19905 MAPLEWOOD DR.PDFIIIIIIIIIIIIII
12204
19905 MAPLEWOOD
DR
7-11'T11710j1r17,T --w— — " I I wil __N_ 'r — �!
CITY OF MMONDS - SIDE SEWER nCft&A T
PERMI
f
PERMIT NO. 4293
Call 7,76-1107 for side sewer Inspections IMFOBE covering any portion of the oonstruetion.N
Inspection will be provided within 24 hours after request. No Sat., Sun., or holiday inspectionx.j
,,4�,;01- ��'japlewoocl Drive-
ADDIIESSIMATION OF CONSTRUMON ...................................................................................... ................... . .. . ........... ...........................................
Lot 17. i'liapleva,,od Estates
FROMMLEGAL DZSCBnwnoN .............................. I ........ I ................................ . .......... . .. . .................................. ........................................................
...................... . ........ ............. . .......... . .......... . ............................................................. .......... ............... . ...... . ..... .................... . ...................................................
John 'Brooks
... . . . .................. . ................................... OWNER A24D/Oft BUUMEU ........................................ . ................................... .......................................................
Russ Johnson 161010-4 111 readowdale Road. Edmonds 'v"as'n 98Q�q
CONTZ&OTM8 NAME & ADDRESS ....................................... $ ............... : ....... !� . ...................... ................... . ......... . .. . ....... P ........ ...........
February 14
to &VARW .... ...... ............. ............ _-, . ............ 19.D., for repar and/or coew"Ou Of a side Sewer to the city sulltary sewer
sysbm In zeowdMoe with City of FAlmonds ordinanem
N 'a C D To THE FOLLOWING:
No. I—Ii.= of the property may obtain a permit to construct sewer Inside property line. A licensed Side Sewer Contractor must be employed to construct
.t, t
side sewer In ree area. Do not cover maypertion of sewer before It has been Inspected.
CINNNo... 2—All work performed In city right-Of-WSV requires an Invasion of Right-of-way Permit obta4nable from the City Engineer's office.
KO= No. $--Obtain full information regarding Ordinance 11.1&OWL and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 in abas �co v er*V at property line and 12 inches Inside property I Ins; minimum grade of 2%. No bends In grade
sharper than % will be permitted.
NOTE No. 5--Trenchen 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 oVoomPletlon.�
NOTZ No. 6.—It is unlawful to alter or do any other work than Is pt"ded for in the permit� or to do any work on the maln sewer or Its appurtenances except to in-
sert the pipe into the wye.
DjSApj%OVED 0 Date
.............. nr� .............. Date ....... B ............ Date .......... . .. . ... ............... . By ................
"PRo"M .................... BY—— . . .. . .. . ............................... .......................................................
Remarks: ....... . ...... . ................ ....... ....................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .. I . . . . . . . . . . .... . . . . . . .. .. . . -.4 .. .. ........ .. .. ... .. .... .. . .. . .... . . .. . . .. . . . . . .. . . .. . ... . . ... ... . .. . . . ......... .. .. . .. . . . . . . . . .
.. .. .. ....... .
By'own er of Firm Performing Construction PRIOR TO Reques! or.
pied t inspi4oft,
................ hereby certify that the side sewer InaWlation constructed under, this permit
............ ...
con Firm Construction) City
ordin"oes of the of Edmonds.
....... to-Z-3.
OaMd fl" ...................... .
j CtW& Mpg,= Y",
sewer Other
,f- 2 - 7 6
dif
STREET ADDRESS HIM
CITY OF EDMONDS
7110-210TH ST.S.W. EDMONDS, WA 98026 (206) 771-0235 FAX (206) 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION
March 7, 1996
CV Jenkins
19905 Maplewood Drive
Edmonds, WA 98026
RE: LEAK CREDIT (#408050)
Dear Mr. Jenkins:
FILE COPY
BARBARA FAHEY
MAYOR
I have reviewed your account and will allow a credit from December 11, 1995 through
February 13, 1996 in accordance with our City policy. The policy states that the customer
will be billed at the retail rate based upon the average water consumption for the same
period during the previous year. In addition, the excess water lost from the leak will be
billed to customer at the City's wholesale rate with a 15% surcharge added for
administrative cost. Only one leak credit will be granted in any three year period.
