1034 4TH AVE S.PDF1111111111115047
1034 4TH AVE S
Side Sewer Drawing
' The ,City of Edmonds EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION n REPAIRS Ej LID NO. 24=>1-4 ----- - ASMT. NO - ------------------
OWNER .... --------------------------- CONTRACTOR ..LP �.W- ---- - - --------------------------- PERMIT NO.
JOB ADDRESS <= - - ------------------------ LEGAL DESCRIPTION: LOT NO. .............. .................. BLOCK NO- ------------------- ---------------.
PWW-0001-11/75 (REV.11178)
NAME OF ADDITION .... ...... C�� .... \ ------------------------------------------------
Approved:
DATE....... ...... B, ---- --------------
CITY OF EDMONDS
NEW
❑ ADDITION
❑ RETIREMENT
DESCRIPTION
LAJ
LOCATION
. ASSETRFORMATION SHEET
ST'lEET FILE ASSET NO. G o ? 6 c. S�
ADDITION TO ASSET NO.
03y 417- Au
SERIAL NO.
DEPT. NO.
"PURCHASE ORDER NO. *PROJECT NUMBER
PURCHASE ORDER DATE PROJECT COMPLETION DATE 6 - 3o - g o
COST COST go • % 1
B.A.R.S. ACCOUNT NO. /,:S- - 3 ySr- oa
® ESTIMATED LIFE a
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
'SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
0 DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
6 G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO.
INITIAL
by
2
E
SUBJECT:
DATE
m
A. 44iWe4gel Alf, If
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KV6,00
A
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SIGNED
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DATE:
SIGNED
CITY OF EDMONDS ON
PUBLIC WORKS DEPA MENT FOR INSPECTION CAL. Permit
SIDE SEWER PERMIT 775-2525 Ext. 220 Issue Date 34)
* PERMIT MUST BE POSTED ON JOB SITE
1. Address of Construction 10.E 4 .,.,
2 . Property Legal Description ( include all easements)
< * P LT LOT L
3. Single Family Residence �p Multi -Family No. of Units
Commercial i
4. Owner and/or Builder "% de r � .
5. Contractor & License No. — -� E
'� )
6. Invasion into City Right -of -Way: No i Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
7. Cross other private property: Yes No t,--- Easement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain a permit to install side sewers on
>' their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
w b. The side sewer contractor assumes full reponsibility for each
E' installation for one year.
ac. Commercial establishment req ' res a ini At-96IG' ch (6")
uside sewer line. ` as HOURS
d. Side sewers may not be instal ed ha �Ein he (30")
to any structure.
M e. Side sewer lines must be laid at U (1. 50)
O and maximum grade of 100% (450).
H f. No turn in side sewer greater th d
between cleanout. All 90 turns must
bend) and wye with removable cap. 141
g. No down spouts, footing drain t1tI��000RDiNATIN6��copnected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE: I ..,,. ,
I certify that I have�rea
and shall comply with the above
PERMIT FEE: DISAPPROVED By: Date:
` 7 /N FEF- 0 By: Date:
P4 CONNECTION FEE: APPROVED By: m j�,^ ,c Date: 1?vc
* PE IT 14UST-Bg POSTED ,0N JOB SITE
5-4
CITY OF EDMONDS '' mit No. _ - f
PUBLIC WORKS DEPARTMENT STA"EET
` �1�� Issue Date "r l 7 °roc-0
RIGHT - OF - WAY CONSTRUCTION PERMIT 1
A. •Address or vicinity of Construction
<64
• Owner: ����_
Name
,
Mailing Adchess
City, State, Zip Code
• Permit Issued To:=-g--
• Type of Work to be Done:
♦ Work in Connection With:
❑ Sub or Plat ;< Single Family
❑ Comml. / Ind. ❑ Apt. Condo.
• Pavement Cut: ❑ Yes ❑ No
• Contractor: � 4
Name
Mailing Address State License Number
City, State, Zip Code Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
INDEMITY: 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, 'foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's 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.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance ofthe restoration by the Engineering Division.
Funds held from the Security Deposit .(estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220. r'
I understand that this permit ' ust;availabl;.dt the job site for inspection purposes at all times.
Signature:
* THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES ,k
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued Byr
Time Authorized: Void after M0 days
Special Conditions:
Ammendments:
0 42
Permit Fee:
Security Deposit:
Receipt No.:
Fund i 1 I Fee:
Street Cut Dimensions
X =
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * tit
Eng. Div. December 1978
FIELD INSPECTION NWES (Fund 111 - RIWe cony to Street Dept.
Comments:
Diagram:
Contractor called for inspection Yes TIO-)
Work Disapproved By: Date: 1Date:
?cork Approved By: `_.� _ Date :
Inspector:
Ena. Div. December 1978
BUILDING DIVISIdIp Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
NA%E IOR NAME OF BU INESS)
(A/ ��� ; C E' eJJ j
W MAILING ADDRESS
3 c? its qt h :s, �.
Q CITY ITELEPHONE NUMBER
Bo-nl ELL _�01�o
W ADDRESS
1 iw
Al,
u
E CITY ELEPHONE NUMBER
774 - 0788
- NAME �f
C
Q ADDRESS
F
U
It
E CITY
F
Z
0
UISTATE LIC F;;X
NUMBER
UN-1V- 2 2
2—HARK -WIS
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W
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ELEPHON
NUM
row Below or Attach Four
USE /\/ PE SIT
ZONE ! NUMBER
[LEGAL
OB�yDDRESS jAV; DESCRIPTION SUBDIVISION SHORT sUR NO.
