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1133 EMERALD HILLS DR.PDF1133 EMERALD HILLS DR W J Z CITY OF EDMONDS - SIDE SEWER PERMIT WATER -SEWER DEPARTMENT PERMIT /Call 775-2525 for side sewer inspections BEFORE c8vering any portion of the constiuction.1 \Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections./ ADDRE ATION OF CONSTRUCTION. �_���m ��� 1 - I_� A `e o o".............. .... ......... ...... 99 .p . . ........................ PROPER EfiIAL DESCRIPTION. �...:'.�-^.............. �............. �;���fl �:..\`n.�;�.._�,........... . ..................... ........................ OWNER AND/OR BUILDER ......lV--:! , r°.� .... lf.......--- .;...9............................................................................ .CONTRACTOR'S NAME & ADDRESS .:..:::.............(7.....�4.� . .... ............ -� �I ...._....................................................... P ion is granted ... .:: . `..'.......--...__-.:;.19 � for repair and/or connection of a side sewer to the city sanitary sewer s�n in accordance with City of Edmonds ordinances. AION IS CALLED TO THE FOLLOWING: NIW14o. 1—The owners of the property may obtain a permit' to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct side sewer in street area. D_ o not cover any portion of sewer before it has been inspected. NOTE No. 2—All work performed in city right-ofcway requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office. NOTE No. 3—Obtain full information regarding -Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade ' sharper than % will be permitted. NOTE No. 5—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper work which may develop within one year of completion. NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the madn sewer or its appurtenances except to in- sert the pipe into the wye. DISAPPROVED p Date akt�i BY Date... . ....._._................ By ............. Date ............... By................ APPROVED Date. BY ........................._.............................. Remarks: _...._.... _................ .......... __._............................ .......................... ................ -........................................................................................ .................................... _......_..._.............--.........._.................. — BOT# Pern yCopi ' MUS Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection — • I,.. _ .. ..........:.............................................. .... hereby certify that the side sewer installation constructed under this permit �o Co tracting Performing Construction) w" t ; in a rd ce all •governing ordinances of the City of Edmonds, Dated this...-��.............day of..S' :..................................... 172 Check BEFORE you dig for: Water p, Gras p, Telephone p, Power ❑, Sewer F Other 0 The City of Edmonds *PPLICATION for SIDE SEWER PERM NEW CONSTRUCTION U---�REPAIRS El 4e OWNER ----------------------------------------------- ------ '05 JOB ADDRESS ------------ . ...... 0 ..... r V. 1v vkz EASEMENT NO- --------------------- LID NO. -- -------------- - ASMT. NO ------------ CONTRACTOR " - - -------- PERMIT NO. ------------------ LEGAL DESCRIPTION: LOT NO. --------------- BLOCK NO. - --------------------------------- ................................. .......... ----------------------------------------------- ----------------------------------------------- NAME OF ADDITION. .......... al--r-" ...... --------------------------------------- DATEI ------------------ BY---------------------------------------------- v i7ye APPUCAntN The City of Edmonds for SIDE SEWER PERMIT EASEMENT NO- ---------------------- AiE NEW CONSTRUCTION REPAIRS ❑ LID NO - ------------------ -ASMT. NO. ----- .