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16928 73RD PL W.PDF111111111111 5813 16928 73 R D P L W CITY OF EDMONDS ULF ASSET INFORMATION SHEET lYJ NEW ❑ ADDITION ❑ RETIREMENT ASSET NO. t6'�? ;7S ADDITION TO ASSET NO. DESCRIPTION lam/ C /�✓ Lam/ SERIAL NO. LOCATION � ) PI—N. "" PURCHASE ORDER NO. PURCHASE ORDER DATE COST * PROJECT NUMBER PROJECT COMPLETION DATE O COST Ali, 4%-/7 B.A.R.S. ACCOUNT NO. �� SOD�`~ • UU • ESTIMATED LIFE e_—� 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 0 G.L. ENTRY REFERENCE b P INITIAL DATE VERIFIED BY PROCESSED BATCH NO. DEPARTMENT FILE .0 "-. t -... "T luu LU co 0 V7 V-ea -ftct t 5*+ tee) - 12Z6" + a0507 U-C). 0 V-4 fill b� t-04 6 4--YT - - t _ jj� �{ �� I • � I i � • V. K ; CITY of EDMONDS REcMVEQ SIDE SEWER, PERMIT For Inspection Call 771-3202I'M% MAY 111987 ST E'�_,. f 0%%695 Address of Construction: I C( 29WRIC ViPP-'�'.j— Property Legal Description ( Include all easements) : `•._m \\6�(,�5 v co 0 r Q% N •r a) W Owner and/or Builder: LYNNV'Vopo LINE Contractor & License No: - 3 'N Q Single Family Residence g Multi -Family (No. of Units ) 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 )(, Yes (If Yes, easement required, attach legal description and county easement number.) PLEASE READ THE ITEMS LISTED ON THE BACK I certify that I have read and shall comply Date with the items listed on the back. Permit Fee: 2 50-oo Issued By: �MG Trunk Charge: �J00 Date Issued: -g_g Assessment Fee: Receipt No.: Partial Inspection: Comments Date Initial Final Inspection Approved: "7 � A-4-� Initial Rejected: Reason Date Initial ** PERMIT MUST BE POSTED ON JOB SITE ** White Copy - File Green Copy - Inspector Buff Copy - Applicant The City of Edmonds Side Sewer Drawing EASEMENT NO- -------------------------------- ----------- NEW CONSTRUCTION k REPAIRS El LID NO_ ------------------ - ASMT. NO. .................. . OWNER DIASAXDY -------- = 5---------•-------------------- CONTRACTOR Q--c>-L?4--\A ....... ---------------------- PERMIT NO. C>-14-9-6- JOB ADDRESS j- (P-11�3 -77- 3- 9- 0 ...... R -1 -------- VC, ----------------------- LEGAL DESCRIPTION: LOT NO. ------------------------------ BLOCK NO. --------------------------- ------------- . ........ .............. ------------------------------------------------------------------------------- NAMEOF ADDITION --------------------------------------------------------------------------------------------- 14 (e 7,9tiq uk MIg 0 A7 /ICA i" P 0--llo AA 2 e s k t-, s -,,� c- c- '?;' ?-" � \\.- , \J\.. 3 - Approved: pQ PWW-0001 -11/75 (REV. 11/78) DATE NAM, t 'ro%saff„w oLY"PTIVP Mom. l/a PtiO►J��110dI�SS .�.. 1 �•• __ _ _ _ - - CO VENTS h FIRE Sim= FAMILY/MULTIPLE/COM4Esc1m - (Circle One) PLANNING Hbviawed by:7.: it date WTR/Smt IsTRgT I ENCIaNG BUII = CHDCKEU - Planning VARIANCE/SE'TRAM ADJ. / / // TM COWITIONhL USE. PERMIT //////' ! /////I/// //////// ////////// 2 ADB RDQUIREMEM S CHECKED /://// 3 t anm ZONING REQUIRimEm S ////// ///////// / //////// / 7=- 11,4111111 4 pNWF0043PTAL FEATURES ////// 111 // // ///////// //////// 5 AOCESS SLOPE S VEHICLE ACCESS ---- ///////// ///////// //////// 6 — IRAINAGE PLAN (On Site) /// ///////// /17711111 ///////// //////// 7 STREET FILE. � // 8 f,EGAL DESCRIPTICN VFRI'FICATTCN ////// ///////// ///////// ///1//// 9 SUIT CIAIM/DFDICATICNS ALJ////// ///////// ///////// //////// 10 WEMENT - PUBLIC/PRIVATE 'ALCIllATE SEWER CONNDCTICN IF NO LIDU l ////// ///////// ///////// //////// 12 PUT/SUBDMSICN REQUIREMEN'I5 UGHT-OF-WAY CONSTRUCTICN PERMIT REED ////// ////// // ////// ///////// ///////// //////// � 13 14 -10M REQD FOR POBLIC IMPROVEME M ////// ///////// ///////// //////// 1 15 30IIS CCNDITIONS S Gi4•JUNO WATER FIELD COCKED ////// ///////// ///////// ///// 16 STREET PAVING REQUIRED ////// ///////// ///////// 17 -mm AND G[IPTER REQUIR® ////// ///////// ///////// ////////// 18 3IDEWALX REQUIR® ////// ///////// ///////// 19 'M CUT FOR DRMAY R ////// ///////// ///////// ////////// 20 STREET NAME SIGN•RDQD ///////// ///////// ////////I/ 21 MOM SIGNING RDQD ////// ///////// ///////// ////////// 22 3IDE SEWER AVAILABILITY ////// ///////// ///////// //////// 23 SXISTING {4A M MASN SIZE ////// ///////// � //////// ////////// 24 4AM METER SIZE ////// ///////// 3 S //////// ////////// 25 30MCE LINE SIZE T77777 ///// ///////// �'y 11111717 26 JYDRANT MIRED ///////// ///////// //////// ////////// 27 iYDRANT SIZE EXISTING ////// ///////// %~ / //////// ////////// 28 'ROSS CONNECTION INSPECTION READ ////// ///////// //////// ////////// 29 dATER METER OW40E RDQD ////// ///////// _�.