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16320 70TH PL W
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ADDRESS:�(Q,3%�
TAX ACCOUNT/PARCEL #: Dp(Q3 (Q3 p� (.QOO
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
CRITICAL AREAS #: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENTS) RECORD FOR:
PERMITS (OTHER — list permit #'s):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED: Gj S
SIDE SEWER PERMIT(S) #: �j 1
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
The City r Edmondi.
APPLICATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS ❑
EASEMENT NO - -------- -------•------------- -------------
LID NO. .................. ASMT. NO- ------------------
p�-A..TTEO SEW�.FZ.
OWNFk •---TNE---Ial.--1�,QICJ�-CQNj-----N- CONTRACTOR PERMIT NO. 511...........
JOb ADDRESS ----- ...r... 75PT-------- PLC w............. LEGAL DESCRIPTION: LOT NO. ----------------
-------•---•-----•- BLOCK NO- ------------------- --•-------••---...
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,10
-----...•••--•----•----•-------•-----•-•--••--•---•------•-.---••-•--••----•------------------------•. ...........................................................
NAME OF ADDITION ----- WEST MOUNT------------ V IE`�1....
Approved:
DATE BY- �`•---- G;�=?�
•-
�' •�5 � $ F tie' � � � i�' txi*)� � , � � a�� +'� _ F �.� t i` $�'� �'� ''� �n' i,, � - i . ;-;�
v a CITYd ; OF YE iIT, } 1 IDS aStl'DE �EWMERf, ]PER�M 1T
a W''ATEWSEWER',DEPARTMENT2'
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lry
♦PERMIT
k d?� ✓' k � � �{ t _ t ?.!m�sX..,p•Lt, � i�d 1;- t C7� (x (•.
>,d, Yt f ' t/�Callj 7,73 252St for side=• ewer inapectlons! •RI NORE.t covering any porn' of :the construction
+. .,. \Inspection wiles.belPprovideq %within 24"•houra�'after •requsL ,NO, Sat., :Sun ,'or'holiday :.inspeetlons.'j - A
•.r
A' `RESSL+�OCATIONOF° CONSTRUCTION
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P PERTY BEGAU DESCRIPTION I.:r7I ?EEi• tic�rf mfai�s� Vi Alp ni ,- � c3 n;t_ in............................................
.: .. OWNER AND/OR BUILDER. UP -RIM
R11 T 4 C r7
CON.TRACT.OR SNiA�MEE& •ADDRESS-:I�ni''?.r.1.� kP.•_Cf3P�PP'fai P-:�i9iih •. 7 �i��4 iZ:t r .. :Wnnrii n�r� l l a. WA.:..
Permission wgranted, la+�tt�ro!. 7...... ...... ; 19: jh., for repair. and/or coI°inection 'of ♦'side: sewer.tto the, city -sanitary: sewer,
ssy tetninaccordanee;with'.City of:Edmonds{:ordinances: )
c A ziTION$ISiCA�'LED TOI,THEi FOLLOWING:
? BNOTE�^No r;T....h��ee••••...•••�..."""owners of. -the?.property.. ma.y. obtain a. permit to, construct sewer - Inside property line.: ;A licensed, Side. Sewer: Contractor must ,be empd loyeto_�consiruct
a >�sldetsewer!in atreefxarea.( D'onotcover any portion ;of sewer. before iL has been;inspected., y' • ':�
$NOTE�Nya 2� All work ;performedPinGclfy,:right-of-way-•requires• anJnvasioni dfr'Rlght of-Way^Perriiit. obtainable• froth, thetClty •Engineers office., _ k\
NO,TE�No 3' :Obtain{ fulli infor-matfon;;regarding •Ordinance> 1.1:18:030`. and• Regulationai governi�g•side- sewers;:whsn:�you get:'pertnit • - �3
NOTEiNo .4'.Tope`ofasidensewer,must.,have.'at"leasf`30 inches:coverage,at:property llneia.nd 1211nchesl:ln.We;;property line;, minimum'gradesof.2.j,;% No,•bendstiin grade
,Zsharperlthan ',4,i wilit,be: permitled� - -
_ 4 IVOTEI No:C5--Tienchesidn{'street+:mush,,be _water':settled' and-:aurfiiee ",of street`restored, to.:originair•c6ridltiom , -'Contractor♦ ishall.,be responsible•, for• failure• due-to"ilmproper,
:work, which" may„develop; within.. one: year: -of .completion: - - t • _. - - .: - - - ` •-' '
NOTDf No - 6—It-ia ,uNawful ato •alter:oi •dbj; y .other •work than'is,;proyide&,for in •ehe�.permlt ;;or; to do>any work: on the main sewer, or.its,,appurtenanceat except to, in=_I
'serU thelipipe, into -:the .wye 3
T) PPROVEDi1{I'd f Date . By ]t)'ate r; �a By Date By ;
xx
r77
SG �APPROVED3 ? " / Date:- e ,�-.... o-...�d ,.,.Byre
-;per°°"'•` • d i s . >
2 e, ;t`Reiiiarks r.:-...... ...
s S........ ...:. ....................... :.... - .... - .. ..
