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1159 7TH AVE S.PDFIIIIIIIIIIII 6949 1159 7TH AVE S jr- -I a...�--;m�T.,v.7•-�r-- - ac - zr. "R`: ".r". u.-r,••.w.... . •' - ...i.L.. -nL :�...,- .. .. _ r-�i ... .,r. .t� �.. .. ,;l:drr,.?�w. y.,i ,�.'ti: c n_ ..-,>.,,�-i..-. .... ...�. �J•, �.r .......r _-.=r'...'_, ... , Im City of Edmonds RIGHT-OF-WAY CONSTRUCTION . PERMIT Permit xuml►er. - C7 Issue Date - A. Address or Vicinity of Construction: 1 16q -74h AY S B. Type of Work(be specific):2AlSTA[.L a/' ,PVC.. C6/4D I C. Contractor: "" t Contact: z) Mailing Address: y f� S•�' Phone: State License #: �/ �� all _161 Q A Liability Insurance: Bond: � D. BuildingPermit#(if-'applicable): Side Sewer Permit# if applicable): (� E. [1 Commercial ❑ Subdivision [1 Multi -Family ❑ Single Family INSPECTOR: ❑ City Project 1n %Ttil0, (PUD, GTE, WNsi!�ABL ATER) ❑ Other INSPECTOR: �l4� F.:Pavement or Concrete Cut: es ❑No G. Size of Cut: '_ rx_ H. APPLICANT TO READ AND SIGN x INDEMNITY: Applicant understands and by his signature to -this application to hold the City of Edmonds harmless from injuries, damages, or claims of any kind or description ivhatsoever, foreseen or unforeseen, that may be made against 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 and attorney fees by reason of granting this permit. 1 THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC- TION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY.FORCES, AT WHICH.TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Two sets of construction drawings of proposed work required with,permit application. A 24 hour notice is required for inspection. Please call the Engineering Division, 771-0220. Work and material is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut trench work shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. I have read the above statements and understand the permit requirements and the pink copy of the permit will be available on site at all time or inspection purposes. Signature: Date: '�j�/ (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CiTY USE ONLY APPROVED BY: TIME AUTHORIZED: VOID AFTER -Nome. - Gj_--� j� DAYS SPECIAL CONDITIONS: p. P II RIGHT OF WAY FEE: 5CO � 6>0 DISRUPTION FEE/FUND i 1 I: RESTORATION FEE: r T OTAL FEE: e'76 --oo RECEIPT NO.: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997 FIELD INSPECTION NOTES (Fund 111 Route copy to Street Dept.) Comments: V t,\ f LN, Diagram.: V1, CONTRACTOR CALLED FOR INSPECTION DYES ❑ NO Partial Work Inspection. by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: U i ZX4' W.INWV/ SC LF i Pv, I y, M 06/02/1998 07:27 7752299 CHAMBERS CABLE i facsitnUe transmittal PAGE 01 RECEIVE® J U N 2 - 1998 To,. KQ / / Fax: Frorn Oats: 9 Re: Pages: CC: ❑ urgent � Review 0 Please Comment ❑ Please Reply Q PWm Recycle Q!dY� LUG � CdN'��p�1 r� QfiLI�NGYL 0 98-NJ-d 98 -�03 APPLICATION 00"REET E for The CitY FIL Of Wn'OndlP Smic SEWER PERMIT EASEMENT No ................................... NEW CONSTRUCTION 0 REPAIRS 0 7b( — OWNER -.B......e... ... .............................. ---------- CONTRACTOR --------- . A ----------------------------------- PERMIT so ADDRESS........................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................ ......... NAME OF ADDITION ...... Y-t-,S--7f -------- F Z)Z'-$-f ... ! ----- ................................................................ RECUVED APR 2 7 1,03 7 1 Approved: DATE .... ------- OY - _7.- - y �S E;WER `PEkMV ITT','.' ' r }VATER=SEWER DEPARTMENT ' 1 s, •y, r PE1RMIT9n I I Calh 7787107 for side sewer inspectlonsi BP FORE covering any portion, of the •const uc. " S r l •�:,�SInspeetlon will •tC.,providedl with ln.,24,hours,�after� request.. NO;Sat: Sun.;,:oi•'lholiday.,inapectiona /� : .-.,. • -i 1ip' � 7'1 sv z>tzn �C. t+h ADDRESS LQCATIONI'OF „CONSTRUCTION :. :. .: ...... ....... ; .... ........ r do - Z� 6Q'• aE-:Lz� .:�.. � dock v �re�, r T' �� Pddi� n to k.dmond� PROPERTY LEGAL:'DESCRIPTION : ..3 ... j ......................................................... .. .......................................................... ... .... t :-. OWNER AND/OR BUILDER l F 1 intro J .....T.'. r 1 , ,.l ) lir�r rinnCONTR?ICTOR'S),N•AME,'&,,"i)AESS tlricl l•l�st}tints ........ a1 �1�f1 ±P.erinissloriis'rgranted'... ........ A. Z 7:.:., 19 ..:I: , for repair"and%or connection of a: -sidesewer to„the city, sanitary sewer systemr`in accordancelwith City of Edmonds ordinances ENTION ISi CALLED TO THE FOLLOWING i •�_, E,NO: - ­'-The,<owners!�of (thenproperty, mayobtaia'a.,permit•;to.constiuct sewer"inslde�property'line Ailicensed Side. Sewer , Contractor,:muAt be•einployed••to construot si4e.sewer. In, street'-area...Do,,not-cover<any-portion,-of sewer'before'lt: has'been'inspected :NOTE No.,-2 A9p;work; erformed',;1n;'clt rl�ht-of wa - - ' - x y 'g - p y- y4,requirea'an'Invasiom�of It.igtit-of .WayPermlt obtainable' -'from the Clt En sneer a office a ,•'.,NOTE;,N6: 3-ot.tiLin-'fullldnformatio.,regarding-Ordlnancerll48:030-and}Regu]ationa-:.governing sides sewers when you,get'permit: - ,,NOTE'No: 4=Tc•p:of•side sewer,inches,'coverage'�af�prop erty``11ne;and'12 inahesanside),property;line; ,minimum grade of t /;;,- No bends im grade j -'sharper than 1/8-will'�be'•permlttcdt: NOTE"No.-l5-Trenches�in,.stredf must be water settle6eLnd,surfe:ce;;of-street.restored �to :originaG'conditiorr -'Contractors;'sNilll•be':responsible ;for' failure:idue,ta-improper, , or :- :wk which may •develop, 'wlthin`.one' year of completion„ • • ' .. : • = - - i NOTD;No:`�6=IC�Nal,unlawful!.,to:alter or :do any othea'wyrk:than..is provided for in "the,perinft or ta;iio.any work on,th� maid sewer or•its appurtenances except,ta•in serf ;thee -Pipe into the wye.. - - _ - 1 ;DISAPPROVED, Date . By:. Datti .: B Dat©.. B 1 1❑ . .. .... • • x L Y,• `APPROVED ,' , r+�1t Date By ll ..G c............ :Remarks ........: . ---- ... ... .. . �. -- ' BOTH Perm t:Co ies ,MUST,, a SignB Ownertof Fir-m-Performin Construction, 'PRIOR •To,.Re uest For Ins ectioni .. p g y .. � g. � .. 9 p - I,........ ........ .. ....` ....:... .... .e, ' ....., hereby :certify. that she;sidessewer insta'llatron constructediunder,.this',permit F (Owners `f 3Contracting Firm, Perfcrming,'Constructlon)� r installed: in,'acco_ dance with all',,governingfordinances of'thel City-, of Edmonds,.•, i l ... - Dated. this . iday, of 19t: 7" .I Check BEFORE you dig for.: Water,: Gas'a� •{. Tcleplioner�;: Power _` Sewer'El Other �' 2 - %