1017 DALEY ST.PDF11111111111111
10716
1017 DALEY ST
ADDRESS:
TAX ACCOUNT/PARCEL
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 (OTHER):-gUPN,�IL1 M I t%Y--IqqOZvqO
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:L �Q
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR: 1
WATER METER TAP CARD DATED: 1 I Zb S-f
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LATEMPOSTsTorms\.Street File Checklist.doc
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%-i--.CITY`OF EDMONDS. WA1SHINGTON •— DEEP ARTMENt'OF BUILDINGSIF
SUILDING
.IT
;ebq' certifies that a plot; plan, drawings, and sufficient details to indicate
i,to: fulfill -all requiremrnts of this code are attached hereto.
ma&.-lor permit to do the following work:
s hereby
C
......._.._..._............................................ .......
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(Streeto r or la a blcrY oumben)
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�l aBtulding dimensions are ................................•-x---'--..............- •----._........
Y.,2. -1nt dimensions are _..-.._-..4c.. ........... x....__.....---...------.................
3. Budding will be_-._.._-__-_,� .stories in height.
g g
': 4. -Number of basements ........ T �
t' S. Occu an of building will be ......--_•-------..._
P cT g .I.._...--.... -- -
6: Building will be..._ : feet f- : ----_----�aaJo--- lot liryf'
7. Owner..:.__.--..../-. __...-_....-----
...._...........
8. Owners Address ...................'--......................---._..._.._........................._....................--•
9" -Builder ............................ .. .... ........................
10, B6ilders Address ................. ........... �...........-.........-......_..
11. Architect or.enggineer................. _..a ...................
/._.�.C-....... -.. ......._...._...._......._-..
Date ....... 111ct... / . fJ-...... `� _..19......... / d \ A' x
Applicant's
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Estimated cost a---...........CG a -,
GroupNo. ..... ........... .................. ...........
., ..:
Life of permi t! i
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- dale
Plans filed:
Yeq-&L- do G
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Permission is hereby granted to do the work detrbed hereon, according to the :.pproved plans and speci5cations pertaining hereto,
subject to compliance with the ordinances of the City of Edmonds. This copy is your receipt .for the following fees:
1. Building permit fee ....................................................... $---•------•-.-._..._.__
2. Sewer permit fee.:. ........ _...................... ................. ..... $...................................... ;
3. Inspection and supervision fee ............................. .......... $---------------------------- -------- O
4. Total ..................................................... ................... ..-..... ......................... _.... _.... .... _.. $......
Receive b
als;'
PERMITl�lQ �r��1 Y Dep_rttnentof•Buildings .•'
111 City of Edmonds:
1. The Luilding permit fee which applicant pays wLm permit is issued shall be based on estimated cost of the proposed structure, at the rate of $1.00 for nib
$1000.00 of cost. If the actual cost of the structure, when finally determined, exceeds the estimated cost by more than 5cl, applicant agrees to pay an additional fee
f_S=•00 for. each 51000.00 of such excess cx,— In such event no use permit shall be issued until such "discrepancy fee" is paid.
•�Whmevu a contract fOr mna nialotl is executed for any stnamare costing more than SI000.00 for which a licensed architect of engioeer is am regtiired•by.
(\ 1lding Code of [he Ciry•of Edmonds, the applicattien for a building permit shall be semmpanied by • copy of the contract and 'a copy of the denfled '
Prionm edtPbyin ray labnr_or tnbtmegcing work, notify, tbe.lndustrial Insd�rancE'Di�tsion of the Pa+tQt Qf Labor and Industries, giving an estimate of
the pay -roil and make monthly riitnrm of piyroll��-Fu11 ms--h;n ns sn�ufd•k, o�tjincd� from the orarnt ice oP.(Y��`bePa+tmmt of labor sod 0oarries. • More
final payment• tb, ov(ner shgnld obtain a reiease, from the general contractors who in,turn should obtain release from all aub•contracron. �The`releaees should be -
sstested by the Depariltramt of'Labcrand Industries:; T'he,abtive procedureiar requiremenn of the'State Industrial lasuranca,Aa. '"'1 �_`,, �•�`.