...... ...... ....
=' BOTH�Pern it Copies MUST "Be+'Signedi�By !Owner of Firm Performing; (Construction' PRIOR' To.Meque_st. For I•rispection'.,
.fA - " � �� 4.ft. ....... hereby certify that' the_ iside sewer Installation',,constructediunder this Mit
F c ..-
+ - l a c-(Ownerf'iContracting- Firm •Pe forming •Conatructinn•) _ - _ - - -
tbi—tt tallea6int.aceordancewith;a71!•governing, ordinances -of ,the -:City: of''Edmonds:
..
��., u+
Dated this:. .....day of•;:; ,v v ..,,19'--!�•
T JS y' g ❑ ❑' P ❑ 0❑❑! J J -
Check BEFORE ou di for Water t Gas{ Tele hone Power { Sewer Other; {
7 '
`
The City of Edmonds
APPUCATION
SIDE SEWER PERM
NEW REPAIRS []
-''--'----------------------------''--'--'--------------------
'.` �
PLANNING DATA
SINGLE FAMILY RESIDENTIAL
STREET FILE
Name: i/� ZI ,C- S _ C:!—D = o0 363 OooOA6op
Site Address: 1.6 3 ZQ 70 �IqC�
-Date__1r 1 3
Plan Check
Project Description:
Reduced Site Plan Provided: ES NO)
Zoning: S- ( Z
Map Page:
rner Lot: / O)
Flag Lot: (YES
Critical Areas Determination 1#: c_ �( S
❑ Study Required .
V:LNaiver
_
SEPA Determination:
(Exempt
❑ Needed (fog over 500 cubic yards of grading)
❑ Fee ❑ Checklist ❑ APO List with notarized form
Required Setbacks
St[w:
L 2S
Sid
� �0
Side-
�G� I
Rear:
///z
_
Actual Setbacks �odecTES
Street: S 51
Side: 2
Side:
Rear:
❑ Detached Structures:
❑ Rockeries:
❑ Fences/Trellises:
❑ Bay Windows/Projecting Modulation:
❑ Stairs/Deck:
8uildin Height
Datum Point: ---
Datum Elevation:
Maximum Height Allowed: Z S
Actual Height: •
Other
Parking Required: __-- -
Parking Provided: --
Lot Area: j Z, (Z
Maximum Lot Coverage: 35% Proposed: Z�,
Lot Coverage Calculations: ffovSe ti Z Soo 4- o&Ck-S �"� /c904 + `100 �= '" 36004
ADU Created: (YES
Subdivision: p U� I/jt J �(-V on V I (' (�✓ / (/ / s(�/1 �1—
Legal Nonconforming Land Use Determination [ssued: (YES O)
Comments
Plan Review By: K (vq d/\ ([ (3
Planning Data Form 04-1t-06.dm
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101t OF EDMONDS Permit No.fL
COMMUNITY SERVICES DEPARTMENT
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date
A. • Owner
Washington Natural Gas Company
Name.
815 Mercer
Street
SeantfLleddress WA 98111
City
State Zip
STFIEET
FILE
B. • Contractor:
Name
Mailing Address
City State Zip
State License Number Telephone Number
C. • Address or Vicinity of Construction: 16320 70 Place West
Type of Work to be Done: Install New Ser6ice
D. • Work in Connection With: ❑ Sub or Plat ❑ Single Family ❑ City Projects
❑ Commercial ❑ Multifamily (A Utility
E. • Pavement Cut: IM Y ❑ N F. • Size of Cut: 2 X 4 (2) @ Gas and H20=
APPLICANT TO READ AND SIGN
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, 7 that may
be made against the City of Edmonds, or any of its depart;W P' ploo s-, jfidMdin�/ctr, not limited to the defense
of any legal proceedings including defense costs, court costs; rid 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 andthat this permit must be available at the job site for inspection purposes at all times.
Signature: A 4G',AA 04A J Date: November 2, 1990
Owner or Contractor
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY: f3W
Time Authorized: Void after -SA 3O TM ems.
Special Conditions: N
RELEASED BY
PERMIT FEE:p� C2-40 ,ram—
Restoration Fee:
Receipt No.:
Fund 111 Fee: —
Street Cut Dimensions: x = $
Date 1 17_1-1 / 0 INSPECTED BY
Date
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
'Frig. Div. March 1989
FIELD INSPECTION
(Fund II I - Route copy to Street D4.)-
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 1985
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proposed
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Addendum to:
City of Edmonds
Permit Application
Engineering Aide: Kerry Walsh
Washington Natural Gas
622-6767 x2761 e
47
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Key:
-s- sanitary sewer
-w- water
-g- gas
water valve
hydrant
815 Mercer St. (P.O. Box 1869), Seattle, WA 98111(206) 622-6767
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APPROVED BY PLANNING
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Zone 2S
Corner
Setbacks
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UIT'i OF EDMONDS
_M EN Z i E S RESIDENCE
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