1234 8TH AVE S.PDFIIIIIIIIIIII
8689
1234 8TH AVE S
m City of Edmonds Permit No: ZOW— O 184
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date: i 00
A. Address or Vicinity of Construction: 1234 8 AV S
Type of Work (be specific): PERMISSION REQUEST TO INSTALL A 1 1/4" PLASTIC MAIN, TIE—IN FROM
1300'n C/L OF 223 ST SW & ±17'W C/L of * av S. continue west to end of main atttkz•a'w
o ,servetzx@ ptt z 1Z34 8 aysw
C.. Contractor: PUGET SOUND ENERGY
1 1122 75th ST SW
Mailing Addres . .
tve.�e�
State License #:
D. Building Permit # (if applicable
10-7009 _L
Contact: DOUG USITALO
Phone: 425-356-7520
b ,
Liability, Insurance: Bond: $
Side Sewer Permit # (iapplicj�b��: '
E. ❑ Commercial ❑ Subdivision ❑ City Project ❑ EUC (PUD, GTE, PSE, CHAMBERS, OVWD)
❑ Multi -Family ❑ Single Family ❑. Other
INSPECTOR-
F. PAVEMENT: ® YES ❑ NO G. SIZE OF CUT 2x4 X `''' H. Charge: $
CONCRETE CUT: ❑ YES ❑ NO,f'a"
- 't-
4
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 against 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 ofgranting this permit.
THE CONTRACTOR IS ;RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORKK, 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.
♦ Traffic control and public safety shall be in accordance with City regulations as required by -the City Engineer. Every
flagger must be trained as required by (WAC) 296455-305 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.
.i 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
SUSAN SIDICK ` 05/15/2000
Signature.
Pate:
(Contractor or Agent)
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
USE. ONLY
Right=qf-way Fee: ' 10 °� + S `
Disruption Fee/Fund 111,:
Restoration Fee:
Total Fee:
Receipt No•_[t
Issued by:*�1'0
UPON COMPLETION OF PERMITTED WORK, AN"ENGINEERINGFINAL
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT CODE.
FINAL APPROVAL OF PERMITTED WORK A 1•
�^ INSPECTOR'&SIGNATtIRE DATE:
For inspection requirements see EngineeringTn-formation Handout.
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
t
.i
r
r, 14
Date:
To:
MEMORANDUM
May 31, 2000
PSE
From: :Maryanne Zukowski Traffic Engineer
Subject: Right of Way Permit traffic control conditions of approval
Traffic Control in the City Right -of -Way
• All signs, barricades and related equipment and their use must be in accordance with
Part IV, "Traffic Controls for Highway Construction and Maintenance Operations," of
the Manual on.Uniform Traffic Control Devices, as prepared by the National Joint
Committee on Uniform Traffic Control Devices and per the City of Edmonds
Developmental Standards. Reasonable accommodations shall be made for distance
requirements in signage for geometrical conflicts.
• Coordination with the City Inspector prior to all work to check traffic control on
gth Ave S.
• Particular attention should be made to the following items:
• There shall be at all times reasonable pedestrian and vehicular access to and
egress from the properties adjacent to the project, so far as possible. Contact the
affected homeowners directly to prevent conflicts.
• The Public Safety Department (police and fire), 771-0200 and 771-0215, the
Edmonds Public Works Department 771-0235 shall be notified.24 hours prior to
the construction. Proper provisions shall be made for public convenience,
safety, and travel.
• Any asphalt concrete pavements, crushed surfacing, gravel base or water
required for maintaining traffic during the life of the project shall be placed by
the contractor immediately upon request by the engineer and/or inspector.
• All unattended excavations shall be properly barricaded so as to prevent
accidents.
• Construction along or across the City right-of-way shall be as per the contract
documents, City of Edmonds Standards, or as directed by the engineer and/or
inspector.
City of Edmonds
1 a a 50'
I;NO MA I N
220 - W (�
P I NGH ep >%U66 ---\ o' 60
6X. PUP N/K m
17'W C� 300'N C� I
� z
d .
