15707 70TH AVE W.PDFlillIIII lillIII lill
5497
15707 70TH AVE W
CITY OF EDMONDS
JWNEW
❑ ADDITION
❑ RETIREMENT
C
EET F4LS91'T INFORMATION SHEET
ASSET NO
N TO ASSET NO. _
DESCRIPTION
SERIAL NO.
LOCATION
/:� %O _7
DEPT. NO
**PURCHASE ORDER NO. _
PURCHASE ORDER DATE
COST
*PROJECT NUMBER LcJ�ti�S l� 7
PROJECT COMPLETION DATE
COST .2
B.A.R.S. ACCOUNT N0.�-oa0 O/C-3(, UO• (o�
ESTIMATED LIFE
INITIATED BY
DATE
APPROVED BY
**SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT _
J�o
G.L. ENTRY
q�p
INITIAL
by
REFERENCE
c�
VERIFIED BY
PROCESSED
BATCH NO.
DATE
DEPARTMENT FILE
lw*i • a- v NO
7za �a 7".'0'7i 'N1 �ti y �•".�v--r,..�::.s,.y., � .•R•�.tif.p,aa 'N 'j s;nz.
City of Edmonds
4'VAY- CONSTRUCTION
RIGHT -OF-
-•�:: EE' FILFEW7
J Permit Number.
s ! � Issue te•
A. Address or Vicinity of Construction: 15707 70th A�3 ue W.
GTE i placing tele one v ce wire from 6 at
P 9 P
I O
B. T of Work specific):
15712 7 h v W n J 3 Ot A u der : Oth A W 00 fee � t u
8 9 G _ 1 9 � Type � P� ) road
to pedestal at 1570,•70th Av W. 300ft r.o.w.
M. Bower, Permit Coord.
C. Contractor: GTE NOrthwest Incorporated Contact: Mar 2 /488-1628
Mailing Address: 22118 20th Av SE, Suite 130 Rom: En r• , Bill Jira 823-6683 or 669-5716
State License #: Bothell, WA 98021 Liability Insu� ce: Bond: $
D. Building Permit # (if applicable): Side Sew r Permit # (if applicable):
E. ❑ Commercial El Subdivision El City Pro'z& Ig Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Otherr 2100-9POOIDB 242310
INSPECTOR: II4SPE OR: t, jkjc_vF+
F. Pavement or Concrete Cut: ®Yes ❑No Size of Cut: 2 x f t H. Charge $
AP LICA T TO READ AN SiGN
INDEMNITY: Applicant understands a b is nature this application, gr to hold t e City of Edmonds harmle from injuries, damages, or
claims of any kind or description what s ve reseen o of en, t e ade against the City of Edmonds, or any of its departments or
employees, including or not limit a en of any gal, race 'ding siding ense costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS O IB .FOR WO MANS � ND M TERIALS R'4� PE,I D OF ONE YEAR F�LLO,W THE FINAL
INSPECTION AND A CCEP O THE WO ES T1M R ORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITYFO E , WHICH - MEA DEBIT _DIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction d wing o ropose ork equired with permit application.
A 24 hour notice requi d for i pectio Please call the Engineering Division, 771-0220.
Work and materia to a ins " cted progress and at completion.
Restoration is to ke in cord ce ity Codes.
Street shall be kept clean at I • e '
Traffic Control and Public afety all be in accordance with City regulations as required by the City Engineer.
All street cut ditches shal ' e patche th asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above (to,�s
tements and stand the permit requirements and the pink copy of the permit will be
available on site at r i s ses. ;
Signature: Date: February 2, 1995
(Contracto O A n
Joh . Stewart, Oprns Supv-OSP Engrg.
.f4; " CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
L .
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Nv. 1991
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:
LEGEND
PERMIT SUBMITTED BY
GTE
0
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POLES 0
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R.O.w.
EOP
THE FOLLOWING INFO TO BE PROVIDED
RIGHT OF WAY LWES.EOP OR FACE OF CURB. EXISTING SIDEWALK. POLES. ROAD CUTS ARID THE UTILITY UNDER ROAD CUTS.
ABOVE GROUND FACILITIES.(Ie:) PEDS.BOXES.CABINETS. ETC..UNUERGROUND TRENCHING AND OVERHEAD LINES.
a. FOOTAGE OF WORK IN R.O.W.
