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1052 B AVE.PDF11111111111111 10196 1052 B AVE 000 -------------------_----...Districts City of Edmonds ---Water Department - TAP CARD JAN - Date ......... 7 .....1.. k., ....0 AID.. I Meter No. T ... Ta. No. , - * " ......... .............. Size------------------------------ p Size-- : .................... .............. Mfgrs. No ........................ ;1 ..... ........... Style ............................................... For....... CAA1a, ...... 6-YA.112 . . . . .......... 4 .................................. ..................................................... . .... .. .. ....................................... . ....... . .............. ....................................................................................................................................... LotNo ........................................... Blk., No....................-----------------.............. Add. ................................................................ ..... X .................. ............................... ServiceLocation .... : ..... . .............. . . ................................ .. ................................................................. 4 ............ ...... . ............... . ....... . .............. I Meter Location fj��.V, ....................................................... .............................................................................................................. MakeTap ............................................................................... Pressure .............................. lbs. Test.......-----------...--------------. % SendBills to .................................................................................. ............................................................................. ...... Date of Work --A......... ..................................... ............... Foreman Guar. Voucher No ........................................... $ .......................................... Remarks:,0. . ............................................. ............. ... " 11� ------------ ..................... ................ . .. .. . ............ . --------------- - ------------- .......................................................... ............. ............................................... ---------------- -------------- ................................................ a-IRM- .*T1Lr - ------- . ....... . .............. ............................................................................................ . .......................... OUTGOING Index ......... Reg ....... Route Bk --------- Stencil ------ Card.._ - INCOMING Index ......... Reg ...... Route Bk .......... Stencil ...... Card_ ....... 1VVrrial Chargeable to Installation Nrs SIZE DESCRIPTION RATE AMOUNT �NO. ail_-._._.. Meter ...................................... ----•----- --- -I� ----• .......... Meter Box .............................. •-- - .......... -... .......... Meter Plate ............................ .............. .._......... ---....... .............. .......... Check Valve ..... -.... _.... -....... -----•................_._. •-••---------- --------- Pipe, Galv. Screw .................. .............. --......... .......... .............. --•------- Nipples -•-----•-•----------------------•--- -----•-------• ........ _... .......... •------- Bushings .................................. -•-•----•----- .._..... ... •--------- ----------------- ------- Plain Ells ................................ .............. ----------- .......... .......... -- ---------- St. Ells ................................. -- --------- -... ........ .......... .......... - --- ---------- Tees ......................................... --•--------- ..- ..................... Material Chargeable to Taps Connected NO. SIZE DESCRIPTION ' RATE AMOUNT ..............I ......... Pipe, Black Screw ----------------•- ---�. .............. --------- ..-----•------ --•-----•- Pipe, Galv. Screw .................. •----•--•---• ............. ......... .. •--••• .