X
-2'X5' GUTS MAY 0E RE0'
OVER WATER MAIN
Pvf Did
Q
d
,
PKOP- I-1/4" MPE I MAIN
5'N Of:;5 Z
m
d
N
6 '
alc
I
I
NOTES: The C i ty of Edmonds
I. F 1 EI.O I.OGATE ALL Ut I I. If 1 ES)
GALL. 24 HOURS WORE 01661Nbe 1-800-424-5565
' 2. SURVEY 15 NOt REOUIR60.
3. MA I NtA I N A M I N I MUM 0f 5' HOR I ZONtAI. ANO 3' VERt I GAL.
GI.EAKANGE FROM ALL 01tY UtII.It1ES ANO APPUKfONANGBS.
4. GUf6 IN PAVIN& ARE SHOWN AS
5. 3 GUTS IN PAVING ANtIGIPAf6V.
j 6. PROJBGf MANAWs OOU& USITAI.O 425-356-7520
i
FREED"dINAR"Y aptvLy
i
Not for Con
Structi0n
223 5T 5W
i
i
GAS
MAIN
INSTALLATION RETIREMENT
WU
ID
SIZE
LENGTH
TYPE
MANUFACTURER
I -I/V
210'
MPE
GAS MAIN PRESSURE & TESTING
TYPE
TEST:
PRESSURE:
TESTED BY:
DATE
ON:
/ /
ITIME ON:
DATE OFF: / /
TIME OFF:
DATE
ON:
/ /
TIME ON:
DATE OFF: / /
TIME OFF:
DESIGN:
PSIG
SYS MAOP:
PSIG
NCALL 1-800-424-5555
2 BUSINESS DAYS�BEFORE YOU DIG
THIS SKFTCH NnT Tn RF RFI TFn IIPnN FnR FXA(T i n(ATTnKi nc FArTi ITTcc
5
/ /
REAL ESTATE/EASEMENT
PERMIT,
E0MON06'
4
/ /
3
/ /
FUNCTION
CONTACT
PHONE NO \
DATE
2
/ /
PROJECT MGR:
0. U5 If 4 l.0
(425) 356 -7520
04/ 1 9/ 001
1
/ /
APPROVED BY:
REV#
DATE
BY
DESCRIPTION
ENGR - GAS:
COUNTY
5NOHOM 1 5H
EMER SEC
Work Center
N5NHG
DRAWN BY:
J. N&UYEN
(425 )290 7026
04/ 19/ 00
REVISED BY:
1/4 SEC
6W - 25- 27- 3
OP MAP
164. 062
PLAT MAP
165.066
APPROVED BY:
FOREMEN #1 :
U-MAP# (POWER)
CIR MAP#
CIRCUIT#
FOREMAN #2:
MAPPING:
JOINT FACILITIES
ARRANGEMENTS
UTILITIES
CONTACT
PHONE#
1 -1 /46 MPE I P MAIN OX-fEN5I ON
PUGET
SOUND t0 6BRV6R:
ENERGY 1234 - 6 AVO 5
INCIDENT#
DRAWING#
SAP SUPERIOR ORDER#
107006612
SCALE: 1" = 50
1 / 1
N
ide Sewer Drawing
The City of Edmonds sTrm"EET FILEs: Y..
EASEMENT NO.', --• ......
NEW CONSTRUCTION REPAIR LID NO . ............ ... ASNIT. NO.--.:..
.............
OWNER....................................................... CONTRACTOR .............. ................................................. .................... PERMIT NO.
JOB ADDRESS ......... ..... . ..... NO. . ................
........ ........................... •LEGAL DESCRIPTION: LOT NO . ..... ..................... BLOCK .... 1.* ............
......................... .......
...................................... .....................................................
EDMONDS.,rfAY
am
Approved:
IWW-0001-11/75(REV.11/78) y
DATE ..... .......... ....... .. .. ...... ..... ..... ...
