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17618 72ND AVE W
CITY OF EDMONDS
�,PUBLIGWORKS DEPARTMENT
SI.DE,SEWER PERMIT
2.
3.
4.
5.
6.
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FOR INSPECTION CALL Per 0
7,7,5,A4-W5 Ext. /�70 Issue Date i L I 15�q
PEP -MIT MUST BE POSTED ON JOB SITE LYNNWOOP LINE
Address of 7onstruction
Proper�y Legal Description (include all, easements)
Single Family Residence Multi -Family No. of Units
Commercial
Owner and/or Builder
Contractor & License No.
6,,- ii!- 7 X
Invasion into City Right -of -Way: No Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (jU/-,5'jA/4') b�fore
excavation). 1-800-424-5555
E-4 7. Cross other private property: Yes No Easement required
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
04
a. Property owners must obtain a permit to install side sewers on
>q their property. A licensed sidg*sewer contractor must be employed to
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")
P4
:E: side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
U
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 (1/8;bend) 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. �1: . .,
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 6xit 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: 44
I certify that I have read
and shall comply with the above
--PERMI.T FEE: 30, OC) DISAPPROVED BY: Date:
�k r q t� -2 0 0 B e:
bONNECTION FEE: APPROVED By 477X_77- 7—
Date: 7-31,,04f
PERMIT MUST BE POSTED ON JOB SITE
The City of Edmonds Side Sewer Drawing EASEMENT NO - ----------------- .......................... .
NEW CONSTRUCTION [?F REPAIRS F� LID NO - ------------------ ASMT. NO - --------------
OWNER CONTRACTOR ---------------------------------------------------------- ---------------------- ... PERMIT NO.
JOB ADDRESS J7GIL-S --------- - - ---------- LEGAL DESCRIPTION: LOT NO - ----- i ------------------------------ BLOCK
------------------ --------------------------------------------------------- ............................................................
PRIMP c5cMr-rZ
NAMEOF ADDITION --------- ............................. ... -- -----------------------------------------------------------
in
4'. Wn
—2.0,
4"c.c.WYF-
as
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Approved:
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PWW-0001-1 1/75 (REV.1 1178)
DATE .... By
------------- --
CITY OF EDMONDS
'NE W
ADDITION
FIRETIREMENT
ASSET INFORMATION SHEET
ASSET NO. . e
ADDITION TO ASSET NO
DESCRIPTION
SERIAL NO.
LOCATION
DEPT.,NO.
"PURCHASE ORDER NO
PURCHASE ORDER DATE
COST
*PROJECT NUMBER "ZF:5
PROJECT COMPLETION DATE.
COST
B.A.R.S. ACCOUNT NO.
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
'0' 1
2"DEPREC I IATE
MONTHLY DEPRE CIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
0 G.L. ENTRY
REFERENCE
DATE
PROCESSED
BATCH NO.
INITIAL
(�np
DEPARTMENT FILE
CITY OF EDMONDS
/NEW
ADDITION
RETIREMENT
I ASSET INFORMATION SHEET
FEEASSET NO. 045 2)-)-
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION DEPT NO
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
*PROJECT NUMBER
PROJECT COMPLETION DATE
COST
INITIATED BY DATE . APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
2/DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
0 G.L. ENTRY
REFERENCE
VERIFIED BY
PROCESSED
BATCH NO;
DATE 'K.P
INITIAL
kvp)
DEPARTMENT FILE
CITY OF EDMONDS
ASSET INFORMATION SHEET
2 'NEW
El ADDITION
1:1 RETIREMENT
r q
LA
F I ij:�= ASSET NO. �2�A
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION DEPT 0.
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
*PROJECT NUMBER
PROJECT COMPLETION DATE
COST
B.A.R.S. ACCOUNT NO. �,Lll-oevo -0
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
[2rDEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT -
0 G.L. ENTRY
REFERENCE
DATE
4��j
VERIFIED BY
PROCESSED
BATCH NO. -
INITIAL
itnp
DEPARTMENT FILE
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GLENDAN COlItTRUCTION INC.
