1015 ALDER ST.PDFiiiiiiiiiiiiii10028
1015 ALDER ST
------------------- _....... Distn-ck % 4 r9�
0
mtCity of Edmonds ---Water De arV'
TAP CARD
Meter No ..................
-
Size------------------------------
For
DatM AY..-.1.1954.PA111...
No- ----------------------------------------
TapSize ----------------_...........---.... ..
�..... Style .............................................
-----------------------------------------------------�-
.... FILE . . ......................
REE
LotNo ........................................... Blk, No. .......................... ..........................
Add---------------------------------------------------------------
Service Location ..,leJ1 ......................
.................................................
Meter Location .......
.........................
Make Tap
-----------------------------------------------------------------------------------------------------------------
Pressure------------------------ --lbs. Test .................................... %
SendBills to ... ...............................................................................
.................................................. --................................................. _..............
Date of Work ........ .. '�`�;f......................................:......
---- ci�.�... ----- ------- ----------------------------------------- Foreman
Guar. Voucher No ............................ --............. $..........................................
Remarks: ............................................................................................. .....................
OUTGOING Index .......... Reg ....... Route Bk......... Stencil ...... Card- .......
INCOMING Index ......... Reg ....... Route . Bk......... Stencil ...... Card ........
Oterial Chargeable to InstallationWers
NO.
SIZE
DESCRIPTION
RATE
AMOUNT
Meter ....--•------------------•-•---•-•---
-----•-•------
a...»---
T-57P
..........
Meter Box N -.-.'mo t{ .....
--.5--
.7.S
.----•••.................
Meter Plate ............................
..............
..............
......---•
Check Valve ..... -...................
..............
_».... ....
..........
..............
-••••••--
Pipe, Galv. Screw ..................
......... ;....
•- .........
..........
--------•-----
-•--------
Nipples ....................................
--------------
•.........
Bushings ..................................
..............
.........................
Plain Ells ................................
..............
.._.........
..........
......... »...
--••-•----
St. Ells ....................................
•---•------•••
..»........
.......... »...
----------•-••
...............
...............
---••-----
..........
-•-••----
........
Tees .........................................
-----•----•-----•-----•--•------•----•-•-----•-----•-
-••---•-•--------....................................
••••----••-•••••--•-•---•...............•-.............----..._----••
-..............
..............
..............
.... »......
......................
....--------
..........
..........
Material Chargeable to Taps Connected
NO. SIZE DESCRIPTION
RATE
AMOUNT
... _.........
....• ....
Pipe, Black Screw ..................
.............
•---•••.••---
.... -...
----•-•---••-•
..........
Pipe, Galv. Screw --------------•---
•-•---..-» ....
.............
.........
.............
.........
-
-------
tr
..
Lead Connec jo .......... ...
Curb Cocks ---------•-••• . • --
Ceeks.
............
•---•-------••
........................
.•--------.
.......
.........
D
Unions ....................................
........
-----•----
Saddles -------------•--•-------•-----.. ...
..............
..... .........---...
---•-••-------
•----•---.
Nipples ....................................
--•--••--------
» --
---------
--------...............
Bushings -•------•-----••---••----•---.....
..............
;::..»----
---••--------
----------
Plain Ells ................................
............
.... » .... »-
..........
..-----•-•----
..........
Street Ells .......................... ...
........ ....
.... ».... ».
----•• ......
..........
Tees---------------•----••--•---------•-------
-•------------•
........ ............
..............
..........
Curb Boxes ............................
•---------••••
--•-•-•----
..........
..............
..........
S. O. Extensions ..... ».............
------.......
....... »...
-•-------•
...............
..........
Gates ........................................
..............
--.........
...........
..
M3
Plugs •-- =-- ... . -•---- .
Couplings :�.........
.............
---------•--.......»..
-------
••---••-------
..........
Gate Boxes ------------------•-••------
...............
»....
--------------
-•
-------------•------
--------
-•----....»..
» ..»...
..;I
JQY
------------••
..............
.............................................................
-•--------
»--------
...........................................................
-------•-•••..............................................
............................................................
......-- »..
...............
------••------
»»»._...
-•----------
••------....
».......
-........
..........
..............
•--••-------•
---------•--.
-------------•
...............
----•----•
..........
»--------
-
_.
...........................................................
...----•..................................•--....---.••••••
...........................................................
Hours Time —Day Men ----••................
Hours Time —Monthly Men__
•-------------•
.............
