20201 84TH AVE W.PDF111111111111
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20201 84TH AVE W
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CASCADEO Ll-C2375
CITY OF EDMONDS
FOR INSPECTION CAL*
PUBLIC WORKS DEPAILNT Permit
SIDE SEWER.PERMIT 775-2525 Ext. 220 Issue Date
PEP -MIT MUST BE POSTED ON JOB SITE
1. Address of Construction
2. Property.Legal Description (include all, easements) LQT4
We'�+_ 4ia_Te)P_ Lot-t�S' E�ff E=6momd
�14 S &-_ves
3. Single Family Residence V10", multi -Family No. of Units
Commercial
4. Owner V-0 J k evc (�gm S
.And/ar=_�4�1_.der 9 & -zt_:5, I 1 0 r,: V-. -
5. Contractor & License No. 8a t 1-, 1) 1? vvr. Com x+. 8 8 -/-7-- Z�__j
6. Invasion into City Right -of -Way No Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation) .
7. Cross other private property: Yes V001"No Easement required
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN: C� ej
P4
P4
4 a. Property owners mustlobtain a permit to install side sewers on
>4 their property. A licensed side sewer contractor must be employed
M construct side sewers in the public right-of-way.
Im -
b. The side sewer contractor assumes ns'bi )�Lf.MJQ h
installation for one year. OURS
.48
c. Commercial establishment requires mi o a sit
P4
z side sewer line. IG
0 d. Side sewers may not be installed c oser i t 3011
to any structure.
e. Side sewer lines must be laid at a 1 1 rn r f.
0 and maximum grade of 100% (450). C I
H f. No turn in side s8wer greater than end9% UNC11
between cleanout. All 90 turns must be co of
bend) and wye with removable cap.
I 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 1001 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: 0 111-7 1
T/6ertify7that I e read
and shall comply With the above
to Mar rml
el-- DISAPPROVED BY: Date:
PERMIT FEE: I V By: Date:
P4 Date: tolat-1
CONNECTION FEE: APPROVED By: LE�
0
rZ4 PERMIT MUST BE POSTED ON JOB SITE
2,
7.
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:,0 A S N 71 . . . . . . . . . .
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ON For a good and "aluabl" consid.'ration the grantors y,.,,,,
.C3 1--slie Balt201j, hu,L,,, Ind wifL- An'] ZC-
01% husband and "ife, h,,reby
giant to the owng"y S. haltzell T-'lc�d
Baltz_11 or" z
, hulhand and G 11 -hd
husband and r,..Yory s. Bajtz,!j1
and assiv" of: I,"j T""d Yjl�n Balt:)
Th" Norti, (,5 r,
ACr,s, Dj 0 Wt half, of 1, t
EXCul't thV. No. 2, IL-C-Ord'. f 5' Pl�t Of Eu,t
W-�t 2(; ft. f ounty, W-4.h.
An Easc�—_nc for the
"'St'lldtion, ,fl-'rat,on I,,d a
Proprry, sit.j-'.d in t L
City of 1:,j snrl"
, , , "i j
Tho No,,t, W,,,,. tc'-wit
A,-,,., thc MSt 7 ft. of
N. iv. No
EXCL:1-T th, 'tt,
1 " thelcOt u,d
Subject 20 It.
p a"y to od�", nts, restrIctiOns and
cost of
or
U, "Lli t
f
M -
-ircL.1 'hall not J_ E."'L
any lwur P
REQUIRED o
L'ovu thuir
col"Lluct tt,,� th
V entry L, Plrti�� to fhi�
for that pu,,_,.
�'f'q Did, N6.1i lf� T
14 ajrvo.,ml,t
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IN IVjTN[.,;S
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19
STATE OF WASHINGION.
