1045 ALDER ST.PDF11111111111111
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1045 ALDER ST
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City of Edmonds ---Water Departmen`'S'
TAP CARD /--
Date....-
Meter Ta
......
No.................."............ p No .................._............. .......
�
Size.............................. Size ......................................
Mfgrs.Style...................................... .
For---- ..--------------------------------------------------------
.................................................. ................................... _....... ......... _..... -------- ------------
_
LotNo ........................................... Blk. No....... .............................. --
Add. ".................................................. ........... ...... ............
Service Location ...%.. . ��.. _ ......._
Meter Location
MakeTap..............................................._---------------..._......._.........._..................
..................................................----........------......---------.._..............._.......-....-._.........._
Pressure .............................. lbs. Test .................................... %
SendBills to .......................... _......................... .................. ......... -............ -... - .....
Date of Work ................E.f
Guar.
I
Foreman
VoucherNo ........................... -.............. $.......... ......................... _.....
OUTGOING Index ......... Reg ....... Route Bk......... StenciL..... Card........
INCOMING Index _......... Reg ....... Route Bk .... - ... StenciL..... Card... -.-
Saterial Chargeable to Installatioveters
NO.
{/ -----
SIZE
`�~
DESCRIPTION
Meter ......................................
RATE
---............:_---
AMOUNT
....
•-- ----•_..
•.........
Meter Box `t'. -----
--------------
----•----- •
.......
-------••------
-•------•-
Meter Plate ............................
----------•••-
----•-•------•
--••----•-
Check Valve ..........................
..............
--.........
..........
...............
---------
Pipe, Galv. Screw ..................
-----•----•---
---.........
..........
..............
--•••-••--
Nipples ------------------------------------
--------------
-_.........
..........
--------•-----
..........
Bushings ----------------------------------
...............
..........
Plain Ells
..
.............
..........
.......... ...
..........
St. Ells ....................................
.......... _...
---•------....
..........
..........
I
Tees ..........................................
-----•----•-----••----•----•----------• .............
----------•-
........•----
Material Chargeable to Taps Connected
NO. SIZE! DESCRIPTION •
RATE
AMOUNT
--------_-•...
..........
Pipe, Black Screw ...................
.............
.............
••---.---
..............
..........
Pipe, Galv. Screw ------------------
..............
•-----------.
..........
Lead Connections ................................
Curb Cocks
..............
..•---
r. -
-`�
/••••-.
-•11e..
Corp. Cocks ¢.-jam`--`----------
----••
-------•
-----
---••---•-••••
-•---••---
Unions ....................................
-•-•-•---.....
......... f
O
..............
..........
Saddles ................................ ...
..............
••-------•--
---------••---
..........
Nipples -•--------•-------------------------
...............
-•-----•---
-------- -
...............
.........
Bushings .............. =...................
-----•---•----
----------
•---------••...
---••-----
Plain Ells .......................... •----
......----••--
..........
Street Ells ---------------------------..
.............
•-•--•-•--•-•
..........
.............
..........
Tees ................................. --------
•-••----•-•-•••
......... _.
-----•----
----------••--
..........
Curb Boxes ............................
..............
-••---•••--
..........
..............
•-••--•---
S. O. Extensions ....................
----•--•-•-•--
--•-••-----•
..........
...............
••-•-•----
Gates ---------------•--------------•--.---_..
..............
•--•------••
...........
Y
Plugs=---•----------------
Couplings.....f
-
D_
-
,2 --
-------••-----
..........
Gate Boxes ............................
..............
.............
-•---•----
/ .
..•.....
•..... . t _. N
-------------
---•----
�
..............
..................... ......................
-----�
--------
............
.............
.........
..•-•-••.....•--•.............-----•-••-•-....................._...................
...........
... `•^
, .
�.---
...........
----•-------••
......
... ..
...........................................................
Hours Time —Day Men --------
Hours Time —Monthly Men ..
..........
•-------•---•
..............
-----
r
-
..............
--.......
Hours Time —Auto . -- .. .......
Superintendence .................._--
._.......
-----
....
Total
0--
-
ADDRESS: i Dr2 AmO,V f-L
TAX ACCOUNT/PARCEL NUMBER:�cal(�'�f,?�bJ�
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS>� DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA'
SCALED PLOT PLAN DA'
SEWER LID FEE $:
LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED,
SIDE SEWER PERMIT(S)
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
LATEMP0STs\Forms\Street File Checklist.doc
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CITY OF EDMOiiwi, WASHINGTON—DEPARTMENa-OF BUILDINGS
BUILDING PERMIT
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e _.,t:,-,,,c hereby certifies that a plat, Plan; drawings, and sufficient details to indicate
the intention to ' _:il' 1!! reavirements of the code are attached hereto.
