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1201 6TH PL S.PDFiiiiiiiiiiii 5469 1201 6TH PL S ,. , .. -...�. .1l♦•r.' .�4'V - �' r �. ..�y. �. .. •• i. , r�-. y ...�;. N,. ' ;.; ,�` .',l:i ♦ i r ,.. .....�.... .. ..i y r H\♦ •�. . •..7'.' : .! ...-. .'.'��=-1. RECEIVED CITY of EDMONDS SIDE SEWER PERMIT .bf For Inspection Call 771-3202 APR 28 1986 PERMIT NO. 0760- PUBLIC WORKS VIA EDMONDS WAY, Address of 'Construction Q TRUNK LINE �1 00 _o -n a� a Property Legal Description (Include all easements): 16¢41m,111Y11l9- Owner and/or,Builder: Contractor & License No Hn — VV\'IE-- Singl:e'Family Residence_ Multi -Family (No. of Units. ) I Commercial (No. of fixture Units ). Invasion into City Right -of -Way: NoYes (If Yes, Rilght-of-Way Construction Permit required. Call One - Call- Center (1-800-424-5555) before any, excavation.) Cross other Private Property: No Yes (If Yes, easement required,.. attach legal description and county easement number.) PLEASE READ ENE P 1MS ED ON THE BACK I certify. -that I read and shall comply with ,the items listed on the back. Permit Fee: 2D-too �.N Issued By. Trunk Charge: �Lo� Date Issued:` , Assessment, Fee: Receipt No.: S—A/F �2� Date. Partial Inspection: Comments Date Initial Final Inspection Approved:. 122� _Z Date Initial Rejected: eason Date Initial ** PERMIT MUST BE POSTED ON JOB SITE ** White Copy - File Green Copy - Inspector Buff Copy - Applicant Side Sewer Drawing The City of Edmonds EASEMENT NO. ............... ---------------------------- I NEW CONSTRUCTION g REPAIRS ❑ LID NO_ ------------------ ASMT. NO . ............... - OWNER ... 14o- AM-.--- ------ CONTRACTOR - ------------------------- PERMIT No. 74-88 .... JOB ADDRESS 12.01 ------- G --- r . 14.... ------ ---------------------- LEGAL DESCRIPTION: LOT NO. --5 ------------- ---------------- BLOCK NO. -V _4A..EDM0ND&--WAY I TRUNK LINE \ ,I.*- 7 tv4- , O.-S.S�. PVVVV-0001-11175 (HF-V.11/78) NAME OF ADDITION --IZ- ------ P-LPsc.& 12,01 G-r" PL.S.. 1,0P. -rc.0-W!lE Approved: / ..... j5y .... % . ..... ......... ................... 401,41' Ltil' GLACE LOT 100R.- 0, . NW-5--W Y4 SiC. 2S, -r-,)7AI. D A4 0 Al D WA s 1 LU SELLER LL-ZP___ I STREET FILE (-ro 's 2 0 s c sc .09 L r- I ,!�' ,, PROJECT REVIEW CHECKLIST .+ F 'fan' '-:. '. S'• P r ' 1ZD/ ��:• I`1`S/� /f�%%il�ff�l<!�/l�s ROJEcr :: P RA7DCP ADDRESs: , f,�._/�//ice APPLICATION RECEIPT DATE:_ �,• Reviewed by:, (initial 8at� ".WTR/SWR COMENTS PLANNING _ : STREE'PENQJRN( FIRE` BUILDING•. , ' SIiJ6WFA[�Y/MULTIPLE/OagMCIAL'-!?(Circle One) ` ////// ///////// ///////// //////// /%///%/i SETBACKS CHECKED - Planning "' . VARIANCE/SETAACK• ADJ. CCNDTTION=I USE PERMIT . s.;;a••i . ' ' : ; ////// 7777777777777/77 ///////// //////// %/'%/%%/r ADB •REQUIRREIENIS CHECKED OTHER ZONING REQUIREMENTS////// i•" ///////// //////// / / /i/777777 ACCESS'SIAPF.=& VEHICLE ACCESS SZ72E�T •FILE ".. " ////// ///////// ///////// //////// ', +• :, . NOW '/• LEGAL DESCRIPTION VERIFICATION ,!�" ////// ///////// ///////// /////"///- % 9"8� 'itI'I QUIT'CLAIM/DEDICATIONS '�/Z" EASEt+gNP -` PUBLIC/PRIVATE T,;;:, .. CALCULATE SEWER CONNECTION IF'NO LIDS'IZI& Z%Jr PLAT/SUBDIVISION REQUIRDOM:. --• /% RIGHT-OF-WAY; CONSTRUCTION PERMIT RDQD n '//////// BOND READ i.&PUBLIC'IMPROVEMENTS ////// ///////// ///////// SOILS.00NDITIONS & GROUND. WATER" FIELD CHECKED711111 ..- c;..":�,°'; ;REQUIRED' STREET PAVING •;:`F CURB AND Gnim REQUIRED' "^ ////// ///////// ///////// sN* SIDE%1k&'RDQUIRID .`, �,F' ////// ///////// ///////// °� ., . CURB CUT FOR�DRIVEWAY'sREQDI: r°o'' •, +77Tf= STREET NAME SIGN REQD"' :. f ///////// 7TIT=t /////////e°: C►IiiII2 SIGNING*RFK1D :''° :.' :',# a', :, //.//// ///////// /////'/// //'/%/r/ SIDE SEWER tAVAILARILITY' %%%%////// EXISTING WATER MAIN SIZE /////%// WATER MF'TER'SIZE SERVICE: LINE -SIZE u N,...? 