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1020 4TH AVE S
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CITY OF EDMONDS ASSET INFORMATION SHEET
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L]4 NEW ASSET N0.
❑ ADDITION ADDITION TO ASSET NO.
❑ RETIREMENT
DESCRIPTION /,ry
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SERIAL NO.
LOCATION ✓
DEP NO.
* * PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
*PROJECT NUMBER &,),
PROJECT COMPLETION DATE
COST
B.A.R.S. ACCOUNT NO. '���� GG�' ��'�� � � �'� 6--�
ESTIMATED LIFE 6
INITIATED BY
DATE
APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
2---DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE
b P INITIAL
DATE
Zees 2,
VERIFIED BY
PROCESSED
BATCH NO.
CJi:lsriR`i'KEN"; - F11, P
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CITY of EDMONDS S EP 27 AL,' SIDE SEWER PERMIT
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For Inspection Call 771-3202 PUBLIC WOWRMIT NO. 07388
Address of Construction: i� t-.
Property Legal Description (Include all easements): EDMONDS
NT
Owner and/or Builder: itt.�`TZ. �IG�'L.t
Contractor & License No: I��.4�� L����C.'_ �1��`"�rtillj i-1 =)
Single Family Residence
Multi -Family (No. of Units )
Commercial (No. of fixture Units )
Invasion into City Right -of -Way: No V' 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 required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
`1
71.
I cer ify that I ha e,read and shall comply bate
with the items listed on the back.
Permit Fee: 30• pU
Trunk Charge: 0D
Assessment Fee:
Partial Inspection:
S _1EET FILE
Till
Issued By: ,'a6
Date Issued: 2�- 2 �7-9
Receipt No.: '9f315-1
Comments �S
Final Inspection Approved:
Date Initial
Rejected:
Reason
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy - File Green Copy - Inspector
Date Initial
Date Initial
Buff Copy - Applicant
a0go/
The City of Edmonds
Side Sewer Drawing
EASEMENT NO- ........................................ A%
NEW CONSTRUCTION X REPAIRS n LID NO . ................... ASMT. NO . ..................
OWNER ----- �AO..M.. S5 ...... I 5;�-t .......................... CONTRACTOR ................... PERMIT NO. 773.1611B.
JOB ADDRESS ... tO 2,0 .......... 4-- r ". A,4. F-.. .......... LEGAL DESCRIPTION: LOT NO ....................................... BLOCK NO. ......... IEDMGNOS .....
TREATMENT PLANT
............................................................................................................................ .. I - ------- _ I
If— 22.'---wi
PWW-0001-11/75 (REV.11/78)
NAME OF ADDITION
.......................... ............................. — ........................................... ........
3.5'DP.
220 BEND
Approved: 1
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DAT16&IL15, M5.. By., 414. f .....
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PROTECT REVIEW CHECKLIST
PROTECT ADDRESS: /Gb�Oyr'-
Reviewed by: (initial date)
COMQNTS
PLANNING
WTR/SWR STREET ENGNRNG
BUILDING
01177//
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4 FIE
mmjT PLC/COMMERCIAL - (Circle One)
®; -' Planning
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HACK AD
(%' PERMIT '„
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CHE
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@QUIREMENTS
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1111177FI
FEATURES
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VEHICLE ACCESS . '�'
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6
(On Site)
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7
_
1F17T15T
ION VERIFICATION &A
ICATIONS '
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10
LIC/PRIVATE —1 �S`
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11
R CO OMMON IF LID "
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12
ON REQUIREME[JI'S !/
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13
JNSTRUCTION PERMIT READ
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14.
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PUBLIC IMPROVEMIIM
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15
NS 6 GROUND
/
OCKED '`^
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16
RE)UIRED
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17
R REQUIRED
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18
111171111
RID
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19
RIVEWAY REQD
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20
��
GN REQD
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21
22
ILABILITY
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23
MAIN SIZE
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25
777777777777
26
27'
%ISTING :;..
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777777/77
.ON INSPECTIM REQD
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MM REQD ��
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30
fARGE"READ - SPRINKLER.
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31,
32
34
35
DQD
37,
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T SITE PLAN
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VAGE MAINTAIN
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146
PLANNING MM.
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ENGINEERING MM. .
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CITY OF EDM-ONDS
CONSTRUCTION PERMIT APPLICATION
N ME (OR NAME OF BUSINESS)
fbft •'i Tn;e� J
MASS zL(,zz
Cf TELEPHONE NUMBER
t.A,(. I 14- 3 -- 7-,5)%
CITY TELEPHONE NUMBER
I
NAME
ADDRESS
CI. TELEPHONE NUMBER
STATE LICENSE NUMBER CITY LICENSE NUMBER
Legal Description of Property • Include all easements
(show below or attach four copies)
USE
ZONE
JOB
ADDRESS
'PERMIT
NUMBER
.EGAL DESCRIPTION CHECK SUBDIVISION NO. I
PUBLIC RIGHT F`'WAY PER OFFICIAL STREET MAP.
