Loading...
16216 N MEADOWDALE RD.PDF16216 N MEADOWDALE RD BUILDING DEPARTMENT Applicant Fill USE PERMIT ZONE _I NUMBER ERMIT APPLICATION Inside Heavy Lines JOB ADDRESS NAME OF BUSINESS) �, �. �u ��I O ) /�f LEGAL LOT PLAT NAME ,SU BDIVISION NO. W OYES No MAILING ADDRESS Z 30 C Zv _/60 NO. V� PUBLIC RIGHT OF WAY PER ORDINANCE CITY ELEPHONE NUMBER / _i7 EXISTING RIGHT OF WAY �C/ NAME PROPOSED RIGHT OF WAY F, )-_/( � �J� V�`J V DEFICIENCY OF RIGHT OF WAY D N U W h_ ADDRESS STREET/UTILITY WORK REQUIRED YES ❑NO Y 0 I M PERMIT FOR WORK IN PUBLIC R/W- MYES El 3 U It CITY TELEPHONE NUMBER 7 UNDERGROUND WIRING REQUIRED OQYESi ❑NO U_ Q Q CONNECTION TO SANITARY SEWER XYESi NO J U—) ig.� LU SEPTIC TANK PERMIT REQUIRED ❑YES KNO m a NAME CI f �� JS-e-r / cem1 I v , SEPTIC TANK PERMIT NO. 'v 0 .ADDRESS F' SEE MEMO DATED ?� � anPAO M C TY /i TELEPHONE NUMBER REMARKS A 0 U S E LICENSE ER CITY LICENSE NUMBER CHECKED BY A Legal Description of Property (Show Below or Attach Four Copies) METER IZE. BUILDING SUPPLY SIZE II W W F ' Z I I REMA K Q F' a_ SIGN AREA ENV. REVIEW ADB NO. C ALLOWED PROPOSED COMPLETE EXEMPT U In SHORELINE W J REMARKS W W J I VARIANCE OR CU PLANNING REVIEW BY DATE YARDS ' LOT COVERAGE 5 FRONT O SIDE ��REAR NEW RESIDENTIAL GAS ❑ LINE FIRE ZONE TYPE OF CONSTRUCTION CODE HEIGHT ❑ NON-RESIDENTIAL ❑ SIGN ADD ' ❑ DEMOLISH ❑RETAINING SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT ❑WALL -ALTER EXCAVATE FENCE ❑ OR FILL ❑ ( X_M REQUIRED ❑ YES ❑ NO GROUP LOAD PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY PRE -MOVE SWIM ❑ OF EDMONDS. LOCAL SALES TAX REPAIR INSP. POOL � SHOULD BE CODED 31.04. REMARKS Z NUMBER OF STORIES NUMBER OF I• 0 ` �J C WELLING / U N I T S. Z W i2se*Cp. a NATURE OF W RK TO BE ONE U Q eew 44 c=�•'v�✓ W 0 W m 0 0 PLAN CHECK FEE VALUATION FEE -' PROPOSED USE __ I• ^y� ►` ' Z W PLOT PLAN INDICATE BUILDING SETBACKS, - i a ABUTTING STREETS) BUILDING U In 0 J W PLUMBING W o i m 0 MECHANICAL W 0 FENCE f t Z m "Applicant, on behalf of his or her spouse, heirs, assigns and SIGN successors in interest, agrees to indemnify, defend and hold harmless f the City of Edmonds, Washington, Its officials, employees, and RETAINING WALL 0 Ir agents from any and all claims for damages of whatever nature, = arising directly or indirectly from the issuance of this permit. Issu- SWIMMING POOL 0 au)cc of IhiS I+rrnlit shrill not be deemed to nnldify, waive or reduce h V , v III — -- 1 Date MEMO TO: Building Division Community Development Department FROM: Engineering Division Public Works Department SUBJECT:Lnz CC After review of the subject building permit application, we have the following comments: 1� Coordination of the location of.any structure with respect to utilities, streets, property lines and driveway grades is the responsibility of the contractor. L7 The contractor is required to keep the abutting streets cleaned of dirt and debris caused by the construction. Sr 6(7 — /7 'Tv /_7 /7 /7 31 The "Right -of -Way Construction Permit" is required,.from the Engineering Division of Public Works, for any work within the Public Right -of -Way or.public easement. Driveway slope not to exceed 14%. Connection to sanitary sewer required. Septic Tank Permit required, submit design. Fire hydrant required, submit design. Site drainage per code #171l- See approved plans Curb /7 Sidewalk / Paving required. Bond required for public improvements. Submit cost estimate. Underground wiring required. Approved Engineering Plans required when applicable. 