20407 79TH AVE W.PDFIIIIIIIIIIII
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20407 79TH AVE W
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@ 1' BELOW GRADE
EEP
CITY OF EDMONDS SIDE SEWER AS- BUILT
A
:::) ADDRESS
tA 20407 - 79th Ave W
HOMEOWNER CONT ACTOR SCALE
Paul Rendon NTS
DATE DRAWN PERMIT
12-06-04 By Sibrel NO, 9910
PERMIT NO: NO
City of Edmonds
PERMIT EXPIRES
SIDE SEWER PERMIT
-7, —74�r# 1.
"dress of Construction: Ll U
Property Tax Account Parcel No. 00 4/�
Attach copies of all access and utility easement
Owner and/or Contractor:
Contractor License #: ic::�_ 0 �v
Single Family
F-1 Multi -Family (No. of Units
F� Commercial (No. of Units
F-1 Public
. 0 C, 194 —
",;� - Pd I',
C-) qo(j
Verified and Approved by
ing Permit #:
Invasion. into -City *Right -of Way: Yes VNo
*RW Construction Permit
Cross other "Private Property: 0 Yes -No
"Attach legal description and copy of recorded ease ment.
A/
&ZLZZJ11,- 41 6&,E44427:0, Contractor dr"
Owner or contr/a�tor 'signature and acknowledizement statement: �1� Date
By signing for this permit.1 certify that I have read the City's public handout entitled
ide Sewer Specifications., and shall comply with all City requirements outlined therein.
2 CALL DIAL' -A -DIG (1-800-42P,-5555) BEFORE ANY EXCAVATION W
W FOR INSPECTION'CALL 425-771-0220 extension, "30. W:
24 HOUR NOTICE RtOUIREJ) FOR ALL INSPECTION REOUESTS
............ ..................... ...... .
. .... .. ...... . FOR OFFICE QSE�ONLY
.. . .. . ....
..... ... . ..... ..
Repair Fee
Pe . rmit Fee -% $ ..... 30 Issued BY: �T-
I V
Tr&rik-Gharse $ Date Issued: IuLi
ID� '15,50
Assessment Fee $ Receipt No
City Permit Surcharge Fee 454W Total Fees,paid
NOTE: IF JOB ' SITE IS NOT READY FOR INSPECTION, WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED..
Job Site. Ready YES NO Date: Initial:
Partial Inspection: Date: Initial:
P p
artial Inspection: Date: Initial:
FINAL INSPECTION APPROVED: Date: ff Initial: 3-il As -built to Street File:
1,� PERMIT MUST BE POSTED ON JOB SITE t�
White Copy: File Green Copy: Inspector Buff Copy: Applicant
L;temp;bldg;forms;sspertnitjlg4/00
Water Service Drawing
The City of nonds EASEMENT NO . ............................................
NEW CONSTRUCTION REPAIRS [0/ LID NO . .................. . ASMT. NO . ..................
OWNEP . ...................................................................................... IT NO. N00 110
.......... CONTRACTOR ................................................... ................................ PERM ..........
........................ BLOCK NO . ....................................
JOB ADDRESS ..2�0407 ....... 7.9 ... LEGAL DESCRIPTION: LOT, NO . ..............
................................................ : ..................................................... ...........................................................
NAMEOF ADDITION..: ........................................................ ...........................................................
A r-14-5---
"W heki- VAL-vG
Approved:
PWW-0001.1 1175 (REV.1 1178) DATE FEB: .. 12� .... t aa (,V... By . .. ..... ............................
NOTICE:
No warranty 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 forth on these
map(s). Any person or entity-reque sting a
copy should conduct an independent
i , nquiry regarding the information shown on
the -map(s), including, but not limited to,
the 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
employees or officers Shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPARTMENT Call PROSPeCt 6-1107 when weft
IS ready for Inspection. (No luspeo-
SIDE SEWER PERMIT ti— Saturday, Sun&W or holIdays.) N2 1781
ADDRESS ............ A ... 20407 - 79th Place West
........ . ................................................................................................................ : ..........................................................
OWNER ........... .... 3� ... 2.0 .... J.01311sm .......................................... CONTRACTOR .... HU ...... I n.0 . . ..................................................
Permission is granted ....... . M ' a ' rch 14
............................. Ig..§.7_, for ...................... daysp 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:
NOTE 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.
NOTE No. 2—Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side Sewers when you get permit.
TE 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 % will be permitted.
NOTE No. 4—Trenches In street must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to Improper work which may develop within one year of completion.
JOTE No. 5--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 ap-
purtenances except to Insert the pipe into the wye.
APPLICATION
y
.LyNfq PL."ily
for
F111
The City of Edmonds SIDE SEWER PERMIT SEMENT No . ..........................................
NEW CONSTRUCTION E) REPAIRS P
OWNER ...... ............ n7k/ 7.1�� ............................ ........... CONTRACTOR ----- I.W ... Z—z <f-z ... .............. ............ PERMIT No. 1,-
;� ' ,
ADDRESS ........ ....... . ....... ....... �-;— LEGAL DESCRIPTION: LOT No . ....... .............................. BLOCK No . .......................
NAME OF ADDITION ......... ......
........................................
I
Approved:
DATE--- z;�? .......... q .............................. By ..........
...............