1040 CEDAR PL.PDFiiiiiiiii I III 1 11
10598
1040 CEDAR PL
•
TAX ACCOUNT/PARCEL NUMBER: Z--O �a QD 1 ( 38pD
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS :
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED: I' Zq 'g
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
SEWER LID FEE $: (� LID #:
SHORT PLAT FILE: �—L ' LOT: () BLOCK: -
SIDE SEWER AS BUILT DATEDD:: &
SIDE SEWER PERMIT(S) #:�n TJ
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSTs\Forms\Street File Checklist.doc
CITY OF EDMO
i BUILDING PERMIT A
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Below or Attach
NEW
IR.ESID..TIAL
FJ f.V MBING
ENTIAL
❑ ADD
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� 5 GNMECHANICAL
O A! -TER
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Z NUMBER OF STORIES
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NUMBER OF
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UNITS
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PLAN)
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LEGAL DESCRIPTION SU bU1VISIUN
ORT SV11 NO.
PUBLIC I':IGHT OF WAY PEP OFFICIAL STREET MAP
EAISTIN.^.�S /UGGJ;�_
PHo POsf.o ��-
DEFICIENCY OF RIGHT OF WAVE Ol/
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SEE ENGINEERING MEMO DATED �T
REMARKS
NiETc. SIZE DUILDING SUPPLY SIZE
I FIXTURE UNITS
HCMARKS
SIGN AREA
ALLO'NED �-ROPO5ED
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ENV. REVIEW
COMPLETE- EXEMPT
ADU NO,
5HORC/1INE <
VARIANCE OR CU
PLA I RE ca
DATE.
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AROS /
0FRONT „} 51DC EAR
LOT COVERAGE
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REMARKS --- '
CHECKED BY
TYPEOFCONSTRUCTION
CODE
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SPECIAL INSPECTOR
REOVIREO rr••��
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AREA
OCCUPANCY 7
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OCCUPANT
LOAD
REMARKS
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BVILDING
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F LUMBING
MECHANICAL
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This Permit --rs work to be done on private property ONLY.
•
Any construction on the public domain (curbs, sidewalks, driveways,
FENCE
marquees, etc.) w)II require separate pormiss.on.
-
SIGN
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 120 Days
RETAIN111G WALL
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"Applicant. on behalf of hl% or her sl)ou%e, heirs. assig;Illd
SWIMMING POOL
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s Iccess.,rs in interest, agrees to ind em..IN. defend and held hankie%+
VALUATION FEE
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the Clap of Edmunds. Wa hin ton it, olu gals employees, anti
I;enl. ItVtll Jny Ind .11I - I ltt 'r ' II IF el 10 I Illl,lrl',
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arl,ing dilCelly f.r 111111reetl Ir II11 the I. .'l I el this l Illlf l%%ll-
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TOTAL AMOUNT DUE
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on" e shJli
any rt'(luircinenl u(an)Lily ,idiiianee our ;inlit in any \ � the
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ability I,)Cnl,,rce an)' ordinance {ire%'isi•�n.
ATTENTION
APPLICATION APPROVAL
"'^
I he:eb) Jcingwledgc that I h-c reed thl, Jppbcatwn; that the in.
F•, L,
- (elnlallnn n ie \ur:ee;, and II:J: I .,in fhv L•%%:I L:, of the del) JUIII Uf.
the I to Coml)Iv with city :1nd %tale lass refill-
THIS PERMIT
AUTHORIZES
TIIIC application I% I701 a permit
Until signed \• the Building Official or
1[ed agent of o\vner. agrCe
Iating con,tructwn; and In doin-L' the work auchotl/ed Iher1.•bv, no person
ONLY THE
his -Deputy; ;ind fees are paid, and
'•:\e' ,`'
�`�•4':�,';,.:��!,
Will be emphiyed :n %wt,:wn e: dtc I.A de Vl :he StJ:e
rCla ling lU \\"e fit Wien t Compensation IIl%rir:ftic•:.
SIGNAT VRE IOWNE R OGENT) SIGNED
wORP NOTED
INSPECTION
ic'eclpl l,\ ;li {.RU\\'iedp,Cd In cpal:t• pro.
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JDATE
DEPARTMENT
OIR OH'S SIGNATURE
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CITY OF
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' S SITE IS
IN THE
EDMONDS
DATE
��
Ty LOCATED CITY
- OP EDMONDS LOCAL SALES TA>
775.2525
.A
SHOULD BE CODED 31.04.