FILE
CAT" BASIN:
ADS *IS-30(OP. TRGNCN LYCNGTH
AWOL)
19
s
_rIkWNICH COvcR
�o
L
6` -nG UNE LCVN'L TRCN"
(i" PERF PIPi CAP
fi"TEE Wf b" LONG LEGS
SYSTEM CROSS-SECTION
T0.ENCN COVER -
3/4' - I L/Z" WASI4ED
GRAVEL
6" DIAM PERF PI
TRENCH CROSS-SECTION
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2
for LJ- - e-0,--y UM
ju
location
plan by
phone.
date •
DESIGN DATA
Trench Perc LF per Imperm Trench
Number Rate 1000 sq.ft. Area Req.
Is
mav"
���
nn�
m
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals (at least
twice per year).
i
CITY OF EDMONDS
DC�
N5r A?Sf+At,T
SITE PLAN, SCALE:
2'7 1
2
_ 13a9l�if: ,
t2jg 2,F, Rezf'A&A�I, s
oz& 20 -pr. -10e&ofte Moor c*
I DAD _ AP. fev' q - 5. v� K
?7vn 45,E Ir T IMP A-10A
NOTE: DO NOT USE INFILTRATION SYSTEM
ON SLOPES OVER 15 PERCENT (15
FOOT RISE PER 100 FEET HORIZONTAL)
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
c
PAGE 2 OF 2
CITY OF EDMONDS
PUBLIC WORKS, DEPARTMO FOR INSFECTION CA
LL• permit �
775-252 2 Issue Date Jag j
SIDE'SEWER.PERMIT A / �
* P.ERMIT'MUST BE POSTED ON JOB SITE
..1. Address of Construction /,2--3 r--_ 0,
2. `.Property Legal Description (include all easements) g7—,,-- -2.
3. Single Family Residence Multi -Family No. of Units
Commercial VIA EDMONDS WAY
4. Owner and/or Builder (�-I !//� TRUNK
5. Contractor & License No. c2G" ewM4
6. Invasion into City Right -of -Way: No2<, Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
z 7. Cross other private property: Yes_ No Easement required -
v attach legal descri tion and county easement number.
H S te /!/ ,�1t� �f1/ /- '1 N t/s1i dal-/Ae D �"-
READ THE FO .�0 , _ ,.NG D SIGN:
a. Property owners must obtain a permit to install side sewers on
their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
C. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
e. Side sewer lines must be laid at a minimum grade, of 2% (1.150)
and maximum grade of 100% (450).
f. No turn in side sewer greater than 45° (1/8 bend) is0allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the. City.
1. Inspection during.normal working h.urs only. Two (2) working
days notice required.
DATE:..-�2j.. [[[
*Ice
rtify that I ave read
and shall comply with the above
PERMIT FEE: 'V50, 00
11
W i r (,+ n l C' 1f)cc r� was, 0 S
CONNECTION FEE : T �� 7 �'
O
* PERMIT MUST BE
DISAPPROVED By: Date:
By: Date:
APPROVED By • Date: 8'
TED ON JOB SITE
1
TREET FILE'
MEMO TO: John .Mitchell, Supt.
Water/Sewer Division
FROM: James E. Adams, P.E.
