20818 77TH PL W.PDF111111111111
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20818 77TH PL W
1771-r
r CITY; OF EDMONDS
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Addres's of Constr . uption: -2 1 <6 b -vj
SIDE SEWER PERMIT
PERMIT IN_ 9,076
Property Legal Description (Inclu . de all easements): 4_ c) —r S C- t C 0JR T_
<C_
Owner and/or Contractor: L
State License No. 44 KAA� )uilding Permit No. cps
Single Family Invasion into City Right -of -Way: No Yes
Multi -Family (No. of Units—) RW Construction Permit No.
El Commercial ^Cross other Private Property: K_No El Yes
13 Public :i�,
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Attach legal description and copy of recorded easement .
I certify thay I f hav6-R��nd shall comply with all city requirements
as indicateNon the back of the Permit Card.
': 5 7 17-
Date'/
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION *
OFFICE USE ONLY
FOR INSPECTION CALL 771-19M, PUBLIC
0A1315
Permit Fee: — 0 . Issued By
Trunk Charge: Date Issued -
Assessment Fee: Receipt No.:
Lid No.:
Partial Inspection: Date —Initial —
Comments
Reason Rejected: Date —Initial —
Final Inspection Approved: Date AP 40 nitial
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy; File Green Copy. Inspector Buff Copy. Applicant Revised 3!90
The City of Edmonds Side Sewer Drawing EASEMENT NO . ................................ ...........
NEW CONSTRUCTION -Ilk REPAIRS F� 'LID NO . .................. AsmT. NO . ..................
OWNER............................................................... ................................ CONTRACTOR .................. ............................................ -- ................. PERMIT NO,
JOB ADDRESS ..... a.00 ........ 6P ....... /.,0/ ...... 4V ..................... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
PWW-0001-11/75 (REV.11/78)
NAMF C)F AnnTrTC)N
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Approved:
'>-A 1 -71 ........... � By ...... ...........
DATE ....... /. -L ....................
.611/1 bi.91W
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CITY of EDMONDS BUSIN S LICENSE AP I JJQU DATE LICENSE NO.
Civic Center - Edmonds, Washington 98020
City Cilurk Phone 775-2525 ktf �ILL ANNUAL FEES PENALTY AFTER FEB. 15
I �/HOME OCCUPATION
INSTRUCTIONS: CLASS ��EAR LIC. EFFEC. DATE JREASG. LIC� NO.ISPEC.1 $10.00 (A) ADDITIONAL $5.00 0
0 /,V I
• All items must be completed - 1 0 SMALL BUSINESS
or application will not be ac- RECEIPT NO. DATE PAID PRINT'X' $15.00 (B) ADDITIONAL $7.50 0
cepted. /-A- I -Pi e;�i /I VL-5�1-j IN SPEC. BOX El Business with 10 or
FOR ISSUE OF
• Sign and return application FEE PAID CORRECTED more employees ArDDITIONAL $25.00 0
WITI
LICENSE
with fee. Renewals received 'LC'ACTION. $50.00 (C)
after February 15 must pay X' 4EW APPLICATION (LA)
penalty in addition to fee. 0 RENEWAL (LB)
NEW BUSINESSES AFTER 0 CHANGE (LC)
JULY 31, 1/2 FEE. (PLEASE MAKE ANY NECESSARY CHANGES) 0 DELETE (LD)
NAME OF FIRM I BUSINESS PHONE . I NO. OF EMPLOYEES
.4-1, 'r Z.;I� / - C', — _', �z _� / I
MAILING ADDRESS NATURE OF BUSINESS
7';77-14 7' 6r/e
BUSINESS ADDRESS
INDIVIDUAL
QM (S)
PARTNERSHIP
(P)
CORPORATION
P
OWNERS NAME
HOME ADDRESS
HOME PHONE DATE 9F BIRTH PLACE OF BIRTH SOCIAL SECURITY NUMBER
EMERGENCY NOTIFICATION: (1) NAME & TELEPHONE Zz!z� .40 c4
(PLEASE LIST TWO) (2) NAME & TELEPHONE
WASHINGTON STATE TAX NO.ZV- _11Y- .7
&-e'l APPLICANT'S SIGNATURE
STAFF REVIEW:
DO NOT WRITE BELOW THIS. LINE
FILL IN LAND USE CODE, LIFIR NUMBERS, ZONING, ETC. CHECK APPROVAL OR
DISAPPROVAL, DATE, AND SIGN. IF DISAPPROVAL, PLEASE COMPLETE "COMMENT"
SECTION. ROUTE TO NEXT DEPARTMENT ON LIST.
PLANNING DEPARTMENT DATE LAND USE CODE ZONING CODE
APPROVE 0 DISAPPROVE SIGNATURE T
*w F
CONDITIONAL USE PERMIT
COMMENTS Em
BU��DING DEPARTMENT DATE 6 - Z5- Eb
—
E!r-APPROVE 0 DISAPPROVE SIGNATURE kA, PWAXO_z;�_
Building El
Permit El
Hotel/Motel
Apt. Bldg.
(L)
(A)
ET I I I I 10
Office Bldg.
(0)
COMMENTS:
Occupancy 0
Restaurant
(R)
Group 0
Hosp/Nurs Home
(H)
I I CAPACITY: (NO. UNITS, APTS., OFFICES, SEATS, BEDS, STUDENTS)
3 EEI
School
(S)
IFTE DEPARTMENT DATE -a(O 90 U.F.I.R.
2R APPROVE 0 DISAPPROVE SIGNATURE 1*1 1/7 YF9�:�
COMMENTS: PAOtuIC 0^361
�09CE DEPARTMENT
Lt--i'-APPROVE El DISAPPROVE DATE SIGNATURE
COMMENTS:
PUBLIC WORKS DEPARTMENT
0 APPROVE 0 DISAPPROVE DATE SIGNATURE
COMMENTS:
DI I=ACI: 01=71 10KI -rn f'17V rI C:0V
a low APPLICATION P�LA-
for
The City of Edmonds FILIZ SIDE SEWER PERMIT 'EASEMENT No . ......................................
NEW CONSTRUCTION REPAIRS
OWNER ........ CONTRACTOR ........ . ... .................... PERMIT N
. ... .. ... ... ....
................
............. BLOCK No.
S� -AL
ADDRESS ........................ LEGAL DESCRIPTION: LOT No . .. ......... ............. _73:7
[ 5-
*7 77," le. e4l" NAME OF ADDITION ................... ........ ...... . A . . ......................................................................
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Approved 7
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DATE B, ................ )� ....... ...................
7a ..... t",` ......... ""
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 requesting a,
copy should conduct an independent
inquiry regarding the information shown on
the map(s), in cluding, 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
call PRospect 6-1107 when work
CIVIC CENTER — WATER -SEWER DEPARTMENT is ready for Inspection. (No inspee-
tions Saturday, Sunday or holidays.) NO. 1517
SIDE SEWER PERMIT
ADDRESS............... 20.0 ... =_24thAvenim --- S-outb ..........................................................................................................................
OWNER ...... QQrdPA--L.' .... BAPP'st r ......... .... ......
.................
......... ACTOR
... .................. CONTp
Perirmssion is granted __Janmaxy .. �ZQ .............. 19_5:1., for ...................... days, to REPA]ER 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.
f 7E No. 2--Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
eE 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.
NOTE No. 5—It is unlawful to alter or do any other work than to 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.