Counlyof
On thi,
d'y .1 SAFECO .,.rz
Wh;,.y,uo
Publ-c in w,
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ml,u .,1. to oo� I` ,own
to o., th.,
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io
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Ivot"s, A'Al" i
Nil T 41
OF WASHINGTON,
C,00nty of
On this SAFECD
P.bl.t: n and for the S14le Of W,h;ngfon. dwy cumm,tl—ed th, -.4. 0—
nt. 111-1 1. .. .... j.
... cux-, I -01.n n,l,.., to, - I 1 16 b
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in In, C's,'Cov I'd I, the —s —d
pI.l.c,p,jl S not U�---d -Ir incon1puteni.
/IV ks,17Ntss .... h—onto 1-1 IIIY h—d no .11,.ed In, oll,l s,,j he Il'y —a (),;t
—itte".
?909260 0 NOIjlY P�blic in and to, III, State. of V,
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NOTICE:
N:o---war-rantyOTaC(,U-l�:clk--:�Y.-
The information . shown on the attached
map(s) was compiled for use by the City Of
Edmonds, its Employees and Consultants.
Th,,e City of �Edm.qnds does not - warrant the
accuracy of anything set for.th on t hese
map(�_)- Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform - ation shown on
ited to,
_tRe -m a p (s) , Including, but not lim'
b shown, Such
the lociation of any sewer stu
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the City of Edmo-nd(.:,z nor its
ernplfo'yee's o'r offi-ce-rs -shal] be l-`1a-b`1--e for the
information given. on this map(s)) nor for
ion provided based
any one representat'
upon . said map(s).
Side Sewer Drawing
The City of Edmon 9TREET FILE E; 9;4 ASEMENT NO.
NEW CONSTRUCTION REPAIRS LID NO. 140
.... I ........ ASMT. NO . ..................
U ......................... PEFLMITNO. -G��99 ..
OWNER ..... Bjrq .Crl; ..... CO.Y.Ut CONTRACTOR r
JOB ADDRESS ........... LEGAL DESCRIPTION: LOT NO. .2 ................ BLOCK NO . ....................................
.... .......... .. . .. ......
L.oi- -" 2- am cl W... kal-F..,o F L-6t 4
... .......................................... ................. ......................................................................... . ................
NAME OF ADDInON .... EASt .... EAYWOAdl ... 4* 2--
...............................
t
CA --
8 47" Ave - W -
E
PWW-0001-11175 (REV.11178)
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40
Approved:
N
.... By O(A K t
DATE.Q!�t .... .......................... 41
AIIII&
USE nzUREET FILE
----
BUILDING DI%
—t'r'
ZONE _*UMB.
PERMIT APPLICATION
inside Heavy Lines
i
J013
NAME (OR NAME OF BUSINESS)
�OORESS 0
0 s,
LEGAL DESCRIFTION
SUBDIVISICJN
SHORT SUB NO.
MAILING ADDRESS
z
�
i 6. zo
OF WA`Y PER OF,FfIAL STREET MAP
C��
0
PUBLIC RIGHT
CITY
ELEPHONE NUMBER
EXISTING
NAME
PROPOSED
DEFICIENCY OF RIGHT OF WAY
ADDRESS
PUBLIC IMPROVEMENTS REQUIRED 0
DRAINAGE IMPROVEMENTS REQUIRED
U
0:
CITY
TELE P HONE NUMBER
DRAINAGE PLAN REQUIRED
U
UNDER'GROUND WIRING REQUIRED K
j
K
NAME
CONNECTION TO SANITARY SEWER
IL
PERMIT REQ'O E3 NO.
9AUT Z ef I eo;z.
SEP . TIC TANK
0
ADDRESS
ELEVATION OF PROPERTY CORNERS
U
& FOOTINGS REQ'D
M IT
C4
TELEPHONE NUMBER
I-
Z
SEE ENGINEERING MEMO DATED
0
AN b
U STATE -LICENSE NUMBER
CITY LICENSE NUMBER
CHECKEI BY(
�S #E
M E T E
BUIL 2
al Description of Property (Show Below or Attach Four Copies)
�Le
W
FtI.Z
_S
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0
SIGN AREA
ENV, REVIEW
AO13 No.
