19226 76TH AVE W.PDFIIIIIIIIIIII
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19226 76TH AVE W
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CITY of E DIVI ON DS SIDE SEWER P E R M I T
For Inspection Call 7*71-'3STREET RLE PERMIT NO. 0.7543
'76
avc � �d
Address of Construction:
Property Legal Description (Include all easements):
1,&:�,l z p ,- ./ Xg�l Xaa� ;Z 7 41
Owner and/or Builder:
Contractor & License No:
Single Family Residence
Multi -Family
(No. of Units
RECEIVED
JUL 24 1986
Commercial. (No. of fixture.Units, PUBLIC WORKS
Invasi'on into City Right -of -Way; Nae:::N_� Yes. (If Yes, Right -of Way
Construction Permit requi-red. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No., Yes (If Yes, easement required,
attach legal description and county,easement number.)
PLEASE READ THE ITEMS LISTED'ON-THE BACK
I certify that I have read and.shall comply Date
'with the items listed,on the back.
op
Permit Fee: A2) Issued. By:
Trunk Charge:, Date Issued:
lfli�0 . —AD
Assessment Fee: Receipt No..:
Partial Inspection:
Comments _ffa —te Initial
I%Jsp.
RON 40L_LAWb
Final In,spection Approved: 7� 9,4 �-
Date -Initial
Rejected:
Reason DTte _Tn i —ti a 1
PERMIT MUST BE POSTED ON JOB SITE
Wh.ite Copy - File Green Copy - Inspector
Buff,Copy - Applicant
%e City of Mmonds Side Sewer Drawing I
EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION M1 REPAIRS LID NO - ------------------ - ASMT. NO. - ----------------
OWNER i+—CORSIG14 ------- C.0"-S-T, ---------------------------- CONTRACTOR XG-Vil-a ---- \1 ACT Z V,-Y -------------------------------------- PERMIT NO. 7542>1
JOB ADDRESS --- ).9.2t2IG ---------- -- 7.( r
LEGAL DESCRIPTION: LOT NO. -2 --------------------------------- BLOCK NO.
--------------------------- ............ ----------- — --------------------------------------------------------------------------------------- -------------------
NAME OF ADDITION ---- A-Dz - - ---------------------------------
4,& wy� I' or 1 W*3 -t 16 "Dp
+
-:Yc> K." bf-. 1—t^ 'to" DP
Approved:
-2
PWW-0001-1 1/75 (REVA 1/78)
By
PRWECr REVIEW'CIMCKLIST''
PRaTECT NAMEt
IV /__-, ff __7�
APPLICATION RECEIPT DATE:
Reviewed
by:
/da
OCMMENTS
PLAMING
- WrR/SWR'
STREET
I 04GMG
iyuILDING
FIRE
fTI-T=71111111
SIN= FAMILY/MULTIPLE/CaMWIAL (Circ.le One)'
SEMACM CHECKED Plarining
7777/-/T/T7T/T/T/7
VARIANCE/SETBACK ADLT.,
ITIONAL USE PEWTT
717/—/ 7777
-71WITI-IFI-1-n—Ilul-117
77777777
7 7 7 7 7 7 7 7 7
7 T11 777
CHhCM
111711
OrHER ZONIM REQUIRUeM
MTURES
/////7
ACCESS SLOPE, VMaCLE ACCESS nle
77711"u
DRhn= PLAN (On'Site)
777777
111711
7777777/7
MEET FILE
LEGAL, DESCRrPTI . ON VERIFICATL(jLjg&
- __
777777
///"/
77TI7777
////////
9
I
OUIT CLUWDEDICATIONS 71
//////
111111M
-1
10
EASEMM - PUBLIC/PRIVATE
C%LCULhTE SEWER CONNEMON IF NO LID#. _40a,
///777777
—
12
PLAT/ . SUBDrVISICN REQUIREMENTS.",,
17777T17T
13
RIGHT -OF -MAY CONSTRUC . TIO& PEMM REQD
///T-j"TR77_7r
14
BOND.REOD-FOR PUBLIC n4PROMMM
77//7`T/7/./77/7/`////////
15
-SOILS CONDITIONS & ��-.-
1"UT
7TIT7777
7777TTF17
WATER FIELD CIO=
//////,
/////////
/////////
z
16
SMUET PAVIM REWIRED
MR7111
/////////
7777777-77
/////////
17
am AND Girm REQuxRED
TITT17
7T7777T77
18
SID'EWALK REQUIRED
7r/7
19
CURB CUT FOR DRIVEKAY. REM
*/7/
77
// .....
