1228 9TH AVE N.PDFiiiiiiii lill
9834
1228 9TH AVE N
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER: UCl Y l S 7 060 001 UCf
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS(RECORDED)FOR:
CRITICAL AREAS:
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #: I�D
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
I
WATER METER TAP CARD DATED:
I L
OTHER: &Zy —qS -
L:\TEMP\DSTs\Fomis\Street File Checklist.doc
• •
PLANNING DATA STREET FILE
Name: Mark- A Tavn0.►/a StA+it-Ovt
Date: 0 9. 2.40, 2.00(p
Site Address: 1 k l g 2 -M AV.& N (P q rm a lie, fiDL45e
Plan Check #: BLD-2006- (0 (o (o
Project Description: P-oof add(ti v'1 ove y vg- po✓Lv1 ten lootvl c i de g of
I-Ae. Cc/vi lN-4.1 m o ftd, p o tr t:kl
Reduced Site Plan Provided: ( ES NO)
Zoning: P-5
Map Page: y 5
Corner Lot: ( ES NO)
Flag Lot: (YES / NO
Critical Areas Determination #:
❑ Study Required N A- ' VW GI(✓'(' VvI, A—
D Waiver
SEPA Determination:
® Exempt 41:e�
❑ Needed (Requires: 1 Fee, 2 Environmental Checklist, and 3 APO List with notarized form).
Required Setbacks
Street: 2196
Side: , O
Side: I O
Sr'C� 2S
Actual Setbacks
Street: (O 9%
Side: v
Side: S
Rear: 4-5r
❑ Detached Structures: 0U,rdilyt 51KtOL 1+(p LP
❑ Rockeries:
❑ Fences/Trellises: noy1e
❑ Bay Windows/Projecting Modulation: GJVIoWV1
❑ Stairs/Deck:
Parking Required: y
Parking Provided: 2-t'
Lot Area: , t}.(p au 4 yo a p 3 J- . (p O
Lot Coverage: ?•y 52. ,; 1 y'/.
Lot Coverage Calculations: U. 5 f z-' 20 Zla rp
h-ew roof--. 125 O +- l
qy6ldinq Height
Datum Point:
Datum Elevation:
Maximum Height: ?, S /
Actual Height: L ZS t
ADU Created: (YES / 10
Subdivision: p j 4 h q l,Ze P-d d i iY 6)(1 Z• 51 kk 0o o b - Ou Lot 1
Legal Nonconforming Land Use Determination Issued: (YES / NO)
Other
on -me, 47fiatr-- Hi5-tvh c, re-g( ' -t'cv
Plan Review By: sure aeescra
"Not iing in this per aht proval process shall be
inter retell as allo .j f► permitting the
main Hance of any urr~ tly existing illegal,
v
notc2nforniiing or a ^pr - ittsd building, structure OWNER/CONTRACTOR IS RESPONSIBLE
re. scope
or ei conditu:l; b..^ t,;,F ,�.� chs sco of the FOR EROSION CONTROL AND DRAINAGE
ppee t applicatioT. �.: � ew of whether such
boil ' g, structure .at!ition is s wn on e
site lam or drawing Sup building, ructure or x�sT/tip P t-r! o
con tion may be th subj t of a crate - - -
enfo meat action. -
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Zone RS -14 Corner ✓Flag_
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ReQuired
I w5'
r Front w/N
Sides 5/C 1 C)l
e R-eff-
Other 2 5,1 c. z6 i
Height -
APPROVED BY PLANNING
O'►/ti'k/v►%- 10 • 0 6.0 40
�zK.s4
24 HR. NOTICE REQ.
FOR INSPECTION
ate:
SEP 21 Z006
BUILDING DEPARTMENT
GTY OF EDMONDS
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APPLICATION
for
The City of Edmonds STREET FILE SIDE SEWER PERMIT
OUTSIDE ❑ INSIDE ❑ REPAIRS
OWNER--� y O ' Y.........................................
HOUSE No. �./°�. ... ...1.._ ...._ ...... ....Y.....................................
CARDNo. ......................................