Should you have any additional questions after you receive your new billing, please
contact Ilene Larson, Utility Billing Clerk, at 771-0241.
Sincerely,
Gj
Ron Holland
Water/Sewer Supervisor
RH/j h
cc: Ilene Larson
Utility Billing Clerk
wordata\water\credit96\#408050
. e Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
The City of Edmonds Water Service Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION [] REPAIRS JZ LID NO . .................. ASMT. NO. -1- ...........
OWNER VERNON ...... 3.Et4.K.A.W..S .......................................... CONTRACTOR ..... M.Ont--S ........................................ PERMIT NO.9.600.47
JOB ADDRESS ... [-55.0 ... b .... ... MAPjr�e.�4jOQO .... DR - LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . .............. .....................
--I* N 0 Rmii-.4w
PWW-0001-11175 (REV.11176)
NAMEOF ADDITION .. ....................................................................................................................
-44 it 041rn
Approve.-�: MAPLP-L,300Z
DATE By
------------------
I
11
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS E] EASEMENT No . ..........................................
OWNER ......
------------------------------------------------------------------------------------------------------- CONTRACTOR ........ PSL.X� ......
............... N ..................... PERMIT No...!!M-a�
...............
rAINDRESS ... ...... CN:k LEGAL DESCRIPTION: LOT No . ............. ......................... BL()CK No . ............................................
NAME OF ADDITION ....... .........
.................. ................ .. .. ..... ...........
10A
IL
IL
I/a BEND- WWN Imligp-ND DOWN
IC2�sc)s -(Z-117. DEEP) I/aSSNO
DGEP).-
MINPLEWOM
r72)
fall
10 -Z
0
in
'a
00
Approved:
DATE By ..... . . .......
CITY OF EDMONDS ��L'_'�:T FLE
DEPARTMENT OF 0L4ftM)&VXXW Engineering
250 Fifth Avenue North, Edmonds, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to: .................................................... ......... . ......
For installation at: (street address)..1.99.05 ... Maple.wood ... D.r.i.-v.e ....... E.dmond.s ...... W.a.ShJ.n.9.to.n ..........................
Addition or Subdivision ....... M4P1.eWQQd..Zs.t.ates_ ................ ..... .................................. Lot ........ 1.7 .... Block ................
Type of Building: New ............ Existing X . . Single family residence X Number of bedrooms 3 . .. .........
Other: (specify type or use)..-.. .... RePAi.r.-Remit ...... _ ................................. .............. ................... _ .................................
Builder.............................. ......................................................... Address ............ ... ........................ ------ .................... .......... .......
Designer ---- Ce --- Re .... LYM.. �ngineeri.n.g ............................. Address.P...0— --Box ... 1.8.7 ....... Lynnwood,...Wash ..... 98.036
SoilLog Hole No. 1_ --------- ................................................. — . .. .. . . ............... _ .... . .... .............................. _
SoilLog Hole No. 2 ...................................................................... -- ----------------------- _ ...... ............. .................................
Elevation of Water Table, ifencountered. (Distance from ground surface) ..... None...encountered ...........................
Corrections to control surface water if needed ...... ........ We ..................................................................................................
.......................................................................................................................... ........................................................ ; ......................
Specify if any removing or grading of topsoil in field area.—Non.e ......... I ............. ...........................................................
....................
Percolation -
Test Hole No. I —Average Rate ..... 13 ...... . ... ... .. (Fall in rninutes/inch-bottom 6" test hole)
Test Hole No. 2—Average Rate ................. ................................ ..... (Fall in iiiinutes/inch-bottom 6" test hole)
Test Hole No. 3—Average Rate ................................. ........... _ - ------- (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design ...... ....... ..... Date Taken . ..............
Septic tank requirements based on present rules and regulations:
Septic Tank Size ... .... �QQ ............. gallons.
Amount of Square Feet o;A
- �?sposajZ�ield..21Q.Aq..t
Signature — Designe4�m�._-_'.:�.'�_ .� .. J-) .... %�� ... ... ......... ............ Date -April ... 22.,.:.1.968 .......
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date) ................................................................ Permit Number .............................................
Remarks:...... ..Permit issued for repair as temporary drainfield pending installation of
....... .. ........................ .. .. . ..... .......... . ............................ .........................
