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[PERMIT EXPIRES
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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1L11*E1 I PROPOSED
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LEGAL OESCILITIO1 OF PROPERTY -LEXE Ad. EASEMENTS
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LOIC IERACE
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PROPERTY TAI ACCOUNT PARCEL NO
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LOT AREA
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P GRESS INSPECTIONS PER UBC 108
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DESCRIBE INORK TO BE DONE
FINAL INSPECTION REQUIRED
FEE
PLAN C.EC. ISE
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PLAN CHECK NO:
-EEN.
70—
TINI PERMIT ALINDROES ONLY TIE TWORI NOTED. TH23 PERMIT COINEIS IORI TO
O"INNITI"OPETITIONLY
5 ANY -11MUCIPS. 01 - PI11C
DO 11 ARNSIPAY.
SEPARATE ASINATESIO.UES1 ETC I PRLL RE.U.E
N
G-RELFILL
PER TAPPUC.- IMI-I
PERMIT LIMIT 1 -1 - P1011DED .01. IS STARTED 1-11 111.15
11.R. DR..., 'E',
AIRL-1, ON 1-1101 .15 OR IEI SPOUSE, 1- .$11IS AID SUCCES015 IID NERECTI-EE
'E. I �CEEAE I AGREES TO 1.0-11 FY, DEFEND AND O,D NA-1LE SE I.E CITY OF
'-%-A`N IT. EMPLOYS El, AND AGENT 5 FROM ANY -
ALICLA FDA j OPI-ER NAILPTE-SING-ECT-ALARAPTECTLY
FROM TIE ISSUAKE OF T11S ISIART. ISSUANCE OF -S PERMIT TRIAL E
EE.E.T. IoF=e ft. C.- DEPOSIT
N OR I LA I T IN "I" -I NE'C 01 REDUCE ANY R-REMENT OF .11 C
"15 ABILITY TO ENFORICE AIY ORDEPAUNCE PRIONTSKIN' TOIA1 -.1 DUE
.GIEIEBI AC —EDGE THAT: A-E READ IN 5 APKICATION, 7.17 INFORMATION I
"E, IS CD RECTANO .,T M T—E-R TIE DULYAUT- .'EDAGENTOF APPLICATION APPROVAL
- I_NER I AGREE 70 COMPLY INITI, CITY AND STATE L,UNS AT ILNOCO.ETRUC CALL IN. . IN . .-1 -, P.- I -
TION A-1 D'"' TE IONI AUTIDAITED T.EREBY. NO PED= LL BE EMPLOYED .1 O-Il -d
IN IOLATIOI OF TIE LABOR CODE OF TIE STATE OF VWA-NDT.N REIATITS TO FOR INSPECTION ......
10111ENSCOMPEISATIO-SUT NCEANDIC-521.
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771-0220 - - 4",/
RILEASED91 All/
A17ENfION , III,
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI. —1— 11,1lE1.1.11
CATE OF OCCUPANCY HAS BEEN GRANTED. URC SECTION 109 CO. ----
STM
0.v City Of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number: 0
Issue Date: -3 3 cr 9_3
STROEET R�E
, c
A. Address or Vicinity o ( onstruction: 19709 80 Place W. (9312125)
44
9 B. Type of Work (be specific): Nn stall New Service
C. Contractor: Washington Natural Gas Co. Contact: Frank Swan
Mailing Address: 815 MerdeipiSt/Seattle, Wn Phone: — 224-2278
State License #: Liability Insurance: Bond:$
D. 'Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. f� Commercial E] Subdivision F] Ci ty Project IMXUtility (PUD, GTE, W`NG, CABLE, WATER)
F1 Multi -Family E] SingleFamily F1 - Other
INSPECTOR: INSPECTOR: W�A")A
F. Pavement or Concrete Cut D Yes PAo G. Size of Cut: H. Charge$
APPLICANT TO READ AND I
INDEMNITY. Applicant understands and by his signature to this. application' agrees r e City of Edmonds harmlessfrom injuries, damages, or
�N d .�
claims of any kind or description whatsoever, foreseen or unforeen, that may be maidesag Ci y
of Edmonds, or any of i�. departments or emplo -
,4, no
Uo
ees, including or not limited to the defense of any legal proceedings including defense cbs4�o meyfees by reason of grandni�Alvpermir
7HE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MA TERIALS FOR A PERIOD OF OAE YEAR FOLLOWING THE FINAL INSPEC77ON
AND ACCEPTANCE OF THE WORK ESTZMA 7ED RESTORA 77ON FEES WILL BE HELD -UN77L THE FINAL S7REET PATCH is COMPLETED BY
CITYFORCES, AT WHICH 77MEA DEBITOR CREDIT WILL BE PROCESSED FOR ISSUANCiid THEAPPLICANT
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Eii gineering Departin
Work is to be inspected during progress and at completion.