-�-• . Lead Connections .:................ Curb Cocks ......... ...................... . .. .--.•--•./ ............ -•-- -- -------------- l".- ...........'Corp. Cocks ........................... ............. •------------ -•-- ..... .......... Unions ...----•-----...._................. •------•------ -•-----•-• Saddles ................................ ... .............. ---------- w........ ------•---•--- .......... Ninples..................................... •------•----•-- ......... =- ......... ............... ......... Bushings --------------------••-•----•----- .............. .... --.... .......... -------------- ---------- Plain Ells ................................ ......... --• ............. .......... .............. .......... Street Ells ---------• ................... ............. ..... _... .............. Tees --------•• .......... Curb Boxes ---------=------------------ -------------- ........... ---------- .............. .......... S. O. Extensions ................... .............. ....... -... .......... ............... --•-•- Gates ......................................... ............... ............ •-....... -------•---- ------•--- Plugs --•----•-----•--•--------•-------------- ............. ............ .......... .............. .......... Couplings ............................... .............. ............. ......... .............. .......... .......... •----•---- Gate Boxes ---•---•------••------------ ................ ------------------------------------- .............. ............. --•-••-•---• _._._.... •-------•-• .................................................---- -••-....._.... --•-••--•--- ........... .. .. __ .. .. ...__ ..i"_.. _. .............. ...... .......... ....................................................... ......................................................................... ............... 7i -............. _�� --........ .............. ..... -- ----- ..-------- �- +t.-- ----------------------------------------------------------- Hours Time —Day Men ---•---- Hours Time —Monthly Men---------------- --------------- -------------- ------- ---- • --�-. ---------- --•._... --. ........ Hours Time —Auto ......... ....... -----••.............•--• Superintendence _....._______......._....._...._... --- - ._ TotalTotal��. N ADDRESS: TAX ACCOUNT/PARCEL NUMBER: �(�tll�gTy O TU ()r2D j BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) FOR: &C -16ajg jWP ffi� �tAl f (R M-00 CRITICAL AREAS: q Q—DJ A DETERMINATION: ❑ Conditional Waiver ❑ Study Required x Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: SHORT PLAT SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR: WATER METER TAP CARD DATED: LID #: LOT: BLOCK: L:\TEMP\DSTs\Forms\Street File Cheeklist.doc ;.....I��_ o�O�� a �I'� � � ^� 'Pl ai t r Ft r 'W3 4 t. 4.__. CITY a� EDMONDS. W115HINGT i 4 B61LDINGERMIT s 1 utr� indiate Thl -.S •.ice Is For r s t 7.i sand niffiaent dcils to P4. s { S Applicant hereby certifies that a Plot,Plan dlawirig . ed hereto. City inspector; Only l t I requirements of this code are attach the intention to fulfill all req ! ttts e! t PPli�aO° ia'hereby wade for permit to do the following work: ........._. ..._...._.. - _ _- ... 4 ..-...--•_- .r .. I,.:. ................. _.......... _...................... _..... ........._-..-...-.._. • -l- 1-__.-.._._.--__.._........�..-._..—....— ............... ..-_....i...._...--...--_.--._... lYnt.-- y.................._..._..._- ............-...... B.ock-.._-.. L.oc----..?.................................... •__. .--_.._..- i�• ; 1} ;`S s:.1'r'rcr: i-.-..._...._.-......._.........__...._..._...._...-_....__.._ _.-__... E ._._.._--.__.----- ----------- — — . ... y1.. __..--.. - __._ _. at...._..:. -.-... 1. Budding dimensions .............. I. _ t...J_y..................... %.Q........-. 2: ,.ot dimensions .................- ., '• ,� t -,i tiY • .--.....:-stones. r 3. Building end he ..--.....1... a . - E: =. 4. Basement -.. �.. "1 l S. Occupancy of wilding w ll i c..._ J� ... ( 2L...----•---'- - 6 , S •,•-,.-. feet from the nearest adjoin ng line. p t '� it �� 'fib '',•i�'' _.