20213 84TH PL W.PDFIIIIIIIIIIII
8014
20213 84TH PL W
CITY OF EDMONDS t �f- 4 �, i
FOR INSPECTION CALL 0
PUBLIC WORKS DEPARANT Permit
775-2525 Ext. OZO 75V issue Date
SIDE SEWER PERMIT
�tj
PERMIT MUST BE POSTED ON JOB SITE
1. Address o Construction 46, -- (1- Y 71X, V
2. Property Legal Description (include all easements) FDMC)Nr)
ETREATMENT PLANT
LAL
r3.- Single Family Residence Multi -Family No. of Units
U Commer'cial
UJ 4 Owner and/or Builder
5. C ontractor & License No.
6. Invasion into City Right-o-f-Way: NoV' 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 -
U attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
P4
P4
4 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.
$4 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
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.. I
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.
I 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 noticeirequired.
DATE: /P
I certify that I- have read
and shall comply With the above
P PERMIT FEE: DISAPPROVED BY: Date:
0 By Date: IXZ3
CONNECTION FEE:
D
APPROVED By: tA%2 ate: j-16.A3
PERMIT MUST BE POSTED ON JOB SITE *
NOTICE:
urary:o
-N'o - w a r r a n t ached
The information shown on the att
Map(s) was compiled for use by the City Of
Edmonds" its Employees and Consultants.
Th.e City of Edm.onds does not. warrant the
accuracy of anything set for.th on t hese
rnap(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform'ation shown on
tRe -map(s), including, but not limited to,
C ion of any sewer stub shown. Such
the lo' at*
-not exist and may
sewer stubs may or may
or may not exist at the location shown.
Neither the city of Edmonds nor its
empJo*yee*s o*r office-rs -shal-1 be Via-b-'Fe for iffie
information given on this map(s), nor for
tation provided based
any one represen
upon said map(s).
Side Sewer Drawing I
The City of Edmonds EASEMENT NO . ............................................
NEW CONSTRUCTION REPAIRS [-1 LID NO. ..A(Od ----- ASMT. NO . ...................
OWNER .... )BEI-T ------ aam-c-s ---------------------------------------------- CONTRACTOR ..... A3 .. /V -- - ------------------------------- PERMIT NO. (09-0 --- 9
:Z
....... . ... ...... LEGAL DESCRIPTION: LOT NO. -10.3 ------------------- ...... BLOCK
--- - ---------
JOB ADDRESS ...................... TREA-1 %*�Ei�,-r --- PLA-N-T -- ----------
..................................................................................................................................................................
-.4 -N-
PWW-0001-1 1175 (REV.1 1/78)
b4TH -PL.
NAME OF ADDITION --------------------------- IN
------------
DATE ...... ;.Zt7J.0---.!a3 ....... ....... . .....
0
0-
Tha lr;fu o%; FAmr%r%Aa
Side Sewer Drawing
EASEMENT NO . ............................................
NEW CONSTRUCTION REPAIRS [3 LID NO . .................. . ASMT. NO . ...................
........... CONTRACTOR
OWNER ..... xZ10 .42,-5 ...................................... --- 4 --- ... C-A#I. 70.c -------- * ...................... PERMIT NO . ....................
JOB ADDRESS ------ K . .................... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK,NO . .....................................
NAME OF ADDMON ........................
Approved:
lu
PWW-0001 - 11/75 (REV. 11/78)
DATE
............. By ..................
CITY OF EDMONDS
E� NEW
1:1 ADDITION
F-1 RETIREMENT
ASSET INFORMATION SHEET
STREET FILE
ASSET NO. e!5?
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION DEPT. NO.
6 �fo
"PURCHASE ORDER NO. PROJECT N U M BE R L,) 3
PURCHASE ORDER DATE PROJECT COMPLETION DATE 6-3o
COST COST 2- 8%
B.A.R.S. ACCOUNT NO. If
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 —
0 G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO.
INITIAL
(�np
DEPARTMENT FILE
W.
