1025 CASCADE LN.PDFIIIIIIIIIIIIII
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1025 CASCADE LN
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TAX ACCOUNT/PARCEL NUMBER nO5g22tiTi( minO
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS //►►� �tt,, Q DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S: cUH - 1 g4 ' 1 z / I"fh2 ' Qb
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: vj LOT: I BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #: g )
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
L:\TEMP\DST's\Forms\Street File Checklist.doc
I
APPLICATIOc BUILDING PERMIT Appl. Noc4Z-::-411r-
CITY OF EDMONDS Building Depa"m*09 Permit limit, -one year
7 -
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APPLICATION is hereby made for a permit to construct the following work, in accordance with du, accom.
parying plans and spe:ifications. Two sets are submitted herewith for appro%ral
Off-st.
new alter
repair ......... .......... Parking
....... ... ......... Work addn
Occupancy .............................. Con3t. type . . ................... . ....... Use zone.. -Fire zone.. ----_---_-
Addrcss./ . ..................... Lot. Blk..-: Ad&.i
Lot frontage........ !4/ ....... 7 ........ Septic
Bldg. set -backs — frontt:r2 . ............... r. side.. ..-Y ......... I. side-1- ............ rcar _�Z
Ir �Tel NoZz
TeL No jS
Planaby ... ....................... . ............. ...... .............. Address ................................. --------------- T4
Remarks.. . .. ..... =� . .. .... . .............................. ....... ... ..................... ...
.......................................................................................................... : ................. .................
......................................................................................... .... . . ....... . .................. I ...................
The above is a correct statement, and I agree to comply with all ,applicable Codes and State .laws regulating -
work.
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C� Sigr.�xl
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PERMIT for the above work is hereby approved, subject to the above con. d to com,
proved plams, ard specifications. and Building Department'notatiovw. th
Valuation
............ Permit fee............._
21
Building Department, B
%
-y
mbing, Sewer or Electrical ft-ssta. lla"
is per .nit does nor cover plumbing
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J1W.,
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The City of Edmonds
(PPLICATION
for
SIDE SEWER PERMIT
OUTSIDE 0 INSIDE 13 REPAIRS 0
CARD f . . ................
EASEMENT No. _ ...................
OWNER .............................. CONTRACTOR
. .............. .......
1STREET
HOUSE No.....00. .............. AVENUE LOT No . ......... I .......... &
...................................................... BLOCK No.
rk,
NAME ADD . ............
.. ........... t"16'a'a6:� ........ .......
BACKFILL WORK ORDER ISSUED.. ..........
SEWER WORK ORDER ISSUED ...............
PERMIT No. ( 4_
Date
Approved:
.......................... DEPOSIT, $ .......
............ ........... DATE.......
.............................. .............. ...................
/10
BUILDING. PERMIT"
19 p I �j
.sa -
Street Right -of -Way -Existing
6VO REQD
z
Access Easements Existing
REQD
H
Utility Easement Existing
REQD
w
Lot Per Subdivision
Plat_ Assess r.Map
W
Site Plan Checked for Accu racy
12 -its
z
Underground Wiring Reqd.
H
0
Check Accuracy of Legal Description - 'L
z
Review by
Date 12
w
.
Existing Water Main Size
ter Main Required.
Se rvi e Required
Hydrant Size ti_ng
c4
Hydrant: Reqd Per Fire de
Size
w
Detector Check Meter Reqd.
Cross Connection In ion
Fire De par Comments
3
ater Meter Charge Reqd.
Review by
Date
Septic Tank Design Approved
Date
Se 'c Tank Permit Reqd'.
Permit No.
Sanitary ewer Availability-
Proi.
Drawing No.
File No.
Side Sewer Availabi '
w
Sanitary Sewer Connection
Reqd.
Review by
Date
w
Open Ditch Existing
Reqd.
Culvert Reqd.
e
r4
Catch Basin Reqd
Indicat on Site Plan
Shoulder dr age maintain collection on swale open runo
H
e reqd.
Indicate on Site P1
oil Conditions and Ground Water
Field Checked
Review by
Date
Y)
i
M
71
.—I
mn e
Revised: lv10-1977
Page 2
M
Stre Paving Reqd.
H
Curb and Gu Reqd.
w Sidewalk ,Reqd.
Curb Cut for�Driv�ew;ayRedRight-of-Waion Permit Reqd-:
Reqd, for Public Improvements
Street Name Sign Reqd.
cn
"A Other Signing Reqd.
A... Pre Permit Site Inspection made on
a BY: SEWER
H
w w WATER
w
STREET
H
ENGINEERING
Special Requirements listed in mean to. Comwnity Development Department,
Building Division
BY_�_ Date
d
o All items filled in on Building Permit Application 1
P4, BY 5-:N)Date f
a' Drawings Stamped and Notations, Made
a' BYj� Date
d
Approved by Public Works Department
Revised: lv 10-1977