17912 72ND AVE W.PDF111111111111
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17912 72ND AVE W
CITY OF EDMONDS
FOR INSPECT�7:1%e CAI* fjo
PUBLIC WORKS DEP MENT Permit 0
SIDE SEWER PERMIT 775-2525 Ext. . 220 Issue Date (�Q -7,_3 /7
PEP -MIT MUST BE POSTED ON JOB SITE�,�-J-
l.. Address of Construction I 9q 17 - -7 2__ ") CS-�7 640AW)MA 9ko?,o
2. Property Legal Description (include all, easements)- /,07- q-4
-z 4 10 2 3 4,11 kit ew (44(l.
ly
3.� Single Fam Residence k,.-",Multl-Family No. of Units
Commercial
4. Owner and/or Builder npm
5. Contractor & License No. -72
R 11 -RE
6. Invasion into City Right -of -Way: No),_,,-"-"' Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
E-i 7. Cross other private property: Yes No LXEasement required
attach legal description and county easement number.
READ THE FOLLOWT.NG AND SIGN:
04
a. Property owners must obtain a permit to install'side sewers on
>4 their property. A licensed side 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.
�4 C. Commercial establishment requires a minimum of a six inch (6")
a4
side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
e. Side sewer lines must be laid at a minimum grade, of 2% (1.150)
0 and maximum grade of 100% (45'). - 0
f. No turn in side s8wer greater than 45 (1/8,bend) is allowed
1 0
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 100' 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 un-fY1--khspected and approved
by the.City.
1. Inspection during normal working'hours J31y two (2) working
44za / -7 4
days notice required.
DATE:
V'cLE.-,ttifv that j_,haCve read
and shall comply With the above
�:PERMIT FEE: 10 'DISAPPROVE D 9Y: Date:
c) B Date:
CONNECTION FEE: APPROVED By: Date: al7a-
0 0
44 PERMIT MU$T BE POSTED.ON JOB SITE
Side Sewer Drawing
The City of Edmonds EASEMENT NO. ...............
NEW CONSTRUCTION REPAIRS 0 LID NO. ----- ASMT. NO - ------------------
OWNER --- -------------------------- - -------------- CONTRACTOR ..... .................................. ........................... PERMIT NO.
....................
(L ...................... BLOCX NO - ------------------------------------
JOB ADDRESS --- ... . .... . ..................... ............. - -------- LEGAL DESCRIPTION: LOT NO . ......
or
..................................................................................................................................................................
NAMEOF ADDITION .......... .............................................................................
. .1.
J 1-or. Pro crTy sl,*,K4t
enj
PLACE - W
A
PVVW-0001-1 1/75 (REVA 1178)
C CITY OF EDMONDS
q FOR INSPECTION CAL Permit N 60 30- -60 5..
PUBLIC WORKS DEPAR- 1ENT 0
PU L
S ,DE SEWER PERMIT 775-2525 Ext. 220 Issue Date! i-K X 71
, - I 1 0
PERMIT MUST BE POSTED ON JOB SITE t
1 .
3
4.
5.
6.
Address of Construction OWD —
Property Legal Description (include all, easements) Lo-r4+1
Single Family Residence t.," Multi -Family No. of Units
Commercial
Owner and/or Builder F E - L k 4�e_ I
Contractor & License No. mA-x.n4-Ac-x-2.�e_L_
Invasion into City Right -of -Way: No-LzYes (If Yes Right-of-
way Co nstruction Permit Required - Call Dial Dig (342-5344) before
excavation) .
