1043 BELL ST (2).PDFIIIIIIIIIIIIII
10229
1043 BELL ST
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: 62.pi�) DETERMINATION: ❑ Conditional Waiver ❑ Study Required �aiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
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PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED-�M
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
SINSW'M7
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Critical Areas Checklist
Site Information �A ,
Project Name: S N� N S I
PL,-W FOUL/
Permit Number:
DEC Z 3 1992
PERMIT COUNTER
Site Location: (04- Dl�il. Sr, Property Tax Account Number: ��� - 09'�
I Approximate Site Size (acres or square feet): G. I 1C (I!7, — 00
Have you filled out a Critical Areas Checklist for a project on this site before? Vo
General Site Conditions V-=K(S` 100 W1W1 6 qP0 �,t) Pwu�1�0
I
1. Has the site been cleared or logged? — Date of most recent action: —
Soils / Topography;,,,x,�,4, (,,J
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? &M f MY)
3. Describe the general site topography. Check all that apply.
Flat: less than 5 feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a
horizontal distance of 66 feet.)
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise
of 10 feet of horizontal distance.) ,
Steep: grWIE
s of greater than 30% present on site.
sCommentQ(t %'� $ ...IUD
W
Hydrology/Vegetation
4. Site contains areas of year-round standing water:
Ic".V11
! fM s'r.
5. Site contains areas of seasonal standing water: Approx. Depth:
co
6. Site is in the floodway floodplain of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? _ flows
are year-round? -- Flows are seasonal? M
8. Site is primarily: forested meadow ; shrubs, ; mixed�,'
9. Obvious wetland is present on site: •n
10. Wetland inventory or map indicates wetland present on site: t` �-
11. Critical Areas inventory or map indicates any Critical Area on site: yes. M
For City Use Only
City of Edmonds
Critic'al.Areas Checklist
The Critical Areas Checklist contained on
this form is to be filled out by any person
preparing a Development Permit
Application for the City of Edmonds prior
to his/her submittal of a development permit
to the City.
The purpose of the Checklist is to enable
City staff to determine whether any potential
Critical Areas are or may be present on the
subject property. The information needed to
complete the Checklist should be easily
available from observations of the site or
data available at City Hall (Critical Areas
inventories, maps, or soil surveys).
An applicant, or his/her representative, must
fill out the checklist, sign and date it, and
submit it to the City. The City will review
the checklist, make a precursory site visit,
and make a determination of the subsequent
steps necessary to complete a development
permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary assessment of the site.
I haute completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Name..
Title
Street Address
City, State, ZIP
Signature
Ap licant Representative:
Name
Title
- I q 60 1 W
Street Address
. `
WA
Phone y, State, ZIP
Phone
Date Signature Date
The City of Edmonds Side Sewer Drawing EASEMENT NO.----------•-•-------•-•----•-------
218-01500 NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO . .................. ASMT. NO...................
OWNER..... -------------------------------------------- CONTRACTOR---------------------------........................................................ PERMIT NO. ...................
JOB ADDRESS ----- 1Q43--BELL---ST---------------------------------------------------- LEGAL DESCRIPTION: LOT NO. --------- ............................ BLOCK NO. . -----------------------------------
NAMEOF ADDITION--------------------------------------------------------------------------------------------------....................
•
DYE TESTED ON SE[AIER
Approved:
PWW-0001-11/75 (REV.11/78) DATE -------------------------------------------- BY------------------------------------------------------------
890.19ci-
., City of Edmon
RIGHT-OF-WAY CONSTRUCTION
PERMIT
A. Address or Vicinity of Construction:
Permit Number: ? 3 —o,3
Issue Date: e2L ; _
1043 Bell St. (9308098)
B. Type of Work (be specific): Install New Service
C. Contractor: Washington Nat'l. Gas Co.
Mailing Address: 815 Mercer St.Seattle.l�Jn.
State License #:
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 994-997R
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project Rk Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR: ll�hd
F. Pavement or Concrete Cut : ❑ Yes Mlo G. Size of Cut: x H. Charge $
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be made against the City of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including defense 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. ESTIMATED RESTORA77ON FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY
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CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Department 7_ 020 'a r��l
Work 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. [�
I have read the above statements and understand the permit requirements and the pink copy of the permit will be available
on site at all times for inspection purposes..
