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City of Edmonds STREE T
-w Y CONSTRUCTION
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Permit Number:
ENGINEERING Issue Date:
FILE
A. Address or Vicinity of Construction: '_ Zd "!;"M 7OZ 13 64 -r'4 r;4. U./
B. Type of Work (be specific): W—FP4Ar_4 QX�r-fC_-rtVr%. U6 CA
-710'0r- #100 V3 U6 CA,
C. Contractor: Cpmap r> & e-4 1S(1,00_eZ1 O,e Contact: JA(!.A!z_ 6,dCA,,DUj0t4L,
Mailing Address: _573 3 M A-1 A/ S 7' Phone: 7 74- — S'14 4.
State License #: Jcolef_4 C_ C_ V / Q A Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Perrmit # (if applicable):
E. Commercial [:1 Subdivision El City Project [Ktility (PUD, GTE, WNG,
Multi -Family E] Single Family ��ATER)
n Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut 0 Yes FFKO—G. Size of Cut: x H. Charee $
REA
APPLICANT TO . #,�D SIGN JI. B 016.
INDEMNITY. Applicant understands and by his signature to this application, ag s hold the City of Edmonds harmlessfrom injuries, damages, or
claims of any ikind or description whatsoever, foreseen or unforeen, that may be m gainst the City of Edmonds, or any qf its departments or employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, and atiorneyyees by reason of grandhg this �ermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF OAT YEAR FOLLOWING THE FINAL INSPEC77ON 40
AND ACCEPTANCE OF THE WORK. ES77MA7ED RESTORA77ON FEES WILL BE HELDVAIHL THE FINAL STREET PA TVH-IS 1;OMftETED BY
C17Y FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSVAIkE jT0 THE APPLICANT.
Construction drawing of proposed work required with permit application. 'tv
A 24 hour notice is required for inspection; Please call the Engineering Department- 771-3202.
Work is to be inspected during progress and at completion.
Restoration 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 the City Engineer.
All street cut ditches shall be patched with/sphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I
I have ri the ab?V-e-'statements and undeAtand the permit requirements and the pink copy of the permit will be available
o sit a t
n ie all tim tt
Signature: U Date:
(C+tractor—or Agen 0
CALL DIAL -A -DIG PRIOR TO BEGNNING WORK
.......... ... ... ... ........
FOR CITY USE ONLY
APPROVED BY..:.:.
....RIGHT...OF.WAY DEPOSIT:
JIME. AUTHORIZED: V-OIDAFrER. V rV A. 11, DAYS. ....DISRUP.TION.,F.EE/FUND.1.1.1:,
............... ............
:::SPECIAL, CONDITIONS:,.: No OA P cAaS RESTORATION:FEE.::�
. ........ ... . ........ ... ........ .
DCURArr rt:C.
Prr_(L_ A1P10Li(.A-TI0)J
................. ...
TQTAL.FEE;:;�
.......... ...... ... ........... .... ... ...... ....... .......
COMMENTS;.,
DATE: - - ------- ..ISSUED
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.)
U
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
5-L F
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CITY OF EDMONDS
"T
�A' FOR INSPECTION CALL 13
PUBLIC WORKS DEPAR'*T 77'5-2525 Ext. 220 Permit "0
SIDE SEWER PERMIT Issue Date
PERMIT MUST BE POSTED ON JOB SITE * R
1. Address of Construction
2. Property Legal Description (include all easements)
3. Single Family Residence,>�,_ Multi -Family No. of Units
Commercial
4. Owner and/or Builder
5. Contractor & License No. 1�9
6. Invasion into City Right -of -Way No Yes (If Yes Right-of-
way Construction Permit Required Call Dial Dig (342-5344) before
excavation).
E-4 7. Cross other private pro.pe rty: Yes No Easement required -
U attach legal description and county easement number.
H
�4 READ THE FOLLOWT�.NG AND SIGN:
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.
�4 C. Commercial establishment requires a minimum of a six inch (6")
A4
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: d 4
'-I certify that I have read
and shall comply With the above
PERMIT FEE: 49" DISAPPROVED BY: Date:
Ili o
A" ,- �?: By: Date:
CONNECTION -FEE,:. APPROVED By,.;����Date:,,v7,,:3
PERMIT MUST BE POSTED ON JOB SITE
r
The City of Edmonds Side Sewer Drawing EASEMENT NO. — .............................
