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16317 70TH PL W.PDF1111111111115533 16317 70TH PL W 8- 77rc��' FILE INSPECTION RECORD CITY OF EDMONDS, PUBLIC WORKS DEPARTMENT DATE: PROJECT: 1-7 -%p� -\DL S.W. :53 kTa- T&)saa.LTnom c)4 -(o�v\ 8mvxu CcA 'ni0 6Y : 1/781V - 14 STREET FILE 0 MEMO TO: FROM: SUBJECT: DATE: a 111 Building Division .. Community Development Department Engineering Division Public Works Department w fir 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. (2) The contractor is required to keep the abutting streets clean- ed ot dirt and debris caused by the construction. (3) A "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. PW 5/77 Driveway slopenot • exceed CON ► E SEW& ' N - 1 PUBLIC WORKS DEPARIWCKLIST . BUILDING PERMIT '&0I r I ILL (address). to Street Right -of -Way Existing REQD z N Access Easements Existing Q ( REQD p,, Utility Easement Existing _ � ' , L REQD w Lot Per Subdivision r Plat Assessor .Map ^ w Site PlanChecked for Accuracy z Underground Wiring Reqd. N Check Accuracy of Legal Description z Review by Date w Existing Water Main Size $ "D f- Water Main Required --- Service Line Required Hydrant Size Existing —' c4 Hydrant Reqd Per Fire Code Size w Detector Check Meter Reqd. A-'O Cross Connection Inspection H Fire Department Conments 3 Water Meter Charge Regd. Review by Date /ery Septic Tank Design Approved Date Septic Tank Permit Reqd. u Permit No. Sanitary Sewer Availability Proj. �>Il Drawing No. File No. Side Sewer Availability. *'M e- w Sanitary Sewer Connection Fee Reqd. 3 Review by Date / 78 w Open Ditch Existing /f// Regd. Culvert Regd. Size c4 Catch Basin Reqd. /Lr/ Indicate on Site Plan O Shoulder drainage maintain collection on swale open runoff H `n Manhole reqd. Indicate on Site Plan Soil Conditions and Ground Water Field Checked Review byti ; Date Revised: 1v10-1977 Page 2+- Street Paving Reqd. H Curb and.Gutter Reqd. W` Sidewalk Reqd. w Curb Cut for Driveway Regd. ' I c� Right -of -Way Construction P rinit Reqd. H Bond Reqd. for Public Impravements Street Name Sign Reqd. cn Other Signing Reqd. 0 A ._. Pre Permit Site Inspection made on z BY: SEWER H � �a w WATER a H z STREET fd' F-1 ENGINEERING I I Special Requirements listed in mean to Comrnmity Development Department, Building Di�v}ision BY r�� N Date o4lo All items filled in an Building Permit Application i w BY Date ` a' Drawings Stamped and Notations Made w BY Date Approved by Public Works' Department CITY OF EDMONDS PUBLI OORKS DEPARTMENT, ENGINEEOG DIVISION S� EET FIMPLICATION FOR RIGHT-OF-WAY CONSTRUCTION PERM THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES Applicant to Complete Parts A and B A, Permit to be issued to: For Work. at :(address or vicinity) 1 Type of Work to be done: C_ t,- (attach drawing when applicable) Time Required -- Start: V 7 Owner:Iff_r Name Mai1in�Ad�ress City State Zip Contractor: Name Sor 4 -r & Mailing Address City State Zip c ze�. 7 7 iVe- Lua-V Finish: _141VI-12 / _? ly 7 ? 6 - z7z Telephone Number State License Number Telephone Number B. 