18407 90TH AVE W.PDFlill 11111111
8755
18407 90TH AVE W
C Qf -9dmonds
ity
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number. -
Issue Date: —,:Q
A. Address or Vicinity of Construction: lgqo)7 qo7q&AII W A
11 8 9 0 C) Q5 B. Type of Work (be specif1c)::TAJSV4LL AIEW LIAIDE-11,69MAJD
OtTV D&P LUI &M B 645
C. ContractonOt"RE95 150 PEA& 6 IL Contact: 'TOM AlVhE�XQOIJ
Mailing Address: &l39ljAJ s7, Phone:
State License #: EJUPEW- 21-7 J6 Liability Insurance: Bond: $
D. Building Permit # (&applicable): Side Sewer Permit # (if applicable):
E.. n Commercial E] SubdivisiT'n roject 0godillity (PUD, GTE, WNG,(6
.�ATER)
El City P
.-:—.r--l-.,-Multi-Family'-E3-,Single-Fa�]6ily
INSPECTOR:
I INSPECTOR:,
F. Pavement or Concrete Cut : FLY,�s DNo , G. Size
Ro-s3lay'a bJJkDaJ.S-)-q5 JAJb
APPLICANT TO RE,
INDEMNITY. Applicant understands and by his t ignature to this application,
claims of any kind or description whatsoever, foreseen or unforeseen, that r
employees, including or not limited to the defense!ofany legal proceedings inci
THE CONTRACTOR IS RESPONSIBLE FOR W,
INSPECTION AND A CCEPTANCE OF THE WO
IS COMPLETED B Y CIT Y FORCE S, A T WHICH
Construction drawing of proposed w,
A 24 hour notice is required for mSpE
Work and material is to be inspected
Restoration is to be in accordance wi
St;eet shall be kept clean at all tim e-z' r
Traffic Control and Public Safety sh.-
All street cut ditches shall be patched,
NO EXCEPTIONS.
Ihave read the abouestaternents and
auailable on site at afftiniesYor insp
- Signature:
tractor or
?KMANSHIP AND MATERFt
1C. ESTIMATEDRESiORATJ
I
IF, A DEBIT OR CRE DIT WIL!
k�req witfi permit
aon; Please 0114hoz Er
iffing progress and at
L City Codes.
be in accordance with
ith asphalt or City apt
Cut: 4.1 H. Chargq�,$
8 y Lelef�T6
)A N XS G N
the
-es to h the Ely ofEdmonds harmless fro;t injuries, damages, or
,e made against the City of Edmonds, or any of its departments or
9de
_LensL- costs, and attorney fees b,�,�as�o,-Jgrantin g44 this permit.
kill
iLSIFOR.-A PERIOD OF ONE YEAR;FQL1,OWING THE FINAL
ol� FEES 'W'ILI, BE HELD UNTIL THE k!lkll, S��k!ET PATCH
r, BE PROCESSED FOR ISSUANCh, TO THE APPLICANT.
K.
DiVisioA-;, 771-02M, f t,
ty regulations as require�a , by' the City Engineer.
ved material prior to the end of the working day;
Verstand thepermit reluirements and thepink copy of thepermitwillbe
ion purposes.
D�ate.-
7 0
CALL DIAL -A -DIG PRIOR TO !BEGINNING WORK
FOR CITY USE ONjY
APPROVED BY: Frilani-OF-X&Y DEPOSIT
TIME AUTHORIZED: VOID AFTER DAYS' DISRUPTION FEE/FUND 111:
SPECIAL CONDITIONS: �4—
COMMENTSF-Ml�,
RESTORATION FEE:
PERMIT FEE: 0
TOTAL FEE:
RECEIPT FEE:
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
En��g. Nv. 1991
V.
FIELD INSPECTION NOTES
Comments:
I Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.M.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
0
pit
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ROAD
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4
I IQ/ I^rl a A44k, A\) lil
13 WMER
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"fts .\r4
All.
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W -A 6' M M. Eq 0 R 1 q1b
.Permi t Address
Reviewer's
Intials
. 3/9/76
Legal Description
STREET FILE
J' LL- 1A t,?<", i
BUILDING PERMIT RFVIEW FMGINFFRINr, DFPARTITNT
CPECK LIST
S eptic Tank Sy
,stem Design Approved L,
i Y, silt. �f Dwn. Mo.
JI Sanitary Sewer Availahil t
Project: Side Sewer Availability-:
Any Sanitary Sewer Connection Fees
Site Drainage Checked
torm Sewer Availabilit.v: Sht. of DWq. No.
