20125 MAPLEWOOD DR.PDF12227
20125 MAPLEWOOD
DR
"CITY OF EDMONDS
EANEW
ADDITION
RETIREMENT
ASSEON FORMATION SHEET
ASSET NO
ADDITION TO ASSET NO.
a . ,__) :V c q �;,
DESCRIPTION
SERIAL NO.
LOCATION
DEPT. NO.
**PUR CHASE ORDER NO. .*PROJECT NUMBER 7F 4,,r4- s-,s
PURCHASE OR -DER DATE.. PROJECT COMPLETION DATE 12- 3� —�i
COST COST 95.
B.A.R.S. ACCOUNT NO.'
ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING -ONLY
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT.
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE
DATE
VERIFIE4
PROCESSED
BATCH NO.
INITIAL
t�np
FINANCE
November 10, 1981
MEMO TO: Hal Reeves
Building Official
FROM: James E. Adams
City Engineer
SUBJECT: 'SIDE SEWER PERMITS
Please attach a copy of the contractor's drawing, with all side
sewer permits, showing site locations, clean outs, bends and
size and type of pipe.
JEA: jky
CITY OF EDMONDS
FOR INSPECTION CALL
I PUBLIC WORKS DEP-ARON Permit 671.4
SIDE SEWER.PERMIT 775 1 -2525 Ext. . 220 Issue Date
PERMIT MUST BE POSTED ON JOB SITE
l.- Address of Construction Xo/.�,5
2. Property Legal'Description (include all, easements)
'4�s T
'3. Single Family Residence I-- Multi -Family No. of Units
.__ -1
LL Commercial
4. Owner and/or Builder
5. Contractor & License No. RL 3o�)3R_
VA6. Invasion into City Right -of -Way: No i-- Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig.(342-5344) before
co excavation).
E-4 7. Cross other private property: Yes No Easement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a4
a. Property owners must obtain a permit to install side sewers on
>I their property. A licensed side sewer contractor must be employed to
construct side sewers in the public' right-of-way.
b. The side sewer contractor assumes full reponsibility for each
E-4 installation for one year.
N
C. Commercial establishment requires a minimum of a six inch (6")
P4
Z� side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
0
e. Side sewer lines must be laid at a minimum grade. of 2% (1.15
0 and maximum grade of 100% (450). 0
E-4 f. No turn in side s8wer greater than 45 (1/8,bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and Wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
. i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
'k. Side sewer must be left uncovered until inspected and approved
by the City.
. 1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE:
I certify that I have read
and shall comply With the above
PERMIT FEE:
OW -7-
C k
ONNECTION FEE:—,
0
Pk * PERMIT MUST BE
DISAPPROVED BY: Date:
By: Date:
APPROVED By:_����Date:
TED ON JOB SITE *
The City of Edmonds Side Sewer Drawing aovll�
EASEMENT NO - --------------------
NEW CONSTRUCTION pr' REPAIRS F� LID NO - ------------------ - ASMT. No - -------------
OWNER ...... --------------------------------------------- CONTRACTOP . .....
- --- --- ------------------ PERMIT NO.
JOB ADDRESS --- A.��-IA .... Di . ...... LEGAL DESCRIPTION: LOT NO - ------------- 4# ..................... BLOCK NO - ------------------------------------
PWW-0001-1 1175 (REV. 11/78)
....................... ----------------------------- .............
................. -----------------
Appmved:
DATEA 2 ......... - --------------------------------
CITY OF EDMONDS Permit No. 'S'l — / '�3 ()
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PUBLIC WORKS DEPARTMENT T f Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMIT L=
A. *Address or vicinity of Construction 0 Permit Issued To: f5N)0-06&_\� '_:7;kA
2C(?
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Owner: L_[.� D r 0 Type of Work to be Done: -x2
Nar�e -6 1 K) U_ T
0 Nhork in Conn'ection With: L�) I IL
Mailing Address Sub or Plat
N1� El ,�-�S'i`ngle Family
El Comml. / Ind. 0 Apt. Condo.
6y, State, Zip Code Pavement Cut: El Yes El No
Contractor:
Name
qq
Mailing Address State License Number
I -, I I V, IQ")\,\ I In (4 _T1 4 __1Z :2
City, S ta te, Zip Code Telephone Numbe�r
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
pr oceedings 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 res.toration.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 Ci ty 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 th�t this permii,,must be available at t e job site for inspection purposes at all times.
