17624 69TH AVE W.PDF111111111111
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17624 69TH AVE W
APPLICATION
�The City of Edmon for EASEMENT NO . .......................................
d8TIrlEET FILE SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID NO . .................. . ASMT. NO . ............
OWNER .... ....... .................................. CONTRACTOR
............................... -----------------_---- PERMIT NO. ............
JOB AVDR.ESS --4
--- ----- LEGAL DESCRIPTION: LOT NO� ...........
....... -------------- BLOCK NO . ........... ............
i ---- -------- th ...........
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p, scf forth a i -�- mu., I'., a c2py
colldfuc�ar, in". .-th� NAME OF ADDITION --- \-/.I =--\N ..... F51.CX= --- — ---------------------------------------------------------------------
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Approved:
1-77
DATE .... Zd��..7
.. ..... _ol__/ --------- By -----------
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
STREET FILE 1�11 "1 -1
PERMIT
Call 77 -2525 for side sewer inspections BEFORE covering any portion of the construction.%
Inspectl5on will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.]
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ADDRESS LOCATION OF CONSTRUCTION ............. ...... _1e ................... . J ..................... . ........... ................. .........................
PROPERTY LEGAL DESCRIPTION ........... q t)ljtj� .... _.A.Z . ............................................ . ...............
..... ; ................. _... __.T=!T!� .. .... ........ ....
....................... . .......................... . .......... . ........... ........................................................................ - -------------- - ------------------------------- - -------
k4.-� U ....... A S_ ........... ................................... ....................
........ ....................................................... OWNER ?AlqD/OR BUILDER ...................................
CONTRACTOR'S NAME ADDRESS --------------- �—.CA� .......... .......... 4_4� k� --- - -- - ---------- ........................................
Permission is granted ..... 3_en,_P�� ...... 73 --------------------- 19 .., for repair and/or connection of a side sewer to the city sanitary sewer
system In accordance with City of Edmonds ordinanc4es.
JNTION IS CALT D TO THE FOLLOWING:
NOTE No. 1—The owners of the property may obtain 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 Ilight-of-Way Permit obtainable from. the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE 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 bands in grade
shaxper than 'A will be permitted.
NOTE No. 5—Trenches in street must be water settled and surface of street restored to original condition. Contractors 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 provided for in the permit, or to do any work on the ma4n sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVEDDate
APPROVED
... .
Date.._.,-,-e�
................................... By ................ Date .. * .. ----------- By ---------------- Date .............. . ................... . By ----------------
--- 7 --- 27. -----------_---------- By- ........... . .. . ............................... .......................................................
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- Remarks:
....... . ..................................
. .. . ..........................................................
. ...................................... . ...................................................................
..................................................................... . ........................................................................................ . .................................. . ............................................. .........
BOTH it Cop' MUST Be Sired.By Owner of Firm Performing Construction PRIOR To Request For Inspection
f
................... .... hereby certify that the side sewer installation constructed under this permit
X(Owner �ofCjontracting Firm Performing Construction)
�ct'
nstalled in accordance with all governing ordinances of the City of Edmonds.
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Datedthis.k.:��___/.ZAy of ................................................................ 9 19 .........
V V Check BEFORE you dig for: Water E], Gas C], Telephone [3, Power 0, Sewer [3, . Other [] V V
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FILE APPUCATION
the City of EcSJUEET for
SIDE SEWER PERM17
NEW CONSTRUCTION
h., -------------- -.1 -------------------------------
OWNER --------- ..... CONTRACTOR
JOB ADDRESS ?-..d -------------------
------- t ...... --- LEGAL DESCRIPTIC
EASEMENT NO.
KEPAIRS, LID NO - ------------------ - ASMT. NO - ------------------
- -------------------- - --------------------- PERMIT NO . .... ......... ...
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LOT NO. -'-17 --------------------------- BLOCK NO - ------------------------------------
.......... -------------------------------------------------------------------------------------------------------------------------------------------------------
NAME OF ADDITION ..... IV, ...... fi.a- V- ------ ------------------------------
Approved:
DATE
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I Street Ripllt-oF-I-,aNr Existim REnD
Access Eascuicitts Existing
Utilitv E,157,C111011t Existim" 1\' 17 n n
Lot 11cr'Suhdivision p I a t , Lf5� Assessor I !,IT)
Site PI'm Cl�ccl-cd for Accurnc-�
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#-77
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BUrLDING DEPARTMENT
PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
H et 11 BYIAYII�S.' im.
W MAILING ADDRESS
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P. 0. Box 6114
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AZ'I,r
USE PERMIT
Applicant Fill ZONE NUMBER
Inside Heavy Lines
JOB
ADDRESS 17624-69th Ave. W.
VARIANCE OR COND. USE NO. ADB NO. HEIGHi
YARDS L OT COV RAGE
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ELEPHONE
77�_l 9'
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M I CITY TELEPHONE NUMBER
NAME
Sam, e
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CITY TELEPHONE NUMBEii
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U STATE LICENSE NUMBER ICITY LICENSE NUMB[
J 223-01-9080
L L eg_a_12DesI:ription of Property (Show Below or Attach Four Copies
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Lot 7 Viewridge 71/6
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FRONT
SI DE
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REAR
SIGN AREA
ENVIRONMENTAL REVIEW
ALLOWED
PROPOSED
I
El COMPLETE OEXEMPT
REMARKS driveway
s-Iopes not
to exceed those
indicated
on Standard
Dwg.
No. 103
PLANNING DEPT. APPROVAL
DATE
WYES []NO
I
r L-144 I
STREET R/W
EXISTING STREET R/W 675 FT. DEFICIENCY
THIS PROPERTY
COMP. PLAN ST. R/W '50 FT.
C) FT, *
REMARKS Driveway slope not
to exceed those
indicated on Standard Drawing
#103.
CHEC
STREET AND/OR UTILITY WORK
R/W PERMIT
REQUIRED
R E Q'D. El YES '%NO
0 YES -ONO
UNDERGROUND
WIRING REO'D. &YES NO
TYPE CONNECTION YES
SANITARY SEWER N 0
JVERI[10
:N
SEPTIC SYSTEM
El YES
ERMIT NUMBER
APPVD BY CITY ENG,
&NO
" I-P
REMARKS
METER SIZE
ISERVICE SIZE
ICLEARANCE
ICHECKED BY
REMARKS
FENEW x RESIDENTIAL
NON-RESIDENTIAL
GA S
LINE
SIGN
FIRE ZONE
TYPE
I
OF CONSTRUCTION
ICODE
A DD
ElDEMOLISH
EXCAVATE
ALTER OR FILL
r
RETAINING
WALL
FENCE
_ X FT)
E] I— X—FT)
SPECIAL INSPECTOR
REQUIRED
0 YES El NO
JAREA
JOCCUPANCY
GROUP
OCCUPANT
LOAD
I
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY—
REPAIR PRE -MOVE
1:1 INSP.
swim
0_ POOL
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31,04,
REMARKS
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
1,,!ew construction
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Sin,71e fw.ily residence
OT PLAN (INDICATE BUILDING SE
ABUTTING STREETS)
See attached — — —
PLAN CHECK
NO.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
VALUATION I FEE
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