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, foreseen or unforeseen, that may be made against the applicant or 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. 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 subject to inspection and restoration in accordance with City Code. A 24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220. I understand that this permit must be available at the job site for inspection purposes at all times. Signature: Date: Owner or Agent C, TO BE COMPLETED BY ISSUING AGENCY: Date Issued: ` Permit No.:on Fee: Security Bond: Time Authorized: APPROVED B Date: 11-117-V_ 10-771v (Revised) c i PUBLIC WORKS DEPARTMENT CHECKLIST BUILDING PERMIT REVIEW ez (address) to Street Right -of -Way Existing 60 /45 c) REQD NA z Access Easements Existing N Q N H 04 Utility Easement Existing tS.�N REQD w Lot Per Subdivision r Plat Assessor Map ^ w Site Plan Checked for Accuracy z Underground Wiring Reqd. , �. H Check Accuracy of Legal Description z Review by Date w Existing Water Main Size 9 "D f- Water Main Required --- Service Line Required Hydrant Size Existing c� Hydrant Reqd Per Fire Code Size w Detector Check Meter Regd. A-D Cross Connection Inspection Fire Departnent Conments Water Meter Charg Reqd. 29© Review by Date /� Septic Tank Design Approved Date Septic Tank Permit Reqd. _� Permit No. Sanitary Sewer Avail ility Y.Gs Proj . �Jl Drawing No. File I�To . Side Sewer Availability ''lam H k e w Sanitary Sewer. Connection Fee Reqd. 3 Review by Date / 7� w (n Open Ditch Existing /lam/jf Reqd. Culvert Reqd. Size w Catch Basin Reqd. Indicate on Site Plan 0 Shoulder drainage maintain collection on swale open runoff//- H " 1�ianhole regd. A / Indicate on Site Plan ; Soil Conditions and Ground Water Field Checked ` Review by�� r� ` =;�, ; Date — Revised: 1v10-1977 BUILDING DEPARTMENT PERMIT APPLICATION Applicant Fill Inside Heavy Lines USE 1 PERMIT ZONE A v NUMBER ADDRESS - (Ivl W NAME (OR NAME OF BUSINESS) Q LEGAL LOT MYES ❑ NO I LOT AREA SUBDIVISION NO. ��:�- V/ 0 pj Z Q MAILING ADDRESS O QU IU. STREET R/W EXISTING STREET R/W �'O FT. DEFICIENCY THIS PROPERTY - COMP. PLAN ST. R/W5D FT. FT. CITY s ELEPHONE NUMBER 7?6 - S6S F U NAME /.� REMARKS Z W iIP0CITY ADDR SS c 9�/ CHECKED BY W TELEPHONE NUMBER STREET AND/OR UTILITY WORK REQ'D. ❑ YES WNO R/W PERMIT REQUIR ❑ YES VI NO Z W NAME ��w UNDERGROUND WIRING REO'D. -&YES ❑ NO 0 ik Q A DRESS /V /�� U� TYPE CONNECTION *YES SANITARY SEWER ❑ NO VERIFIED BY Ir F- 0 CITY I�y! TELEPHONE NUMBER (�b I� _/S6-5 SEPTIC SYSTEM ❑ VES APPV'D BY CITY ENG. TONO PERMIT NUMBER - STATE LICENSE NUMBER — CITY LICENSE NUMBER REMARKS U Legal Description of Property (Show Below or Attach Four Copies) METER SIZE /f BUILDING SUPPLY SIZE W H REM R S Q Z t1 3 SIGN AREA _NV. REVIEW ADB NO. C ALLOWED PROPOSED COMPLETE EXEMPT U W W 0 J Q REMARKS U W J VARIANCE OR CU PLANNING REVIEW BY DATE YARDS F' �5 FRONT © SIDE REAR LOT COVERAGE - NEW RESIDENTIAL ❑GAS LINE ko FIRE ZONE TYPE OF CONSTRUCTION CODE HEIGHT ❑ NON-RESIDENTIAL ❑ SIGN ADD - ';' ❑ DEMOLISH ❑RETAINING ' WALL ❑, ALTER ❑ EXCAVATE i ENCE X-�) OR FILL SPECIAL INSPECTOR AREA REQUIRED ❑ YES ❑ NO OCCUPANCY GROUP OCCUPANT