21028 SHELL VALLEY WAY.PDFiiiiii iiiiiiii
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21028 SHELL
VALLEY WAY
ADDRESS: goo" I
TAX ACCOUNT/PARCEL NUMBER:--�
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:
DISCRETIONARY PERMIT #'
DRAINAGE PLAN DATED: —
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED F1
DETERMINATION: E] Conditional Waiver F] Study Required n Waiver
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER
OTHER:
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Legal Deicripilon Of Property - inclClOd all eas(ements
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�Ky �Onst;UCI;Dr`,O-� In- S,de�al".
�i , separale permission
cf�ve*a�s. marGu#eS, ire
-1,Cal,en
Pefm�j App
Permit Limit' I Y.a,�,PIO�,Ced WO1,, 'S,Slaltec W-IMIA 160 Gays.
�eql! of. -Ifs o�pdr spouse, 1;81m. assigns and
SwCCeSS rsin, interest -agrees to !noemndy, aetepa amd no' d
hafrnle5o the, Cil�' oi Eamonos.. Wkshing, its Pffi�lal
employee;, ano.aglintj l(orp ah).ans: ali claims 1vj damages Of
-whalevei nature. arising affecoyor ivdifecth- from Me issuance
of this pe,mil, 11 suance OJA�IiS pefrMjn 3 Mall not do Veemelfjo
en I -of any City Ofd-rW
mcalty, we ve.,or feCuc: an, ,equi�,1,M,.
ncr limit Tal`,� way in City's abi y* nC8
TOTAL AS�OUNT DUE
�erecqr #Xnewipage that I haV6 riaa MIS app�calion: that trI8'
ATTENTION,.
APPLICATi&�
Duly
Infor'pitibin given is Correct; anO thald am the ownet� Of thb duly
4.
1,
1.89f I GlAg comply w
a4thoriled agent of the owney'. Hh city and
an�0";
Thij,applic�lion to not a permit until.
r!gu!6ting c9V oing the*work lituthorizz.
$Isla law r 'io' I'M "" lon ef In@ LaDol
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acknowtodg*d In sp&CS P(OVIC180.
SIG
C�TY 'OF-'
ED MONDS
THIS SITE. 'CITY
-IS LOCATED IN.THE
I
OF EDMONDS,, LOCAL SALES TAX-'
75-25,
OAT(
E NT SHOULD BE CODED 31.0 A.
.
IT IS 6NLAWFUL TO USE OF; OCCUPY- A BUILDING OR STRUICTURE
.
UNTIL A FINAL; -INSPECTION,HAS BEEN' MADE AiQ APPROVAL OR -M -ORIGINAL —.File YELLOW — inSpaC lor
A ..CERYIFIC4kE OF ..qCCUPANCy, *A� BEEN �GRA ED.
UB A
PINK O.Mal GOLbi asslisor,
MAR' 3 1983
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------------ I -------------
..��OPES.'QVE,R'- 6-PE0.6 T
INFILTRATION STEM
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11711
"TW rlm DISAPPROVED 5Y- Date;
Date.,
p APPROVED Datet!
The City of Edmonds
Side Sewer Drawing
EASEMENT NO - ------------------------------------------ -
NEW CONSTRUCTION REPAIRS 0 LID NO - ------------------ ASMT. NO. -- ------------
I
OWNER ---- -E)---H0tAF-5 ---- INVC,-, --------- CONTRACTOR -MOMTF-5 ---- DOMIN-G-- -------------- .- PERMIT NO. -6—W-0,7
JOB ADDRESS -2.102-8 ---- SlAF—LL.-VALL-E-Y--Wkl LEGAL DESCRIPTION: LOT NO. ------------- --------- ----- BLOCK .- -- - ---- - - - ----- I. -
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lll� �-LEC-Mbj�Nn---
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----------------------------------------------------------------------- ----------------------- ------------
NAME OF ADDITION --- MA-PLE-CREEK ---------------- --------------------------------------------
PWW-0001-1 1/75 (REV.1 1/78) SH E L
V
2- 10?,8 SHELINALLEY WAY
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DATE --- --------
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VALt-F-,-j-
W#�y
RA FAHEY
By A MAYOR
CITY OF EDMONDSSTREET ADDRESS
7110-21 OTH ST.S.W. - EDMONDS, WA 98026 - 1206) 771-0235 - FAX (206) 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS. DIVISION
jS90
May 15,1996
Mr. & Mrs. Glen McPherson
21028 Shell Valley Way
Edmonds, WA 98026
Dear Mr. & Mrs. McPherson:
I would like to thank you for your participation on the lead and copper compliance
testing done at your home.