City Engineer
SUBJECT: SEWER CONNECTION CHARGES
1234 - 8th Ave. S
treet"-Ad ress "
(Legal Owner
DATE: Fe ry ll, 1982
Single Family Residence X Subdivision Plat
PRD Multiple Commercial
LEGAL DESCRIPTION: That portion of the Southwest quarter. of the North-
east quarter of the Southwest quarter of Section 25, Township 27 North,
Range 3 East, W.M., described as follows: $eginning at the Northeast
corner of said subdivision; thence South 89 59'07" West, along the
North line of said subdivision, a distance of 195 feet; thence South
0 31'10" East, parallel with the East line of said subdivision, a
distance of 61.07 feet to the T6ue Point of Beginning of this'descrip-
tion; thence continuing South 0 31'10" East, a distance of 93.93 feet
to the Northeast corner of Lot 5, Birch Addition Division No. 2,
according to the plat thereof recorded in Volume 37 of Plats, on Pages
71 and 72, Records of Snohomish County, Washington; thence North 80 25'
01" West, along the North line of Lots 5 and 6, said plat of Birch
Addition Division No. 2, a distance of 127.00 feet; hence North 9034'
59" East, a distance of 100.00 feet; thence South 80 25'01" East, a
distance of 37.78 feet to the point of curve of a curve to the left
having a radius of 65.00 feet; thence Easterly, along the arc of said
curve to the left and consuming a central angle of 18008156", an arc
(continued on attached oaae)
Z.F.F. Calculation:
( 111.392) Z.F.F. x ( 15 ) _ $ 1,670.88
( ) Lateral x( ) _ $
( )_ Units(s)x( $25.00) _ $
$
jak
cc: Owner
Connection Fee
Lateral Charge
Equivalent Count
(when applicable)
Trunk Charge
Permit 1
as
TOTAL
(;�n4_a)Mar6h Dt rdie Hyde Dt
distance of 20.59 feet to a point of reverse curvature; thence Easterly,
along the arc of a curve to the right having a radius of 20.00 feet and
consuming a cen8ral angle of 98°02'47", an arc distance of 34.22 feet;
thence North 89 28'50" East, a distance of 27.00 feet to the True Point
of Beginning.
SUBJECT TO AND TOGETHER WITH the terms and conditions of that certain
"Notice of Easement and Maintenance Agreement" filed under Auditor's
File No. 8005210098, records of Snohomish County, Washington.
Situated in Snohomish County, Washington.
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FOR' 104,N,
RECORDINGi•,.�n"'....'••.Z�
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September 18, 1979
LSA File No. 77-162
LEGAL DESCRIPTIONS FOR COCKRUM SUBDIVISION
ENTIRE PARCEL
That portion of the west half of the northeast quarter of the southwest
quarter of Section 25, Township 27 North, Range 3 East, W.M., described
as follows: Beginning at the southeast corner of the north half of said
subdivision; thence North 0032'20" West, alonq the east line of said
subdivision, a distance of 20 feet; thence South 89059'07" West, parallel
with the south line of the north half of said subdivision, a distance
of 289 feet; thence North 0032'20" West, a distance of 105 feet; thence
South 891 59'07" West, a distance of 66 feet; thence North 0032120"
West", a distance of 94 feet; thence South 89159107" West, a distance of
150 feet; thence South 0132'20" East; a distance of 219 feet; thence
South 0031'10" East, parallel with the east line of the south half of
said subdivision, a distance of 102.50 feet; thence South 80125'01"
East, a distance of 314.87 feet to an intersection with a line drawn
parallel with and lying 195 feet westerly of the east line of the
south half of said subdivision; thence North 0'31110" West, alonq said
parallel line, a distance of 155 feet to an intersection with the north
line of the south half of said subdivision; thence North 89159107" East,
along said north line, a distance of 195 feet to the point of beginning.
EXCEPT the most easterly 30 feet thereof for road.
SUBJECT TO easements, reservations, and restrictions of record.
Situated in Snohomish County, Washington.
PARCEL 1
That portion of the southwest quarter of the northeast quarter of the
southwest quarter of Section 25, Township 27 North, Range 3 East, W.M.,
described as follows: Beginning at the northeast corner of said sub-
division; thence South 89159'07" West, along the north line of said
subdivision, a distance of 1.95 feet; thence South 0°31'10" East,
parallel with the east line of said subdivision, a distance of 61.07
feet to the True Point of Beginning of this description; thence con-
tinuing South 0°31'10" East, a distance of 93.93 feet to the northeast
corner of Lot 5, Birch Addition Division No. 2, according to the plat
thereof recorded in Volume :t7 of Plats, on pages 71 and 72, Records of
Snohomish County, Washington; thence North 80*25101" West, alono. the
north line of Lots 5 and 6, said plat of Birch Addition Division No. 2,
a distance of 127.00 feet; thence North 9°3459" East, a distance of
100.00 feet; thence South 80025'01" East, a distance of 37.78 feet to the
point of curve of a curve to the'left having a radius of 65.00 feet; thence
easterly, along the arc of said curve to the left and consuming a central
angle of 18°08'5611, an arc c'istance of 20.59 feet to a point of reverse
curvature; thence easterly, along the arc of a curve to the right having
a radius of 20.00 feet and consuming a central angle of 98002'4711, an
are distance of 34.22 feet; thence North 89128150" East, a distance of
27.00 feet to the True Point: of Beginning.
