17836 TALBOT RD.PDF11111111111111
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17836 TALBOT RD
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PERMrr
Permit Numbeirl
Issue Date:
A. 'Address or. Vicinity of Construction: - 17836 Talbot -Rd (9701164)
B. Type of W�ik (be specific): 11nsta11 Seritce
C. Contractor: _VashLugton Natural Ga,
Mailing Address: 1122 75 St SW Evp-rp-tt
State License #: 98203.
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1 9 C) ,
D. Building Permit # (if applicable):
Con6ct: Hariamne Kingbbury
Phone: vifi-7,i
Liability Insurance: Bond: $
Side Sewer Permit #(if applicable):'
E. 0 Commercial Subdivision 0 City Project J) Utility (PUD, GTE, WNG, CABLE, WATER)
n Multi -Family F1 Single Family E) Other
INSPECTOR: INSPECTOR: NyJ
F. Pavement or Concrete Cut: W Yes UNo G. Size of Cut.-`,�-- x H. Charge$
t-(J-1 cut
APP.LICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legalproceedings including defense costs, and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF . THEWORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITYFORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction dra�wing 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 ta 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 priorto the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and thepink copy of thepermit will be
available on site at all times for inspection purposes.
Signature: Date:
(I(Con'trdc-tor or ent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY. RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOI . D AFTER _3M 5 DAYS
SPECIAL CONDITIONS: P A -
DISRUPTION FEE/FUND 111:
RESTORATION FEE:
PERMIT FEE. 0 Do
TOTAL FEE:
COMMENTS: RECEIPT FEE:
DATE:
ISSUED BY:
NO WORK SHALL. BEGIN PRIO . R T 1 0 PERMIT ISSUANCE E . ng. Div. 1994
FIELD INSPECTION NOTES (Fund.111 - Route copy to Street Dept.)
Comments:
I Diagram.:
CONTRACTOR CALLED FOR INSPECTION El YES NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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A AL- —IL-2— MORN
WWOMMOWwwwo — —
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AVJb4wgIOnErOWCarVOV Addendum to: Ci!l of Edmonds
Right of gay
Permit Application
Submit''ie'd 6y:' Mirlawne Kinisbury
Ragineering Aide
Washington Natural Gas
0356-7500 X7596
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-w- Water
Watermain depth -G- Gas
-SS- Sever
Water hydrant
gas main Water valve
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Washington Natural Gas Company
1122 75th Street S.W., Everett. Washington 98203, (206) 355-3331
APPLICATION
10
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The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
Z- NEW CONSTRUCTION REPAIRS F� LID NO. - ................ ASMT. NO - ------------------
OWNER ---- ------- k--A(0.k---AlE� ------------------- CONTRACTOR ----------------------- PERMIT NO.
JOB ADDRESS LEGAL DESCRIPTION: LOT NO - ------------- L ........................ BLOCK NO - ------------------------------
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Ca 11 ',775-2525: 4ew�r ln'si4c'tlons, . �E'IFORk �co�erin
g any' portion� of the 'e.onstructl6n'
llnspe�ctlon� willrbe prov e rw thin ',24. h rs:i-after:4eq'u4st� Norsie'-'. Sdnt, hollda�. Inspelc6o"n's.