LOAD PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY PRE -MOVE swim REPAIR 1:1 INSP. El POOL OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. REMARKS 1. NUMBER OF STORIES NUMBER OF / DWELLING Z UNITS W F NATURE OF WORK TO BE DONE E Q L W 0 PLAN CHECK NO. VALUATION FEE Z 0 OF. N W 0 m 0 F- Z W L J > W 0 PROPOSED USE ow PLOT PLAN INDICATE BUILDING SETBACKS, ABUTTING STREETS) BUILDING PLUMBING HEAT Be GAS LINE FE14CE F Z SIGN f ' RETAINING WALL 0 U SWIMMING POOL 4 APPLICATION The City of Edmonds `:r"' for g �s SIDE SEWER PERMIT EASEMENT NO_ -------------------------------------------- L NEW CONSTRUCTION E REPAIRS ❑ LID NO_ .................. _ASMT. NO................... OWNER R N ...--L— ---------------------•------•--•--------•----_--._-. CONTRACTOR .... ..... 1-at�!�,��t�1 PERMIT NO. JOB ADDRESS --« 77-7? PL ,-w .........--•..................• LEGAL DESCRIPTION: LOT NO. ----••------- �---------•-------- BLOCK NO.-----•----•------------.------------ ....---.••...•-•---•-------•-••------------••• •-----•-• •-------------• •--•--------------•-•-......--•-------------••----•---•-•-•-•----------•----•-•••--•--.----- NAME OF ADDITION ... ___•._1�u11�>N_*k.___. �3 —T� • i Approved: DATE ... BY - 1 1 /75 4'�CIaTiY;.'O,F_yEDM10�NOS,'=- MOEr SEWME- PIERMIT z' •, }4 ,WATEWSEW.ER, •DEPA`RTMENT' HEET-FILPERMIT 4 �'9 Calk i776 2626� for side aewer, 'Inspections, BEE- cover1%.any •portion -af--the .4., construction 1. - .«;, ` `•:�•:'*' \•InepectionFwlll,'be provided within-24'-hours• after.requat NO•;Sat, Suq.�. or ,holiday lnspeatfons /x f , ADDR''ESSfL>OCATIONfi'OF CONSTRUCTION A : 1,•` �!•• . r ti PRUPERTri'�,o' G&L•:DESCRIPTION 1..>"� :•• ��' c' , q ,r c'... ..................................... ........................................:+ :. l ;.i.:-..1... ... P:. ..77 OWNER' ANWOR 'BUILDER-c. ....r. -1 CONTR'AGTdOR14SINAMEL &.ADDRESS .................).. ~. - } for repair and/or 'connection of 'a. side sewer 'to,.,the city, sanitary sealer' ?P,erinission�isegranted !% ...:......:.... ............. syp --j_ W!L oor`danoe.with,.City:of%Edmonds ordinances ATTENTION(I81"CAtLLED�TO THEI FOLLOWING: ed to constrtict NOTES-No-]=TheC.owners:ot',theiprope_rty.,;ma.y,:,obtafri.a'permft to co,istruct'-sewer inside,property-dine 'A•llcenaed'$Ide Sewer Contractor must�be employ, '� ^x, ' �sldesewertlntstreeYarea not cover.any portion of,sewer-before -.it - ha's;been,lrispected. - -- _ n [ .NOTE�No 2 ,'d11Rwo��k',performe&in- city. rlghf-of;.way,�requirea an Invasiom:ot FtJght-of-W.ay,•Permit obtainable from •the City Engineer's. office r x J•NOTEk�No,3—•;Qbtalnrfult•lhformatlon.regaiding..Ordlnance. 11'.16.030; and RegulaElons governfng<side•lsewera when you,•get permit -- NOTE`•No�r4-Topnof=tilde•aewer:•must�hsve:at'•least`30. Inches coverage at property line and 12�'Sriches Inside' property ]Ins-minimum',grade of 2%NoA'Ibends(in ;grader. ha:iper.tithan;''�¢�,will.be..permltted. .. - .