19812 81ST PL W.PDF7488
19812 81 ST PL W
CITY OF EDMONDS
USE
ZONE
PERMIT
NUMBER
CONSTRUCTION PERMIT - APPLICATION
JOB
ADDRESS
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ITE/APT
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WN
0 4 NAME NAME OF BU INESS
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DESCRIPTION
1<dWIZrA
LEGAL
CHECKI
SUBDIVISION NO.
LID NO,
MAILING ADDRESS
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Place 09
PUBLIC RIGHT OF
EXISTING —
WAY PER OFFICIAL STREET MAP.
REQUIRED DEDICATION —
TESCP Approved 0
RW Permit Required 0
Street Use Permit Req'd 0
0 Ill V4 1P S 11"
CITY ZIP
A
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TELI:FHONE NUMBER
-7 -f6 -.36 31�?
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inspection Required
Sidewalk Required
0
0
NAME
METERSIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES 0 NO 0
LW) ADDRESS
REMARKS
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tom;
TY ZIP
TELEPHONE NUMBER
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��P,OK e j a n v i
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C'[ CITY OZIP TELEPHONE NUMBER
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STATE LICENSE NUMBER EXPIRATION DATE
Legal bescription of Property - include all easements
Property
Tam Account
P...I No.
03y na
coog
MNEW
RESIDENTIAL
PLUMBINGfMECH
COMPLIANCE OR
El
COMMERCIAL
CHANGE OPUSE
FIREMODEL
0- APT. BLDG.
SIGN
GRADING
FENCE
REPAIR
— CYDS.
I x —FT)
DEMOLISH
WOODSTOVE
SWIM POOL
INSERT
HOT TUB/SPA
RETAINING WALL/
FGARAGE
]CARPORT
ROCKERY
RENEWAL
7YPE OF USE, BUSINESS OR _ACTIVITY) EXPLAIN
CAL
NUMBER NUMBER OF CRITI
OF DWELLING AREAS
STORIES UNITS INUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
CAL.
I LL I A )01-Ar-A=
ENGINEERING MEMO DATED
REV I EWED BY
SIGN AREA SEPA REVIEW ADB NO.
ALLOWED i PROPOSED COMPLETE EXEMPT SHORELINE N
EXP I
VARIANCE OR CU PLANNING REVIEW BY DATE
SETBACKS— FEE T I HEIGHT IL . OT COVERAGE I
FRONT SIDE REAR I
CHECKED BY TYPE OF CONSTRUCTION CODE OCCUPANT
GR99P
4A)r 9(/ K
SPECIAL INSPECTOR AREA OCCUPANT
REQUIRED DYES LOAD
EMARKS
1111PROGRESS INSPECTIONS PER .. 108
FINAL INSPECTION REOU,IRED
VALUATION FEE
PLAN CHECK FEE
GLAZING
BUILDING
9-5
HEAT SOURCE:
PLUMBING
Plan Check No.
MECHANICAL
GRADINGWILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewpiks,
driveways, marquees, etc.) will require separate permission.
STATESURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENG. INSPECTION FEE
,n
successors in interest, agrees to indemnify, defend and hold
2
harmless the City of Edmonds, Washington, its officials,
2
employees, and agents from any and all claims for damages of
a:
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, waive 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."
ql 76
Is
I hereby acknowledge that I have read this application; that the
ATTENTION.
APPLICATION APPROVAL
information give * n is correct; and that I am the owner, or thp duly
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
T his application is not a permit until
ed thereby, no person will be employed in violation of the Labor
ONLY THE
.
signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insurance and FICW 18.27.
INSPECTION
acknowledged in space provided.
SIGNA URE (OWNER OR AGENT)
DATE SI NED
DEPARTMENT
I!!ap I
7 L-
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CITY OF
EDMONDS
DATE
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9`70� '(�--d-:Zie
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ATTENTION
CALL FOR
RELEASED BY: DATE
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
PINK — Owner GOLD — Assessor
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CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
19812 8 1 �&T W-
e Owner: WASHINGTON NATURAL GAS CB
Name
<73')805 156 AV NE
Mailing Address
Bellevue, Washington 9 00
city, State, Zip Code
9 Contractor: WASHINGTON NATURAL GAS CO
Name
805 1 56 All NE
Mailing Address
—Bellevuef Washington 98007
City, State, Zip Code
Permit No.
Issue Date
9 Permit Issued To:
9 Type of Work to be Done: Tn-,f--;; 1 1 New Sp-r-uri ce
Work in Connection With:
El Sub or Plat 1�1 Single Family
El Comml. / Ind. 0 Apt. Condo.
