21014 76TH AVE W.PDFIIIIIIIIIIII
6312
21014 76TH AVE W
77
m
io
. . . . . . . . . . . . . . .
a
m
io
. . . . . . . . . . . . . . .
a
DATE REC)7/, j
1�,4t (D [PERMITEXPIRES
;9/aw I
I f USE" PERMIT
CITY OF EDMONDS ZONE NUMBER--�,/
Y7
OB SUITEIAPT#
CONSTRUCTION PERMIT APPLICATION ADDRESS
OWNER NAMEINAME OF BUSINESS 1j, �420_1e'.ZY2
OCL— "ALeA+j
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
MAILING ADDRESS
vot4- -747M- AdS VJ
PUBLIC RIG14T OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED
REQUIRED DEDICATION- FT
TESCP App c -
RW Psm* Required
street Use Peffnit Rocfd
Inspection Required
Sidewalk Required
Underground
0 fequww
CITY ZIP
b�ov-401zes cftz(o
TELEPHONE
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YESD NO 13
ADDRESS
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR iROSION CONTROL/DRAINAGE
71 r% J_ jl**". I A . I - - - / - -
CITY ZIP ITELEPHONE
NAME
ADDRESS
22-4 Njr1e_j_—W
CITY Zip'
WSTTE LICENSE NUMBER
"C-121'(2
NEW
RESIDENTIAL
ADDITION
COMMERCIAL,
REMODEL
MULTIFAMILY
REPAIR
GRADING CYDS
DEMOLISH
TANK
oGARAGE
0 RETAINING WALL
CARPORT
ROOKERY
(TYPE OF USE. BUISINES OR ACTIVITY)i EXPLAIN:
NUMBER
NUMBER OF
OF
DWELLING
STORIES
UNITS
DESCRIBE WORK TO BE DONE'
DATE FHNKE
0 PLUMBING/. MECH
COMPLIANCEPA
CHANGE OF,USE
0 a
SIGN.
IFENCE
3 ( _.X FT)
1:1 OTHER
FIRE SPRINKLER
FIRE ALARM
z
z
a
I I Z�-� 14 J y I Af F."I 11% 4 1 Vol �A L.J J.%.d -1 - I -
ENOINEERIN REVIEWED BY DATE
FIRE REVIEWED By DATE to
it
Ir
T
VARIANCE OR CLI
SHORELINE -OR ADBIII,'I
I.' INSPECTI40N
BOND
1..� -REOP
POSTED
$
SEPA REVIEW,-,
SIGN AREA 4,�`
HEIGHT
COMPLETE EXEMPT,
ALLOWED. PROPOSED
i ALLOWED PROPOSED
.XP
LOT COVERAGE*
- 'REQUIRED SET13ACKS (F . r),,
PROPOSED SET13ACKS (FT)
ALLOWED -PROPOSED
FRONT SIDE REAR
FRONT LIR SIDE REAR
PARKING.
LOT. AREA ]PLON
Nl��REVIIEWED.ISY DATE1 I
RECt
,�+PROVIDEO
REMARKS
m_
CHECKED BY.
I TYPE OF CONSDUCTION
CRITICAL
AREAS
NUMBEIR;
VA
SPECIAL INSPECTION
REQUIRE
0 El YES:.-
REMARKS.' -
PROGRESS INSPECTIONS PER U13C 108,
ILL.
L.o,^ A AA
VALUATION
$
OCCUPANT
GROUP
OCCUPANT
LOAD
INSPECTION REC
tul
Description
ZEE
Description
FEE
Plan Check
State Surcharge
City Surcharge
HEAT SOURCE
GLA23NG %
)LOTIOPE %
S6,
iftt
A. - 9
�Buildihg�Per
PLAN CHECK NO: VESTED DkTE
A
?lU
Mechanical
THIS PERMIT ALUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
It BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
2
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
Ul PERMIT APPLICATION: 11SO DAYS
PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
a EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
IC
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapeinsp.
Total Amt Due
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.".
.11
Recording Fee
Receipt #
I
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORIRECT� AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This application Is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Official or hiather Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt Is acknowledged in space provided.
