1126 2ND AVE S.PDF1111111111
4839
1126 2ND AVE S
j .; 1ITY of EDMONDS
For Inspection Call 771-3202
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Address of Construction: j
SIDE' SEWER
PERMIT NO
S.
Property Legal Description (Include all easements): 4 Dt
T\x-&-
PERMIT
07744
Owner and/or Builder:
Contractor & License No: e"
9.4
Single Family Residence —Z OND
PUBLIC WORKS
Multi -Family (No. of Units ) 7'
RAEN7'PLAN r.
Commercial (No. of fixture Units )
Invasion into City Right -of -Way: No I Z_;es (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No Yes (If Yes, easement required,
attach legal description and county easement number.)
PL
THE ITEMS LISTED ON THE BACK
sted on the back.
Permit Fee:
Trunk Charge:
Assessment Fee:
Partial Inspection:
Pit
t
Issued By:
Date Issued:
Rec.eipt No.:
Comments
Final Inspection Approved:
Date Initial
Rejected:
Reason
** PERMIT MUST BE POSTED ON JOB SITE **
Wh.ite Copy - File Green Copy. -'Inspector
Date
Date Initial
Date Initial
Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing EASEMENT NO_ ____________________________________________
NEW CONSTRUCTION REPAIRS ❑ LID NO . .................. ASMT. NO. ..............
''11 •
OWNER-1 5____- ..:................ CONTRACTOR�i�_w_i9��.___.,.._. Y''\_S__._.._,? _._.__.. PERMIT NO. �.�.7.- pp�-- - -
JOB ADDRESS AA-��P........ -_----V-a-------5®-'-.._..... LEGAL DESCRIPTION: LOT NO. ---.. - -------------------------- BLOCK NO. ----------------_-..---..---------_.
Rs
R-kk (o Ohs Lo t e aF �,r� �,
NAMEOF ADDITION...----•---------------•------....._..------•---•-----••----•------•---•-•----------------------------•---
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Approved:
h.-. DnIQNDS
Pt -A
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�O `p� v �. DATE �.�-- ......••-- YC� 2 t�V-
PWW 0001 11/75 (REV.11/78) tom}{U -
CITY OF EDMONDS
ASSET INFORMATION SHEET
M NEW
i
❑ ADDITION
❑ RETIREMENT
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION - ° L` �c���
L'
SERIAZ NO.
LOCATION „ /
DEPTA0�.
/
* * PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
* PROJECT NUMBER io o a
PROJECT COMPLETION DATES �O
COST X& 4//
B.A.R.S. ACCOUNT NO. %�/ ( -SOD lc���_D�•�-�
ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
**SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE DATE
b a INITIAL
DEPARTMENT FILE
VERIFIED BY
PROCESSED
BATCH NO.
26o
CATCH 6AS11(: �_30 �
AC�j '*I T70(oti TKGNCN LWNCTH
nsuw�
1'�S►+CN COVCA
4-! -n G U N C L:Y rL 77C C N `
g Frylr PIPG CAP
TEE w/ 4"LONG LEGS
SYSTEM CROSS-SECTION
Fitt
MIRAQQFI SooX
f5�uLAYE 7
Ep
w
TFIENCH COVER
WAS $4E0
GRAVEI
4+DIAa.1 F ERF P
'-04
TRENCH.CROSS-SECTION
oo .
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2
(or (:5PI
location_ C)OP—e ceu
plan by •a
phone
date -
DESIGN DATA
Trench' Perc LF per Imperm Trench
Number Rate 1000 sq.ft. Area Rea.
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals (at least
twice per year).
r
CITY OF EDMONos
Slap
SITE PLAN. SCALE:
NOTE: 00 NOT USE INFILTRATION SYSTEM
ON SLOPES OVE,F 15 PERCENT (15
FOOT RISE PE,q 100 FEET HORIZONTAL )
STRE- 1 FILE
O.S.
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE 2 OF 2
Zip 4t
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u 20_CP
CATC14 d!`51N: �
A.CM "IT30�Oti 30
"UAL)YP,[:NCw LarNGTH
f
,rK W NC H Cov"
............. I ..........