NEW CONSTRUCTION F� REPAIRS F-1 LID NO . .................. ASMT. NO ..........
OWNER ---------- CONTRACTOR.
------------------------------------------ --------------------------------- -------------------------------------- .. .............. ..... PERMIT NO.
JOB ADDRESS ------------------------------------- LEGAL DESCRIPTION: LOT NO - -------- ........................ BLOCK NO - ------------------------------------
P�%'VV-0001-1135 (REV.11178)
....................... ..........................................................................................................................................
NAMEOF ADDITION ... ------- V ....................... --------------------------------------
129'
—Y-
9VAD Nwr w A-r- -nme- oF
PL4 7* FILE- J-pg AtAAj�, Iffi(E- 1)4FO.
Approved:
2��;V 4-;0
DATEet— - -------------------- By .. . ..... ........... -----------
STREET FILE OCT
Dir. Ot Public VV0rKs HARVE H. HARRISON
CITY OF EDMONDS MAYOR
CJV1C CENTER - EDMONDS. WASHINGTON 98020 (206) 775-2525
COMMUNITY DEVELOPMENT DEPARTMENT
October 19, 1981
Belt Homes
c/o Thomas Belt
9808 215th S.W.
Edmonds, WA 98020
RE: CHANGE OF ADDRESS; PERMIT #810362
Due to an error in assigning addresses, the address
for the above -permit must.bb chan�ed. You were
assigned the address of 20204 84th Place which will
be changed to 20205 84th Place.
We will notify oth�r city dep artments and it shall
be your responsibility to notify all other concerned
parties.
& 0-"� c-, q , � -P� "'�' - - �'- - -
Harold Reeves
Building Official
c n
cc.:; Utility billing-j
-Mop APPLICATION
FILE for
The City -,offdmondstil REET SEDE SEWER PERMT
M,�0M,Lur'.LN.L LNO . ..........................................
NEW CONSTRUCTION jg� REPAIRS 0
r 7
e'r L c-
.................. G ... .... CONTRACTOR .................................................................................................. PERAUT No.
OV17NER -------------------------------------------------- ....................... . .....
,_�z 0 __2 1) �5- s__ V 4t' 0 " S � -4�) - - I "I
ADDRESS .......................... .. .. .. . ............... . . -- - ------ -- -- - ------- LEGAL DESCRIPTION: LOT No . . .......... 4 ....... BLOCK No . ............................................
I
NAME OF ADDITION ......... ......................... am �s
........................................................ Ac f, c S
......................................
APPROVED
SEP I u 1969
�:v 4-1 , �� / Approved:
�#4
Y It
DATE .... ...................... .......... B ..... 4velAox.-4 . .......
........................... .............. ...........
6_
:CITY OF EDMONDS
I CIVIC CENTER — WATER -SEWER DEPARTMENT
S-IDE SEWER PERMIT
Call -PRospect 6-11:67 _W�6'n. _,wiirk
is ready for Inspection (No -inspec- -&-To
tions Saturday, Sunday or-holid"s.') 3440
ADDRESS ... .............. 2.0205 - 84th Z Avenue West
------------ *** ....... ------ *"** ----------------- ................ ........... * ........................ ---------------------
.�an
.. ....... ....... .. .. ....... ..
OWNEP ...................... S......L-.....G.erh.ard.t ............................... CONTRA TOR ..... .. ..... i .... Safe ..............................................
Sept. 10 69
Permission is granted ............................. ............... 19 ......... 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:
140TE No. I —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.
N No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
N,,_ .-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 1/3 will be permitted.
NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condi6on. Contractors shall be responsible for
failure due to improper work wWch may develop within one year of completion,
NOTE No. S—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.
�q
NOTICE:
-u
- - --------- w-o--w----arranty OT acc Y.
The informat-ion 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. wa rra nt the
accuracy of anything set for.th on these
map(§-). Any person or entity -requesting a
copy should conduct an independent
rn - ation shown on
inquiry regarding the infor
I ited to
_t-Fe -m a p (s) , including, but not
the loc'ation of any sewer stub shown. Such
not exist and may
sewer stubs may or may
or may not exist at the'location shown.
o s nor its
Neither the �;ty of Edm nds.
empto-yee's o,r offi-ce-rs -shall be 111a.b.-Ife for t-he
5 map(s), nor for
information given on thi-
tation provided based
any one represen
upon . said map(s).