19428 88TH AVE W.PDF8412
19428 88TH AVE W
PUBLIC JAURKS DITARI=,
CHECKLIST Date
BUILDING PERMIT
STREET VILE
REVIEW
AS74t Address
Street Right -of -Way Existing
REQD J5
Access Easements Existing
INA 1. REQD -WON
Utility Easement Existing
REQD
Lot per Subdivision !33 1 Plat
Assessor Map
Site Plan Checked for Accuracy
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Underground Wiring Reqd.
P4
Check Accuracy of Legal Description
9S
W
Environmentally Sensitive Area
Environmental Checklist Reqd.
Flood Hazard Zone
U
Shoreline Management Area
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Slope, Soil, Vegetation
�j 0
Stream, Creek, Drainage Basin
?IM5
Existing Zoning Per Code
Amenities Design Board Approval Reqd.M(!)jQ.%7 ADB # Mumma Approval
Board of Adjustment Approval Reqd.
Review By:
Date:
Existing Water 14ain Size O-,p_r
Water Main Reqd. -AIE)
Service Line Reqd.
Hydrant Size Existing E,>A!L-
Hydrant Req4. Per Fire Code
Size
Detector Check Meter Reqd. wk�
Cross Connection Inspection
Fire Department CmTnents
Water Meter Charge Reqd. z5D400
Review by: Date: 4�ylls ;;)'p
SeptL: c Uai-K s i gn i p prove
ate:
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability
Proj
Drawing No.
File No.
Side Sewer Availability
Sanitary Sewer Connection Fee Reqd.
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Review By: "/k;
Date: �a,)131'2
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,.BUIIDING
DEPARTMENT
Applicant Fill
USE PERMIT
ZONE 1p(� IYLNUM13ER
PERMIT APPLICATION
Inside Heavy, Lines
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ADDRESS 9 LA)
NAME (OR NAME OF BUSINESS)
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C_ a k' m Ii lc�
SUBDIVISION N
- 75 1-7 I
PLAT NAME
ASSESSOR MAP NO.
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MAILING ADDRESS If
PUBLIC RIGHT OF WAY PER ORDINANCE NO.
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--7TELEPHONE
CITY
NUMBER
S-e-AfUe,
b
EXISTING RIGHT OF WAY
1361 -/ 73
PROPOSED RIGHT OF WAY C)
NAME
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DEFICIENCY OF RIGHT OF WAY 0
ADDRESS
STREET/UTILITY WORK REQUIRED YES NO
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PERMIT FOR WORK IN PUBLIC R/W 12YES 1-1 NO
UNDERGROUND WIRING REQUIRED WYES El NO
CONNECTION TO SANITARY SEWER WYES ONO
SEPTIC TANK PERMIT REQUIRED El YES SNO
0
3.
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0
IL
CITY
ONE NUMBER
NAME
SEPTIC TANK PERMIT NO.
ADDRESS
SEE MEMO DATED
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CITY
TELEPHONE NUMBER
REMARKS
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0
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
CH
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Legal DeSCription of Property (Show Below Or Attach Four CopiesT
METER 512A-
BUILDING SUPPLY SIZE
W
REMARKS
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IL
SIGN AREA
ENV. REVIEW
ADB NO.
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ALLOWED PROPOSED
COMPLETE EXEMPT
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REMARKS
W
VARIANCE OR CU
1P
LANNING REVIEW BY
DATE
YARDS
FRONT SIDE REAR
ILOT COVERAGE
0 NEW RESIDENTIAL GAS
1:1 LINE
El--- NON-RESIDENTIAL SIGN
DEMOLISH RETAINING
WALL
ElALTER EX CAVATE FENCE
Fl OR FILL F7 : --' "
FIRE ZONE
ITYPE OF CONSTIR UCTION I
CODE
HEIGHT
SPECIAL INSPECTOR JAREA
REQUIRED
ED YES El NO I
OCCUPANCY
GROUP
I
OCCUPANT
LOAD
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
ElREPAIR PRE -MOVE swim
1:1 INSP. POOL
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
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NUMBER OF STORIES
NUMBER OF
DWELLING
REMARKS
UNITS
W
NATUREOF��TO Er
IL
W
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0
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IL
U
0
W
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0
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PLAN CHECK FEE
VA UATION
FEE
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PROPOSED USE
PLOT PLAN (INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
BUILDING
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PLUMBING
CI
MECHANICAL
0
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FENCE
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SIGN
PRETAINING
WALL
Side Sewer Drawing
Tho City of Edmond %-, �� EASEMENT NO. __ --------------- -----------------
HEET FILk EW CONSTRUCTION REPAIRS LID NO - ------------------ ASMT. NO - ------------------
OWNER
-CONTRACTOR ------------- ---------- PERMIT NO.