ALLOWED
PROPOSED
COMPLETE
EXEMPT
SHORELINE
W
J
4
—
REM ARKS
W
VARIANCE OR CU -7
NNING REVIEW BY
DATE
1
YARDS /
LOT COVERAGE
k /
FRONT a SIDE /6'REAR]
NEW
RESIDENTIAL
GAS
L NE
FIRE ZONE
TY7F'CONsTRUCTION
HEIGHT
NON-RESIDENTIAL
SIGN
I
ICODE
ADD
F�
F� DEMOLISH
Ej RETAINING
SPECIAL INSPECTOR'
REQUIRED
AREA
CCUPANCY
ROUP
OCCUPANT
LOAD
ALTER EXCAVATE
R F] OR FILL
WA LL
FENCE
Ell— X—FT)
E) YES El N 0
70
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
PRE -MOVE
r-1
swim
OF EDMONDS. LOCAL SALES TAX
REPAIR
INSP.
POOL
SHOULD BE CODED 31.04.
REMARKS
Z
NUMBER OF STORIES
NUMBER OF
I'_
0
DWELLING
I
Z
UNITS
NATURE OF WORK TO BE DONE
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(A
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0
PLAN CHECK FEE
ALUATION
FEE
a
I
'
PLOT PLAN
�_
BUILDING
PLUMBING
MECHANICAL
FENCE
SIGN
In "Applicant, on behalf of his or her spouse, heirs, assigns and
In
11 successors in interest, agrees to indemnify, defend and hold harmless
J
2 the City of Edmonds, Washington, its officials, employees, and
M agents from any and all claims for damages of whatever nature,
i C arising directly or indirectly from the issuance of this permit. Issu-
RETAINING WALL
SWIMMING POOL
9 1 :Mce of' this permit shall ii-� )I fie (I comed to modify. %% aive or redu cc
ENGINEERING
UIREMENTS FOR BUILDING P
CITY 010 E11)!.-IONDS,
PUBLIC WORKS DEPARTFENT
IT APPLICATION
DATE:
SLWtECT:
Subdivision -I C!> Plat PRD
Multiple
Commercial
G EIERAL REQU IRF74ENTS
Coordination of the location or any structure wit . h resnect to utilities, streets, oroperty
lines and driveway grades is the responsib.�.lity of the contractor.
The� ccnstra,�!-or is required to I<eep the abutting street cleaned of dirt and debris caused
by the construction 7.30.200 Violations - Penalties 7.30.290.
A "Right-Cf-Way Construction Permit" is required from the Engineering Division of Public
Works for any work within the Public right"of-way or public easement. 7.30-010 Violations
Penalties 7.30.290.
SPECIFIC REQUIPOENTS
UNDERGROUiM POI,ER
. iR�nderground vari ng Req I d Not Req'd
SANITARY SE�-ERAPEH,IIT REQ-D)
Connection to Sauiitary Sewer Req'd Water ValvQ Req I d on Side Sewer
Septic Tank Pei-7 It Rea I d. Desip
ni _;n Approval Req'd
Approved Dt. Permit Number
STOFJ4 SE�-.E_H SYSTE7.1 (PER CITY CODE
Drainage Plan Req'd
D
t!�-Site Drainage to be Contained on Site
ROADWAY AND DRIVE1,1AY ET,,ID.JTS
Drive,, -jay Slope Not. to Exceed 14"
ii_Driveway Faving Req'd
EJ Vertical Curb Req'd
EJ Street Paying Reqld
EJ Drainage Plan Api ' Droved Dt.-
0 Site Drainage to be Connected to City System
EJ Driveway Culvert Req'd Size
El Sidewalk Req'd
E] Approved DesiF
)i Req'd
Bond Req'd for Public Imp.rovements Ej Submit Cost Estimate
Note :
Inspections Tl'.�_n I d. , Engineering Division
11 Foundation -R!-Side Sewer El Septic Tank
Q�'ater Service EJ Fire Protection 11 Drainage
EJ Site Improvements
A 24 - hour notice is required for inspection �ly Engineering, call 775-2525, extension 220.
