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18107 85TH PL W
0
ADDRESS: 1'9') (5-7 ':-eEt,�T I at --p
TAX ACCOUNT/PARCEL NUMBER: MD33 1 00000 q �>C)
BUILDING PERMIT (NEW STRUCTURE):— n-11 -- a�(D
COVENANTS (RECORDED)
CRITICAL AREAS: I — DETERMINATION: F] Conditional Waiver F] Study Required E] Waiver
DISCRETIONARY PERMIT #
DRAINAGE PLAN DA
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER): 1" 11 —
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:— as I
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: q
e-1%
SIDE SEWER PERMIT(S) #: 3Ub
GEOTECH REPORT DA
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
m,
LATEMP\DST's\Fomis\Street File Checklist.doc
POSTED ON LL MAP NO.;_
PERMIT
NUMBER
710086
(44.tp�t'� D'E P A R W
N T
Applicant Flu
11V"-'APPL1cATr6
N
Insido Heavy Lines
JQ13 ADDREbS 17
EDE YARD SETBACK
13TREET SETBACK
REAR YAJ1EU_rETBACX
OP-TEW
U ONE
LOT AREA
TELEPHVN� - UMBER
- 6
I
0 NO
-FI I:
BUILDING A_RFA
NCE NUMBER
VARIA,
T—LOT PLAN APFROVLU
STREET It/%V
EXISTING STREET R/W FT. DEFICIENCY
COMP. PLAN ST. R/w _e..4p F"r.
THIS PROPERTY
REMARKS
M�.� how Belowtor Attach Four Copies)
0707-
..SIDIENTIAL
GL IAS .
NEW
I.N-111.11=1TIA
-I.-
ADD
RETAINING
WALL
F-1 AIT11
EXCAVATE
OR FILL
FENCE
........ . .......... F,.,
El REPAIR
M
PRE_ C—
I,
13 SWI I
POOL
4;MBER Oil STORIES
"""' OF
DWELLING
I
UNITS
'ATURE OF WORK TO BE DONE
(f " " S -�— P /' C_ 7--
indicated on Standard Drawing #103.
RE �/y N
MARKS
at nfwt�-
TYPE dONNECTION
PERC. TI;dT
REMARKS
FIRE TYPE YOST;
SFMAL INSPECTOR- REQUIRED
C-] YES )O.No
E Plan check No
BUILDING
PLUMBING
HEAT & GAS LINE
FrNCF
SIGN
fRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE.MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
h
I hereby acknowledge that I have read this application: that the In-
t'o"
do"
formation given Is correct: and that I am the owner, or the duly author-
'y
�gent of wner. I &=ee to comply with city and state It— ergo-
,,rd a the 0
hereby. no per on
Eating consitruction; and In doing the wc-k authorlud thereby no person
ATTENTION
will be employed In violation of the Labor Code of the State of W"bingtOn
Tfus rEnNfIT
relating to Work.,.'. C..pen..tt.. Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (E.Cept DEMOLITIONS which
Jbe
OYLY THE
WORK VOTE D
shall be completed In ninety days: hIOVFD-IN` BUILDINGS hall com-
pleted in six months.)
AGNATURE OWNER OR AGENT) D l
V
INSPECTION
DEPARTMENT
CITY OF
ED' MONDS
NOTE: Applicant Subject to Plat; Check Fee
PR 6-1107
This PIt .... re —k -.a br d� 7-te property ONLY.
Any constructlon an the public domain rb, Md,walkl, &Ilawya,
rru.queeo, ete.) �111 rm.1ra separate 1,er-1.0—
STREET IMPROVED
[J YES ON..,
77--r— /
Valuation Fee
� . _�;-w lo / Iq 00
z
1 //2 -L2-0
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged In space provided.
I :I <�' - rl !
, JS
Thim City of Edmonds
APPLICATION
STRET FUS for
IDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS E]
EASEMENT No . .................
L 110 1' '�) i
CONTRACTOR ... ...... PERMIT No
............................... ............................................................
............. ............. .......
ADE)FESS
............. ..... . .......................................... LEGAL DESCRIPTION: LOT No,
. . ......................... BLOCK No . .................
...........................
NAME OF ADDITION .... 'L
..... .... ..... .............. ..................................................
APR
Approved:
DATE ...... ....... .........
7
FTT '.:OF,' D-Sa S1 J..
WATEM-SEWER, DEFARTMI
`E kk'
N
M , `b; N Dk`�t- -i Wilt-W
V..ERM T
T
4
4
PERMPIT�
"pec
Call' 776-1101"JorsIde *sew�r..-ins -ti6�ns..-IIEFOItEi�coverinF,a,ny :�6r�ton.- of the constructlon
Irfspec;t.lon� will,.be �provldbd within 2:1*, h . ou�.s' aftcr:r,;4uest.'.1 -NO, Sit Sun ,
holiday ihspections)�,
........................... . ........................................................
DRESS,-%L'0_C AMOM�OP-GQNSTRUCTION._'
...........
RRORERTY'LEGAL .-BESCRIPTION..,., . .....................................................
.....................................................................................................................