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'&idi;nCe!-`,%Vlth- Cli�. dt'EdtAorid&�ordin"i 6e
ThEj POL�O.V�JriG:
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pertnW,to-conk ucC-'.se' er,:Anslde,Oop6ky,--ii�'�� -A-licensed- Sid e,Sewer?'Contracto'�.�mus*t -13��_'ernpf��ed'l. t
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rtin(street;,area.; Do.not.cover,-.any. portion iof sewer.:before -it' hasj.be*6n':Inspe'Cted
;,.?7?�,llf��ork,..P�e�forMed'.in:t�'city'rikht-of-viay"require;�,:an- Iny"160 ;f
-of-.Way,41e�ml�;`obtajnabf�- fr*6m. the,6ty.,
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�ANOTE,No.N3L�LObtE�in-f�Ill,inf6rinati6�,,reg'a.'rding�:Ordiiiance�,1.11-'.16.Oi6!'alid,.�li&gulkt'16ns. i6ve�nIfilPsidi yo perml
property line:, mlnlffium�",grade,of
NPMN6.�_,4—' Wp.lof��slde; sewer musV ha�e.at least 30!!Inches.'�o�e�aie',at,p�op��ty* `ilne,and' 42-iin&�e� lnslde��
sharper-AhaK-1/s will�be permitt6d.,�
n--street. must,be. N
atsr*:B� tied wand,�gurfa�ce '6f stre`et.xestored� �to- originiLlOconditibm,- 'CO�t tors' - reip�nMbls
w6rkWhIchvmiy jeveiopwithi n, onet year--of,c6mipletiom.,
w iv r n, Ahe, per!nit, �,or,'�to'doi'any'-work on th6-ma�,'sower�.!or, its�;& u
if�l to, alter--.or.:dojan' '6ther-.:
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a o k . theCn., . J��,�ro�lde&.for, i' I pp rtenan, io :ii -
the- pip , e intott.he.wye.*,
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DATE:
MEMO TO: Building Division
Community Development Department
FRO?4: Engineering Division
Public Works Department
SUBJECT: NOMW�50r) tjoMfS,)RC,
After review of the subject building permit application, we have
the following comments:
C,
Coordination of the location of any structure with respect to
utilities, streets, property -lines and driveway grades is the
re.sponsibility of the contractor.
(2) The contractor i's required to keep the abuttina streets clean-
C�
ed ot dirt and debris caused by the construction.
trUCt4
(3) A "Right-of-1%,lay Cons -on Permit" is required, from the
Engiiiecring Divisio,-i of Public Works, for any work within
the Public Right -of -',%,ay or public easement.
(4) D�iireway slope not to exceed--1410.
WNW
PIV 5/77
PUBLIC vows DEPan4 aiEmisT.
. BU11DING PER�11T REVIEW
Tki5cT
(address) te)
Street Right -of -Way Existing is�
A5 i�� N -A,
Z
Access Easements Existing
QD
g
Utility Easement Exist'
REQD
W
Lot Per Subdivision 'Plat
Assessor
Site -Plan Checked for Accuracy
Z
Underground 'Wiring Reqd.
0
Check Accuracy of Legal Description
Z
Review by
'Date I
Eid'sting Water Main Size
Water Main Required A.,'Al
Service Line Required
Hydrant Size Existing
Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd. WO
Cross Connection Inspection A.)O
Fire Department Comnents
Water Meter Charge Reqd. J, 2,,
Review by.
Date- _21> flit/ -e
Sep�-ic tank -Design Approved
Date
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability-
Proj. F604:1--
Drawing No
File No. 1.4-92
Side Sewer Availability 7-FP PA!2�01099;0_072��
Sanitary Sewer Connection Fee Reqd.
A45ylte
�3:,
Review by
Date 'S
Open Ditch Existing
Culvert Reqd. j_/X
—Siz e*
P4
Catch Basin Reqd.,
Indicate on Site Plan
0
Shoulder drainage maintain collection on
swale open runoff
g�_
U)
Manhole reqd.
-Z-41 V
Tnciicatp on Site Plan
Soil Conditions and Ground Water Field Checked
I t
Review by
Date
Revised: lvlO-1977
Page 2
Street Paving Reqd.
Curb and Gutter Reqd.
Sidewalk Reqd..
(�A,.Cut for Driveway Reqd.
p4
Right -of -Way Construction Pennit
Bond� Reqd. for'. Public, L-nprove`n')ent� A4-
Street NaTm. Sign Reqd.
Other Signing Reqd.
Pre Pei:tnit Site Inspection made on,:: `2_1 -16
z
0 -BY:
SEWER'
WATER
P-4
z
ST1MT
ENGINEERING'
Special' Requirements listed in,nibm to- Com=ity Developnmt Department-,
44
Building Division
BY Date-
b
All items filled in an Building Permit Application
r4
BY Date
P'
Drawings Stairped and'Notations Made
BY fgl\j Date
Approved by Public Works Departrrmt
Revised: lv 10-1977
1�
PUBLIC �DRKS DEPARTMENT-d&ECKLIST
-BUILDING PERMIT
T-&* Pl�
(ad&--es-s-T— (date)
Street Rig1-it-oA-':-1qay,EFxisting_
REQD—
Access Easements Existing_____Nn_hj-9:
PEOD__N
-A--'
p4
Utility Easement Existing
W
Lot Per Subdivision Plat.
