20421 86TH PL W.PDFIIIIIIIIIIII
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20421 86TH PL W
APPLICATION
for I AYMENT PLA"T
The City of EdmondgFIE5 SEDE SEWER PERNaT lim
BASEMENT No . ..........................................
NEW CONSTRUCTION El REPAIRS E:]
4 /,0
OWNER ....... .......... 4 ............. #q.VP.,Vc ..................................... CONTRACTOR .......... L4 ..... . "I,. Y'U ......... --------- PERMIT No.
ADDRESS ..... ----------- R6.--rj ....... e . . ............................ LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
N, 3yrr 467- / 7 y. 5 3 1,o7 /6
NAME OF ADDITION ............................. DnJ ......... Pj..�cc ......... R?Y.5�.e .........................................................
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Approved:
gle - 28 - ............... By
DATE .............................. >,�'
NOTICE:
of"�Woc -21-cy
No-w -a r-r a n y. U.-r—A-T,
The information . shown on the attached
map(s) was compiled for use I by the City Of
Edmonds) its Employees and Consultants.
The City of �Edm.qnds does not. warrant the
these
accuracy of anything set for.th on -
rnap(�-). Any person or entity -requesting a
copy should conduct an independent
e inform - ation shown on
inquiry regarding th
tf�e -map(s),, including, but not limited to, -h
th . e lociation of any sew-er stub shown. Suc
ex st and may
sewer stubs may or may not I
at the location shown.
or may not exist
of Edmonds nor its
Neither the City
empto-yee-s o-r office-rs -sha-'H be Via-b-'Fe for the
information given on this map(s), nor for
e representation provided based
any on
upon said m.ap(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
2 0 ��, 0i
Call 7.76-1107 for side sewer inspections BEFORE covering any portion of the oonstruction.N
Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections.1
ADDRESS LOCATION OF CONSTRUCTION ...... WJ427 - CStli
.................................... C
............................................................................................................
PROPERTY LEGAL DESCRIPTION -...':I. 35' Lot _'_7 E S. 335' Lot 1� F0.
............................................................................... ? .................................................................................
-------------- OIVNERANDJOR BUILDER ----- L-P T . I oN-de
,j ........ -------------
CONTRACTOR'S NAME & ADDRESS ------ 6*, �L-n_ . , -4,1 ". — 0
H ...... . ILLOM;
........ ........... I ............................ i"A
. ... ... . ... ........................ * --------------------
Permission Is granted 2 ...................................... 19 ... 71, for repair and/or connection of a side sewer to the city sanitary sewer
system In accordance with City of Edmonds ordinances.
�ENTION 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—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtain -able from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property I . ine; minimum grade of 2%. No bends in grade
sharper than % will be permitted.
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors sball be responsible for failure due to improper
work which may develop within one year of completion.
NOTE No. 6--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 appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED[] Date ... .................................... By ------ --------- Date --------------------- .............. By ---------_---- Date .................................... By ................
APPROVED ----------------------------- By -----
........................................................................
..... C-4 ........
Remarks: J�� ........ D
1..C4 ....... _?q ......... ?f�kz�
Q ..... ....... (?&P.e�8,7�7 ......... ....................................... ..............................................................
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
I ------ 4jj I.. ............ .......... .... hereby certify that the side sewer installation constructed under this permit
(dWner of Cdntracting Firm PerfGrming Construction)
-)Installed in accordance with all governing ordinances of the City of Edmonds.
Dated this ....... .... day of .............
V V Check BEFORE you dig for: Water [-], Gas 0, Telephone E], Power E], Sewer
:�, ............................ 19 ?. /..
Other [:] j /
The City of E FILE
APPLICATION
for
SIDE SEVEM PIMM"
NEW CONSTRUCTION E] REPAIRS 0
LA-942-r
OWNER... ............................................................... ..............................
2,0 -q 7-- / ".. 4 te-0
ADDRESS..... ...................................... ........ k ... !!� ............
EASEMENT No.
CONTRACTOR.................. ...............................................................................
LEGAL DESCRIPTION: LOT No. AJOAT . ..... BLOCO/KA/N4fo . ..........
..................... ..........
NAMEOF ADDITION ................................................................. ..........................................
Approved:
DATE ... 1�0 ... . .. y
... .... .... .... * ----------- :� * -- - -------------------------
I
CITY OF EDMONDS
CIVIC_'.-'6Ei14TER — WATER -SEWER DEPARTMENT
SIDE SEWER PERMIT
ADDRESS .......... 8.6.th..F.1ace ... West
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Call pRospect 6-1107 when work
is ready for Inspection. (No Inapec- NQ 3462
tions SnturdaY, Sunday or ho"dfl-YH-)
owner
.. Tic eisen
...................... CONTRACTOR ...........................
OWNER............. .........................
Peri-nission is granted ....................... Sept ...... 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: licensed Side Sewer Contractor must
NOTE No. I—Tbe owners of the property May obtain a permit to construetvsewer inside property line. A
be employed to construct side sewer in street axea. Do not co er 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.
NOTE No. 3—Top of side sewer must have at least.,30.1nehes coverage at property line and 12 inches inside property line; minimum grade of 2%.
No bends in grade sharper than 'A will, be permitted.
% . I e " condition. Contractors shall be responsible for
NOTE No. 4—Trenches In street must be wat6r settled and surface of street restored to original
failure due to improper work whIch.maY de, velop within . one year�of completion. ts appur-
NOTE 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 I
tenances except to Insert the pipe into -the wye.
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SNOHOMISH HEALTH DISTRICT
AMR,
DIVISION OF SANITATION —%qF T FILE
wREE
3011 Rockefeller Avenue, Everett, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to: --- 040'Ve.w./ .... -_-------------- ----------------------------------------------------------- ........... __ ........
