16423 72ND AVE W.PDF111111IIII lillIII III5605
16423 72 N D AVE W
BACKFL
CEM
NOTE:
1" COPPER CONTINOUS
FROM METER TO HOUSE
PLACED IN ORIGINAL TRENCH
1" PLASTIC PIPE REMOVED
BACKFLOW UNIT INSTALLED
FOR FRONT YARD
SPRINKLER SYSTEM
., 0 F ED&_
F
INV
CITY OF EDMONDS WATERLINE AS -BUILT
d ADDRESS: WATERLINE
� 16423 72ND AVE W NO. UNKNOWN
CONTRACTOR: HOMEOWNER: SCALE:
UNKNOWN UNKNOWN NTS
DATE INSPECTED: INSPECTED BY: DATE DRAWN: DRAWN BY:
4/04/02 D G 9/ 12/06 1. AB I LA
The City of Edmond �,. • FL side Sewer Drawing
��� "`� EASEMENT NO.
NEW CONSTRUCTION REPAIRS ❑ LID NO_ __________________ ASM I'. NO. ------------------
OWNER ----- C_la.ir.--- -U-hlla- ?----------------------------- CONTRACTOR ------ c>wne—v-r'--------..--------------------------------------_-_-_ PERMIT NO. .---................
JOB ADDRESS ----- 'L /'T ve � -W -__ LEGAL DESCRIPTION: LOT NO. BLOCK NO.
+cs C&I in pticted __ For . sue - ScAimr
Iowa
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----------------------- -----------------------------------------------------------------------------------------------------------
NAME OF ADDITION --------------------------------------------------------------------------------------
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_.... Approved.:
WM-Wl-11175 REV.11/78 DATE .... - ��.......... B .-
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BUILDING DIVISION
PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
C MAILING ADDRESS
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NAME
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USE n P IT
Applicant Fill ZONE f�GN ER
Inside Heavy Lines JOB
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LEGAL DESCRIPTION I SUBDIVISION
LEPHONE NUMBER
LEPHONE NUMBER
ELEPHONE NUMBER
ow Below or Attach Four Copies
SHORT SUB NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING
PROPOSED
DEFICIENCY OF RIGHT OF WAY
PUBLIC IMPROVEMENTS REQUIRED
❑
DRAINAGE IMPROVEMENTS REQUIRED
❑
DRAINAGE PLAN REQUIRED
❑
UNDERGROUND WIRING REQUIRED
❑ '
CONNECTION TO SANITARY SEWER
❑
SEPTIC TANK PERMIT REQ'D ❑
NO.
ELEVATION OF PROPERTY CORNERS
❑
& FOOTINGS REQ'O
SEE ENGINEERING MEMO DATED
CHECKED BY
,/I/
METER SIZE I BUILDING SUPPLY SIZE
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SIGN AREA
ENV. REVIEW
ADO NO.
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ALLOWED
PROPOSED
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EXEMPT
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REMARKS
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VARIANCE OR CU
PLANNING REVIEW BY
DATE
YARDS
LOT COVERAGE
FRONT
SIDE REAR
NEW
RHSIDHNTIAL
GAS
LINE
FIRE ZONE
. TYPE OF CONSTRUCTION
.CODE
HEIGHT
NON-RESIDENTIAL
El
SIGN
ElRETAININGRETAINING
El DEMOLISH
SPECIAL INSPECTOR
REQUIRED
❑ ALTER 1:1 ORCFILLTH
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WALL
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El YES El No
PLAN CHECKED BV
REPAIR PRE-NSP.µOVE
swim
POOL
REMARKS
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NUMBER OF
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a NATURE OF WORK TO BE DONE
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PLAN CHECK FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
W successors in interest, agrees to indemnify, defend and hold harmless
J
g the City of Edmonds, Washington, its officials, employees, and
agents from any and all claims for damages of whatever nature,
arising directly or indirectly from the issuance of this permit. Issu-
0 ance of this permit shall not be deemed to modify, waive or reduce
env reouirement of any city ordinance nor limit in any way the
BUILDING
I
F�
4 OCCUPANCY OCCUPANT
GROUP LOAD
._J
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
VALUATION I FEE
PLUMBING
MECHANICAL
FENCE
SIGN
RETAINING WALL
SWIMMING POOL __
DATE':
1117,110 TO: RIIII(IiTIFII
Community Development Dcp,,.irLmc,,jc
FROH; Eri�,ineerj.rip, Division
Puhlic I,Icirl--,s DeparOmen t
SUBJECT:
revic,.,7 of the sl")jc'CC "i1cliTIP, PeMiL 11)Plic,--iLion, have
Clio F-0110winli, COMUCIILS:
I.JAU� =(',I
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PUBLIC WORKS DEPARMM CHEacusT
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BUILDING PERMIT REVIEW t 14 1-7---�2 Z —�' �►�� W I
(address)-,,,((ddaate
Street Right -of -Way Existing
READ
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Access Easements Existing
REQI)r
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Utility Easement Existing
/REQD
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Lot Per Subdivision Plat
/,,L sessor Map
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Site Plan Checked for Accuracy
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Underground Wiring Regd.
