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20208 84TH PL W
"CITY OF EDMONDS
PUBLIC WORKS DEPARTST
SIDE SEWER PERMIT
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FOR INSPECTION CALL 0 Permit 11�190
775-2525 Ext. 2-,,ZO _25� Issue Date
PEP -MIT MUST BE POSTED ON JOB SITE
Address of 7ornstruction 0 6-7,T7 W�/, 4--�
Property Legal Description (include all easements)
L
Single Family Residence Multi -Family No. of Units
Commercial
Owner and/or Builder
Contractor & License No.
LT- -T-,�::-, 3 14, P 4-
EDMONDS
TREATMENT PLANT
Invasion into City Right -of -Way: No X, Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
7. Cross other private property: Yes No Easement required
attach legal description and county easement number.
READ THE FOLTOWT,.NG AND SIGN:
a4
a. Property owners must obtain a permit to install side sewers on
>4 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
installation for one year.
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.
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e. Side sewer lines must be laid at a minimum grade. of 2% (1.15
0 and maximum grade of 100% (450).
f. No turn in side sSwer greater than 450 (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:. Zoe
I certify thaC I have read
and shall comply With the above
PERMIT FEE: :3 0 DISAPPROVED BY: Date:
By: Date:
CONNECTION FEE: _5L5
P4 APPROVED By��:���Date
PERMIT MUST BE POSTED ON JOB SITE
NOTICE:
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The inform ation'shown on the attached
map(s) was compiled for use by the CitY Of
Edmonds its Employees and Consultants.
Th,e City of �Edm.onds does not * wa rra nt t,
accuracy of anything set for.th on t * hese
rnap(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry r'egarding the inform'ation shown on
-map(s), including, but not limited to,
th . e lociation 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
empl-o-yee-s o-r office-rs -sh-a-11.1 be Via.b-'Fe for the
n on this ma p(s), nor for
information give'
tation provided based
any one represen
upon said map(s).
0
The 'City of Edmonds
Side Sewer Drawing
EASEMENT NO . ............................................
NEW CONSTRUCTION 42��' REPAIRS E] LID NO . .................. . ASMT. N 0 . .................. .
OWNER ...... 3-4:�.17� ........................ CONTRACTOR
..................
. . .................................. PERMIT NO.
JOB ADDRESS ...... 17 a -- — ---- Ki?.Ilx;
x ................. LEGAL DESCRIPTION: LOT NO . .............
.................... BLCCK.NO . ....................................
.......................... ................................................... ............................................. --------- F-DJMQUDS .......
TREATMENT. PLANT
NAME OF ADDMON ......
........................................
PWW-0001-11/75(REV.11/78)
8 4 '�_ Pl, W,
Approved: -0
DATE... .................... ...... ............
I-1U I L I
pie
Commerc-ial
BUILDING ADDRESS. 0 M
BLDG. DEPT. SUSPENSE DATE _11131�2_ INITIAL DATE
E]OFFICE ADMIN. — PUBLIC WORKS LOG IN
[2�CITY ENGINEER (check)
0 Access Slope and Vehicle Access
0 Drainage Plan
0 Screet File
ElLegal Descripci6h
ElQuic Claim
ElEasement
E)Calc'ulate -Sewer. Connection
/SEWER DIVISION
j
Determ ne'.
S ze
'B6i1ding'.'Permit'.'Review'
om�plete,l
TREET DIVISION
ilding Permit',Re''v'iew
o lete;Bu
mp
OFFYCE ADMIN. - LOG OUT -TO BLDG-.-' DEPT.
-------------------------------------------------------------------------
[D-1_6ILDING PERMIT APPLICATION (COMPLETE). 2-
COPIES OF SITE PLAN *62
2 COPIES OF FIRE PROTECTION PLAN
(PREVIOUSLY REVIEW`E-D 13Y FIRE DEPT.)
ro_�
COPIES OF DRAINAGE PLAN 14ITH CALcnATIONS
REQUIRED BY SUBDIVISION
GREATER THAN 2,000 SQ. FT.