Project:- Roadside Ditch
Grading & Final Contours _.A V.,
7. Sidpwalks (Site Tnspection shows condition of existinn vialks as follows):
'J2
Underground Wiring P, Street Liniltina
.4e. �Street Riqht-of-way A Rldq. Sethacks: 1: -
Sht.
of Dwq. No, of Official Street Map.
�.F'xistinq Utility Easements J.
1 3,,o-<cess Easements
�14-ater
�-atei Mains A. Fire Hydrants (Indicate Size, !-later Main)
N,
onds for Site 14ork
Special Requirpments listed in memo to Bldg. Dept.
Commercial Apt. Requirements form comnleted Y
Draviings stamped nd.tations made 4f.
8
0
e Inspection made on
�Si t
All items filled in on Rldg. Permit Application
�M�-_This Lotincluded in Subdivision (List any speci I al req ui remen ts
Permit Address
Lecal Description
STREET FILE
BUILDING PERMIT RUTF14 — F%,INFFRING DFPARTl,4FNT
CPECK LIST
Reviewer's
Tn+iilc
Septic Tank System Design Approved,
20.0'00 Sanitary Sevier Availability Sht* �f Dvin. No. .
Sid e Sewer Availabili;ty:
Project: PLI" r
!!.
Any Sanitary Sewer Connection.Fees
ite Drainage Checked
I"
Storm Sewer Availabilitv:
Sht.
of Dwq. No .
-Project:
X.,�i C
Roadside
Ditch
Grading &
Final Contours
I
Sidewalks
(Site Inspection shovis condition
of
existinq vialks
as follows):
0�
Curbs
nderground Wiring Pt Street Linhtinq
Street Riqht-of-vialv Bldg. Setbacks: 1:-`/ Sht.
740 �1-
of Dwg. No.- of Official Street Map.
Existing Utility Easements
1 Access Easements
Oater-Mains A Fire Hydrants
(Indicate Size 9ater Main)
Bonds for Site i4ork
i _6
"000
�Special Requirements listed in memo to Bldg. Dept.
Commercial.& Ap.t. Requirements form comnleted
8. Drawings stamped & notations made
Site Ins.pection made on
All items filled in on Ndg. Permit Application
cluded in Subdiv (List any special requirements):
This Lot in is ion
4.
3/9/76
NOTICE:
N' '0***w*. a . r
-ranty ... o i.- uk:., u- -1 -
The Jnform ation'shown on the attached
piled for use by the City Of
map(s) was com
Edmonds� its Employees and Consultants.
Th,,.e City of *Edrn.onds does. not. wa rra nt the
accuracy of anything set forth on these
map(�). An*y person or entity -requesting a
copy should conduct an -independent
inquiry regarding the infc')rm-ati(Dn shown or
_th� -rnap(s), including, but not Jimited to,
th'e lo�-,ation of any sew-er stub shown. Suc
-not exist and may
sewer stubs may or may
or may not exist at the location shown.
Neither the city of Edmonds nor its
empl-o-yee-s o-r officers -sh- al -I be ]Jab -'Fe for the
information given on this map(5), nor for
'ded based
any one representation provi
upon said map(s).
APPLICATION
11
0
The City of Edmonds for EASEMENT NO . ...............................
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS E] LID NO . .................. ASMT. NO
c-- ak
OWNER --------------- --------------------------------------------------- CONTRACTOR ---------- t ------------------------ --- F!�'c -- --------------- PERMIT NO.
---------- -----------------
JOB ADDRESS ... LEGAL DESCRIPTION: LOT NO - ---------- CEP ------------------------ BLOCK NO - ------------------------------------
..................................................................................................................................................................
F=IF;;5 1" 1
----------------------------------------------------------------------------------------------------------------
ed:
DATE ... �Zlz,�X, /B440 ..... t .................
"IT
CITY OF 1DI'MONDS, !SI1DE,_,$EWER -PERM
WATEWSEW�ER,,DEPANRT-MENT�,,,
-5 7 21
E.
kM -T
41
'er' in�spectjon
il, a It :7 7�1$ s de��;sew JIFFORK%coyering'. �any portiow -of the
K Jnspec . tlon�,wlll,-be proyide&'wlthin;'24� h6drsi after, r�4 ust. NWSaf. 'su
. n., lor-holiday"inspectlons)
WCONSTRU, CTION
AMDRES&EWNTION 1 9`0 7 0, V A -Vr-�-11 I tl� W P'. r, t Xil,
............. ........ ... .................................................................... ....... n� ..................... ...............
