18732 92ND AVE W.PDFiiiiiiiiiiii
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18732 92ND AVE W
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CITY of EDMONDS S DE SEWER P E R M I T
For Inspection Call 771-3202 STREET FIE PERMIT NO.
Address of Construction:' 9'2,,Jy,'Q
EDMONDS
Property Legal Description (Include all easements): fi/lc TREATMFN-T F?1 A T
Owner and/or Builder: o lem HI _10//1
r L) C e 0 kit) MM,
Contractor & License No:
Single Family Residence
Mul ti-Family (No. of Units
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No 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 Ye s (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
I tertify that I have Yad aQ shall comply Ddte I
with the items listed on the ack.
Pe.rmit Fee: go. 00
Trunk Charge: 00
Assessment Fee:
Partial Inspection:
issued By: 13—
Date Issued:
Receipt No.:
Comments Date Initial
Final Inspection Approved: 915-sco y 4f.
Date Initiai
Rejected:
eason
Date !—nitial
PERMIT MUST.BE POSTED ON JOB SITE
Wh.ite Copy -.File Green Copy - Inspector
Buff Copy - Applicant �$
NOTIC�:
a n
6-r. --ac-c-Ur . . . . . . . . . . .
The -information'shown on the attached
map(s) was cOM ' piled for use by the City of
Edmonds/ its Employees and Consultants.
Th,..e City ofEdrn.onds does. not * warrant the
accuracy of anything set for.th on t * hese
map('�_). An'y person or entity -requesting a
copy should conduct an -independent
inquiry regarding the info'rm-ation shown- or
_�Re -rnap(s), including, but not limited to,
-er stub shown. Suct
the lociation of any sew
not exist and may
sewer stubs may or may
or may not exist at the location shown.
Neither the city of Edmonds nor its
tompl-o-yee-s o-r office-rs -shal-1 be 1--ia-b-11--e for the
information given on thj5 map(5), nor for
any one representation provided based
upon said map(s).
Al
The City of E monds Side Sewer Drawing EDMONDS
EASEMENT NO - ----- - TREAT.MEl*E._PLAj*Tj
NEW CONSTRUCTION REPAIRS LID NO. V,5A -------- ASMT. NO . ..........
OWNER CONTRACTOR R.U;515 .... AQ-R 9?W.4 ----------- .......................... PERMIT NO. 75.49..
JOB ADDRESS AS ------------- LEGAL DESCRIPTION: LOT NO - --------------- --------_--------- BLOCK NO - -------------- ------------------
V P-V.c.
ru'ralks. VMS
18805 1941*4
PROP Go Amcp 0
C,-.k / [- 4w, P.V.0
two Im"Ce-
ro'*C� -C.— 1-05
r. - l7r. 4'
94-rm Avc. '282.5 94-tm
1. 10' —1
PWW-0001-11/75 (REV.11/78)
------------- ........... ------------------------------------------------------------------------------ ----------------------------- I -------------------------
NAMEOF ADDITION -------------------------------------------------------------- I ----------------------------- -------------------------
V
2.,Dp
4"C. 0. W C
14 C.O.C^p
'bP
72'
S,Dp
41, j,-V'
CAP
ILI
'PROP. CoRmsix
Approved:
D A T E 25, /3 % B y J4* I . ..... ....... ........................
�W&11700_
PR3= REVIEW CHEMIST
PMJECT NAMET PROJECT ADDRESS: le;�32 Xw- J41e---;I-
APPT.TrATTCW RFrFTPT nATF! In
V, - I--,
Reviewed
by. (initial/daa—te)-
CC614ENTS
P ING-
-XM/SWR-
-STREET--j
-- E-NGNFNG
FIRE
BUILDING
SINGLE FAMTLY/KJLTIPLE/Ca%MRCIAL - (Circle One)
SETBACKS afECKED Planriing
111111711
//7/////
1111171111
VARLMCE/SE'rBACK ADJ.