S* z (_� - f-' `
ignature: s I rA k I --Date-
Owner_or_A,g`e`nt
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued
Time Authorized: Vold after —days
Special Condltlon�:
Ammendments:
Permit Fee. —
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
X —
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
FIELD INSPECTION NOTES (Fund 111 - Route cony to Street Dent.
r^MM_ - +- � -
Diagram:
Contractor called for inspection Yes No
Work Disapproved By: Date- By: Date:
Work Approved BY:— ___—Date:
Inspector:.
Eng. Div. December 1978
1018
REV 12179
PUBLIC UTILITY. DISTRICT'No�
oflnohomish County
—Area' z�
LOCA.T [ON'
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DAJE
w-O�:,NO Z9
POtE NO:
-1-� 4 S 0 T R
REVISION
LI.G. FILE NO.
'REASON FOR -WORK
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�ENGI N E E I
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DRAFT ER
SCALE
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DATE:
MEMO TO - 1.3uilding Division.
Community Development Dcpartment
FROM: Engineering Division
Public Qorks Department
SUBJECT: 5- "!�Wo6v> pe/l/25-7
After revi'ew of the subject Building Permit application, we have
the following comments:
1. Connection to City water system required.
'C'onn'ection to City sanitary sevier system required.
2.
Right-of-way Permit re'quired for any work on City _property.
4, Driveway slope not to exceed
5. Backwater vnlve requircd if dokvii.,;rairs plumbing is belok-I
elevation of upstream manhole,.
6. Water and sewer linos to be ,;eparated by 1.0 foot minimum.
Si,,n
ignaLure
St' et Paving Reqd.
re
Qxb and Gutter Reqd.
Sidewalk Reqd.
curb -cut for Driveway Reqd.
Right-of-way construction Permit Reqd. ".2
Bond Reqd. for Public Improvements —
Street Name Sign Reqd.
Other Signing Reqd.
Pre Permit Site Inspection made on
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WATER
P4
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ENGEqERING
Special Require�ents listed in memo. to Comnunity Development Department,
Building Division
BY. Date
All items filled in an Building Permit Application
C4 1 BY Date
P4 Drawings'Starrped and Notations Made
P4 BY . Date
Approved by Public Works Department
1. � . : . .. - 1 419
j,� Revised: lv 10-1977
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Street Rig�it-of-Way Existir��....JEQ�__
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Access Easements Existing, d,1,eAq-
IIEQD
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Utility Easement Existing Per J20f
_REQD__
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Lot Per Subdivision �lat
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Assessor Map_ See
Site Plan Checked for Accuracy e k
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Underground Wiring R.eqd. 0 Is
0-4
Check Acc s c;i t ion ,�rk
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Review by
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14'
Existing Water Main Size
Water �bin Required ZA
Service Line Required _9A
P. .51 11
Hydrant Size Existing
c�4
Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd. AIA
Cross Connectim,Inspecti
Fire Department ConTnents
'dater �tter Charge Reqd. eg,
Review by
Date -
Septic Tank Design Approved -Date—
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability
Proj.
Drawing No. /_/P
File No.
Side Sewer Ava ilability Y;O' 5
Sanitary S r Connection I/ee Reqd. -7a
:2:
Review by
Date- jP .13- ;-I_
Open Ditch Existing____Z��� ...Reqd.
Culvert Reqd.
Size
r�4
Catch Basin Reqd.
Indicate an Site Plan
0
Shoulder drainage maintain collection an
swale open runoff q,
L4- 14 �r i5 7-4)
�"ole'v rdq?cf. -
Indicate on Site Plan
Soil Conditions and Ground Water Field Checked
Review by,
Date 7-
Revised: lvlO-1977
PUBLIC WORKS DEPARTMENJO
L, Single Family
BUILDING PERMIT REVIEW
Multiple
4 Commercial
BUILDING�ADDRESS',,
BLDG. DEPT. SUSPENSEIDATE
INITIAL DATE
UTE: OFFICE ADMIN. PUBLIC WAKS &G, IN
CaCITY ENGINEER (check)
-3 1
0 Access Slope and Vehicle Access 1-7 -18 r-9-1
19"Drainage Plan -®r, 8 �=4
0 Street File
OLegal Description
OQuit Claim
ElEasement
MCalculate Sewer Connection
[a"WATER/SEWER DIVISION
13Determine Meter Size
13Complete Building Permit Review
as-TREET DIVI'SION
Complete.Building Permit Review
S-OFFICE ADMIN. LOG OUT TO BLDG. DEPT.
