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17214 77TH AVE W
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RIGHT-OF-WAY CONSTRUCTION.
7
Permit Number:
Issue Dhte:
FILE
A., Address or Vicinity of.C6nstruction:.� 17214 77 Avenue,,West
Type of Work (be specific):, Install New'ServiC6
C.' Contractor: 'Washin gton Natural Gas.Company.. . Contact: 'F . rank Swan
Mailing Address: 1 815 Mercer Striet.' Phone: 224-2278
State License #: 'Seattle,ft 98111 Liability Insurance,
Bond:$
Building Permit #.(if applicable)! Side
Sewer Permit # (if applicable):'
E. Commercial F1 Subdivision El City.Pioject, Utility (PUD, GTE, WNG; CABLE, WA TER)
Other
Multi-Faniily El Single Family.
INSPECTOR,: INSPECTOR: W �A%-tc_.j r -r
F. Pavement or Concrete Cut [ZlYes. 'E]No (1 � G..' Size of Cut:' 2 x 4 H. Charge $
APPLICANT TO REA�D AND SIGN.'
Ale.
to
INDEMNITY. Applicant,unders nds and by his signature to this dpplication,.a eei to h i4d.-theOty of Edmonds'harmless from injun" damages,or
1__'ciaims of any.,kind or description whaisoever,.foreseen or un/bieen, that may be nitade against ihe'aly of Ed d,, or',any of itsdepartments or" employ-
ees, including or not limited to the defense of any legal proceedings including*defi�nse costs, and attorrieyfees by reason of granting this permit'..
7HE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIPAND MA7ERIALSFORA PERIOD OF ONE YEARFOLLOW[NG THEFINAL INSPEC77ON
AND ACCEPTANCE OF THE WORK ES77MA TED RESTORA77ON FEES WILL BE HEL6-TJA,4X E
THE FINAL S7REETPAT(jl11,jgOAf7 7'. D I BY.
CITY FORCES, AT WHICH 77ME A DEBITOR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT
Construction drawing of proposed work required with permit application.
A 24 hour notice
is required for inspection; Please call the Engineering Departmi� w �47J
Work is to be inspected during progress and at completion. 771-0220
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times. -
Traffic Control and Public Safety sha.11 be in accordance with City regulations as required by the �ity.,��n-� e
gin er.
All street cut ditches shall be patched with asphalt or City -approved materoial prior, to the end of the working day;
NO EXCEPTIONS..
I have read the above st!tten n& and undersyrand the permit requirements and the pink copy of the permit will be available
on site at all timesfo
�fiqpection
Signature: Date:
SeRtember 2. 1992.
(Contractor. or Agent)
CALL DIAI, A -DIG PRIOR TO BEGINNING WORK
NO. WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. -Div. 1991
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES El NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1985
VAW* on
. - wt-
Maturid GO—
LJAddendum to City of Edmonds
Right of Way
Permit Application
Submitted by:
-7 2-14 -7 AV Engi . nee—ri-nig Aide
Washington Natural Gas
622-6767 x2761
pager
<0
'* WNG
Water ztaim depth
un)mown
i V4" gas main,
z%ey ;
-w- water
-g- gas
-ss- sewer
water bytrant
815 MM= SL (P.D. B= 1369). Scwk. WA 98111 =6) 6=4767,
c c ity OF EUMONDS
'14-- BtDG. DEPT.
C. CONDIPONAL PERMIT
WORK-
(7 ADMESSz /7-214 -7 -7 Y�h 144
OWNER -
APPROVED DATE -
BY
BLDG. OFFICIAL
KE C7D THESE STAMPED
�ITE FOR
PLPONS ON JOB
-ALL UNSPECTIONS
A i
H E Et IT
PERN11IT NO.
84026917
OF
STREET FILE ZONE _k,'�> - 12, IV
SETBACKS:
F R 0 N T'-.
S D 1E
REAR
OTHER
HEIGHT
�2 3'
20 7, 5-
r
pacK
17 MAY 3
-311 %3 19 84
A
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16
S 'R�ET FILE
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NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of Edmonds does not warrant the
accuracy of anything set forth on these
map(s). Any person or entity requesting a
copy should conduct an independent
inquiry regarding the information shown on
the map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
employees or officers shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
The City of Edmond STREET FILE Side Sewer Drawing EASEMENT NO. ----------------------------------
NEW CONSTRUCTION REPAIRS [I LID NO - --------------- — -ASMT. NO - ------------------
1� -I-- -
OWNEP - ------------ lbkX ------ ---------------------------------------------------- CONTRACTOR .-4.-!-Shh-W-00J ----- SVAN: --- -C-0— ------------------ PERMIT NO.