•, , - i - j/ 'NOTEliNo S=T�enche'si in• street •must -,be' water settled - and surface :of street restored -to; originak, condition., ';Contractors shall .be% responsible for';failuretdue�to 'improper �, rw work: which may';develop within one otheraworkCthaneleoprovtded�-tor in 'the permit i,or !to fdo any work one the; main! sewer• or its`�a.ppurtenancess{except;da�irr-•- NOTDP+Not'B—IU IsNnlawful• ioLalter or doiany, t (•eertgthei,pipe Into;;the O ED,., , ti Date:.: gy Date �e .: By .. .. , DISAPER ,�' .. ❑, t Date BY } ;By.•-_: ::............ APPROV�Epf ' ,. u inarks ?T r :;``• �'• ...... a L.................................... - - .. - BOTIi Permit C pies MUST"Be• Signed By Owner',of Firni Performing,'Constructioir.PRIOR' To Request For +Inspectiorn I hereby certify that. the:s deasewer installation constructed) under 161 this permitl� i der fra�ing Firm Performing Construction), �3 wainstalledrin�accordance;with a]gover ning r-ning ordinances`,of the;.Ctty of`'Edmonds of Con Dated 'this:, day, of•. „�,.. a��. ❑ Other ❑y,� Check BEFORE yoti dig, for: Water ❑; Gas- Telephone ,❑,. 'Power';❑ 'Sewer ❑, hl . E :. APPLICATION The City of Edmonds ~ 3 for ' SIDE SEWER PERMIT NEW CONSTRUCTION Ej/ j� OWNER --- �9N1------ C�7/ 6L- �2"---------------------------------- "la(- JOB ADDRESS ----/ 3(•// ..---------------2-Q-.......... s 7 ------ 1n u is 5- / r CONTRACTOR EASEMENT NO . ............................................ REPAIRS ❑ LID NO . .................. ASMT. NO. -.-.--------.----- . 5---•-•- �..1 ................. PERMIT NO. l LEGAL DESCRIPTION: LOT NO. ....--5.......................... B . -----------.---------•----------•--- NAME OF ADDITION -•--- .Jll1Ql.V------.1/...------------ DATE............................................ BY............................................................ 1 1 /75 iw STREET FILE Raw 15-0 1fo3i1 `��"��:y,:�^�?�3a1,i�;�C,��-•� Y, '{' � � a .v- iU"7•�.`Yflfit�'��+Y�YK�N.,.,c,�„�3�q �'k�°o-yri�',i�r v�.i.'L�'�'�..�''1E..; %::/�4i '.', .,�' City of Edmonds RIGHT -OF -WAS °CbNSTRUCTION Yry `r •' i "E Permit Number. '/ LE Issue Date: ' A. Address or Vicinity of Construction: 16317 70th Place W 18 9 c� B. Type of Work (be specific): GTE to pl ace tel eOhone service wi re f rom Ped #2839 r 0 - 1 under driveway then push pipe un er 10th P1 W. Appros 35—foot r.o:w. mary bower, permit coordinator C. Contractor: GTE NOrthwest INcorporated Mailing Address: 22118 20th Av SE, Suite 130 State+c> bxMsa#x Bothell , WA 98021 D. Building Permit # (if applicable): Contact: Mary 206/488-1628 Phone: Engineer: Bill Jira 206/823-6683 or 669-5716 Liability Insurance: Bond: $ Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project ❑X Utility (PUD GTE) WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other 2100-9P001 DB`� 242310 INSPECTOR: INSPECTOR: W LN r F. Pavement or Concrete Cut . ®Yes ❑No G. Size of Cut: 4' x 2' H. Charge $ APPLICANT TO READ AND SI N' INDEMNITY: Applicant understands and by his signature to this application, agrees to hold th C%t Of Edmonds har�s f+4 itiju4s�emages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against a 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 FOR PERIOD OF ONE YEAR. FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATIOMF-E �IZ7j BE HELD UNTIL T.HE EINAII S'`REET