18012 ANDOVER ST.PDF11111111111111
10163
18012 ANDOVER ST
District 09/
City OfIrrionds — Water Departmelf'
TAP CARD
Reading: J00 Date
No. No.
Meter Size Tap { Size
Mfgrs. No. Style-P,\,J SR
Purchaser: 4&Uw,, Cc,, � P,,,�uo
Serv. Add. 9 Of a A ydb5s� �� xac-A
Lot No.
Add.
Blk. No.
Residential:
Other:
C-%TDr; FT F; I I F
V
Meter Location
e�e)mw_
:57 aj
,!5:TaR_M
Servic e Material:
Pressure 7,5�� lbs.
Test %
Date of Work
" I
Guar. Voucher No.
Pro'j. No: —LUTSs- i��_i
Foreman
Remarks: 'Q-zL n(-2cg—_p
K-v-p-- 'Svinp 11 -5-S7
OUTGOING Index— Reg.
INCOMING Index— Reg.
—Route Bk.—Stencil Card
—Route Bk. — Stencil— Card—
.0 ROWING SLIP
I�EW SERVICE INSTALLA,*
ADDRESS:- A
DATE:
-Nq�vcq- ON L--.:3
DIAL A DIG #
P.U.D.
TELEPHONE
CABLE T.V.
GAS \WIN Lu;
FOREMAN
STORM SEWER
OTHER
FUTURE SERVICE INSTL: NO
BORE: CUT:
LOCK
CREW
DATE: INITIAL:
INITIAL:/
METER SHOP
ACCOUNT NUMBER: SZ595
SUPPLIERAW D, Ae
TREATMENT PLANT
FOREMAN
B L T
FOREMAN
INITIAL: D A T E: //A/, P,7
TAP!!!IMETER
SHEET
APPLICATION/
UTILITY
DISPATCH
'BILLING
7176
0,
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER: -,Z-7 041 Lb 0 1 OM(��
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREA - DETERMINATION: E] Conditional Waiver F] Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER): M700,
PLANNING DATA CHECKLIST DATED: �* jf4Ag
SCALED PLOT PLAN DA'
SEWER LID FEE $:
LID #:
SHORT PLAT FILE: 5- Z% .-+4 LOT: BLOCK:
SIDE SEWER AS BUILT DATED: - t I I I �j
SIDE SEWER PERMIT(S) #: �3119� .
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSTs\Fon-ns\Street File Checklist.doc
PERMIT
NUMBER
CITY OF EDMONDS
70
CONSTRUCTION PERIVIIIT APPLICATION c A
A(,;�IIE � ",3 >12_ 41VOOV6P- 5719�
ESS)
LEG/7
VJ
9 5ct Y PER OFFICIAL STREET MAP.
cl
ro ry Is
HAW
RIGHT OF WAY CONSTRUCTION PEP.11 RILOUIRE.
STREET USEPER.IT AEOVIRE.0
ADDRESS 2
SEE ENGINEERING MEMO DATE
TELEPHONE.NUMBER ;7
CITY t,_� REMA S
NAME
ADDRESS
METJ IZE,
CITY TELEPHONE NUMB'
Nil
REMA;r
S7ATE4ENSF NUMBER SIGN AREA ADS NO.
COMPENV. REVIEW
ALLOWED PROPOSED LETE EMPT Ili 4)t,
F.1 Descri5irlon IPl '8rIyl;,In lude all easements
LO 0 5� ...
is . r
fO
t>elcw 0 ".0 u
9 PLANNING REVIEW By
VARIANCE OR CU
2-46
:5�
HEIGHT L COVE v
YARDS
FRO SIDE REAR
P
EW D PLUMBING
-'-E 'AL
AIDDIALTER J.--EFICIAL MECHANICAL
C1REPAIR RETAINING WALL SIGN
EXCAVATE E] FENCE CHECKED B TYPE OF CONSTRUCTION CODE H
OR FILL FTJ WM 45"
E PA T
SWIM SPEC4AL IN OA AREA ROU LOAD
c—
REQUIRE G P .1000U
11 REMODEL =NCE IP-`SF`
0 YES
rTO El MARKS
INSERTV APT. EILDO RE4EWAL
A/If
A4
2 14136 &Los
NO UMBER OF STORIES F
NUMBER 0
DWELLING
UNITS
0 j4TURE OF WORK TO BE DONE (ArTACH PLOT PLAN)
771.1V
y
VALUATION FEE
It,
P
PLAN CHECK FEE
61.