Unit 3 (L.I.D. 161) sanitary sewers.
................................................................................................................... . ......... ...........................................................................
C. R. LYON ENGINEERING
P. 0. BOX IB7
LYNNWOOD, WASHINGTON 9aD36
April 23, 1968
Mr. John W, Brooke Jr.
19905 Maplewood Drive
Edmonds, Washington
Re: Sewage Disposal System for Lot 17 - Maplewood Estates.
Dear Mr. Brookes:
Enclosed herewith is a drawing on which we have shown a temporary sewage disposal
system for your lot. The system is classified as temporary in as much as it is
not a standard method of handling the waste of a residence and it is anticipated
that public sewers will be available within the not to distant future for the area.
We have shown a line which is to be as long as is possible, outside of your basement
and which shall be dug at least five (5) feet deep and thirty-six (36) inches wide
across the rear of the lot After digging the trench it shall be filled to within
two (2) feet of the ground*surface with a three-quarter inch minus washed gravel and
then have placed upon it a four (4) inch drain tile and backfilling shall be performed
in the standard met.hod'of construction for drainfields in sewage disposal systems.
This method of disposal of your waste is the cheapest one presently available although
the actual area available -for absorption of water is much below that normally'required
for a residence. It is hoped that it will suffice at this time. It is our under-
standing that you anticipate renting this house in the very near future. It is
suggested that you be a little bit choosey in the renters and rent only to those who
have a small family of at the most one or two children. This will keep the water
usage down and extend the life of the drainfield.- Should the drainfield fail,
there is only one alternative, and that is to tap the line and to take a pipe down
to the base of the hill. It is felt that the method proposed here, although not'
the best, is the one most economical and feasible and it is hoped that it will
suffice the needs until such time as public sewers are available.
If you fiave any questions with respect to this matter, please do not hesitate to
contact us.
V truly yours,
rCRL:bl
CRL:b1
CITY OF EDMONDS
DEPARTMENT 0FW4WM"VM Engineering
250 Fifth Avenue North, Edmonds, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to: ................................................................. ...... .. . ...........
For installation at: (street addre,$).19905 --- tviapieyqod Drive - Ed=ndS. %Abq�q� ..........
........................ .................................................... ..........................
Addition or Subdivision ....... NplAwpPO.-Estates
.................................... .................................. .. Lot.,..* ... 17 .... Block ................
Type of Building: New ............ Existing-1 ....... Single family residence.1 ........ Number of bedrooms ...... _ 3 ..............
Other: (specify type or use) ........ .................. I ..............................................................................................
Builder............................................................. ........................... Address ................... __ .......................... ......................................
Designer.. -------_-- --------------- Address PAA A911. 187..,P ... UVOW.0.04, Nas h ----- 9.8036
SoilLog Hole No. 1... ........................................................
SoilLog Hole No. 2 .... ___ ...... ............................................................ ................................................................................
Elevation of Water Table, if encountered. (Distance from ground surface) .... 00ne...QnC01MtMMd ...........................
Corrections to control surface water if needed. ............. ..................... ...........................................................................
..................................................................................................... ............................................................................. ; ......................
Specify if any removing or grading of topsoil in field area ... Pqpe ....... .. .. . . ... ...... ................ _.
..............................
....................
Percolation:
Test Hole No. I —Average Rafe..... 1.1 ............. ............ ._ .. . (Fall in iiiintites/inch-bottom 6" test hole)
Test Hole No. 2—Average Rate ........................................................ (Fall in iiiinutes/inch-bottom 6" test hole)
Test Hole No. 3—Average Rate ................................. ........... .. ....... (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design Date Taken . .....
Septic tank requirements based on present rules and regulations:
Septic Tank Size ....... ............. gallons.
Amount of Square Feet o isposa ield..2-1-0...
Signature — Design ... .................. ............... ..... .. ..... DateAPH-1 --- 22-9_1968 ..............
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date) ....................................... ........................ Permit Number .................. ..........................
Remarks: .. Permit . issued. fOr..r Dair as teMDorary drainf ield..p in installation of
..... ................. . ........ ---------- . .... ....... ................... .........
........................ UnAt ... 3 ... ..... . ............................................................ ..................