N
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Check Accuracy of Legal Descrj�ptlm*
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Review b
Date
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Existing Water Main Size
Water Main Required
Service Line Required
Y,
Hydrant Size Exist'
9
Hydrant Reqd Per Fire Code
Size-
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Detector Check Meter Reqd.
H
Cross Connection Inspecti I S REQU1�E�
Aai
'� qgQ ""'~ � s `�
Fire Department Conments
d
3
Water Meter Charge Reqd.
Review bye .. cc S ► - -;, k 3
Date 7 -Z -go
Septic Tank Design Approved
Date
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability
Proj.
Drawing No.
File No.
Side Sewer Availability
w
Sanitary Sewer Connection Fee Reqd.
3
Review by
Date
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Open Ditch Existing
Reqd.
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Culvert Reqd.
Size
x
Catch Basin Reqd.
Indicate on Site Plan
0
Shoulder drainage maintain collection on swale open runoff
H
U'
Manhole reqd.
Indicate on Site Plan
Soil Conditions and Ground Water Field Checked
Review by
Date
Revised: 1v10-1977
Page 2 •
H Street Paving Reqd.
Curb and Gutter Reqd.
w Sidewalk Reqd.
w Curb Cut for Driveway Reqd.
c4 Right -of -Way Construction Permit Reqd.
H Bond Reqd. for Public Improvements
Street Name Sign Reqd.
ti
Other Signing Reqd.
A.. Pre Permit Site Inspection made on
z
a off BY: S&gEER
w w WATER
a
En
1-4 N STREET
ENGINMRING
Special, Requirements listed dri memto Comaamity Development Department,
Building Division
BY- Date
o All items filled in on Building Permit Application
rx BY Date
a' Drawings Stamped and Notations Made
a' BY Date
Approved by Public Works Department
Revised: lv 10-1977
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mn 15 _Z
7`77 FT.75�F
BUILDING DEPARTMENIW Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
NAME (OR NAME OF BUSINESS)
W MAILING ADDRESS
CITY TELEPHONE NUMBER
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NAME
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NAME `` Q�i j�
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ELEPHONE NUMBER
LEPHONE NUMBER
NUMBER
a"(P-al Descri' . Property (Show Below or Attach Four Copl
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USE
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PERMIT
NUMBER -� •I �
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JOB
ADDRESS
LEGAL LOT
LOT.,AREA
SION NO.
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OR
COND. USE NO.
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PROPOSED YARDS �'
/FRONT
HEIG FIT
Z
SIDE REAR
2
Z
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ALLOWABLE
PROPOSED
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SIGN AREA
SIGN AREA
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OTHER
REOVIREMENTQb-�
PLANNING DE1PTT.' APPROVAL DATE
1 ► \ �� W V� r r
STREET R/W
EXISTING STREET R/ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. /W FT. ® FT.
REMARKSDrive ay slopes not to exceed those
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indicated on Standard Dw'. No. 103
it
CHECKED BY
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W
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STREET AND/OR UTILITY ElYES
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WORK REQ'D NNO
UNDERGROUND ❑ YES
WIRING REQ'D NO
TYPE CONNECTION VERIFIED BY _
SEPTIC SYSTEM ❑ YES PERMIT NUMBER
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APPVD BY CITY ENG.'Nt --NO
p;l
REMARKS
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METER SI E. SERVICE SIZE CLEARANCE C CKED
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REM KS Q
NEW RESIDENTIAL GAS
LINE FIRE ZONE TYPE OF
❑
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ALTER
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❑ DEMOLISH
EXCAVATE
❑ OR FILL
PRE -swim
NSP.
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SIGN
RETAINING
WALL
FENCE
( X_FT)
POOL
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SPECIAL INSPPECCTT9R
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❑ YES 111 N0
PLAN CHEJJKEID BY
R ARKS
NUMBER OF STORIES
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NUMBER OF
DWELLING
UNITS F
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NATURE
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REA OCCUPANCY JOCCUPANT
GROUPP LOAD
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THIS SITE IS LOCATED N THE CITY w
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31,04,
t7
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PROPOSED USE
VALUATION
FEE
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BUILDING
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POOL
I hereby acknowledge that I have read this application; that the In.
TOTAL AMOUNT DUE
/ J�
formation given to correct; and that I am the owner, or the duly author,
ized agent of the owner. I agree to comply with city and state laws regu-
lating construction; and In doing the work authorised thereby, no puma
ATTENTION
APPLICATION APPROVAL
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
relating t0 Workmen's Compensation I[uureace.
AUTHORIZES
This application is not a permit until
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
signed by the Building Official or his Dep-
, 11 be completed to ninety days; MOVED -IN BUII,DIN08 shall be OOID-
WORK NOTED
llty; and tees are paid, and receipt is ac-
pleted In six months.)
knowledged in space provided.