� //////// ////////// 30 FIRE LINE CHARGE READ - SPRINKLER ///////// / 31 3TRFET CUT ////// ///////// ////////// 32 VEN DITCH EXISTING ////// ///////// ///////// 33 RDQD ' ////// ///////// ///////// 34 =VERT REOD ////// ///////// ///////// 35 SIZE 7777/777 36 JATCN BASIN REDD ////// ///////// ///////// 37 INDICATED CN SITE PLAN ////// ////////% ///////// 38 3HOUMER DRAINAGE MAINTAIN SHALE OPEN RUNOFF ////// ///////%/ ///////// 39 a6c: ///////// ///////// 40 BY: PLANNING MGR. yima Wei,• s MEMO TO: Building Division FROM: Engineering Division SUBJECT: A�GI� After review of the subject building permit application, we have the following comments: 1) Connection to City water system required. 2) Connection to City sanitary sewer system required. 3) Right-of-way permit required for any work ,on City property. 4) Driveway slope not to exceed 14%. 5) Back water valve required if downstairs plumbing is below elevation of upstream manhole. 6) Water and sewer lines to be separated by 10 foot minimum. 7) Builder/owner responsible for containing all temporary runoff and erosion on site and may not impact neighboring properties in any way. 8) Construction hours from 7:00 a.m. to 10:00 p.m. on weekdays and 10:00 a.m. to 6:00 p.m. on weekends and holidays. USE PERMIT CITY -OF ' EDMON DS ZONE fJ NUMBER CONSTRUCTION PERMIT APPLICATION JOe r NAME (OR NAME OF BUSINESS) ADDRESS LEGAL DESCRIPTION CHECK SUBDIVISION,, //NO. LID NO. MAILING ADDRESS LO%- .0, k CITY , e'(� TELEPHONE NUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. N ` � 3 EXISTING RE UIRED DEDICATION NAME ` PROPOSED O To �^` `S Q RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED ❑ j ADDRESS STREET USE PERMIT REQUIRED ❑ SEE ENGINEERING MEMO DATED I CITY TELEPHONE NUMBER / 1 —f7 -22435� REMARKS CITY LEI N NUMBER L METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS :PHONE NUMBER W W REMARKS SIGN AREA ENV. REVIEW easements ALLOWED 1 PROPOSED COMPLETE I EXEMPT i ` VARIANCE OR CU PLANNING REVIEW BY DATE \ - I YARDS HEIGHT I LOT COVERAGE �1V FRONT SIDE REAR L—J NEW RESIDENTIAL Li PLUMBING ADDIALTER 0 COMMERCIAL El MECHANICAL REPAIR RETAINING WALL SIGN EXC11 FILLVATE FENCE KED BY TY DEMOLISH OR' II x—�[REMARKS . REMODEL PRE -MOVE INSPJ COMPLIANCE INSP SWIM IAL INSPECTOR IRED �wNINSERTSTOVE I 0 YES ❑ NO APT. BLDG RENEWAL a NUMBER OF STORIES NUMBER OF o /I DWELLING A m ,L UNITS I — NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) GROUP � VALUATION PLAN CHECK FEE BUILDING PLUMBING MECHANICAL This Permit covers work to be done on private property ONLY. GRADING/FILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Permit Application:180 Days Permit Limit:1 Year - Provided Work is Started Within 180 Days ENERGY CODE "Applicant, on behalf of his or her spouse, heirs, assigns and, successors In Interest, agrees to indemnify, defend and hold harmless 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. Issuance of. this permit shall not be deemed to PLAN CHECK DEPOSIT modify,. waive or reduce any requirement of any city ordinance nor limit in any way the City's ability to enforce any ordinance provision." TOTAL AMOUNT DUE 1 hereby acknowledge that 1 have read this application; that the information given Is correct; and that I am the owner, or the duty ATTENTION authorized agent of the owner. I 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 ti n Insur nc§L INSPECTION DEPARTMENT CITY OF SIGNATURE (OWW OR AGENT) DATE SIGNED EDMONDS HEIGHT j f s- 2� OCCUPANT 3 LOAD G "4100It) 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 771.3202 ATTENTION V IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE NTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC \^HAPTER 3. RELEASED BY: DATE ORIGINAL — File YELLOW — Inspector PINK — Owner GOLD — Assessor IL JcRVW -14 4 �`;°!'!� j{l;� �;j`� !;• Ir i'+ x�W I Hll IT 00 ILL oo.oq w*-Y � 1W)