W.
U.
LEGEND
PERMIT SUBMITTED BY
GTE
1 1
1
I 1
1 1
PEDS
POLES 0
ROAD GORES
�. r*v •r . w . � .ram
)LE ED
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[Mulls
THE FOLLOWING INFO TO BE PROVIDED
RIGHT OF WAY LINES.EOP OR FACE OF CURB, EXISTING SIDEWALK. POLES. ROAD CUTS ARID THE UTILITY UNDER ROAD CUTS.
ABOVE GROUND FACILITIES,(1s:) PEDS,BOXES.CABINETS. ETC..UNDERGROUND TRENCHING AND OVERHEAD LINES.
o. FOOTAGE OF WORK IN R.O.W.
ce.
LL
LEGEND
N
m
N
CD
PERMIT SUBMITTED BY
GTE
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`'------------------ - - - - -
-
PEDS 93
POLES 0
ROAD BORES
OVERHEAD LIES
LD. UTLITY POTHOLE U
t!G TRENCHNG --WT
-------------------_-�
R.Q.W.
EOP
THE FOLLOWING INFO TO BE PROVIDED
RIGHT OF WAY LINES.EOP OR FACE OF CURB. EXISTING SIDEWALK. POLES. ROAD CUTS AND THE UTILITY UNDER ROAD CUTS.
ABOVE GROUND FACILITIES.(le:) PEDS.BOXES.CABINETS. ETC..UNDERGROUND TRENCHING AND OVERHEAD LINES.
-'FOOTAGE OF WORT( IN R.O.W.
LA.
R.Q.W.
EOP
THE FOLLOWING INFO TO BE PROVIDED
RIGHT OF WAY LINES.EOP OR FACE OF CURB. EXISTING SIDEWALK. POLES. ROAD CUTS AND THE UTILITY UNDER ROAD CUTS.
ABOVE GROUND FACILITIES.(le:) PEDS.BOXES.CABINETS. ETC..UNDERGROUND TRENCHING AND OVERHEAD LINES.
-'FOOTAGE OF WORT( IN R.O.W.
LA.
8K �h'.E✓.`T..�.'Il��""•^Ikh!7�FK� `Y�f" �"+rlL�'Mr'i9I .. -.- C !� k�1�.'n ��i�Y71yiMifii'wi1-�f� �'('.f'�I`+rV Y`. '. C+v^K;I�rT.�1�K'iJ-�7.:r "n w� .1
City of Edmonds "
RIGHT-OF-WAY CONSTRUCTION
-- IT --_.
����� Permit Number.
Issue Date:
A. Address or Vicinity of Construction:
l 8 —4now— C B. Type of Work (be specific): GTE to pl ace tel ephone servi ce wi re from TM #653
9 0 - 1 9 at 15712 under 70th Av. W. to pedestal at 15707 70th Av W.
APprox. R.O.W. 300 ft.
GTE NORTHWEST INCORPORATED
C. Contractor: 14ARY A BOWER PERMIT COORDINATOR Contact: Mary 206/488-1628
gineerl
Mailing Address: R0THF1 t VIA g8021 one: 206/823-6683 or mobble 669-5716
State License #: Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision El City Project a Utility (PUD, TE G, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other 2100-9P001 DB 242310 li
INSPECTOR: INSPECTOR: Wl,�+c���
F. Pavement or Concrete Cut': n Yes xllNo G. *Size of Cut: x H. Charge S
APPLICANT TO READ AND SI
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold't o yf Edmonds harmless f?, (cjur7}r mages, 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 defense of any legal proceedings including defZ�se costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION F'EES WHA_E HELD UNTIL THE -FINAL STUEET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCFSSF. FOR ISSUANCE TO THE APPPLI SVT.
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.
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 day;
NO EXCEPTIONS.
I have read the above statements a erstand the permit requirements and the pink copy of thepermit will be
available on site at all timfor.l s.
Signature: QJJJ Date: March 14, 1995
(Contrac 8 iir ent)
JOHN H. STEWART, OPRNS SUPV-OPS ENGRG
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY:
TIME AUTHORIZED: VOID AFPER 4 EAIZ DAYS
SPECIAL CONDITIONS: NA
COMMENTS:
DATE: ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
F,ntirK. Div. 1991
FIELD INSPECTION NOTES
Comments
Sr
Diagram
(Fund 111 - Route copy to Street.Dept.)
