1324 OLYMPIC AVE.PDF1324 OLYMPIC AVE
E P A I l"v
CITY OF. EDM S °" ��ER
buoL®o�vo PERnni-r APP�.icA�ion�
ADDRESS
NAME (OR NAME OF B SINE'S$\J
� LEGAL DESCRIPTION SU BDIVISI N SH
aw MAIILLI_INN_GG ADDRESS
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3 -0? VVl G—L.�3� -' ��../ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
G CITY ELEPHONE NUMBER
��� 177Y- ' EXISTING /
PROPOSED (�0
NAM `
. Cs \ DEFICIENCY OF RIGHT OF WAY
U
W ADDRESS
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E ITY
TELEPHONE NUMBER
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NAME „r
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0 ADDRESS
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Q E CITY TELEPHONE NUMBER
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U STATE LICENSE NUMBER CITY LICENSE NUMBEI
b - UJ Z ?101 L
Legal Description of Property (Show Below or Attach Four Copies
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MEMO DATED
SEE ENGINEERING
REMARKS
SUB
METER SIZE I BUILDING SUPPLY SIZE I FIXTURE UNITS
REMARKS
SIGN AREA JENV. REVIEW ADB NO.
ALLOWED I PROPOSED COM PLETEI EXEMPT
SHORELINE
f�lgl
VARIANCE OR CU I PLANjV REVIEW�BV IDA
YARDS LOT COVE
Jvi FRONT /0 SIDE REAR
REMARKS
I,/I EW ElRESIDENTIAL❑ PLUMBING CHECKED BY TYPE OF CONSTRUCTION C
ODE
N
❑
NON-RESIDENTIAL
❑ MECHANICAL
ADD
DEMOLISH ❑ SIGN
SPECIAL IREQUIRED SPECTOR
AR
❑ ALTER
❑
EORCFILLTE �I ENCE
X FT)
[I YES ❑ NO
REMARKS
REPAIR
❑
swim
El
COMPLIIANC ESINSP. POOL
NUMBER OF STORIES
NUMBER OF
Z
DWELLING
O
UNITS
I -
a NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
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PLAN CHECK FEE
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BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
FENCE
SIGN
Permit Application: 180 Days
Permit Limit: 1Year - Provided Work IsStarted Within 120Days
RETAINING WALL
SWIMMING POOL
N "Applicant, oil behalf of his or her spouse, heirs, :Isslgns and
W successors in interest, agrees to indemnify, defend and hold harmless
J
2 the City of Edmonds, Washington, its officials, employees, and
�- - _I:Is f:nrt :11SY ;Ind all 1'I•iiniy fnr dainsges of whatever nature. `-.
__---- -- - —
OCCUPANCY
GROUP
VALUATION
FEE
HEIGHT
OCCUPANT
LOAD
DATE:
MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Public Works Department
SUBJECT: I -3Z4
After review of the subject Building Permit application, we have the following
comments:
1. Connection to City water system required. v
2. Connection to City sanitary sewer system required.
3. Right-of-way permit required for any work on City property.
4. Driveway slope not to exceed 14%
5. Backwater valve required if downstairs plumbing is below elevation of
upstream manhoTe.
6. Water and sewer lines to be separated by 10 foot minimum.
i
6/82
E
Table 2 - Detention Pipe Lengths
Pipe Diameter
Impermeable Required
Area Sq. Ft. Vol. Cu. Ft.
1�:i '
jl8
29"
30
L
,116
110
2000 50
40 #
28 ,
2500 62
50
35,
20
�� 13
3000 75
60
42
24
115
z4 9 r;
E-7,
80
56
32
21
4000 100
4500 112
90
63
36
23
5000 125
100
70
40
25
Table 3 - Outlet Orifice Sizes
Impermeable Outlet
Area Orifice Diameter
Inches
Sq. Feet
2000
5/8
2500
5/8
3000
3/4
3500
3/4
4000
7/8
4500
7/8
5000
7/8
k
>- Required
pipe
length,
feet
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,£03 . Alclody Lane
Edinords, Wash. 98020
890.199-
City 9f Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number. 17
Issue Date:
A. Address or Vicinity of Construction: 1324201vmuic Av (9617573)
B. Type of Work (be specific): Install Service S$stem Improvement
C. Contractor: Washington Natural Gas
Mailing Address: 1 122 75 St CB Everett
State License #: 98203
D. Building Permit # (if applicable):
Contact: !larismne Kingsbury
Phone: 356-7500 X7596
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project KJ Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR: I A:
w F. Pavement or Concrete. Cut.:_..