, I--,'
7. Cross other private property: Yes No Easement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain a permit to install side sewers on
their property. A licensed side 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")
side sewer line.
d. Side sewers may not be installed tv inches (30")
to any structure.
e. Side sewer lines must be laid at 4-'4'�4m- m ra EDWQE)IG1 150
0
and maximum grade of 100% (45 48 HOURS
f. No turn in side s8wer greater th 4 5 8 be dBBFAQjRE10 ed
between cleanout. All 90 turns must b dbn o Voubla/
bend) and wye with removable cap.
g. No down spouts, footing drains r i s can connec ed
to side sewer system.
h. Pea gravel is required for beddi ihMnstsm""100"O s
through other than granular soil. - UT111TYC00RU1NAT1N6C0 C11_
i. Cleanouts are required at 30"-60" from each p 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: _77
'I cdrtify that I have read
LM-2-03 and shall comply with the above
DISAPPROVED BY: Date:
PERMIT FEE:. 55'�—' ( " '0"I' L.
of lwr_
UN _j By: Date:
'n CONNECTION FEE: k ) 1'k APPROVED By: Date:
P4
PERMIT MUST BE POSTED ON JOB SITE
7j�
City'of Edmonds
I __ p ,
ob
(Y 9 0 - 1 9 4 -
'7
PERMIT PermitNumber: q'A
7-T FILB
610, r"" 127 0 sue Date:
19 1
.2
A. Address or Vicinity of Construction: - 17912 72 Airenue West
B. Type of Work (be specific): Tnstall Npw qpryie-p
C. Contracton. WASHINGTON NATURAL GAS CO. Contact: Frank Swan
Mailing Address: 815 Mercer St. Seattle, WA Phone: — 224-2278
State License #: 98111 Liability Insurance: Bond:$
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. EJ Commercial
Subdivision
El City Project
EgxUtility (PUD, GTE, WNG, CABLE, WATER)
F] Multi -Family
SingleFan-iily
Fj Other
INSPECTOR:
INSPECTOR:
RyJ
F. Pavement or Concrete Cut aYes []No G. SizeofCut(02 x 4@ Wtr. H. Charge$
APPLICANT TO READ ANDf SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees t ld the City of Edmonds harmll�_)Ll _i1_1J'_._11'J1_'7-mages or
AIM
claims of any kind or description whatsoever, foreseen or unforeen, that may be made,.against the City of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this pennit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERJOD)OF ONE YEAR FOLLOVJWG-THE FrIAIAL INSPEC77ON
AND ACCEPTANCE OF THE WORK ES77MATED RESTORA77ON FEES WILL BE HELD UN77L THE FINAL S7REET PATCH IS COMPLETED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Department- 771-3202.
Work is to be inspected during progress and at completion.
lZestoration is to 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 b the City En
. y . g!peer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permi�,reqi rtrement�,and the pink copy of the permit will be available
on site at all timesfor inspection purposes. 005a��'
Signature: Date: 12/4192
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR. TO BEGINNING WORK
y
.................. . ..... .. .
RJGHT:.QF.WAY:DE1
AFrER:..MA1'-QA DAYS.
....................... ......... .........
COMMENTS:
/ �_ , 17
DATE: ISSUEDBY:. 411,
WORK SHALL. BEGIN PRIOR TO PERMIT
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street De-0c)
Comments:
I Diagram:
0 1
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. Ju
- ME--4-
M�
WasM
ngton
NabirSiGm
''dendum to
City of Edmonds
Right of Way
Permit Application
Submitted by: HILI-AQC>
Engineering Aide
Washington Natural Gas
622-6767 x2761
LO pager -qW-jC,5G
1� 2x.+)(P
r
WNG to window.-/
Water main depth
unknown
-L" gas main
CZ -IS
-w-
water
-g-
gas
-ss-
sewer
-e-
water hydrant
0
water valve
815 Mcrccr SL (PO. Box 1869). Smtk. WA 98111 (206) 622-6767
I,? C. 18 ()"1
CITY - OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) M -0221
Website: wwwdedmonds.wi.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering "
October 18, 2005
Jayme V. Larsen
17912-72 rid Avenue West
Edmonds, WA 98026
RE: Request for Copy of Traffic Study
Dear Ms. Larsen:
GARY HAAKENSON
MAYOR
Per our email conversation recently, please find enclosed a copy of our most recent speed study
along 72"d Avenue West
If you have any further questions, please feeffree to call me at 425-771-0220,.
