20801 80TH AVE W.PDF111111111111
7145
20801 80TH AVE W
"" Edmonds
Y of.
RIGHT-OF-WAY -CONSTRUCTION,
PERMIT
Permit Number.
Lssue Date:
A. Address or Vicinity of Construction: 208 01 80th Avenue W
—
1.
GTE to place ogera I t "'nd maintain a buried service
B. Type0fW0rk(besPecif1*v1ire fro exist ng poolea#5512 located at 20800 80th
c.,
Avenue W then east to a residence at 20801 80th Avenue West. G feet,
18 %Xow JJb
push one(l) driveway 17 feet, and push no road. R.O.W. Foota e
G7 Northwest Incorporated
C. Contractor: Marilun Wn1mqrPn, PArmit A" rdingtorContadt: Jerry Scott 425/774-5921
Mailing Address:23t2d'W.
Casino Rd Phone: Marilyn 425/710-0786 or 488-1628
Everett,
WA 98204-1440
State License #:
Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. n Commercial E] Subdivision F1 City Project )ff] Utility (PUD, GTE, WNG, CABLE, WATER)
Multi -Family EJ Single Family Other
GTE #-.2100-9POOlDB 242310
INSPECTOR: INSPECTOR: 21 J W/o
F. Pavement or Concrete Cut 0 Yes JL'1No G. Size of Cut: x H. ptarke S
Please see attached sketqh.-.,
APPLICANT TO READ AND §IGN
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INDEMNITY: Applicant unders
tands and by his signature to this application to hold the City of Edmonds harmlessftom injuries, damages, or claims of any
kind or description whatsoever, foreseet� or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legal proceedings including defense costs and attorneyfees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP ANDMATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED
BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR 1.5SU.4NCE TO THEAPPLICANT
Two sets of construction drawings 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� �ept clean at all times.
Traffic Controli and Public Safety shall be in accordance with City regulations as required by the City Engineer.,
Ali\street cut trench work shall be patched yyith asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the ab ve 'aateyrenq'�n un
derstand the permit requirements and the pink copy of the permit will be
available on site I 1 0 . tctl ur oses.
Signature:. KIWALIEOVQ� DoividSquirese Date.,
"�f '
/I/-w -?/ "7gent) Section Manager -Access Design
CAL- L AL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY FEE: _30'oo
TIME AUTHORIZED: VOID AFTER DAYS DISRUPTION FEEIFUND I 11:
SPECIAL CONDITIONS: RESTORATION FEE:
..,TOTAL FEE:_
RECEIPT NO.:
ISSUED BY
NO WORK SHALL B.EGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
11-YES E] NO
Date:
Date:
LEGSIND
�PERMIT SU8MITTED BY
GTE ap- Z
PEDS 3
POLES 0
ROAD BORES
OVERHEAD LINES
1.0. UTILITY POTHOLE
UG TRENCHIN C ----UC T—
ReOdWs
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E3o Ry% NN
--------------- ------ --------------
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CUTS,
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(�_). Any person or entity-reque sting a
copy should conduct an independent
inquiry regarding the information shown on
.,-----fh-e -map(s), including, but not limited to,
the loc'ation 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-oyee-s o-r officers .1-3hal-I be Ha-b-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
. for
The City of �Edmonds FILE
STREET SIDE SEWER PERMIT EASEMENT NO . .............................................
NEW CONSTRUCTION REPAIRS E] LID NO . .................. . ASMT. NO..--.
OWNER ---- - ---------- ------------------------------------ CONTRACTOR
....... F; ......... PERMIT NO.
JOB ADDRESS --- 2_x�D_e�_CDA ...... .............. BLOCK NO . ...........................
----------------- LEGAL DESCRIPTION: LOT NO - ----------------
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DATE ... Z ... /'/ By,%:Z,�� .........
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EMME
41,
IN
J -EN
EP V
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4., 91det tsewe r,11 nspect Ions, -;R E FORE,, cove he;�,con struct qn'
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"'(Inspectlorf will.,be.,provideciP.within" 24' hourst after reqt pil'fli�olld a ; Y�- . in . specti. ns
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WTJON�W� CONSTRODT40 N ............. 7
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ji�M.�I,-,Jo' relmir and/pr.connDdtioa of:a.s1de'S'e'Wi6r to;,)t1i6,.,CktY Sani ar-Y,SeWe
...............