......... ................................. ................. ....... ....... .......
............................... ........ ................................................ .......... .. ..... ..
fqh f
.......... B ----- ------ ....................................
.......... ..................... .............. ...... ..O.WNEM A-ND/,OR,' UILDEK.:.,- i .;-. -,
----------------- * ...... .........................
Y�
1. It
F S C &IG C _60we! ti
IN J
CONTRACTOR S�NAWEW, "DRESS .......................... ................ ............................... ...........
T--------- .............................................. ......................................
�Penffliision, ls4ran . te I d� ......
and
for repai /or- a si the, �Ity'� an't
...... .. ........... .... f9. 7-1 cp4nectiou..of de':sewer,*:f& 's i ary jseweih,_��i
itfi,' y of gdm*�*o*'n*'d*sl*o�r.'�'i.n..a.-.n ... 6-e's.
-,system, I'n accorda�c`eiv C it"
',N.T.I'ON1,]S,.CALLED�TO.THE'FOLLOwir4d:.
. . : ; I - * ..,* d
& No. I—The� owners-, of 'Ahe�,�p* P
rqperty,�r�iay,obtaln -a -perrhit-to onstruct� sewer ifisid�;propeity�.,Iihei,-;A,li6ense*d. Side, Sc�;er� Contractor -ffiust�,,iie m 16' &f'�'to�fonstruA,�
�,A
gl&,sew6r inj street, axev�.. Do not. cover iimi_porCion't�cf sewer. �efore:a ha:s� �een: insp'ected�`
E NG . 2—A-Ilt work per-formed"in,.city right -of-' way'requlres.�an__Invas I ion, of'RI . gh I t-of-Way.Pe . rmit obtainable f : rom the City, Engineer's,offfee.
NoTE-No..3—Obtain full information regarding Ordi�ance. 11 M-630 -an�,�i�eg6latic.ns.-Tgoverning, .-side�s6vers'-when you, get perm�t*.
'�No. 4 '--Top. slae-*sewer must,have at,least,,30, ine�es:-C*o'y,'era''ge!;�Lt,,I),�,, 2� N6�,bcnd*s,An - ', -,, grade
.�OTE 0 -perty Alne:sLnd� 1, :inches,: inside property line:,,minimum grade..of.'
sIfarper'than7��/s.,Nvill-�bd:pe��iftedf
�.I�OTE No�' &-�-,Trenches 1A�,stieet-:must *�bc water settled, and zurf ace�of_ street restored -to �original��coii�iticirf."Iio-ntraptors sha'll/be,'respdnsibf6,.for,-faiiure,,,d ',�O;Ilmi�r6per',
work which'may develop�*Wlthtn one'year of completion ue
—It., is,unlawful�rto,,alter or,.do -any-.9ther, work than. is*,provided 4orin'.the N 'any work, on the,ma ei. r-' -e
1,� �NOT..El.�,No�. .6., rmlt;.,or.'to do' in, sew: o Its appurtenances. xcept to.qn-
sert the. pip
e Into. the.'-%Vye.
Date... -By, D
DISAPPROMEDi ln:� .................. ..... ............ ........ --- - -------- ......... ..... tvate ..... I ......... .........
Date ..... .... 71.
APPROVED By ..... .................................... ......
Relluar rs; .....................
............................... ........ .. ...................... I ............... ............. .................................. ........
7
................. ...................................... ................ ............. ............. ......... .................... .............................................. ....... ....... ................................. .........
T.
BOTHCIP6�mi tConies�'MUST' Be 0* ndi�,.bf ,,,Firm,. Perfonyi �fg. �Constrtfction PR1[0k:To Request For-.Inspiectioi�
.......... ............. ....... ...,...:..-r-hereby,.-,certify-.that�thesidi���sbw6r,inst;illation,,.�cbn�tructed iuiider'�this,-permit�.,:
'y
ns
(Oii!ner' of rContracting Firm Per mi C. n fii ion-)�
Installed�;in�i�et6rdance.,with- all g6v ni �qqrdinaixes,lof -the--City':of.-Edm'bndS.
Dilted,-this ...... :1.7 . .... ........ ........ ....... 76:
19.
e 'TO�Ph6.6- 9wer 'E],- S�wer E]", '9ther-,E],. V. _V
Cheek:,BEFORE� you. -dig -for:, -*:it rl! -P,
NOTICE:
-Nb warrah
The information on the attached
Map(s) was compiled for use by the City Of
Edmonds, its Employees and Consultants.
The City of 'Edmonds does not . wa rra nt ti ic-
accuracy of anything set for.th on these
rnap(�_). Any person or entity -requesting a
copy should conduct an independent
-ation shown on
inquiry regarding the inf rm
t-Fe -map(s), including, but not limited to, -h
th-e lociation of any sewe r stub shown. Suc
sewer stubs may or may not exist and may
or may not exist at the location shown.
o s nor its
Neither the City of Edrn 'nds.
ernpl-o-yee-s o-r office-rs -shall be i1a-b-'Fe for -the
information given on this map(s), nor for
tation provided based
any one represen
upon . said map(s).