1z11 �rv,L�—.`Q a �� wh2 ) uE_v)W AcruE`hS ^ �� o� . r Y= 1/1 / � ►-� � r� /// ►�' Da ii � /lm�r1., _.�r-�,., � .� A�� /I .0 n i �/ i n nLr J�a-z,i Rev. 7/78 aloi5 slew" _-- __-. b, ..r. City Engineer Department of Public Works CLIC.INTORKS DEPAIM11M CHE.CKLO BUILDING PERMIT REVIEW 10� Street Right-of=Way�'Existing �a�� �'!, REQD Access Easements Existing nt.4m.. °._RF.QD a. Utility Easement Existing WwAp_ REQD Lot per Subdivision Plat Assessor Map Site. Plan Checked for Accuracy Underground . Wiring Reqd. Check Accuracy of Legal Description Z- I(o -•7G) Environmentally Sensitive'Area� Environmental Checklist Reqd. J Flood Hazard -Zone Shoreline Management Area Slope, Soil, Vegetation Stream, Creek, Drainage Basin Existing. Zoning, Per, Code Amenities Design Board Approval Reqd. Board of Adjustment Approval Reqd._ Review.:By: _�� TIo ADB # Approval Date: 2-I(a- Existing Writer TMain Size Is " V j, Water Main Reqd. Service Line.Regd. Hydrant Size Existing !'{ Hydrant Reqd. Per Fire Code Size Detector Check Meter Reqd. AIX Cross Connection Inspection Fire Department Comments Water Meter Charge Reg.: Review by: Date: 02 7 9, r -- i'' Septic Tmik Design Approved vate: r�j Ch- 1 Septic Tank Permit Regd. j 1,c&_ Permit No. Sanitary Sewer Availability Proi. Drawing No. �• 'Z� ����� File No. Side Sewer Availability —� ,� ( t vim w Sanitary Sewer Connection Fee Reqd. 00 M Review By: t � Date: g1nA. rLM Open Ditch Existing_ Regd.f Calvert F.egd. Size x Catch.Basin Rcqd. Indicate on Site Plan -- e' Shoulder drainage nkni.ntai:n collection on Swale open runoffJ. ,y :•►d-ihol.e regd. eNP Indicate on Site Plan .Soil. Conditions and Ground Water Field Checked C/ _ Revi.e7.a by Da to K Street Paving Reqd. Curb and Gutter Reqd. w F� Sidewalk Reqd._ 44 w Curb Cut for Driveway Reqd: Right-of-V.'ay Construction Permit Regd. ,. ► .j F, Bond Regd. for Public Inprovemmts 0- En Street Name. Sign Reqd. /Vl Other Signing Reqd._ OV9, t sz-�s Q Pre Permit Site Inspection made on a o► �t BY: SE[,]ER E U ' w t� VIATER S11 ET p , ENGINEERING , Special Rcquireii,�rhts listed in ri�enxn to Coinr u~►ity DeveloPr�eiit Departrren:t; Building Division BY Date r e t o All. i.tc,ns filled in on Building Pernii.t Application p. N 13Y " � ._ _ Date to n' t Drawim's Staimcd and Notations 1L-ide y BY Date Approved• by Public t'ai-ks Departr�nt i-tevi.sed: .1v,10-1.977 a _. �• :. r A �. EASEMENT N 8SP 56! 58`• EUTILITY o �y 164.00 ,\ ; rJ 69.00 _ O + mop Io I 4 Q=49 010�59• L= 38.63. P. L = 52.303 Q-;O°0`' 57 • ° a �\ I +... I 0 R=229-73 .LOT .Ei `a' { \ ♦ EJSt s•t• C t0' UTILITY N 26 35 00.E 3? ` . - •- H •• C S I - _ _ ram\ I EASEME4T 20.00' • 99' \� ' N 89 10 10 W R r R ?:'• _ 001, W Q:2 / _ z Q= 64 37' 23" c00 / In w I L=28.20' ►ui Q-67 50'20` R=25.00` 20�� o v W (=03 17 50 Oi f- to R=179.03, �), ' U) ZI a L=10.30' I s/> � op-CP W z 3 s' a I A=61*00'53" a`ti I ao Cr- L = 47 9 2` / lu E L� 20�' '� N C-3 10• �� '� — R =p O I� 179. W� I f- � / a L =78.6� o� 111 ° co Q F- °ham 2 vo 4 _ - ( Cv 2 ' o ^'' t ` SS. _ { I .20.18` } =� JI I 10� UTI.:TY _ EASEM( •ITS • 6872, el 1! So 97 77o 8pI I �� t 32'22"E i �.