EXISTING v REQUIRED DEDICATION
PROPOSED_ 19
ro _
RIGHT OF WAtY%CONSTRUCTION PERMIT REQUIRED ❑
STREET USE PERMIT REQUIRED ❑
SEE ENGINEERING MEMO DATED
SEE PIW DEPT. REVIEW CHECK LIST DATED
REMARK6,/ 1 17
NG SUPPLY SIZE
REMARKS
a
FIXTURE UNITS
Q
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3
SIGN AREA I ENV. REVIEW
ALLOWED I PROPOSED COMPLETE I EXEMPT
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VARIANCE OR CU
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YARDS
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QW0 FRONT l SIDE
REVIEW BY
ADS NO.
SHORELINE N
DATE
LOT COVERAGE
REAR =4!�- 1
NEW L.Od RESIDENTIAL
ADDIALTER NON-RESIDENTIAL
REPAIR RETAINING WALL
EXCAVATE
DEMOLISH 1:1OR FILL
PRE -MOVE INSP./
COMPLIANCE INSP.
El PLUMBING
MECHANICAL
SIGN
FENCE
( x-FT)
SWIM
POOL
CHECKED BY
TYPE OF CONSTRUCTION
CODE
SPECIAL INSPECTOR
REQUIRED
OYES ONO
AREA
JOCCUPANCY
GROUP
SIDE SEWER WATER LINE
REMARKS
El 1:1
NUMBER OF STOgIES
l(
NUMBER OF
DWLLLINU
uN1I ti
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
VALUATION
4 _:.etl
PLAN CHECK FEE
BUILDING
I
i
PLUMBING
MECHANICAL
GRADINGIFILL
This Permit coveR w to be done On private property ONLY.
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of. this permit shall not be deemed to
modify,. waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
F1jW/If
TOTAL AMOUNT DUE
_-
1 h b k i d e that I have read this a Iication that the
FEE
HEIGHT
OCCUPANT
LOAD
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M
ere y ac now e g pp ATTENTION APPLICATION APPROVAL
Information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and THIS PERMIT This application is not a permit until
state laws regulating construction; and in doing the work authoriz- AUTHORIZES signedis b the Building Official or his
ed thereby, no person will be employed in violation of the Labor ONLY THEY 9
Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
tion.lnsurance.. INSPECTION acknowledged in space provided.
SIGNATURE (OWNER OR AGENT) DATE SIGNED DEPARTMENT
CITY OF OFFICIAL'S SIGNATURE
EDMONDS
ATTENTION 771.3202 DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE JUL 519
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR RIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC _
r`2- PINK —Owner GOLD —Assessor
CHAPTER 3. �u
102.78 TTT ManYOn Prmbnp EGmonOL W� »599
Y
DATE:
MEMO TO: Building Division
Planning Department
FRO14: Engineering Division
Publ is Works Department
SUBJECT:
After revievi of the subject Building Permit application, vie have the following
Cowen is
1, Connection to City via ter system renuirpd
2.
Connection to City
sanitary
sewer system required.
3.
Right-of-way permit
required
for any work on City property.
4.
Driveway slope not
to exceed
14*1
5.
Back-,iater valve required
if
downstairs plumbing is below elevation of
upstream manhole.
6.
Water and sewer lines to be
separated by 10 foot minimum.
00 6/82
86
e�ooe
PROP05ED
I-5TORY
RESIDENCE
DRYWELt_ E L=
SUMP i i
k!Af (5E E r , �' P-2
DETAIL ,:
CM
~ i• 'P-1
G0
N (GB. 15)
W/ORIFICE 1E.92.00,
' o 270, 96.0 (SEE DETAIL)
DOWN SPOUTS (TY P.) 8 4'
100, r -' — — — '�
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PROPOSED
I -STORY I
3
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RESIDENCE
PROPOSED C.a
_STORY; (C.B 17)
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- - - - - -RESIDENCE,
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--PRWB"T REVIEW CHECKLIST
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PROJECT. mAME: /L�. "i _ I1�1
G PROJECT ADDRESS: ,
0 4L"� Ve,
APPLICATION RECEIPT DATE:`
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Reviewed by: (initial/date)
'
COMMENTS
PLANNING
WPR/SWR I
STREET
ENGNRNG
s E. }
FIRE
BUILDING
7177T17T71
/// //p.a�y
SII=E FAMILY/MULTIPLE/COtIAL -
(Circle`One)
SETBACKS CHECKED -,Planning'.
VARIANCE/SETBACK ADJ.
'USE
F ,CONDITIONAL ?
PERMIT.41
ADB RDQUIRDOM CIDC!®71
OTHER ZONING REQUI'REMEMTS
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STREET FILE'.
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LEGAL' DESCRIPTION,VF.RIFICATICVs A
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QUIT CLAIM/DEIDICATICNSI ,;' _S
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CALC[JLATE SEWER CONNECTION IF LID I
PLAT/SUBDMSION REQUIREMENTS
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RIGHT-OF-WAY 'CONSTRUCTION PERMIT REI D
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BOND REQD FOR PUBLIC'IMPROVDOHS
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WATER'FIEID CHECKED
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STREET PAVING REQUIRED. z ;
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<: CURB' AND G[nTER REQUIREDTTR
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CURB CUT FOR DRIVEMAY READ
STREET NAME SIGN REQD
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AA ,• OTHER SIGNING REQD
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SIDE SEWER AVAILABILITY
k i -.. .
