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18509 85TH AVE W
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TAX ACCOUNT/PARCEL NUMBER: X!� (P-7 S o 0 QQ0 (.a 0
BUILDING PERMIT (NEW STRUCTURE): 09 B
I .
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: F] Conditional Waiver 0 Study Required [-] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER): Add)-hon
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED: bi Igo
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:— 11 1
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED: c2 siyp-
OTHER:
IN
LATEMP\DST's\Fortm\Street File Checklist.doc
BUILDING DEPARTMEN
PERMIT APPLICATI 0 NJ
NAME (OR NAME OF BU31NESS)
;&
MAJL&NG ADDRESS
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CITY
rn on a/S
NAME
ADDRESS
CITY,
—TREJ
NA NE
ADDRESS
L,�, 17-7
=TE
Z
Lagex! Deac-"PtIon of Property (Show Selo or
AppUcant IM
side Heavy Lines
1— 2 7�1_!;�
P U 1 0 L^_1 P c ;- qP C I�Z,;rl
RIEW ... TIAL
0
GAS
NEW
NE
NON-RESIDENTLALL
F]
SIGN
r7
F—i
RETAINING
WALL
ALTER
DEMOT TRU
ExCAVATE
FENCE
OR FILL
( . ........ Ft.)
REPAIR
E]
PRE -MOVE
0
swim
INSP.
POOL
�UMBER OF STORIES
NUMBER or
DWELLING
UNITS
rATURE OF V�ORK TO BE DONE_
-;J
POSTED ON KROLL MAP NO.:
6704 1'�
7,
jOB ADDRESS
SIDE YARD S=BAC BETI�AGA
K STREET BET A
M i rA 1"Y tA
USE ZONE AREA VACANT SITE
YES NO:
Z
96
HEIGHT BUILDING AREA VARIANCE NUMBER
PLAN A
7OVEDPLOT
STRFXTjU/
E)aSTING 9�. R/w DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W
REMARKS
CHECKED BY
METER SIZE i SERVICE LZE CLEARANCE
C7
q
RZMAYLKS
TYPE CONNECTION
T
—Fliv Y
PERC. TEST
PERMIT rOMER
REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
TE13
0
SPECIAL INSPECTOR REQUIRIM
OCCU�-- GROUP
YES lr�
I Z_
Plan check No ..........
PROPC�IED USE
BUILDING
PLOT PLAN (Indicate Building setbacks. abutting st.ecte)
PLUbMiNG
HEAT & GA.$ LINE
FENCE
SIGN
30"
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION'
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge thitt I have retul th',a ppllmtl..: that the I. -
formation given Is correct: and that I amt the owner, or the duly "thor-
ized agent of the owner. I agree to comply with city and state lAwe regul.
ATTENMON
latIng construtcUon; and In doing the work authorized thereby no person
will be employed in violation of the Labor Code of the State of WaahIngt—
TRIS PrILMIT
ra'suing to Workmen's Compensation Insurance.
AUTHOFUZES
NOTE: Permit Limit One Year (Except IMMOLITIONS which
ONLY Tirr
WORK NOTED
.haa be completed in ninety days: MOVED -IN BUILDINGS h.11 be com.
pleted In .1% months.)
SIGN AAURE _ (OWNER __ OR AGENT)
DATE SIG,
NED
INSPECTION
7
DEPARTMF24T
CITY OF
ED31ONDS
NOTE. Appticant Subject to Plan Checle Fee
PH 0-1107
This Permit covers work to be done — pri-te property ONLY
Any const—tion on, the public domain (curbs. .1dewn.11cs, dr,,Mays,
�_qticcs, ete.) WW rctitilre s�parnt, Pc_1"1_.
ValuAtion I Fee
M
—( /.,� -L'A 3 q ii -.
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.
15 -1 -rp-u vy t7AN A
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LOT& FPT HN COF--, Sr,4141�-W
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6U[-- Pf-�--5AC,
e-55 A�-JF-- - W .
PL-OT P�AH
156
1�1
Q)
STocET FILE
n t.
JUN 14: jz"JzN�
PERMIT COUNTER
----------------
fl
NOTICE:
-a
-N'o ... wa rra nty of -c.c.-u
The inform ation'shown on the attached
Map(s) was compiled for use by the City Of
Edmonds/ its Employees and Consultants.
Th.�e City of 'Edmonds does not . warrant the
t forth on these
accuracy of anything se
rnap(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform'ation shown on
-t-He -map(s), including, but not l'imited to,
th*e lociation of any sewer stub shown. Such
exist and may
sewer stubs may or may not I
or may not exist at the location shown.
Neither the city of Edmoind's nor its
emp-to-yee-s o-r office-rs -sh-a-1-1 be Via-b-Ife for the
n on this ma p(s), nor for
information give'
tation provided based
any one represen
upon said map(s).
APPLICATION
for
The City of Edmonds FILE SIDE SEWER PERMIT
STREU a= --NEW CONSTRUCTION [:] REPAIRS
/ e
OWNER ... i�,
. ................. ............
DRESS ------- ------
....................................
10,
EASEMENT No . ............................... ..........
-1) � I- I lb �
A PERMIT No. �v
CONTRACTOR ........ tZI..e.a --- �.67_.X ....... ........ e.-A L ..\�
LEGAL DESCRIPTION: LOT No. ../.p ......... ............. BLOCK No . ............................................
NAME OF ADDITION
.............. - ... .............................
z
I---- Y_ APPI, ".*"
NOV 2 2 ISC-7
\Approved:
DATE ........ B
CITY OF EDMONDS
Call I'llospect 6-1107 when work
civic CENTER — WATER -SEWER DEPARTMENT is ready for inspection. (No Inspec- XTO
5 61
tions Saturday, Sunday or holidays.) 2 5
SIDE SEWER PERMIT
ADDRESS----- M0 ... 77 .. ................ ..................................................................................................................
1 NeX ..........
CONTRACTOR ....... P
0'
Permission is granted ........... Nay.emher ----- 21-, ig.6.7.., for ........................ days -to REPAIR or CONNECT a side sewer
,kvith City Sewers In accordance with application an file and governing ordinances.
A'I,,_,.TION IS CALLED TO THE FOLLOWING:
f the property may obtain a permit to construct sewer inside property line. A licensed SidesSewer Contractor must
NOTE No. I —The owners o in pected.
be employed to construct side sewer In street area. Do not cover any portion of sewer before It has been
NOTE No. 2—Obtain full Information regarding 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 in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to improper work which may develop within one year of completion.
NOTE No. 5—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.