AF.PLIU N'1"1'U-Kk;AL ANIJ �IUN f ( C
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 against the City of Edmonds, or any of its departments or
employees, including or not limited to the �efense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE Fl
INSPECTION AND ACCEPTANCE OF Hi
IS COMPLETED BY CITY FORCES, AT W11.
Construction drawing of propoI e
A 24 hour notice is required forix
Work and material is to be inspei
Restoration is to be in accordarIc
Street shall be kept clean at allti
Traffic Control and Public Safety
All street cut ditches shall be pa,
NO EXCEPTIONS. ,
t WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
;H TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
work required with permit application.
Ipection; Please call the Engineering Division, 771-0220.
ed during progress and at completion.
with City Codes.
shall be in accordance with City regulations as required by the City Engineer.
ied with asphalt or City approved material prior to the end of the working day;
4-have read the above statement and understand the permit requirements and the pink copy of the permit will be
available on site at all, times fori inspection purposes.
-- ' Signature:
Date: 7-1 A-96
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
41
FORS CITY USEi ONLY
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COMMENTS:
DATE:
NO WORK SHALL BEGIN PRIOR. TO PERMIT ISSUANCE
Eng. Div. 1994
r� ; � �._ . �• _ .Ar ;1• � :,�... .a.., - - :'ar: rt\: • � ..r Cu:r� tr...- :.f. .. , .. � M
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments • ,
4
IDiagram:
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
CM$, 161.67 Y
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34.
CA FILE NO.
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/Location: 13.L�- O�y_vwpx N.C. l lv�u ds
2. Property Tax Account Number: 066 "b Oo — oo i — rn b—(
3. Approximate Site Size (acres or square feet): ^' 4 ACvza
4. Is this site currently developed? ✓ yes; no.
If yes; how is site developed? i� k 1Vn0U_e ova
5. Describe the general site topography. Check all that apply.
W 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: NO ; Approx. Depth:
7. Site contains areas of seasonal standing water: 1ac) ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway W floodplain 00 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? 00 (What time of year? ).
10. Site is primarily: forested ; meadow ; shrubs ; mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: 0 .
Rev 01/04/94
890 .199-
City of Edmonds
Critical Areas Checklist
The Critical Areas Checklist contained on
this form is to be filled out by any person
preparing a Development Permit
Application for the City of Edmonds prior
to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable
City staff to determine whether any
potential Critical Areas are or may be
present on the subject property. The
information needed to complete the
Checklist should be easily available from
observations of the site or data available at
City Hall (Critical Areas inventories, maps,
or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
and submit it to the City. The City will
review the checklist, make a precursory site
visit, and make a determination of the
subsequent steps necessary to complete a
development permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
other pertinent information (e.g. site
plan, topography map, etc.) or studies in
conjunction with this Checklist to assist
staff in completing their preliminary
assessment of the site.
I have completed the attached Critical Area. Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Name
13=-4 olnic A"Q-
Street Address
F-Jhw4s 0 11� �$t1t 'I-L I - 4519
City, State, ZIP Phone
.� /,4.- M
Signature Date
Applicant Representative:
Name
Street Address
City, State, ZIP Phone
Signature
Date
•
��Q CONa ATION
CITY OFOEDMONDS 0, oR
CIVIC CEENTNTER • EDMONDS, WASHINGTON 98020 • (20Q) 775-25�
PUR8%ll9E�� �ENTORY REQUEST �ORK REQUEST
V
E
N
D
0 ZIP_ CODE
R
SHIP TO
&)& j q
THIS NUMBER MUST APPEAR
ON ALL INVOICES,
PACKAGES, BILLS OF LADING
AND CORRESPONDENCE.
0
VENDOR PHONE NO.
VENDOR NO. _
DOCUMENT NO._ __. _ _
E _
BATCH_DATE_
j,QRDER_DA
PLEASE FURNISH THE FOLLOWING ITEMS:
N
UANTI
UNIT
CATALOG
NUMBER
DESCRIPTION
UNIT
COST
TOTAL COST
ESTIMATED ACTUAL
v r
J
t °uSUBTOTAL
TAX
TOTAL AMOUNT
ee, �O
BY:
APPROVED BY
RECEIVED BY:
•
1
CODE
- - - - --/-- - --- - /- - - -- - -
Q / Q /
PROJECT
- - - -- -
AMOUNT
--ESTIMATE--- - -- ACTUAL- -
Q, Oro
2
3
4
5
6
7
s
9
10
11
.