TO1�THE,:FOLLOW4NG:,
-ontra st-be� em�Q.4-:td.-c6nstruct.'
side property line.1 A:'IIc6nsed1 Side Sewer C ctor,mu
T -Thi;o1Vner'-.10fA'he�-- property� may obtain 'a. permit to.construct sewer in
'inspected-.,.
.,'�side-sower-ini,itrect"ar�a*., Do�,not. cover, any, portiori,lof sewer:.before ivhas-been,
office.
.,NOTE� Aper form, 4 i'n,, city 'ri gh t -o f- way iequires.an Invasion of* RJght-of-Way:-Perinttfio6tainablerf;.�m..th6 City, Engineer;'s.
'-,'O'btaIn,-.'fuiII' ItNrmatlon .,re gardi fig, � Ord Inance 1T.16.030 and' Regula tions .. :goyern . Ing si . d6:-��wers'�,;�hen�you.;get�.perrn I I t. m.:1
�-�NOTEI,,No.-�,3.�, least 30. Inch'ei--c-overa96 at property line and;' um, grade? of.�2%.� No,-Pends� inj �grade
have at, 12Arfcheq Inslde,,pr�operty:Atne; in nt
0 0-4� up,;of side.-seWer,.mu t
be. permitted'.'
-to.-improper.
d.,and-suifacc -of street r; 9* be, responsible for� fallur . eAue:
-d actors
be*,�vater seitle tore to �ori Inal 'cohaitlon: Contr
cb�esvjn'�treet �m"t . es
j of cornplefiorl-:'.
,-woi�,which�.may,develop within one yea work� onAhe, main' sewerl,or,� its,���pur�tenanc6,te)eceot,,',Co)�l.n--
t� 0�
or, dw,any- -other -the -perml r,to, do. any.
OTED 61 ork 'than:. Is: p�ovided: f6r'in
rC,'the:pIpe:i6to:�the.wye;
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t Insp6dti on—
T.6,'Rib
-'Si . gned, Bytowner of:Firm� Pe�fcriming,'Construc ion PRIOR_ qued '.,For.
C, Be
!BOTH(.,P&mit,,
Y
e -his��,P
b efti yj zLt-.,thei,-..�ide�;sewer�in�taliati6n,.,6oiigtru6t6d'.�.iind- rA
...... ............... .... .. �here, y..c
f Cont-fi�,* 'i;�--,&ifo'rming"Corigtruction)
'ac
iN� '�(Owner jo � -,,,��ng;rl�i
1`n'stjjjj��dU A�dccordanb6 %With -all gpverning, ordi anceS-6f the, City 9f; Edmond
...................... 491,:'
..Dv�ted .......
thi� ..... .
S w e r
Telephbnef],
-';Chee BEFORE�y6ti-Aig,46r: Matei ,Nwe
APPLICATION 1�
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION F� REPAIRS Fj LID NO - ------------------ - ASMT. NO . ..................
rlV.l ---------------------------------------------------------- CONTRACTOR ...
OWNER ----- --- RAO, ?016.�...qPERMIT NO. .5729.9
JOB ADDRESS - — -------- 7C - -------- LEG4L DESCRIPTION: LOT NO - ------ --1 ........................... BLOCK NO - ------------------------------------
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....................................................................................... ..................................... .....................
NAMEOF ADDITION ...... ........... .... . ........................................................................
Approved:
DATE............................................ By ............................................................
11/75
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-:.LOT NO. 3
_C LEGAL;4DESCR
-CORNER OF.
'.SOUTHWEST
,K -THE
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0,"NC I
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THE
NCE S 89013'W 'E' ALONG fkE."SOUTH'. L'
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EG I NN I Nd';- THE'NC.E N: 5 1314
AL
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14 0 1 -�;�TEETiq"JHENCE N 8991W k j2AO-PEET;
JHENCE.