JOB ADDRESS IF-- LEGAL DESCRIPTION: LOT NO - ------------ E�? ------ .............. BLOCK NO - ------------------------------------
..................................................................................................................................................................
NAME OF ADDITION ------- .........................
DATE -In Jf`
- -------------- � BY --- c_ F-,a�a� -i
PWW-0001 -11175 (REV. 11/78)
NOTICE:
U- .1 - -0 y
--War-ranty---oi -du-�-
N'o
The information . Shown on the attached
iied for use by the UtY Of
map(s) was cOmP
Edmonds/ its Employees and Consultants.
The City of *Edm.onds does not. warrant the
these
accuracy of anything set for.th on . -
Map(�_). Any person or entity -requesting a
copy should conduct an independent
o m'ation shown on
inquiry regarding the inf r
._.___t_Fe -map(s)l including, but not limited to, -h
th . e location of any sew-er stub shown. Suc
sewer stubs may or may- not exist and may
hown.
or may not exist at the location s . . .
";ty of Edmoind's nor its
Neither the k__1j
emp'fo-yee-s o.r office-rs -shal`l be 1--',ja-b-1Fe for the
information given' on this map(s), nor for
ov'ded based
any one representation pr I
upon'said map(s),
71
CITY OF EDMONDS -SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 77 -2525 for side sewer inspections BEFORE covering any Portion of the construction.N
Inspecti5on will be Provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.)
ADDRESS LOCATION OF CONSTRUCTION----
........................................ . ..................... . . .......................................................
PROPERTY LEGAL DESCRIPTION ..... C_ A �_
........... :e� .................. 5;4 ...................... . ......................
............. I ......... . ........................... ........... . .......... . ..................................................... ................... ............... .................................. . .........................................
....... . .................. - ----------------------------------- OWNER i��/OR BUILDER .... ;.CA qQ -0— / z 'T - ----------
... ....... . ....................... --- W ........................
CONTRACTOWS NAME & ADDRESS
. .....................................
Is granted ............ ..... :fn1�,,-_,.(,1.._.1.�z—.1 1975� for repair and/or connection of a side sewer to the city . sanitary sewer
-- - ---------
k �an in accordance with Citj of--E-dmond . s ordinances. -
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—The owners of the property may obtaln a permit to construct sewer inside Property line. 'A licensed Side Sewer Contractor must be employed . to construct
side sewer in street area. Do not cover any Portion of sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-wav requires an Invazion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3--Obtairi full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at leazt, 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. 5—Trenches in street must be water settled and surface of street restored to originaJ condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the m
sert the pipe into the wye. ain sewer or its appurtenances except to in -
DISAPPROVEDEi Date ... . ................................... By ----------------- Date ..................................... By ................. Date ............... . ......... ...... 'BY ...... ; .........
APPROVED (k— ')
. . .. . .. . ................................................. e .....................................
Remarks: ....... . ...... . .......................... . .. . ............................................
............... . ....................................................................... a ....................................
..................................................................... . ............................................................................................
... . .. ............. ..... . ............ ....... ............. .... ..
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construct i o n PRIOR To Request For Inspect ion
�0;"Zr.f cn;;;ci(.... ierf rmin ----- hereby certify that the side sewer installation *constructed under this per
ing Firm Performing onstructi n) mit
was installed in accordance with all governing ordinances of the City of Edmonds.
-1 77
-V V 'Check BEFORE you dig for: Water Dated this ------------- IS .......... day of ......... 7 .......... . .................... ..........
Gas [], Teleip'hone E], Power E], Sewer (], Other