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
LEGEND
• PERMIT SUBMITTED BY
GTE
_tm
(.06
POLES O
ROAD SORES
)LE 0
{JGT
R.o.w.
EOP
fHE FOLLOWING INFO TO BE PROVIDED
RIGHT OF WAY LINES.EOP OR FACE OF CURB, EXISTING SIDEWALK, POLES, ROAD CUTS AND THE UTILITY UNDER ROAD CUTS.
ABOVE GROUND FACILITIES.(Ie:) PEDS.BOXES.CABINETS. ETC..UNDERGROUND TRENCHING AND OVERHEAD LINES.
o � OTAGE OF WORK 1N R.O.w.
Of
LL
ease.
LEGEND
• PERMIT SUBMITTED
GTE
POLES O
ROAD BORES
w.rreti .r. w . -
XE 0
i1GT
R.o.W.
EOP
N.
fHE FOLLowim INFO TO BE PROVIDED
RIGHT OF WAY LINES.EOP OR FACE OF CURB. EXISTING SIDEWALK. POLES. ROAD CUTS AND THE UTILITY UNDER ROAD CUTS.
ABOVE GROUND FACILITIES.(Ie:) PEDS.BOXES.CABINETS, ETC..UNDERGROUND TRENCHING AND OVERHEAD LINES.
r OOTAGE OF WORK IN R.O.W.
LL
LEGEND
• PERMIT SUBK41TTED BY
GTE
-to
66
POLES O
ROAD BORES
Ahlrn"l mv% f ar�-
)LE 0
UGT
R.O.w.
EOP
rHE FOLLOWING INFO TO BE PROVIDED
RIGHT OF WAY LINES.EOP OR FACE OF CURB. EXISTING SIDEWALK. POLES, ROAD CUTS AND THE UTILITY UNDER ROAD CUTS.
ABOVE GROUND FACILITIES.(Ie:) PEDS.BOXES.CABINETS. ETC..UNDERGROUND TRENCHING AND OVERHEAD LIMES.
o FOOTAGE OF WORK IN R.O.W.
U.
was. �.�.
USE PERMIT
ONE NUMBER
CITY OF EDIMONDS Z , �Z-
CONSTRUCTION PERMIT APPLICATION AD j � 777
ADDRESS /
NAME (OR NAME OF BUSINESS) +
Jnd� �� YTG H I -G. LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID H0.
MAILING ADDRESS -- I
U ._7 .7 CI
TELEPHONE NUMSEf PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
CI Y r`-y
EXISTING REQUIRED Dl�ICATION ^'
O
J PROPOSED_z
NAME
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0 i
STREET USE PERMIT REQUIRED C p
ADDRESS
SEE ENGINEERING MEMO DATED �
CITY TELEPHONE NUMBER --- .,
REMARKS
NAME
ADDRESS
METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS Is
1 W
H
I TELEPHONE NUMBER _
CITY
REMARKS
SrATE LICENSE NUMBER SIGN AREA ENV. REVIEW ALB NO,"1.
ALLOWED PROPOSED COMPLETE EXEMPT
Legal Description of Propeurrty • Include all easements SHOREUNEI,.
(show below or attach focopies)
7 DATE 'i g' • - -
VARIANCE OR CU PLANNING REVIEW BY
L •Y e
y
� HEIGHT LOTCOVERAGE "
YAnDS r. _
a FRONT SIDE
rIEAR
LU REMARKS
NEW RESIDENTIAL D PLUMBING
DD COMMERCIAL D MECHANICAL
ADDIALTEIt -
D REPAIR D RETAINING WALL D SIGN
CHECKED 8V TYPE OF CONSTRUCTION CODE HEIGHT` ,
D DEMOLISH D OR FIL TE ENCC
D r x
PRE -MOVE 1NSP.1 r7 SWIM SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
DREQUIRED GROUP =� LOAD' REMODEL D MP I N P p YES G NO
DwpISERTOD VEI D APT.BLDG RENEWAL �/>n� ", 2_
o
cc
~a
(n NUMBER OF STORIES NUM
P,ER OF
o OWELL114G
m ' . UNITS
O' NATURE OF WORK TO BE DONE (ATTACH PLO' PLAN)
PLAN CHECK FEE
�I kGRADINGIFILL
This Permit covers work to be done on pi)vate property ONLY,
Any construction on the public domain (CUrbS, sidewalks,
driveways. marquees, etc.) will require separate permission. Permit Appiication:180 Days
Permit Limit: 1 Year • Provided Work is Started Within 180 Days
"Applicant, on beh.Alf of his or her spouse, .-sirs. assigns and
hod
harmless successorthe s in ICity eof Edmonds,st, agrees to ) Washington. feIts offnd fiicialls,
employees, acid agents from any and all claims for damages of
of then permit f nature
oife this permit or rshalll no
om the issuance modify,be deemed to PLAN CHECK l °POSIT
modify, waive or reduce any requirement of any city ordinance T. AL AMOUNT DU:
nor limit in any way the City's ability to enforce any ordinance T0
provision."
