17015 76TH AVE W.PDF111111111111
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17015 76TH AVE W
The City of Edmonds Side Sewer Drawing
^-rr% EASEMENT NO. - -------------------------- ---------------
0 1 MEET FILE NEW CONSTRUCTION E) REPAIRS LID NO- ------------------ - ASMT. NO ----------
'B.L CONTRACT OWNER ----- UE-PRIM-T ----- 14.o-wes -------------------------------- OR ------------------------------------------------------------------------------------ PERMIT NO. _715.8-
JOB ADDRESS --- 1770-1-5- ------- - ---------- LEGAL DESCRIPTION: LOT NO. --21- ---------------------------- BLOCK NO. ------------------------------------
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NAME OF ADDITION --------------------------------------------------
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NORT4
t-"TREET FILE DATE:
MEMO TO: Building Division
FROM: James E. Adams
City Engineer
SUBJECT: SEWER CONNECTION CHARGES
17015 - 76th Ave. W.
Atember 29, 1983'
(Street Address)
Blueprint Homes
(Legal Owner)
Single Family Residence X Subdivision Plat
PRD Multiple Commercial
LEGAL DESCRIPTION:
Lot 2 S-23-81
Z.F.F. Calculation:
( Min ) Z.F.F. x ( ) _ $ 300.00
( ) Lateral x( ) _ $
( ) Unit(s) x($25.00 ) _ $
Connection Fee
Lateral Charge_
Equivalent Count
(when applicable)
Trunk Charge
Permit
TOTAL
s t
cc: Owner
Street Address File
STREt: i FILE
CITY OF EDMONDS
CW C CINTE01 - IDMOHDS. WASHwG1ON SO=
` SINGLE FAMILY MULTIPLE COMMERCIAL
PROJECT NAME
ADDRESS
ACCESS SLOPE AND VEHICLE ACCESS
DRAINAGE PLAN
I STREET FILE
LEGAL DESCRIPTION VERIFICATION
\QUIT CLAIM/DEDICATIONS
EASEMENT - PUBLIC/PRIVATE
Z CALCULATE SEWER CONNECTION IF NO LID /
Q
W
W STREET PAVING REQUIRED A1
fp-
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O CURB AND GUTTER REQUIRED
W SIDEWALK REQUIRED �I
CURB CUT FOR DRIVEWAY.REQUIRED
RIGHT-OF-WAY CONSTRUCTION PERMIT REQUIRED
ENGINEERING & PUBLIC WORKS
PROJECT REVIEW
/< 14
BOND REQUIRED FOR PUBLIC IMPROVEMENTS �—
STREET NAME SIGN REQUIRED ,
OTHER SIGNING REQUIRED
CHECK LIST
CONTACT NAIIE 3 TELEPHONE NUMBER
(ADDITIONAL COMMENTS ON BACK)
EXISTING WATER MAIII SIZE
WATER MAIN REQUIRED y/,q
SERVICE LINE REQUIRED
:j HYDRANT SIZE EXISTING
r
< HYDRANT REQUIRED PER FIRE CODE ,y�,q SIZE
CROSS CONNECTION IHSPECTION
HATER METER CHARGE REgUIf:EO
REVIEW BY r .rr�-�Ln� DATE ���� �y (ADDITIONAL COMMENTS ON BACK
Ir
W
3
W
SANITARY SEWER DWIING
SIDE SEWER AVAILABILITY
IIUM.BER
FILE WIBER
SANITARY SEWER CONNECTION FEE REQUIRED
OPEN DITCH EXISTINr,
REQUIRED
Y
y fr
CULVERT REQUIRED ����Q(���
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cS)/S,
SIZE '
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CATCH BASIN REQUIRED
INDICATED ON SITE PLAN
=
SHOULDER DRAINAGE FIAINTAIN
COLLECTIOtl ON SWALE
OPEN RUNOFF
WHOLE REQUIRED
INDICATED ON SITE
PLAN
Q
0
SOIL CONDITJ A
0 YA R FIELD CHECKED
H
pp
REVIEW BY
LATE /
(ADDITIONAL CO►41FNT5 ON BACK,
n\l,,N
F EDMONDS
CONSTRUCPERMIT APPLICATION
NAME (OR NAME OF BUSINE
NUMBE.
tsX
NUMBER
NAME
ADDRESS
CITY TELEPHONE NUMBER
STATE LICENSE NUMBER CITY LICENSE NUMBER
10,
Legal Description of Property - include all easements
(show below or attach four copies)
-It- /_/e3,,7
USE PERMIT
ZONE P� - /2- NUMBER
JOB -
ADDRESS
LEGAL DESCRIPTION CHECK SUBDIVISION NO.