IMPERMEABLE SURFACE E]
LESS THAN 2,000 So. FT. Ph- 1/17
ffCFCK
ECK ZONING'REQUIREMENTS (SETBACKS) J
COPY OF ENGINEERING CHECK LIST
1 COPY OF PUAT:LIC 14ORKS MEMO
MULTIPLE OR CO101ERCIAL
YES [] '-(ATrAcH:qoPY OF 'ADB APPROVAL INCL. ALL DRA�-TINCS)
N 0
ffSUBDIVISION — YESPrNA11E '0a',
DATE
NUMBER
NO (ATTACH 'COPY'OF ROQUIRF24ENTS)
El CHECK SEWER DRAWING AND ATTACH COPY 11-19el—
is DE DICATION REQUIRED YESU (0 QUIT CLAU 0
CITY CODE
NO
3--DOES CITY HAVE EASEMENT ON PROPERTY
r6rTy
YES (ATTACH COPIES OF DRAWINGS)
0
0
M'6HECK LEG�AL ACCESS' INGRE UTILITJES
YES YESxj
NO NO C1
0 HAS SEWER ASSESSMENT BEEN PAID
YES E] - L.I.D. NO.
PLAT NO.
.-.-.SUBD IV I.S JOIN
10
01-.11F':'MULT.1PLE: ',INCLUDE NUMBER OF UNITS
I-F` C*OMMERCIAL: INCLUDE NUMBER OF FIXTURE UNITS ...... .
0 0
MLIC UDF4(S EEPARMIM CHEacLisT
BUnDING PERaT REVIEW ff 4,A6,d ZI-4 -
(address) (date)
Street Rig�ht-of-Way Exist
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Access Easenmts Existing 4///P
REQD
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Utility Easenmt Existing_ 01411'
-7'gg
REQD
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Lot Per Subdivision Plat --Assessor
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Site Plan Checked for Accuracy,
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Underground Wiring Reqd.
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Check Accuracy of Legal Desdiption
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Review by
Date
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing,
9
Hydrant Reqd Per Fire Code
—Size.
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Detector Check Meter Reqd._
Cross Connection Inspection
E-4
Fire Departamt Comments
4C
A
Water Meter Char e Reqd. ='It,-3757
Review by
Date 11Z4KZ"
Septic Tank Design Approved- /7,/`/4
Date
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability-7P"L
-Proj
DrM,7ing No.
File No.
Side Sewer Availability /
(4
Sanitary Sew Connectid/h Fee �eqd.
3:
A.pyv,
Review b, /'4�//
Date__,/
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Open Ditch Existing--&a2L�
Reqd.
CC;,f_ ; C I A
Qdvert Reqd. j �n r
Size
ad
Catch Basin Reqd� cc--,y /'7 C,
- Indicate on Site Plan
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Shoulder draM*ffZtai-n colfe"cr-lon on
swale open runoff
Manhole reqd.
Indicate an Site Plan--------.
Soil Conditions and Ground Water Field Checked L;24,
Review by do"�2;1
--Date S-- 2-
Revised: lvlO-1977
Page 2
;�7c'*4
Street Paving Reqd.'—
Curb and Gutter Reqd. t t;l
Sidewal� Reqd.
Qxb Cut for Driveway Reqd.
