18026 85TH PL W.PDFIIIIIIIIIIII
8040
18026 85TH PL W
ADDRESS:
TAX ACCOUNT/PARCEL NUM13ER: 0C) L"3 o 0 c) 0 10 0
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
DETERMINATION: [] Conditional Waiver Ej Study Required Ej Waiver
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: ghllt,�
SIDE SEWER PERMIT(S) #: 011-1,
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DA
m�
LATEMP\DST's\Fomis\Street File Checklist.doc
APPLICATION
for
The City of Edmon_-d 'TRM7 FILE SEDE SEWER PERMT
NEW CONSTRUCTION REPAIRS EASEMENT No . ..........................................
Z /1' 1�2
OWNER .... /-,' - . r—ae-- .
.. ............................................................................
ADDRESS....... ...........................................
............
------------------------------
A P p R()V ED
SEP 16 1966
e-le
CONTRACTOR. -- -------- - --- ------ ----- ........... PERWI� No." T1 L7
LEGAL DESCRIPTION: LOT No . ..... ....... BLOCK No . .......
................. ... ........................ .......
NAME OF ADDITION ............. A
. I -e— --- ft.,p . ..............................
Approved:
FoWr—ED KROLL KAP NO.:
1rTOnYrED T803�2
ER
BLI ILI) ING 0
DEPARTMENT ppucant FW
In.1de Ifeavy Lines joB ADDRESS
7
14AILE (OR VAM-1%i
PERMIT APPLICATION
i— YXRD,S TB K
Or USINESS) AA
- ��! ��/ ��-7 RE
K
BIDE TA-RD SETBAC 8 TBACK
5
WAILLNG KODREBU LOT AREA
0 YES r 'No
-�j
-C T��
CI BUILDING A
NAME -FL-017 'PLAN�PPROVED
flW. ADDRY.Bb -----------
H STREEr 'RTY�
PROPE
EXISTING STRF'-P R/W DEFICIENCY TMS
—i T.a:P110NF FJIJN—� "T
CITY
coir,,. PLAN sT. R/W..- Fr. r 0
Z
-ffE—KARKB
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NA.MO
0
'CaCKI"D —BY
CITY TELTPHONF
Li;1it"CL
0 XETMR SU7
CITY LICEN. E NUMBER
Q -STATEWCENSE NUMBEII
C
el or Attach YO- Copies)
Legal Description Of Property Maw
ZYPE CONNECTION
P/ I —P L—R, HT PL T '"BER
0 F--LE ZONE TYPE OF CON!HTRUCTION
STREET 1111111
0 YES [3 NO
-OCCUFANC- GROUP
=CLAL INSPECTOR —W—
GAS YES r'l NO
RESIDEN'TIAL I -IN E P E 7, K TaU c xem. h, 3 —Y
V
N"EW
E� VON."-SIDENTLk- 0 -i-N
E] RETAINING j
WALL
-FFE—MXRKS
DEMOLISH
ALTER EXCAVATE FENCE
LL r
OR
REPAIR rRE-MOVF Fi
INSP. POOL
NUMBER OF 10—S I NUMBER OF
UNITS
6F WOlUC TO BN VVNZ
Receipt No.
Valuation
Plan Cheek No.. M,
-FROPOSED U9E
BUILDING 6 a
j:LL0
r FLA
PLUIMNG
PLO N �I. is Building setnecks. &auttlng st—ti C2 A
r-0 .
HEAT & GAB
1A
FENCE
SIGN
U"
RETAINING WALL
0-1
SW7MhaNG POOL H
N4
DMIMMON
PRE—OVE INKITCTION
EXCAVATION OR FHL
TOTAL A.1101 DUE
I ht.1by acknowledge UM' I he,., end Uil, ap:,liciation. that the In-
ano the o-aer, or the duly anthor-
given is co ect: and that I
tile —"er. I M, to Comply with city and late laws ragu- ATTENTICzN A.?K..CPiTION APPROVAL j:�
no persom
in doing Lh.Z;r,, &uthorl2ed thereby,
cen.trueti..; �m
be TIM PERMIT !-his apph�iatlon is not a perrilit Until
Code of the State Of Witedlington
'm"'Oyed I. "I�tlp` of the L' I-uraoce. AUTHOEUI.ES
relat!.�g to Workmen" COm��UO signed by the Building Official or bis Del
ONLY TaL Uty; and fees are paid, and receipt is ac-
-,%rh
(Except DEMOLITIONS
NOTE: Permit Limit one Year WORK N017ED
MOVE knowledged in space provided. -o
she, N Completed in nicety d.M _n.IN BULLDIN08 shall b� Vim -
I, o,lhl*l
—TI57--F, -- INSPECTION IRECIMOR"fl, BIGNATUrE
R AGENT) Aj el,)iNED 11 ez"
A
DFrAl0'SfZNT
-All
CITY OF
r
Fee
NOTE: Applicant Subject to Plan Check rn 6.1107
This P,,rt W be do's M private Property ONLY.
rivew"S. FILE
Ad, co.strocilon the pablie domaJa (Ca,b%, sidewalks,
—q— Cie.) lep—le
NOTICE:
urar
'o...war.ran c-C
ached
The information shown on the att
map(s) was cOmPiled for use by the City Of
Edmondsl its Employees and Consultants.
