Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1131 A AVE S.PDF
11111111111111 10003 1131 A AVE S ------------------- - -- - ---- District City of Edmonds ---Water Department <At)TAP CARD Meter No..1.6 . .7......... I Size ........ ..................... PAID AUG 3 01962 Date.............. * .............. ..... . ........... Tap I No .................. ...................... Size...... ........... ..... .............. _. Mfgrs. No .........2 ..... .. ............................. le---....--------------....._......--...... I ...... .... ............ .................... For ................. ......................................................................................................................................... -------------------------------------------------- - ---- ............................. . ................ . ....... . ...... . .............. LotNo------------------------------------------- Blk. No ................................................. Add. ............................................................... Se:� Xe Location ...... . J, Meterlocation .................... . ............................... . .............................. Make Tap Pressure .............................. lbs. Test .................................... % SendBills to ................................................................................. .................................................................................................................................... Date of Work ... to ........................................................ Lt ................................................... Foreman Guar. Voucher No ........................... . .............. $ ................................... . ..... Remarks: ..................................................... ............................................................ OUTGOING Index ......... Reg ....... Route . Bk ......... Stencil ...... Card.. --- INCOMING Index ......... Reg ...... Aoute Bk .... . ... Stencil- ----- Card ....... bterial Chargeable to Installation fAters NO. '> SIZE DESCRIPTION RATE AMOUNT --------•----- ......-•-- Meter ..................................... ......... .............. •-•------• Meter Box .•..............._.....------ •--•-•-----•-- ---......... .......... -... .......... Meter Plate ............................ .............. _........... -------------- .......... Check Valve .......................... .............. _- .... -... .............. ......... Pipe, Galv. Screw .................. .............. .._......... .......... ------------- ---------- Nipples .................................... -----------•-- ........ ..... .......... .............. ---------- Bushings --•---------------------•-•------ ............... ...... ---- Plain Ells ................................ .............. ............ .......... .......... -- -••------- St. Ells--••-------------------------------- --•--------•-• ----........ .......... .......... -- .......... Tees -•-•---•-----------------•----•---------- ............... ............ .......... Material Chargeable to Taps Connected NO. SIZE DESCRIPTION &ATE AMOUNT .............. .......... Pipe, Black Screw .................. ............. ............. ......... ........................ Pipe, Galv. Screw .................. .............. ............. ......... •---••----••.. .......... Lead Connections ---------------•-- ............. .------..... ......... .............. .......... Curb Cocks .......................................... ..................... .............. ........... Corp. Cocks ........................... ............. ............. ......... .......... Unions -•••----------•--- •--•--•--•-- .......... Saddles .............................................. ..... .... ....---- Ninvles -------------•- --------• Bushings .................................. .............. ............ , ............... --•-•----- Plain Ells ................................ ............ ............. .......... .............. -----•-•-- Street Ells ..........-•................. ............. ............ --•••-----•- .......... Tees .......................................... --............ ........ .. ------•--• ----------•--- -•-•...... Curb Boxes ............................ .............. ............ ---•-----• ............. -•-•--; S. O. Extensions -•-•--•------------- -------------- ------------ ••-•-•-- ••-- .......... Gates ........................................ •----------•. --•-----••-• •--•------• ------------ .......... Plugs ......................................... ------..---- -----------• --•--•---• ------------- .......... Couplings ............................... •-----•------- ............. ........ .............. -------------- --------•--•-- --•-•--••----• .......... ---------- .......... -------•-• Gate Boxes --------------------------•- •-•--••-•-----•---•-•---------••---•---•••-•--•--•--- .................................................... •.................•••••..................-•----....---•••-• .............. ----•--------• ............... .............. ............. ............ --....._.... ._......... --.._.... •---------• .......... •--------- .............. .............. ............... -------------- -••-•-•------• --------- .......... ---------• _........ -........ ----------------------------------•.--------------------- - -••--•••-•-•-•-•...--••••••...•••••-••-••............................................. ........................................................... •-•-•••---••----••-•---•-•----•---••-•...........•-----... Hours Time —Day Men ---•---- -------------- .............. .............. -------------- •---------- ............ ....... -... --••-----... .......... -........ - ........ -........ ........... ............... .......... Hours Time —Monthly Men ............---- ....•------- ------- --- ..............• -------•-- Hours Time —Auto ............ ... .............. ....... -... ....... •. ........................ Superintendence ------•---- •.. •. . .............. ............ ....... •. .............. ......•--. Total ---------- . • • -- ._... ......__.. ADDRESS: I /;3 / AA"ui, TAX ACCOUNT/PARCEL NUMBER: BUILDING PERMIT (NEW STRUCTURE):19 e2,02S3 COVENANTS (RECORDED) CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DA SEWER LID FEE $: 2 / LID #: SHORT PLAT FILE: f 7 ) Le 2) LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: 1 . GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DATED: L:\TEMMST's\Forms\Street File Checklist.doc �� • • APPLICATION &� UI�9NC PERMIT �. CITY OF EDMONDS Building Department Appl. No. Permit limit, one year • APPLICATION is hereby r,ade for a permit to construct the following work, in accordance with the accom- panying plans and specifications. Two sets are submitted herewith for approval. • �j , Off -St. %( new / alter + til .1�;,:��it__._:-------------------- Parking ..........__ LVork � repair .. _...Q ._.....s.__.... :... s Occurancy................................ Const. type ................................ Use zone...!\ ......- Fire zone . all Address..._. //I/ ------- .-------------------- Lot----. •------------- Blk......:r ........... Addn_ Zt:...--�---....1_............���,.� Lot frontage .. Area... C....�_ ...:-� ...... Septic' Septic tank... 'C �`. e�1. ............ ` �1--� r. side..........L 1. side....... � 0 . _ Bldg. set -backs —front..:._- _--- -.._..._... rear .............................. Ow- er._ :.._...Z 4 -.� �` .---•-•--...... Addre_e5-.• .J ........_... t/ ✓ 3),3 Y' . Tel. No,j .% Buildr- r **- -- -- "PARCEL All All of '-.Ile TTorth one—half of Lot 8, Block 8, Yost ° s First Addition to Rena Edmonds, according to the Plat thereof recorded in Volume 8 of lolats, on Page b, Records of Snohomish County, Washington; 1 ETIiER with the West one—half of the vacated alley adjacent thereto. _= =; • . . The above is a correct statement, and I agree to comply with all' applicable ;odes and7Z5tatC' laws 'regulafmg...tliis'` work. 2 Signs.'_• Owner/'Agent.r.X-G' `•2 . _...�..._a ?J:.._.. Address........... Date ..:......... PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ap%, f proved plans and specifications, and Building Department notations thereon. --•••-••--•--•--.. Permit fee.... ��?%'.�3jV ..... Recd. Val•,iationby ......%+��.�•�•..--� `.:j Bwlding Department, By ................................. •.------------- Date .7 .......... :. . ;. NOTE — `I is permit does not cover plumbing, sewer, or electrical installations, nor does it permit any work to be done in the .Right of Way areas. Driveways and walkways must be planned to meet the official grates -of streets and alleys, and plans for future sidewalk development. Kf 45 E/P577- 47 pvc EL/ i zi7 os 5 I ou. 24* 13-,.Gwj The City oF Edmonds APPLICATION for SIDE SEWER PERMIT OUTSIDE INSIDE 0 REPAIRS IJ CARD No. ........... . EASEMENT No. ......................... OWNER ...... . ........ 9 A.7 . . ................................................... CONTRACTOR ......... e4� ------ i ........... I ......... ............... .. ........ PERMIT No. STREET HOUSENo. ..... ....... . ..... 4.9 ...... zz ......................................................... AVENUE LOT No . ................ W .....: ...Z..? ..... .......... BLOqK No . ........ ......... .............. .......... NAME ADD ............. ..... -44&-w ............. - .............. .......... C/ 19 /-7 rt 'I Date BACKFILL WORK ORDER ISSUED ........................... SEWER WORK ORDER ISSUED ..................... u -/0- q AAOM X Approved: APPROVED ............ .............. ...................... -1-1 DATE- ://..7 ........ 6 BY .... ........ ...