�'• ti,,ar�'`r�K4rr�o+'�'�+=�ic,.rrr`�+vr��kr^�t-hA-w�,r,du�u�r•r•�-,nr.�r•._ , :: '�'yv^�,1�„'t,Sni�yy��•^^Nye"�i••�#`�iw?�nrEA'Fr�tw�'fYe�"'"�^+rs'rr�'9�iti-Y'���
CITY OF EDMONDS R E CV V D
COMMUNITY SERVICES DEPARTMENT r
yr. RIGHT-OF-WAY CONSTRUCTION PERMIT
APR 17 1991
A. • Owner: NWashington Natural Gas Company ENWIN E
8a,SeMercer Street
14jilipElIddress WA 98111
City State Zip
Permit No.
Issue Date — 6 5
Name
Mailing Address
City State Zip
License ; Number , . . ` Telephone Number
C. • Address or Vicinity of Construction: 1017 Daley Street
Type of Work to be Done: Install New Service.
D. • Work in Connection With: ❑ Sub or Plat ❑ Single Family ❑ City Projects
❑ Commercial ❑ Multifamily C] Utility
E. • Pavement Cut: ❑ Y ® N F. 6 Size of Cut: X No Cuts
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and. by, his signature .to, this application,. agrees to ,hold the City of Edmonds
harmless from any injuries, damages,. ot'claims' of any kind `oi: description whatsoever, forseen or unfocseen, that may
be made against the City of Edmonds, or'any.-of.its;Oep rt ents or employees, including or not limited to, the,,defense
of any legal proceedings including:defense costs, cou t 2csfs, and a orney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR'W R ANS A -M ERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND; ACCEPT, E OF -THE WORK.
Estimated restoration fees will be held until the final.street patch is completed by City forces, at which time a debit or credit will be
processed for issuance to the applicant.
• A 24 hour notice is required for inspection; Please call Engineering: 771-3202
• Work is to be inspected during progress and at completion.
• Restoration to be in accordance with City, Code. '°'• �"
• Street to be kept clean at all times.
• Traffic Control to be in accordance with' City regulations.
• All street -cut. ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and that this permit must be available at the job site for inspection purposes at.all times.
r
Signature: Date, April 10, 1991
Owner or Contractor
J
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG PriorJo Beginning Work
>, APPROVED BY: R W PERMIT FEE:
a
OTime Authorized: Void after I 4I gAil— days. Restoration Fee:
w Special Conditions: N ?- Receipt No.:
to Fund, 111 Fee:
a --
E�„ Street Cut'Dirrietision ,I x =
U RELEASED BYI ��/ a r\ �'� —�� I INSPECTED BY y Date
� Date
O
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. March 1989 .
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Den t.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1
.1 0
4
101-7 1�6-lam`(_ ��
Addendum to:
City of Edmonds •
Permit Application
Engineering Aide : Kerry Walsh
Washington Natural Gas
622-6767 x 2588
t�i O �,1TS
pFbR"��C�
"SAS MAk
KEY:
-ss- sanitary sewer
-s- storms
-w- water
0 water valve
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CITY. OF EDMONDS S / �JcO Z—
Permit No.
COMMUNITY SERVICES DEPARTMENT
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date
A. • Owner: B. • Contractor:
Name Name
Mailing Address Mailing Address
7 cam, 4-t
City State Zip City. State Zip
i-s caa��'c 67a-ydr//
State License Number Telephone Number
C. • Address or Vicinity of Construction: a /-- / o i 7 L) . F y 1
Type of Work to be Done: _5 C'
D. 4 Work in Connection With: ❑ Sub or Plat &I Single Family ❑ City Projects
❑ Commercial ❑ Multifamily ❑ Utility
E. • Pavement Cut: ❑ Y ;LN F. • Size of Cut: X
APPLICANT TO READ AND SIGN
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, forseen or unforseen, that may
be made against 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.
THE CONTRACTOR IS RESPONSIBLE. FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF I ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Estimated restoration fees will be held until the final street patch is completed by City forces, at which time a debit or credit will be
processed for issuance to the applicant.
• A 24 hour notice is required for inspection; Please call Engineering: 771-3202 STRtt
• Work is to be inspected during progress and at completion.c
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times. LE
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and that this permit must be available at the job site for inspection purposes at all times.
Signature: Date:
Owner or Contractor.
This Permit Must be Posted at the Job Site .For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY: �E7
Time Authorized: Void after �� days.