BUILDING ADDRESS
IYU ILIT11vu--i- r, full-rl- -Al,
,v lnw
D
1%
Multiple
Commercial
6
�m
BLDG. DEPT. SUSPENSE DATE I c� I /-�� o I / s? -) INITIAL
F� OFFICE ADMIN. — PUBLIC 14ORKS LOG IN
ITY ENGINEER (check)
C) Access Slope and Vehicle Access
0 Drainage Plan STREET FILE
0 Street File
CILegal Descripti6h
DQuit Claim
DEasement
.......i.i:...':;.[3ca1c"ulate Se,,�dr. Connec,tion
WATER/SEWER DIVISION
nIe,-.M ter; Size:'
C Det6rmi e
11 ding'
L)PNomolete,tEu '..P,ermiLt`.;Review'
TREET'DIVISION
-'Building Permit,Review
omplete,
[]OFFICE ADMIN... LOG OUT -TO 'BLDG,.-' DE PT.
DATE
LCII
110
- - - -- - - - - - - - - --- - - - - - - --- ---- ----------- -- - - - - - - - - - - - ---- -- --- ---- -- -- -----
�UILDING PERMIT APPLICATION (COMPLETE).
� -
.13--I'COPIES OF SITE PLAN
2 COPIES OF FIRE PROTECTION PLAN
(PREVIOUSLY 'REVIEWED BY FIRE DEPT.)
COPIES OF DRAINAGE PLAN WITH CALcnATIONS
REQUIRED BY SUBDIVISION
zlivj�
GREATER THAN 2,000 SQ. FT.
IMPERMEABLE SURFACE
LESS THAN 2,000 so. FT.
ff 0ECK ZONING'REnUIREMENTS (SETBACKS)
&��OPY OF ENGINEERING CIIECK.LIST
1,-`COPY OF PU6"LIC WORKS Maio
Ll MULTIPLE OR COMMERCIAL
YES [] '-(,A7rAqH:coFY OFADB APPROVAL TNCL. ALL DRA!,TINGS)
N 0
O/SUBDIVISION — YESEY"N 9S
DATED'RECORDEJ)
NUMBER_
NO (ATTACH -c0PY,OF -Ra)nM.UjM)
ar CK SEWER DRAWING AND ATTACH COPY Ito 51 -h VITTr f�6T-
6 7T
IS DE . DICATION REQUIRED YESQ 0 AIN QUIT CLA12
Tr
No [jj'k CITY CODE
DOES CITY HAVE EASEMENT ON PROPERTY
YESE] ATTACH COPIES OF DRAWINGS)
No
3--CHECK LEGAL ACCESS* ING UTILITTESEf"",
YESY YES
NO [] NO
-13"HAS SEWER ASSESSMENT BEEN PAID
YES J-j L.I.D. NO.
PLAT NO.
10
0 1. '. .:,
I'F:MULTIPLE:..INCLUDE NUMBER OF UNI TS
-I'F'. * 60MMERCIAL: INCLUDE NUMBER OF FIXTURE UNITS
0 0
PLMLIC UORKS rUARM= CHEacLisT
BUILDING PERMIT REVIEW joQ1 3 A,) &12 e�-42-
(addr6§s) (date)
0
Street Right -of -Way Exist
Z
Access Easements Exist
cd
Utility Easement Existing— 01V�
W
Lot Per Subdivision Plat PIZ-
Assessor
W
Site Plan Checked for Accuracy. rV�j- i2lat
Z
Underground Wiring Reqd.
H
0
Check Accuracy of Legal Des2ription
Z
Review by.
Date 10 -2k 87,
Existing Water Main Size
Water Main Required XZA
Service Line Required
Hydrant Size Existing,
o�
Hydrant Reqd Per Fire Code :ZLA
Size.
Detector Check Meter Reqd. 441
Cross Connection Inspectim
Fire Department Comnents
:3'
'Water Meter a-iar Reqd.`�4
Review
Date
Septic Tank Design Approved
Date
Septic Tank Permit Reqd-
Permit No.
Sanitary Seuvr Availability,
-proi-
Drawing No. 111D ILI
File No.
Side Sewer Availability /Y/&,, ,)14Zt
- I
Sanitary Sewer Connection Fee'ieqd.
:3
Review by, 2
Date LOZZ�La----
Open Ditch Existing
Reqd.