C. R. LYON ENGINEERING
P. 0. BOX IE37
LYNNWOOD, WASHINGTON9aD36
April 23, 1968
Mr. John Wj Brooke Jr.
19905 Maplewood Drive
Edmonds, Washington
Re: Sewage Disposal System'for Lot 17 - Maplewood Estates.
Dear Mr. Brookes:
Enclosed herewith is a drawing on which we have shown a temporary sewage disposal
system for your lot. The system is classified as temporary in as much as it is
not a standard method of handling the waste of a residence and it is anticipated
.that public sewers will . be available within the not to distant future for the area.
We have shown a1ine which is to be as long as is Possible, outside of Your basement
and which shall be dug at least five (5) feet deep and thirty-six (36) inches wide
across the rear of the lot. After digging the trench it shall be filled to within
t
two (2) feet of the ground surface with a hree-quarter inch minus washed gravel and
then have placed upon it a four (4) inch drain tile and backfilling shall be performed
in the standard method of construction for drainfields in sewage disposal systems .
This method of disposal of your waste is the cheapest one presently avai*lable-although
the actual area available -for absorption of water is much below that normally required
for a residence. It is hoped that it will suffice at this time. It is our under-
standing that You anticipate renting this house in the very near future. it is
suggested that you be a little bit choosey in the renters and rent only to those who
have a small family of at the most one or two children. This will keep the water
usage down and extend the life of the drainfield. Should the drainfield fail'
there is only one alternative, and that is to tap the line and to take a pipe'down
to the base of the hill. It is felt that the method proposed here, although not
the best, is the one most economical and feasible and it is hoped that it will
Suffice " the nee . ds until such time as public sewers are available.
If you have any questions with respect to this matter, please do not hesitate to
contact us.
V truly yours,
CI?L:b.l
CRL:bl
CITY OF EDMONDS
DEPARTMENT OF KNKMXN&iv rg Engineering
250 Fifth Avenue North, Edmonds, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to: ........................................... ............ .............
For installation at: (street address)_19935 Roplai,,60d DrIvo - Edmnds, 0a5hiftotan
--- I .... "I .......... ...... 11 ... ........... ............. ................................................... ..................
Addition or Subdivision ....... P !!;4't3' P 0 0 to 's ......... ....... ........... I ............. ............. .. Lot ....... V .... Block ................
Type of Building: New ............ Existing.R ..... ... Single family residence Z . Number of' bedrooms 16, . . .......
Other: (specify type or use) ........ ..................... .......................................................... .................................
Builder................................... _ .......................................... ......... Address ...... __ ..... .......................................................................
Designer ... 'a
_�yp.Epqb 'owqq
.... ..... Addressp 9Sj,',-'5
. . . ... .. ......
Soil Log Hole No. 1 .. .. .. ... . .. . .. ...... ..... ..... .
SoilLog Hole No. 2 .............. .............................................. ............................. ........ ..............................................
Elevation of Water Table, if encountered. (Distance from ground surface) .... ...........................
Corrections to control surface water if needed ......... .... 40 P Z) ...................... ........................................... ..............................
................................................................................................................................................... ......................................................
Specify if any removing or grading of topsoil in field area ... - @no __ ................................................................................
....................
Percolation:
Test Hole No. I —Average Rate .... 13 ........ ................... (Fall in iiiintites/inch-bottom 6" test hole)
Test Hole No. 2—Average Rate .................................................. ..... (Fall in ininutes/inch-bottom 6" test hole)
Test Hole No. 3—Average Rate ................................ ........... .. ....... (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design . ............ .. ...... .............. Date Taken .......................
Septic tank requirements based on present rules and regulations:
M0
Septic Tank Size ...... ............... .... gallons.
Amount of Square Feet of�Disposal Field ..... .............
Designer,- -------- ...... ............ ... .............. ......
Signature ................... ............. ------ / -------------------------- Date.
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date)..... ......... ................................................. Permit Number .........................................
Remarks: ........... Permit --- ... f
Qr..rqpAir_.as__tem orary drainfield Dendiniz installation of
..... ..... -------- P ....... --------- --- ..... - ---------- . ... ..... -------- ------------
........................... Upit .... 3 .... (_I_jAjp.at ... 1�;k) ... q?!n1t.ary ... s.ew.er.s_.... . .....................................................................................
