1148 3RD AVE S.PDF111111111111
4945
1148 3RD AVE S
CITY OF EDMONDS SIDE SEWER PERMIT
, 190° PERMIT N2 9153.
Address of Construction: 44? �ry
Property Legal Description (Include all easements): M�-r�z
Owner and/or Contractor:
State License No. /Z- n��� t,---Building Permit No. anDle'k--Iy�Y//
)d Single Family
❑ Multi -Family (No. of Units )
❑ Commercial
❑ Public
Invasion into City Right-of-Way:lo ❑ Yes
RW Construction Permit No.
Cross other Private Property:F4No ❑ Yes
Attach legal description and copy of recorded easement
I certify e2qYI have read and shall .comply with all city requirements
as indicated on the back of the Permit Card.
Date
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE USE ONLY
* FOR INSPECTION CALL 771a3242,—PUBLIC WORKS DEPT.
Permit Fee O OIssued
Trunk Charge: — Date Issued:
Assessment Fee: Receipt No.:���
Lid No.:
Partial Inspection: Date —Initial —
Comments
Reason Rejected: Date —Initial —
Final Inspection Approved: Dated Initial"
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Bull Copy: Applicant,
Revised 3190
The City of Edmonds
Side Sewer Drawing
EASEMENT NO. ............................................
NEW CONSTRUCTION K2" REPAIRS ❑ LID NO . ................... ASMT. NO...................
OWNER.................................................................. ............................ CONTRACTOR ...�.� C%.e I .......................................... PERMIT NO. ..�.�.��.. ....
JOB ADDRESS.......�.S...._..3.rJ....Ftuv..- .................................
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LEGAL DESCRIPTION: LOT NO ....................................... BLOCK NO. ....................................
NAMEOF ADDITION..............................................................................
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PWW0001.11175 (REV.11178) DATE .-c a.... ................
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NOTICE: NO WARRANTY OF ACCURACY. The information shown on the
attached map was compiled for use by the City of Edmonds, Its employees
and consultants. The City of Edmonds does not warrant the accuracy of
anything set forth on the map. Any person or entity requesting, a copy
should conduct an independent Inquiry regarding the information shown on
the map, including, but not limited to, the location of any sewer stub shown.
Such sewer stubs may or may not exist and may or may not exist at the
location shown. Neither the City of Edmonds nor Its employses or officers
shall be liable for the Information given on this map, nor for any oral
representation provided based upon said map.
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CA FILE NO.
Critical Areas Checklist Ack®
Site Information (soils/topography/hydrology/vegetation) ' �ryoTs o 1999
1. Site Address/Location:
/ `f Y�� flu s. ofFDMON°ssorR.
2. Property Tax Account Number: C, C( G ? o D F- VJ
3. Approximate Site Size (acres or square feet): ;p 6 0 0 APR
- jAS9
4. Is this site currently developed? yes; no. fit .��b+>i:t�
_ DEFT.
If yes; how is site developed? S �
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of
10-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
8. Site is in the floodway /�# floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? (What time of year? ).
10. Site is primarily: forested ; meadow : shrubs ;mixed '
urban landscaped (lawn,shrubs etc) r
11. Obvious wetland is present on site: KG
SCS .mapped soil types)?: J.
3 Wetland inventory or C.A..map:ndicates.wetland present on site? T�.
4.. ... Critical Areas inventoryor C.A:map indicates Critical. Area on. site? ;J
S..:. Site within designated_ earth subsidence landslide hazard area?:.:.
6 Site designated on the Environirientally. Sensitive Areas Map?.t7
DETE MINATION
^ca chk.doc; Rev 10103/97
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941.50 --- -
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36Z0.84 - TOTAL
25 4.83 TOTAL
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PLAN
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CITY OF EDMONDS
CONST UCTION PERMIT APPLICATION
OWNER NAME/.NAKAE OF BUSINESS
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ZMAILING ADDR SS -
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CITY ZIP. TELEPHONE`
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NUMBER
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ADDRESS -�
LEGAL DESCRIPTION CHECK
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SUBDIVISION NO.