WORKMENS COMPENSAT120N�ASURANCE AND RCW IS.27.
SIGNATURE (OWNER OFfAGENA DATE SIGNED
(425)
OF U AT
ioz
771-0220
/1 /1 Tic
RE By DATE
ATTENTION
W 1333
60/v
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL - FILE YELLOW - R
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
PINK -OWNER - GOLD -ASSESSOR
GREEN _ ACCOUNTING
4,17 C. 189 V
GARY HAAKENSON
CITY OF EDMONDS MAYOR
PUBLIC WORKS DEPARTMENT - 7110 — 210TH ST. SSWIEDRISAARRESS FILE,
(425) 771-0235 - FAX (425) 744-6057 - E-MAIL: k1ein&i.edmondsma.us
WEB SITE: wwwxi.edmondsma.us
January 7, 2000
Albert Malean
3104 - 156" St. NW
Stanwood, WA 98292
h
Subject: Water Leak Credit Account #449875, 210;14 - V Ave.- W.)
1� 2- ___
Dear Mr. Malean:
I have reviewed your account and will allow a credit for the billing period between
September 14, 1999 through January 18, 2000 in accordance with our City policy. The
policy states that the customer will be billed at the retail rate based upon the average water
consumption for the same period during the previous year. In addition, the excess water
lost from the leak will be billed to customer at the City's wholesale rate with a 15%
surcharge added for administrative cost. Only one leak credit will be granted in any three-
year period.
Should you have any additional questions after you receive your new billing, please
contact Denise Burke, Utility Billing Clerk, at 771-0241.
Sincerely,
A
Jim Waite
Water/Sewer Supervisor
JW/lk
cc: Denise Burke
Utility Billing Clerk
wordata\water\credit99\#449875
Incorporated August 11, 1890
Sister City - Hekinan, Japan
7
TRospect 7��24,`hours (plus
turday,;,*,Sunday��i�4,klp�lidays) be-
CITTOPEDMONDS
SIL
CITY11AILL WATER -SEWER DEPARTMENT 0-- 93
Ll fore work)s,' resd�.'J'or, -inspection,.
PEIZ
SIOESE Ek
J MIT'
S,
ANAES th:
82 25th W6.5
-OWNER
't CONTRACTOR
A 'I" -_ VaoLd W. - '_�'
AJV0
Peri:qission -is granted ... ..... 19.�.... for
..... EPAIR oe,:CONNECT a side sewer
.-With: Clty� Sewers in: -accordance; with application,on file and.governing ordinances.'
days,,to.R
W7�,ENTION -is CALLED, T Th E
FOLLO ING,:.
W
p
'NOTEINo., 1 —The, owners of the property may.,.o a. ermit.to construct sew�r in I e pr9perty line. 'A li�cnsed,,Sids sews, Contractor
MUStL be employed to construct side �sewer'in street area. Do not -co e L, S
v r any portion, ��of sewer before itha�.q been'. inspected.
NOTE- No. 2—Obtain full . information regarding 0
rdinance 11.16.030 and:Re ulations:koveriiing -side sewers when You get pe mit.
9
-1 NOTE No. 3—Tbp of sidei,'gewer must .,have at.least,30: inches coverage at props'
rty line and UAnches inside propert 11'
2%. No- bends in rade:sha:ri)er than j�s will be Permitted Y. ne minimum grade,of
g
-NOTE, No. 4-�—Tmnches in -street must -be Water settled an&�sq'rfsce f street restoredL t 'condition. ContraAors shall be
failur6.due to improper work which may develop withfu� on o original, I responsible for
_e, Year. of�complctionl
N,OTE �No. 5�lt 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.
P L urtenances except to insert this pipe'into the'wye.
.41
RECEIv
_.~
_-_'-_-_�x-=,==-�_--^~~-"-~=^=��="�--------~-~~�---'---'-----------------
+��
0
APPLICATION CARD No . ......................................
P*- for
The City of Edmonds SEDE SEWER PERMT
OUTSIDE E] INSIDE E] REPAIRS F] EASEMENT No . .............................