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'-�RIGHT� HAVING A TANGENT 'BEAR I-W W.' N'.4,57
-AND A CENTRAL ANGLE OF`112044!19l4,.*,,, -.35�
f-Eq
18.00 FEET TO THE NORTH "LINE. OF--,SAlD' ILAT, I* �llftfxl
'W E WES'
-ALONG-SAIMNORTH TN
-29..di�!-- EET,- -j
LrNC" Oil
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PARK NO.' C.- AS RECOADEDAN VO�UME--1,0 OF 'PLAT
0*
W
SNOHkSH COUNTY;'THENCE S 0 M34 'pi L I N E.,t
ALONG �E WEST.v
132.16 FEET TO THE -SOUTH LINE OF. SAI D. LOT .20; NM�� lc::8
ALONG THE -SOUTH LINE OF.SAID LOT" -�q,�_ 3.4 -...66" Fitt, im
NG:
BEGINNI
-'AN,EQ6AL'ANb' UNDI VIDED `ONENtAl�;;
TOGETHIER.WITH
UNDER 'RO� RA T' FOR.THE PURPOSES OF
AND AC t T' C -A -INGRtS �G
-UTILITIES.
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0TqqT)FILE 0 P6
LIST
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Strcct Kight-oE-Way Existing_...rc�� c Y)
Acccss Enso.;:,.cjits Yxistim, r----% A I ef? pj7nn
Utility Fascmcnt Existint',
Lot Por Asscssmr !,g)
Situ Plzin Cl:ccl.cd for Accurao-
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1�!s
OUILDING DEPARTMENT
Applicant Fill
USE PER,
ZONE NUMBER
PERMIT APPLICATION
Inside Heavy Lines
JOB
ADDRESS
To e�� tezal-
N A R NP BUSINESS)
MME WZ�OF
LEGAL LOT
LOT AREA
SUBDIVISION NO
MYES 1-1 NO
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3:
0
CITIY ELEPHONE NUM E
7C
0
21 /7
STREET R/W
EXISTING STREET R/W &0 FT. DEFICIENCY THIS PROPERTY
T. T.
COMP. PLAN S R/W 6po F 0 FT.
NAME
REMARKS I)riveway slope not to exceed those
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indicnted on Stnndard Drnwincr #I IDS
W
ADDRESS
ICHECKE
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CITY
TELEPHONE NUMBER
STREET AND/OR UTILITY WORK
REQ*D. a YES 1:1 NO
R/W PERMIT REQUIRED
2YES ONO
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UNDERGROUND
WIRING REQ'D. As YES NO
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ADDRESS
TYPE CONNECTION gi-YES
VER
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SANITARY SEWER
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CITY
TELEPHONE NUMBER
SEPTIC SYSTEM
APPV'D BY CITY ENG. YES
ZNO
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PERMIT NUMBER
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STATE LICENSE NUM13ER
CITY LICENSE NUMBE
REMARKS'
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Legal Descri tio Prope� ShowA
elow or Attach Four Copies)
METER ;IZE
BUILDING SUPPLY SIZE
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REMARKS
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SIGN AREA
ENV. REVIEW
ADB NO.
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ALLOWED PROPOSED
COMPLETE EXEMPT
REMARKS
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VARIANCE OR CU
PLANNING REVIEW BY
DATE
YARDS
FRONT SIDE Ell
11) _/ - IR
LOT COVE AGE
R
R1
GAS
NEW RESIDENTIAL LINE
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NON-RESIDENTIAL SIGN
A 0 1
El 1 0 1 11
DEMOLISH RETAINING
1:1 WALL
E] ALTER EXCAVATE FENCE
F� OR FILL I— X—FT)
FIRE ZONE
TYPE OF CONSTRUCTION
1
CODE
SPECIAL INSPECTOR AREA
REQUIRED
13 YES E NO
JOCCUPANCY __r0CCUPANT
GROUP
—
LOAD
I
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
PRE -MOVE swim
REPAIR D INSP. POOL
OF EDMONDS: LOCAL SALES TAX
SHOULD BE CODED 31.04.
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NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
REMARKS
N WE�OF WORK TO BE DONE
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PLAN CHECK
NO.
VALUATION
FEE
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PROPOSED ysy?
PLOT PLAN (INDICATE BUILDING SETBACKS,
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ABUTTING STREETS)
BUILDING
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PLUMBING
HEAT & GAS LINE
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FENCE
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SIGN
RETAINING WALL
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SWIMMING POOL
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