I hereby ackrowledge that I have read this application; that the ATTENTION
Information given is correct; and that I am the owner, or the duly
auttiorized agent of the owner. I agree to Comply with City and THIS PERMIT
state laws regulating construction; and in doing the wo k aQthohlrZi AUUTHORIZES
ONLY THE
,Sa0 f" .y
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his
_ - _"t nnrf rpcaint Is
• �
...»— ,�,r . �
.,.,.. r .....ram
. ' :. •I»:tpro •,
,41'�T-` °' i.f .j �}..t i»f'-M^+a ra.,... n.4:'o•brwr/'H r'1+tr�x.wa"'A�`'MN
'4•�,
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OF:._:oat_
RECORD e _Pa
~• NAL APPROVAL GIVEN BY:
4 Initials Date
i
;;:_ilding I -------—
i e Dept.
r
."''snning (ADB)
;gineering
FOUNDATION .
House
porches, piers
Retair•inP, walls
Gara;,e, carport
PLUM 'JNG
IJc,dergrotmd
Roush -in
Water'
SYSTE.
HEATING
FRAWING
WALLBOARD
CIh..L
00
0
IN
a�
CITY of EDMONDS SIDE SEWER PERMIT
0 c l 221985
For Inspection Call 771- 2Q p PERMIT NO. M O O
BLIC WORKS
SIP
U a �, ZUNNW,0QD LANE
Address of Construction: ' - -777 AVE
Property Legal Description (Include all easements):
r
Owner and/or Builder: ®H I IITCH
Contractor & License No:
Single Family Residence
Multi -Family (No. of .Units )
Commercial (No. of fixture Units )
Invasion into City Right -of -Way: No tom/ Yes (If Yes, Right -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.)
PLE9SE--READ THE.ITEMS LISTED ON THE BACK
I certify that I have read and shall comply
with th9fitems listed on the back.
Permit Fee:
Trunk Charge:
Assessment Fee:
Partial Inspection:
Date
Issued By: 62"�f Ic
Date Issued: /0- Z 2 -
Receipt No.: 44dl_s�
Comments / Date Initial
Final Inspection Approved:
Date Tnitial
Rejected:
son
Date Initial
** PERMIT MUST BE POSTED ON'JOB SITE **
Wh.i to Copy - File Green Copy - Inspector Buff C'op.y-AAp`�� ant
1�
The City of Edmonds
Side Sewer Drawing
EASEMENT NO - -------------------------------------
NEW CONSTRUCTION og REPAIRS F-1 LID NO. 2,10 ------ -ASMT- NO- ------------------
OWNEk -,6Kt4. ----- M ------ KVT7��,*Ae A-1 ------------------------- CONTRACTOR ------- 0 --------------------------------------- --------------- PERMIT NO. 7(cGrL
JOB ADDRESS A5-7707 ---------- LEGAL DESCRIPTION: LOT NO. P� Ll E
-------- -------------------------------------- BLOCK NO. N
C41P 1.5,vp.,�
PWW-0001-1 1175 (REV.1 1/78)
-5c-F- SIDE SC -Jerk
FOR
15705 'TOT%A
"]Dl-.
Approved:
DATE 2 ---- 7VA 7 B,,Lf-C
------------
. ,, .• _ �I . ,� rr _- .. •• r '; t.. ._ter .-ii ..yi.., •.
�i
CITY of EDMONDS _T EET IDE SEWER PERMIT
For Inspection Call 771-3202 STR�� PERMIT NO.