MEN Imam 1=30amemommem
M % = i Mm ME a a= a Clemma am = .0a m :M= omvma� OEM 0 am a ma I am a 1=8 M I "M a mm
[:]-tUILDING PERMIT APPLICATION (COMPLETE)
COPIES OF SITE PLAN
2 COPIES OF FIRE PROTECTION PLAN
(P-REVIOUSLY REVIEWED BY FIRE DEPT.)
3 COPIES OF DRAINAGE PLAN WITH CALCULATIONS
REQUIRED BY SUBDIVISION El
GREATER THAN 2,000 SO. FT.
IMPERMEABLE SURFACE
LESS THAN 2,000 SO. FT.
1;rCHECK ZONING REOUIREME14TS (SETBACKS) f
1 COPY OF ENGINEERING CHECK LIST
13�1 COPY OF PUBLIC WO'RKS MEMO P4
MULTIPLE OR COMMERCIAL
YES (ATrAcH copy OF ADB APPR.oyAL INCL. ALL DW-TINGS)
NO
OrSUBDIVISION — YES[a' NAME j�,rAAe,,1,j
DATED RECOR D'-711,7e
DE 760 06�0
NUMBER [,7-Y-7
1 --
NO 0 (ATTACH COPY OF'RIMUIRDlENTS)
CHECK SEWER DRAWING 'AND ATTACH COPY
PIS DEDICATION REQUIRED — YES[] (OBTAIN QUIT CLAIM)
( CITY CODE
NO 13,
Q/DOES CITY HAVE EASEME14T ON PROPERTY
YES (ATTACH COPIES OF DRAWINGS)
NO
13/'C'HECK 'LEGAL ACCESS INGRESS3/-, UTILI ES31
YESE9" YES
NO [3 NO 13
HAS SEWER ASSESSMENT�BEEN PAID
I -
y En L. I. D. INO.
�PLAT NO.
SUBDIVISION NO,
E3
0 IF MULTIPLE: INCLUDE NUMBER OF UNITS
1-3 IF.COMMERCIAL: INCLUDE NUMB I ER OF FIXTURE UNITS
V
RECEIVED
AUG 14 1981
Dir. U1 Fubh� VVul,s
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CITY OF: ED DS
gUILDING PERMIT APPLICATION
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ALLOWED PROPOSED COMPLETE1 EXEMPT L
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This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks ` driveways,
FENCE
marquees, etc.) will require separate permission.
SIGN
Permit Application- 180 Days
Permit Limit; 1 Year - Provided Work Is Started Within 120 Days
RETAINING WALL
In
in
"Applicant, on behalf of his or her spouse, heirs, assigns and
SWIMMING POOL
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successors in interest, agrees to indemnify, defend and hold harmless
2
tile City of Edmonds, Washington, its officials, employees, and
agents from any and all claims for damages of whatever nature
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arising directly or indirectly from the issuance of this permit. Issu
a
ance of this permit shall not be deemed to modify, waive or reduce
TOTAL AMOUNT DUE
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any requirement of any city 'ordinance nor limit in any way the
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City's ability to enforce any ordinance provision."
ATTENTION
APPLICATION APPROVAL
I hereby acknowledge that I have read this application; that the in.
formation given is correct; and that I am the owner, or the duly author-
THIS PERMIT
This application is not a permit
ized agent of the owner. I agree to comply with city and state laws regu-
AUTHORIZES
until signed by the Building Official or
lating construction; and in doing the work authorized *thereby-, no person
ONLY THE
his Deputy; and fees are paid, and
will be employed in violation of the'Labor Code of the State of Washington
WORK NOTED
receipt is acknowledged in.space proT
relating to Workmen's Compensation ln;iKance. : .
: .
vided.