1
7777ff
711111
CONDITIONAL USE PERMIT
ADS REQUIREMENTS CHOCKED
3
7F/777/7
MHER ZONTNG REQUIRE14ENYIS
4
FNVIRONMF=AL FEMIMES
5
ACCESS SLOPE & VFMCLE ACCESS
6
7T17T177-1
DRAINAGE PLAN (On Site) *jAZ ;3W gal=-
7
u
TIT11-1-17-17T7TFI-11
STREET FILE
////////
8
7777T7
11171111
LEGAL DESCRIPTION VERIFICATION A�eA Ir-gs
//////
////////
9
1/
171-777
117111111
CkJIT M.AIM/DMICATIONS /441
//////
/////////
10
/////////
///-//77T--
FASM= - PWJMC/PRT\fATF4 IV,"Ul ff -,?S-
/////////
//////M
11
_-3
V
CALM -NIT SM&R CONNECTION IF NO LID#
//////
11111111T
12
-/77/////
PLAT/SUBDIVISTCN ftECkJTRMMS 4,Po��- 01-41aw
13
RlGffr--OF-WAY M4STRUCTTON PERMIT RE(_)D
24
11177111
BOND REM FnR PUBLIC IMPROVEMENTS
15
SOILS CMMITTMIS & MUND
WNPER FIET,D OlEO(ED
16
-/T/-//-/77-/777-//-7T7
STREET PAVTNG Tt1%)UTPYD
17
7-l-l-ll-T7-11-1-1-1-77T-fl7771-77T
CURB AND GU`1'MR REQUIRED
18
SIDEWALK REQUIRED
19
CURB CUT FOR DRIVEWAY REQD
20
STREET NAME SIGN REQD
21
7/T/-ff
-1-17-1-1-IT17
OTIM SIGNING REM
22
77TIT117777TUTff
SIDE SEVER AVAILABILITY
/////////
////////
23
EXISTn,4G WATER MAIN SIZE
7R77T
7TT17T17T
5T
1IT1777T7TITRIIII
////////
24
-
/////T/7
TFI-1111111
WATER MEWER SIZE
////////
25
7 7 7 / TUT
77777777-77
SERVICE LINE SIZE
26
1111111117TRIIII
1111117777
HYDRANT REQUIRED
-7TITR
27
HYDRANT SIZE EXISTING
28
17T17TM
CROSS CONNECTION INSPEMON REQD
/////////
29
MATER MER C[MRGE REM
77-77/7
7Tf/-/-/-/ 7-77
30
///7770
111171IT17
FIRE LINE CHARGE REOD - SPRINKLER
31
STREET CUT
32
OPEN DITCH EXISTING
33
711111
REM
34
777/7 7-
CULVERT REM-
35
11111177T
C
SIZE
/////////
36
711111
CAMI FIMIN RF-00
37
ITUT117T
INDICATM, CN SITE PLAN
38
SHO=ER DRAINAGE MAINTAIN
SHALE OPr.,N RUNOFF
39
MISC;
40
m
dMNLVM
r�-
m
USE PERMIT
CITY OF EDMONDS ZONE < NUMBER
CON9TRUCTION PERMIT APPLICATION JOB
NAME (OR NAME OF EIUIIIEIS�� ADDR . ESS _7 119
'52 72
LEGAL DESCRIPTION CHECKI SUBDIVISION NO. LID NO.
MAILING ADDRESS
3-3 If --ksr—
NAME
ADDR
NAME 4tMMIEL �6AAGS.
ADDRESS
CITY j!�,5 -2Z 159
STATE LICENSE NUMBER
IE NUMBER
- 11) liq :2
qE NUMBER
TELEPHONE NUMBER
4d / -Z/
CITY LICENSE NUMBER
Legal Description of Property - include all easements
(show below or attach four copies)
Z
9
Uj
N-7
LZ20 NEW
RESIDENTIAL
PLUMBING
ADDIALTER
NON-RESIDENTIAL
MECHANICAL
ElREPAIR
E] RETAINING WALL
E] SIGN
E] DEMOLISH
EXCAVATE
El OR FILL
FENCE
El ( x _ FT)
r__j PRE -MOVE INSPJ
r--1 swim
0 SIDE SEWER
WATER LINE
n
PLL F I
E]
cr
0
u) NUMBER OF STORIES
NUMREROF
Uvvt:LLINU
0
UNI 6
I NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
I -51F AE,51,0EImc I
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
PROPOSE��*_,X
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED C3
STREET USE PERMIT REQUIRED 0
SEE ENGI NEERING MEMO DATED—_7
SEE PIW DEPT. REVIEW CHECK LIST DATED
REMAR
METER SIZE IBUILDING SUPPLY SIZE IFIXTURE UNITS
REMARKS
SIGN AREA ENV. REVIEW
ALLOWED I PROPOSED I COMPLETE i EXEMPT
VARIANCE OR CU IPLANNING REVIEW BY
YARDS OT
FRONT REAR
CHECKED BY TYPE OF CONSTRUCTION
_MA
.30
19 /,v
SPECIAL INSPECTOR AREA OCCUP
REQUIRED GROUP
El YES L! NO I I
PLA14 CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY
GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
mit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
2 harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
modify,.waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
440,
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and in doing the work authoriz-
ed thereby, no person will be employed in violation of the Labor
THIS PERMIT
AUTHORIZES
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
tion Insurance.
INSPECTION
DEPARTMENT
SIGNA77T�( WNER 08 AGENT) OATE,SIGNED
7-3,
CITY OF
EDMONDS
771-3202
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND'APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
&-A
VALUATION
a:
ADB NO.
SHORELINE N
�D E
Vf
,�613E
Z
Z
HEIGHT
12—
OCCUPANT
L�-3 LOAD
IA4 4601
0
APPLICATION APPROVAL
/A L
I
This application Is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt Is
acknowledged In space provided.
. ..4
OFFICIAL'S SIGNATURE .
DATE
ORIGINAL
PINK
0
00
iw,� .1�6LD As'80880
CHAPTER 3.
102-78
mavu To: Building Di-O�ision-
FROM: Engineering Division.
SUBJEM.
After review of*the subject'building permit application, we have the
,following comments:
1) connection to City-water:,system required.
2) Connection to City sanitary sewer system required.
3) Right-of-way permit requir . ed for any work on City property.
4) Driveway slope not to exceed 14%.
5) Back water valve required if.downstairs plumbing is below
.elevation of upstream manhole.
6) 'Water and sewer lines to be separated by 10 foot minimum.
7) Builder/owner responsible for containing all temporary runoff and
erosion on site and may not impact neighboring properties in any
way.
AAI