JOB ADDRESS ------ 1-7
.Z 7
...........
. .... AM -------- W ..................... LEGAL DESCRIPTION: LOT NO - --------- 5 ---------- --------------- BLOCK NO. - ---------------
................................... ------- 6rllz
-------------------------------- ............. ..................................
NAME OF ADDITION
\AJAT.Pk /-/,Of
160 P-6/. A96
4-3 A Aeco I
0
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N
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PWW4=1-11175 (REV.11178)
Approved -
DATE. ............ By, -A&�--- -------
CITY OF EDMONDS
PUBLIC WORKS DEPARAT FOR INSPECTION CALL Permit IV-30
775-2525 Ext. 220 Issue Date
SIDE SEWER PERMIT
PERMIT MUST BE POSTED ON JOB SITE
h177
Address of 7onstru'ction '7 Z -2 V IZl
2. Property Legal Description (include all, easements)-
3. Single Family Residence Multi -Family No. of Units
Commercial
4. Owner and/or Builder 114
5. Contractor & License No. 1 /-../ , /,-? 1_-&/'
6. Invasion into City Right-of-W/a': No'N/ Yes (If Yes Right-of-
y
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
E-1 7. Cross other private property: Yes NO,X' Easem P=1
U1 If 4F
attach legal description and county easement numbe
READ THE FOLLOWT,.NG AND SIGN: WHORE YOU DIG
P4 1- 800 - 562-6478
a. Property owners must obtain a permit to install side sewers on
>4 their property. A licensed side sewer contractor must be employed to
9Q
construct side.sewers in the public' right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
C. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
0
e. Side sewer lines must be laid at a minimum grade. of 2% (1.15
0 and maximum grade of 100% (450). 0
f. No turn in side s8wer greater than 45 (1/81bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend), and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum.intervals of 1001 along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due -to poor compaction of fill.
. k.. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only.' Two (2) working
days notice required.
DATE:
I-dertify that I have read
and shall comply with the above
PERMIT FEE: DISAPPROVED BY: Date:
By: Date:
CONNECTION FEE: APPROVED By: Date:
PERMIT.MU$T BE -POSTED ON JOB SITE;*.:
IK
Aak - A 0-
Ah-M
-7
BUILDING DIVISION Applicant Fill
USE PERMIT
Z 0 N NUMBE
i
Inside Heavy Lines
PERMIT AMMON
i:�� Q9:;:T F11 F
I a bm NAWf V
ADDRESS ae-. A).
NAME (OR NAME OF. BUSINCSS)
LEGAL DESCRIPTION TSUWDIVISION
SHORT SUL) NO.
W
MAILING ADDRESS
0z
CITY TELEPHONE NUMBER
PU13LIC RIG14T OF WAY PER OFFICIAL STREET MAP
EXISTING 140
PROPOSED A-0
6
I.
U
FA#A
C X
DEFICIENCY OF RIGHT OF WAY 0
W
M
ADDRESS
PUBLIC IMPROVEMENTS REQUIRED 0
DRAINAGE IMPROVEMENTS REQUIRED
0 FEB 19 ig8o
DRAINAGE PLAN REQUIRED 0
UNDERGROUND WIRING REQUIRED X Dir.
CONNECTION TO SANITARY SEWER 01 ljllhl'r Works
SEPTIC TANK PERMIT REQ'O 0 No.
30:
U
C3
CITY
TELEPHONE NUMBER
NAME
JCN- I'-*%- ;-k
ADDRESS
0
I.-
V
ELEVATION OF PROPERTY CORNERS 0
& FOOTINGS REQ-0
M
I-
z
CITY
TELEPHONE NUMBER
SEE ENGINEERING MEMO DATED
0
U
STATE LICENSE NUM13ER
S11 s-2 C,
CITY LICENSE NUMBER
CHECKED BY
Legal Description of Property (Sho, Below or Attach Four Copies)
METER SIZE
BUILDING SUPPLY SIZE
z
0
-7
I
W
REMARKS
SIGN AREA
ENV. REVIEW
ADrj NO.