------------ OWNER .... ..L....t.. -L- ---?�OY-----------------------• ----------------------- CONTRACTOR ---- a 7:: 1 NI � ----_ PERMIT NO. JOB ADDRESS ---- ---------------------------------------------------------------------------- EGAL DESCRIPTION: LOT NO. --------------- rLS-------------- BLOCK NO. ------------------ ------------------------------------------------------------------------------------------------------------------------------ ------------------------------- T=MEi� �1—� NAME OF ADDITION ----................... ----------------------------------------------- K A ur Now dE i LEI _ N N Approved: DATE --------- ' Y 11 /75 G CITY OF EDMOfJDS STREET THIS PERMIT MUST BE AVAILABLE AT THE JOB'SITE FOR INSPECTION PURPOSES Applicant to Complete Parts A and B J A, Permit to be issued to:A(f l✓ For Work at :(address or vicinity) Type of Work to be done:_ (attach drawing when applicable Time Required -- Start: Owner: Name 12 Mailing Address City State Zip Contractor: ,?a ,,/ �ee / Name _ r Mailin Address City State Zip �� T 4-14 l- p //Z- /- 1. Finish: Telephone Number o S— t� License Number Telephone Number p, INDEMNITY: Applicant understands and by his signature to this application, agrees to hold:.the City of Edmonds harmle.ss from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the applicant or 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. Upon issuance_ of this permit, the contractor is responsible for workmanship and materials for a period of one year following the final inspection and acceptance of the restoration by the Engineering Division. Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at which time a debit or credit will be processed for issuance to the applicant. Work is subject. to inspection and restoration in accordance with City Code. A 24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220. I understand that this permVmtaveaabatthe job site for inspection purposes at all times.%01 Signature:.'� Date: Owner or Agent C, TO BE COMPLETE1 BY ISSUING AGENCY: Date Issued: �"? Permit No.: ,�;^> �� Fee:�(�� Security Bond: Time Authorized: '1 APPROVED BY 1 Date: 1n_771 , (R(-,,;.;,-(I) ,��s)7� "� /l ����� �� vv a''�'t � �`„� �-�-�/ 6 � ��- BUILDING DEPARTMEW ApplicantFilr PERMIT _APPLICATION Inside Heavy Lines NAME (OR NAME OF BUSINESS) .) TN A,`4 i^ Y. A4 . A/ / yEj MAILING ADDRESS a /,0 z l /. =<c I 0 CITY ��.�� ELEPHONE NUMBER ['7 2 NAME I- H/I it c c /� /� �� �'/ , f a At,-. U W ADDRESS h j .I U TELE 0: CITY PHONE NUMBER < t7 NAME C 0 ADDRESS U C CITY TELEPHONE NUMBER F 2 0 U STATE LICENSE NUMBER CITY LICENSE NUMBER Legal Description of Property (Show Below or Attach Four Copies) L.ro /�L� S F 6 R U VI W 0 - J 0 W J ADDRESSJ _® P7�` LEGAL LOT LOT AREA SUBDIVISION No. 