20225 81ST AVE W.PDF11 lill 111111
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20225 81 ST AVE W
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, 8 90 - 19 C5 -
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number. e��-Ifze
Issue Date:-Y - / 7 45'
A. Address or Vicinity of Construction:.20225 81 " V ( 9521423 )
B. Type of Work (be specific): Ins tall 2" PE If Main 3220 to 347 9 N c/1L
203 P1 SW on 81 Av V OVEEUAY PROJECr
C. Contractor: Washington NaturaJL Gas
MailingAddress: 1122 71i qt qw ltyprptt
State License #: 98203
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: AA7-1784
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. Commercial E] Subdivision n City Project IN Utility (PUD, GTE, WNG, CABLE, WATER)
Multi -Family E] Single Family E] Other
INSPECTOR: 114SPECTOR: C_Jd
F. Pavement or Concrete Cut: 0 Yes [MNo G. Size of Cut: x H. Chargq�,$
_FT
I4%N
APPLICANT TO READ AN 10 -
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold ch� Q1+ ofEdmonds harmless from iniuriei,,damages, or
claims of any kind or descriptibp whatsoever, foreseen or unforeseen, that may be made againdt the City of Edmonds, or any -of its departments or
employees, including or not limited to the defense of any legalproceedings including defense costap and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PE)?1OD OF ONE YEAR FO'LidWIV�THE FINAL
INSPECTION AND ACCEPTANCE OF TH47 WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETE0 BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material 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 asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above Aatgwents and understand thepermit requirements and thepink copy of thepermit will be
r
a, i .
available on sift imes ;��urposes.
Signature: '�4Mf Date: R-7-95
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
NO WORK SHALL BEGIN PRIOR TO PERMIT IS'SUANCE Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
Diagram:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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WER PERMIT
CITY OF EDMONDS SIDE SE
9 0 19" PERMIT N2 8664
Address of Construction
-Z 0 2;�- 5
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Property Legal Description (I nclude all easements):
t;
cov, 403
e
Owner and/or Contractor:
State License No. 0,040 do 4,.,
isingle Family
El Multi -Family (No. of Units-)
11 Commercial
El Public
-00(f)- 017-61-
0
11
Building Permit No.
EDMONDS
TREATMENT P1 ANIT
Invasion into City Right-of-Way:xNo El Yes
RW Construction Permit No.
I , Cross other Private Property: Ck No 0 Yes
Attach legal description and copy of recorded easement
I certify�fiat I have read and shall comply with all city requirements
as indicated on the back of the Permit Card.
Date
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE USE ONLY
FOR INSPECTION CALL 771-30k, �, UBLIC WORKS DEPT.
-0.1u, a S,
Permit Fee: Issued By
Trunk Charge: Date Issued:
Assessment Fee: h1l Receipt No.: /23 77
Lid No.: -
Partial Inspection: Date - I nitial
Comments
Reason Rejected: Date -Initial
Final Inspection Approved: Datd�f' Initiak::
PERMIT MUST BE POSTED ON JOB SITE
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3/90
NOTICE:
o--wa rra inty -of -accuracy. ------
The information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edmonds does not warrant the
accuracy of anything set for.th on t hese
map(s-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information sho.wn on
'._'___tFe -map(s), Including, but not limited to,
th . e location 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
emp-l-o-yee-s o-r office-rs -sh-a-11+1 be H-lab-Ife for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
4
The City of Edmonds Side Sewer Drawing EASEMENT NO . ............................................ 4
NEW CONSTRUCTION REPAIR S>( LID NO . .................. . ASMT. NO . ..................
P
OWNER CONTRACTOR --------------- -------------------------------------------------------------------- PERMIT NO. Q ------ ... ......
................................................................................................
JOB ADDRESS ..,� .............................. E
........... 7 .1 ........................
LEGAL DESCRIPTION: LOT NO . ................ . -NO . ....................................
EDMORDS
1),
T .........................................
............................................................. ................ TREAT
NAMEOF ADDITION .......................................................................................................................
Approved:
?11 (044'rE fxk-
WE
PWW-0001-11/75 (REV.11/78) DATE .......... B)t ..
..... .. ... ... . ...... .............................
, 890 . 199
STREET FILE
CITY OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works * Planning 9 Parks and Recreation e Engineering
October 26, 1992
Mr. Ralph McAllister
�0225 - 81st Ave. W.
Edmonds, WA 98026
SUBJECT: SEWER PROBLEM IN JOINT SEWER LINE
Dear Mr. McAllister:
LAURA M. HALL
MAYOR
In October of 1992 you contacted the city of Edmonds because your sewer
was backing up. The city responded and reported that the plug was
close to the property line. The city agrees that when an obstruction
occurs again in this line, because of questionable doubt as to who is
responsible, the city sewer crew will provide the jet truck to assist
in the clearing the line so we may properly identify where the
obstruction is and who should do the repairs at that time.