)< A�;sessor
Site Plan Checked for Accuracy
—
Underground Wiring Reqd.
Y
Check Accuracy of Legal Description
Z
Review by
Date
r4-
Existing Water Main Size —
-6.
Water Main Required A,,�A-1
Service Line Required -�114
Hydrant Size Existing
Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd. �1/0
Cross Connection Inspection �L)O
Fire Deparn-ent Conn�ents
Water Meter Charge Req
Review by
a-ite V142,8
Septic Tank Design Approved
Date
Septic Tan1,7 Permit Reqd.
Permit No.
Sanitary Se�-.,er Availabilit"
Proj. lc�L4-7—
DrL--n.7i-,) 1,7o.
File No.
Side Se,.-�er Availability 7 9�,
Su-iitary Sa-jer Connection Fee :,-7,eqd.
Revie�.-7 by
Date
4ZI121-0
Open Ditch Existing
Reqd.
Culvert Reqd.
Size
OL
P�
Catch Basin Read.
Indicate on Site Plan
0
Shoulder drainage maintain collection on mN7ale open runoff
Z
Man1hole reqd.--
Indicate on Site Plan
V
Soil Conditions and Ground Water Fie"Id Checked
Review by,_-
1111'�
Date
CD
CD
Revised: lvlO-1-97/7
BUILDING DEPARTMENT
PERM APPLICATION
INAME (OR NAME OF BUSINESS)
USE PERMIT
Applicant Fill ZONE NUMBER
Inside Heavy Lines
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Legal DeSCription of Property
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JOB
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LEGAL LOT
LOT AREA
SUBDIVISION NO.
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TREET R/W
E X'ST ST
XISTING ST�REET R/W
-50
JUMBER
FT. DEFICIENCY THIS PRQPERTY
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COMP, PLAN ST. R/W
,q Ll
F-r.
REMARKS
CHECKED BY
C�,
NUMBER
TREET
S AND/OR UTILITY WORK
R/W PERMIT REQUIRED
rE_C�E
REQ1D. El YES
NO
1:3 YES NO
UNDERGROUND
iNc
WIRING REQ'O.
M YES NO
TYPE CONNECTION
EYES
BY
A IN ;:F
SANITARY SEWER
1:1 NO
I—RIFIED
'FELEPHONE NUM13ER
SEPTIC SYSTEM
Y E S
PERMIT NUMBER
G�5
APPV'E) BY CITY ENG.
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CITY LICENSE NUMBER
REMARKS
Lj LP
Below or Attach Fou , Copies)
METER SIZE
'PLY SIZE
REMARKS
SIGN AREA
ENV. REVIEW
I _PTj
AOB NO.
ALLOWED I PROPOSED
COMPLETE I
EXEM
REMARKS
VARIANCE OR CUC�"-I IPLANNING REVIEW 13Y DATE�
YARDS T COVERAGE I
NEW
RESIDENTIAL
GAS
S7 F R ON T SIDE �LZREARL
I
NON-RESIDENTIAL
I
LINE
_� SIGN
FIRE ZONE TYPE
OF CONSTRUCTION ICODE HEIGHT
0
ADD
ALTER
REPAIR
MOLISH
EXCAVATE
OR FILL
PRE -MOVE
INSP.
RETAINING
1:1 WALL
FENCE
I— -- -
swim
POOL
SPECIAL INSPECTOR
REQUIRED
El YES N 0
PLAN CHECKED BY
OCC UPANCY OCCUPANT
GROUP LOAD
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
N ___F_
UMBER OF STORIES
on
NUMBER OF
DWELLING 0 "4 .�
UNITS
REMARKS
NATURE OF WORK TO BE DONE
C-7—
k
PROPOSED USE
F(+ ri
PLAN CHECK
NO.
06
FLUT FLAN (INDICATE BUILDING SETBACKS,
X
ABUTTING STREETS)
BUILDING
ju
ILI
0
PLUMBING
mq
0
HEAT' 8, GAS LINE
FENCE
SIGN
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RETAINING WALL
-,SWIMf4ING P0,_
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VALUATION I FEE
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III
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