The results of your test have been received from the lab and are as follows:
Maximum Contaminate Level Your Home
by D. 0. H. Results
Copper: 1.3 mg/L 0.018
Lead: .0 15 mg/L 0.046
This is not the end of our sampling and hope we can use your home again when
required samplings are needed. Again thank you for you assistance.
Sincerely,
Ron Holland
Water/Sewer Supervisor
wordata\waterMeadsam * Incorporated August 11, 1890 *
Sister Cities International — Hekinan, Japan
City 9f JEdmondf
7-1- 11� I I I .
RIGHT—OF—WAY CONSTRUCTION
PERMIT
Permit Number. e�75- 175
Usue Date:
A. Address or Vicinity of Construction: 7,I&A 514E-LL VALLE�Y WAcY
89 0 B. Type of Work (bespecific): k0lAC-E ME VkDP& ALON& A
A CAM Sr
C. Contractor: CWAMMER-� ISUPEOVOk CA, Contact: TOM AMbEkSON
MailingAddress: E33 HAIQ ST Phone: 774-574(o
stateLicense#: SUPEP—C-ti6taA Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. Commercial El Subdivision EJ City Project 10 Utility (PUD, GTE, WNG<�, WATER)
Multi -Family E] Single Family F1 Other
INSPECTOR: 114SPECTOR: 4C�Jr�
F. Pavement or Concrete Cut 5d Yes []No G. Size of Cut: __2*L x H. Chargt�,$
Oki LY IF -0-67011) PIEP, UT11.- LO CATE S
APPLICANT TO READ AN4?N
INDEMNITY. Applicant understands and by his signature to this application, agrees EQ, City ofEdmondg harmless fr9m in *u, * 8 damag r
of� IZ. es, o
claims of any kind or description whatsoever, foreseen or unforeseen, that may be mad7rfikainst the City of Edmoruls,-�,:aay t. ent. or
employees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgrantinfl thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTO#ATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETEO BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDI"VI6L
'�BE�P
.#74�ESS ANT.
'�DAFORISSUFfXTOTHEAPPLIC
i
Construction drawing 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 kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above state t8 and understand thepermit requirements and thepink copy of thepermit will be
available o at ti e or inspection purposes.
>0;2MV, 1 19 ele'o Date: Iff 2- S- 9 -T-
Signature: a-4dz-- &- o. k-&-
(Contracroror Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVEDBY: k-AJ2j*' + cAj�-4— RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER NJ 04 5 DAYS
SPECIAL CONDITIONS: 14, A,
COMMENTS:
DISRUPTION FEE/FUND III:
RESTORATION FEE*
PERMIT FEE:
TOTAL FEE: ff/;p , o c)
RECEIPT FEE:
DATE:
ISSUED BY.
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994
a
a
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES E-] NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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CITY OF EDMONDS
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ASSET INFORMATION SHEET
40 NEW ASSET NO. t2 0 :�7�1
ADDITION ADDITION TO ASSET NO.
EIRETIREMENT STREET FILE
DESCRIPTION
S df2u lcd
SERIAL NO.
LOCATION DEPT. NO.