It is our understanding you have agreed to this and are willing to
correct the problem if an obstruction occurs at the property line or in
area back toward the house.
Sincerely,
Z'- 1� al
Ron Holland
Water/Sewer Supervisor
cc: Street Address File
'3l 1% ZD-28-11-
- rN Of, -
Noel Miller Date
MCALLIST/TXTSEWER
Incorporated August 11, 1890
APPLICATION
for
The City of EdnWEE""I FILE SIDE SEWER PERMIT EASEMENT NO . .......... .................................
NEW CONSTRUCTION 0 REPAIRS F� LID NO . .................. . ASMT. NO. .- .............
OWNER - -------- <a�v--
<EE� . .. .............................
JOB ADDRESS - --------
0
CONTRACTOR ---------- �- ------ PERMIT NO.
LEGAL DESCRIPTION: LOT NO. BLOCK NO - ------------------------------------
........... By ---- ------
11/75
CITY- -'OF E
I Y! MV0 N I D S ERYMI
E ER, P A
,P
WATEPV�SEWMIVDEPARTMENT
037
j(�C -2525 -for :side. sewer, inspections; IBEFORF cover n any,. portion, 'of �construct16n.),,
peWon.*wjll, be.pro�lded withiii 24 fiours; after, reclust. Nd,-S��t.,.,Sur�,,Z'Or,-,ho,liday, I ns
All,
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3�i CT_ 1 j�z.
�Oir,�C 0* STRU
N 2
..... ... .. . . .... ............ ......... ................ ........
,_ Dij E. CRIPTION .. ............ . ... ................... * ................................................. ........ .................
.............................................. ........................ ................................... .......................... ...............
..................... ................. ......... ...................
............ ..................... ................ *..ff ",ER AND/�OR BV- ILDEW ... .. 77. .......... ...... ..............
C IDN.TiOi C TORI&NMIE &�ADDRESS .........
F ............ er toAh
- ; " —. .1 or�repEdr and/orVoilinection of" a;.,sidei� sew Eian i ea�y, s-`ew,,e` r,
I i� d— I"
4s, paccor an6e)m, Ith I /City df,)Edmonds, ordihances.
�TTENTIOMIISCCALLED�To �THE- FOLLOWING:
NOTE No'� i—The� 0'wn�m�4'-.tb�,pr.�.rty 'MIL btain a permit fo "construct sewer Inside' property' line: A licefised'Side Sewer� Contractor must be,employeif,,toi construct
E;. -o',ro
side- sewei'-in�street area. cover an portion of sewer before if has; beenAnspectied.
NOT '�",Vfi'hwork lJe?fc, T:
E' No:' r ned"in -city right-of-way requireg"an, Invasioni.of RJght -of-Way,PermiV obtainable'. from the City Engineer's of ce.
e "VOTD-No' ful IL, In format Ion-:regar`d I n`g -Ord I nance 11 16.030.andt�Regulations- governing' side sew;ers when: you get permit
cover& e at
`NOTE'�Nc' - �L—To�',of,iide'sewer,,,n�ust.�tiav�,:at, least,30 inches 9 - property line %.nd, 12. Inches Inside property* line:. minimum grade' of 2%. Nw. bends�Jn� grade
_,)d1i
','0&i6er;AhSM� LIA be permitted;
iir�itlm6st,'be-*ate� setiled,and'surface of strek restored' to original,condit
NOTE No:, 5�Venc�iWm& 9 Ion. Confrar-tors shall be responsible for falluredue to 'improper
work, which-'rhay!develop m;ithin- one year of completl6n.
NO T E No. &�ItAsiiunlaw�'ful!.�o �lt�r or.do4any, other work than Is provided for in th6,permit, or. to -do, any'worik on the main, sewe� or Its appurte'nance& except to in-
.',sert�,the,Oi�6,,intoithd:wye..
A�IISATPAUVEDL 'By . ...... Date ------- -- ..... . �77 .........
........... 'Date:
'7
.............. . Byl.�.... ......... ... ............................................................... ............. .........
— V.7, Reilly
His* ......................... ......................................................................................................................................... ............. ....................................
-
................................................. T .................. ................ ................ ....... ....................... .......... ........ 7 ............................. .............................................. .....
lrEll "it wner f:,Firm, Pe
OT Ppies, MUST e Signed: By'O -o rforiniiiiz�,:6onstruction.-,,PRIOR -To� Request For* Inspection
.................. .. ......... :.,.'here�y is.permi
tify sidd, seiA�er installation, 6" ristructed und r' tfi�i
cer that, the 0 e
wner. of� Contracting - r Perform truction).