��.w..�r• - •-.�-i..•rJW-r.'I"!1 'WrTr . ••rz... �r,� ..w r•wIF -w7•ow" "..'r^�•'�"�'. i r•. . .... IMINARr COMMITMENT Iva 1I INSUIUN E NaMNyY�UN •1+►a 1"t�13" No. F-219683 UNIT 3 i RE: WESTMO14T VIEW JOINT i To: PACIFIC NORTHWEST ESCROW VENTURE:/CORNeL5EN, 410U ZOOTIi S.W. KLOSSERYOUR N0. 8-24469 ' LYNNIVOOD, WASH. 98036. ATTN: CAROLYN Date;. JANUARY 15p 1979 AT 8:00 A.M. Amount py� ti•� ( ) Ownei s smndard coverage j•r .; fir,, j. (X Purchaser's uandard coverage $17 0, 5 0 0. 0 0 WOOD ( ) Mortgagee's 8 standard covers e gag SALES TAX V e 3 i 1. ,it+,6•i�� ,iri'.. ( ) Mortgagee's ALTA coverage r p( YY 111 J PIONEER NATIONAL TITLE INSURANCE COMPANY agrees to Issue on request and on recording of an► oppro"Idt, dogsit�, of policies as applied fur, with coverage as Indicated• based on this '�• ; , Pd�7 Po ' PP g prelimltury cummltrnent that tibia to the �°%w'1, d+otsibe+}+•'� � . herein is rested on the data shown 'above In JOHNS � WESLEY E. JOHN50N AND MARGA(tET L . QN, NLS WIFE,. /1N0 +, .1� ?' J�.�;'/��i�;��"'�•%"•'• DONAL C. MILLER AND CHARLOTTE .Es MIL6F.Rp HIS WIP4i T: subject only to the exceptions shown herein and to the terms, conditions and exception& contained In the POkiails i 1 � ,, �•• A Y� j' 1� � •r ' (,•. l'..�;i , Tbit repors awl sonswismew rball base wo Jorte or 00#00 except are 6WA1 for the eorerige tpesll j baralw. ,' r ( ! •• ,t , ,� •.t r DII=IPMON i LOT 10,WLSTMUNT VIEW DIVISION NO. 2 ACCORDING TO PIa►T TNER 1!'lNr�;, �► RECORDED IN VOLUME 36 OF PLATS.. PLCi 24 AND 15# RAGORDS QF.; 1.y { SNOHOMISH COUNTY, WASHINGTONa �' �' r •�'-, EXCEPTIONS. ,, 1� EXCISE TAX IF UNPAID. ! kt + si;�s+� 1 �. �,',..;� .• t t n 2. FOR ADDITIONAL EASEMENTS, COVENANTS, RESTRICTIONS AND.' ,�, RESERVATIONS, SEE EXHIBIT 8 AS ATTACHED HERETO. YR,� 1�; •� 1t'/', �, 1 I N THE AMOUNT OF $18 S. 34' 'MMI t T:>;'��;y•���k% ' ` NOTE: GENtRAL TAXES FOR 979 • CANNOT BE PAID UNTIL FEBRUARY 15, 1979. r'r!'' ���'��.;y�. (TAX ACCOUNT NO. 6495-000-010-0007.) ANY CONTRACT FOR THE PURCHASE OF COMMUNITY REAL P R 0 1! T*Y'? NOTE. • SHOULD BE EXECUTED BY BOTH SPOUSES PURSUANT TO RCW 26:16.030.Ai ;.� ;:;' •: •'':: •; NOTE /: The lan ale contained In the printed Exclusions from Coverage and Conditions and Stipulations of the Polley COMM' of Jo+wear N d ce�M=g%'. � 't Inquiry at the office which Issued the Commitment, and a specimen copy of the insurance policy form (or forms) refired to In shd towswlt+w.wr rAl M iw`I wtehed promptly upon request. ". '': r �r MOTE l: /nvestigartow should be made to determine if there are any .Irvlc., Installation, ntolnnenanae, or conirrwetlan elNl>ZeJ for Mover, MM . 9'!'�rA' , ry-r •A.,. , fr+ .. -, .-pn. .r, .., w � ......, n....,.....www..-, ..., �.w.�ww..