O
4�irRf vlrc i
TEE w/ 4"LONG LIrGS
LCYKL 77t NCH
CAP
SYSTEM CROSS—SECTION
MIRArI soox
OP, 1%1/ELF=r-r
TO B LAYED c
W,\-n�4I::D FO=K
TRENCH COVER
WAS14ED
GPAY EI
4romm MRF P
TRENCH CROSS—SECTION
r
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2
for �P ix -A
location_ V—)O t C R,5 rs k,
plan by
phone
date
DESIGN DATA
Trench* Perc LF per Imperm Trench
Number Rate 1000 sq.ft. Area Rea.
NOTES
1. Call Engineering Division (111-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals (at lest
twice per year).
✓� . 2 23 $ 7
r
CITY OF EOMONOS
* 'Zo
30
At
SITE PLAN, SCALE:
NOTE: DO NOT USE INFILTRATION SYSTEM
ON SLOPES OVER 15 PERCENT (15
FOOT RISE PER 100 FEET HORIZONTAL)
J s-
o.s.
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE 2 OF 2
M
MEMO TO: Building Division
FROM: Engineering Division
SUBJECT:
After review of the subject building permit application, we have the
following comments:
1) Connection to City water system required.
2) Connection to City sanitary sewer system required.
3) Right-of-way permit required for any work.on City property.
4) Driveway slope not to exceed 14%.
5) Back water valve required if
edownstairs plumbing is below
elevation of upstream
6) Water and sewer lines to be separated by 10 foot minimum.
7) Builder/owner responsible for containing all temporary runoff and
erosion on site and may not impact neighboring properties in any
way.
g) Construction hours from 7:00 a.m. to 10:00 p.m. on weekdays and
10:00 a.m. to 6:00 p.m. on weekends and holidays.
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rs�e
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NASe'dopa
E (OR NAME OFESS)
Ovh�S Ir�C,
MAI❑ ADD ESS
_�> O O �� SS
CITY TELEPHONE NUMBER
NAME
ADDRESS
CITY TELEPHONE NUMBER
-yfa Lj O � Q-
ADDRESS
O
CITY I � �-j � TELEPHONE NUMBER
STATE LICENSE NUMBER
SeaLob I �5 C-c>
Legal Description of Property - include all easements
(show below or attach four copies)
--tlp.4 1")p"e C2>`�l�
NEW
RESIDENTIAL
PLUMBING
/❑ ADD/ALTER
COMMERCIAL
MECHANICAL
REPAIR
RETAINING WALL
SIGN
DEMOLISH1:1
REMODEL
ORCFILLTE
PRE -MOVE INSP./
COMPLIANCE INSP.
II NCE x-FT)
❑ SWIM
POOL
WOOD
INSERT
1D APT. BLDG
RENEWAL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
USE 'ROW PERMIT
ZONE NUMBER
JOB
ADDRESS
_EGAL DESCRIPTION CHECK SUBDIVISION NO. LID NO.
LoT 70t4 1 P- 3 - 86 �:54 - 14-5
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING 6O REQUIRED DEDICATION
PROPOSE Q
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED
STREET USE PERMIT REQUIRED ❑
SEE ENGINEERING MEMO DATED
REMARKS
4 T
G1h0/r�r��/hil /W/04107 YP�
METER SIZE IBUILDING SUPPLY SIZE/ ' IFIXTURE UNITS
REMARKS
SIGN AREA I ENV. REVIEW I ADB NO.
ALLOWED I PROPOSED COMPLETE I EXEMPT
VARIANCE OR CU IPLANNING REVIEW BY I DATE
YARDS I SIDE �1 REAR HEIGHT ILOT COVERAGE
FRONT i 1
LL- - v
CHECKED BY
TYPE OF CONSTRUCTION' L_GODE
HEIGHT
-tJ
z51
SPECIAL INSPECTOR
AREA
OCCUPANCY
OCCUPANT
REQUIRED
GROUP
LOAD
0 YES ❑ NO-
-
REMARKS
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,
7ht:"AL ig86 S-F bitYj�
c VA vt_
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL >�
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
ENERGY CODE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of, this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify,.waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
Information given is correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and In doing the work authoriz-
AUTHORIZES
ed thereby, no person will be employed In violation of the Labor
ONLY THE
Code of-th tate of Washington relating to WOr en's Compensa-
WORK NOTED
ti n Insur nC .
