17009 76TH AVE W.PDFIIIIIIIIIIII
6184
17009 76TH AVE W
; CITY OF EDMONDS
.t,. PUBLIC WORKS DEPARTMENT FOR INSFECTION CALL Permit l®
"".SID&E SEWER PERMIT 7'19,L/Y5'25 Ext. 2W Issue Date
PEP -MIT MUST BEn POSTED ON JOB
1 1. Address of Construction �'�i 9 �k'E� Rhy-NNWOOD LINE
1
1 2. Property Legal Description (include all, easements)
1 ',e�o >r 2 1
1 3. Single Family Residence i� Multi. -Family No. of Units 1
1 Commercial
1 1
1 4. Owner and/or Builder
1 5. Contractor & License No.
1 6. Invasion into City Right -of -Way: No / Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (3k2-!5UA ) before 1
excavation).
1-800-424-5555
1 1
zF'H 7. Cross other private property: Yes No -,/ Easement required - 1
1 U attach legal description and county easement number. 1
1
1 a 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 1
1 1 °q construct side sewers in the public right-of-way. 1
1 w b. The side sewer contractor assumes full reponsibility for each 1
w installation for one year. 1
w
C. Commercial establishment requires a minimum of a six inch (6") 1
z side sewer line.
1 o d. Side sewers may not be installed closer than thirty inches (30")
1 to any structure. 1
1 e. Side sewer lines must be laid at a minimum grade of 2% (1.150} 1
1 H and maximum grade of 100% (450). f. No turn in side sewer greater than 45° (1/8.bend) is°allowed 1
1 between cleanout. All 90 turns must be constructed of a 45 (1/8 1
1 bend) and wye with removable cap. 1
1 g. No down spouts, footing drains or floor drains can be connected 1
to side sewer system. 1
1 h. Pea gravel is required for bedding when installing sewer lines 1
through other than granular soil. 1
1 i. Cleanouts are required at 30"-60" from each plumbing exit line 1
and at minimum intervals of 100' along sewer line run.
1 j. Trenches within City right-of-way must be restored to original 1
1 conditions. Contractors shall be responsible for right-of-way failure 1
1 due to poor compaction of fill.
1 k. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal -working hours only. Two (2) working 1
days notice required. 1
DATE: / - /� Q�"L_4
1 0444��-
'I- cer"tify that I have read
and vsha-1-/comply with the above
+ _PERMIT FEE: --7(J, 00 DISAPPROVED BY: Date:
c4eS.OD By:-nl Date:
1:4 CONNECTION FEE: �, ?CjO, 00 APPROVED By: _ � Date:
c=. 4Wo,"
* PERMIT MUST BE POSTED ON JOB SITE
The City of Edmonds
Side Sewer Drawing
EASEMENT NO. ............................................
NEW CONSTRUCTION REPAIRS D LID NO_ ------------------ ASMT. NO. - ---------------
OWNER -L-QC-RRlNka ... TINC . ........................ CONTRACTOR --------------------------------- ---------------- ................................. PERMIT NO. - ---AA
JOB ADDRESS -170.0-3'.T-
-------- -7(br --- Ay-c-M, --------------------- LEGAL DESCRIPTION: LOT NO. ------ 3 --- ------------------------ BLOCK NO. -------
....................................................................... S- ...................................... ...........................
PROP GORN. I NAME OF ADDITION ----------------
IRONPIN ----------------------------- -------------------------------------------------------------------------
4!DP
A".- A -W-4c
77'
PWW-0001-11/75 (REV.11/78)
Approved:
L
A It :It ---------- i. -
DATE 1.9.8 --- By -------- j ---- ----
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CITY OF EDMONDS
E NEW
•
❑ ADDITION
❑ RETIREMENT
SYPREET RLE ASSET INFORMATION SHEET
ASSET NO. DCi 64;i -moo
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION DEPT.
l.<.� . N5l0
"PURCHASE ORDER NO. *PROJECT NUMBER
PURCHASE ORDER DATE PROJECT COMPLETION DATE
COST COST &, .;2 -2
B.A.R.S. ACCOUNT NO. WIZ '"-eoU _&err
• ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
"SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
ws�7-4-'
U DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
• . G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO.