C. R. LYON ENGINEERING
P. 0. BOX 187
LYNNWOOD, WASHINGTON 98036
Apri 1 '23, 1968
Mr. John W. Brooke Jr.
1,9905 Maplewood Drive
Edmonds, Washington
Re: Sewage Disposal System for Lot 17 Maplewood Estates.
Dear Mr. Brookes:
Enclosed herewith is a drawing on which we have shown a temporary sewage disposal
system for your lot. The system is classified as temporary in as much as it is
not a standard method of handling the waste of a residence and it is anticipated
that public sewers will be available within the not to distant future for the area.
We have shown a -line which is to be as long as is possible, outside of your basement
and which shall be dug at least five (5) feet deep and thirty-six (36) inches wide
across the rear of the.lot. After digging the trench it shall be filled to within
two (2) feet of the ground surface with a three-quarter inch minus washed gravel and
then have placed upon it a four (4) inch drain tile and backfilling shall be performed
in the standard method of construction for drainfields in sewage disposal systems.
This method of disposal of your waste is the cheapest one presently availa-ble.although
the actual area available,for absorption of water is much below that normally required
for a residence. It is hoped that it will suffice at this time. It is our under-
standing that you anticipate renting this house in the very near future. It is
suggested that you be a little bi.t choosey in the renters and rent only to those who
have a small family of at the most one or two children. This will keep the water
usage down and extend the life of the drainfield.' Should the drainfield fail. -
there is only one alternative, and that is to tap the line and to take a pipe down
to the base of the hill. It is felt that the method proposed here, although not
the best, is the one most economical and feasible and it is hoped that it will
suffice the needs until such time as public sewers are available.
If you have any questions with respect to this matter, please do not hesitate to
contact us.
V 'truly yours,
CRL:bl
CRL:bl
The City of Edmonds
APPLICATION
for
SIODE SEWER PERMT
NEW CONSTRUCTION REPAIRS 0
.............
OVVNER �� ---- I /
ADDRESS
RECEIVED
FEB 1419k
EASEMENT No . ....................
CONTRACTOR -- ---- . .........
,J'-<�� <�<� ......... -... PERMIT No.
LEGAL DESCRIPTION: LOT No . ......... 14? ------------------------- 13LOCK No . ......
NAME OF ADDITION .. 5�
...........................
Approved:
DATE................................................ BY- ................
. ......................... _ ........
A,�� LIC 4 p la c "op
Ce A6 A" I
Zl*d'2 74o bd-- 7,5
tit
7
Z-
L `7
JohKi W, ffrooKe- Jr,
M6,-,!C.J)oc6- D,
C, /1", 0 rt
C:516-KI 742� Z�/,7
175
A.P VED- .8y*:. DATE.
C LYON E NG INEFRING
.,77
LY NNW 01 00t W AS
��Vo It
-7_
0,
do..
'72
it
vc pla'ec -4 ',f�vv
h-, 7-.=g 4 -:1 "rll I
0 C IL
4
771,� C Z ',l C A0
0
7,!;;,. 7
CIO 0
iL
JT
7z
lir 0-11
r
z
r
Pot NC.
t 2. R USKI FISHER C., ASSOCIAT: , I
-yops
Civil- e4sir, -
SHI
PP, �ul el ��l
or
444
Rev �sce) A..
-A P Jos
I) AT E:" C R LYON CNIGINVERINC.:
DATE
LY
NNW000o WASH.
r 1 '4-
a
13
IV)
T7� T! 7 9,r!RMF7- MP
M 004PORIAN 7, -,.W- -
Z /,4 Pl- F W,
4 pla ec
Z 7,5
cl�
c)—
A
ITZ I
Z
(or
71-
- 71
j" p
5--1,1--�---
Z�11T .17
I
Z
z
johy', W, brooKe- JY-,
- - e-; r
C) 9 0 -15, p r
o rt
az, -4
REvisl c.\TE
ON
RUSK' FISHER ASZSPOCIA3�51-�, iNC.
OP '"RIVEyolls,
CIVIL ENGIN -L
...........