SIGNAT NER A T)
DATE SIGNED
INSPECTION
DEPARTMENT
DIRECTOR'S SIGNATURE
CITY'OF
EDMONDS
DATE
THIS SITE IS LOCATED IN THE CITY
775-2525
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
ATTENTION
ORIGINAL — File YELLOW Inspector
IT IS UNLAWFUL TO USE OR OCCUPY A'BUILDING OR STRUCTURE
PINK — Owner, GOLD — Assessor
AUG 13 REcD
UNTIL A FINAL INSPECTION HAS BEFN�MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 304,306.
102-78
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LEGAL DESCRIPTI IN-1 V(
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING
PROPOSED
DEFICIENCY OF RIGHT OF WAY
CH ED
SEE ENGINEERING MEMO DATED
REMARK9
METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS
REMARKS
SIGN AREA ENV. REVIEWP ADS NO.
ALLOWED I PROPOSED 1COMPLETEl EXEM T
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This Permit covers work to be done on private property ONLY.
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 120 Days
Ul "Applicant, on behalf of his or he'r spouse, heirs, assigns and
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J successors in interest, agrees to indemnify, defend and hold harmless
2 the City of Edmonds, Washington, its officials, employees, and
< agents from any and. all claims for damages of whatever nature,
I arising directly or indirectly -from the issuance of this permit. Issu-
0, ance o this permit shall not be deemed to modify, waive or reduce
0 any requirement of any city ordinance nor limit in any way the
I City's ability to enforce any ordinance provision."
I hereby acknowledge that I have read this application; that the in-
formation given is correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu-
lating construction; and in doing the work authorized thereby, no person
will be employed in violation of the Labor C6de of the State of Washington
relating to Workmen's Compensation InKance.
SIGNAT R N R AQ T) DATE SIGNED
7
THIS SITE IS LOCATED IN THE CITY
OF
EDMONDS. LOCAL SALES TAX
SHOULD BE CODED, 31.04.
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY'A� BUILDING OR s-rRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN,MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 304,306.
102-78
BUILDING
PLUMBING
MECHANICAL
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
775-2525
OF CONSTRUCTION
AREA OCCUPANCY
IGROUP
VALUATION
FEE
HEIGHT
LOAD
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 pro-
vided.
DIRECTOR'S SIGNATURE
ORIGINAL — File
PINK — Owner
AuG 13 REO
YELLOW Inspect . or
GOLD — Assessor
D
M
PUBLIC VOWS DEPAMENTAMLIST
v 5� �A, io) wo
REVIEW a Ee
BUILDiM PER41T a ess
0 -a-81
-WE-eT
&=:am
-Way Exist
0 street Rig�it-Of r
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Access Easements Existin —A RMD_
ity Easement Exist' wf
Util, 1 )9—
_/_�Assess
Assessor 14a?
Ing Ca t
W Int Per Subdivision ------------ e 2y_11
W Site Plan' Checked for Accuracyi__4����
Underground Wiring Reqd.-
1'.4 ;Yjp�tion �,,K
Legal Des PtiOn '0
Check Accuracy Date 14
Review by 7
Existing Water Main Size
Water y0in Required
Service Line Required
Hydrant Size Existing Size
Hydrant Reqd. Per Fire Code
Detector Check Yeter Reqd.
Cross connection 'Inspection
Fire Departllent
Reqd.
:3: rqater Meter Charge Date A7
Review b
Date—
oved ---------
Septic Tank Design APPr permit No.
Septic Tank Permit Reqd.
Sanitary Sewer Availab' itY ����'Proj
/_/P / / File No.
Drawing No TiE�t�
ee
Side Sewer Availability-
Sanitary S er connection Fee
Date___f
:3: Review
W
tn
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Cd
- 13 -gr/
------------ Reqd.
open Ditch Existing
Culvert Reqd.
indicate an Site Plan,
Catch Basin Reqd
collection on swale open runOf
Shoulder drainage maintain
7��-,1 �zTg, Indicate an Site Plan —
,
r�,4jt-ions and Ground Water
Field Checked.
Zx).Li. Date
Review b
..THIS SITE IS LOCATED
OF IN THE CITY
EDMONDS. LOCAL SALES TAX
-ATTENTION SHOULD I BE CODED 31 1 .04.
T IS UNLAWFUL.TO USE OR OCCUPY A 66ILDING OR S`TFUCTURE
JNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
k CERTIFICATE OF OCCUPANCY HAS BEEN, GRANTED. UBC 304, 306.