--••----------•
.......___..
-----••---•-
....... »...
....... »...
............=
.-./.x..
»--------
».... »--
».... »--
Z--..
--••----------
..........
Hours Time —Auto ..........•. ••.
............
_».......
...............
Superintendence ......................
... ---
__»...
.»-------
Total
.,
ADDRESS: V`Afdg-,o�
TAX ACCOUNT/PARCEL NUMBER: f )"g p,374,356D
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS(RECORDED)FOR:
CRITICAL AREAS DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS
PLANNING DATA CHECKLIST DATED: AL�7lik
SCALED PLOT PLAN DA
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:� �'�`
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED: �� i Lf
OTHER: RD Vy ' N ' Z9,9 ( ?a
L:\TEMP\DSTs\Forms\Street File Checklist.doc
USE NMI VET18
BUILDING DEPARTMENT Applicant Fig 'ZONE 'UMBER 0366
a t I Inside Heavy Lines U _h
P
PERMIT AP:,.aTION ,DE _
TNAM[ lOR NAM[ OF BUSINESS) toil ALLi�iL Sln•E6 ` i'
j SUBOI V`SION NV. PLAT NAME ASS L990R M:1P No. •'li" 7:'.' 'i'
Y N.P.IL1N'i A
DORES) '��,� •�;P^.'Y:_").
PUBLIC RIG•.T OP WAY PCR OROIr1ANCE NO.
Q C TV J LLCP.tON4 NUMB[R
�� t1 �•fL 3e �^.2O C%1'J i1NG RIGHT OF wAV
S f
PROPOSF-O RIGNT OF WAY ,t... '•:,�>-E �"-
F - aer,CICNCY OF R,IGIIT OF Villy 1 Y
Y "OR",
DDAR9S STREET/UTILIt'Y WORK RCOU'Pec' ❑VCS ONO
r Q
PERMIT Pon WORK IN PtIn LIC R/W Oves ❑NO -•� •'e'-j,; •• '
CITY -- - - T[L[P:f ONE NUJ10LROENGRO UND WIRING IlCOU,RCD L'l VCS UNO U
j 11
NECTION TO SANI-ARv SEWL'R [IYES ONO at
NAMC TIC.. TANK PER...IT REQUIRED QYL's ❑NO [ t ��-- -,�• 4 �}.�
� ,t j--TIC TftNK PERMIT rI V. -__ - } ` }•• •'
Q ADDRESS I Ft
MEMO DA'reo
- L[ONON[ NUMG GITVCITYLIcCNSEC:tED BY[R SIZ[tK11l1.TNG 9VPlegal Description ofPrcperty,IShoW Belo;' o• Attach Foual
r� 4,V ` S C7 tIARK. PRE Js V ze - ;
z RuicE Sf3VLA10tL-R%Q t. i"tck
L��s �c'S� Is)v 5c
l lc o 7' G o- S--' 6
• F 41GN AREA �- i:N Re�tEW ADD
R ALLOWED I PRefPGSED COMPLETE
_ 1 IpA�RF
D � � it �e�t• �..,
rt
�5 -} VI,RIANCE OR CV PLANN,N. RNKW BY'. t).A'rE 'V P;{1 '•
K} YAnRO�b c C' LDT COV[RAcc
t ttt���••-���. 1r , 20 FRONT 5, 41D[ 15 *CA rt� .P/M i�l1VV+
Y[W lJ RC[•OENTIAL n OA[ i •�J `
LIM[ "R[ zo"L TYF[ OI COMirr RUCTMN C'a0[ Ii613NT 47 1 x t r y^•�,
3 V - tJ 9�`3 3� rnA�c• t'
'j ❑ NO N•q [SIDCNTIAL a aION tY �;ij�W,ty"'
❑ ADO �I..
r RETAINING SKGIAL IrtSP[ROR AR[A ill:': w°h,;Y IOCNPANT t,
O[MOL14N tJ WALL IA--[1OVIACJ 11717 eL IC F:.n•� 1 LOAD t 2. " J 4C1
[%CAVATR FCNC[ 0 Y[S t ;
ALTRR t^��
'; ❑ ❑ bR FILL I� {%_etT1 {'LAN CN6C [D oY -1- TM,S SITS 15 LOCATED 11J THE CI Y.,
• OF EDMONOS.' LOT SALES TAXI
i ❑ ❑Fq[-MOVE ^1swIN1 t�• SHOULD'BE CODED.3-04. •+ ',v �.�r
t R[►AIA INSP. POOL'
N:Imi—FT nI sTVRIes NVM 06R OI / _ + I•,-' ': -�;
( IOW[LLIN. Lo'C M,-A1tsA66 CiriL. QP=p• J7 4'' •,; rs;.�
NATUR[ OF WORK TO BE DON6 "'j'lyEfZt�1A l� 1NSu l.lq-Clo1•,j. �•.�Q.; .-1•{�':9"(�-6
tu•Q!w .1 �� /�;�QA,p�_� ,`. S 31 \`.in.. i'3.� l•.