FiIP YELLOW
- ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
`
ORIGINAL - - Inspnctor
PINK - Owner GOLD - Assessor
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- UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 304, 300,
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CITY OF,EDMONDS
. Wiit No:
COMMUNITfY SERVICES DEPARTMENT Issue Date
RIGHT 1OF-;WAY CONSTRUCTION PERMIT
A. • Owner: t .%7P7hY1►1 �'i[.J �..`3'UrG
Name InIglN 'S
Maililk/ Add v,
City (� State Zip
• Address or Vicinity of
of Work to be Done:Jl�.(J�� r'
B. • Contractor:
U f /C
1V1dll���=f
n City /
, r(,
State License Number
/3
�2--
StateS- Zip
Telephone Number
Woik in"'Connection With: fl Sub or Plat ❑ Single Family ❑,City Projects
Xl/ P j
Commercial ❑ Multifamily. Utility 1
Pavement Cut: Y ❑ N
APPLICANT TO READ AND SIGN A 1
INDEMNITY: 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, forseen or unforseen, that may
be made against the City of Edmonds, or any of its 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.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR "PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Funds held from the Security Deposit (estimated restoration fee) will' be held until the final street patch is completed
by City forces, at which time a debit or credit will be processed for issuance to the applicant.
• A 24 hour notice is required -for inspection;, Please call Public Works: 771-3202'
• Work is to be inspected during progress and at completion._; , ti
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times..
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
no exceptions.
I understand the above and t t this permit must be available at the,jobssite for inspection urposes at all times_
Signature: Date: � S
Owner or Contractor
This Permit Must Be Posted at the Job Site For Inspection Purposes
Call DIAL -DIG Prior To Beginning Work
ISSUED BY: C-a) • �y
Time Authorized: Void after f 6 days.
Special Conditions:
Amendments:
PERMITTEE: t�C: 0C `1&
Security Deposit:
Receipt No.:_
Fund 111 Fee:
Street Cut Dimensions:
X
NO WORK ,T�O`BEGIN PRIOR TO PERMIT ISSUANCE
,, Eng. Div. July 1985
a
FIELD INSPECTION NIRS ( 111 - Route copy to Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P. W.:
Work Disapproved By: Dater
FINAL APPROVAL BY: Date:
Eng. Div. July 1985
lo -3,�
1
16
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CITY OF EDMONDS
Ta` PUBLIC. WORKS DEPARTIOT FOR INSPECTION CALL • permit
SIDE SEWER PERMIT 775-2525 Ext. 220 Issue Date
PERMIT MUST BE POSTED ON JOB SITE
1. Address of Construction
2. Property Legal Description (include all, easements) _DnnnNDS
TREATM.ENT PLANT
3. Single Family Residence �, Multi -Family No. of Units
Commercial
4. Owner and/or Builder --, , rr;lr v%;. ,4P`
5. Contractor & License No.
6. Invasion into City Right -of -Way: No >(' Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig.(342-5344) before
excavation).
E-1 7. Cross other private property: Yes No //Easement required -
attach legal description and county easement number.
H
a READ THE FOL.LOWI.NG AND SIGN:
a
a
4 a. Property owners must obtain a permit to install side sewers on
>4 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
H installation for one year..
wc. Commercial establishment requires a minimum of a six inch (6")
z side sewer line.
o d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
e. Side sewer lines must be laid at a minimum grade of 2% (1.150)
and maximum grade of 100% (450).
H f. No turn in side sewer greater than 45° (1/8,bend) is0allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
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 'certi y that "I have read
and shall comply with the above
Fi PERMIT FEE: „-- DISAPPROVED By: Date:
�� B Date:
CONNE.GTI,ON FEE?. , , ;� - APPROVED Date .
0
w * PERMIT MUST BE POSTED ON JOB SITE
0
0
Sid'e- tier Drawing-.'...,
The City of Edmonds'
EASEMENT NO.
. .......... ..........
NEW CONSTRUCTION jal. REPAIRS E] LID NO... ASMT. NO . ............
OWNER 0. .... 4�rd* ..................................... CONTRACTOR . ..................... A:1
........................ PERMIT NO. .6.71_:�
JOB- ADDRESS .... RZ.,? .. /...0 ..... ..... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO. ....................................
....................................................................................................................... .......... EDMONDS ..........
TREATMENT PLANT
NAMEOF ADDITION ............................................................................ .........................
7 Pyr see ,5-9-81
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Approved:
PWW-W01-11175 (REV.11/78) DATE ... ............. :B .......
. ........ .........