�`• 1� r -'- - - - �'_ - - 1 .: P. yii U H a a a 04 A w H w a a z 0 U w M 0 H CITY OF EDMONDS ,F�JBLIC WORKS DEPARTMENT FOR INSPECTION CALL Permit SIDE SEWER PERMIT 7755. Z5.2`5 Ext. 2-2-Q Issue Date a a PERMIT MUST BE POSTED ON JOB SITE 1. Address of Construction �. Property Legal Description (include all. easements) DZINE 1 /X )PSI Mr. 04 I/ifCAJ .Ny Single Family Residence Multi -Family No. of Units Commercial Uj-Uj Owner and/or Builder �. Contractor & License No. Invasion into City Right -of -Way: No/�' Yes (If Yes Right-of- way Construction Permit Required - Call Dial Dig ( 3,4�2f� 5,c3,4/4�) before excavation) . 1-800-454-5555 7. Cross other private property: Yes No b-l"' Easement required - attach legal description'and county easement number. READ THE FOLLOWT�.NG 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 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% (1.15°) and maximum grade of 100% (450). 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 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. r 1. Inspect -ion during normal working hours only.' Two (2) working days notice re/quir/ed. DATE: 1X4,V t ' �,Y icerti% y t at I have read and shall, comply With the above P. PERMIT FEE: 'JJO, OU CONNECTION FEE-: ll000 bn) O w * PERMIT Mt DISAPPROVED By: Date: B Date: XW4APPROVED By : Date: T BE POSTED ON JOB SITE The City of Edmonds Side Sewer Drawing EASEMENT NO - -------------------------------------------- MAID. CONNECT iam NEW CONSTRUCTION F] REPAIRS ❑ LID NO. 2.1-0 ------- - ASMT. NO_ ----- ------------ OWNER --Sv-WkA --- Fi--tmc7 ------------------- ------------- ------- -C4-1 -------------------------------- PERMIT NO. -652-9 CONTRACTOR ---- RJUSS .... �.IOMPIS ----------- JOB ADDRESS .... 169-1-(0 ------ - ----- ---------- I'(:)- Mg-AIDOW01I.Lr- PWW-0001-11175 (REVA 1178) 13 BF-A,c-l4 LEGAL DESCRIPTION: LOT NO. ----- 1-0 -------------------------- BLOCK NO. ------------------------------------ LYNNWOOD LINE ---------------------------------------------------------------------------------------- ---------------- ................... - - ------------ J& NAME OF ADDITION --- -- \NEST.K.ONX ----- VAR W� ----- 1 V ---- -- ? - ----------- -------------------------------- ICO2-IG No. MEM.BCO.Rz. 41-AWIFE 4 sop 4.,:Zr !lc CA�cnWp VIDP Approved: AW ------------- -,-/j ----- 43-44- .,_.,,�,r1 �i -�i ..n '��i'�nG�!>.���4' ��t'ii. ,., t�i�.�rti-. .. r.>�s✓'.l�r�.. `_ -'u". d' ,.� �h4'S�/"��az-vN'�`rY ��.f�`>SL,r—,,y�....u'"%�!^rri ...Jt;•{:.���i.l�v�i..r11 ., � ( - r r� C. City of. Edmonds .M RIGHT-OF-WAY CONSTRUCTION PERMIT Permit Number, Issue Date: o,/ �4 A. Address or Vicinity of Construction: 16216 N. Meadowdale Road s ific GTE to place operate, and maintain a buried svice t U w re from ex,stin oere locdte at 16216 N. Meadowdale n� 1g9 B. Typeof Work�P� ): Road then south to a residence at 16216 N. meadoWdale Roacl. UIL toplow '60"feet, push no driveway, and push no road. R.O.W. Footage 5 feet. GTE Northwest Incorporated Contractor: Marilyn Holmgren, Permit Coordinator Contact:Jerry Scott 425/774-5921?or Chuck Roberts 771-9036 Mailing Addres 2312C W. Casino Rd Phone: Marilyn 425/710-0786 or I488-1628 SEye?ett, WA 96284--144n State License #: Liability Insurance: Bond: $ D. Building Permit # (if applicable):. Side Sewer Permit fl (if applicable): E. ❑ Commerciaf ❑ Subdivision ❑ City Project J] Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ® Single Family ❑ Other ,r. 2850-9P001DB 242310 INSPECTOR: INSPECTOR: w �' F. Pavement or Concrete Cut : ❑ Yes xONo G. Size of Cut: x H. Please see attached slie r: ✓'2- " 3 r � APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application 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 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 FORA PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC- TION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTH THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Two sets of construction drawings 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 trench work 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 and understand the permit requirements and the pink copy of the permit will be available on site at all times for in�*nposes. Signature: nav-d SquiresDate: /�r-) aIf — f (font actor o gent,$ection Manager -Access Design CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: TIME AUTHORIZED: VOID AFTER DAYS RIGHT OF WAY FEE: DISRUPTION FEE/FUND I 1 l: SPECIAL CONDITIONS: N 4 RESTORATION FEE: T OTAL FEE: RECEIPT NO.: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997 FIELD INSPECTION NOTES (Fund Ill - Route copy to Street Dept.) Comments i. ,CONTRACTOR CALLED FOR INSPECTION ❑ YES; ❑ NO Partial Work Inspection by P.W.: ,Work Disapproved By: Date: FINAL APPROVAL BY: Date: PERMIT SUBMITTED BY GTE LEGEND PEDS ® " POLES O ROAD BORES z OVER�icAO LIMES1.0. UTILITY POTHOLE O UG TRENCAING ---iJG T— R. O.tv. - - - - - .� - - - - - .. .. - .. .. - - .. .. �. .► - .. - .. .r - -r .- - - - - - - - - - - - .. - - .. - - - - - _ w i - - I- V p N. N1e-Qat3wAolt �Q. ---------------------- CUTS' ti ,H '4•d rM:. ,.r.-�•�. rw.it: xWrr; �+.: a:.ti�S%i :A .�....1.,,-.I.rn.'^+.%i.-�j%.�;,i.•`?.rtr�.i.rx•n"r3� i�v'"':-vim _�i 5�..^�r.;^,,:.y'{:vS �� _ Y ^ .� i f. _7_" . -, , a Z O W V) E- R CITY OF EDMONDS Permit No. 0 / COMMUNITY SERVICES DEPARTMENT RIGHT-OF-WAY CONSTRUCTION PERMIT GREET FILE Issue Date Owe (145 A. •Owner:-�/`��`'' `, ,,ttom� B. •Contractor: e.� � Name h2i NMFkV��t P9, Nam .2L31 0 Mato c il'ng Ad e s M lin�gLAd54 dr City State Zip City State Zip S}ytta)�te License Number �t Telephone Number C. • Address or Vicinity of Construction: !'- V ly (� �O (� C� . Type of Work to be Done: G-•A 105CA0 dJ (T' D. • Work in Connection With: ❑ Sub or Plat )5-Single Family ❑ Commercial ❑ Multifamily E. • Pavement Cut: ❑ Y ❑ N F. • Size of Cut: X APPLICANT TO READ AND SIGN ❑ City Projects ❑ Utility INDEMNITY: 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, forseen or unforseen, 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 defense costs, court 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 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. • A 24 hour notice is required for inspection; Please call Engineering: 771-3202 • Work, is to be inspected during progress and at completion. • Restoration .to be in accordance with City Code. • Street to be kept clean at all times. • Traffic Control to be in accordance with City regulations. **All street -cut ditches must be patched with asphalt or City approved material prior to end of working day; NO EXCEPTIONS. I understand the above and that this permit must be available at the job site for inspection purposes at all times. Signature: Date: 2U Owner or Contractor T �.'