Address. of Construction: �l 7 0�K dV • 4Y_NNWOOD LINE
Property Legal Description (Include all easements): 0� �1e,
�6 D6
Owner and/or Builder: M BC H L (,
00
0
r
N
N
a�
Contractor & License No:
al AV FQ
Single Family Residence I.sAR ? 3 199.E '
Multi -Family (No. of Units ) ip�UB�C WORI($
Commercial (No: of fixture Units )
Invasion into City Right -of -Way: No Yes (If Yes, Right -of -Way
Construction Permit required. "Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No V Yes (If Yes, easement required,
attach legal description and county easement number.)
READATHE ITEMS LIS,TEDAON THE BACK
�—ce Ffy that I have rdad and. shall comply
with hie items listed on the back.
3— aQ - 57
Date
'-
Charge:Trunk
Assessment Fee:
00
00
Issued
Date Issued:;
Receipt No.:
6 9412
Partial Inspection:,
Comments Date Initial
Final Inspection Approved:, 2 S
Date Initial
Rejected:
Reason Date Initial
** PERMIT MUST BE POSTED ON JOB SITE **
Wh.ite Copy - File Green Copy - Inspector _ Buff Copy - Applicant
r
F
IONS'
ORD'OF iSPECT
DATI OUN OK .4-`
Mg�D Q�FIN
FINAL APP".10VAL GWEN BY:
pbrcfies, piers
initials'
Retaining walls —
Building
Garage, carport:
Fire Dept,
PLUMBING
Planning (ADB) :.. - - - - .
Engineering
W�v
JE. Z-- -
Rough-
-Water.iJ `.
HEATING SYSTEM
FRAMING
—e57-
WALLBOARD - r _
FINAL
r f.
i USE PERMIT �.
ZONE � NUMBER � � -
CITY CF EDMCGNDS. /v
CONSTRUCTION PERMIT APPLICATION ADDRESS o —Ae_ -
NAME (OR NAME OF BUSINESS) LIO'NO.
' / /C / LE AL DESCRIPTION CHECK SUBDIVISION WO. � .
MAILING ADDRESS
852 Poplar Way
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. }�
CITY TELEPHONE NUMBER K
/ EXISTING WA REOUIREDDEDIC.TION
Edmonds, '- PROPOSED -
NAME
SAMERS3HT OF WAY CONSTRUCTION PERMIT REQUIRED
STREET USE PERMIT REQUIRED --;°
ADDRESS
SEE EN3INEERING MEMO DATED ua a
p TELEPHONE NUMBER `�`�'� � ":%�;1: rr•
` CITY REMARKS
NAME:.r'i-V, .
S ADDRESS METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS,.
o SAME
TELEPHONE NUMBER
CITY REMARKS = �'
ENV. REVIEW -ADO W. ''?: •;;y -.
V STATE LICENSE NUMBER SIGN AREA _EXEMPT
ALLOWED PROPOSED COMPLETE y;r
Legal Description of Property Include all easements
SHORELINE/ `�,: • r err"
_ (show below or attach four copies) ,��•
VARIANCE OR CU PLANNING REVIEW HY ., i`�«' •
R Lot C of S at recorded under
Auditor's File No.8509.1601.89 bein HEIGHT' LOT-COVERA '
o portion of Tract 2Y, hleadowdale .each, YARDS i
as er lat recorded in Volume 5 'of Plats FRoREAR %
on page 38, records of Snohomish County REMARKS
State of Washin ton. cF.f
(� F
[J RESIDENTIAL
I ❑ PLUMBING
❑ N Ew
❑ ,
ADDIALTER COMMERCIAL ❑ MECHANICAL
❑
Cl RETAINING WALL ❑ SIGN CODE HEIGHT
REPAIR CHECKED BY TYPE OF CONSTRUCTION t =
❑ EXCAVATE a FENCE - � r
OR FILL L--'x__FTl r '
DEMOLISH cA OCCUPANCY OCCUPANT
PRE• ❑ POOL REQUIRE
COMPLIANCE INSPECIAL INSPECTOR AR GROUP L
MOVE 1NSPl OAD i tom•- ; ;
1 J D NO
-.