Culvert Reqd. 1� // ;7 Q
Size
94
Catch Basin Reqd.
Indicate on Site P lan
0
Shoulder drainage maintain 4diectim on
swale open runoff -e
P
tn
Manhole reqd.
Indicate an Site Plan
Soil Conditions and mA Wnk/-r Field Checked
Review by
te lo -.2 7.-,Yz--
Revised: lvlO-1977
'I
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4)
45; 17Z Th
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9
11
OCT 2 0 1982
%a
CITY OF EDMONDS ZONE
CONSTRUCTION PERMIT APPLICATION
1 JOB
NAMEJOR NAME OF BUSINESS) ADDRESS
,9,c�7_ �Iome c) 1 LEGAL DE
-'W 4�;-7
TY
Edm 0 &2/_5
ADDRESS
NAME
_45I In e, ,;�5
ADDRESS
CITY
STATE LICENSE NUMBER
Legal Description of Property -
(show below or attach four cop
ee_
-S. ol -
TELEPHONE NUMBE
7 7 /, —,m2y-7-
TELEPHONE NUMBER
"" y e—.
TELEPHONE NUMBER
CITY LICENSE NUMBER
e all easements
i'*!
rRM IT
, I 7E
I r-6,-17 161
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING 5� — REQUIRED DEDICATION
PROPOSED:j2Y_
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
STREET USE PERMIT REQUIRED I-.]
i SEE ENGINEERING MEMO DATED
SEE PIW DEPT. REVIEW CHECK LIST D
ATED
REMARKS
METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS
REMARKS
SIGN AREA ENV. REVIEW
ALLOWED I PROPOSED I COMPLETE I EXEMPT
ADB
cr
W
�VARIANCE OR CU
PLANNING REVIEW By
/D4A
07
01
YARDS
LOT COVERAGE Z
I
Z
FRONT
SIDE /57 REAR
Z
!REMARKS
CL
Z
0
P:
cc
U
0)
U)
a
CO
0
ElNEW RESIDENTIAL PLUMBING
ADD/ALTER NON-RESIDENTIAL El MECHANICAL
REPAIR RETAINING WALL SIGN
EXCAVATE FENCE
DEMOLISH OR FILL x FT)
PRE -MOVE INSP.1 swim
COMPLIANCE INSP. El POOL
CHECKED
:SPECIAL 11
�REQUIRED
1-1 YES
R SIDE SEWER El WATER LINE
:REMARKS
0LL
NUMBER OF STORIES
40A
NUMBEROF
DWELLING
UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
Aye*1 To S&__
I
BY ITYPE OF CONSTRUCTION
1! NO
CHECK FEE
This Permit covers work to be done on private property ONLY.
GRADING/FILL
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
w
successors in interest, agrees to Indemnify, defend and hold
ow
harmless the City of Edmonds, Washington, Its officials,
m
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
0
modify, waive or reduce any requirement of any city ordinance
0
nor limit in any way the City's ability to enforce any ordinance
:TOTAL AMOUNT DUE
provision."
I !
I hereby acknowledge that I have read this application; that the
i
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
I
Code of the State of Washington relating to Workmen s Compensa-
WORK NOTED
tion InsuFance._
INSPECTION
DEPARTMENT
SIGNAT2UVOWNER OR -AG DATE S Ey
JIT)
C11Y OF
OCCUPANCY OCCUPANT
GROUP ILOAD
0
Z
0
_j
VALUA
FEE
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 provided.
OFFICIAL's SIGNATURE 11 1
THIS�'SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL iSALES TAX DATE
ATTENTION SHOULD BE CODED 31�04. 775-2625
IT IS UNLAWFUL TO USE 08 OCCUPY A BUILDING OR'STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspectoi,
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER OCT 20 19C)4 PINK Owner GOLD — Assessor.
1 2-78
W. ?MSM
DATE: JQ Z 6 le2-
I I
MEMO TO: Building Division,
Planning Department
FROM: Engineering Division
Public Works Department
SUBJECT: o�'0,21 3 P4--�kfW �/d
After review of the subject Building Permit application, we have the following
comments:
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 requ ired if downstairs plumbing is below elevation of
upstream manhole.
BD 6/82