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1021 BELL ST.PDFiiiiiiiiiiiiii 10224 1021 BELL ST 0 00 ADDRESS: TAX ACCOUNT/PARCEL NUMBER b2� '1T� D Zoo BUILDING PERMIT (NEW STRUCTURE): `� 09 1 b 4 Q1 COVENANTS(RECORDED)FOR: CRITICAL AREAS I/ DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: b I - gC1 • q Z koww"u DRAINAGE PLAN DATED: PARKING AGREEMENTS DA' 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: OTHER: LID #: LOT: BLOCK: L:\TEMP\DSTs\Forms\Street File Checklist.doc IN U V 13 Idubll-0 ............. . .... . .......District City of Edmonds ---Water Department TAP CARD PAID NOV 131959 Date................................................ No.............:................. (No . ..................................... .. MeterTap Size............ Size.................................. Mfgrs. No../ . ....... ......... ... ... .... ...... ............ tyle ...... ..................................... eelFor .......... ......... .... .................. .... . . ............ .. .. ........................................ ..... . ....... . .............. ....................................................... I ............................................................. . .............. LotNo ........................................... Blk. No.................................................... Add. .............................................................. ................... Service Location. ..)z;,4 .. .. .. ... ........ ...................................................................................... . ................ . ................ . .............. MeterLocation ................................................................................................ ............................................................................................................ ...... . ....................... MakeTap ............................................................................................................... ...................................................................................... .................................. ............... Pressure .............................. lbs. Test.................................... % SendBills to ......................................................................................................... .......... . ....... . .............. ............... ..... . .................. ..................... ....................... . ............. Foreman Guar. Voucher No ........................................... $ .......................................... Remarks: .................................................................................................................. ................................................................................................................. . ....... . ............ ................................................................................................................. . ....... . .............. .................................. .................................. ;>.M.E' ....................................................................................... . ......................... . ....... . .............. OUTGOING Index .......... Reg ....... Route Bk ......... Stencil. ..... Card -.— INCOMING Index ......... Reg ....... Route Bk ......... Stencil ...... Card ....... P" •aerial Chargeable to Installation ]` `ers NO. 1,S4ZE DESCRIPTION RATE AMOUNT :.... ..�---• .......... Meter ...................................... Meter Box .............................. .............. .............. .. _•_.... .`.�.? ...................•-•__. Meter Plate ............................ .............. ............. -....-••- .---•---. ..._._ Check Valve ........................ ........... _......... .............. ......... Pipe, Galv. Screw .................. •-•-••---• _........... .......... ............. .......... Nipples .................................... .............. .. ....... ........................ Bushings -•---•-•-•---•..._......_..._..._. .............. ............. .......... .......... Plain Ells ....... ......................... ............... .......... St. Ells .................................... .............. ............ .......... -... -••---•--- Tees -•_- / --- - -•-- e°2 ll .... ........... ... ........ ------•------• 1- !� •--'--_.1.q................ --•__._.................. - .......... ......... ..... Material Chargeable to Taps Connected NO. SIZE DESCRIPTION PATE AMOUNT .............. .......... Pipe, Black Screw ................... ............. .............. .... --... .............. .......... Pipe, Galv. Screw ----___.__.-_._....-__.......... .................. •••-•................... Lead Connections .................. ............. ........... .......... .............. ........... Curb Cocks .......................... ................ ............ ......... .............. ........... Corp. Cocks ........................... .............. ............. •-•----------- ---------- Unions ....-----------..__._.._........_... .............. .........__ .............. .............. .............. .......... .......... ......... Saddles ................................ •. Nipples ..................................... Bushings ----•------._...-------•------•• .............. „-_--............. -_._....... _...---..... ._....... .......... ...