PATCH IS COMPLE?1E6BYCITYFORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCET6 THE APPLICANT. i 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 and understand the permit requirements and the pink copy of the permit will be available on site at arzs for! �ses. Signature: Date: March 31, 1995 (ContrautorUeAg&nt) J. H. Stewart, Oprns Supv-OSP Engrg. CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: t ►� Ly RIGHT OF WAY DEPOSIT TIME AUTHORIZED: VOID AFTER JU^1 G 10 DAYS DISRUPTION FEE/FUND Ill: ' SPECIAL CONDITIONS: RESTORATION. FEE: Po On te- 8" 5AtvtTA1%Y AUS0 PERMIT FEE: TOTAL .FEE: COMMENTS: RECEIPT FEE: 1 DATE: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 a A FIELD INSPECTION NOTES Comments 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: PEFUT SUMMED BY GTE 16317 i 3 t FA -------------------------- 70T" PL W (k�- ----------------------- J-ac-: WATER 4X2 POTHOLE PM Pan O OIRES � a OVEI�� LEES LIL UTILITY POTHOLE Q UG TFIENC --- UGT— r R.O.W. -=--=_---------------------------- EOP F%xir% Li PUSH 35 _ ------------- ----- --- -- ------ - ---- -31 PE D Z$39 DRI v r- vvAY PUSH 250 a THE FOLLOWING D FO TO BE PROVIDED . RIGHT OF MAY LINES.EOP OR FACE OF CURB. EXt$TING SDEMA�K, POLES„ ROAD CUTS AND THE UTILITY LMXR ROAD CUTS, ABOVE GROUND FACEITIES.Ree1 PEDS.8OXES.CA6KTS. ETCJMPtGMM. TRENCIONG AND OVEW" LOES.. FQOTaGE OF WORK IN R.O.W. E 0 LL PERMT S"TTED BY GTE - --- ------------- -------- 70T" PL W ----------------------- WATER 4x2 POTHOLF Pos POLES O ORES � a O JID LNES- uL ununr MOLE Q UG TIIDJD*C---WT R.O.W. . _=---------------------------- . FOP 36: PUSH ----------- ---- -- PEa 2839 DRIVEWAY PUSH 25" THE FOLLOWING INFO TO BE PROVIDED RIGHT OF WAY LINES.EOP OR FACE OF CURB. EXl$Tx►1GSIoEWAq. POLES,. ROAD CUTS AND THE UTILITY LOMR ROAD CUTS. ABOVEGROUND FACUTIES.000 PEDSoBOXESoCA604TSo ETCJMptGF4MIND. TRENCHM AND OVERHEAD LDS.. FQOTaGE OF WORK H R.O.W. PER#BT S"TTED BY GTE - 16317 --------------------------- 70T" PL W < ----------------------- J4-- WATER 4X2 POTHOLE PM Pam 0 �anR�w go Es v� LINES t1L UTLITY POTHME Q JUG tRENO"---4xT - - r t R.O. w.. ----------------------------- EOP ROAD 35` PUSH - - .�------------- ----- -------------------- PED 2839 _ DR[1C.1NAY PUSH 25" THE FOLLOWING IWO TO BE PROVIDED = . RIGHT OF WAY LMIESrEOP OR FACE OF CURB. EXI$TiNG SIDE-WM� c. POLES„ ROAD CUTS AND THE UTILITY UNDER ROAD CUTS- ABOVE GROIN? FACILMESA60 PEDSA0XESXA8R4M FTCJ=PtCi M . TRENCIMNG AND OYEMEA0 LDS.. F90TAqE OF WORK IN R.O.W. i t R.O. w.. ----------------------------- EOP ROAD 35` PUSH - - .�------------- ----- -------------------- PED 2839 _ DR[1C.1NAY PUSH 25" THE FOLLOWING IWO TO BE PROVIDED = . RIGHT OF WAY LMIESrEOP OR FACE OF CURB. EXI$TiNG SIDE-WM� c. POLES„ ROAD CUTS AND THE UTILITY UNDER ROAD CUTS- ABOVE GROIN? FACILMESA60 PEDSA0XESXA8R4M FTCJ=PtCi M . TRENCIMNG AND OYEMEA0 LDS.. F90TAqE OF WORK IN R.O.W. i 04/19/95 18:46 N0.404 Vol .. , Citp.of Edmonds HT -OF -WAY CONSTRUCTION aaR 1 19$5 PERMIT �T, 5=02, FAX MESSAGE APR; Z p 1995 - 'FNG�I�F�r�liVCa TO: d NOTIFICATION OF IS -WIRE JOB VART PERMIT if i ADDREM 1' Q lr , TF- 0