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Snohomish, WA 98290
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WALK
FOOTINO DRAINS
24'
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TYPICAL
4' TI&HTLINE FOR
DOWNSPOU775 GaS
/01.20,
NOV 2 1983
DETENTION PIPE LEN&TH CONTROL
UPPER CATCH 45 LIN. FT 15"0 ADS CATCH
BASIN (VENT) rZ- I'MIN, Z'MAX COVER BASIN FROM
111101 �J;F. � — = = Mull 1�=WlEffi OUTLET
OUTLET CONTROL
CONTROL
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/76 M
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4" 0 PERF ADS PIPE WICAP
IA161DE TRENCH
(TO BE LEVEL)
DRAINFIELD
4/% MIN 51- 6RAVEL TO THE
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TLET�
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Gd-1 To ou
SYSTEM GROSS SECTION
It
1IMPERM AREA - 22130
PIPE DIAM. - /5'
PIPE LENC7TH - 46'
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DETENTION SYSTEM
FOR
�0, AT
17619 7Zmd AVE.. W.
EDMONDS. WA. 418020
Lovell- Sauerland & Assaoistes, Ina.
SURVEYORS o DEVELOPMENT CONSULTANTS PLANNERS
23105 1 OOTH AVE. W. o EDMONDS WA. N= PHONE 775-1593
M;W=N ChUn I nATE IF. SCAL6 " FIT NO.
KM I RZ 110-ZO-83 P, 20, 1
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DATE:
IEM TO: Building Division
Communitv Develonment Department
FRO14 :
I Engineering Department
--1-'2
SUBJECT: 74 It? / zwo
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.
Driveway sloT)e not to exceed 14%.
5. Backwater valve required if downstairs plumbinp is below
elevation of-'ui)stream,manhole.
6. Water and sewer lines to be sei)arated by 10 foot minimum.
7. Builder/Owner responsible for containing all temporary run-
off and erosion on site and may not impact neiqhborin
properties in any way.
Signature
USE qW
PERMIT
ZONE
CITY OF EDTONDS NUMBER
CONSTRUCTION PERMIT APPLICATION JOB
U
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S
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E
107N NE
OB
RESS
D
NAME (OR BUSIN S) _Z? Auutitbb -7 1 S 7 2, Av e-
9- MI&O e-.', 1-. / I
71 0,�, e 17 L
7�1 LEGAL DESCRIPTION CH ECISUB—DIVI SION 10, ILID NO.
0
4-
Lo
w ITA—ILING ADDRESS
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9
PU BLC RIGH OF
CITY TELEP�Op �UM�F�. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
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2,f
�2 EXISTING REQUIRED DEDICATION
NAME
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
Lo ADDRESS STREET USE PERMIT REQUIRED n
SEE ENGINEERING MEMO DATED
CITY TELEPHONE NUMBER SEE PIW DEPT. REVIEW CHECK LIST,,PATED
REMARKS
NAME lel"1141, P - f
cr ADDRESS
0
METER SIZE BUILDING SUPPLY SIZE IXTUR
cc CITY TELEPHONE NUMBER
z
0 REMARKS
STATE LICENSE NUMBER CITY LICENSE NUMBER
6 1�lq IY6 6 AM SIGN AREA ENV. REVIEW
ALLOWED PROPOSED I COMPLETE i EXEMPT
Legal Description of Property - include all easements
(show below or attach four copies)
/Y /Ik '9.5, 1-4. al e
M d, &,-t, d'i n <1
S
VARIANCE OR CU
7-
6
YARDS
FRONT
REMARKS
FLrIEW
f7tl-
Li:j
RESIDENTIAL
PLUMBING
ADDIALTER
NON-RESIDENTIAL
El MECHANICAL
REPAIR RETAINING WALL SIGN
EXCAVATE FENCE
El
CHECKED BY
DEMOLISH OR FILL I- x _FT)
PRE -MOVE INSPJ swim
SPECIAL INSPECT
COMPLIANCE INSP. -POOL . I
REQUIRED
ViJEW BY
Jf
SIDE REA
TYPE OF CONSTRUCTION I CODE
2-SIDE SEWER
aWATER LINE
I I YES I 'NO
REMARKS
NUMBER OF�rTORIES
NUMBERO
DWELLING
1
/ :2.
UNITS
WATURE OF WORK TO
BE DONE (ATTACH PLOT PLAN)
/� el. / d eqf e
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 holld
i
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatewnr natwo nrininn rfirpntiv nr ineflrantIv frnm thn iq_qit2nen
OCCUPANCY
GROUP
VALUATION
E UNITS
ADB NO.