L REMODEL S°. ❑ YES ''- ' :�•"�
WOOD STOVEI ❑ ❑ RENEWAL REMARKS4
INSERT APT. BLDG
r NUMBEROF
NUMBER OF STORIES,
pweLUNG
UNI IS
NATURE OF WORK TO BE DONE( ACH PLOT PLAN) -
There are a lot of small trees that need
VALUATION FEEv•e;, '-y
to be chopped down and cleared in order
PL:Ld „HECK FFFtu
Soo
to prepare the lot before cols------ on can, BUILDING !(�a ,L "`•
VLUMBIN6 a -
begin.
MECHANICAL "•�•
7"
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain !curbs, sidewalks,
driveways, marquees, etc.) will require stlparate permission. •�'b _ I ;
Permit Application: 180 Days owt F,EE
Permit Limit: 1 Year •Provided Work is Started Within 180 Days ;
"Applicant, on behalf of his or her spouse, heirs, asslg �s and
H successors in interest, agrees to indemnify, dofend ana hold `•, rt
W harmless the City of Edmonds, Washington, its officials, h 4
employees, and agents from any and all claims for damages of # ,?
a whatever nature, arising directly or indirectly from the issuance , Y�
= permit shall not be deemed to PLAN CHECK DEPOSIT
of this permit. Issuance of. this .�.Jj
° modify, or reduce any requirement of any city ordinance TOTAL AMOUNT DUE L��+'-' X
rxx
= nor Ilmit in any way the Clty's ability to enforce any ordinance
provision: '
I hereby acknowledge that 1 ave read this application; that the
ATTENTION APPLICATION APPROVAL
_ .. _ 4 -s-f I am thn owner, or the duly „
-lu
t)ul
3U
1 Ail
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ci
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..........
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MOV15,
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P,
ENGINEERING "GR,
USE
CITY OF EDMMIDS ZONE
CONSTRUCTION PERMIT APPLICATION SOB S ��
NAME (PR NAME OF BUSINESS) y( ADDRESS
n V A� M i/� ` 1 l c-` ` e L_� . LEGAL DESCRIPTION CH
or )Z�415 1 Is -7/ _&
MAIL119N AYYI�L�I.I
SZ A
CITY TELEPHONE NUMBER
NAME
ADDRESS
S A M CE
ADDRESS
CITY
STATE
)tlon of Property -Include all easements
or attach four copies) AT A c M E
NEW
® RESIDENTIAL
PLUMBING
ADDIALTER
COMMERCIAL
MECHANICAL
REPAIR
RETAINING WALL
SIGN .
❑ 'II NCE
DEMOLISH
ORCFILLTE
X—FT)
1--1 r-1 PRE -MOVE INSPJ r 7 SWIM
WOO INSERT
[:] APT. BLDG RENEWAL
NUMBER OF STORIES NUMBEROF
' OWtLUNG t
UNI Id
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
s
PERMIT
NUMBER
PUBLIC RIGHT
OF WAY PER OFFICIAL STREET MAP.
EXISTING JA REQUIRED DEDICATION
—
PROPOSED
716
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED .
STREET USE PERMIT REQUIRED 0 1
SEE ENGINEERING MEMO DATED
U1411
0
Z
cc
Z
a
Z
w
ss
METER SIZE 816ILDING SUPPLY SIZE FIXTURE UNITS
w
REMARKS 3
SIGN AREA ENV. REVIEW ADB NO.
ALLOWED I PROPOSED COMPLETE I EXEMPT
VARIANCE OR CU
YARDS
FRONT SIDE �D I
REMARKS
1
BY
SPECIAL INSPECTOR
REQUIRED
❑ YES ❑ NO
'
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
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
J
successors in interest, agrees to Indemnify, defend and hold
harmless the City of Edmonds, Washington, Its officials,
a
c
o
=
employees, and agents from any and all claims for damages of
whatever nature, arising directly or Indirectly from the Issuance
of this permit. Issuance of. this permit shall not be deemed to
modify,. waive or reduce any requirement of any city ordinance
nor limit In any way the City's ability to enforce any ordinance
provision."
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the
Information given Is correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner. l agree to comply with city and
state laws regulating construction; and in doing the work authoriz-
ed thereby, no person will be employed in violation of the Labor
THIS PERMIT
AUTHORIZES
ONLY THE
Code of the State of Washington relating to Workmen's Compensa•
WORK NOTED
Insur nce.
INSPECTION
DEPARTMENT
CITY EDMONDS.