EASEMENT No . ............ .........................
....... CONTRACTOR ............7�./ J -------------------- -------v ----- PERMIT No.
STREET
......... AVENUE LOT No.............................................................. ......... BLOCK No. ------------------
NAME ADD. ------ /-- �!/-------- 4-z ..%---- -------------------
q. T 14, /K
.6
Date Approved-, V
BACKPIL.L WORK ORDER ISSUED ................................... DEPOSIT, $------------------------------ ..._..--------- % q
SEWER WORK ORDER. ISSUED ----------- •-------------------••-•--- DATE ` ..I.. - BY ... L z...------f�
Y[+��-
t'�n
_!`�: �. _..._�. .. rl iy.`...... �'1_,'.._
.-.; f��:d L
_• t6 � _ .__ :.. .:_1 Gf .t
_ � :1 ...
.._ .....-....................... .u✓� ._:��';�„- .. .........,._..
.... _.._....._ ......... Ia; .. _'`max :•r}i:, i�:'.�, .....
.. .. .. .. ... ..•..
.. ... .:• _-�... .."::.:.
..:�%i ;_�r-.: �i.�
CITY OF EDMONDS
JIVIC CENTER — WATER -SEWER DEPARTMENT is r dy for ju ecu oz when wore
r o=� for o,r holidays N2 1350
SIDE SEWER PERMIT
lADDRESS 1228--Ninth.-Avenue...North. -- ---- ---
OWNER ............. Belt_ ................................................... CONTRACTOR.------. B _.IM-.COntr`3Ct0 ` ........................
Permission -is granted --- De.ce. bex..1-0.............. 19.55_, for -................._.. days, to REPAIR or CONNECT a side sewer
with City Sewers in accordance with application on file and governing ordinances.
j ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 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. Do not cover any portion of sewer before it has been inspected.
NOTRlNo. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
T/ jNo. 3—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. 4—Trenches to 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. 8—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its ap-
purtenances except to insert the pipe into the wye.
•
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' «! `'�. .. hK�;,� .�'i`�s4'"f��`•i '6"'�'o-'h�r i'.+[�wn#}. Y'�:7'�s�,:<+i^i�:v�"T�J�'�r•i�"'"�:v�±. �'�,
City of Edmon#
e.: RIGHT-OF-WAY CONSTRUCTION
PERMIT
Permit Number.
Issue Date:
% / Al. 9`7
A. Address or Vicinity of Construction: 1228 9 Av N ( 9520004 )
18
9p 19 C B. Type of Work (be specific): Install Service
-
C..-.Contractor: Washington Natural Gas
Mailing Address: 1122 75 St SW Everett
," r : : State,License #: 98203
+J
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 447-3284
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project Ja Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other "
INSPECTOR: INSPECTOR: V) W� 1
A
F. Pavement or Concrete Cut : pLJ Yes UNo G. Size of (hut: x H. (:harge s
APPLICANT TO READ AND ..
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made againsti 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.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS ORTA'iPRIOD OF ONE YEAR FLLOWITHE FINAL
INSPECTION 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.
Construction drawing 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. f
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 ditches shall be patched with asphalt or City approved material prior to the end.of the working clay;
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 tl inspection purposes.
Signature: 7, Date: 7-3-95
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
CITY -USE ONLY
APPROVED BY: V`l�►1
TIME AUTHORIZED: VOID AFTER DAYS
SPECIAL CONDITIONS:
RIGHT OF WAY DEPOSIT..
DISRUPTION FEE/FUND III:
RESTORATION FEE:
PERMIT FEE:
TOTAL .FEE:
COMMENTS: RECEIPT FEE:.._
DATE: ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES
Comments
Diagram
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION ❑ YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
❑ NO
Aft
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Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural -Gas
1356-7500 X7596
Pu�,�T WY
� s 7�00�.•
Key:
-W- Water
No �t�1DlG• o WTTR. -- Gas
-SS- Sewer
2 Water hydrant
gas main p Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
P. 03
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_... RECEIVED
0 C T 1 1 1995
ENGINEERING
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