k F/7777/
20
S"MT N AME SIGN REQD
1111111M
21
arm sicN= R=
TRI1101
/////////
TITFITR7
/////////
7 TTI TITT17 '
22
23
.SIDE SEWER AVAILMILITY
17777111111
�EXISThC WATER MAIN SIZE
I
///1/777777/-77
.77777777
////////
24
VATER MMM SIZE
///R77T//////
//////
7(11
7777TFIT17
25
—
SERVICE LIM SIZE
7TTFIT
If
11111117U-
26
7777=77TT-TRT
HYDRANT REQUIRED
27
HYDRANT SIZE EXISTING
-7/////
/////////
ITITIM7
1111711111
28
7T/T/T/77
CROSS CONNECTIM rNSPECTION RECD
29
I-ATER METER CtWGE REg
-D
TI-1 77 7
Tfl —77 _77 7
TIT111
-71-1-7
30
77T/7T/7
FIRE LINE I REQD SPRINKLER
77777777W
31
STREET CUT
/w/W/
32
I
OPW nT"-14 rVTC.-PTlAV-
ASk 771
IIIINIIII
CITY OF DS
USE PERMIT
ZONE VFNUMBER
A _y__
6ONSTRUCTION PERMIT APPLICATION
-1)
- - - -
NAME (OR NAME OF BUSINESS)
JOB
AUUNtbC. PU116 W, �I-A-C-LtAfSl_
LEGAL DESCRIPTION CHECK[SUBDIVISION NO. NO.
'MILING ADDRESS
r 2
CITY TELEPHONE NUMBER
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
'i;AME
PROPOSE ?k"
RIGHT OF WAY
CONSTRUCTION PERMIT REQUIRED 0
ADDRESS
STREET USE PERMIT REQUIRED 0
CITY TELEPHONE NUMBER
SEE ENGINEERING MEMO DATED
REMARI�S
NAME
14_�
ADDRESS
eE-5�E"71 / �� 7��,
METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS
CITY TELEPHONE NUMBER
A/-
REMARKS
STATE LICENSE NUMBER
SIGN AREA ENV. REVIEW ADB NO.
Legal Description of Property - Include all easements
ALLOWED PROPOSED COMPLETE EXEMPT
(show below or attach.four copies)
SHORELINE#
VARIANCE OR CU PLANNING REVIEW BY DATE
YARDS ___rHT LOT COVERAGE
FRONT SIDE REAR
REMARKS
2"NEW E
RESIDENTIAL PLUMBING
-ADD(ALTER 1:1
COMMERCIAL MECHANICAL
REPAIR D RETAINING WALL SIGN
EXCAVATE FENCE
DEMOLISH OR FILL X _FT)
ICODE
CHECKED BY TYPE OF CONSTRUCTION HEIGHT
Z�
I /YZ
PRE*MOVE-INSPJ SWIM
REMODEL COMPLIANCE INSP. POOL
SPECIAL INSPECTOR JAREA JOCCUPANCY OCCUPANT
REQUIRED GROUP LOAD
0 YES
WOOD STOVE/
INSERT APT. BLDG RENEWAL
0 NO
REMARKS
/hw loe AR/0 ��-�,Ie. 6>a�_
NUMBER OF STORIES NUMBEROF
Ar, ;Ize he 41_�- 2, a / /V,::Y/
DwhLUNU
I
I UNIIb
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
PLAN CHECK FEE
BUILDING
PLUMBING
This Permit covers work to be done on private property ONL
MECHANICAL
GRADINGIFILL
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
"Appilcant, on behalf of his or her spouse, heirs, assigns and
successors In Interest, agrees to Indemnify, defend and hold
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*harmless the City of Edmonds, Washington, its officials,
_j
2
employees, and agents from any and all claims for damages of
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whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of. this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify,.walve or reduce any requirement of any city ordinance
0
x
nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowl;dge 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-
THIS PERMIT
AUTHORIZES
ed thereby, no person will be employed In violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
-tign Insurance.