y - - 0-
1 - - FLAN CM ECK.PEE VALUATION ►4C F J'T 3! %•j'•
PROIF-F ED USE
a E Li -• __ jOT PLAINDICATE BUILDI SETBACKS, eu,LDINb 29 324 12/
ADUTTI+O STRC 91C L „-/ 'a ar ax•�• x
•
i±
B /� Lo,—� y MECAANIC AL
FENCE - f - ) •,�i
SIGN
/ RETAINING WALL
Iu
SWIMMING POO1-41
__-9' •�'�
Ii//� � i LET'S LE6 FlR -- •�: =Y S-t
ko An
I hereby ackn3wledgc that 1 have read this npi iication; that the in• TOTAL AMOUNT DUE 'i i44 v
at t!
tormation gi%,n is correct; and tLat 1 am the owner, or the duly author-
ized agrnt of Ole owner. 1 agree to comply with city and state, taws regu- ATTENTION APPLICATION APPROVAL - ?' •,-,,x�,,, -
IaUng couswctinn; and in doing the work authorize.; thereby, no perien
will be employed in violation of the Lzbor Codc of the Stsle of Washington —IS .'ERM.IT Thi, applieatioJ is not a permit
eclat ng to Workmen's Co^ en_tie^. [� `•ra^'�. AUTNORIzcs until -signed by the Building Gffici7l or
NOTE: Permit Limit One Yezr(Except DEMOLMOSS and FILL- ONLY TNT his Deputy: and. fees are .paid, and
PERMITS without conditional use permit, which shall be completed in 90 WORK NOTED receipt is acknowledged in space pto-
4`s .
dayi: MOVED -IN BUILDINGS t112)1 be competed in >Ix nanths.) ,NS►ECTION '•Ided-
r I TUNE (OWNER OR AG'_N T! DATC SIGNS' DEPARTMENT DIRERO ATV �A 'J•-`
crrY
• . EC MON U3 Onrt .•?'
'this Permit coven Work to be dorm on private property ONLY. � 775-2525 � w _�y �
��� i .:�.�•,�::,_,'
1,y eun:trUetion on the public domain imrbs, sidewa.ks, Iriveways,
Tlarqu6ei, etc-) will require "Potato pe-rnrssioP. ,,,•,,., ,,„ c,i., voI :env _ :.....a. rnr I �..�
APPLICATION
The City of Edmonds for EASEMENT NO- --------------------------------------------
SIDE SEWER PERMIT
103-041 50 NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO ................... ASMT. NO...................
OWNER �1�ill am-E.--Carlson---------------------------------------- CONTRACTOR...............-----------------------...------------------------..------------..... PERMIT NO. --------------------
JOB ADDRESS ... 01S.-Alder --- Street...........................................
LEGAL DESCRIPTION: LOT NO- -------------------------------------- BLOCK NO. ......... --------------------------
........................................................................................................................ .........................................
NAMEOF ADDITION-----------------------------------------------------------------------------------------------------------------------
DYE TESTED ON SEWER - February 11, 1976
By Jim Jensen
Approved:
DATE............................................ By------------------------......----------------......iins
CITY OF EDMOUS c R T,FILE
i T
Ply ,RKS DEPARTMEtJT, ENGINE �iID I
APPLICATION FOR RIGHT-OF-11AY CO'4STRUCTIOf,1 PERMIT
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION 'PURPOSES
Applicant to Complete Parts A .aand B
A, Permit to be issued to: ( U, V D M11H CD 14VT
For Work at :(address or vicinity) \'� i L tir- S T
i,J '0 � �� �J Iv 1 _ -s � � �•-� � tic � � s
Type of Work to be done: a
(attach drawing when applicable)
Time Required -- Start: V3 A -I Finish: I21=c
Owner: I• a,
Name (; �t NOV 7 1978
L k D 1 9 Y '1 -I Mr. Of Public
Mailing Address Works
City State Zip Telephone Number
Contractor:
Name State -License Number
Mailing Address
City State Zip Telephone Number
B, INDEMNITY: Applicant understands and by his signature to this application, 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 or not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until
the final street patch is completed, at which time a debit or credit will be
processed for issuance to the applicant.