/'errni(�-M-u-\st be Posted at the Job Site For Inspection Purposes �- ­ r Call DIAL -A -DIG Prior to Beginning Work APPROVED BY:r Time Authorized: Void��;tiafter �days. Special Conti 'tion�s t L RELEAS D BY: PERMIT FEE: -$ 3 Q 0 t7 Restoration Fee: Receipt No.: Fund 111. Fee: Street Cut Dimensions: Date & -a70 & 5 INSPECTED BY Date O �c -- t w r •NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE } ".� Eng. Div. March 1989 FIELD INSPECTION NOTES (Fund III - Route copy to Street Dept.) Comments: Diagram: CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. July .MEADO.WDAL E RD: CORNELSEN CON.STRUCT101 GGL[. A►IROV[D 8T, DRAWN By DAT[, • ....... PLOT PLAN -� STREET FILE A UILDING DEPART.MEN1� Applicant Fill USE IT ZON— .� E I BER ERMIT APPLICATION Inside Heavy Lines JOB ADDRESS f 1� / /oil v( N�AM('EL OF BUSINESS) E c IU �7 tau �jr iO - ) /�J LEGAL LOT/ DYES ❑NO PLAT N,A(MvE SUBDIVISION NO. MAILING ADDRESS 0 6820 �-/60 NO. VLV PUBLIC RIGHT OF WAY PER ORDINANCE CITY TELEPHONE NUMBER ✓, Cf &ini oncl ' ivA 41 S -- EXISTING RIGHT OF WAV PROPOSED RIGHT OF WAY NAME r IJD (�1.1�� U DEFICIENCY OF RIGHT OF WA D' W ADDRESS r_ STREET/UTILITY WORK REQUIRED �IYE's ❑NO I U IVES PERMIT FOR WORK IN PUBLIC R/W DM UNDERGROUND WIRING REQUIRED KYES ❑NO ❑NO E CITY a TELEPHONE NUMBER CL v1��Do _ CONNECTION TO SANITARY SEWER gQYES SEPTIC TANK PERMIT REQUIRED ❑YES ONO KNO NAME CI r)I (.mot_I S-�o •� J C �. ,v 4 t�( r Y SEPTIC TANK PERMIT NO. E 0 ADDRESS F' U SEE MEMO DATED 2 ?o� It C TV n TELEPHONE NUMBER REMARKS Z 0 U S E LICENSE ER CITY LICENSE NUMBER CHECKED By L h - Legal Description of Property (Show Below or Attach Four Copies) METER IZE BUILDING SUPPLY SIZE REMARKS Z 0 _ f- SIGN AREA .ENV. REVIEW ADO NO. IL_ 0: ALLOWED PROPOSED COMPLETE EXEMPT ' U to SHORELINE W 0 J REMARKS Q W J VARIANCE OR CU PLANNING REVIEW BY DATE YARDS LOT COVERAGE NEW RESIDENTIAL GAS LINE �C FRONT O SIDE &C REAR � FIRE ZONE TYPE OF CONSTRUCTION CODE HEIGHT ❑WALL ADD ALTER ❑ NON-RESIDENTIALD SIGN ❑ ❑ RETAINING DEMOLISH EXCAVATE FENCE ❑ OR FILL ( X_FT) SPECIAL INSPECTOR REQUIRED ❑ YES ❑ NO AREA OCCUPANCY GROUP OCCUPAI LOAD PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY REPAIR PRE -MOVE swim Q INSP. POOL OF EDMONDS. LQCAL SALES TAX SHOULD BE CODED 31.04. REMARKS Z NUMBER OF STORIES C NUMBER OF WELLING F asi­,gLK UNITS • a NATURE E N OF WObRK a TO BE ONE CoriS f i u U7�. `o�✓ W 0 m 0 PLAN CHECK FEE VALUATION FEE -- PLOT PLAN (INDICATE BUILDING SETBACKS, K ABUTTING STREETS) BUILDING U N W PLUMBING 0 MECHANICAL m 0 FENCE SIGN m "Applicant, on behalf of his or her spouse, heirs, assigns and successors in interest, agrees to indemnify, defend and hold harmless i the Cily of Edmonds; Washington, Its officials, employees, and RETAINING WALL