__. . I? 7. Owner...._.. • ' Uq7� 8 . owners -- __._.__.__..._...._. _ 9. Builder...._ ... ---,•.d ' ...... ............. _� . tf, _..._. _. 10. Builders Address-•-•_-:-•s°� •'''' - y� n t�`rf`PNk }u rs�l� --- - —._. y b Date-..-- .............. k : �-� r ( •.. ..... .. roved pl tns and spectGratloru peruuung hereto `,"� hereon. according to the approved tf it Ss2 f++ permission s hereby granted to do the work descnbed of a p t compliance wit the ordinances of the City n idly f Y subject to comp E. _.a 1 mat S ., � �_ i. U L f�._ I t�✓^ I r)S# C 1 �t f l Life of permit . d a.•. ` Received byi Mt' C 111 �No, `' PERMIT N° 562. plans filed: Yes g N ,O �rC➢epaaztmmt cf BuIIa kk. o r • . �� r � ju th me d p.rw tm�tb: ' Yw• ' ,Ae ; - F , is iwed tb.LL 6e baud w e.tlmued'tort a the D-fioiO't seoctitre !m .dd8ton.• fee S t lee which vDPlicm[ D•r• tc tbm 5%- ppl cad .geu to P•r t. 1. -ne building Phan- when rm.lb aettrmloed. taeds the e.r,m.ud tau by coo ` y si000.00 of tort. If t6 tm.i < u of the mannte. w -- « mF e, i.- d $z o0 for each ii000.00 of such eatKv ctrt. toWu mats thm Sttpo.ao 1« .bub aavr d, to dj.taai,l�d�, r ' tx rue cu.tutunien u aaa cd tot urr meet"• .hW 1a .nnmpudtd by ooDl•`°I.� 000rc.a . 2. Wbetu.et . ewtn f Pdttwnd+. the .DDheuioo roc . baDdfoe Dot - L. _ v% Building coda or the Cl, o of iabw.ud.lr • dd•iOi _m ��t9m d; t •'l ' } �� ,Decira.ti— ha Iad a rial l,.«acce raaia an d he l� a th •��t et tab«;me work• aatdr shnatd be abt,mea [.tm the dearer om« d the p, ,lb��e.xs shculd b..A •';, ;-rlw m emoiorfu6 .m Lb-.VO « �4-, Fun ianaurdou. m io ,tttty shndd; oyofo,rdaaae:tram .Il,wb<ooa.m:a.. ,..� v, e4• the D•rt°n and make movthif teDore of P•l•o tm«avn Aa: �qt k -rail P•rm•°S the owtar ah,lold obtain . rcloae f•® the Igme•i enrm.tvm �•$mte Icdvmr+l .muea br the Deveetmmt d tabor .ereii"- .'lite••b°"y`D14 .-•y ^e-�:• 3�" d{; h ,.k 5k t at � - 4 3Y rtMly' l. J.r- . b n r i 0 PERM) eLa t'JIV�� PkL6Y lvo ,CITY COPY N fi.acy CA FILE NO. - Vol Areas Checklist 00 Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: / D S 2 2. C,;Pmperty Tax Account Number: de /!q 00 Gi—O 6 A 3. Approximatetlte size (=es or square feet): 4. Is this site.curready developed? dyes; —.no. AqR ® If yes; how is site developed? 5. Describe the general site topography. Check all that apply. r��r 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% ( z vertical rise of 10-feet over:a horizontal distance of 33 to 664iu0_= Steep: grades of greater than 30% present on site (a ver 9 rise of W-feet over a horizontal distance of less than 33-feet). Other (please describe): r 6. Site contains areas of year-round standing watih ; Approx. Depth 7. Site contains areas of seasonal standing water. r4r_2 Approx. Depth: What season(s) of the year? 8. Site is in the t1oodway_.A0_ floodplain of a water course- 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year- round? Flows are seasonal? (What time of year? ). 10. Site is primarily: forested ; meadow: ; shrubs ;mixed ; urban landscaped (lawn,shr ubs etc)_ . 11. Obvious wetland is present on site: . For City Staff Use Only mapped soil typew? (q �M(e�f,_,.,,. IMi9wn' I.a.A' �ndL,e 9-Isw..,s - 3 r< .Vetlaa8 inventory or CA. map indicates wetland present on site?,. No 4s .; %lri6cahAreas inventory C.A: u�ap iodic tes Qritical Area n site? 'WItbIII'designated eattll denOC'iandSlldChBZSrd BPCa? j`Ip o tx'desrgnated'on'the Eavirvnmen�ly Se�tive.Ar�eas Map? -, ETERMP4ATION xX. .. VTtJDY REQUIRED f >` OONDI'I'IONAL WAIVE' � a' a_. f 6 fanner .Date _. }•�• ♦a .I>A.7.i - � ,. ,.1145/-yi; - ytil !- - - $i1�iSc1?�F!�• . ins ti- 3 MAR �J City of Edmonds : ;; ....