Special Conditions:
RELEASED BY:
Date
PERMIT FEE:
Restoration Fee:
Receipt No.: 102960
Fund III Fee:
Street Cut Dimensions:
INSPECTED BY
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Date
Eng. Div. March 1989
1
FIELD INSPECTION
Comments:
Diagram:
!
(Fund I I I - Route copy to Street Dept:)
J;
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 198.)
, •..-• .,...,.v' .._r�,:,: r•�... . � .yam-; �•. ,•1 f`ii f,�'•.. .,�;,,y�tarVhti`V �� _; i,,,,y-,a�v.� 1" r�✓'��*i- 4:'�� 1� '_-J-.J rl��i"�5��' +��cL�`!r.6"' YJ
�T CITY of EDMO S SI SEWER FER�MIT,::
For Inspection' Call 771-3202 PERMIT N0. '08036
Address of Construction: /U / 7
Property Legal Description (Include all : easements,) : ,_; e0,7,5
Owner. and/or Builder: 0 V
Contractor & License No: A efaeCa r-Co
Single Family Residence EOMONDS
TOWMENT. PLANT
Multi -Family-
(No. of
Units )
Commercial
.(No. of
fixture Units
)
Invasion into
City Right -of -Way:
No
Yes. (If Yes, Right -of -Way
Construction
Permit required.
Call One -Call
-Center (1-800-424-5555) before any
excavation.)
Cross other Private.Property:
No Yes
(If Yes, easement requi.red,
attach legal description.and county easement n er.)
PLEASE. READ THE ITEMS LISTED ON THE BACK
I certify that I have read and shall comply
with the items listed on the back.
.S--2
Date
Permit Fee:
F Issued By:
Trunk Charge:
Pl���-'
!Date Issued:
2 �9
Assessment Fee:
,:;rt
Receipt No.:
/DSO
Partial Inspection:
Comments
Date
Initial
Final Inspection
Approved: 12�
00
Rejected:
Date Initial
w� o✓ �:
%/_
Re son -�;ws� .
Y p �b o.
a�
Initial
** PERMIT MUST BE
POSTED ON JOB SITE.**
a�
White Copy - File..Green"Copy -`.Inspector
Buff Copy -
Applicant
I
The City of Edmonds Side Sewer Drawing EASEMENT NO_ _________________________________________
NEW CONSTRUCTION ❑ REPAIRS Q� LID NO___________________ _ASMT. NO...____.___.__.__..
OWNER----------•----------11-------------------•--•-----•--•--•-•------------------------------------- CONTRACTOR----•-••----•--•-----•-•--•----•------------------•--•----------------------------- PERMIT NO.tc&— 3-(p
JOB ADDRESS .�_Q..`.._-.___ `- _�=-_ ------ �...:................ LEGAL DESCRIPTION: LOT NO. --------------------------
------------ BLOCK NO. ----------------------•-......
---•-----------------------------•--•-••---•-----------------------------------------------•--------------•--------------------------•----------------•----------
NAMEOF ADDITION----•--•-----------------------------------------•-------------•--•-•-------------------------------•------------------
t\ \
f
-�vqv��w� 7 0.�
Se,��
PWW-0001-11/75 (REV.11/78)
E �"••":O tV DS
TREA-i'�1EN'i PLAINT
Approved: (�
DATE.----1�...--•---.......-•-•----- BY ...................
•
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT EASEMENT No ...........................................
NEW CONSTRUCTION ❑ REPAIRS ❑
118-04250
OWNER. .......... Erwi.n..E...-Leibel-t--------------------------------------------------------- CONTRACTOR........................------......---...................------................------............ PERMIT No.......................
ADDRESS ......101% Dd1ej! St................................................................ LEGAL DESCRIPTION: LOT No............................................... BLOCK No.............................................
NAMEOF ADDITION.........................................................................................................................................
Dye Tested On Sewer 1972
Approved:
DATE................................................ By ...................................................
..................._.......District
City of Edmonds ---Water Department
TAP CARD
Date. ......... .: ...
. ...
NO... ..........
zl-z
........................................
Meter I Size......................... ....... Tap I No.'
Size....................... ..............
Mf9rvN .... . ....... ...... ...... Style .............................................