�'Wa�& Inst-'�lled�-in-,-ddd6r.db�nte�with,,allr.kpverning 6rdinances. ofthe,City �qf'Edillofid&.,
this.... �,. I. ................ -19
Ditedi ............ "Y.�of..* ...........
7
6�'CkBEFORE- y'9Wd1g- for:, Wdt i �Gwo,,,, IP'P,�yver.;' Se er_:[] Ptlie V"':V
W
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11
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APPLICATION
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION n REPAIRS LID NO . .................. ASMT. NO . ..................
OWNER ------------------------------------------ CONTRACTOR .... .......................... PERMIT NO. -;7p- - - - - - >7
JOB ADDRESS W ....................... LEGAL DESCRIPTION: LOT NO - --------- R ....................... BLOCK NO - ------------------------------------
....................................................................................................................................
NAMEOF ADDITION .............................................. ..........................................
T k-O-A "w --->-
Approved:
DATE ..............
V - - V >
............ By ..........................
....................
11/75
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Strcet Right-oE-1-:ay Pi T) 11)
Access Easewmits J7xistinv, SO Fq) -Ar,
Utility Fascmciit Existin,-_ oil
Lot Pcr Anscssor I 'at)
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Site Plan Oiiod.cd for Accuracv
1!n,!cr-r(xid Icod.
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Datc
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C,ntch Indicate u) �il:c
-on lri,��wcdo.
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N-111,1ole Indicate On sitc -u
Soil Conclitl
OnF, F, Grmnd 1."Itni. F:CM CIOCI(�d
Ruvi (n: 1""" 1 e
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B911MING DEPARTMENT
Applicant Fill
USE PEMWt
ZONE Ri—f NUMBER
PERMIT APPLICATION
Inside Heavy Lines
JOB
ADDRESS
, 0
INAME (OR NAME OF BUSINESS)
16 le '252' S16121, -
LEGAL LOT
11YES 0 No
LOT AREA
SUBDIVISION NO.
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MAILING ADDRESS 7
13o 7" 7
STREET R/W
EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W FT. FT.
CITY
ELEPHONE NUMBER
NAME
REMARKS-
I-
U
W
ADDRESS
HECKED BY
W
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CITY
TELEPHONE NUMBER
STREET AND/OR UTILITY WORK
REQ'D. 4itYES ONO
R/W PERMIT REQUIRED
4511YEs ONO
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W
NAME
UNDERGROUND
A7L
WIRING REQ'D. 11YES 0 NO
0
ADDRESS
TYPE CONNECTION 17YEs
ED BY
I-
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IVERI
SANITARY SEWER
No
( 031-j-
CITY
TELEPHONE NUMBER
SEPTIC SYSTEM 0 YES
APPV'D BY CITY ENG.
%NO
PENMIT NUMBER
z
0
U
ATE LICENSE NUMBER
CITY LICENSE NUMBER
REMARKS
� /� : I/ /V -z-' (� - /�' -3"v- / XA
Legal Description of Property (Show Below or Attach Four Copies)
METER SZE BUILDING SUPPLY SIZE
REMARKS
W
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SIGN AREA
ENV. REVIEW
ADB NO.
It
U
LO
W
ALLOWED PROPOSED
COMPLETE EXEMPT
REMARKS
W
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VARIANCE OR CU
PLANNING REVIEW BY
DATE
YARDS
FRONT SIDE REAR]
LOT COVERAGE
GAS
NEW ESIDENTIAL LINE
FIRE ZONE
TYPE OF CONSTRUCTION
ON-RESI.EN
A DD N TIAL SIGN
rRETAINING
DEMOLISH WALL.
rALTER EXCAVATE FENCE
OR FILL I:].(— X—FT)
REPAIR PRE -MOVE swim
INSP. POOL
ICODE
I
SPECIAL INSPEETOR AR
REQUIRED
1:1 YES 0 No
EA
JOCCUPANCY
__T-0AU1'
OCCUPANT
CC
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
W
NUMBER OF7TORIES _TDWELLING
NUMBER OF
U NITS
REMARKS
NATUR� OF WORK TO BE DONE -
/Y�' 1v �'o e 75 0'
IL
W
PLAN CHECK
NO.
BUILDING
VALUATION
FEE
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2
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W
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0
W
L
0
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PROPOSED USE
PLOT PLAN (INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
— z Z
T 7,-- L
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
go
RETAINING WALL
U
SWIMMING POOL
law
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PLA rT I lot
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