E agents from any and all claims for damages of whatever IlaturC, I arising directly or indirectly from the issuance of this permit. ISsu- SWIMMING POOL 2 W r Q 3 r Z W f r Q a W 0 t r z f 0 U 01 ance of this permit shill not he deemed to modify, waive or reduce o:Illy h"11Wrlllrnl i.f ;Illy -i(y ordinaocr nut limit in any way lho PUBLIC T:LIS DEPi`� - - Date vm BUII.U]NG PE1RIT RI -VIEW I Ray' Strcat ludit-cf-fury 'Existing D REQD - Acma eta E xis t ing nM �,. RFQD - Utility t-Existing REQD LoG, par, �n Plat Assessor clap ,., , z Situ" rlmn ' Cwdwd for Accuracy z . • -1 ►.� Un+cla� Wiring Reqd. YML& Ovck &c U=Ty of Legal Description z- Ke -7q w Environmentally 'SensiCive Area zt E nvirainwtat Checklist Reqd. Z 1 ' Floor! lWard Zone U Shoreline Kinagement Area Sl OP c,' Soil; Vegetation w Strenm, Creek.. Drainage Basin 00, W, Sting Zoning Per Cade �S• �� r� Amenities Design Board Approval Reqd. _1_40 ADB # Approval ✓�( Board of Adjustment Approval Reqd. 'TIO Review By: _ — Existing Water Main Size Date: Water Main Reqd. Service Line Reqd. Hydrant Size Existing - Hydrant Rcqd. Per Fire Code Size A Detector Check Meter Reqd. jCross Connection Inspection Fire Department Coninents Water Meter Charge Rcqd. Rcviecv by: - Date: �2 ZY/ •�"� f'► i� 3�� 3� i��.��'Lr .S�ill�il� ���i.S. �.L �����C R Septic i1�.. .;! l�aiUc 1ksipi approve jQ lute: ,J p l Septic Tank Permit Reqd. j®. Permit No. ►J �.�. 61 Sanitary Sewer Availability Proj . . � ys� t� �Q. Drawing No. (� ��'7(� � ��) File No. P• �� � Side Sewer Availability c•� �,p, Nr ��a,i_e CO Sanitary Scxver Connection Fee Reqd. �90= Review BY: , O! Date • �_ •- T O CD( `1 -_ Z STREET FILE f�. CITY �q �p HARVE H. HARRISON ' �.o� Y �� E�1�,®AEG® ,J! % MAYOR 200 DAYTON ST. • EDMONDS, WASHINGTON 9©020 • (206) 711 3202 OFFICE OF THE CITY ENGINEER May 5, 1983 Gene Cornelsen 905 Bell St. Edmonds, Wa. 9802.0 Dear Gene: SUBJECT: 16216 N. MEADOWDALE BEACH ROAD � I/ / The subject house will be permitted to hook into the new sanitary sewer that extends down North Meadowdale Beach Road. The costs for this hookup will be the unit price for "extra side sewers" and the necessary appurte- nances, together with the standard hookup charges. if-1/st Sincerely, I � JAMES E. ADAMS, P.E. City Engineer JerryjHauth, Dt 0 Side Sewer Drawing The City of Edmonds EASEMENT NO_ ____________________________________________ NEW CONSTRUCTION REPAIRS FI LID NO . .................. . ASMT. NO - ------------------- OWNER&we .... Co-nnel.sem •----- VI CONTRACTOR . ......... C) W ................................................. PERMIT NO. -------------------- ................. JOB ADDRESS ..... ....... . ................... BLOCK'NO. ................................ .... Kea� Mle. tN(MGAL DESCRIPTION: LOT NO . ..... .................................................................................................................................................................. NAMEOF ADDITION ----------------------------------------------------------------------------- 7 ..................................... PWW-0001-il/.75 (REV.11/78) Approved: .. 7T DATE A U ..... I r)9.. -n 2- r-o M