PUBLIC RIGHT OF WAY PER OFFICI4 L STREET MAP
EXISTING
G I
PROPOSED
DEFICIENCY OF RIGHT OF WAY
PUBLIC IMPROVEMENTS REQUIRED
❑
DRAINAGE IMPROVEMENTS REQUIRED
❑
DRAINAGE PLAN REQUIRED
❑
UNDERGROUND WIRING REQUIRED
0
CONNECTION TO SANITARY SEWER
❑
SEPTIC TANK PERMIT REQ'D ❑ NO.
ELEVATION OF PROPERTY CORNERS
❑
& FOOTINGS REQ'D
SEE ENGINEERING MEMO DATED
CHECKED BY
SIZE I BUI
SIGN AREA
ALLOWED I PROPOSED
REMARKS
VARIANCE OR CU
YARDS
������----������//////'''''
FRONT
NEW
RESIDENTIAL
GAS
FIRE ZONE
TV
LINE
ADD
❑
NON-RESIDENTIAL
SIGN
SPECIAL INSPECTOR
REQUIRED
RETAINING
❑ DEMOLISH
WALL
ALTER
EXCAVATE
FENCE
❑ YES ❑ NO
❑
OR FILL
( X_FT)
PLAN CHECKED BV
REPAIR PRE -MOVE
POOL
Z NUMBER OF STORIES
NUMBER OF
REMARKS
Q
DWELLING
f
UNITS
a itN
URE OF WORK TO BE
NE
a�t1 T
GS
c
W
0
IC
O
PLAN CHECK FEE
' PLOT PLAN
BUILDING
PLUMBING
MECHANICAL
FENCE
"Applicant, on behalf of his of her spouse, heirs, assigns and SIGN
� successors in interest, agrees to indemnify, defend and hold harmless
i the City of Edmonds, Washington, its officials, employees, and RETAINING WALL
a agents from any and all claims for damages of whatever nature,
x arising directly or indirectly from the issuance of this permit. Issu- SWIMMING POOL
a ance of this permit shall not be deemed to modify, waive or reduce
any requirement of any city ordinance nor limit in any way the
zlp�s
SUPPLY SIZE
ENV. REVIEW
PLETFA EXEMPT
L
PLANNING REVIEW BY DATE
LOT COVERAGE
SIDE REAR
EIGHT
IGROUP ILOAD
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
VALUATION I FEE
a
DATE: 2� c-g
MEMO TO: Building Division
Community Development Department
FROM; Engineering Division
Public Works Department
SUBJECT: (�j�� .- .q t,► ��
After review of the subject building permit application, we have
the following comments:
�-��
Er 0. ff;--I I N�MLN
•
PUBLIC WORKS DEPARTMENT CHECKLIST
U
BUILDING PERMIT REVIEW
(address) (dto
0
Street Right -of -Way Existing
z
H
Access Easements Existing
Utility Easement Existir
w
Lot Per Subdivision Plat (7.�._Assessor Map
w
Site Plan Checked for Accuracy
z
Underground Wiring Reqd.
N
Check Accuracy of Legal Description e
z
Review by t , Date
w'
Existing Water Main Size
Water Main Required tihn,
Service Line Required
Hydrant Size Existing S�4
rx
Hydrant Reqd Per Fire Code J/X Size
w
Detector Check Meter Reqd, f�
H
Cross Connection Inspection 1 J//4,
Fire Department Comnents
Water Meter Q#ge Regd.
Review by %✓ Date 124S/�7!2
Septic Tank Design Approved Date --_
Septic Tank Permit Reqd. Permit No. —
Sanitary Sewer Availability ,�-,-, 24-n't Pro
Jl 4'
Drawing No. r7 File No.
Side Sewer Availability Q_ .
w
Sanitary Sewer Connection Fee Reqd. ' !
3
Review by. Date Date
w
Open Ditch Existing e/L a /1i Regd. �---
Culvert Reqd. 1/0 /7- Size ----
c4
Catch Basin Reqd. Iiel c> ;v Indicate on Site Plan
O
Shoulder drainage maintain collection on swale open runoff
H
(n
Manhole re d.
Q ,ti o jv ,E Indicate on Site Plan
Soil Conditions and Ground Water Field Checked
Review by. ����., Date S
Revised: 1v10-1977
Page 2 0 •
Street Paving Reqd.
H
Curb and Gutter Reqd. < <
w Sidewalk Reqd.
w Curb Cut for Driveway Regd. i
a Right -of -Way Construction Permit Reqd.
H Bond Regd. for Public Lnpravements
En Street Name Sign Reqd.y s
Other Signing Reqd. W o All, <Z
A . Pre Permit Site Inspection made on
z
BY: SEWER
H
U
w a WATER
En
~ z STREET
F-1
ENGINEERING
a
d
Special Requirements listed in memo to Commmity Development Department,
Building Division
BY- Date
All items filled in on Building Permit Application
Date
Drawings Stamped and Notations Made
' Date
proved by Public Works Department
®1
Kevised: lv 10-1977
0529 189th S.E. Bothell, Wa. 9800 485-0080
PROVED — DATE c 0 7 j
TY OF EDMONDS - BLDG. DEPT. 4 /AV E7, S. Ury
INSPECTOR
L�
HEFT
DATE: D1-- C Z-�F C-Io)
14EMO TO: Building Division
Community Development Department
FROM---_Engineering--Divis-o
Public Works Department
SUBJECT: 1� � — -q,,, A�i 790589
After review of the subject building permit application, we have
the following comments:
WWI