1128 2ND AVE S.PDFIIIIIIIIIIII
4841
1128 2ND AVE S
CITY OF EDMONDS
ASSET INFORMATION SHEET
10 2 NEW
❑ ADDITION
❑ RETIREMENT
GTE ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION C
SERIAL NO.
LOCATION
DEBT. NO.�
" PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
" PROJECT NUMBER Gti%�1%�
PROJECT COMPLETION DATE
COST
B.A.R.S. ACCOUNT NO. VDU " D �y y • C�l>• &�
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
V DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE
b P INITIAL
DATE
0-1
VERIFIED BY
PROCESSED
BATCH NO.
DEPARTMENT FILE
-" CITY of EDMONDS
For Inspection Call 771-3202
Address of Construction:
Property Legal Description (Include all easements):
SIDE SEWER PERMIT
PERMIT NO. 07722
S I VIA .EDMONDS WAY
TRUNK LINE
W
Owner and/or
Builder: _S2,�,
-J
o�
7.5
,
Contractor &
License No:
,s e-�
w a A,
5
G
Single Family Residence
Multi - Family (No. of Units
Commercial (No. of fixture Units )
Invasion into City Right -of -Way: No I/ Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.) /
Cross other Private Property: No v Yes (If Yes, easement required,
attach legal description and county easement number.-)
PLEASE READ THE ITEMS LISTED ON THE BACK
47
LIT /mT/ 2 41
-1--c'ertify hat`"I!/have read and shall comply Date
with the items ;fisted on the back.
Permit Fee: 00
,Issued By:
26
Trunk Charge: 25- CO
Date Issued:
Assessment Fee:
Receipt No.:
7/6
Partial Inspection:
Comments Datel/%�'In_ifiti:
AY
lf
.-
Final Inspection Approved:
%- 87 j
r
� ��'� � •
Date Initial00
`,,'f'Id1�i��G'i)
Rejected:CD
L`w,
Reason
Date
Initial
v
a�
** PERMIT
MUST•BE POSTED ON JOB SITE
**
a�
`�
Wh.ite Copy - File
Green Copy -'Inspector
Buff Copy -
Applicant
4
The City of Edmonds
Side Sewer Drawing
EASEMENT NO. ---------
---------------------------
NEW CONSTRUCTION REPAIRS E] LID NO. ------------------ - ASMT. NO. ____________---"
OWNER --S-F-PxW- --- 0.0V ----- ----------------------- CONTRACTOR K0A:rW%.AKf - ----�qK ................................... PERMIT NO. ......
JOB ADDRESS AA-Z-8 -------- zN-- -70--'ON,
--ve--Sa- ................. LEGAL DESCRIPTION: LOT NO. -------------------------------------- BLOCK NO. YAWS-EDVID-- WA - Y
I TRUNK LINE
----------------------------------------------------------- ---------------------------------------------- ................. ......................... ---------
NAME OF ADDITION
F4:1
AI 15 VDp
II
4*to)P.
. . . ........ All PA C--
Approved:
2 ND NVE . SO
PWW4=1-11/75 (REV.11/78) DATE� ---- ..... By
--ft I,- . ------- -----
STANDARD DRAINAGE PLAN
CATCH DA51N: �_�O�
A� IT70(0k wouwL TRCNCW LrrNG7H
�
�. >
TPCNCH Cov"
T! .................... ...... _..........
�r -nG UNC
4PEILF PIPC
Tee r,/ 4"Lo►+G Lers
LCVNL TICCNCH
GAP
SYSTEM CROSS-SECTION
MIRAFI soox
OR Ui",/EL=Li-r
TO B LAYE D c
W-\154tfD F.o=-K
TRENCH COVER
WA541 E D
GRAVEI
4�oiAm FEPF P
TRENCH CROSS-SECTION
Is
INFILTRATION SYSTEM
PAGE I OF 2
for �Paa�JLl� �aM.0
location_
plan bye
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 responsibflit7
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials frcn entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals (at le=st
twice per year)
- Z3 g 7
?aj_.a
CITY OF EOMONOS
'b
SITE PLAN. SCALE:
cb
0.;
ao �
NOTE: DO NOT USE INFILTRATION SYSTEM
ON SLOPES OVER 15 PERCENT (15
FOOT RISE PER 100 FEET HORIZONTAL )
I
I
I
I
0,S-
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE 2 OF 2
,CITY OF EDMONDS
CONSTF(OCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
MA15R6 ADDRESS
CITY TELEPHO E NUMBER
� � 731=,q
VAME
O e � � ® PERMIT
ZONE � NUMBER
JOB
ADDRESS
tv
IlLnA /W
'TION CHECK SUBDIVISION NO. LID NO.
i
3 �-3-St ask
PUBLIC RIGHT F WAY PER OFFICIAL STREET MAP.
EXISTING � REQUIRED DEDICATION
PROPOSED
n ' RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED'
ADDRESS` TT \ STREET USE PERMIT REQUIRED D
U) SEE ENGINEERING MEMO DATED
CITY TELEPHONE NUMBER j� a`�
15 e�A\( 0__ IA �e�U � REMAR
NAME �
said UAZ C .
ADD�R{E�SS {�
C V O \ \ J J METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS
CITY TELEPHONE NUMBER ( �j
1 , -77'Q - 7 �O 1 REMARKS
STATE LICENSE NUMBER
0(V&,\ �� c;Z-_> SIGN AREA ENV. REVIEW
Legal Description of Property - include all easements ALLOWED I PROPOSED COMPLETE I EXEMPT
(show below or attach four copies)
�_s
I CQC-Lk
NEW
El PLUMBING
ADDIALTERMMERCIAL
LI�I-RESIDENTIAL
MECHANICAL
C� REPAIR
RETAINING WALL
SIGN
DEMOLISH
EXCAVATE
FENCE
NCE
❑
REMODEL
OR FILL
❑ PRE -MOVE INSP./
I xF7)
❑ SWIM
COMPLIANCE INSP.
POOL
WOOD INSERT APT. BLDG
RENEWAL
NUMBER OF STORIES NUMBER OF
DWELLING
I
[UNITS
I NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
ADB NO.
VARIANCE OR CU IPLANNING REVIEW BY I DATE
YARDS HEIGHT I LOT COVERAGE
FRONT SIDE REAR I
CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
) Z5-
> OCCUPAN@1,� OCCUPANT
GROUP '444../...------ � LOAD
�TIONS PER UBC 305
ICY INSPECTION REQUIRED
VALUATION 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
N 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
omodify,.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 1 am the owner, or the duly
ATTENTION
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and in doing the work authoriz-
THIS PERMIT
AUTHORIZES
ed thereby, no person will be employed in violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
ti r 1ns_u-�ce..
INSPECTION
SIGNATURE ( NER OF;{AGE DATE SIGNED
✓
DEPARTMENT
CITY OF
EDMONDS
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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ATTENTION 771-3202
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102•7e
RELEASED BY:
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
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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 downstairs plumbing is below
elevation of upstream manhole.
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.
8) 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.