INITIAL
t(p)
DEPARTMENT FILE
STREET FILE
PLOT PLAN FOR
BLUEPRINT ING.
.AT 1700cl 7&tn AVENUE V.
Eic POW Pal \VL�tr Wo To W
LOT 51 SHORT PLAT 4 9- 2:501
ACOFS5 4. UTIL-1w
S&!�EVEWT TO
7(o Tit 6/2WUE V
ZONE
SETBACKS:
FIR, 0 INIT c>2
REA
HEIGHT c,2 4- 'ma
MORTtt
,904LrEs II&SO
7 Q -i�70 Ot�' 27
exieT1wre W,
UTILITIESvop
. STREET FLE
CITY OF EDMONDS
I OVC CSNTEpi • (O40NDS. WASHINGTON 90M
2.r�-
SINGLE FAMILY IIULTIPLE COMMERCIAL
ENGINEERING 3 PUBLIC WORKS
PROJECT REVIEW
CHECK Ll-ST
PROJECT NAMEc�ilf wit CONTACT N0E 5 TELEPHONE NUMBER
ADDRESS l'OC3 �Z
ACCESS SLOPE AND VEHICLE ACCESS
DRAINAGE PLAN
STREET FILE
LEGAL DESCRIPTION VERIFICATION
,,QUIT CLAIM/DEDICATIONS
EASEMENT - PUBLIC/PRIVATE
CALCULATE SEWER CONNECTION IF NO LID /
STREET PAVING REQU
CURB AND GUTTER RE
SIDEWALK REQUIRED
CURB CUT FOR VHlYLMAT.KtYUl KLV
RIGHT -OF -MAY CONSTRUCTION PERMIT REQUIRED
BOND REQUIRED FOR PUBLIC IMPROVEMENTS
STREET NAME SIGN REQUIRED
OTHER SIGHING REQUIRED
(ADDITIONAL COMMENTS ON SAC
EXISTING WATER MAIN SIZE
WATER MAIN REQUIRED YA
SERVICE LIRE REQUIRED
W HYDRANT SIZE EXISTING
r SIZE
< HYDRANT REQUIRED PER FIRE CODE __ VI-4
CROSS CONNECTION INSPECTION
WATER METER CHARGE REQUIRED e�S �-
REVIEW BY DATE �'1i�1,� (ADDITIONAL COMMENTS ON B,
W
W
co
SANITARY SEWER DWING HUM-BER
SIDE SEWER AVAILABILITY
FILE NUI4BER
SMIITARY SEWER CONNECTION FEE REQUIRED
OPEN DITCH EXISTINri REQUIRED
CULVERT REQUIREDr a /� ����//� �L.� SIZE
CATCH BASIN REQUIRED l . INDICATED ON SITE PLAN
SHOULDER DRAINAGE 11AINTAIN COLLECTIOM ON SHALE OPEN RUt10FF
MANHOLE REQUIRED 1, / 11 ' If INDICATED 04 SITE PLAN
SOIL CONDIT] NDGTEIELD CHECKED
REVIEW Br
CAT � /� � (ADDITIONAL COMMENTS ON B
USE PERMIT
�
CONSTn��� -,-ciCATION
NAME (OR NAME OF J3USINEft
ZONE NUMBER
s 2'
JOB
ADDRESS^O �
LEGAL DE CRIPTION C ECK
L%
SUBDIVISION NO.
S-.,3 _g
LID NO.
ZMAILING DRESS
o 31d (oaf
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING _& REQUIRED DEDICATION
CITY �r
TELEPHONE NUMBER
PROPOSED
NAME
RIGHT OF WAY CONSTRUCTION PERMIT REOUIRED
STREET USE PERMIT REQUIRED
w ADDRESS
SEE ENGINEERING MEMO DATED
SEE PIW DEPT. REVIEW CHECK LIST ATE
=
a CITY
TELEPHONE NUMBER
�7
J
REM S
NAME
N
01 ADDRESS
METER SIZE
SUPPLY SIZE
FIXTURE UNITS
0
U
711UILDING
¢ CITY
TELEPHONE NUMBER
zz
REMARKS
O STATE LICENSE NUMBER
CITY LICENSE NUMBER
SIGN AREA
ALLOWED PROPOSED
ENV. REVIEW
COMPLETE EXEMPT
ADS NO.