0 s-
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING (/Q(n/ REQUIRED DEDICATION
PROPOSED��� _-
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRE ❑
STREET USE PERMIT REQUIRED ❑
SEE ENGINEERING MEMO DATED
SEE PIW DEPT. REVIEW CHECK LIST DATE
METER SIZE (BUILDING SUPPLY SIZE
REMARKS
RE UNITS
SIGN AREA ENV. REVIEW
ALLOWED PROPOSED COMPLETE EXEMPT
VARIANCE OR CU PLA
NNING REVIEW BY
YARDS I /O 4r-/ LOT CO\
FRONT SIDE REAR 3�
L__T NEW
El ADD/ALTER
C� REPAIR
DEMOLISH
1-
RESIDENTIAL
NON-RESIDENTIAL
CI RETAINING WALL
ORFILLFENCE
LJ PRE -MOVE INSP,/
COMPLIANCE INSP.
CJ PLUMBING
MECHANICAL
SIGN
X_FT)
SWIM
POOL
CHECKED BY TYPE OF CONS
SPECIAL INSPECTOR AREA
REQUIRED
❑YES NO
SIDE SEWER
WATER LINE
REMARKS
NUMBER OF STORIES
�
NUM8F.R0F
UWtLLING
UNIIJ
/
NATURE OF WORK TO V DONE (ATTACH PLOT PLAN
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGIFILL
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
ON
OCCUPANCY
GROUP
VALUATION
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DATE:
14EMO TO: Building; Division
Communitv Development Department
FROM: Engineer.in„ Department
SUBJECT : I70f —/,� If
After review of the subject Building Permit application, we have
the following; comments:
1 Connection to City water systen required,.-
2. Connection to Citv sanitary sewer _system required.
3
Ri$-ht-of-way
Permit
required
for.__illy work on City property.
4
Driveway slope
not
to exceed
1410.
5. Backwater valve required if downstairs plumbing is below
elevation of i�pstream manllolc __
6. dater and sewer lines to be separated by 10 foot minimum.
7. Builder/Owner responsible for cont ainin all tem orar -
off and erosion on site and may not impact neighboring
-- Signature
DATE: September 29, 1983
MEMO TO: Building Division
FROM: James E. Adams
City Engineer
SUBJECT: SEWER CONNECTION CHARGES
17015 - 76th Ave. W.
(Street Address)
Blueprint Homes
(Legal Owner)
Single Family Residence X Subdivision Plat
PRD Multiple Commercial
LEGAL DESCRIPTION:
Lot 2 S-23-81
Z.F.F. Calculation:
( Min ) Z.F.F. x ( ) _ $ 300.00
( ) Lateral x( ) _ $
( 1 ) Unit (s) x ($25.00 ) _ $ 25.00
$ 30.00
$ 355.00
st
cc: Owner
Street Address File
Connection Fee
Lateral Charge
Equivalent Count
(when applicable)
Trunk Charge
Permit
TOTAL
F:LCT PLAN FOR
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CITY OF EDMONDS
.L_J NEW
•
❑ ADDITION
❑ RETIREMENT
S,Tr�72ET FILE ASSET INFORMATION SHEET
ASSET NO. 6',0 0
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION
DEPT.
"PURCHASE ORDER NO. _
PURCHASE ORDER DATE
COST
*PROJECT NUMBER &1v D l�
PROJECT COMPLETION DATE
COST �Cv-121R
B.A.R.S. ACCOUNT NO. .�L��'000 �BO'� — Yam' -0p G•
• 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
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT" "
ANNUAL DEPRECIATION AMOUNT
• G.L. ENTRY
REFERENCE DATE
VERIFIED BY
PROCESSED
BATCH NO. _
INITIAL
by
DEPARTMENT FILE
iCITY OF EDMONDS
FOR INSPECTION CALL �t�® r-
PUBLIC WORKS DEPARTMENT Permit Pj L o
SIDE SEWER PERMIT 7/75,=AIZ5 Ext. NO Issue Date
PERMIT MUST BE POSTED ON JOB SITE
1 AW.� LYNNWOOD LINE
1 1. Address of Construction
1 2. Property Legal Description (include all, easements),-� 1
1� J g, 1
1 3. Single Family Residence /� Multi -Family No. of Units 1
1 Commercial
1 1
1 4. Owner and/or Builder
1 5. Contractor & License No. /ram /' qri�%�� 1
1 6. Invasion into City Right -of -Way: No Yes (If Yes Right -of= 1
1
way Construction Permit Required - Call Dial Dig (3;444!5�3,4,4) before
excavation).
1-800-424-5555 1
1 H 7. Cross other private property: Yes No_,--' Easement required - 1
1 U attach legal description and county easement number. 1
a READ THE FOLLOWING AND SIGN: 1
1 a. Property owners must obtain a permit to install side sewers on 1
1 >-I their property. A licensed side sewer contractor must be employed to 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
H installation for one year. 1
wC. Commercial establishment requires a minimum of a six inch (6")side sewer line.
1 u d. Side sewers may not be installed closer than thirty inches (30") 1
1 to any structure. 1 CQ e. Side sewer lines must be laid at a minimum grade of 2% (1.150) 1
1 1 0 and maximum grade of 100% (450). 0 1
H f. No turn in side sewer greater than 45 (1/8 bend) is allowed
1 between cleanout. All 90 turns must be constructed of a 45°•(1/8
1 bend) and Wye with removable cap.