SHORELINE#
DATE
LOT COV
15-
FEE
HE
OCCUPANT
LOAD
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ENGINEERING A PUBLIC WORKS
CITY OF EDMONDS PROJECT REVIEW
CIVIC CENTER - EDMONDS. WASMINGTON OW20
SINGLE FA14ILY MULTIPLE COMMERCIAL C H E C K L I S T
PROJECT NAME CONTACT NAME & TELEPHONE NUMBER
ADDRESS
ACCESS SLOPE AND VEHICLE ACCESS
DRAINAGE PLAN
STREET FILE
LEGAL DESCRIPTION VERIFICATION
QUIT CLAIM/DEDICATIONS
EASEMENT - PUBLIC/PRIVATE
CALCULATE SEWER CONNECTION IF NO LID #
INITIAL-
DATE
COMMENTS
eql-f —
4V
051
4 -sve
STREET PAVING REQUIRED Al /�,� 1,
- �r-Yl -
CURB AND GUTTER REQUIRED
SIDEW ALK REQUIRED
CURB CUT FOR DRIVEWAY REQUIRED
RIGHT-OF-WAY CONSTRUCTION PERMIT REQUIRED
BOND REQUIRED FOR PUBLIC IMPROVEMENTS
STREET NAME SIGN REQUIRED
OTHER SIGNING REQUIRED
(ADDITIONAL COMMENTS ON BACK)
EXISTINC- WATER MAIN SIZE. 6/1
WATER MAIN REQUIRED
SERVI CE LINE REQUIRED
uj HYDRANT SIZE EXISTING 51-1
19 HYDRANT REQUIRED PER FIRE CODE j11A
CROSS CONNECTION INSPECTION SIZE
WATER flETER CHARGE
__�EQUIRED
5
REVIEW BY
DATE (ADDITIONAL COMMENTS ON BACK)
c.ANITARY SEWER DRAWING NUMBER FILE NUMBER
cc
Ul SIDE SEWER AVAILAB.ILITY SANITARY SEWER CONNECTION FEE REQUIRED
UA
co
OPEN DITCH EXISTING REQUIRED
w CULVERT REQUIRED _AZ�! A010keCAEO SIZE
CATCH'BASIN REQUIRED INDICATED ON SITE PLAN
z
SH6ULDER DRAINAGE �%INTAIN COLLECTION ON SWALE OPEN RUNOFF
co
7!
MANHOLE REQUIRED INDICATED ON SITE PLAN
cr i, I
0 SOIL CONDIT-IONS
_,MD GROUND WATER FIELD CHECKED
PEVIE� BY DATE (ADDITIONAL COMMENTS ON BACK)
2_2
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, op
/0/.201
UPPER GB.
4)
_(0. TICIHTLINE
Av
42'
/. C�_C'CWTROL C.a
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F5—' WALKWAY
25'
)RIVEWAYCa
COW.,RETE
DRIVEWAY
1 �9 1 4" FOOTINCY DRAINS
1
24'
DOWNSPOUTS
TYPICAL"
4" TICINTLINE FOR
DOWNSPOUTS Ga.'s
101.20,
NOV 2 1983
DETENTION PIPE LEN6TH
CONTROL
,,PPER CATCH 45 LIAZ FT IS " 0 ADS CATCH
ASIN (VE-AIT) BASIN
c
— _��)rf-PMIN'Z'MAXCOVER-n
FROM
WEI 1 .5
ff-111VEM OUTLET
p !174
OUTLET CONTMOL
CON TROL
/% &OPE % '
EYSTEM CRO65 SECTION
QU/!�N— QATA
IMPERM AREA - 22130
PIPE DJAM. - IS"
PIPE LEWTH - 46'
ORIFICE Dh4M. 6/0"
1% ANN. SL.
4w
3�!
Z
uj
/76 th
PL. S.W.
4' 0 PERF ADS PIPE WICAP
1AI-41DE TRENCH
(To BE LE-VEL)
kIma. "17
2' 4 41 DRA INFIELD
6"VEL TO THE
SURFACE
QL�PER61NG TRENCH
DFTENTION SYSTEM
FOR
GL EAIL Gj2,ALLCER
t 14c, AT
/7(o/L3 7Zmd. AVE. W.
EDMONDS, WA. '78020
I -
L Lovell- Sauerland & Associatom. Ino.
SURVEYORS rELOPMENT CONSULTANTS p PLAPMRS
23106 100TH AVE EDMOf" WA. W= Had "&IM
A"
MA" CHEMD TE 111.0. W. 17
Km t?Si lo-ZO-83 20,
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