z_ ,�,ezL m m I rl- m (�A n r, •=yam �7� -s3 v/ L.' ................... ....:.... DiSti-iet _ �J City of Edmonds ---Water Department Date..' . t...... ........... ( Meter No ............................... Tap No ......................................... !: 1 Size.............................. Size........................................ Mfgrs. ��..Y........ %:X ttyle............................................. rr For ........ .................................................. .--•................................................................................................................................. LotNo ........................................... Blk. No.................................................... Add..................................... ...............-- Service Location .:f-"... t' ................... .........................................................................................................................._.............. MeterLocation.............................................................. _................................ MakeTap ............................................... ................................. ................................................................................ - ....... ............... Pressure..............................lbs. Test .................................... % SendBills to....................................................................................................... - ..................................................................................... .............. Dateof Work .................................................. ...... .... . .................... . Foreman Guar. Voucher No ........................................... $................................... _..... Remarks: ........................................................ ......................................................... ................................................... ^."r ..... ... . ....... . .......... 'EET ... ...............••---..................----.................------................................. .......---................... OUTGOING Index .......... Reg ....... Route Bk......... Stencil- ..... Card ...... .. INCOMING Index .......... Reg ....... Route Bk......... Stencil ...... Card ....... aterial 'Charge able to Installation ✓aers 1 p SIZ DESCRIPTION RATE T .Meter -•--•- :�..... yl._........ _ Meter Box ... -•---• Meter Pate .... Check Valve ...---•-••---••----•---•--.............. __.............. .. •- Galy. Screw -- Pipe, •----•- - Nipples ... ... ....... Bushings ----------------------------------- 7. •................ Plain Ells --.•. .......................... ... -.......... --------- St. Ells .................... ............ Tees ..-- -------- -.... ..... -.----- .............................................. Material Chargeable to Taps Connected NO. SIZE DESCRIPTION RATES T --.........--........................ ....._..._ Pipe, Black Screw . ......... Pipe, Galy. Screw ................ ...... _• __ Lead Connections " ............. 1- _.._.. Curb Cocks •. " . . ... Corp. Cocks ----•..................... -•--. - ............. .......... .._- Unions --••----•• ........................... .............. -•---•-- Saddles ...... ................ •-----• Nippy Bushings--.---------•-•--------•--------...----- Plain Ells ---------- ---.. »: ...--.......... Street Ells ........... ... Curb Tees ......................... .•-•-......._..... ............. Boxes ............................ . j----•--•----- -------- S• O. Extensions ...... ..... ......._.•-- •... Gates .........................•-•-- -- ....----• -- plugs f Couplings ,� '`tom' .. -• Gate Boxes ------• .................... •----------•-- ; /................................ .......... :----... ....... ........................................................... ..................-- .......... .........•....... ............................_.. s Men -------- .......... -.-•-.. Hours Time—Day-.-•_.r...... ...... ..----•---- -- �; Hours Time —Monthly Men.._-......... . .. Auto .......... Hours Time —Auto ......_... Superintendence ........... . .....Sup Total . . The City of Edmonds Side Sewer ®yawing EASEMENT NO- -------------------------------------------- 218-01400 NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO_ ------------------ _ASMT. NO................... OWNER ��- H- GREEI`1E----------------- CONTRACTOR PERMIT NO. JOBADDRESS ----- 1035_.BELL__ST.................................................... LEGAL DESCRIPTION: LOT NO.-------------------------------------- BLOCK NO. .................................... • • ------•-------•---------------------------------------------------------------------------------------•---------....---•------------------------------------------ NAMEOF ADDITION..........................•--•--------.......----•---------------•---•--------._.---------------------•--.........---- DYE TESTED ON SEGIER Approved: • PWHV-0301-11/75 (R'EV.11178) DATE ............................................ BY------------------------------------------------------------ y.:, 'Jt .i.r,: l"b�,�vyip•� t ti��J.sn a'-`71 �C�'C'aii�rV�ry";."'G•t��'�fy�'y{q'�'v."`r � •v -I a .. � `YtJ•v •.,�_; �•�(:"-r ^R}'iW ,Y City of; Edmon e RIGHT-O&W_LY CONST CTION PERMIT ,�. Permit Number. Issue Date: ��•� f +O 7 y A. Address or Vicinity, of Construction: 1035 Bell St ( 9502370 ) 18 9 0 1 9 B. Type of Work (be specific): Install Net, Service C. Contractor: Washington Natural Gas Company Mailing Address: 815i Mercer Street, Seattle ` State License #: WA 981111 r D. Building Permit # (if Contact: Frank Swan Phone: 22472278 Liability Insurance: Bond: $ 1 , Side Sewer Permit # (if applicable): _ E. ❑ Commercial ❑ Subdivision ❑ City Project ff .Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family J ❑ Other INSPECTOR: { INSPECTOR: V'J �'•i w 1"1 F. Pavement or Concrete Cut: ❑ Yes []No G. Size of Cut: �`; x H. Charge $ �t APPLICANT TO READ AN ( 31�N r: INDEMNITY: Applicant undera;anda and by his sign ture to this application, agrees to h e City ojEdmonds harm4n, o en/ damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its ep¢r �menta or employees, including or not limited to the defense of ay legal proceedings including defense coat, And attorney fees by reason of granting this permit. THE CTOR IS RESPONSIBLE FOR WORfMANSHIP AND MATERIALS F RIOD F ONE YEAR NAL INSPECTION AND ACCEPTANCE OF TH WORKI ESTIMATED RF,STORA ON FF.FSS WI/.T1RF. HOLD UNTIL THF. FI'O 'STR%� PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIM A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE. APPL/CANT. Construction drawing of proposed worq required with permit application. �. A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and material 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 Safety shall be'in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. Ihave read the above statements and understand thepermit requirements and thepink copyof thepermit will be available on site t MGs or insp ction purposes. Signature: : Date: November 11, 1994 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK a' FOR CITY USE ONLY'' =` APPROVED BY: �N� }W RIGHT OF WAY DEPOSIT TIME AUTHORIZED,: VOID AFTER IF 11- DAYS DISRUPTION FEE/FUND' 1`TIi SPECIAL CONDITIONS: N A �• RESTORATION FEE: '-`,�r, S 1 ✓u 1� A l %A I A �� PERMIT 'FEE: TOTAL FEE: 30 tyO COMMENTS: RECEIPT FEE: DATE: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 • 'MashIng htaturat Gas AVA&►rgW&v gvCc YWv Addendum to : Right o Way. Permit Application Submitted by: Engineering Aide Washington Natural Gas -WNLt3'yt0 wfndow -� ^ - ';'^��''-s v _ •:' :�. :...,r _' - -fit ;r ��'.. q v ,r �.* t 3 .s.c .. ...:.-�`'_ Y.xe--�a k- t =. c-•��a �.. •a..'. aims- rv-ra.�.n-�:x �riv - >. .. 2»Key � yr�-t.. b.s '.7,•�"t"s-b.'�aa� s'*S..",.. ev ..t.:s..3- Water lna f n depth _w water "" rio- �n .gas main water hydrant -a Is Maur St. (P.O..Boa,1a69). Seattle. WA 98111 (206).622-6767 A r y SPRAGUE a t -----=-- - .. -- ---� - <N R ry TW 1P 'g u .al .tlry y 2 �x di rc J'A an C� .a �• 1. � • S W 1••�' C �@ �� 1j ec1- 9001 QCOI L50• ecO .1 n ` —_ 965 033 • nn' , r. Z In ° J VON x a EDMONDS ST. 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