1 g. No down spouts, footing drains or floor drains can be connected 1
1 to side sewer system. 1
1 h. Pea gravel is required for bedding when installing sewer lines 1
1 'through other than granular soil. 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
1 k.. Side sewer must be left uncovered until inspected and approved 1
1 by the City. 1 1. Inspection during normal working hours only. Two (2) working
1 days notice required. %%
1 DATE: /. --12 - �et /). a, / —
1 I cert`ify,,t "at I have read
and shall comply with the above
PERMIT FEE: u. t�t7 DISAPPROVED By : Date:
w B : Date:
CONNECTION FEE nb, n ® APPROVED By: Date:
0
w * PERMIT MUST BE POSTED ON JOB SITE * ��
r
The City of Edmonds
Side Sewer Drawing
EASEMENT NO - -----------------------------------------
NEW CONSTRUCTION X . REPAIRS ❑ LID NO- ------------------ ASMT. NO. ----.--.--_____---
OWNER Z3lt.,Q-V-P-Rl.N:T ---- 14.0-t-ve-5 ---------------------------------------- CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO. 7715-8--
JOB ADDRESS -1-770AS .... ------------------- LEGAL DESCRIPTION: LOT NO. ----- 2 - ----------------------------- BLOCK NO.
I ................................................................ S-2 -.8.1 ----------------------- ...................................................
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PROP LINE - F04CA
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NAMEOF ADDITION --------------------------------------------------------- .............................................................
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17015 7ro IrH A..VF-.
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&DATE 1.3. ATM... ByAno-011.f .. ..... . ..... _-,
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- Sewer- ®cawing
a
-The City of Edmonds
4
_
-
EASEMENTN
O.-
_
j
_,-NEW CONSTRUCTION ®
REPAIRS
LID NO_ ASMT. NO.
_____________
.............
r-:OWNER •------------- L1U-%OR► -r..�MES__=tA.c,
..__...__ CONTRACTOR ------
.. :.:..
PERMIT NO. -
"-JOB ADDRESS 1?O
1}170��,1�OQ9,•_--------__:-_,�]�
—!'!_AYFmW. LEGAL' DESCRIPTION: LOT _NO_ _____________ ________________________
BLOCK NO.. _.________._._..___ _..______.____
NAME OF ADDITION ......... -
'PROP.. C09-mER
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Approved:
DATE..:.:.:..•--•_______________________________ By
...._---=--.._-_.____..-_._:•__--•--•------•..._...........
City, of Edmonds
RIGHT-OF-WAY CONSTRUCTION.:
PERMIT Permit Number. —
u Issue Date:
A. Address or Vicinity of Construction: 17015 76 Av W (9608811)
B. Type of Work (be specific): Install Service
9p.19
C. Contractor: Washington Natural Gas
Mailing Address: 1122 75 St SW Everett
State License #: 98203
D. Building Permit # (if applicable):
Contact: Marialdne Kingsbdri,... I
Phone: 356-7500 X7596 ;
Liability Insurance: Bond:
Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project U Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family- ❑ Other
INSPECTOR: INSPECTOR: I^; i (-t1
F. Pavement or Concrete Cut : 91Yes ❑No G. Size of Cut: x' H. Charge $
APPLICANT TO READ AND S GN)
+= INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from injuries, damages, or
claims of any kind,o description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any'of its departments or
employees, including; r 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 A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION,FEES WI�lBE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA IDEBIT OR CREDIT WILL BEPROCE SEl�'FOR ISSUANCE T&THEAPPLIC/A'NT.
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 cop of the permit will be
available on site at all times for insi 2ection purposes.
Signature: Date: 4-24-96
Tntractor Agent) ,
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY:
TIME AUTHORIZED: VOID AFTER 3 A Z DAYS
11
SPECIAL CONDITIONS: 11eloow avco- Z�
COMMENTS:
DATE:
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND 111:
RESTORATION ,FEE:
PERMIT FEE: .30,00
TOTAL FEE: 36 QU
RECEIPT FEE:
ISSUED BY:
17
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION. NOTES
Comments
Diagram
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
(Fund 111 - Route copy to Street Dept.)
❑ YES
Date:
Date:
❑ NO
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Watermain depth
qlas Main
BE
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
170W �4 #056-7500 X7596
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v►xu s4 C-UT I IJ S I o E WA.LIG
Key:
-w- Water
-G- Gas
-SS- Sever
dater hydrant
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Washington Natural Gas Company
1122 75th Street S.W.; Everett, Washington 98203, (206) 355-3331
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Watermain depth
sgs vain
N-
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
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Key:
-W- Water
-G- Gas
-SS- Sever
Hater hydrant
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Washington Natural Gas Company
1122 75th Street S.W.; Everett, Washington 98203, (206) 355-3331
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AVArl-gbonEnergyGoi d
Watermain depth
spas main
Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
MJZ-7� DOW 1�04 L#56-7500 X7596
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Key:
-W- Water
-G- Gas
-SS- Sewer
_ dater hydrant
Washington Natural Gas Company
1122 75th Street S.W.; Everett, Washington.98203, (206) 355-3331