+tir sv►s Critical • Areas "� Checklist The Critical Areas Checklist contained on and submit it to the City. The City will this form is to be filled out by any person review the checklist, make a precursory site preparing a Development Permit, "Visit, and make a determination of the Application for the City of Edmonds prior subsequent steps necessary to complete a to his/her submittal of a development development permit application. permit to the City. p • With a signed copy of this form, the The purpose of the Checklist is to enable applicant should also submit a vicinity map City staff to determine whether any • " " or plot plan for individual lots of the parcel Potential Critical Areas are or may be '��with enough detail that City staff can find present on the subjectproperty. The - - . ... end identify the subject paroel(s). In information needed to complete the . ; _ add'ih'on, the applicant shall include . Checklist should be easily available from offier pertinent.information (eg. site observations of the site or data available at Plan, topographY map, etc.) or studies in City Hall (Critical Areas inventories, maps, eogjunction with this Checklist to assist or soil surveys).. �4i ": Y )• : '" - ;. . staff in completing their prelimmary assessment of the site. An applicant, or. his/her representative, :. must fill out the checklist, sign and date it, i have 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). $lgABhicC. �L Date} - si$08�(� ' . r dot Dg1C ti a ♦p,�.s < n i 4:- \ - �:� .•tea �/ -•,a � .. - wn. - 97 _r. i � al ' J� E `- s �� •�� n r:_t. re�w4"'°q;� {+3 � S ''�S z� ' �� :`* x �� •,i..r,� � :r-d' .< ��&^�` ,sue qay ", �,, '.`� , -�=� y�%'+ rol i-7k..1,-7 �rak�. .c y� < �.�,; � y, fit•` u`. [� ., y 3nx.�'�y.L zrr � ,-�i�- Fs".y �'..� . .. -'fin . . �-� Y.. - (�.f!6!i�. .., •'�`f`•'.S �'��....� , .�Y'+'u, , . •t Dy!'M . '«k �t Q-t'C4� f'r� .'.Lc��a Yf-t i,-` �.- �%'t1�J's"`�'� F.. .. APPLICATION The Cityof Edmonds for SIDE SEWER PERMIT NEW CONSTRUCTION 0 REPAIRS C] EASEMENT No ........................................... 107-05800 OWNER._...._. Chris _. E �_....... 1................................................................ CONTRACTOR......................................._..__.................................... ............. PERMIT No....................... ADDRESS .....10.2...B...Street ................................................................... LEGAL DESCRIPTION: LOT No.................. ............ BLOCK No............................................. is NAME OF ADDITION....................................................... DYE TESTED ON SEWER JULY, 1972 Approved: DATE................................••.............. By...........•.................................................._....... �� cc RECEIVED APR.2 0 1998 PLAhrow DEPT. Return City 9B020.401ij�1 Clerk City of Edmonds 0 2/ 0 4/ 9 8 10 : 2 6 1215thAve N. p.0004 Recorded Edmonds, WA98020 Snohomish County Covenant for Accessory Dwelling Unit Property'Owner 0 (grantor): Donald Paris Lois Paris Legal Description: Lot 5, Block 4, Yost's First Addition Section 25 Township 27N Range 3E. WM. Tax Account Number: 6194- 004-005-0109 The purpose of this document is to establish that a legally created nontransferable accessory dwelling unit exists for the above grantor/grantee at the site described. Terms for this covenant have been agreed to and signed by the property owner(s) in the following document., COVENANT ACCESSORY DWELLING UNIT WHEREAS, the undersigned owner of property has been granted a conditional use permit by the City of Edmonds to maintain an accessory dwelling unit on the hereinafter described residential realty, and WHEREAS, such approval is subject to certain conditions and will automatically expire in the event that such conditions are no longer met, and WHEREAS, among those conditions is the provision that the permit is personal to the applicant and will. expire in the event that the primary residence and accessory dwelling unit are rented, leased, sold or otherwise conveyed to a person other.than the applicant and undersigned owner, NOW, THEREFORE,,d_.Q,Q,,,�u, (hereinafter "Owner(s)") does hereby covenant, stipulate and promise as herein set forth: 1. Touch and Concern the Land. This covenant touches and concerns a tract of residential real property (hereinafter "site") with a street address of Edmonds, Washington, and legally described on the attached Exhibit A, incorporated by this reference as fully as if herein set forth. 