SUBJECT TO AND TOGETHER WITH the terms and c:oiiditions of that certain
?' "Notice of Easement and Maintenance Agreement" filed under Audit.or's
,.
File No. 8005210098 , reccrds of Snohomish County, Washington.
},Situated in Snohomish County, Washington.
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CITY OF ED,MONDS
PUBLIC
RIGHT - OF - WAY
DEPARTMENT
CONSTRUCTION PET R E ET , F LE
A. *Address or vicinity of Construction
• Owner: gOSSELL_ CC)%_t- R Q M
Name
2 T1+ ® P, E_
Mailing Address
City, State, Zip Code
• Contractor: PU D
Name
Mailing Address
1 y'kjowool-) vu quo
City, State, Zip Code
Permit No. 7
1_
Issue Date n .�
• Permit Issued To: -- UA (.�`•
• Type of Work to be Done: t�y, q7r-
waN 1 ► )ST- A-1_l t �v�`TLIC(�I ►=i Glt t1
• Work in Connection With:
❑ Sub or Plat A Single Family
❑ Comml. / Ind. ❑ Apt. Condo.
• Pavement Cut: ❑ Yes R' No
State License Number
1 " 7 4--- z i rz_
.Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's 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 to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit must be available at the job site for inspection purposes at all times.
Signature: /\:�, Date k 2'10 `
Owner or Agent
* THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK .
C. Issued By
Time Authorized: Void after days
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
X_
* * NO WORK -TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.
rnmmcan +- c
Diagram:
Contractor called for inspection._ Yes No
`A1ork Disapproved By: Date: Bv: Date:
[cork Approved BY: — -_-Date :-
Inspector:
Eng. Div. December 1978
ST'-'11.:ET FILE
SEWER EASEMENT 14"A>
IN CONSIDERATION of benefits to accrue to the grantor herein, the j
undersigned, EDITH B. COCKRUM, as her separate property, owner of the
following described property, hereby grants to the CITY OF EDMONDS, a
Municipal Corporation, a permanent easement for the installation,
i
operation, and maintenance of a sanitary sewer pipeline and a storm
sewer pipeline over, across, through and below the following described
property, and the further right to remove trees, bushes, undergrowth
i
land other obstructions interfering with the location, construction and
a maintenance of said pipelines, together with the right of access to the;
jeasement at any time for the stated purposes.
The easement and right-of-way hereby granted is located in the
lCounty of Snohomish, State of Washington, and is more particularly
(described as follows:
That portion of the west half of the northeast quarter of the
southwest quarter of Section 259 Township 27 North, Range 3 j
East, W.M., described as follows:! Beginning at the southeast I
corner of the north half of said subdivision; thence North
0 32120" West, along the east line of said subdivision, a
distance of 20 feet; thence South 89 59107" West, parallel with.
the south line of the north half of said subdivision, a i
distance of 289 feet; thence North 0 32120" West, a distance of
105 feet; thence South 859107" West, a distance of 66 feet;
thence North 0 32120" West, a distance of 94 feet; thence South;
89 59107" West, a distance of 150 feet; thence South 0 32120" '
East, a distance of 219 feet; thence South 0 31110" East,
parallel with the east line of the south half of said subdivision,
a distance of 102.50 feet; thence South 80 25001" East, a dis-
tance of 157.00 feet to the true point of beginning of this
parcel; thence continuing South 80 25101" East, a distance of
30.87 feet; thence North 9 34'59" East,.a distance of 30.87
feet; thence Southwesterly to the true point of beginning. I
The City agrees to restore to substantially the original condition
such improvements as are disturbed during the construction, maintenance+
and repair of said sanitary and storm sewer pipelines; provided,'the
grantore, their heirs or assigns shall not construct any permanent
structure over, upon or within the permanent easement.