Legal Description of Property • include all easements
(show below or attach four copies)
SHORELINE
z
O
Q \
VARIANCE OR CU
PLANNING REVIEW BY
`
DATE
w
YARDS ZJT SO / Z/AR LOT
FRON
�V17'
✓U NEW LJ RESIDENTIAL
PLUMBING
ADDIALTER
1:1NON-RESIDENTIAL
MECHANICAL
REPAIR
RETAINING WALL
SIGN
CHECKED BY
TYPE OF CONSTRUCTION
CODE
HEIGHT
EXCAVATE FENCE
El
DEMOLISH
OR FILL
( xFT)
❑PRE -MOVE INSPJ
❑ SWIM
SPECIAL INSPECTOR
AREA
OCCUPANCY
OCCUPANT
COMPLIANCE INSP.
POOL
REQUIRED
F-I YES NO
GROUP
LOAD
2r�S,DE SEWER
aWATER LINE
1:1REMARKS
z
m NUMB EP OF STORIES
uN �,L NOF
O (/
NATURE OF WORK TO BE DONE (ATjACH PLOT PLAN)_
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.
Permit Application: 180 Days
Permit Limit: 1 Year- Provided Work is Started Within 180 Days
"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 1 '
of this permit. Issuance of this permit shall not be deemed to
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........... .
1 MEMO TO:
FROM:
SUBJECT':
It
DATE:
Building Division
Communitv Development Department
Engineering Department
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
Ri.,ht-of-way Permit
required
for any work on City property.
4.
Driveway slope not
to exceed
14°0.
S. Backwater valve required if downstairs plumbing is below
elevation of iinstream manhole.
6. Water and sewer lines to be separated by 10 foot minimum.
7. Builder/Owner responsible.for containing all temporary run-
off and erosion on site and may not impact neighboring
properties in any k,iay.
Signature
PLOT PLA1J FOR
k3LUEPRLNT t-ION1E5►LNG..
LT 1700°I 7760th AVEN U� \V
LOT 3, 5HGP-T FLAT
AG05516' t UTILITY
EGSE!/IENT TO
7/o7H 16vENUE V.
f"aon.�j � Dot✓N�41uT5 C�e�vNss¢7�p Td 578.2rrJ _6�7��
IAI W�
IJ i�7Old GO' \V 1401.111
10' STORKA PRAI EaSEVEIJT
S ... .
U IJ66
�EIGHT�
25'
ul
N
Z
EKI✓Tlwo 1D
LMLITIE5 E,c*
N 570 0$' 27' `�/
DATE:- September 29, 1983
MEMO TO: Building Division
FROM: James E. Adams
City Engineer
SUBJECT: SEWER CONNECTION CHARGES
17009 - 76th Ave. W.
(Street Address)
Blueprint Homes
(Legal Owner)
Single Family Residence X Subdivision Plat
PRD Multiple Commercial
LEGAL DESCRIPTION:
Lot 3 S-23-81
Z.F.F. Calculation:
( Min ) Z.F.F. x
( ) Lateral x(
st
_ $ 300.00
( 1 ) Unit (s) x ($25.00 ) _ $ 25.00
$ 30.00
$ 355.00
cc: Owner
Street Address File
Connection Fee
Lateral Charge
Equivalent Count
(when applicable)
Trunk Charge
Permit
TOTAL
• ER FILE
MEMO TO: Building Division
FROM: James E. Adams
City Engineer
SUBJECT: SEWER CONNECTION CHARGES
(17909 - 76th Ave . W
loptember 29, 1983
(Street Address)
Blueprint Homes__
(Legal Owner)
Single Family Residence X Subdivision Plat
PRD Multiple Commercial
LEGAL DESCRIPTION:
Lot 3 S-23-81
Z.F.F. Calculat:LQ11 :
( Min ) Z.F.F. x ( ) = $ 300.00��
( ) Lateral x( ) _ $
( ) Unit(s) x($25.00 ) _ $
st `
cc: Owner
Street Address File
Connection Fee
Lateral Charge
Equivalent Count
(when applicable)
Trunk Charge
Permit
TOTAL