.2 1 (-) 2- U ell 1-4L it y f./ q C3
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
B.A.R.S. ACCOUNT NO. It — o 0
ESTIMATED LIFE
*PROJECT NUMBER 6 3
PROJECT COMPLETION DATE
COST
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
51 DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT -
0 G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO.
INITIAL
Up)
DEPARTMENT FILE
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MAR 3 1983
ZONE
SETS"ACKS:
PPONT
'EA,
SITE PLAN, SCALI':
HEIGHT
NOTE: DO NOT USE INFILTRATIOPI
ON SLOPES OVER 15 PERCENT (15
/W"? p /- E c R, E E
L,07- 2
EDVOAID-g j W,19-
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE 2 OF 2
F 7
830192
CATCH BASIN:
&D5 OIS30(00. TRrLNCW LWNGTH
WUUAL)
14D
TAW?4CH C0VLrR-J,
............................. . . .......... INI
-n& UN I IKE LCVrL TRIZNCH
4,� prpkr I PV "/ CAY
ra"TrEE wl (.11 i-oNG LErs
SYSTEM CROSS—SECTION
TP,E�CH COVER -
3/4u— 0/2." WASWED
GRAVEL
6" OIAM FERF PI
TRENCH CROSS—SECTION
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2
for
location
21nN zvzell
plan by
phone
date
DESIGN DATA
Trench Perc LF per Imperm Trench
Number Rate 1000 sq.ft. Area- Req.,
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals (at least
twice per year).
CITY OF EDMONDS
I
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*
DaR C H
DIDJ vz
ZONE
%Q F T K S:
0 NT
SITE PLAN, SCAL-I':
HEIGI-IT
NOTE: DO NOT USE INFILTRATI15H 9�9+E-
ON SLOPES OVER 15 PERCENT (15
Jo
20"
MAR 3 1983 '
/W/-? PL E /-,Z,> EE
L,07- 2
ED,(110A1,DS ; Wq-
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE 2 OF 2
1. 11 =.. 1 121 # 0 1 0
BUIL.DIW PERMIT REVIEW
4DW'.2-
J-1 uzllld-AV14�� ��-e3
(address) 6f V (date)
Street Right -of -Way Exist' REQD
Z
Access Easea-ents Exist' REQD
#-4
gz
Utility EaseTient Existi REQD
W
Lot Per Subdivision Plat Assessor 11ap
W
Site Plan Checked for Accuracy 4eu /,'7
Z
Underground Wiring Reqd.
�-4
0
Check Accuracy �f Legal Description X
Z
Review by Da te
94,
1
Existing Water Main Size -
Water Main Required IYIA
Service Line Required
Hydrant Size Existi
ce.
Hydrant Reqd Per Fire Code Size
W
Detector Check X1eter Reqd.
Cross Connection Inspection
Fire Depar tment Conments
Water Yleter Char d.
,g Req 5
Review by Date
Septic Tank Design Approved Date
Septic Tank Permit Reqd. Perndt No.
Sanitary Sewer Availability Proj
Drawing No.,E�� File No.
Side Sewer Availability_
Sanitary Sewer Connection Fee Reqd.
3:
Review b Pate
Y-74 - -'
W
W
Open Ditch Existing. Reqd.
Z
Culvert Reqd.'N5L - APPi2,uUP-[-)-- Size
W
Catch Basin Reqd.1 \, k � I lk Indicate on Site Plan
0
Shoulder drainage maintain collection an swale open runoff
P
0
�twthole reqd. f-�-7p 14 (-IN i�3 Indicate on* Site Plan
22L_
Soil Conditl and Ground Water Field Checked
Review b Da te
Revised: lvlO-1977
0 - ' — -1-4w. ''. r'.e'
DATE: 4— '�—h
MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Publ ic Works Department
SUBJECT:
After review of the subject Building Permit application, we have the following
comments:
1. Connection to City water system required.
2. Connection to City sanitary sewer system required.
3. Right-of-way permit required for any work on City property.
4. Driveway slope not to exceed 14%
5. Backwater valve required if downstairs plumbing is below elevation of
upstream manh—oT—e.
6. Water and sewer lines to be separated by 10 foot minimum.
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