U
0
W
0
ALLOWED PROPOSED
COMPLETE EXEMPT
SHORELINE 4V—
REMARKS
W
J
VARIANCE OR CU
PLANNING REVIEW BY
DATE
I
YARDS LOT
FRONT SIDE REAR I
COVERAGE
GAS
NEW RESIDENTIAL LINE
ADD El NON-RESIDENTIAL SIGN
DEMOLISH RETAINING
WALL
ALTER EXCAVATE FENCE
OR FILL I— X—FT)
FIRE ZOP41E
TYPE OF CONSTRUCTION JCCDE
I
HEIGHT
SPECIAL INSPECTOR JAREA
REQUIRED
0 YES C11 NO
OCCUPANCY OCCUPANT
GROUP LOAD
I I
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
REPAIR PRC-%IOVE swim
El 1'-4 S P. POOL
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
z
0
I -
z
W
NUMBER OF STORIES
r4 I UMBER OF
DWELLING
UNITS
I
REMARKS
—
NATURE OF WORK TO BE DONE
tr
W
0
I-
PLOT PLAN
PLAN CHECK FEE
VALUATION
FEE
W
BUILDING
0
j
PLUMBING
W
MECHANICAL
W
FENCE
SIGN
z
:)
x
0
1A
VI
W
2
"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. Issu-
RETAINING WALL
SWIMMING POOL
ance of this permit shall not be dderned to modify, waive or reduce
J
. I -
- - --- --- :- —, 1-�
0
PUBLIC WORKS DEPARUENT CHECKLIST
BUILDING PERMIT REVIEW Z7— 7-
(ad&es—s�— (date)
Street Right-of-14ay Existina--4�����—REQD A,--, Mo -Pr-7-9
Z
1-4
Access Easeumts Existing,
g)4
-REQD
Utility Easement Existing REQD
94
Lot Per Subdivision Plat V q �ssessor Map 9,EY4
W
Site Plan Checked for Accuracy
Z
Underground lqiring Reqd.
�-4
U
Check Accuracy of Legal-7Descriphon
"Date
Z
Review by IL�,, J-;�)P7SM0
Existing 14ater Main Size— Z."
Water Main Required
Service Line Required
Hydrant Size E.--,,ist"
13�
Hydrant Reqd Per Fire Code Size
,LA
Detector Check Metcr Rcqd. AYA
Cross Ccr-mection Inspection 1YI14
Fire Deparnmt Conrmts
14ater Meter Charge Reqd. 4-/
Review b Date �2� -
Septic Tank Design Approved--- t e—
-Da
Septic Tank Perm:i t Reqd._ vil Permit No._
Sanitary Sewer Availability A.= Proj.
Drawing No. _ 41-A 14- k File No.
Side Sewer Availabili y 110.
Sanitary Se,7er Connection Fee Reqd.
Review Dat
LO
Open Ditch Existing d.
X
Culvert Reqd.__ Size
Catch Basin ReQd.
- -- - A,-,�' ,,- Indicate an Site Plan
0
Shoulder drainage maintain collection on swale open runoff/��
�bnhole reqd. Indicate an Site Plan
—
Soil Conditions and Ground Water Field Checked. '7- cle,
Review by., -1
Date.-2
4LI,2
nev3-sea: IvIU-1977
DATL:
14FMO TO: Building Division
Community Development DepartMent
FROM; Engineering Division
Public Works Department
SUBJECT: -7:z i:A-.. A xt ty.. W
After review of the subject building permit application, we have
the following comments:
40
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CITY QF EDIMONDS
BLDG.'DEPT.
r I
CONDITIONXL PERMIT cl,
n e- L3
ADDRESS. i AUO—U)'
OWNER -Mk
6 > 7 rl—'2s, ZONE
APPROVED DATE- T
FSETBACKS:
ts y 'n, R-EcErvEDr
BLDG. OFFICIAL N' T
KEEP THESE �TWNff
PLANS ON JOBSITE FOR
R
ALL INSPECTIONS A I WYOF Eo, UjVDS
LANNING 6EPT.
SHEET
PERIVI-IT NO. OTHER
OF [H IE I G H T
AW
WASKI N G T40
ED MON DS.' UNPLATTE�D.
LA�VN_- TE R R A C Ef3
DI V:
:N-JL8% 00 275.GO'
110.02,
0 260.60,
—1 0
E-X 1-0'—S A-N- S—E W_ E-R
EASEMENT
A. F NO. 2121652:
-0
Ln 4 0,
01i -1
lo'STORM DRAINAGE t
J 0 ul _�ASEMENT
A's -, I " , 0*� ., A z 63o EX. 10' SAN. SEWER
a,;,- L A. F'N 0. 21216 5 2
%EASEMENT-
-01 0/1
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EX. 10' SAN. SEWER
-EASEt4ENT
TYPICAL BLDG.,
AF NO, 2121652 ENVELOPE ry
al 0
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tv 'A
130,00'
N 89 0 07 '00 W
10' SAN.- SEWER
3
90.00, 4000' '0' 1 t EASEMENT
. / / , I 1 11
CIS 460 11 18 2
.C,l 1�%. R� 25.00,
4b / . I - - -
00 ; ?\ 20. 15 SCALE"' I"
CO It, —4. -117. 50' 0
1.50.11 .0
N 890 03 '50" VJ
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N 89003'50"W
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