FRE,D F. 1ERZBER(3, P.E.
C)
CIS, I I+
4
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(�, 5,3
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ID
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W, kALP c)P �-cA -15, EA--;:J
ED Yy\o rQ D-S Acp-e7s D, v.
vo . LQme la 'j. pAOE ellcl
Nt 2c
..Awe
70 C
Rj lz p () s C--
PUBLIC TN'ORKS DEPAI;�IMWr CHEC�&ST
BUILDING PERm REVIE14
n - '_�!) - 7 �?> Date
U
Z
Street Right-ofr,�4�
,y, Existing REQD
Access Easements'txi�ting f3 REQD
Utility Easement Existing
�REQD
Lot per Subdivision Plat Assessor Map
Site Plan Checked for Accuracy fE� . n .
Underground Wiring Reqd. U,
Check Accuracy of 1.4� A
,gal� De:§cri
Environmentally Sensitive Area
Environmental Checkli�t.Reqd..
tion
Flood Hazard Zone
Shoreline Manaaement Area
Slope, Soil, Vegetation
Stream, Creek, Drainage Basin o Ptj mus' Dks i tJ
Existing Zoning Per Code
Approval --
Amenities Design Board Apj5roval Reqd'. ADB #
Board of.Adjustarent Approval Reqd.
,.Reviei��.,By: Date:
n7i�isting Wate'r,'IMin Size
Water� Main Reqd. A11A
',"Service Line Reqd.
Hydrant Size Existing
H�Hant R-bqd. Per Fire Code 411A Sizd
K
N Detector Check Meter Reqd. NIA
Cross Connection Inspection 1111A
Fire Department Comments
Water.Meter Charge R6qd..
Review by- Date:
Septic Tanl< Design Appro,%.7ed uate:
SeDtic Tank Permit Reod. Permit Do —
Sanitary Sewer Availability Proi.
Drawing No.
Side Sewer Availability
Sanitary Sewer Connectik_T��d.
Reviei By: Date:
No.
521 11;S11 1:,; 1116,15 1, 1 11111 �I'l, I
Noy
q)en Ditch Existi-i Reqd.
Culvert Rcqd. 'Size
Catpli. Basin Reqd. Tndicate on Site Plan
0 Shoulder drainage maintaiii col*lectioii on .,:a,7ale open rLuioff Ver
E-
.1-nihole reqd. Indicate oii Site Plan
Soil Conditioiis and Ground WaLer Field. Giecked
Y
Street Paving Reqd.
Curb and Cutter Reqd.
Side,4alk Reqd. 4"
Curb Cut: for Driveway Reqd..
P4.. Right -of -I -lay Construction Permit Reqd.
Bond Reqd. for Public 1uproven-c-1-its
Street Narin Sign Reqd. AIX
U)
Or.her Signina Reqd
Pre Termi t Site'Inspe'cti(xi w- de on
C)>
BY: SD,TER
WATER
SIREET
-2�
IGINEERING
R
Special. Rccluire-lii2nLs listed in iiiaTo to Commniity Develop,,-.r-nt Departin2nt,
5L6.1dilig Division
By. Date
All iteirs filled in on. Buildhig, Permit Application
13Y Date
DralWings Staii-ned and Notations �L-ide
BY Date
Approved by PLiblic 1,,Iorks Depai-U,,�c-wit
Revj.!;c-d: Iv 1.0-1977
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CITY OF EDMONDS Permit No. )e,
PUBLIC WORKS DEPARTMENT Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMITSTREET FILE
--------------
A. eAddress or,vicinity of Construction 14 0 Permit Issued To: (�`, 0
,4.7 , i
— 6 _, � LU
• Owner: e Type of Work to be Done:
Name
o Work in Connection W�ith:
Mailing Address M'Sub or Plat 0 Single Family
11 Comml. / Ind. 0 Apt. Condo.
City, State', Zip Code Pavement Cut: F1 Yes 0"No
• Contractor% _01 el (Allh-11 (�,V-J1ri*__._
Name
Mailing Address State License Number
City, State, Zip Code 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 comple red, 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 permit must be available at the job site for inspection purposes at all times.