LID NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING 40 t2
TESCP Approved
Rw Permit Required
EH
REQUIRED DEDICATION
Street Use Permit Req'dN
Inspection Required
-
PROPOSED
Sidewalk Required GA
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
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YES NO ❑cc
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REIAAKS
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ENGINEERI MEMO DATED REVIEWED BY
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STATE LICENSE NUMBER EXPIRATION DATE
CHECKED BY
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SEPA REVIEW
SIGN AREA
HEIGHT
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COMPLETE EXEMPT
1
ALLOWED PROPOSED
ALLOWED PROPOSED
1-11
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LEGAL DESCRIPTION OF PROPERTY -INCLUDE ALL EASEMENTS
_ _, EXP -)
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR 0
J _
PROPERTY TAX ACCOUNT PARCEL NO. _ . _. Z
• .�' I ? - '" I LOT AREA PLANNING REVIEW BY DA E at
EW RESIDENTIAL rVtAl Z-
N
PLUMBING / MECH
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❑ ADDITION
❑- COMMERCIAL
❑
MPLIANCE OR
COANGE OF USE
❑ REMODEL
❑ APARTMENT
❑
SIGN
❑ REPAIR
GRADING CYDS
❑
FENCE
CHECKED BY
TYPE O CONSTRUCTION
CODE
OCCUPANT
( X FT)
❑ DEMOLISH
❑ TANK
❑
OTHER
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GROUP
GARAGE
RETAINING WALL
❑
❑
RENEWAL
SPECIAL
REQUIRED RED SP
REA 15� NvV 4` ,\
V
UPANT
D
CARPORT
RO K RY
❑ YES
(TYPE OF USE, BUSINESS
OR ACTIVITY) EXPLAIN:
REMARKS
PROGRESS INSPECTIONS PER UBC 108
NUMBER
NUMBER OF
CRITICAL
OF
STORIES
DWELLING
UNITS
AREAS
NUMBER
nn
1 1
DE/SCRIBE WORK TO BE DONE/1_
/�� ,
1 %` - � , l' mot.., r`1 r 1
: ,:. f �-; .� \ \ I /�'. f-' ' (`�
► r t—'- r .. (
tTy7ii�Y�/6`N^'' IYL—fi^Ib—r \il ISIY(FFAIa f/
FINAL INSPECTION REQUIRED
~ I VALUATION FEE
PLAN CHECK FEE
HEAT SOURCE GLAZING % LOT SLOPE %
F -
)
59
BUILDING
PLAN CHECK NO: VESTED DATt
PLUMBING
L -7 ..-.
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
5 BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
7 DOMAIN (CURBS,SIDEWALKS, DRIVEWAYS, MARQUEES,ETC.) WILL REQUIRE
GRADING/FILL
t^
SEPARATE PERMISSION.
¢
STATE SURCHARGE
w PERMIT APPLICATION: 180 DAYS
a
PERMIT LIMIT1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
STORM DRAINAGE FEES
D c0
U)
J "APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
Jv
f 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
0 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
O DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUIREMENTOF ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
= NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
�•' '
TOTAL AMOUNT DUE
(
I HEREBY ACKNOWLEDGE. THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
t
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
This application is not a permit until signed by the
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
Building Official or his/her Deputy: and Fees are paid, and
FOR INSPECTION
0 WO EN'S COMPENSATION INSURANCE AND RCW 18.27.
receipt is acknowledged in ace provided.
9 P
t
IC;NA URE (OWN DATE SIGNED
(425)
O�FIAAIGN EDATE
�
ATE TION
HEL S Y'tv DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL - FILE • YELLOW - INSPECTOR
5/98
PINK - OWNER • GOLD - ASSESSOR
C %
City of Edmonds Permit No:
,4
5 RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date: `a'-7 00
)
A. Address or Vicinity of Construction: //4e " 3 ff4V(,,F' S
-B: Type of Work (be specific): -51146 Lr r ft /li/ c- y o o N s%� u ni v
4arS .2 13
C. Contractor: �+� G Contact:
Mailing Address: / / d 1 o? yob r y ` t;1C *1 d 2- Phone: t>
.,
State License #: / '` �w % Liability Insurance: Bond: $
D. Building Permit # (if applica le): Side Sewer Permit # (if applicable):
{
E. ❑ Commercial Subdivision Jq City Project ❑ EUC (PUD, GTE, PSE, CHAMBERS, OVWD)
❑ Multi -Family Single Family ❑ Other
INSPECTOR•
F. PAVEMENT: ❑ YES, ❑ NO G. SIZE OF CUT X H. Charge: $
CONCRETE CUT: ❑ YES ❑ NO
APPLICANT TO READ AND SIGN
IDEMNITY: Applicant understands by his/her signature to this application he/she holds the City of Edmonds harmless from injuries,
damages or claims of any kind or description whatsoever, foreseen or unforeseen, that'may be made agdinst the City of Edmonds or
any of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs and
attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR If D OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FE,4 BE HELD UNTIL THE FINAL STREET PATCH IS
COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL
B� PI�OCkAED FOR ISSUANCE TO THE APPLICANT.