IGN TORE (OWNER OR AGENT) DATE SIGNED
M`' ��S
L
BY DATE
LlHEIGHT LOT
--jr /
2 .. 3.
IV 2-
OCCUPANCY OCCUPANT
GROUP 0 ., LOAD
0-
VALUA
/-CmpAk zoZ
�!l/its!-fir m
�I
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt Is.
acknowledged in space provided.
OFFICIAL'S SIGNATURE DATE
RELEASED BY:
DATE
ATT N T I O N 771.3202
IT IS LMLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102.78
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
PERFORMANCE BOND , FROZEN FUND
CITY OF E D M O N D S TARRY S. NAUGHTEN
MAYOR
250 51h AVE. N. • EDMONDS, WASHINGTON 98020 • (206) 771.3202
COMMUNITY SERVICES PETER E. HAHN
DIRECTOR
DATE : 5-g j
ATTENTION: BUILDING DIVISION
RE: Edmonds File No.: S--1\ -03
Developer/Contractor: x,,h1A N
Project Address:
Gentlemen:
With reference to the above-identif
certify that this
/Y1
institution has a savings account (or lc �� pnced developer for i development of the
the project so identified. In considez !hereby agrees that it
property, and in lieu of a performance improvements pending
will freeze the following sums of money I City of Edmonds:
written authorization for release o-
The total sum indicated will be withheld by this institution from any
disbursements of any kind until written authorization has been received by the
institution for the City of Edmonds to release the sum of money indicated by the
written authorization fran the City.
The design, location, materials and otherspecifications nds for as the
ricatin sthe
improvements are those required by the City
above -referenced Edmonds file and in canpliance with. Ordinance No. 1620 of said
City..
In the event the developer/owner fails to complete demand, indicated �stivem Bi
_(s/s), ts
on
withinthe City of Edmonds may improvements can be
shall make, payment to the City of said funds so that the
y to City standards. The institution shall not be
installed or completed irnnediatel
liable to the owner for -any disbursement of said funds to the City of Edmonds.
It is hereby spec
agreed by and between the parties hereto.that in the
visions of
is
or
event that any legal action must be taken to en
fsnc�ail the entitled to collect itsdcost
to.collect said bond, that the prevailing party
and reasonable attorneys' fees as a part of the reasonable costs of securing the
obligation hereunder. In the event of settlement or resolution of these issues,
prior to the filing of any suit, the actual costs incurred by -the City, including
reasonable attorneys' fees, shall be considered a part of the obligation hereunder
secured. Said costs and reasonable legal fees shall be recoverable by the prevailing
proceeds of is bond , iinaadd tion to rlso over and ecovery on ttheve said ybond
party, not only fran the
part of any recovery in any judicial proceed
CITY OF ENIO DS
PERFORMANCE BOND
Page -1-
Commercial/Apartment/Plat/Subdivision
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SHOPT PL A T MOD/F/CAT/ON FOR
✓A N GR/FF/ THS
MOD/F/CAT/ON TO SHORT' PLAT S - 71 67
A PORRON OF TRACT`2/, ME,40OWD,4LE BEACH
/N THE NE //4 OF THE 5W 14 OF SEC. 5, 7 2 M. t R.4E., W.M.
C/TY OF EDMON05o .SNOHOM/SH COUNTY, WA ✓$H/NG TDIV
CATCH EA.Sik.
r
TRRMC41 LKNGTH
:r
'�- 9
TNC►+CN' COVER
4►6RF v►vc i
TEE W/ 4 LONG, LEGS
SYSTEM CROSS—SECTION
MIF2AFI SOOX
Oft Mu I V E LEMT -
TO Be= L/-IYED oN
wk-sL:t.D IKO K
T.0.ENGN COVER
3/40 - 11/2" WAS9ED
GRAVEL
r
4 O1AM FERF PI
TRENCH CROSS—SECTION .
CAA
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lu
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2
for )aKUSALL'Ml?CHr.��
P�SZ Pa PlA/t WA`I
location- I S1 01 .7 or" w
plan by e --
phone
date t 0 ^ 7-' 52
DESIGN DATA
Trench Perc LF per ImDerm Trench
Number Rate 1000 sq.ft. Area Req.
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 re ular intervals (at least
twice per ye �.
J
CITY OF EDMONDS.
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 re ular intervals (at least
twice per ye �.
J
CITY OF EDMONDS.