DATED this 9th day of September , 1981.
-Page 1 of 2 Pages
.c 1
•
STATE OF WASHINGTON)
as.
COUNTY OF SNOHOMISH)
On this day personally appeared before me EDITH B. COCKRUM, to me
known to be the individual described in and who executed the within
and foregoing instrument, and acknowledged that she signed the
same as her free and voluntary act and deed, for the purposes and
uses therein mentioned.
GIVEN under my hand and official seal this __ day of
I -F-1 M t3�1 , 1981.
Not'&�blic in and foi"-�e State of Washington,
residing at
Page 2 of 2 Pages
I
;PUBLIC WORKS DEPARTME Single Family
I BEET FIL BUILDING PERMIT REVI Multiple
! Commercial
BUILDING ADDRESS
BLDG. DEPT. SUSPENSE DATE INITIAL DATE RECEIVED
JTE: ® OFFICE ADMIN. PUBLIC WORKS LOG IN
O l 1981
CITY ENGINEER (check)
❑ Access Slope and Vehicle Access OiC 9• 10, Public YYuins
Drainage Plan -e propc�e,,�alo�sJvre q
❑ Street File
❑ Legal Description
❑ Quit Claim,
❑ Easement
t!J Calculate.Sewer Connection
i
❑ WATER/SEWER DIVISION
❑ Determine Meter Size e
GrComplete Building Permit Review
❑ STREET DIVISION
i
❑ Complete Building Permit Review
n OFFICE ADMIN, — LOG OUT TO BLDG. DEPT.
r�e�resr�erarr®rr®a®r®r®raeor®e®a®ate®®a®r®r®e®r®aaore®s®r®r®retie®ao
�®®rr�r ®r�r ®a ®r ®rs®®®■ ®r ®r ®r ®r ®r ®■ ®■ ®ram r ®r�r ®r ®r ®■ ®rarer ®r s
i
BUILDING PERMIT APPLICATION (COMPLETE) i
2 COPIES OF SITE PLAN
2 COPIES OF FIRE PROTECTION PLAN
(PREVIOUSLY REVIEWED BY FIRE DEPT.)
tom` 3 COPIES OF PRAINtGE. AN YIT LCULATIONS
REQUIRED BY SUBDIVISION
GREATER THAN 2;000 SO. FT,
IMPERMEABLE SURFACE
LESS THAN 2,000 SQ, FT, ❑
0CHECK ZONING REQUIREMENTS (SETBACKS) ,a5
1 COPY
�`OF ENGINEERING CHECK LIST �s 1 COPY OF PUBLIC 14ORKS MEMO
❑ MULTIPLE OR' COI-DIERCIAL ,
YES ❑ (ATTACH COPY OF ADB APPROVAL INCL, ALL DRA-TINGS)
NO
i
SUBDIVISION = YES NAME 661f%rd--7
DATED RECORDED q-?fj-7y
NUMBER 2 % Oct 4p 24 r%S
NO ❑ (.ATTACH COPY OF REQUIREiIE1VVTS)
CHECK SEWER DRAWING• A Np T /"0�
p�2gWiNGS Z>S
® IS DEDICATION; REQUIRED — YES[] (OBTAIN QUIT CLAI11)
( CITY CODE )
p�
NO
IU DOES CITY HAVE EASEMENT ON:PROPERTY
—YES IT (ATTACH;COPIES OF -DRAWINGS)
'STREET FILE
DATE
MEMO TO: Building, Division
Community Development Department
FROM: Engineering Division
Public Vlorks Department
SUBJECT: /.4" WA J
AVE SOUT14
After review of the subject Building Permit application, we have
the following comments:
1. Connection to City water system required.
2.
-Connection to Citv
sanitary
sewer system required.
