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1028 DALEY ST.PDFiiiiii iiiiiiii 10720 1028 DALEY ST TAX ACCOUNT/PARCEL NUMBER: ✓ yy TZD �am bo BUILDING PERMIT (NEW STRUCTURE): .,l 54 b�Dg COVENANTS (RECORDED) CRITICAL AREAS: DISCRETIONARY PERMIT #'S: W. qD `g� DRAINAGE PLAN DA PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS ( PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver SEWER LID FEE $: LID #: 22 SHORT PLAT FILE: LOT: q. ID BLOCK:J SIDE SEWER AS BUILT DA SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DATED: I �I OTHER�;UW "✓ �.b�� (MSIRAI UIP, L:\TEMP\DS'Ps\Forms\Street File Checklist.doc "' J Y. is.05 APPLICATION for The City of Edmonds SIDE SEWER PERMIT EASEMENT No ........................................... NEW CONSTRUCTION ❑ REPAIRS ❑ 118-03800 OWNER .....-....AL%Se-J......5e- .. er5..------••--••............................................................ CONTRACTOR...-..-...------•--•---.......................--........-.... --------------------------•-------•- PERMIT No....................... ADDRESS ......1028 D41ey Street .... ........... LEGAL DESCRIPTION: LOT No............................................... BLOCK No............................................. is • 0 • NAMEOF ADDITION......................................•-•-............................................................................................... uj i.� uj j LL- Dye Tested On Sewer 1972 Approved: DATE................................................ By...................................................................... CITY .OF EDMONDS, WASHINGTON _DEPARTMENT OF'BUILDINGS hereby certifies that a plot, plan, drawings, and sufficient details to ion to:fultill all requirements of this code are attached hereto. an is hereja ,nlade fosoermit to do the following work: 4. ..................._.........._.................................._...._..............._..................._....._........ « .......... �U.. .. � _..�.......- ------------ -- ----- r'a)r(it ✓ _ , (Street number or lot and block n ben) 01 < n /y�r ✓ 1. Building dimensions are ........ •-••••••x...... .. .................... y'R st r t 2: Lot dimensions are.... ../Z................ x_.._....... ,/.._....._------------- // stories in height. 3. Building will be...........1...---_---... r 4. Number of basement s........ ................. is Occupancy of building will be ................ ��!!���� 6.' Building will be.......... P.- Je fro Barest djoining lot line. - 7. Owner ...._......... ............ r✓ - - 9 Owners. Address .......... �p ....__.. y...5Z _�_.� __----....- ---... 4 Buflder................................. - 10. Builder's Address .................... Lyl 11. Architect or engineer .... .....�............................... _........_............................. Date.....i1. ......... 9.................. 19.��. h l Applicant's Signature ............... .)......_ ............-•.......... . -• ......... (Owner r is agent) Ik { V16. 'O / O "7 pm a N M a O GrW p4 vs 0,to a to z ., a b V) r •. 4 a... i' .bY 'L' Estimated cost $ ...... ..... ......... .:._.. GroupNo .................................................. Life of permit .............. •.... ................... C.;('; Plans filed:-jNo ❑ Permission is hereby granted to do the work described hereon, according to the approved plans and specifications pertaining,homo subject to compliance wiih the ordinance;: of the City of Edmonds. This copy is your receipt for the following fe(s:" 1.. Building permit fee ....................................................... $........... G....... ..... 2. Sewer permit fee........................................... ..........-. $• 3. Inspection and supervision fee_ $ r •' • 4. Total T• ti Received by . :.(;. - t•.ga?c h -, : r .• (issuing a) Department of Buildings z ,� PERMIT 1!T° _ . 358 city of`Edmfinds 1. The building permit fin which applicant Pays when permit is issued &half be based on estimated cost of the proposed structure, at the rate of $l 00 for tack sl000.00 0[ cus[. I� the acruai ins[ of the atructure, when finally determined, exceeds the estimated cot by more than S%, applicant agree to pay an addit&onil fee4, • `�, " _�,. r' + ''i'•,-' of $2.00 for each 111000.00 of such excess cost. In such event no use permit shall be issued until such "discrepancy fee" is paid. - •_ . ' •`� r •�; � � }r \,-�3. Whenever a contract for construction is executed for any structure nesting 00 esting wore than $10.00 for which a licensed architect or engineer. is not requited.,by the Building Code of the City of Edmonds, the application for a building permit shall be accompanied by a copy of the coon ta and a, copy of the-dtrailed specifications. �3.'Pri�•n>\aoplo`ivg any labo6or commencing we_ Wady the IndustrW Insurance Division of the Department of Labor and Induudo. giving an.eietmite i4nu_ _ _ �trc the'payrolL and Ike monthly repormof pa3rtilla.