Th.e City of 'Edm.onds does not * warrantthe
accuracy of anything set for.th on t ' hese
rnap(�_). Any person or en.tity -requesting a
copy should conduct an independent
0 -ation shown on
inquiry regarding the inf rm
t_M2: -map(s), including, but not limited to,
th*e lociation of any sewer stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neitheir the City of Edmonds nor its
empl-o-yee-s o-r office.rs sh.all be Via-b-11--e for -41-he
information given* on this Map(s), nor for
tation provided based
any one represen
upon said map(s).
CITY OF EDMONDS
�'V'C CENTER — WATER SEWER DEPARTMENT
SIDE SEWER PERMIT
Call PROSPect 6-1107 when work
is ready for inspection. (No inspec.
lions Sat —day, Sunday Or holidays.) N? 3119
ADDRESS ............................. --- We-st
OWNER .......... Mack --- i�h_Qadg
� dssion is granted ._.S_e.p_t_eTnbjer ... 11� .......... 19 ... 6.8, for
wil'I'l CitY Sewers in accordance with days to REPAi[R or CONNECT a side sewer
aPPlication On file and governing ordinances.
I NTION IS CALLED TO THE FOLLOWING:
191-E NO. I —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—Obtain full information regaxding Ordinance 11.16.030 and Regulations governing Side sewers when you get permit.
NOTE No. 3—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 bends In grade sharper than % will be Permitted.
NOTE No. 4—Trenches intstreet must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due 0 Improper work which may develop within one year of completion.
�TE 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 main sewer or Its aPpur-
tenances except to Insert the Pipe into the wye.
P
31m AV
WtRL
AMA/; i �
.t*
Notes:
1. All signs and spacing to conform
to the MUTCD and City of Edmonds specs
2. Channelizing devices are 28" traffic cones.
3. Alert affected residents.
4. All signs are 48" x 48" B/O unless 0
stated otherwise. 1z
5. Work area is 18' e/o c/I 85 PL W N TO
SCALE
& 120's/o c/I Olympic View DR
Vi-12
Pilchuck Contractors, Inc.
Job #106125629
8 Mar 03
Sheet 111
J. Buss
National Barricade Co.
CHANNELIZING DEVICE SPACING (FEET)
TAPER :
AfANGENT
20
1 20
21-IA
I LEGEND I
WORK AREA
28" TRAFFIC CONE
--0- EXISTING TRAFFIC
MZ SIGN LOCATION
PROTECTIVE VEHICLE
9M ORWORKVEHICLE
V_
Pernfit No':
City of Edmonds
M.GH -OF-WAY CONSTRUCTION PERMIT Issue Date:
1 7 - *-/-On �, ,
4 / `,z� I �,S T L
A. Address or)y�icinity of Constructi6n: 0 13� LO
B. Type I of Work (be specific): I*cc, w
29- IPL Lo 1,) 0 L n�
C.' Contractor:- ;&-d 'Pi JJ1 La Contact:
Mailing Address: _72jf)SC) 0 ka- a) Phone: Mo-ql
State License #: \A 0, 10 Liability Insurance: Bond: $
City Business License #:
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E.. M Commercial El Subdivision 0 City Project 0 EUC (PUD,'VERIZON, PSE, COMCAST, OVWSD)
F� Multi -Family Single Family F-1 Other � I
INSPECTOR:
F. PAVENIENTCUT: K?YES El NO G. SIZE OF CUT x
CONCRETE CUT: [I YES F-1 NO
G.'� Mail Appibved Permit F Call for Pickup
INDEMNITY. Applicant understands by his/her signai�re to this application helshe holds the City of Edmonds harmless from
1. 1
injuries, damages or claims of anv kind or description whatsoever. foreseen or w1foreseen, that mav be made against the Citv of
Edmonds or any of its departments orCnpl6yees, including but not limited to the defqnse of any legal proceedings including defense
costs and attorneyfees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF, ONE YEAR FOLLOWING THE FINAL
INSPECTION ANDACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS
COMPLETED BYCITYFORCES, AT WHICH TIMEA DEBITOR CREDIT WILL BEPROCESSED FORISSUANCE TO THEAPPLICANT.
+ Traffic control and public safety shall be in accordance with City regulations as required by the City Engineer. Every
flagger must be trained as required by (WAC) 296-155-305 and must have certification verifying completion of the
required training in their possession.
* Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City -
approved m4terial prior to the end of the workday — NO EXCEPTIONS.
* Three sets of construction drawings of proposed work are required with the lieritnit application.
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
I HA VE READ THE ABO VE STA TEMENTS AND UNDERSTAND THE PERMIT REQUIREME14S AND A CKNO WLEDGE
THAT I MUST MAKE THE PINK COPY OF THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR INSPEC 0
III NS
Signature: Date:
(Co_ntra�tq"r`dr, n0l"I'l
%
FOR CIWVSE ONLY,
+
Approved by: Right-of;-,waytee:
Tilne Authorized: Void After.
I., DisrupqqnFee1FhndA 14:
Special Conditions: LkftiOlPhO S' INr-f A &CIL M M Ins ct n-Fee;
PYVP� C_W3S6W6n 9eST", 19Ak) Reeei0t,No:,,
lu
!21Mfl1ZM 4 1 e3a 81=k
Iss
1"4, MOO
Ai
f
REQUIRED I SPECTIONS: �iNA L_
4 Ca .-425-771'0220, Ext. 1326for a 24-hour voice -recorded inspection request line.
1 , /1�1`
FINAL APPROVAL OF PERMITTED WORK:. I DATE:
N
Inspector's SiQnature
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
CADocuments md SettingsTurtisNy Documents\Fonns\Engnrng\ROWpermit_.doc Revised 10/01/03