0 V V N E R rl&l ...... .. . .. ..... ............. ...... ........... CONTRACTOR ...... 4
...... ...... .......................... PERMIT No . ..... il
STREET
-.0 ........... A-!5 -../—
HOUSE N --------------- .............. .......... AVENUE LOT No . ...................................................... —.— ........ BLOCK No - ------ ----------------------- ...............
NAME ADD. ------------------- 3��5� .. ------- ----------
--------------------
-,w Are. d /
r-w '4-ee� lcj- zr
Date - Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .......................... ..................
SEWER WORK ORDER ISSUED .... -- .................................. DATE//V/--'//7 /x
APPROVED
F 171964
3 3 y ......................
i: '- , "T
Ll
C I T Y 0 F
S E P T I C T A N K
TO WHMM IT MAY CONCERN:
40
E D M 0 N D S
AFPROVAL
Thisis to certify that the septic tank— for
I;-) / (,) /
Yk Ael 0
has been inspected and are according to City of Edmonds standards
DATE:--:2�
Inspected by:
0 7 rrr�r OF EDMONDS
L OT`.AP1rRO_VA,L
_�TA
_-IDDIITI.9 ?
C 7ROPOSED
7
�ZIGJLL DESCR1__-T1JTC_,\T! LOT BLOCK ADDITION
'YLz NO. OF BEDROOMS SIZE OF LOT
_01 UCIFI___
SO'�M,�17 015t,' DRTT-TK1NTG 'OTA TER - PLbl-3 o Supply
Private W,-11
TT
A,. RFACE DRAINAGE
li.srosa! field site we1I drained?
2-
X, Any he@7,T slopes.in field are a?
..T� -
2, "V1;.i.!.L present, t-opsoil in f'-',.eld area —be
removed or gr7d-ed before field tiles
a nstalled?. V'�,_C
3. _YTi*V1 any "11. i5;rLerTal be �used i,
. . ;I - _q the disposal field site?
T.P
I yesp ho-vT nrach?
C� S TIMITIONS
Has a h-lp at least 4 feet deep been dug in the disposal field area to
detenaine; -'LLe type of soil pre -sent? I/ -
e S
2� !,fter hole is emg re:.-ord the soil c7d-i-ti-o-ns--a-t—t-he-7olloW3'-ng depths.
(1-Record as sand, clay.. packed sand.9 loan, etc.)
3 inchespijt-j.
inches
21t inchl�. - inches4,,,7-
v F"'.'
J eaching a depth of 4 feet?
?
D
T:,,�S T
A sijap-_ -.-ater tec"D -v..Till shoi.,, how
To n M well.this soil will drain or percolate wa:ter.
=for +his 'U,;�st-
T_111Lj, h(:)1�3 a-15 _Ic�'st 36 inches deep. Use a shovel or post hole digger -
le no d-ifference-only depth.
h.n,_1,e with wnter, Now let all water run out of hole. This soaks
g.,"oi:nd and wi.11.1 give a more accurate reading.
3, Agai.'a water J-1n hole to a. height of 12 inches from the bottom,
Lub -vate,z- ru.n out tmtil there is just 6 inches from bottom let in hole.
Notc how mary r-11-r-utes it takes for this last 6 inches to seep away,
record this tJLY1'e- below,
:�rc_.Lem to rt,.�-.c;r
aT%Ta
Y
by 6 to obtain the rate, per inch- ;z
Da'te. water test was performed
I he-reby ce%_-t_-4.fy the abo-,7-e information to be correct and the above tests were
performed by me as pre�-_-_-ibed. Signe�__ 'W- I xv /'I/-
Addrl'_�:�
U.: e
NOTE: A sep'-Lc tank pel-Mit is issu d on tnb basis ol the abaKre lianform tj
on.
,here are any changes or alterations in the above soil conditions it may result
in -the installation being rejected at the time of inspection.
Pe--colatton Rate and Required Absom
tion Area... For sing
le Family Dwellings.
Percolation Rat-e (Time in Lineal feet of 4 inch tile
Mllnutes for water to xL'alli using trench with width of
0 -ne inch.) two feet
3 IL5o minimum
4
1.7.5
10 25
12 0
15 265
30 285
Over 30 375
Soil Unsuitable