19409 86TH AVE W.PDF8122
19409 86TH AVE W
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RECEI.VED
C I T Y of EDM ON DS S I D E SEWER PERMIT
For Inspection Call 771-3202 PERMIT NO,41254
zi EDMONDS
Address of Construction: ITREATMENT PLANT
Property Legal ''Description (Include all easements): 40TZ 'S-6/6Q1 P&,9T-
Owner and/or Builder: L\ N-7CRY012 /,S
Contractor & License No: AISEE-Z 111 Af
Single Family Residence
Multi -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 Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE
have read and shall comply bate
isted on the back.
Pe rmit Fee: 3o.oO issued By: AM C40 k"(0)
Trunk Charge: -,00
Date Issued:
Assessment Fee: Receipt No.: 3,),
Partial Inspection:
Comments Date Initial
Final Inspection Approved:
Date. InitYal
Rejected:
ason
** PERMIT MUST BE POSTED ON JOB SITE **
Date Initial
Wh-ite Copy - File
Green Copy - Inspector
� , Buff Copy - Applicant
Side Sewer Drawing
TL r; 9 cA.,,.A
W ly a EASEMENT NO. � .................... - -----------
NEW CONSTRUCTION Pg REPAIRS LID NO. /-Tl -------- ASMT. NO . .. ............. .
OWNER --- RANSE X-- - - -P— tsa -Te-(Z- M SG.5 ...... !N.C� ........ CONTRACTOR ----------------------------- ------------------------------
........................ PERMIT NO. .72.5-4
JOB ADDRESS 0A0!5 ------- 8.671�q --- Ava, ........................ LEGAL DESCRIPTION: LOT NO. -2mt ------- ----------------------- BLOCK NO - ------------- - ----------------
EDNIOND'S
........ ....... -- ...................... I ---- ----------------- sp ....... ff,� --- P-:--,,%NT-
.... ................... . .E
L
NAMEDF ADDITION ..... ------------------- - .................. ............................................................. ..........
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'PRIVATE -DRIVE-
PWW-0001 -11/75 (REV.1 1178)
Approved:
DATE� �-.. By Ydq ------
NOTICE:
I '___1 rf, P n tv - 0
The Information'shown on the attached
iled for use by the City of
map(s) was cOMP
Edmonds,; its Employees and Consultants.
Th.e CIty of 'Edm.onds does not warrant the
accuracy of anything set for.th on t * hese
Map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding th*e inform - ation shown on
I
_ff�e -map(s)l including, but not limited to, -h
th'e lociation of any sewer stub shown. Suc
sewer stubs may or may, not exist and may
at the location shown.
or may not exist
Neitheir the r-ity of Edmonds nor its
empl.o-yee-s o-r office-rs -sh-a-H be 111a.b.-Ife for the
n on this map(s), nor for
information give*
e representation provided based
any on
upon . said map(s).
The City of Edmonds 'Si I de Sewer Drawing EASEMENT NO . ................... ------------
NEW CONSTRUCTION REPAIRS [_1 LID NO. -------- ASMT. No - ------------------
OWNER ----------------------------------- CONTRACTOR ----------------------------------- --------------- PER IT N16PMPNDS
---------------------------------- TREATMENT - Pix .,—
JOB ADDRESS ....... -------------- ------------ ----- SCOTW-J-4W.LEGAL DESCRIPTION: LOT NO - ---------------------- --------------- BLOCK NO - ------------- --------------- ........
------------------- --------------------------------------
------------------------------ ............ &P ------ (S ---- -------
NAMEOF ADDITION --------------------- -------------------------------------------------------------------------------------------------
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Approved:
PWW-0001.1 /75(REV.11/78) DATE J4AY91 ................... By
----- ---------------------------------------
CITY OF EDMONDS ASSET INFORMATION SHEET
STREET. FILE.-,
RNEW
ASSET. NO,:.-"-'
ADDITION -.ADDITION TO ASSET NO.
RETIREMENT
DESCRIPTION
SERIAL NO.
k
DEPT NO.
LOCATION
N
-.,,.-,.!'PROJECT NUMBER
"PURCHASE ORDER NO.
PURCHASE ORDER DATE PROJECT COMPLETION DATE t_.�o 4's
ST
COST
B.A.R.S. ACCOUNT NO
ESTIMATED LIFE
INITIATED BY
DATE BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL-PAYMENt REQUEST-..�,
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE. OF* PROJECT..
ACCOUNTING ONLY
!VERIFIED By
O�DEPRECIATE
MONTHLY DEPRECIATION AMOUNT PROCESSED.., -
ANNUAL DEPRECIATION AMOUNT
BATCH NO.
- pz -
G.L. ENTRY
REFERENCE DATE
INITIAL
tnp
DEPARTMENT FILE
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FOOTAGE BY TYPE
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or
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FOOTAGE BY TYPE
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CONSTRUqrl(I/N PERMIT APPLICATION JOB
NAME (OR NAME OFIBUSIIIESS) [ADDRESS
NAME
ID M I R 0 L C019Y 5v 17, 210
TELEPHONENUMBER
SSa r, -
CITY TELEPHONE NUMBER
NAME
ADDRESS
CITY I TELEPHONE NUM
NUMBER
I 5-A-93
PUBLIC RIGHT.OF WAY PER OFFICIAL STREET MAP.