Traffic control and public safety shall be in accordancar#fi City regulations as required by the City Engineer. Every
dagger must be trained as required by (WA%296-155-305 and must have certification verifying completion of . the,
required training in their possession.
♦ Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City-
approved material prior to the end of the workday — NO EXCEPTIONS.
♦ Three sets of construction drawings of proposed work are required with the permit application.
I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THAT I MUST MAKE THE PINK COPY OF THE PERMIT AVAILABLE. ON SITE AT ALL TIMES FOR INSPECTIONS
Signature: Date: ��`/�y 0
(Contractor or Agent)
CALL DIAL -A -DIG (1-800-424-5555)' �\RIOR�TO BE�G�IN�!dIN�WORK
� i
'FOR CITY USE ONLY
Approved by: �a � Right-of-way Fee: k f1. 0O
Time Authorized. Void -After. A / / %mop/ Disruption Fee/Fund Ill:
Special Conditions: Restoration Fee:
Totaffee: ? 0 ). uO
Receipt No:
Issued 'by:
UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT CODE.
FINAL APPROVAL OF PERMITTED WORK
INSPECTOR'S SIG ATURE DATE:
For inspection requirements see Engineering Information Handout.
NO WORK SF-IAI.A, BEGIN PRIOR TO PERMIT ISSUANCE
MAIL BOXES
5
03
MAINTAIN MINIMUM OF
24" COVER IN ROADWAY
10.57' -6"PVC @ I %
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TOP 103.44'
INV 99.85' ---6" (E)
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S 89' 28' 48" E 170.21'
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327#7 Sq ft / e
TEMP ENTRA CEO - —
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ELEV.: 119. 4' Lot 1
11 1109.17 ft2 --__ —
15 ESMT � Exts I
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TYPE 1 03
LOCKING GRATE
TOP 102.08'
INV. 98.55' ---12" (N)
INV. 98.65'---6"(E)
\\ \ 58.22' �-6"PVC @ I % 10 i F.F. ELEV.: 119.23' / �I� 1110 LN FT Ixlstfflg house I CUTto �..� (d)
Lot 4 1343.57 ft2 24" ADS I1 D �2 3Rain /CURB
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INS . 100.40' �6" (S�\ \ FOR CONTINUATION �/ � \ \ ��S AR ND OR LOT 1
5 OO 10 10 108 1 1 1 12 �1 14 CURB cur `
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2327.27� Sq (t .� 5 0
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Lot 3 2
1 1 43. $7 ft METER 0 to
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116 118 120 122
GRADING: S-99- 168
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DATE:ciry C, 2000
C71TY ENGINEER
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OUTLET CONTROL
TO OUTLET
I' MIN. COVER
5% TO I % SLOPE
LOCKING LID
(TYPICAL)
6" MIN. CLEARANCE
MEASURED FROM TOP OF
CONC BOX OR RISER
TO OUTLET
1.8516 IN ORIFICE
UPPER CATCH BASIN OUTLET 12" MIN
CONTROL
.7947 IN ORIFIC
CONTROL CATCH BASIN
E)"ETENTION' CROSS SECTION'
N.S.
FROM CONTROL CB
SYSTEM CROSS SECTION
6'X 10'X2' DEEP, 4-6" SPALLS OR EQUAL
6'X 10'X2' DEEP, 1 1 /4" CRUSHED ROCK
N.S.
ff 101 1 all 5
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AND TEMPORARY EROSION CONTROL PLAN
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1 1-15-99
REVISIONS:
12.13.99
1/3/2000
GENERAL NOTES
1. All work and materials shall be in accordance with City of Edmonds Standards
and Specifications, and Washington State Department of Transportation 1991 Standard
Specifications for road, bridge and municipal construction.
2. Temporary erosion/sedimentation control measures shall be implemented prior to any grading
or extensive land clearing. These facilities shall be satisfactorily maintained until construction
is completed and the potential for erosion is minimal.
3. All pipe shall be placed on stable earth, or if in the opinion of the City Engineer, the existing
foundation is unsatisfactory, then the unsuitable material shall be excavated and the void
backfilled with a free draining granular material, free of debris and clay.