` EXISTING WATER MAIN SIZE
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WATER METER SIZE
SERVICE LINE'SIZE
HYDRANT REQUIRED
HYDRANT SIZE EXISTING'
CROSS CONNECTION INSPECTION REQD
CIiARGE RDQD °�/
WATER METER ' C�• '
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FIRE CHARGE READ - SPRINKLER
STREET CUT
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CAZC4 BASIN READ ,
]NDICATED 'ON SITE PLAN
�:SHOUIDER. DRAINAGE MAINTAIN
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REVIEWED BYs -
PLANNING MGR.
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ENGINEERING,MGR,PUMIC WORKS
SO ( (001 . � 2,01
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DATE
MEMO TO: Building Division
Planning Department
FRO14: Engineering Division
Publ is Works Department
SUBJECT: 6,;w
----
After review of the subject Building Permit application, we have the following
comments:
1. Connection to City water system required.
2. Connection to City sanitary sewer system required.
3. Right-of-way permit required for any work on City property.
4. Driveway slope not to exceed 14'0
S. Backwater valve required if downstairs plumbing is below elevation of
upstream manho e.
6. Water and sever lines to be separated by 10 foot minimum.
A A„ . /._� --,/ _ - T_T - n /G
BD 6/82_
m
mm
- 'SLOOE
PROP05ED
I —STORY
RESIDENCE
ORYWELL 1
SUMP ' ' i
(5EE ;r . 'I' P 2
DETAIL) -I;' .�
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(C.B. 15)
`^v/ORIFICE LE.92.0�
270, (5EE DETAIL)
0
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DOWNSPOUTS (TYP.) 84'
PROPOSED
I -STORY;
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— — — —
— —RESIDENCE
lot' S
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PROPOSED I
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I —STORY I
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RESIDENCE
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(C.B'17)
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DRYWELL
SUMP 1 ' 2'
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19PO DETAIL).,: .}
4. • '1 P-1
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PROPOSED DRIVEWAY
/T' HICKENEID
ED61-
"m77 TO.
TD.�CpU.P,�
DRAIN
FROM
DOWN-
5 Ply UTS
C5 17 \—I•F_.9z.Z5
REMOVABLE TOP
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DOWNSPOUTS
A.D.S. SUMP
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4"A.D,5.
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4"A.RS. PERT
PIPE
SUMP &
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Z70
86
DOWN5POUT5 (TYP.) 84,
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PROPOSED fi
I -STORY r--
RESIDENCE PROPOSED
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- - - - - - -RESIDENCE,
102' S
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Jul
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LEGEiUO
FF/DZ F/rf//SHED FCOD.P
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(R�
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MIRAFI FILTER FABRIC
�— 95.0±
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MIRAFI FILTER FABRIC
11 of
3/4- l%2 WASHED ROCK
13 ORIFICE
96.0
100' r-— -—,
i _ I
Zj
PROPOSED I
1-STORY 1
RESIDENCE
I I
I �
DRAINA
TRAFF.-
WATER
SEWE- 7
STREW
PLANNI► v
CONTROL C.B.
(GB. 15)
`v/ORIFICE 0.92.00
(5EE DETAIL) 1010
_�ntj le
Cp
9
Rb
G.B.
(TYPE-1)
•t:
CONNECT
TO EXIST.
3'
12"CMP
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ROCK FILLED
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DETENTION
t
TRENCH
(5EE DETAIL)
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6t(AA'�
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4 33 c/ C.B.
(C.13.17
too .0 Il^.92.00 _P
OUTFALL CONNECTION DETAIL
A" "--
WITH REMOvA5LE
CAP.
DETENTION TRENCH DETAIL C5 15
NO SCALE
Existing underground facilities have been shown on this drawing for the
purpose of assisting the contractor in locating said facilities in the
field. The contractor shall be responsible for checking actual field
locations and checkingwith appropriate a encies that ma have under
agencies
Y ,
ground facilities within the project, l imi ts. The contractor shall be
soley responsible for any damage to underground facilities resulting from
his operations.
-NO SCALE
DINE
r ra ,
F_XL5T I
�8
- sy✓ F�
30 DA T
MATCH EXIST.
PAVEMENT
r—YV EGINEE
I.E. 50. 59
TYPE I C5
PRI'NT9D
DRAINAGE PLAN JUL 151985
FOR REID-MIDDLEWN & ASSOC.
JOHN HOFTO-
IN THE SE 1/4 NE 1/4, SEC. 26, T27N, R3E, W.M.
CITY OF EDMONDS, WASHINGTON
Reid, Middleton & Associates, Inc.
En ineers o Surveyors e Planners
9 Y
121 5th Ave. N. Suite 200 Edmonds,WA 9802
0
DESIGN DRAWN CHECKED DATE F. BOOK SCALE FILE 02 85 023
JLB JLB RLS 7.11,85 570 1"=20'
SHEET OF
REVISED 7-15-66 JL5