Resle�rition is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by !he City Engineer.
Alt,street cut ditches shall be patched with asphalt or City, app
yoved material prior to the end.of the working,day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy o5f", the permit will be available
on site at all timesfor inspection purposes.
Signature: Z Date: March 24, 1993
(Contractor or-A-j64)�
CALL DIAIA-DIG PRIOR TO BEGINNING WORK
NO WORK SHALL BEGIN PRIOR TO, PERMIT ISSUANCE
Engrg. Div. 1991
Eng. Div. July 1985
Addendum to City of Edmonds
Right of Way
Permit Application
Submitted by:
Engineering Aide
Washington Natural Gas
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1970(q 80 PL. \AJ.
EDNIONDS
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N/A WNG to window*
N/4 Water main depth
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sewer
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water hydrant
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water valve
815 Merccr St. (P.O. Box 1869), Scank, WA 98111 (206) 622-6767
NOTICE:
No warranty of accuracy.
The information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of 'Edm * onds does not warrant the
accuracy of anything set forth on these
map(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
tFe -map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may* not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
emp]-oyee-s o-r officers shall be 1---1a-b-11-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
j'7 7.) APPLICATION
for LYNN PLANT
The City of Edmonds FLt SME SEWER PERMIT EASEMENT No . ..........................................
NEW CONSTRUCTION C] REPAIRS C]
Of
OWNER ...... ..... ... ........................... CONTRACTOR .... .............. .... ....................................... PERMIT No.
ADDRESS 9e .. ... ;-�EGAL DESCRIPTION: LOT No . ....... ............................ BLOCK No . ............................................
rh ......... 6 ....
NAME OF ADDITION .........
0
.- C%
w
Approved:
DATE... g ....... �L-zw ............... By ............. ...........
CITY OF EDMONDS
—XIVIC CENTER _� WATER -SEWER DEPARTMENT
SEWER PERMIT
CaJl' PRospect 6-1107 when work
Is ready for1aspe6tion. (No inspec- XT 0
tions Saturday, 8 . unday.or holidays.) 11 _: 2329
.ADDRESS .......... jqj.Q!� .... ... 8.0t.h .... Pl�a_qe .... We.:_§.t ................................................................................................................................
OWNER ......... Robert -A.... -Fish .................................... .......... CONTRACTOR ..... p,.qth Excavating
. ........................... .. ..................................
-Perinission is granted ...... June ... 7 ....................... ig.0., for ........................ days to REPAIR or CONNECT a side sewer
with City Sewers in accordance with- application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—The owners of the property may obtain a pe rmit 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—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.
NI-E 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.
k
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.
Water Sorvice Drawing
EASEMENT NO . ..............
The city of Ednionds IkEPAIRS 0 10 . .................. AsMT. NO . ..................
NEW CONS-I'RUCTION Cl
I)Fjk�-IIT 1,10-:Z
CTOR ................................. ........................... .
CONTRA
OWNER ........................ ***"* .............. ..... ... V,EGAL DESCIUPTION: LOT. NO . ...................................... IlLC)CK NO . ..............................
...................... ...........................
..120 . , ...........................................................
JOBADDRESS ...... .......................................................
NAMEOF ADDITION ..... ............. *,***"*" ................................ ....................
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F�C�` F A —rnved:
DATE ... :9-14P-t ....................
pV4�Aj-()()ui - 11175 (REV. 1 V76)