SIGNATURE (OWN OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
(�
• F-1 y �, �Q
MIA
CITY OF
IEC O 'S AIGNATURE
-
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-A ..1'-l.
EDMONDS
11 �M�J
NOTE: Applicant Subject to Plan Check Fee
DATE
775-2525
;
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
ORIGINAL -File YELLOW - Inspector
marquees, etc.) will require separate permission,
PINK -Owner COLD - Accnccnr
� STREET FILE S
lot"
-we
CITY of EDMONDS --- PUBLIC WORKS DEPARTMENT
Routing of Building Permit Applications
Proposed Property Address of Application:
16423 - 72nd Ave. W.
DEPARTMENT
COMMENTS
DATE
H A T E R
S 7' R E S T
it
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SEWER
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BUILDING
DEPARTMENT COMMENTS
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BUILDING DEPARTMES Applicant Filli
PERMIT APPLICATION Inside Heavy Lines
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NAME (OR NAM/Ev//OF B+//�
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MAILING ADDRESS
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CITY TELEPHONE NUMBER
G_EAU-Ec NA)A 99199
NAME
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ADDRESS
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TELEPHONE NUMBER
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NAME
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ADDRESS
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TELEPHONE NUMBER
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STATE LICENSE NUMBER
CITY LICENSE.NUMBER
Legal Description of Property (Show Below or Attach r Copies)
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NEW
RESIDENTIAL
GAS
❑ LINE
ElADD
❑
NON-RESIDENTIAL
❑ DEMOLISH
EXAVA
ALTER ❑ ORCFILLTE '
❑SIGN
RETAINING
WALL
� (ENCE X—FT)
❑
REPAIR PRE -swim
❑ NSP.
POOL
El
NUMBER OF STORIES
NUMBER OF
.Z_._
DWELLING
UNITS
I
NATURE OF WORK TO BE DONE
N�vv ICJ I Lai N v
Z
a PLOT PLAN INDICATE BUILDING SETBACKI
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USE PERMIT
ZONE NUMBER
JOB -
ADDRESS 16 7,D-
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LEGAL LOT
LOT AREA
❑ YES ❑ NO
,
VARIANCE OR
A
COND. USE NO. .
PROPOSED YARDS Public WUr
OWT
FRONT SIDE.. REAR
ALLOWABLE
PROPOSED
SIGN AREA
SIGN AREA
OTHER
REQUIREMENTS
PLANNING DEPT. APPROVAL DATE
STREET R/W
EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY
COMP. PLAN'ST. R/W FT. FT.
REMARKS
CHECKED BY
STREET AND/OR UTILITY ❑ YES
WORK REQ'D ❑ NO
UNDERGROUND ❑ YES
WIRING REQ'D ❑ NO
TYPE CONNECTION.
VERIFIED BY
ElYES PERMIT
SEPTIC SYSTEM
NUMBER
APPVD BY CITY ENG. ❑ NO
REMARKS
METER SIZE ]SERVICE
SIZE
CLEARANCE
CHECKED BY
REMARKS
FIRE ZONE
TYPE OF CONSTRUCTION CODE
SPECIAL INSPECTOR
'OCCUPANCY
REQUIRED,
JAREA JOCCUPANT
GROUP
LOAD
❑ YES ❑ NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD E CODED 31,04,
REMARKS
PLAN CHECK
NO.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
VALUATION I . FEE
RETAINING WALL
SWIMMING POOL
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Permit Address
�_ecal Description.
FILE, �-
al1ILD'ING PERMIT P,FVIEI,•1 - F"1GINFFRING DF.PARTOW
CHECK LIST
Reviewer's
Intials
?` 1. Septic Tank Svstem Design Approved%
2. Sanitary Sewer Availahi1ity� Sht.� of Dwg. No.
'Project: Side Sewer Availability: �L
3. Any Sanitary Sewer Connection Fees�tl
4. Site Drainage Checked 4AKH�Av
5. Storm Sewer Availability: Sht. ''"' of Dwg. No.
Project: Roadside Ditch-.
6. Grading & Final Contours
7. Sidewalks (Site Inspection shows condition of existinn vialks" as follows):
8.
9.
10.
-Curbs
- n
Curb Cuts �
Underground Wiring A.Street Lightinq
L11X
treet Right-of-wav &- RldqSetbacks:V�) ,Sht. f Dwg. No. of Official Street Map
12.. Existing Utility Easements .�
13. Access Easements/ •
14. Water Mains & Fire Hydrants (Indicate Size '.later Main)
15.
16. Special Requirement5�.1 sted in memo to Rldg. Dept.
17. Commercial & Apt.` Requirements form completed. 'ice
18. Drawings stamped & notations made
n
19. Site Inspection made on
20. All items filled in on R1dg. Permit Appli anion
21. This Lot included in Lubdivision O� _(List any special requirements):