'RYES ❑ NO I STREET R/W EXISTING STREET R/W © FT. DEFICIENCY THIS PROPERTY COMP. PLAN ST. R/W FT. O FT. REMARKS STREET AND/OR UTILITY WORK R/W PERMIT REQUIRED REQ'D. lip YES ❑ NO 19YES ❑ NO UNDERGROUND WIRING REO'D. ® YES ❑ NO TYPE CONNECTION YES VERIFItD BY SANITARY SEWER ❑ NO SEPTIC SYSTEM ❑ YES PERMIT NUMBER APPV'D BY CITY ENG. i�N O TER JSE'/ I BUILDING SUPPLY SIZE SIGN AREA ENV. REVIEW ADS NO. ALLOWED PROPOSED COMPLETE EXEMPT REMARKS VARIANCE OR CU PLANNING REVIEW BY DATE YARDS ISNEW RESIDENTIAL a GAS LINE FRONT FIRE ZON E TY Q ADD ALTER❑ ❑ ALTER ❑ NON-RESIDENTIAL ❑SIGN RETAINING ❑ WALL i ENCE X—FT) ❑ F] DEMOLISH OR SPECIAL INSPECTOR REQUIRED ❑ YES ❑ NO PLAN CHECKED BY 0 REPAIR ❑ NSP. WIM ❑ POOL REMARKS NUMBER OF STORIES NUMBER Of DWELLING UNITS , NATURE OF WORK TO SE DONE LOT COVERAGE SIDE REAR CONSTRUCTION I CODE AREA (OCCUPANCY IOCCUPA GROUP LOAD THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. PROPOSED USE _ jj _ 0 .J n % PLAN CHECK NO. a PLOT PLAN INDICATE BUILDING SETBACKS. ABUTTING STREETS) == l ,} AN BUILDING U W W `I \�//4V J PLUMBING 0 0 a; HEAT & GAS LINE P' L` Q •� T' z s FENCE CI / SIGN c RETAINING WALL �V SWIMMING POOL VALUATION I FEE ., � PIMiLI[ iY'PT, WI[!, LIST 1,p11�'W:C N]�JTJ���)�.' _ STREET ' FILE ������x���' � '~~7�� --- &Ar. Street Ught-of-11-:ay JixistinF_ Access Easements Existing Utility Exsc/ncut 77xistin- RT)D��' Lot Per S6`dirisj p] ;c ~~ ` Sito PIxo Ozd�..`� for � - } ;r 'zocroroo^o � r,, 14-n/ ` � U '="'": by ---_-_---_- ^'�c 8 | ! ' Fxi!;tizi,- \,'xtcr �.'.,Iin Si:: � [nt -,!in � erPer / 04 �izo . ^ � Pctcctnr Oxccl: ��!tcr 1,cc:114'rc � � ---z-z-L--77� - ._---'^'_---___-.------__----_--_-___--'-___�^----__-------___''___�_---__-_--------___-____- , . / s ptj.0 Tan!: _ � ' � Eo Sz�itxry �,urz Cx:x,cduo Fee 11"C"(111ircd � | � ----r�- --------- ------------------------ K`vn »itc]/ b`-__|equizc�__� | | OOvcrt |e�lir, 5i.re .o � Cxtc}/ Cx!�ix i( --'------ Er, u` ` " ' ^^v`^`� � . � ' ` | | ^ } ---------------------- -�---'--- _____ BUILDING DEPARTMENT Applicant Fill USE �` - PE ZONE D N� - PERMIT APPLICATION inside Heavy Lines 4_3 "L 6 ,OB - - 1 ADDRESS �'j - v�/1 NAME (OR NAME O/F1 BUSINESS) �/ 'T/� IL a; �^ i /\ ♦ �i l L i� rv� LEGAL LOT �VES NO LOT AREA \ SUBDIVISION NO. P� W 3 ° MAILING ADDRESS / T t a 7-I !� �,-L-L. •I / CITY �y.f� ELEPHONE NUMBER ti i� l i �''.L' ��' *7 7 eVZ- STREET R/W EXISTING STREET R/W 0 FT. DEFICIENCY THIS PROPERTY COMP. PLAN ST. R/W FT. O FT. NAME IV14P t �� /� fi'i1/ ,So ti,. REMARKS V Z m W I.-''� ADDRESS C ECKE d BY W W Z E Q CITY (' o `� CI 'v ,r%,J' TELEPHONE NUMBER `. STREET AND/OR UTILITY WORK REQ'D. p YES ❑ NO R/W PERMIT REQUIRED %YES ❑ NO Z W NAME UNDERGROUND WIRING REQ'D. YES ❑ NO tr 0 U ADDRESS TYPE CONNECTION •ayES SANITARY SEWER ❑ NO VERIFI D By E F Z 0 CITY TELEPHONE NUMBER SEPTIC SYSTEM ❑ YES APPV'D BY CITY ENG. RNO PERMIT NUMBER U STATE LICENSE NUMBER CITY LICENSE NUMBER REMARKS Legal Description of Property (Show Below or Attach Four Copies) METER IZE BUILDING SUPPLY SIZE Z P IL o / 4 L .5 F Q " REMARKS SIGN AREA ENV. REVIEW ADB NO. E U N W 0 ALLOWED PROPOSED COMPLETE EXEMPT J Q 0 REMARKS W J VARIANCE OR CU PLANNING REVIEW BY DATE YARDS FRONT SIDE REAR LOT COVERAGE AS LCW NEW RESIDENTIAL ❑ L NE ElADD NON-RESIDENTIAL ❑ SIGN ❑ DEMOLISH ❑ RETAINING WALL ❑ ALTER ❑ EXCAVATE FENCE OR FILL ( X_FT) PRE -MOVE SWIM REPAIR ❑ INSP. POOL FIRE ZONE TV PE OF CONSTRUCTION CODE SPECIAL INSPECTOR AREA REQUIRED ❑ YES ❑ NO OCCUPANCY OCCUPANT GROUP LOAD PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. F Z W f NUMBER OF STORIES NUMBER OF DWELLING UNITS REMARKS NATURE OF WORK TO BE DONE a W PLAN CHECK BUILDING VALUATION FEE Z IL Wf� 0 0 F W i L J W � C PROPOSED USE 1! ^^ r, PLOT PLAN JINDICATE BUILDING SETBACKS. ABUTTING STREETS) /�!/A 1 \ ! Y �y ���.� _ - �= PLUMBING HEAT a: GAS LINE C 57 c� �•i )L�l nl,4)�� t D O FENCE SIGN RETAINING WALL ) u SWIMMING POOL r