2. Existence and Expiration of Accessory DwellincL- Unit Approval. On the application of the Owner(s), the City of Edmonds has approved a conditional use permit to 'installan accessory dwelling unit at the subject tract described in • • A Rfa Olt Abo* 1 in the incorporated paragraph rporated Exhibit A. The terms of such approval and conditions are described in Chapter 20.21.of the Edmonds Community Development Code as the same exists or is hereafter amended. Among the conditions are the requirements that the approval is personal to the Owner and shall automatically expire whenever: 2.1 The accessory dwelling unit has been substantially altered and is no longer in conformance with the plans and drawings reviewed and approved by the City of Edmonds. 2.2 The Owner(s) ceases to maintain three or more off- street parking spaces on the site for the use of the primary residence and the accessory dwelling unit. 2.3 The primary residence and accessory dwelling unit are sold, rented, leased or otherwise conveyed to a person other than the undersigned Owner(s) and applicant. Therefore, in the event that the residence and accessory dwelling unit shall be jointly sold, rented, leased or otherwise conveyed to a person other than the Owner, the approval for the residential real estate shall automatically expire. 3. Covenants to Notify and Restore Property. In consideration of the approval of a conditional use permit to g maintain the accessory dwelling unit permit, the undersigned Owner(s) hereby covenants to notify any prospective purchaser of the automatic expiration of the accessory dwelling unit upon the sale, rental, lease or other conveyance of the herein described residential parcel. The Owner(s) further covenant that, prior to M!g • '1 • closing such sale or conveyance, the premises shall be restored to its original condition by removal of any kitchen, facilities other than the primary kitchen installed for the use of the primary residence. DONE this day of 19L? .OWNER(S) STATE OF WASHINGTON ) ..' "'4 , ss: COUNTY OF -: a ; y �$,.� o V -On this day of �� —�'� 19 ��, before'me" undersigned, a Notary P lic duly commissioned and lit, �.� personally appeared '/ to me kn`�i 7Z� be the individual (s) described in and who executed the foreg8ing..... � Covenant, and he/she/they acknowledged to me on oath tat they executed the same as their free and voluntary act and deed. NOTARY PUBLIC My commission expire : City of Edmore HT-OF-VVY`CONS ON M �,v PERMIT . MAY 2 ? 1996 NGINEERINru tstiueDate:�Zg=`j A. Address or Vicinity "of Construction: _( a-4 :9- , dS.Z PCti E l 8 B.-Type.of Work (be specific): �Ar5e LT Pam."►N G:.:. 9p 19 C. `Contractor.. �� f N Ll)C�1� ' 1 f✓ C6niact: Mailing Address:. r`j y 1 SF Phone: (?�la) C(4 8 — I7—L,=19 State Lcense #: 0lo'l k5 ability Insurance: C*.> k Bond: $ t yON,L0sT b LA 3Z y119-1 . D. Building Permit # (if applicable): Uz Side Sewer Permit# (if applicable): E. ,,�!D Cc6nerciaf ❑ Subdivision. ❑ City Project ❑ Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other INSPECTOR: ' INSPECTOR: F. Pavement or Concrete.Cut : ❑ Yes ONo G. Size of Cut: x H. Charge $ APPLICANT TO READ A14D,SIGN INDEMNITY: Applicant understands and by his signature to this application, agreq* 40hold the City of Edmonds harmless from L; juries, 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 departments or employees, including or not limited to the defen4e of any legalproceedings inchrding ¢ef a costs, and attorney fees by.7 of g thispermit. THE INSPECTION D ACCNTRACTOR IS EZ& SIOF �R WORKMANSHIP AND MATERIALS D kFgTORATIO FOR ESA PE IODYF ONE YEAR EL-0 UDO�C'I� EO 1 7/61R ET��71PH IS COMPLETED BYCITY R ,A T WHl� EA DEB OR b&DIT WILrB�E OCE ED FOR ISSUANCE TO THE APPLICANT• Construction drawing; otgroposed-work-tgquiied With �drin"pplicatign- 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 byth Ci Engineer. Allstreet cut ditches shall be patched with asphalt or City approved material prior to the ei5d 6fthe rkirig d'ay; NO EXCEPTIONS. I have read the above statemepfis and understand the permit requirements and the pink copy of the permit will be NO WORK SHALL BEGIN. PRIOR TO PERMIT ISSUANCE ' Eng. Div. 1994