12
TOTAL AMOUNT
WFA
CUS 0!110 r Zlille
CL!St-*L)M0l' .:�.cco%ult -�o
D, . t o
X Pro
Me C, r oe�) -roc-t
. ...........
•Refund Due
-10 t Or 0 0 - 0 0 0 - 2 5 2 - 0 .2
Street- 4 11 0 0 - 0 0 0 - 2 2 - 0 /Oeq 00
I o
N c
Ci t
Zip
Approval
........ ..
Alldi L:
-)o C, I),:, tOr lit.
util. Acct. Dt.
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. . . . . . . . . . . . . .......
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CIZ,Y, OF,EDMONDS
PUBLIC WORKS DEPARANT FOR INSPECTION CALL • Permit I'J.
SIDE SEWER PERMIT 7%75=u''�5�3Z5'• Ext. 222.0 Issue Date
1.
43-.
W,
PERMIT MUST BE POSTED ON JOB SITE
im
uc
Address of Constrtion /,7-7t4 C7/nJ, ( A
TREATMENT PLANT
Property Lega'l/ Description ( include all easements) L..Oa
I/ f0 tie.. iO`-A-�- 7rl4ep_�
taJr 0-F-.' ��LAf!, PA GG/ k� �P��- ADS' o F SnC) �-�( a�
Single Family Residence Multi -Family No. of Units
Commercial
Owner and/or Builder
Contractor & License
-7`—
Invasion into City Right -of -Way: No Yes
way Construction Permit Required - Call Dial
excavation).
4o
1
1
1
1
(If Yes Right -of -
Dig (342-5344)
before 1
7. Cross other private property: Yes No Easement required
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain a permit to install side sewers on
their property. A licensed side sewer contractor must be employed to
1
construct side sewers in the public right-of-way.
b. The side sewer contractor assumes full reponsibility for each
1
installation for one year.
1
c. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
1
d. Side sewers may not be installed closer than thirty inches (30")
1
to any structure.
1
e. Side sewer lines must be laid at a minimum grade of 2% (1.150)
1
and maximum grade of 100% (450).
1
f. No turn in side sewer greater than 45° (1/8,bend) is°allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
1
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
1
h. Pea gravel is required for bedding when installing sewer lines
1
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
1
and at minimum intervals of 100' along sewer line run.
1
j. Trenches within City right-of-way must be restored to original
1
conditions. Contractors shall be responsible for right-of-way failure
1
due to poor compaction of fill.
1
k.. Side sewer must be left uncovered until inspected and approved
by the City.
1
1. Inspection during normal working hours only. Two (2) working
1
days notice required.
DATE:
I certify that I have read
1
and shall comply with the above
1
H. PERMIT FEE: - 00 DISAPPROVED BY: 4XVd2j -Date: tZZ/g, 3
A, By, ) - -"' By • Date:
a CONNECTION FEE-.;
APPROVED APPROVED By : Date :
w ��-
* PERMIT MUST BE POSTED ON JOB SITE
The City of Edmonds Side Sewer Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION REPAIRS F LID NO . .......... ....... ASMT. NO. ------ I ........
OWNER WA5HOJ . ....................................................................... CONTRACTOR BA-K ..... C t4 Rk4cTOR .................. PERMIT NO. .770-0-1
JOB ADDRESS A.3.24 ------ O-L-j-m.plc ... AVg, ------ LEGAL DESCRIPTION: LOT NO. ------ 1 ----------------------------- BLOCK NO. ...................................
PuG ET DRIVE .................................. --------------------------------------------------------------------------------------------- EDMONDS ---------- ---
NAME OF ADDITION ... VI.E.W.L.A&IND ------ "-E-l.G-RT5 ........ TREATMENT PLANT
ISVP
C.O.WlE Y16MUD
13'--o
1324 C)L�JMPJC AVE
PWW-0001-1 1175 (REVA 1/78)
66 To CENTER
or MkOARC&x
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Approved:
DATE --- ........ ByZ;F
...... . ..........