Signature:
Date I
or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: Permit Fee:--., 1'% k
Time Authorized: Void after 14— —days Security Deposit:
Si ill,
pecial Conditions: n 1JIT Q (A A,- ( + Receipt No.:
Fund III Fee: 11�
Arnmendments:00 �162 vW,%-f - — Street Cut Dimensions
t tel if —I X
'11 J 'it (�Ng M-1A R 4-
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div, Deceinbct 1978
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CITY OF EDMONDS OUREEU IRLE
PUBLIC WORKS DEPARTMENT U
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. oAddress or vicinity of Construction
20201 84th West
e Owner: Baltzell BrotherS
Name 12620 N.E. 142nd
4C-4 Irland, Wash
Malling"Mr'es's
City, State, Zip Code
uias uipcipiLc jLnc.
9 Contractor: R_Q_ -BOX IRO
Nam'-Lynnw*ood, Wash.
98036
Mailing Address
City, State, Zip Code
Permit No.
Issue Date
0 Permit Issued To: kovm C�-pr
P of Work t b one:. 0 ri veLA.) 6--1-
Nork in Connection With:
El Sub or Plat Ekli`ngle Family
El Comml. / Ind. 0 Apt. Condo.
Pavement Cut: El Yes ��o
223 01 OL DS 6 317 BD
State License Number
778 3124
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 permit must avat 6ble at the job iefe-To-r-inspection purposes at all times.
--Date 17 Oct 79
Signature:— 2!4a���
Owner or Age-�,ieannie Mallory
THIS PERMIT MUST AE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
ok- 14ee_
C. Issued By:
Time Authorized: Voi
Special Conditions: —A
Ammendments:_ &
ys
k;7 &0
Permit Fee:
Security Deposit: Ad - C -
Receipt No.:
Fund 111 Fee:
Street Cut Dimensinnc �, A —f
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
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CITY OF EDMONDS W W Permit No. 72-33Z_
PUBLIC WORKS DEPARTMENT FO-) Issue Date /0
- OF - WAY CONSTRUCT cT
RIGHT ION PERZ 7HEE
A. *Address or vicinity of Construction * PermitlssuedTo: 1-(e:�--u 80-U-2-
201/_�- F,, 2-0 2 0 / - gq-7-11 611-e - (A).
• Owner: Rat-t2-ca-1.1 gy-o. Cg'ytst, * Type ofWork to be Done: Rlu) Zwarim,
N�m, (-�p r
12-16 2D — V E 1-2 V Sr
* UWor in Connection With:
Mailing Address ub or Plat &;6 El Single Family
31
�ivk_ldmdj W11. q-60-3-3 El Comml. / Ind. El Apt. Condo.
City, Stat:4, Zip Code o Pavement Cut: 11 Yes V--N—o
• Contractor: So Lf?&_(i Bf-p-s-b-, G-4ct �res /- 2-3- -,f 0
Name
/ 2-f, ZO — A) � F_ - 14--LIVIO _M Z2 4-8
M ding Address State License Number
Xkta�jl I _,tj, &A 903 19 2-1 - _Z G 2-
City, S tatte, Zip Code 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 permit must be availa le at the job site for inspection purposes at all times.
signature- ate
�3wner or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: V4after 14- —days
Special Conditions: N t) ft& R G 4�, L± n -i ±-
Ammendments:
,'%-t--
O-z-
Street Cut Dimensions Ncrv-,p
-rq X
Permit Fee: /v 0 e—
Security Deposit: AJ, P,,
Receint No : IV, I?_ .
Fund III Fee:
** NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE **
Eng. Div. December 1978