9 Pavement Cut: 0 Yes El No
State License Number
747-0650 ex 244
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this pe
I
Signature:
Owner or
be availabli; d
dct,v V
site for inspection purposes at all times.
ate —
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Author/ed- Vciid after 'It=�'_days
Special Conditions:
Ammendments:
Permit Fee: —
Security Deposit:
Receipt No.:
Fund I I I Fee:
Street Cut Dimensions
X —
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. Dcccmbcr 1978
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CITY OF EDMONDS `qwo I n E
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
19812 81 ST 11
0 Owner: T,1TASFTWaT0-w NATTIRAT, apip CD
-Name
*) %805 15 6 NY HE-,
Mailing Address
Bellevue, Washington 9 00
city, State, Zip Code
0 Contractor: �17A-51EINGTON NATURAL GAS CO
Name
R09; 1 9;6; Wy NE
Mailing Address "
__n- 0- 1 y 1) P,9 PlIN'rishin".nn 98007
City, State, ilp Code
Fermit No.
Issue Date
* Permit Issued To:
9 Type of Work to be Done: Tn=�6a I I MenW 5:Zr%-v-xFJ
- 3,03
• Work in Connection With:
El Sub or Plat 4�1 Single Family
El Comml. / Ind. El Apt. Condo.
• Pavement Cut: El Yes 11 No
State License Number
I t
7A7-0650 Py 71-A
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a. debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this ge/mit must be availabig at thetJob site for inspection purposes at all times.
ate /
Signatu
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Vol after days
ill
Special Conditions:
Ammendments:
Permit Fee: Id.4,-
Security Deposit:
Receipt No.:
Fund I I I Fee:
Street Cut Dimensions
- X
NO,,.WQRK TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. December 1978
FIELD INSPECTION NOTES
(Fund. 111 - .96—ute conv to Street Dept .
Comments:
Diagram:
/r-,\
Contractor called for inspection Yes 01-01)
T Bv: Date:
Nork DisaPproved. By: Date: T
Work Aporoved Bv: Date:
Inspector:
Encf. Div. December 1978
FILE
Nr. 4ayne Jones
Aeid, Middleton 4 Associates
324 Hain 6treet
4dmondso Oashin,3ton 98020
Dear Jayne:
�isptember 249 1963
The property a�mers at 198049 19612 and 19818 Blot Place W. wish to
lower the tile in their driveways to eliminate ponding of storm water
in their area,
Request a profile of drainage facilities alon�; the west side of 81st
Place 4, north of 200th Street S.a. be established to determine if
lowerirq; the tile in above driveways will alleviate their storm drainase
problems.
Very truly yourss
CITY OY EDHOZWS
JAI-ILij 11* CONWAY
asst. City I;ngineer
Xic/le
NOTICE:
No--warranty-of -accuracy.
The -information on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edmonds 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
-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
ernp-to-yee-s o-r offic-e-rs -shall be Hlab-]-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
0
APPLICATION
rwaa goo for
SEDE SEWER PERMT
160"Mm
r" NEW CONSTRUCTION REPAIRS
Z-,P I v � I t
OWNER....... ----------- ......................
ADDRESS .......
... .........
.................
The City of Ed
LYNN PLANr
DGMENT No - -------- ..........................
CONTRACTOR A .. &-e . ...... PERMIT No.
LEGAL DESCRIPTION: LOT No. It'
----- ll ............................... BLOCK No . .................. - ..........
NAME OF ADDITION ..... V --- .........
AppkjVED
I
4
Approved:
. . ......
DATE .. ........... .....
r
CITY OF EDMONDS
Call P]Fti)qpi�ct 6-1107 when work
.CIVIC -CENTER WATER -SEWER DEPARTMENT Is read*y'for''insp'ecilon. (No inspec- NO 1519
tions. Saturday; Sunday, or'holiday
SIDE - SEWER- PERMIT
ADDRESS ................... 1-9812. '81st -Place West
.................................................. ....... .......................................................................................................................
OWNER .............. ....... .... Robert Allison TOIL .. P ... ... Q..Side SEwejoq ...................... ........
............... ................ 7 ................................ ....... . CONTRAC ..........................
Pern-iission is granted :-_Zanuary.�23 ............. 19..Z,7.1 for ..* .................... days, 4o 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 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�Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
N' , —E No. .3—Top of side sewer must have at least-30 inches coverage.at property line and 12 Inches Inside property line; minimum.gra,de of 2%._
No bends in grade sharper than 'A will be permitted.
�,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 w1thin one year of completion.
NOTE 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 ap-
purtenances except to Insert the pipe Into the wye.