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17315 72ND AVE W
CITY of EDMONDS --- PUBLIC WORKS DEPARTMENT
Routing of Building Permit Applications kvt-pn",
to u MET FLE
1,,7 3 / 5�
Proposed Property Address of Application: 12-33.5, 72nd Avenue West
DE.PARTMENT
COMMENTS
DATE
W A T E R
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S T R E E T
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S E W E R
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N 0 T E S
BUILDING
DEPARTMENT COMMENTS
01
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"A Good Customer is Worthy of Every Consideration"
WESTERN UTILITIES SUPPLY Co.
Waterworks & Sewerage Supplies
P.O. BOx 352'4
5409 OHIO AVE. SO.
SEATTLE, WASH. 98124 7627025 SEATTLE, WASH. 98134
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OLD HOU-SE NO 7- (SSW
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B UILDING DEPARTMENT
Applicant Fill
Inside Heavy Lines
PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
W MAILING ADDRESS
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�: -7 7o2d A"O.
or, �7S,?
—76",?,�_
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W ADDRESS
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X CITY TELEPHONE NUMBER
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NAME
0 ADDRESS
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CITY TELEPHONE NUMBER
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01
ISTATE LICENSE NUMBER CITY LICENSE NUMBER
Legal Description of Property (Show Below or Attach Four Copies),
So 1/2 of the W 128 ft of Tract 138,
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Meadowdale Beach, as per plat recorded in
'U Volume 5 of Plats,, P 38, records of
V,
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Snohomish Co. situate in the County
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NEW RRESIDENTIAL E] GAS
19 LINE
NON-RESIDENTIAL SIGN
0 ADD
DEMOLISH RETAINING
WALL
F-] EXCAVATE FENCE
El ALTER OR FILL
REPAIR PRE -MOVE swim
INSP. POOL
NUMBER OF STORIES
NUME31ER OF
-7�
DWELLING
UNITS
NATURE OF WORK TO BE DONE j I
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PLOT PLAN (INDICATE BUILDING SETBACKS,
- ABUTTING STREETS)
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0
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0
CIO
prumn
rUSE PERMIT
ZONE NUMBER MAR 2 3 1976
TO B k�A O"ic wWell.
ADDRESS 7 2
LEGAL LOT
LOT AREA
SUBDIVISION NO.
0 YES El N
VARIANCE OR
ADS NO.
COND.USE NO.
PROPOSED YARDS
HEIGHT
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FRONT SIDE REAR
ALLOWABLE PROP
SED
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SIGN AREA SIGN
AREA
OTHER
REQUIREMENTS
PLANNING DEPT. APPROVAL DATE
STREET R/W
EXISTING STREET R/W FT. DEFICIENCY THIS PR.OPERTY
COMP. PLAN ST. R/W FT. FT.
REMARKS
CHECKED BY
W
W
STREET AND/OR UTILITY 0 YES
W
WORK REQ'D 0 NO
UNDERGROUND El YES
WIRING REQ'D NO.
TYPE CONNECTION
VERIFIED BY
El YES PERMIT
NUMBER
W
SEPTIC SYSTEM
I
3:
APPVD BY CITY ENG . No
h.
v)
REMARKS
METE R SIZE
SIZE
EARANCE.
BY'
ISERVICE
ICL I
ICHECKED
W
REMARKS
TY 0 TUTION CODE
NS)
SPECIAL INSPECTOR
OCCUPANT
REQUIRED
JAREA
JOCCUPANCY
GROUJ' LOAD
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I
0 YES �(NO
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PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
12
SHOULD BE ODED 31,04,
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REMARKS
z
VALUATION
FEE
PLAN CHECK
NO.
BUILDING
PLU MBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
CITY of EDMONDS
Civic Center Edtnonds,� Washington 98020 Tel e ph one (206) 776-2525
Building De artment
P
November 19, 1976
Mr. Donald R. Walker
17327-72nd Avenue West
Edmonds, Washington
Dear Mr. Walker: Re: Change of address.for
Permit, #760195
As per our conversation we are today changing.the add.res�
of the above permit to.17315-72nd,Avenue West. The permit
had the number of 17335-72nd Ayenue West.