BUILDING
PLUMBING
MECHANICAL
W , rs work to be done on private property ONLY. GRADINGrFILL
This Permit cove
"L4
sidewalks,
Any construction on the public domain (curtI
drivew s, marquees, Etc,) will requ:re separ3te permission, STATE SURCHARGE
Permit Application: 180 Days ENERGYCODE
Permit Limit: I Year - Provided Work Is Started Within 180 Day
-Applicant. on behalf of his of her spouse, heirs, assigns and
s ccessors In interest, agrees to indemnify, defend and hold
U th
harmless a City of Edmonds. Washington, its officials,
nts from any and all claims for damages of
employees, and aQ
what ver nature, art Sing directly or Indirectly from the Issuance
0 PLAN CHECK DEPOSIT Rm
of this p rm t. issuance of this permit shall not be deemed I
I
modify, waive or reduce any requIrement of any cit ordin:nc
a
y
0 lit f
nor=!� any way the City's ab y to an Orce any ord�n nce TOTAL AMOUNT DUE
7&Z
pro
read this application: that the
I hereby acknowledge that I have ATTENTION APPLICATION APPROVAL
owner, or the duly
Information given is correct; and that I am the
ent of the owner. I agree to compill with city and THIS PERMIT This application is not a permit until
authorized at;
statelaws regulating construction; and Indoing the work authoriz. AUTHORIZES signed by the Building official or hi
WORK NOTE Deputy: and fees are paid. and receipt 1:
ad thereby, no person will be employed In violation of the Labor ONLY THE G
P CTION
nCe. P
;b �6, Code of the State of Washington re acknowledged in space provided.
latinQ to Workmen*3 Compansa-
INS
it nInSur DATE SIGNED DIE RTMEI,T OFFICIAL'S SI N
1 0
A RE 1 0 NT? T RE
CITY OF
`23 - H E 0 M 01 N:0:�S�
RE ABED BY:
771-32 VtE
A ENTION
IT IS UNLAWFUL TO USE OF, OCCUPY A BUILDING 08 STRUCTURE ORIGINAL — File YELLOW Inspector
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
HAS BEEN GRANTED. UBC
PINK Owner GOLD — Assessor
A CERTIFICATE OF OCCUPANCY
CHAPTER 3.
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SYSTEM CROSS—SECTION
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TRENCH CROSS—SECTION
A&ANDARD DRAINAGE PLAN
IRFILTRATION SYSTEM
PAGE I OF 2
for
location
plan by
phone
date
DESIGN DATA
french Perc LF per Impe . r" Tr ench
.T*
Number Rate 1000 sq.ft. Are6.,, Req.
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals (at least
twice per year).
EAOe26e�
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M,
CITY OF EOMONOS
3 64.2. 01- 87-:0.
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CITY of EDMqVS
S S E W E R PERMIT
For Inspection Call 771-3202 FLE PERMIT NO. 07763
Address of Construction: /?0/ 1 Avr--,Ov(f /� 5/-
Property Legal Description (Include all easements): j�07- Ll — �—,3 -2 —�?(o
�_7&9 90-
Owner and/or Builder:
Contractor & License No:
Single Family Residence
Multi -Family
(No. of Units
ell
Commercial (No. of fixture Units )
Invasion into City Right -of -Way: No _Z:� Yes _ (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No (If Yes, easement required,
attach legal description and county easement number.)
PMLEA READ THE ITEMS LISTED ON THE BACK
A0
1 certi a read and shall comply Date
with e items listed on the back.
Permit Fee: -?0 00
Trunk Charge:
Assessment Fee:
Partial Inspection:
Z,-
Issued By:
6ate Issued:
- 76411
Receipt No.: 7
Comments
Final Inspection Approved: 42
Date Tnifial
Rejected:
Reason
PERMIT MUST BE POSTED ON JOB SITE
--Ua—te Initial
_Tn -i
Date tial
Wh.ite Copy - File Green Copy -'Inspector
Buff C opy - Applicant t I
The City of Edmonds
Side Sewer Drawing
NEW CONSTRUCTION 0
OWNER VA
------------------------------------------------------------------------------
OB ADDRESS ------ ....... :�.* ----------
C-0
Al\ t I DIP ct--"c
j
to" ..I
EASEMENT NO - --------------------------------------------
LID NO - ------------------ -- ASMT. NO - -------- ----------
CONTRACTOR � -- -- --------------------------------------------
.............. ----------- PERMIT NO.
------------------------------
LWAL DESCRIPTION: LOT NO - -------- L�- BLOCK NO - ------------------------------------
REPAIRS F�
------------------------------------------------------------------- T-it — -
- ------ ---
A--" - Q- -,Uy -------------------------------------------------------
NAMEOF ADDITION ............. jo ---- — -------------------------------------------------------------------------------------------------
IAI\ 4.20
%j P-m-c- 0,\n wji-t, 4' llae,�>
L I
02L
(D le
PWW-0001-1 1/75 (REVA 1178) 1-10
Awc:�)Qvc,k
a Or
Approved:
ELYNNWOOD UNE
E�� 46
0
-7
DATE ...................... By -4�� .... . ...................
V�' III,--P -,-'1197
Prop'e, ty
CITY OF EDMONDS
N 2- 05421,/
[in' N EW
ADDITION
RETIREMENT
ASS& N FORMATION SHEET
STREt"'i" FILE
ASSET NO.
ADDITION TO ASSET NO. -
,�) 1/1-1:1? /
DESCRIPTION
SERIAL NO.
LOCATION
DIEPT,/NO
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
PROJECT NUMBER
PROJECT COMPLETION DATE
COST
B.A.R.S. ACCOUNT NO. -20 40 0 a
ESTIMATED LI FE—,:`:'�
INITIATED BY DATE APPROVED BY
—SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE
vp) INITIAL
DATE
VERIFIED BY
PROCESSED
BATCH NO.-
DEPARTMENT FILE
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