Application i! hereby made fo ermit to dr the follows g arork: .. � rr
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.<r1CR.tS1....KA..'..... _...._y�........ _......... V 11 a Qp
'•-• (Street vumber or (a a� block e�mbera) o a rr
Gj Nd n s °
1. Building dimensions are ........ ; L,/...........x---._>� ./.......... _.......... �... n ;Q z
m i y`
..............x.. _. / / .a.a•�..............._.......` j
2. Lot dimensions :.re......... .. fi.- ��F•.1-' � C
3. Building will be stories in height. o p
i
4 Number of basements h . "•� ? `o' z ..... F. _:t..._.._......
S. Occupancy of bmlding,vnl1 )k........ ....... ............. .._...---•----' ---•
6. Building ave /1 ... _ fec m 42 adjoining lot line.
Estimated coat 3.lLt
7. Owner... ` ...c.... . ........--..._.. --..........----••
3. Owner - Address. .......... _.......... _................. ....-_..._.
9. Builder... __............- --- Group
......_..........._....................'—_............................. t
10. Builders Address... 2
11. Architect or engineer........................../ Liic of permit..��(..t!��__..__...
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I Datc.......I-<......z.y.----...19...-, - t
> / Plans filed: • Yo, No p' ,''+y s `
Amu's slgnali..e�'tLL:. (:fir. YJN ................_........_.....
1 asmn S wnrr o< t d ZE.
F �y
Permission is hereby granted to do the work described hereon, -cmrding to the approved plans and specifications ptauining herero , ( = a,
subject to csmpiiance with the ordinances or the City of n� e.�L „ i copy
your
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. ... -.. .. ds •T'}�Is w ss our receipt for the fdlovn,l fees:.-
I 1. Building permit fec.................. -
?. Sewer permit fee .............. ........... ....................... .....
$ - ............................
f
3. Inspection and supervisionfee ............ ....................... $............................ ..-.._ - iJ �j"7 �i•h
dr y,,'f''e•a'c
_....... E
4. To...............................
il ................._.
Rec i�d
--'- omerr>
Department of Buildings :•ytS? �Y ?a
PERMIT N? 387 city of Edmonds :
1. The b ndla7 Permit fee whkh aPPlicau Pan whm perm:, it imd .hall be based oo enimated mrt d the P-P-- it the ns of 71.Q/-for tuh
3ta0p.W of cat- u dre a°val eort of —the awmve, whin fivall/ dacrmivd, eareed, the ertimatd roer br roo,e thin 5%, aPPllmr'a7ren m par
of 73.W for each 71 Wp.W of ,aS e:<w mrt. le ,urh event or, vu Perini, tb.11 br in¢d moil -a "du°epavp fee" u P.M. -n
:. whmeeer . cavrnrt for mnrtmnlon 1+ r:ccatd for ao, rtrocrun oo ei" more thm 71000.W for ubiS a ueerued ar Sheet m msinrer Ia vor tegvhd Dr ! - i `• �'ST. � ;, ei'
Se Bulldin7 Code of Se Gry of Edmond,, the aPplic f.. fee a bolidios Petm:r rhall be urvrvpmid by • rope of Sr rvnvaa and • mp/ o[ the• detanrd tt 1�Sf a
.P.Cificarlava.
a. lfri, m rmplo..p8 m/ labor m rommmdva work. oouE1 the Ivdoavial loavrmce Di-isiov of doe Depanmrot of Labor and Ind—drr. long m e,tlerars of
the w1,a;l`and vtiRt r�tLvdtlr. of Pa1ra1L. Fd mmacti abruld be obtainM from the oC of the DIP�+rmm[ of tabor u:d lodmuim Hef
Enal palmm4 .he d�+tet rbouldtob. "tin a nleve °�'l•�ttSROTrdebo w turd-thou)d�oQ a(� nlrue /tnm all rubeonrncton. T.x nlosn ..be
rceated b1, the DrPartmml d E-1— and PLoorvnra:ue requieemeae of ,rhi�3vke Ivauuria! Inmtmce An. t F z
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APPLICATION
The City of Edmonds for EASEMENT NO_ ____________________________________________
SIDE SEWER PERMIT
-1-03- 04400 NEW CONSTRUCTION F-1 REPAIRS E] LID NO_ ------------------ ASMT. NO. ------------------
OWNER ................ Pau.l..Gromko ------------------------------------------------------- CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO. --------------------
...... .. --------------
JOB ADDRESS ...... 1-04.S--Ald.er--.St.ree.t ---------------------------------------- LEGAL DESCRIPTION: LOT NO. -------------------------------------- BLOCK NO.------------------------------------
------------------------------------------------------------------------------------------------------------- ....................................................
NAMEOF ADDITION .......................................................................................................................
DYE TESTED ON SEWER - February 12, 1976
By Gary Raymond
Approved:
DATE............................................ By ....................................................11/75........