NSPECTION
SIGNATURE (OWNER OR AGENT) DATE SIGNED
DEPARTMENT
CITY OF
EDMONDS
ATTENTION
771-3202
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE4�
13"F-I
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-78
-60 - 00 [�?/-S_
APPLICATION APPROVAL
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.
OFFICIAL'S SIGNATURE DATE
RELEASED BY:
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
0
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DATE : I—Ar-IfI6
MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Public Works Department
SUBJECT:
After revie-ei of the subject Building Permit application, we have the following
comments:
1. Connection 'to City water system required.
2. Conne�tion to City sanitary sewer system required.
7
3. Right-of-way permit required for any work on City property.
4. Driveway slope not to exceed 1410
5. Back-.-iater — valve required if downstairs plumbing is below elevation oil
ups t-ream manho7e.
6. Water and sewer' lines to be separated by 10 Foot minimum.
.41 4 77 .12 A01
29" M.E., M- ". "No
CY
TI
ILE
Date July 5, 1974
Memo to: Director of Maintenance & Operation
Public Works
From: City Engineer
Subject,: Sewer.Connection Charges
Legal Description: Lot "D": The W 71.28 ft of the following described
Tract, sd Tr4ct being the S h, n N, N )is SE,h, SE 14,
of Sec. 18, T 27 Nq R 4 E, except the W 1017 ft a6d
the E 30 ft thereof.
Commonly known as: A92,26 76th,Ave. W. Owner: Roy L. Williams
18206 3d 4.W., Seattle, 98177
Z.F.F. Calculation:
min Z.F.F. x
Lateral x ($100
Unit x $ 25
cc: Roy Williams,
$ 300.00
Connection Fee
$ 25-00
Lateral Charge
$ 25.00
Trunk Charge
$ 10.00
Permit
$ 360.00
TOTAL
LEIF R. LARSON, P.E.
EDMONDS CITY ENGINEER
Form 6
0
Da te , July 5, 1974 *
Memo to: Director of Maintenance & Operation
Public Works
From: City Engineer
Subject: Sewer.Connection Charges
Legal Description : Lot at,": The W 104 ft of the E 220 ft of the
following described Tracti sd Tract being the Sh,
N ;u N 1% SE h, SE 1z, of Sec. 18, T 27 N, R 4 E,
Except the W 1017 ft and the E 30 ft thereof
Commonly known as: 19224 76th Ave.. W. Owner: Roy L. Williams
18206 3d Ave. NW, Seattle 98177
Z.F.F. Calculation:
min. Z.F.F. x
Lateral x $loo
unit x $ 25
cc: Roy Wi Iliarn
$ 300.00 Connection Fee
$ 25.00 Lateral Charge
$ 25.0() Trunk Charge
$ In -on Permi t
360.00 TOTAL
LEIF R. LARSON, P.F.
EDMONDS CITY ENGINEER
Form 6
�9-
Da te
I
Memo to: Director of Maintenance Operatiw
Public Works
From: City Engineer
Subject: Sewer Connection Charges
July 5. 1974
Legal Description:
Lot "B": The S 164.93 ft of the E 116 ft of the
folloviinq described Tract, sd Tract being the S'h,
IN h. N )it SE P4, SE Aij of Sec..18, T 27 N, R 4 E,
Except the W 1017 ft and the E 30 ft thereof.
Commonly known as-
Owner:
19222
76th Ave. W.