I)d Right -of -Way Gm-tstruction Permit Reqd.,
Bc6d R6qd. for Public Impr ts'
Street Name Sign Reqd., i's 7,
Other Signing Reqd. A-V
Pre Permit Site Inspection made on
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BY: S94ER
WW WATER
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rL4 ENGINEERING
'4 Special Requirements listed in memo to Commmity Development Department,
Building Division
BY Date
o All items filled in on. Building Perrrm* t'.Applic'a.-tidn
BY Date
Draw-ings Stamped and Notations Made
BY Date
Approved by Public Works Department
Fzvised: lv 10-1977
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MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Publ ic Works Department
SUBJECT:
DATE: 11-24��'
After review of the subject Building Permit application, we have the followin
comments: 9
1. Connection to City water system required.
2. Connection to City sanitary sewer system required.
3. Right-of-way permit required for any work on City property.
4. Driveway slope not to exceed 14%
5. Backwater valve required if downstairs plumbing is below elevation of
up�fream
6. Water and sewer lines to beseparated by 10 foot minimum.
BD 6/82
If
leplel
ZONE
SETPACKS:
FROM
st . B.5 /
RE- 7A
OTHER
HEIGHT 2,S
call"
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ire W4�
k117� A/�O e-,- PV
OCT 2 5 1982
CITY OF EDMCWDS
CONSTRUCTION PERMIT APPLICATION
IJAMERR NAME OF BUSINESS)
6. - " rl- / X/0 M e
UJ MAILING ADDRESS
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CITY —TELEPHONE NUMBER
INAME
ADDRESS
NUMBER
NAME
— _!�-9
ADDRESS
CITY TELEPHONE NUMBER
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0 STATE LICENSE NUMBER CITY LICENSE NUMBER
Legal Description of Property - include all easements
(show below or attach four copies)
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ElNEW
RESIDENTIAL
El PLUMBING
ElADD/ALTER
NON-RESIDENTIAL
MECHANICAL
REPAIR
F1
RETAINING WALL
SIGN
EXCAVATE
FENCE
DEMOLISH
OR FILL
I— x _FT)
PRE -MOVE IN SPJ
swim
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COMPLIANCE INSP.
-POOL
USE M
ZONE JWMSE
JOB
ADDRESS
FGAL LJL6C;HIPIIQN CHECKI SUBDIVISION NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING - �,� REQUIRED DEDICATION _119
PROPOSEK:J 0-E—
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 1:1
STREET USE PERMIT REQUIRED I I
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SEE ENGINEERING MEMO DATED —
SEE PIW DEPT. REVIEW CHECK LIST DATED
REMARKS
NO.
METER SIZE IBUILDING SUPPLY SIZE IFIXTURE UNITS
REMARKS
r�_/i SIDE SEVVER/K WATER LINE
IV-111
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;7
g: F
L) _E
V) NUMBER OF STOFI S
NU MBEROF
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Zl-)s e -
DWELLING
a] UNITS
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NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
ffe a,/ ee.!� Irle
/—,,) A�—
SIGN AREA I COMPENV. REVIEW
ALLOWED I PROPOSED LETE I EXEMPT
a
ADS NO.
VARIANCE OR CU IPLANNI�,f FIEVIEW BY I DA
YARDS I LOT COV
_2,t� FRONT /7— SIDE 1EAR
D BY ITYPE OF CONSTRUCTION I CODE
SPECIAL INSPFCTOR
REQUIRED
1-1 YES I ! NO
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGWILL
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 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
21 harmless the City of Edmonds, Washington, its officials,
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
modify, waive or reduce any requirement of any city ordinance
0
:r nor limit 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
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
ed thereby, no person will be employed in violation of the Labor ONLY THE
Code of the State of Washington relating to Workmen's Compensa- WORK NOTED
tion Infurance. INSPECTION
SIGNIAL191 (OWNER - OR AQFNT) DEPARTMENT
CITY OF
THIS SITE IS LOCATED IN THE CITY EDMONDS
OF EDMONDS. LOCAL SALES TAX 775-2525
ATTENTION SHOULD BE CODED 31.04.
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-78 OCT 2 5 1982
OCCUPANCY
GROUP
VALUATION
I
FEE
OCCUPANT
LOAD
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his
Deputy; and fees arepaid, and receipt is
acknowledged in space provided.
OFFICIAL'S SIGNATURE
DATE
ac
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ORIGINAL File YELLOW — Inspector Li
PINK — Owner GOLD — Assessor