Sincerely,
ARD S11BREL
iEngineering Technician
ES/cmc
Enclosure
I
S:\ENGR\ED\Lettcn\Misc—LCUeM\72 Ave W- 17912.doc 0 Incorporated August 11, 1890
Sister Citv - Hekinan. Jar)an
The Informe.l.— shown on the
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21
24' deep
3'
10 22'
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2 9' 6'
21' deep
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1"' Copper Service
WL s�eevecl in PVC
under driveway
CITY .0 F EDMONDS
WATER SERVICE AS -BUILT
ADDRESS
17912
72nd Ave W
PERMIT
NUMBER 201164
HOMEOWNER Larsen
CONTRACTOR Ed's
Ptumloing South
DATE March
16, 2001
DRAWN Jeanie McConneR
I
BY
M ATE RECEIVED
PERMIT EXPIRES
CITY OF EDMONDS
USE PERMIT
ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB SUITEIAPT#
ADDRESS
Z25�441, 7,-,Q A0
OWNER TMEMAME OF BUSINESS
PLAT NAME/8UBDIVISION NO.
LOT NO.
LID NO.
.-I N
IX
0
MAILING ADDRESS
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED
REQUIRED DEDICATION— FT
TT-P —APPI-ird
AW Pennit Required C3
Street Use Penrift Req'd (3
inspection Required 0
Sidewalk Required 0
Underground 0
1 wiring required
IT ZIP
V410
I TELfPHONE
&0_3
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES C3 No b
I
3
ADDRESS
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
E
CITY ZI7
TELEPHONE
NAME
G, 0 '!:24
ENGINEERING REVIEWED/DATE
ADDRESS
x
M
FIRE REVIEWED BY DATE
W
LL
z
0
C ZIP
TELEPHONE
STATE LICENSE NUMBER EXPIRATION DATE
7 ;7 :511
CHECKED BY
VARIANCE OR CU
SHORELINE OR ADB#
INSPECTION
REO'D
0 YES 0 NO
BOND
POSTED
SEPA REVIEW
COMPLETE I EXEMPT
EXP
SIGN AREA
ALLOWED I PROPOSED
HEIGHT
ALLOWED , PROPOSED
Rj
PROPERTY TAX ACCOUNT PARCEL NO.
NEW RESIDENTIAL "rF LUMBING / MECH
C] ADDITION COMMERCIAL COMPLIANCE OR
CHANGE OF USE
REMODEL C] APARTMENT C] SIGN
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (Fr.)
FRONT . SIDE REAR
PROPOSED SETBACKS (FT.)
FRONT URSIDE REAR
0
z
z
PARKING
REO'D
LOT AREA
PLANNING REVIEWED BY DATE
REPAIR 0 GRADING FENCE
CYDS ( _ X FT)
REMARKS
0 DEMOLISH C] TANK OTHER
z
P
o GARAGE RETAINING WALL
CARPORT 0 ROCKERY RENEWAL
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
CHECKEDBY
ITYPE CgNSTRUCTION
Azlle�lhvw 7�
co DE
OCCUPANT
GROUP
UJ
a
0'
NUMBER
OF
STORIES
NUMBER OF
DWELLING
UNITS
CRITICAL
AREAS
NUMBER
SPECIAL INSPECTOR
REQUIRED 0 YES
AREA
OCCUPANT.
LOAD
a
� -'3
is
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RECI'D
zz&r6c
VALUATION
FEE
PLAN CHECK FEE
HEAT SOURCE GLAZING % LOT SLOPE %
BUILDING
PLAN CHECK NO: VESTED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
GRADING/FILL
_j SEPARATE PERMISSION.
IS lAl E SURCHARGE
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT, I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
UJ IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
i
LANDSCAP NG
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
CC
INSPECTION FEE
< ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
0
PLAN CHECK DEPOSIT
RECEIPT
i DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
x
RECEIPT
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Official or his/her Deputy: and Fees are paid. and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
T
TUF17WNE R AGENT DATEAIGNEDJ
(425)
OFI54rIALS SIGNATURE DATE
771-0220
RELE ASED BY /DATE
YGN
.A E ION
f
EXT)333
------
ITI UN WFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
/ T t
771-0221
INA NSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
.CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
ORIGINAL - FILE YELLOW - INSPECTOR
PINK - OWNER GOLD ASSESSOR
5/98
-