Work is subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this permit must be available at the job site for inspection
purposes at all times.
Signature: �-� Date: %
Owner or Agent
TO BE COMPLETED BY ISSUING AGENCY:
%,F — d o
Date Issued: //_/�-��permit No. P9 Fee:f1
Security Bond: ,;V
Time Authorized: ;FD
APPROVED BY
111- / / 11I 1 W,. •,i cnA 1
Da t e :,I
"UBLIC UTILITY DISTRICT No.l of Sn_ mish County -AREA
k-,10177
locatian ��
r
Date _ W.O. No.
T -3 R Revision Scale
Reason for work \ _ Engineer 1\ As Built —"
1=0i:� : NZ K\\"-\S
U.G. File No.
z 3 K \,4,i
PEI#`MIT REQUIRED
Type L' 17 1�71 �� $
��FOREIGN CONTACTS
Corhpany
JAN. No.
Date Granted
Fees required YesQ No❑
Type
Log Posted
Inventor
Transf.Card
Pole Dept.
Date �� _ 3 Amovn �'0
Map Post
Circuit Ma®
Approvals
�\ EASEMENT ENVIRONMENTAL ANALYSIS
Exempt under District SEPA
procedures, Section 111-A
Grantor Paragraph ,Item\ ��
Date Granted Date \ - LP By J7DS S`
Interpretation Referred To:
Date Released For Construction Date- By
Date Work Completed By Foreman Circuit Number Substation T �_O.H. U.G. Cond KV.i P T '=
Add Ckt Ft PH
Remv Ckt Ft PH
Net Ckt Ft
rJ
Jj
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MA
- O
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AL 13'z
L N/A UL� 1Jk 5TRtc-T
-S l_ 1 A L t. D . -
k\ L1-3'`l'I L K v A r ), ).
\-D1 ST\,D,\CT ,-�1D, V"
SC 1: �-- t,10.
wrarer
I Sewer
Gas
Backhoe
t `-
iz lw
\Rq�csr—
Z)
- T
S,v i RANSF.
\1 DL-7 A c., / (= v .5 t AT ( U PS
V. �- L 3 " $ l- C , �� \ S L1� , T�2 L �t C \A \>\, I \, ti/ 3 (. ' C C-) _S T
L (�. tZ 5� �' O L��•
W.O. No. 3 8 4_ 6 l
. t"
STREET FILE
INSPECTION RECORD
CITY OF EDMONDS, PUBLIC WORKS DEPARTMENT
DATE: PROJECT: L.,%DP-2 ST
;Y:
PUBLIC WORKS DEPARR'RT
BUILDING PERMIT REVIEW
...�r,rcT III F
� 2`7
(address) to
Str -o -Way Existing
(9 b REQD
-
z
Access Easements Existing
(\} (,�;-
FA
Utility Easement Existing jU O
N REQD
w
Lot Per Subdivision —' Plat
Assessor Map
w
Site Plan Checked for Accuracy
2l --7
z
Underground Wiring Reqd.
•�r-
H
Check Accuracy of Legal Description
a-. 2
—7
z
Review by
Date. 2 2
-I8
w
Existing Water Main Size
Wate in Required
Service Line fired
Hydrant Size Existing
c4
Hydrant Reqd Per Fire Code
Size
w
Detector Check Meter Reqd.
Cross Connection Inspection
H
Fire Department Co
3
Water Meter ge Regd.
Revi y
Date
eptic Tank Design Approved
Date
Sep 'c Tank Permit Reqd.
Permit No.
Sanit Sewer Availability
Proj.
Drawing
File No.
Side Sewer Av ability
w
Sanitary Sewer tion Fee Reqd.
3
Review by
Date
w
Open Ditch Existing
Regd.
Culvert Reqd.
Size
r�4
Catch Basin Reqd.
Indi e on Site Plan
Shoulder dra' e maintain collection an swale open runo
H
Manho reqd.
Indicate on Site P1
it Conditions and Ground Water Field Checked
Review by
Date
Revised: 1v10-1977
Page 2
Revised: iv 10-1977