STORM SYSTEM
4. All grates (inlet and catch basin) shall be depressed 0.1 foot below pavement grade.
All catch basins to be type I unless otherwise noted.
The contractor shall be responsible for adjusting all manhole, inlet, and catch basin frames
and grates to grade just prior to pouring of curbs and paving. All catch basins with a
depth over 5 feet to the flowline shall be a Type II CB. All structures located outside of the
right-of-way shall have locking lids.
Catch basin frame and grate shall be Olympic Foundry part No. SM 50G, Herringbone
pattern; part No. SM 52, thru-curb inlet; part No. Sin 44, rolled curb type; or other
approved equal; or as otherwise called for on the plans.
5. Stormwater retention/detention facilities must be constructed and maintained in
accordance with City of Edmonds requirements.
6. All road fills shall be compacted to a minimum of 95% of maximum density when tested
using the modified Proctor test. Compaction shall be accomplished in accordance with
Section 2-03.3(14)C, Method B or C.
7. If cut and fill slopes exceed a maxinwm of one foot horizontal to two feet vertical,
a rock or concrete retaining wall will be required.
8. Approximate locations of existing utilities have been obtained from available records
and are shown for convenience. The contractor shall be responsible for verifying the location
of all existing utilities whether shown or not. The contractor shall call the Utility Locator
Service, 1-800-424-5555, two working days prior to any construction.
9. The contractor shall take all necessary precautions for the safety of employees on the
project and shall comply with all applicable provisions of Federal, State, and Municipal safety
laws and building codes. He shall erect and properly maintain, at all times, as required by the
conditions and progress of the work, all necessary safeguards for protection of workmen and
the public; shall post danger signs warning against known or unusual hazards; and he shall
designate a responsible member of his organization on the construction site whose duty shall be
the prevention of accidents.
10. The contractor shall be responsible for maintaining and repairing asphalt and gravel surfaces
disturbed as a result of this construction until they are accepted by the Public Works Department
of the city.
TEMPORARY EROSION/SEDIMENTATION CONTROL NOTES
1. Maintain natural vegetation for silt control where possible.
2. Temporary erosion sedimentation control facilities shall be constructed by placing siltation
control filters around swales (natural or manmade) and shall be maintained in a satisfactory
condition until such time that land clearing and/or construction of permanent drainage facilities;
are completed and operational. Facilities shall then be removed and the site restored to the original
or final design condition.
3. As construction progresses and expected seasonal conditions dictate, more siltation control
facilities may be required to insure complete siltation control of this property. Therefore, during the
course of construction, it shall be the obligation of the contractor to address any new conditions that
may be created by his activities and to provide additional facilities, as may be needed.
E5C Minimum Requirement - 5tablization of Exposed Areas. All Soils exposed by land disturbing
activities shall be staliblized by suitable application of 15MP9, including, but not limited to, sod
hydroseeding, or other vegetation, plasitic covering, or mulching. All 13MPo shall be Selected,
designed and maintained in accordance with the Manual. The exposed soils shall be Stabilized
according to an approved timetalbe. (Typically, no soils shall remain exposed for more than two (2)
days from October 1 through April 30 and no more than seven (7) days from May 1 through
September 30)
CONSTRUCTION SEQUENCE
I .PRE -CONSTRUCTION MEETING
2. TEMPORARY EROSION CONTROL INSTALLED
3. TEMPORARY ROAD/APPROACH
4. EXCAVATION
5. DRAINAGE SYSTEM &SANITARY SEWER INSTALLED
6. FOUNDATION
7. DRIVEWAY
0„ 2X2 DF
OR BETTER
FILTER FABRIC \
2" - 4"
TOP OF SWALE QUARRY
SPALLS
ROCK CHECK DAM SECTION 1
NO SCALE L
FILTER FABRIC 2X2 DF
\,f-EI// OR BETTER
7/8" WASHED
GRAVEL
r Y
3 6"
119: 1 I LII II II
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7
BURY FILTER FABRIC BURY BOTTOM OF FILTER
IN GRAVEL -LINED TRENCH FABRIC IN TRENCH
FILTER" FENCE DETAIL
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4" - 8" QUARRY SPALS
PROVIDE FULL WIDTH OF INGRESS/ EGRET.
TEMPORARY
ROAD ENTRANCE DETAIL
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REVISIONS:
12.13.99
1 /3/2000
EXPIREi
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E c E.. I v TIE
JAN 0 7 2033
DEVELOPMENT SERVICES (;TP..
CITY OF EDMONDS