Roy L. Williams
18ZU6 3d N.W., Seatt e, 98177
Z.F.F. Calculation:
Z.F.F. x
Connect ion Fee
93.7
$5.50
515.35
Lateral x
Lateral Charge
34-
Sloo
25.00
Unit x
$ 25
Trunk Charge
25.00
Permi t
TOTAL
.1575.35
LEIF
R. LARSC)N, P.F—
EDMONDS CITY ENGINEER
cc: Roy Williams
Form 6
D a t July 3, 1974
Memo to: Director of Maintenance Operation
Public Works
From: City Engineer
Subject: Sewer Connection Charges
Legal Descri'ption: Lot "A" : The " 70 ft of the E 116 ft.of the
follm'ling described Tract, sd tract being the
Sh, NNN't, SEh, SEhof Sec. 18, T 27N, R4E,
Except the W 1017 ft and the E 30 ft thereof.
Commonly known as: 19220 76th Avenue W. Owner: Roy L. Williams
18206 3d Ave NW, Sea tle 98177
Z.F.F. Calculation:
69.1 Z.F.F. x ($5.50
h Lateral x ($100
Unit x $ 25
cc: ROY L.. Williams
$ 380-05 Connection Fee
$ 25.00 Lateral Charge
S 25-00 Trunk Charge
$ 10-00 Permit
$ 440.05 TOTAL
LEIF R. LARSON, P.E.
EDMONDS CITY ENGINEER
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Ey:FOR YOURCC)MM'ENTS,:.
FOR-8.01LIVINFORMAT, ON':r��"
lj'FOR-- YOU k.-APPROVAL
'NOTE:&,RETURN
ACTION
-FILE,
kYOUR SIGNATURE
OCALL ME,
Cj'SEE-jME
000,
)b-'0MMENTS:_
7-
%j_L_
LF'.'004*-2
(Form .1 QA-4)
0,copyrig6j� .1969,1970 Laurel-Offi6e
. viile'�N:Y.
Aids.1ric. Pronx.
0
Date July 5, 1974
Memo to: Director of Maintenance & Operation
Public Works
From: City Engineer
Subject: Sewer Connection Charges
Legal Description: Lot "D":.- The W,71.28 ft of the followi,ng described
Tract-, sd Tract being the S 12-t N P2, N P2, SE.P4, S E 14- ,
of Sec. 18, T 27 N,' R 4 E, except the W 1017 ft afid
the E 30-ft thereof.
RECEIVer)
JUL 5 7974
Commonly known as:, 19226 76th.Ave. W.. Owner:--Rqy-,L.'W.illi[ams
-W.
18206 3d'.-N. -,*Seattle, 98177
Z.F.F. Calculation:
mi.n Z.F.F. x
;4, Lateral x -($100
1 Unit x $ 25
cc: Roy Williams
$ 300.00 Connection Fee
$ 25.00 Lateral Charge
$ 25 .00 Trunk Charge
$ io.no Permit
$ 360.00 TOTAL
Form 6
W71
SLHUIVk_�10;4 PLXN FOR: ROY L. WILUANIS
44,
Tne 5 1 /2, N 1/20 N 1/2, SE 1/4, SE 1/4 of Section 18, Township 27 North, Ranee 4 7:
except the west 1017 feet and the -east 30 feet.thereof.
East, W.
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kHEDUL��A
06 mo ntols 500.,too
Lit 14 76 -A u
—Dat--, May 26, 1972..at 9:00 a.m. Premium 107.00
1. Insuri!d.
ROY L. WILLIAMS and HELEN.V. WILLIAMS, his wife'
2. Title to.the estate, - lien or� interest insured by this, policy is vested in
ANNA Z. GIBB and HOWARD 0. HAFEY, in indeterminate interests
o",
3.*, Esta�� or inte�e�si-insu�red
r
ree simple estate, as separate property.
4. Description of the real estate with respect to -which this policy is issued
That portion of'the South 1/2 of the North 1/2 of the North 1/2,of
the SE 1/4.of the SE 1/4 of Section 18, Township 27, N.R. 4 P.W.M.
lying East of a line parallel to and'distant 225 feet as measured
at right angles from East boundary of Sierra Village No. 3, as
per plat recorded in Volume 18 of Plats on page-121, records of
Snohomish County;
EXCEPT the East 20 feet for road;
situate.in.,the County.of Snohomish, State of Washington.,
A A Z
PF-5-C 7.70
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