.6 �7 P 1) 0
DATE*:. 7--t-R LYON ENGINETRING
'A PROVP�-.Py:'
DATE
LYNNWOO.O, WASH.
a
CITY OF. EDMONDS
ZONE PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION
jog SUITE APT
ADDRESS
OWNER NAME NAME OF BUSINESS
V -e ,e # C - ,
LEGAL DESCRIPTION CHECK
SUBDIVISION NO LID
NO
cc
W
I
MAILING ADDRESS
Z
,
0
4- 1'., ,.p C/ 0 1?
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP
ApRroved 0
RW
Permit Required 0
CITY ZIP TELEPHONE NUMBER
C�
EXISTING - REQUIRED DEDICATION - Street
Use Permit Req'(j 0
Insp
PROPOSED Side..I$t
a,
clion Required 0
Required 0
a:
Lu
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
U
YES 0 NO 0
0
ADDRESS
W
t:
REMARKS
cc
W
CITY ZIP
TELEPHONE NUMBER
Z
NAME
01212 101,5 /_:4�
ADDRESS lf f
cr
0
1
ENGINEERING MEMO DATED REVIEWED BY
M
CITY ZIP
TELEPHONE NUMBER
FIRE MEMO DATED REVIEWED BY
Lu
�_
Z
(.O%C/ �2.
V 177Y
o,,Po?1,1
0
L)
cc
STATE LICENSE NUMBER EXPIRATION DATE
0 12 19 d 0 A"
SIGN AREA
ALLOWED PROPOSED
SEPA REVIEW
COMPLETE EXEMPT
ADS NO
Legal Description of Property - include all easements
Z
Af "Op/ <
SHORELINE N
EXP
0.
a:
k/c a a - 4' 7
VARIANCE OR CU
PLANNING REVIEW BY
DATE
L)
19 o
SETBACKS — FEET
77T
COVERAGE
Z
FRONT SIDE REAR
Z
Z
Property
REMARKS
M
Tax Account
(5.z & &
Parcel No. ta
D
NEW RESIDENTIAL PLUMBING
El
ADDITION COMMERCIAL MECHANICAL
APT. BLDG. El
REMODEL SIGN
CHECKED BY
MM
TYPE OF CONSTRUC"TON
CODE
occu
GROUP -.;P
GRADING FENCE
F�
REPAIR CYOS. I x _FT)
e/
WOODSTOVE SWIMPOOL
DEMOLISH INSERT HOT TUB/SPA
SPECIAL INSPECTOR
AREA
OCCUPANT
REOUIRED 0 YES
LOAD
GARAGE RETAINING WALL/
RENEWAL
RTMARKS
CARPORT ROCKERY
Z
0
PROGRESS INSPECTIONS PER UBC 305
SINESS OR AC !VIT
(TYPE OF USE. BU Y) EXPLAIN:
Ix
IrIWAL 3AN 11) 9 (n
22=0
all
NUMBER NUMBER OF CRITICAL
)
v w
-
0
OF DWELLING AREAS
INUMBER
STORIES UNITS
DESCRIBE WORK TO BE DONE (ATTAC H PLOT PLAN) %
FINAL INSPECTION REOUIRED
;7-e (,,I a- S
L-IF7 77)
VALUATION
FEE
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
IN)
PLUMBING
eck No.
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curts, sidewelks,
driveways, -marquees, etc.) will -require separate- permission._--
_STAIE�_41JRCHAFIGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days .
STORM DRAINAGE FEE
ENG. INSPECTION FEE
"Applicant, on behalf of his or her spouse,. heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
ow
harmless the City of Edmonds, Washington, its officials,
i
employees, and agents from any and all claims for damages of
cc
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 I.imit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
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
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
T his application is not a permit until
state laws regulating construction; and In doing the work authoriz-
AUTHORIZES
THE
.
signed by the Building Official or his/her
ed thereby, no person will be employed in violation of the Labor
ONLY
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
tion Insurance and RCW 18.27.
INSPECTION
acknowledged in space provided.
IGNATURE (OWNER OR AGENT) DATE SIGNED
DEPARTMENT
. "I
CITY OF
OFFICIAL'S SIGNATURE DATE
EDMONDS
CALL FOR
RELEASED BY DATE
ATTENTION
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220
I
ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK — 0,,%ner GOLD — Assessor