1 ,d,ti HYDRANT REQUIRED HYDRANT ' SIZE` EXISTING T,='' ////// ///////// J ".� •/% //////%/ %/%%/t/ CROSS` CONNECTION INSPECTION RDQD . VATER`ME'I' "CHARGE REXA " :?.;, s:,, / ////// ///////// t OfV / i' T111777..r FIREsLINE'CHARGE-READ - SPRINKLM =° "an 2±.' r®rr STRF.Ir ,4r'";A•. :. .• ////// ///////// J;r t.b Wr: r� k " OPEN DITCH' EXISTING..' RDQD ri / CULVERT READ�trv}l%, f• } ////// ///////// ///////// _.x 4 ti Ja- SIZE, �ji.. CA701 `BASIN REQA `• `: ; .}. - ////// ///////// ///////// INDICATED &N SITE PL.i SHOULDER DRAINAGE MAIN. :' -SHALE OPEN RUNOFF ,s PLANNING MGRf ENGINEERING MGR. PI ;r, "• � ar�µy Oil USE l CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION ZONE/�19D — NUMBER JoB ADDRESS � NAME (OR NAME OF BUSINESS) Tt C) cG� ��� , `v LEGAL DESCRIPTION CHECKI !\ SUBDDIIVISSIIION NJ(Oj i } 7 �V LID /NO. -7 /�j �J -L-7 AI MLING ADDRESS Z2•\ l0rj PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. EXISTING REQUIRED DEDICATION PROPOSED r CITY 7ELEPHONNENUMBER -•� -� v NAME I u� RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED ❑ STREET USE PERMIT REQUIRED El ADDRESS , u 0— SEE ENGINEERING MEMO DATED SEE PIW DEPT. REVIEW CHECK LIST DATED CITY f l- TELEPHONE NUMBER ,7q5- (g, lam✓ REMARKS / NAME A^r ADDRESS �Q ICc METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS CITY TELEPHONE NUMBER REMARKS STATE LICENSE NUMBER "O -ME-- L'A _ 1 CITY LICENSE NUMBER N SIGN AREA ALLOWED PROPOSED ENV. REVIEW COMPLETE EXEMPT ADB NO. Legal Description of Property -Include all easements (show below Or attach four copies) SHORELINE = �J (� N T V� VARIANCE OR CU PLANNING REVIEW BY DATE YARDS FRONT SIDE REAR LOT COVERAGE REMARKS © NEW ® RESIDENTIAL PLUMBING ADD/ALTER NON-RESIDENTIAL MECHANICAL REPAIR RETAINING WALL SIGN EXCAVATE FENCE DEMOLISH OR FILL ( x_FT) ❑PRE -MOVE INSP.I ❑ SWIM COMPLIANCE INSP. POOL CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT SPECIAL INSPECTOR REQUIRED ❑ YES 0 NO AREA OCCUPANCY GROUP OCCUPY LOAD ❑ SIDE SEWER El WATER LINE REMARKS NUMBER OF STORIES i �� NUMBER OF UNIt,LING O N i NATURE OF WORK TO BE DONE (ATTACH PLOTP1LAN) In ^ iA e-, N i "Y G I n r, l O -. W VALUATION FEE PLAN CHECK FEE BUILDING PLUMBING MECHANICAL. This Permit covers work to be done on private property ONLY. GRADING/FILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. Permit Application:180 Days Permit Limit: 1 Year- Provided Work is Started Within 180 Days "Applicant, on behalf of his or her spouse, heirs, assigns and successors in interest, agrees to indemnify, defend and hold w harmless the City of Edmonds, Washington, its officials, f employees, and agents from any and all claims for damages of iwhatever nature, arising directly or indirectly from the issuance of this permit. Issuance of. this permit shall not be deemed to jj�}'�-it'L� � Ds/ W4321 0 (raD•Da modify,.waive or reduce any requirement of any city ordinance i 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 ATTENTION APPLICATION APPROVAL Information given is correct; and that I am the owner, or the duly authorized agent. of the owner. I agree to comply with city and THIS PERMIT This application is not a permit until state laws regulating construction; and In doing the work authoriz- AUTHORIZES signedis b the Building Official or his ed thereby, no person will be employed in violation of the Labor ONLY THEY 9 Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is tion Insurance ) 19 INSPECTION acknowledged in space provided. SIGNAT E (O ER OR E DATE SIGNED DEPARTMENT c CITY OF OFFICIAL'S SIGNATURE EDMONDS 771.3202 DATE ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE z w a Z z Z 5 a UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector L A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. PINK — Owner GOLD —.Assessor 102.76 K.nro. P. m g • ¢a-0. w1 • 7759'