INSPECTION
SGNATURE (O ER R AGT)
DATE SIGNED
DEPARTMENT
I
/ /✓
TY OF
EDIMCNDQ
LUATION FEE
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
OFFICIAL'S SIGNATURE DATE
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0
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ATTENTION/ n132o2
RELEASED BY:
DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE ____U
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3. PINK — Owner GOLD — Assessor
102.78
PROJECT REVIEW FIST !.
r1cd
PRWE)CT NAMES ;p PRCa7ECT ADDRESS: I12,�.a v't A ITS i
APPLICATION RECEIPT DATE: I {
Reviewed by: (initial/date),
CLAPS
PLANNING
WPR/SWR STREET ENGNRNG
FIRE
BUILDING
SINGLE? FAMILY/MULTIPLE/DIAL - (Circle One)
SETBACKS CHECKED - Planning
/// /
II
VARIANCE/SETBACK ADJ.
tw,
CONDITIONAL USE. PERMIT
---
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2
/.
II III/
III/ //
II//I//II/
ADB REQUIRII4E M CHECKED
//////
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3
OTHER ZONING REQUIREMENTS
//////
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4
ENVIRCNMENTAL, FEATURES
5
ACCESS SIDPF & VEHICLE ACCESS G
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77777777
////////
1
6
DRAINAGE PLAN (On Site)
//////
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7
STREET FILE �-
//////
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8
T AL DESCRIPTION VFRIFICATION 3'
//////
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1
9
QUIT CLAIM/DFDICATIONS
//////
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10
EASEMENT - PUBLIC/PRIVATE
/////////
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CALCULATE SEWER CONNECTION IF NO LIDS -
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12
/
/
/ /
PIAT/SUBDMSION REQUIREMENTS -�'"
//////
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/////p//
13
RIGHT-OF-WAY CONSTRUCTION PERMIT REND
//////
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Z a /
14
7TIT11
777777777
MR1117T
7T77777
BOND READ FOR PUBLIC IMPROVETIEMS
//////
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////////
15
SOILS OONDITIMIS & GROUND
777TTf
/
WATER FIELD CHDC.KED
//////
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////// /
'16
7/7
/
STREET PAVING REQUIRED
//////
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17
CURB AND GOITER REQUIRED
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18
SIDEWA X REQUIRID
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19
/ 7 / 7
-17TITIT17/
CURB CUT FOR DRIVEWAY REQD
20
STREET NAME SIGN REQD
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21
0711ER SIGNING REQD
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22
SIDE SEWER AVAIIABILITY
//////
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23
//e ////
EXISTING WATER MAIN SIZE
/// //
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11
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24
777777
II
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111111777111717
WATER METER SIZE
//////
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25
SERVICE LINE SIZE
//////
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//%///////
26
HYDRANT REQUIRED
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27
HYDRANT SIZE EXISTING
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� (/
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28
a
/
CROSS CONNECTION INSPECTION READ
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29
//
I/
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3�cJ��
I/
/// //
r
EATER METER CHARGE RD(p
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30
FIRE LINE CHARGE REQD - SPRINKLER
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31
STREET CUT
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32
OPEN DITCH EXISTING
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33
RECp
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34
///
/ //I/I
CULVERT READ
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/////////AP,
35
TT17777V—
SIZE
//////
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36
CATCH BASIN REX_7p
//////
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-
37
INDICATED ON SITE PLAN
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ITITRTITkyj
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38
SHOULDER DRAINAGE MAINTAIN
TITF17TTIFIWITIT
SHALE OPEN RUNOFF
//////
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39
—
II
140
MISC:
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r
NEVIEWED BY:
PLANNING MGR. PUB141C-WORKS MGR.