We will notify.the utility billing department.and it will
-esponsibility to notify any other interested parties.
be your I
Thank you for your cQoperation,.in this matter.
Very truly yours,
EDMO S BUILDING DEPARTMENT
H rry
arry M. itcutt
Building Official
HMW/a.e
APPLICATION
P for
The City of Edmonds,,. EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS F� LID NO. ASMT. NO.
OWNER------- .............................. ................ -------------------------------- CONTRACTOR ----- b��V ------------------------------------------- PERMIT NO.
JOB ADDRESS . ............. LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK No - ------------------------------------
..................................................................................................................................................................
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NAME OF ADDITION .... K:5 -------------------------
.............................................................................
0
P.
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Approved:
DATE.,,,;Pr 'e- ----------- By ............ g ......... I . 1/7 . 5 -
APPLICATION
for
The City of Edmonds
EASEMENT NO - ------
-----------------------
SIDE. SEWER, PERMIT
NEW CONSTRUCTION REPAIRS F� LID NO. ..... . ASMT. NO. ..........
&CAI
............. o ......
---------------- 44� ------------ CONTRACTOR -------- 410 OW.al -------- PERMIT NO.
.OWN- --------
AD RE 3- T-1 -- --------------
--------------- �0!0?41 -tAl LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - --------------------------------
JPB D SS--/-
-----------------------------------------------------------------------------------------------------------------------------------------------------------
NAME OF ADDITION ....... - - ------------- - ----- .............. .
------------------------------------------------- -- - S
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Nblic llf;i:
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Approved:
DATE...... .......................... ............. By --------------
k7
1,14 0:' W'i I
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CITY OF EDMONDS SIDE SEWER PERMIT
WO
WATER -SEWER DEPARTMENT
PERMIT
call 775-2525 for side sewer inspections BEFORE covering any portion of the constructio
n
(Inspection will be Provided within 24 hours after requst. No Sat., sun., or holiday tio
inspee ns.
ADDRESS LOCATION OF CONSTRUCTION ......... . ... ...
......... ...................... ....... ................................ .........................................
..............
PROPERTY LEGAL DESCRIPTION.... 1/29
........................................................ ..................................... .............................................. ...................................
......................................... . ...................... . ................... .......
............. �:'
.......................... ............... . ........... .......................................................................... .
................................................. T2 H, C S
--------------- 011-WERAND/OR BUILDER --------- = ............ �7
....... ................................... .......................................................
CONTRACTOR'S NAME & ADDRESS ........ ........ ccm.c: ......
.............. ............................ ............................... .. . .......................................................
Permission Is granted ----------- . ........ 19.7 for rpal, and/or connection of a side sewer to the city sanitary
..........
system In accordance with City of Edmonds olj4j�j�,ce&
sewer
-7
A(DITION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtaln a permit to construct sewer Inside Property line. A licensed Side sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before It has been Inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion Of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtaln full information regardinikOrdinance 11.16.030 and Regulations governing side sewers when you get permit.
NbTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches Inside property line; minimum grade of 2%. No bends in
sharper than 'A will be permitted. grad
e
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contrartors shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE No. 6—It Is unlawful to alter or do any other work than Is
sert the pipe into the wye. provided for in the permit, or to do any work on the main, sewer or its appurtenances except to in -
DISAPPROVED E] Date ... . ................. 44: ................ By ---------------- Date .............................. �B_y .. . ..............
------------- ----- 'BY ----------------
"PROVED XDat . ... . ............. 7 . .........
.. ...... ........... :;�� ...........
.................................................
Remarks: ....... . ...... . .......................... . ... .......................................................... . ...................................... . .............. . ........ ...........................
...............
..................................................................... . ...........................
............................................................. . .............................................. ............................................
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
'r C hereby certify that the side sewer installation constructed under this permit
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w,,.,nstaJled in accor�' ce with all governing ordinances of the City of Edmonds.
Dated this ......... of.. .. .................................................. 19 .........
day of
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V Check BEFORE you dig for: Water C], Gas El, Telephone E], Power E] ewer C3, Other
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