3 -LN ` ...... - - : ... - *
For .. .. .....
...........................................................................................................................................
...... 7 ................................................................................................................... . ..............
LotNo ........................................... Blk- No.
Add. 7;
I/ - — --------------
/ ................
Service Location .70(r� ................................... - ..... .............................................
Meter Location .... ...........
..............................
.........................
Make Tap
Pressure......... .................... lbs. Test...............................:
Send Bills to ............. w
............................................................... . . ....
# ...... ...... . ..............................
Date of Work ......... ;i�: I
...... .... !�, .................................
........................................ �Z ........ ...... ............. .................. Foreman
Guar. Voucher No
Remarks:
.......... . . ....... ......................................
....................................... . .............................. W.16 ....................... ..............
...........
...................................... .
................................... 4 ........................... ..............
................ ..... . .............................. ....................................
................................
-4i ............. ... . ............ ........................ C., t .. i.T .... F& .. E ... . ..............
.............. ....................... .............................. 7 ..............................................................
....................................................................................... . ...... .......................................
............... ............................................
..............................................................................................................
............................
OUTGOING Index .......... Reg ....... Route Bk --------- Stencil ...... Card ........
INCOMING Index .......... Reg ....... Route Bk ......... Stencil ------ Card ........
I erial Chargeable to Installation leers
NO.
SIZtE
DESCRIPTION
RATE
AMOUNT
-----
-/_--
Meter ........... :...... ...........
..............
...... l...............
Meter Box ..........................
.... :..
��...
•-••--•..................
Meter Plate ............................
--•'•
.....
..........
Check Valve --••----....• ...........................
--.........
..........
------------•
.........
Pipe, Galv. Screw ..................
..............
.._.........
..........
.............
..........
Nipples ....................................
•-----•-•-'--•
.............
..........
..............
..........
Bushings ..................................
..............
-
....._..
Plain Ells ................................
..............
.............
..........
.......... -...
-••-•-•---
St. Ells-------------------••-•-'----•-'----
-•••----
-----.---_.
..............
...............
..........
..........
..........
Tees ..........................................
.....................................................
..... .--------- •---------'•---•--•-----•--•-'•------•
......................................................
...............
-.............
..----------.-
..............
.......................
..... ..............
I ...........
..........
Material Chargeable to Taps Connected
NO. SIZE DESCRIPTION
RATE
AMOUNT
..............
..........
Pipe, Black Screw --•--' ...........................--••-.......
.........
..............
..........
Pipe, Galv. Screw : .................
..............
.............
.........
..............
,�..._....�.
Lead Connections ................
Curb Cocks
.---
..
-'--..............
=
' • j''
Corp. Cocks ... ... ..........
.....
.-.:
..............
..........
Unions ...----•------•--------'--..._......
.............
.............
........
........... ...
..........
Saddles ...................................
..............
.......... ...
.........
--••--••-•-•--
..........
Nipples ----•-----'-----' .......................•-''-_.....
...................--
------------••
.........
Bushings ..................................
..............
..........
.....•....
-•---------- -
--'--- ---
Plain Ells ................................
............
.............
I .........
.....--•---...
.... --•--
Street Ells .._......'•..................
.............
.............
..........
-------------
..........
Tees .......................... ..............
...............
......... _.
..........
.......... --•
..........
Curb BoxesI............................
..............
...........
........••
-------------...........
S. O. Extensions ....................
..............
'-••-----...
..........
...............
..........
Gates -• ...........................'--•........--•-'-•......
............
...........
._...
.J.... _�
... K
Plugs -_..... --
Couplings
-----•--• ....
............
. f
S=rS.
-----•------
•��-
Gate Boxes ----'------
----------
.. ,�.
Y.
..............
..............
..............
.......
_..
..........
..........................................................
-•---•................................................
...........................................................
..............
.
..............
•• •-
............
........
_........
- --
••--'-
��r.t�- ii c Zr. -
......
-9� .
...............
............------.............---..............................-•--....-'•-:..........---
-........
Hours Time Men ........
..............
....... /..
•-
_�....•
..............
.....I..
Hours Time —Monthly Men ..
...............
.......,�...
..........
Hours Time —Auto ------------ ---
-------------
-
......
--•' •...
._..._....
Superintendence ......................
..............
. ¢
Total
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