..........
�PROPERTY,t,EOA%; bESCRim
................................... ..._ ....... .................
V� ............. ...........................................................................
...................
....................... .................................................... .................... .............................................................
......................................................
J DER. E
.......................... ............................. ... OWNER, ANWORIBUIL �81 ........................... .............................. ...................
vawo
1CONTRAR rg
. . .................. _11. � _t , .................... e ................... ........
........................................................ ........................................ .......
-ust :30� _1PIL ... L, f r-, and/or connection, �of a:side sewer -to, the, cit�, sanitary� sewer
Penydss1'6nA§',;ji61ted! -, vi �, �� 76
An 0 palk
'M'�] '"Cor ancet.,*.!W`Clty�, of Edmonds, ordihances.j,
'S "� -I' " - - . .. - .. I ......................... .......
In d"
TION� Isi,CALLFD� TO! THE� FOLLAwING:
�TEN
CNOTE, No. 1�—The, 6wriers,'�'of the,'property [rrfay a p��rmit,tb construct sewer inside property line;,' A licensed Side Sewer 'Contractor must.'be empfoyed-to -construct
�sidw gewer,:iw street -area. bo� not. cover any -portion.. of,'sewuv before it has, belen inspected-.
'�Pe
�)�TOTR No: 2— city right-of-way requires anL lnvaslon�of Right -of -Way, rmit obtaln-able from the City- Englneer'i office.
'NOTE No. 3 Obtaii,, i�lll information; regaxdtng� Ordinance, 11.16.030 and�jRegulations, igoverning., side sewers, when you get- Permit..
VOTE'No. 4�'—Top, 6f,�sfdt�`ewsrmust �have 'if �Ienst 3W inches co�e�age':Ikf,pr6perty line a.4-,32Anches, Inside,.property line,; minimum grade of' 2%.: 'No �bendst:in,�grade
A/,wilD�be-permitted-.
sharpet�,th
VOTE, No. . &4renebes treef�must ibe- water seftlea and, surface, of'street, restored 10 or11gInaX conditi.bn.'..�'Contractors,.SbalI be reibUji—sibld for failure dueAo: improper,
work hi6hy,rnay ldevelop� wit In,: ne,,year of complbtion,_
h
,NOTE) -No. r�—it, is� 6 n f'a'wful, to, alter or! do any," other work iham is proviaed, for in the, permit,:
or to Ao,any work. ow the main, sewev,or I �ccep . t I to, D?-
sert1the,;p1pe into tbe'.wye+,
A
PISAPPROVED) E]i- Date ................. By ................ A.,�,t ....... ......
7,
A
A
'APPRO
V�E .,717 .....
D., ;kkD ...... ..................
..................... ............................ ...................................................... ......
... .........
j
By ---- ........... Date�'..
............. ............ y ......
...................................... % ......... .....
.................. ........................................................................
................
.................. ......
..................... ....... ...... ��Iv/ . ....... I ......................... � ............................ ....................................... ....... .
7=',BOTH, er-rnitqppies.:M1UST,Be ed By Owner of rin Performing, �Cbnstruction PRIOR To Requibst !For lnsp�ction -
_>ign
r'of.�Contractinj rffim. g. Co stru(
waff/insWic v.aceordani�e, with,,611, ning,ordinai
Cfiec�""BEI
.. ..... 4,eru y cer. fy hat the,side sewer ins L.UJI&Liqn�.Coris Cructed unuer thm permit,
)n,)
e& of the,�'Ci,ty of Edrnonds� J�.
oL...Date& this . ..... ............ qay ...... .... .% ............................... 19
blik46u d1gJ6r:*atei:E], ;Gas,�E], e1ephon'e1:[j,, --se,w."6r,
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS F-� LID NO - ------------------ ASMT. NO . ..................
OWNER-----------------------------
'0 JOB ADDRESS d?-40 . ..... Ay-re-W -------
E-cl,
0
110
0
CONTRACTOR --- a --- �4.----Al .... &X040407 ---- PERMIT NO. Z2
LEGAL DESCRIPTION: LOT NO - -------------- ? ------------------ BLOCK NO - ------------------------------------
--------------------------------------------- -------------------------------------------------------------
------------ . W /
NAMEOF ADDITION - ....... ... . ................................... ....................
'00—
Approved:
DATE............................................ By ................................................... vui��