EXISTING _REOL11REDDEDICATION
PROPOSE 0
RIGHT OF WAY CONSTRUCTION PERMIT REOUIREDTTI
STREET USE PERMIT REQUIRED 0 /
SEE ENGINEERING MEMO DATED fl/M 1rZIP
SEE PIW DEPT. REVIEW CHECK LIST DATE4. Z /
METER
SIZE
REMARKS
STATE LICENSE NUMBER CITY LICENSE NUMBER
01 N 5 a-: _-]: I _� I IN T SIGN ARE A ENV. REVIEW
Legal Description of Property - Include all easements ALLOWED PROPOSED COMPLETE EXEMPT
(show below or attach four copies)
r VARIANCE OR CU PLANNING REV)EW BYV
ir
LU
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LU
P
UNITS
cc
LU
A NO
DB
SHORELINE#
YARDS r.f1
,c;>/ LOT COVERAGIE
F`RNT SIDE REARI' 3:9 �Z
0 NEW RESIDENTIAL PLUMBING
1:1 ADD/ALTER NON.RESIDENTIAL MECHANICAL
1:1 REPAIR RETAINING WALL SIGN
EXCAVATE FENCE CHECKE o BY T'
1:1 DEMOLISH OR FILL —X—FT) F
PRE -MOVE INSP./ swim SPECIAL INSPECTO
COMPLIANCE INSP, POOL REQUIRED
0 YES 0 NO
SIDE SEWER WATER LINE E] REMARKS
NUMBER OF STOR.LFS __j —NUMBER OF
DWLLLINU
TUD UNIlb CD 1�
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assign s and
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
j whatever nature, arising directly or indirectly from the issuance
this permit. Issuance of. this permit shall not be deemed to
pof 4-
modify,.waive or reduce any requirement of any city or-.. ----- -
TOTAL AMOUNT DUE
nor limit in any way the City's ability to enforce any ordinance
provision...
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
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
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
0 tion Insurance., I - INSPECTION
0 SIGNATURE (OWNER OR AGENT) DATE S71GD DEPARTMENT
CITY OF
EDMONDS
771-3202
CODE
GROUP
VALLIATION
OCCUPANT
LOAD
FEE
00
1�
119
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
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. oV 11984 11
CHAPTER 3. uBcN PINK — Owner GOLD — Assessor
102-78
DATE
MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Publ ic Works Department
SUBJECT:
After review of the subject Building Permit application, wehave the following
comments:
1. Connection to City water system required.
2. Connection to Ci ty sanitary sewer system required.
3. Right-of-way permit required for any work on City property.
4. Driveway slope not to exceed 14%
5. Backwater.yalve required if downstairs plumbing is below elevation of
upstream manhole.
6. Water and sewer lines to be separated by 10 foot minimum.
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BD 6/82
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FILE
CITY OF EDMONDS
Qw-c C4,11(A - dcsWo-.05. vvA4-wG1c* Man
S IN GLE [AMLY IIULTIPLE COMMI ;C I A.L
PROJECT NAME AIWAKM - F-jd7-C-Af2AfV-11Z
ADDRESS
/;r
ACCESS SLOPE AND VEHICLE ACCESS
DRAINAGE FLAA
STREET [ILI
LEW DISCRIPTION VIRIFICAIION
QUIT CLAIM/DfDICATIONS
CASEMENT - PUOLIC/PRIVATE
CALCULATE SEWER CONNECTION If Ito LID #
STREET PAVING REQUIRED
CURB AND GUn ER REQUIRED
-V/j
SIDEWALK REQUIRED
CURB CUT [OR DRIVEWAY. REQUIRED
RI.GHT-OF-WAY CONSTRUC71DN PERMIT REQUIRED
BOND REOUIRID FOR PUBLIC IKPROVEhENTS
STREET NAME SIGN REQUIRED
OTHER S]UiINC REQUIRED
a
ENGINEERING & PUBLIC WORKS
PROJECT REVIEW
CHE,CK LIST
T NA.11E & TELEPHONE NUMBER
_57-,
(ADDITIOXAL COMMENTS ON BA(
1XISTItir WATER KAIII SIZE C.
WAI[R MAIN REQUIRED NIA
SERVICE LhE REQUIRED
11YORANT SIZE IXISTI NG Z41
11YORART RfqUIRED PER FIRE CvjI
-N,/A
SIZE
CROSS C(INNICTION IRSPECTICH
WATER 11fTER C. Uinio
REVIEW By DATE
�57
(AMITIMAL COPKNTS ON gi
SAAIIARY SEWER DWIING IILJPBER FILE WIB . ER
w SIDE SEWER AVAILABILITY SMITARY SEWER, CONIIECTIO11 FEE REQUIRED
w
so
OPEN D.ITCH rXIST11111, ------------ QUIRLD
CC CULVERT RfqUIRE PLY)
I- UICH BASIN REqUIRED I IL lINDICATED ON SITE PLAm
ShOULDER KkIlLAGE 111INTAIN COLLECTI011 OiN SHALE OPEN RUtlOfF
co
tMH011 REQUIRED I
INDICAT[D 01 SITE PLAN
0 SOIL COno TI kuQZ§K?UND WATCR FIELD CHECKED
AIVIEW by
PAT[ (ADDITIONAL COMKNTS ON &AC