- Full i@iA:ai0As should be obtained foam the _n,;a ,oSce of the Department of Labor and Industrin.<s- final payment• the owner should obt.. ■ reiesae from the geoerai'ioneraaon who la mcu'sbpald-Obti n release from all subcontractors. The releases.abodd'ba utested%by the Deparvnent of Labor and Industries. The'a:)ove procedures are requirements of he Start Indurrial Insurance Aa.� :� r��;a_`.'�i:._.tl.i'. �, �'. '.»7:°;•r,���,-',�.•rJ•. n: ir+.-'..:rY.:,.`..'�9!�,.yfir:;'•:Y�'y.%�#W'1V{Sir''b'tifi'Y.•g'•�yz'✓6'l4aJc.yj'tl'�.�:�.., it �, ;,r•c... ,. :7r .k�c`..`i 'c Cit of Edm Y s g RIGHT-OF=WAY CONSTRUCTION 4 PERMIT Permit Number: - a Issue Date: 'A. Address or Vicinity ofConstruction: 1028 Daley -St. (9311857 ) 18 o O . B: Type of Work (be specifc): Install New Service 9p19 C. Contractor: Washington Nat'1 _ Gate Co. Contact: Frank gwan Mailing, Address: Phone: 224-2278 98111.1 State License #: Liability Insurance: Bond: $ D. Building Permit # (if applicable):' Side Sewer Permit # (if applicable): E. : ❑ Commercial ❑ Subdivision ❑ City Project 6a..Utility (PUD, GTE, WNG, CABLE, WATER) ❑ . Multi -Family. ❑ Single Family ❑''Other INSPECTOR: INSPECTOR:' F` Pavement or Concrete Cut x0ffes ❑No G. Size of Cut{ 1)2 x 4@ Watetf-I. Charge $ APPLICANT TO READ AND,SIGN- INDEMNITYJA licantunderstands andby his signature to this application, ' a rees to "old,the City o Edmonds harmless- oit m'�irie d5 ma es; or. PP y 88 tY .% .. � ,� ' .l �' � 8 claims of any kind or description whatsoever, foreseen or unforeen,,that may made .liidt the City of Edmonds, or any of its departments or employ- ees, including or -,not limited to the defense of any legal proceedings including defense cosrsaand attorney fees by reason of granting this permit.' THE CONTRACTOR IS.RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FORA PERIOD OF ONE YEAR FOLLOWfNG THE FINAL INSPECTION AND ACCEPTANCE,OF THE WORK. ,ES77MA7ED RESTORA77ON FEES WILL BE HfLD.UNr�77L THE FINAL STREET PATCH I COMPLETED BY. CITY FORCES, AT WHICH 77ME A DEBIT'OR CREDIT WILL BE PROCESSED FOR fSSUAIVGE'T0 THE APPLICANT. Construction drawing 'of proposed work required with permit'application. ' A 24 hour notice is required,for inspection; Please call the.Engineering Departm AW— Work is to be inspected during progress and at completion.' '' -R Restoration is to be in.accordance with City. Codes. Street! shall be kept:clean at all times.. /`� " Traffic Control and Public. Safety'shall"be in accordance with Cityregulations as'required by the City'Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end -of the working, day; . NO EXCEPTIONS. I have read thedbove statements and understand the permit requirements "and the'pink copy of the permit will be available on site at all times for inspection purposes. "✓�� Kl1 J; .; { Signature:. Date. JJ. 19/93 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK u 4 WORK SHALL BEGIN PRIOR TO PERMIT Engrg. Div. 1991 FIELD INSPECTION NOTES Comments• Diagram: (Fund I I = Route copy to Street. Dept.) CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P. W.: Work Disapproved By: Dater FINAL APPROVAL BY: Date: Eng. Div. Jul wba M A�-sonErepyCcrrprrH • Addendum to : City of Edmonds Right of Way Permit Application Submitted by: Engineering Aide Washington Natural Gas 52l 52-4 e) l C )ZB r j� ; Eels T IN IN] Q WNG to window Water main depth p h unknown ;51 "d gas main �. CF X4) CAI-F 42' I aavIkr-, Key: -w- water- -g- gas -ss- sewer $ water hydrant O water valve 815 Macs St. (P.o. Box 1869). Seattk, WA 98111 (206) 622-6767 Material irgeable to Installation Meters NO. $IZ%E DESCRIPTION Meter ........... RATE AMOUNT =- - -- ..........Meter Box 'A'..�.c •-----••... ...... &. --- ......_._ Meter Plate ...... :....... : ' ' :_ ......... ......... ------------• -•-•------ Check Valve -•-•----•................ .............. ....................... .............. ......... Pipe, Galv. Screw ------._......................-- ,._......... ............. ...... ............ .......... Nipples .................................... ......_.. Bushings -•-----------, :.a......... --------•- ............... .......... Plaiii Ells ................................ .............. ..»..i:...=.. .......... .... ........ -- St. Ells .................................... .......... ............. -----•-•--- ....................... Tees . ----•).........---••..........................•-•--• -- ....................................... ............................. .............. ........... ._....._..._ ............ ...1........ .......... .......... Material Chargeable to Taps Connected NCO. , SIZ.E DESCRIPTION RATE AMOUNT .............. .......... Pipe, Black Screw -•---•--••-------- ............. ------- •----- --........ ........................ Pipe, Galv. Screw ........... ...... ........--.... ............. --•------ ............ .. "�` j' .. ... Lead Connections .................. Curb Cocks ------•--•-----• ................ .............. ........... ........... . = --- ...j Corp. Cocks ......................................... ----•-- - .. . .............. .......... Unions .................................... ............. .......... Saddles ................................ ---........ ............. ---..._. ........... •--... Nipples ..................................... ........... ........._ ....._.. ....•••••............... Bushings ---........---•-•-------- .. .:.:_ ......._.. Plain Ells ........ .......... *- ........................ Street Ells ...................... •-----.---• ._.......: ............. .......... Tees------•-----.....----•-.........-----:.._. ............... ------•------- ---------- Curb Boxes -•------------------- ......_.: ........ .............. ........................ S. O. Extensions ..................... ........------ ----.................. •............ -- ....... -- -Plugs Gates ...............-----.........•..----- -- •- •--•--•- -_.._ ...V . Y ••--.-• Couplings ................. ----•------- .........._.....------• -------- ---- --------._ ........................ Gate Boxes ............................ • -°? . ........... ...11. --------•-- ----------- •-•--- ....... ......................... . f • ..................... .... ............. -----...... ..... .� . .............. --------••---- ....., -•----••-- ................................................... ........................................................... ......... •-----•................. . . .---•.... ---- ..�-r,�r .......--- ......... ...... _........ :. .............• _........ ...1.... ...............---•-•...---..........-•--......-•-•........ Hours Time —Day Men ........ ............... --- ......... .... '7 ................. J... Hours Time —Monthly Men .. ............. .:. ......:. --------------. .......... Hours Time —Auto ..... ....... ....:....... . ..---•- .......... Superintendence ............ . .. . .... .. t Total , 0 ................... . ....... Distrid�,_-,', City of Edmonds ---Water Department,` TAP CARD Date.. ........ ................. Meter No..---.....----...Tap No ......................................... Size.............................. Size ........................ .............. Mfgrs. No ...... .. .. ... ............ . ................ Style ............................................. , For 7 .. .... i .. ..................... ... ..................................................................... ........................................................................................................................................... .......................................................................................................................................... LotNo ........................................... Blk. No...........----.....----............................ Add. .............................. .... .... .... ........ . ......... ..................................... ServiceLocation ........ . ......... ...... .. ......................................... ...................................................................................... .................................................. MeterLocation ................................................................................................ .......................................... . . .............. . .............. MakeTap ........................................... ................................................................ ................................................................................................................ Pressure.............................. lbs. Test .................................... % SendBills to................................................................................... ........................................... ................ �/ ............................. . .............. 1. ... 4—,y .................................. Date of Work . .............7/ ................................... 4 ..... ......... ......................... Foreman Guar. Voucher No ........................................... $ .......................................... Remarks: ..................................................... ........... . I .................... : ....................... . ......... .... ........................... .............................................. ...... I- ...... 7" .1 , A ................ . ............................................ OUTGOING Index .......... Reg ....... Route Bk ......... Stencil ...... Card ........ INCOMING Index ......... Reg ....... Route Bk ......... Stencil ....... Card ........