3
Right-of-way Permit
required
for any work on City property.
4.
Driveway slope not
to exceed
lri0.
5.
Backwater valve required
if
downstairs plumhin; is below
elevation of uUstream manhole.
6.
Water and sewer lines to be
separated by 10 Foot minimum.
1�0 If le— - - - - h ,n
PUSLIc woRKS DUARM]'T�,glqElET FILE
BUILDING PERMIT REVIEW ,�AVE
(address) e
Street Right -of -Way Exist'
REQD O
z.
Access Easements Existing
REQD
H
�
a
Utility Easement Exist*
REQD
w
Lot Per Subdivision SAE- Plat
Assessor Map
w
Site Plan Checked for Accuracy p
z
Underground Wiring Reqd. et
H
0
Check Accuracy of Legal Descriptionjkry
z
Review by 4_�
Date iN::
w
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing y�
a
Hydrant Reqd Per Fire Code /,Q
Size
w
Detector Check Meter Reqd.
Cross Connection Inspection ,4
Ei
Fire Department Comments
Water Meter e Regd.
O
Review by
Date j �J
Septic Tank Design Approved, /j/p
Date 4/1 A
Septic Tank.Permit Reqd.
Permit No.
Sanitary, Sewer Availability
Proj.
g No
Drawin . ' [
File No.
Side Sewer Availability
a:
w
Sanitary Sewer ectio 'Fee Reqd.
3
Review by
Date
w
.
Open Ditch Existing ,vc+�y �?
Regd•
Culvert Regd. Pe
Size' ----
w
Catch ;.Basin ' Regd., / ! r, i
Indicate on Site Plan
Shoulder drainage maintain collection on
swale open runoff_ qe 2
H
/
y
Manhole regd.
Indicate on Site Plan
Soil Conditions and Ground Water Field Checked
Review. byZ?aZA1�.
Date
Revised:"1v10-1977 . .
USE P
CITY OF ED1V10 DS ZONE .�I. I"� N LjVR
�
BUILDING PERMIT APPLICATION
JOB ADDRESS f (,L kVQC:gj1 i ;NAME (OR NAME OF BUSINESS)
LEGAL DESCRIPTION SUBDIVISION SHORT SUB NO.
WMAILING
ADDRVE S'S Ss! e77
Z
QCITY
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
ELEPHONE NUMBER
EXISTING 60
=�
Z
NAME PROPOSED
i
W
I-
DEFICIENCY OF RIGHT OF WAY �
W
Z
W
ADDRESS BY —
U'
I
SEE ENGINEERING MEMO DATED
=��
Z
_
W
U
C
REMARKS
CITY TELEPHONE NUMBER
. Q
Q
ADDRESS METER SUE BUILDING S PLY SIZE FIXTURE UNITS
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�r%',; r✓
C
`� aim !/' ,:� /I
F.
Z
CITY TELEPHONE NUMBER REMARKS
Q
U
STATE LICENSE NUMBER '-CITY LICENSE NUMBER SIGN AREA ENV. REVIEW ADB NO.
ALLOWED PROPOSED COMPLETE EXEMPT
_(�
G•� SHORELINE
Legal Description of Property (Show below or Attach Four Copies)
VARIANCE OR CU PLAN NG VI BY DAT
0
' F
YARDS LOT COVER GE
L7
2® S
FRONT SIDE REAR ®
Z
N
REMARKS
Z
J
Q
V
�
J
x' NEW RESIDENTIAL ❑ PLUMBING
( x CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
❑ NON-R ESIOENTIAI ❑MECHANICAL
I
❑ ADD Q DEMOLISH a SIGN SPECIAL INSPECTOR AREA - OCCUPANCY OCCUPANT
REQUIRED GROUP LOAD
❑ ALTER EXCAVATE FENCE.