-•-•••••.:...._.. ------------- .......... Plain Ells ................ ..... ... Street Ells .......................... ... .. ............. ... •••_•- _ ............. .......... Tees .......................................... ............... .................. Curb Boxes ---•-----•-----•------------ ----••••--•-•- ............. .......... ••---••---.... .......... S. O. Extensions .................... ••--••••-•---- ............ .......... .............. .......... Gates ........................................ ........... ...••••. ........... ............ ....... Plugs ........................................ ------------- ------------ _... .............. .......... Couplings ............................... •--••--------- ............. ......... .............. •-••-•---••-- .............. .............. .......... .......... ....••••• -•---••--- Gate Boxes ---------•-----•---••••----- ............ ............. .......................... ..................................................... •.................................................................••-•........._.........---••- •----•---•-•-• ............. .............. ............. ............ ...................... .......... - .......... .............. .............. .............. ............... .............. .............. .•............. ................................................................................... .......... •••-•--•..........................................•----...............•-----••-•--......_.........._....._ -•-•........................•....-_.............._._...................._._........ _........ ... ..:... ........................................................... ........................................................... Hours Time —Day Men -------- Hours Time —Monthly Men .. ............... ............... .----________- ............... ............ ............. .....-•---.. _....•-•.... __.... _ -••••-•-- .......... .......... .......... Hours Time —Auto .............. •...; ......_. - .......... •--•--••--• •-•••• .--------- Superintendence ..._._-__- ...... . Total/f'',...... 1-1 e; tF� ,'tTV .44 'APPLICA!"M BUILDMG ,PtUff Appl. No. str C.—If OF EDMONDS �" s n, Fug - _ �ttlllg'2}fPIII}Ol�t _ Permit limit. APPLICATION is h made for ftiKs,� I 1 ^ f , hereby permit to construct she following work, in accordance with: the ° Panting plans and specifications. Two sets are submitted herewith for approval aocam• ; ' ° '' +: + . `' new✓alto Off•St VJorl addn repair ..............._.-_......4° T�� !!!1 y±-4-4�----.-.._._.-...._..__._ Parking R . wi Occupancy ............................... Cont. type .......... ___...._._._-.. Use zone_._/ Fire zone S� v4 r qr` 1 j W n. b� ,y tF Address.............�G?.1........ Blk. — _...:. Addn i o ry Lot frontage ................ ..................... Sci,tic tank..__.- ... _....c. r u; � o Bldg. set -backs — front__..._..__2... r. side__...1. side_._.__-.!�____ Address--- /rri ,�r %Q•:� d o �L ��Y '-war Builder--.Y .G.-...Svf{c o •tit Addr ere.. �//, Tel. o_. __ r t•. Plansby..-_ .............. _....... ...... _...... _.............. Addzess-._---.-_-----•--•----._..------_... Tel. No_._.._-___.._-_— Remarks. Th- above a ...». an-1 : - — —, y work •s—.... -v:r .. arr; a..,.c __ , a' rrguiaLing this - ti,.,�7i y �,; ? �,/ •e .i' (� jr4f Sigrei,'@wnee✓Ag. ..-_. ....... rtxsIhteY r �• . PERMIT ' for the above work is hereby approved, subject to the above condition, and to compliance with provcd'plan and specifications, and Building Uepaftment nott2ttion thereon Valuation ... _.._�.... Permit few._.__ --•- T' Revd. lr Building Department By _.: /= Date-. y — _......---•-- .............. .._ q..-.............. INSPECTION RECORD ' r o Fdn OK ...-...-.. _......_.. Frame, OK — — — — ---. Prnal • C'., Y it ass v� This Perx:it dots not cover PlumSing, Sewer or Elemi:al installations. The City of Edmonds Side Sewer Drawing EASEMENT NO- ----------------- ------------------------ 218-01200 NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO ................... .ASMT. NO. ------.-----_----. OWNERROBERT� ...�- ...... ---------------------------------------------- CONTRACTOR ............................ ....................................................... PERMIT NO. .................... JOB ADDRESS ..... 1021..SELL--ST---------------------------------------------------- LEGAL DESCRIPTION: LOT NO. -------------------------------------- BLOCK NO. ------------------------------------ --------------------------- ------------------------------------------------------------------------------------------------------•------------------------------- NAMEOF ADDITION----------------------------------------------------------------------------------------------------------------------- • • DYE TESTED nN SEGIER Approved: u W PWW-0001-11/75 (REV.11178) DATE ........................................... BY ................................ .............. ENG741NIVISION NOTE Date: 2 � IOWhER/CONTRACTOR IS RESPONSIBLE FOR EROSION CONTROL AND DRAINAGE ------------- Scale 1 "=20" Zone R 5 • (o Corner Flag — Setback ulre etual Front 5 ?rO Sides ra/IA[ - Other ifeiELht 25 .f r-H w J J Q RESUB ARNapm FE FEB - 8 2013 I LKEET UILDING DEPARTMENT - -- - --- -- - CITY OF EDMONDS - �r . Ago WASHIN,GTON NATURAL GAS COMPANY 805 - 156th Avenue North Fust, Rcilceuc, Unshingtou 98007 MAR, 1979 +. Of Public Works T.Jephonc (206) 747.0650