'2 g �� '�/ .
For installation at: (street address) ------ .............................................. ...................................
Addition or Subdivision_.�;- .. ............................. Lot ................ Block ................
Type of Building: New --- Existing ----------- . Single family residence --- X_ Number of bedrooms.. ... 3 ...............
Other: (specify type or use)
.�p X
Builder'-e41v4e_�'.1_1 --- 1140 -------------------------------- Address --- i"Z2__A*"a16r ...
Designerv6/v____.-�._6W ?a2l:/ -------------- Address./;��r ..... 'lei !q
Soil Log Hole No. 1 ... 1-11ZV/ ...... e-71 -.% .. X �
.......... ......................
--- --------------------------------------------------------------------------------------------------------------------------
Soil Log Hole No. 2 ---- - ----- -------------------------------------
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Elevation of Water Table, if encountered. (Distance from ground surface) .100 --- �__26 ...... ........................................
Corrections to control surface water if needed___"/N'7'V__e -------------------------------------------------------------------------------------------------
..........................................................................................................................................................................................................
Specify if any removing or grading of topsoil in field area,eo ---- �7.77_1v; nl ori��Z - - -------
Percolation:
Test Hole No. I —Average Rate --------- X --------------7------- Z-1r-en ........ (Fall in minutes/inch-bottorn 6" test hole)
Test Hole No. 2—Average Rate.___'/40 ------------ /"-Yj ---------------- (Fall in minutes/inch-bottorn 6" test hole)
Test Hole No. 3—Average Rate--...O --------------- ow- /_ W --_----_----- (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design ............ ---_---------_-_--------
Septic tank requirements based on present rules and regulations:
Septic Tank Size --- ?�459Z9 --------- gallons.
Amount of Square Feet of Disposal Field-_-J.P�r-0 .......... ---------
Signature — Designey
--- /$ .... 4� _-_ ............ .- Date._Z/504013 --------------- --__
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date) ------------------- A:;2 (0_3 ------------------ Permit Number ----- ___/ 3-0 J-p
..............................
Remarks:... ............... ---------------------------------------------------------------------------------------------------------------------------------------- .... ___ ------------ ......
BROWN
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6,�r--Ioa
Order*. /o6o33435
Notif #: 3ooD79 IR50
Addendum To: City of Edmonds
Right OfWay
Permit.Application
Submitted by: Craig Simpson
New Customer Construction
Puget Sound Energy
425-356-7500 ext. 7571
004 ST S-V�/-
r\j
PAOPOSED
�;b/" P6 .56gV(C-6,
00 7 5T .5, W
Paving Cuts Anticipated_L_
Cuts
shown
as:
Key: -W-
water
-G-
gas
-SS-
sewer
-SD-
storm drain
Puget Sound Energy 1122 - 75 ST SW Everett, WA 98203
Y
Permit No: 7.
City of Edmonds
-`WWAY CONSTRUCTION PERMIT Issue Date: 97
RIGHT -OF
N. Address or Vicinity of Construction: 20421 86 PL W
B. Type of Work (be specific); INSTALL NEU GAS SERVICE, I PAVING CLIT
C.-Contractor: PUGET SOUND ENERGY COntact: DOUG USITAED
Mailing Address: 1122 75TH SW, EVERETT� 98203 Phone: 425-356-7520
State License #: Liability Insurance: Bor�d:
D. Building Permit # (if applicable): -,Side Sewer Permit # (if applicable):
E. Commerciaf Subdivision n City Project n EUC (PUD, GTE, PSE, CHAMBERS, OVWD)
Multi -Family FL] Single Family Other
INSPECTOR-
F. PAVEMENT: FA YES F� NO G. SIZE OF CUT 2 x 3 H. Charge: $
CONCRETECUT: F� YES M NO
-ILICANT TO READ ANE
IDEMNITY. Applicant understands by his/her signature to this application helshe holds the City of Edmonds harmlessftom injuries,
damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any of its departments or employees, including but not limited to the defense of any legal proceedings including defense"costs and
attorneyfees by reasoiz ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMA TED RESTORA TION FEES WILL BE HELD UNTIL THE FINAL STREET PA TCH IS
COMPLETED BY CITY FORCES, A T WHICH TIME A DEBIT OR CREDIT WILL.BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Traffic control_.-Ahd�,puiblic safety -in, accordance With- City regulitti ons �as --requirei&by*'_the- City- Engineer. Every
flaggir must be trained as required by (WAC) 296-155-305 and must have certification verifying completion of the
required training in their possession.
Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City -
approved mat�r , ial prior to the end of the workday — NO EXCEPTIONS.
Three sets of construction drawings of proposed work are required with the permit application.
IHAVEREAD THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THATIMUSTMAKE THEPINKCOPYOF THE PERMIT AVAILABLE ON SITE A TALL TIMES FOR INSPECTIONS
Signature: FELMA H. LOPEZ—FUGUIAO Pate: 8/31/99
(Contractor or Agent)
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
FOR,,CITY USE ONLY
Approved by: Right -of -'way Fee:
Time Authorized:. Void After ocrr 3a N Disruption Fee/Fund 111: 3? r-)
$pecial Conditions: Restoration Fee:
Total Fee:-
77 7T,
k 9t
e� M ' No:
9_gA!:2 PAvtFo I J 9!9- Issued by:
UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE,EDMONDS
COMMUNITY DEVELOPMENT CODE.
FINAL APPRO VAL'OF PERMITTED WORK.
INSPECTOR'S SIGNATURE DATE:
For inspection requirements see EngineeringInformation Handout.
I NO WORK SI-IAIA. BEGIN PRIOR TO PERMIT ISSUANCE I