❑ YES ❑ NOOR
FILL
❑ ❑
V
REMARKS
Z
❑ REPAIR F COMPLIANCE SINSP. � POOL
O
Z
NUMBER OF STORIES NUMBER OF
m
DWELLING /
F
(/ UNITS
a
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
U
�
0
m
Q
PLAN CHECK FEE VALUATION FEE
•
BUILDING
PLUMBING
'
MECHANICAL
•
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
FENCE
marquees, etc.) will require separate permission.
SIGN
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 120 Days
RETAINING WALL
"Applicant, on behalf of his or her spouse, heirs, assigns and
SWIMMING Pool
W
successors in interest; agrees to indemnify, defend and hold harmless
J
i
the City of Edmonds, Washington, its officials, employees, and
agents front ' any and all claims for damages of whatever nature,
1 �f
W0U�l •
1 SE f
V.
WYE
33'� S Q.
8"6.e7------
1I� 11
Ex. M.H. 1►1
)NV. 248.00 11 I
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DRAIN TO C.6,
78
2=65.00•
QACIOITION L ESM'T. e
x. 21 P - IZA /
-
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059.00' I SEx. C.a.
20' ACCESS E UTILITY
165.00 '
INLET C.6. 15 OR 16
SE M IF REQU12E0
8
I..E V E L
-rA ev Chi
--- 10' 02AINAGE E5M'T
INLET WITH QEST2ICT0rc
1530 02 EQUAL , 15" LO.
W/ k'EMOVAOLE COVER
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STRET FILE
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DO
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D AA I I V.S
CAL(. —777 lop 202
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PAIF S AC K F I L L
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Go
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2EST21CTO2 4" ADS (PERF-)
314" LDIA,
1530'
OQ EQUAL.
I-C),X-24" DEEP
W/QEK40VAE3LE
COVE);z
INLET W/RE6TKICTO
DETAIL
N Ts
47
If 67 f ol
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3/4" WASHED GAVEL.
AC)S
(PEeF-)
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NAGE TRENCH DETAIL
R
P4RC1L 1 :C6CKRUM IYI S(oi.1
That portion of the southwest quarter of the northeast quarter of the
southwest quarter of Sectlofr 25,'Townstilp 27 tlorth, Range 3 East, I.M.,
described as follows: Begiruning at the northeast corner of said sub-
dl%Jsion; t1wr►ce South 89659107" Mcst, along tlic north line of said
subdlvlsJon, a distance of 195 feet; thence South 01131'10" East,
parallel with the east line of said subdivision, a distance of 61.07
feet to the True Point of &:yinnlny of this description; then" con-
tJfruing South 0'31'10" East. a distance of 93.93 feet to the northeast
corner of Lot 5. 81r0r Addition Division No. 2, according to the plat
thereof recorded In Voluere '17 of Plats, on pages 71 and 72, Records of
Sfwlomish County, Washington; thence North W 25'Ol" West, alone the
north lire of tots S and 6, said plat of Birch Addition Oivisior No. 2,
a distance of 177.00 feet; thence Nlortli 9034159" East, a distance of
100.00 (Pet; tf—tee South 80'?V 01" Ialit, r distance of 37.78 feet to the
point of curve of a curve to tire, left having a radius of 65.00 feet; thence
easterly, along the arc of !-did curve to the left and consuming a central
angle of 1M06156". an are c'Istafxc• of 20.59 fcct to a point of reverse
curvature; thence easterly, aluny t1M arc of a curve to the rlgtt having
a radius of 20.00 feet and tunsuming a central angle of 98.0?'47". an
are distarK.-e of 34.22 feet; thence North 69'28'S0" East, a distence of
27.00 feet to the True Point of 1leglnning.
SMJ1 CT 10 MU 10GI 1HUR WITH! Ube terms dnd o.,r,dltions of that certain
"NOtJcc of tasefM'nt and Mdif tendnve Agrevim-nt" filed under Auditor's
I Ili- 14u. buO5210M' . recc rds of Snohumi sh County. Washington.
Situated In Snolwml sh County. IdshJ nyton• �1UT4lORiZ6U
IFOR
• RECtiRDINe .
Hy
VOL7 PAK 675
y
8008010186
9
5( TV� /'lifW - -
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FILE
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