02-78.
ORIGINAL — File
f PINK — Owner
YELLOW — Inspector
GOLD — Assessor
PUBLIC WORKS DEPARTMENJO
BUILDING PERMIT REVIEW
BUILD'IING��ADDRESS _2 r) S O�Q&ui9(�
SUSPENSE�DATE 1-12
--BLDG. :DEPT. INITIAL
UTE: 1-1 OFFICE ADMIN PUBLIC WAKS &C IN
�[D_�'I�TENGINEER (6heck)
0 Access Slope and Vehicle Access
p
0--Drainage P'ian
0Street File
13Legal'Description
T]Quit Claim'
[]Easement
13Calculate,Sewer Connection
[3<VATER/SEWER DIVISION
13Determine Meter Size
Complete Building Permit Review
13--S"TREET DIVISION!!
13Complete Building Permit Review
[]OFFICE ADMIN. — LOG OUT TO BLDG. DEPT.
Family
Multiple
Commercial
DATE
)-7 -155
1-7-el,
=100 1gWIMOZ :=:=j= %MMIM j=3%=%C= %=%I=
cm M = Eno = M = =I = 0M = = = =2 a = M � CM I= an an am am
r,I-AUILDING PERMIT;APPLICATION (COMPLETE)
<)I iz
COPIES OF SITE PLAN (�AA_)
0 2 COPIES OF FIRE PROTECTION PLAN
(P-REVIOUSLY REVIEWED BY FIRE DEPT.)
U3 3 COPIES OF DRAINAGE PLAN WITH CALCULATIONS
REQUIRED BY SUBDIVISION
GREATER THAN 2,000 SO. FT.
IMPERMEABLE SURFACE [3
LESS THAN 2,000 SO. F-j.[3
'13"'CHECK
ZONING.REOUIREMETITS (SETBACKS) f
1 COP17
-L OF ENGINEERING CITECK LIST
13�1 COPY , OF PUBLIC, WORKS MEMO P4
MULTIPLE,OR COMMERCIAL
YES (ATTACH COPY OF ADB APPROVAL INCL. ALL DRN-TINGS)
NO
-13�5UBDIVISION YESEJ NAME
DATED RECORDED'jjqV60,ef0
NUMBER Z)_5
NO (ATTACH COPY OF'RIMUIRDlENTS)
CHECK SEVER DRAWING AND ATTACH COPY
IS DEDICATION REQUIRED — YES (OBTAIN QUIT CIADI)
CITY (30DE
NO
EI/DOES C ITY HAVE EASEMENT ON PROPERTY
YES[i� (ATTACH'COPIES OF DRAWINGS)
NO
EfCHECK LEG -ES
AL,, ACCESS INGRESSO' UTILITT 13/
: I
YES YES
NO [3 NO (3
HAS SEWER ASSESSMENT'BEEN PAID
y L. I. D. NO
;.PLAT, NO�.,
SUBDIVI8ION NO�
RECEIVED
C3 'INCLUDE'
IF MULTIPLE': NUMBER OF UNITS
i
AUG 14 19 811
0 IF COM�ER'CIAL�: iINCLUIDE NUMBER OF FIXTURE UNITS
Dil. U, Pubk vvujs.�
N
DATE:
MEMO TO: Building Divi.,,ion
Community Develoj)ment Department
FROM:
Engineering Division
Public Works Departnent
SUBJECT:
20125-
After revi'ew of the subject Buildin?
, comments: we ha�
the follOwinP _, Permit application,
1 - Connection to ci �c
-1 LO UltY water sYstei,i r uired.
2- -Connection to City sanitary sewer c;N teni req
uired.
3. RiBlic-of-way Peru- it requi
�!d [or
q r C
4. Dri-vewav slope noc LO exceed I./;'/
Yo.
5. Wilve r0cliIii:cd j
.[
e.levaLion of u0sc* 0 w
rezini
6. ater sewer
11 s -,to 1)v 10 100t minitnuin.
ure
LJC,
)6
- Yo 33
N*A"ki
'.1.
8
t-g
FrI
U L L-
A OA
STA ES
3�7"'
'64-NAIL
(Y-O-' j04TUM Pot WT
2(0012:557NUPLEWOOO Poi
033
V—