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Signature:
Date: February 10. 1993
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
AFTER; I:DAYS.. , DISRUPTION,FEE/FUND
RECEIPT: NO:
DATE: -_ -.::::::::ISSUED
O WORK SHALL BEGIN PRIOR TO PERMIT ISSU
Engrg. Div. 1991
•
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�C
RIGHT OF WAY CONSTRUCTION PERMIT ROUTING FORM F/ V
44/C�B 18
DATE APPLICATION RECEIVED C>'jN 81,gg3
�9r�G
WORK ADDRESS
CONTRACTOR %
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1. DATE TO PUBLIC WORKS FOR REVIEpi lei in v i S UEP
REV/APP BY STREET DIV. dated—ICP —7-3
REV/APP BY WATER/SEWER date Z /Z !3
REV/APP BY PUBLIC WORKS 1'j6�rs--� date 2,41-13-
2. DATE TO ENGINEERING FOR REVIEW
REV/APP BY ENG.
or
REV/APP BY ENG.
AID V=U► date �-- (-. l-�
INSPTR.
3. Return to Community Services front desk
date
DATE PERMIT ISSUED - / �- G/ 3 PERMIT # 73-" O ,302
oN'"'11` 'r'Y'HYv�,'•,{'T�+"'V,-.f Nu.! c� ,,,,T,.,_ —' ��..li.'�� .ry S�'Y: •J\^' •v-^.�-.;p"L' �.,:T�—"r ��•.a.L1�. �y ��•^'l .. �v`� ''
rivr •n�.rvv"'4r. wr'"�Y s„u.fa-� 1v' ,t L•� `�vk .N v r^--i�^�..— n�.,•. a ;.-;".
V /
f City of Edmon
RIGHT-OF-WAY CONSTRUCTION
0'90. I o 9 -
PERMIT Permit Number:
173 -03 �
Issue Date: .;�
A. Address or Vicinity of Construction- 1043 Bell St. (9308098)
B. Type of Work (be specific): Install New Service
C. Contractor: Washington Nat'l. Gas Co.
Mailing Address: 815 Mercer S t. Seale, Wn.
State License tt
#:
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: E24-2278
Liability Insurance: Bond: $;
Side Sewer Permit # (if applicable):
E. "❑ Commercial Subdivision ❑ City Project Ec Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR: "V"
F. Pavement or Concrete Cut : ❑ Yes Mo G. Size of Cut: x H. Charge $
APPLICANT TO READ SIGN //. pp
INDEMNITY: Applicant understands and by his signature to this application, agree the City of Edmonds hdrnde oth 44' 'es:"?Jages, or
claims of any kind or description whatsoever, foreseen or unforeen, thai may be made _against the City of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including defense cows, and attorney fees by reason of granting this petmit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC77ON
AND ACCEPTANCE OF CITY FORCES, AT WHICH ME A DEBIT OR CREDIT WILL BE PROCESSED FORWORK. ES77MATED RESTORA77ON FEES WILL T ISSUANCE TO THE APPLIL THE FINAL CANT. ET PA�CH I�S C(j> � LElED BY
Construction drawing of proposed work required with permit application. °y
A 24 hour notice is required for inspection; Please call the Engineering Department- t
Work is to be inspected during progress and at completion. 771-0220
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 fiegulations as required by the City Engineer.
l All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
1 have read the above statements dnd understand the permit requirements and the pink copy of the permit will be available
on site at all times for inspection purposes.
Signature: e Date: February 10, 1993
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WOR87*0CA_
'19
DATE:... ...... _ISSUED BY:.
RK SHALL BEGIN PRIOR TO PERMIT ISSUANCE.
Engrg Pbiv. 1991
V
FIELD INSPECTION NOO (Fund III Route copy to Sfi6et. Byt
Comments:
I Diagram:
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
.Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
r-lig. UIV. Jul,
qF
AMEM.
Washington':,
Natural G� F
AWWV)gbnEr „
Addendum to City of
Right of Way
Permit Application
Submitted by: C—,lk' L-C— t`:IC>05
Engineering Aide
Washington Natural Gas
521- 5Z4E�)
I C>43 F,-)iL ST
�1 `,-0MDs T.
_ C CO� 6
o43
25"d
WNG to window
Water main depth
unknown
2 " gas main
—w— WOLCL
-g- gas
-ss-.sewer
water hydrant
815 Mercy St. (P.O. Box 1969), Seattle, WA 98111 (206) 622-6767