21117 PIONEER WAY.PDF11111111111111
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21117 PIONEER
WAY
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ADDRESS: IA)0-t,�
TAX ACCOUNTIPARCEL NUMBER: U0
BUILDING PERMIT (NEW STRUCTURE): I q (3 7 0(�Ks
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COVENANTS (RECORDED) FOR:
CRITICAL AREAS DETERMINATION: n Conditional Waiver 0 Study Required Ej Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER): --
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
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SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:- -2 7
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER:
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CITY OF EDMONDS ZONE C:�� NUMBER
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WaNST�RUCTION PERMIT APPLICATION JOB 12 20 0,1L
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NAME (OR NAME OF BUSINESt) ADDRESS C;?
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FATE LICENSE NUMBER
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Legal Description of Prop&ty - Include all easements
(show below or attach four copies)
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R9 NEW V RESIDENTIAL HPLUMBING
DADDIALTER COMMERCIAL MECHANICAL
REPAIR RETAINING WALL SIGN
EXCAVATE FENCE
DEMOLISH OR FILL x _FTj
PRE -MOVE INSPJ swim
REMODEL El COMPLIANCE INSP. POOL
WOOD STOVE/
INSERT [:1 APT.BLDG RENEWAL
NUMBER OF STORIES NUMBER OF
DWELLING
14� [UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOTPLAN)
J?,�e L,_) C bn S-�t- (;Ch,9IV\
This Permit covers work to be done on private property ONLY.
Any I construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigds an;
successors in Interest, agrees to Indemnify, defend and hold
harmless the City of Edmonds, Washington, Its officials,
employees, and agents from any and all claims for damages of
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LEGAL DESCRIPTION CHECK
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F 9-E
NO.
PUBLIC RIGHT OF WAY IPER OFFICIAL STREET MAP.
EXISTING-6.P— REQUIRED DEDICATION
PROPOSED,60�_
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
STREET USE PERMIT REQUIRED 0
SEE ENGI EERI G MEMO DATE
�REM s
METER SIZE
BUIL DING SUPPLY SIZE
FIXTURE UNITS
REMARKS
SIGN AREA
ALLOWED PROPOSED
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DATE
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AREA
JOCCUPANCY
GROUP
OCCUPANT
LOAD
REMARKS
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PLAN CHECK FEE
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GRADING/FILL
STATE SURCHARGE
ENERGY CODE
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MEMO TO: Building Division
FROM: ' Engineering Division
SUBJECT: "IllIq I&Ie,
After review of the subject building permit application, we have the
following comments:
1) Connection to City water system req uired.
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) Back water valve required if downstairs plumbing is below
elevation of upstream manhole.
6) Water and sewer lines to be separated by 10 foot minimum.
7) Builder/owner responsible for containing all temporary runoff * and
erosion on site and may not impact neighboring properties in any
way.
8) Construction hours from 7:00 a�m. to 10:00 p.m. on weekdays and
10:00 a.m. to 6:00 i).m. on weekends and holidays.
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R�CEIVED'
CITY of EDIVIODS AUG 241987, Sf E
For Inspection Call 771-3202
PUBLIC WORKS
I "I-).
Address of Construction:
UJ
�J Property Legal Description (Include all easements)
�Z
Lu - Owner and/or Builder:
S E W E R P E R M I T
Z_
7(: �,I) e
PERMIT NO. 07760
�- , =�'? e_-
LJJ Contractor & License No:
cc
-7
,70_3(?S—
Single Family Residence
EDMONDS
Mul ti-Fami I y (No. of Units TM
Commercial (No. of fixture Units =TREATMENIT -PLANT
Invasion into City Right -of -Way: No Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No z Yes (If Yes, easement required,
attach legal description and county easement number.)
co
C)
(A
cr_
PtEASE.REAP, THE ITEM LISTED ON T
S
'I -'certify 'that I 'ave read and 9ha
with the items lAted on the back.
Permit Fee: Y;� oo
T runk Charge: L,
Assessment Fee:
BACK
comply Date
:Issued By: P
IDate Issued: 312 -V 7-
Receipt No.: 7 41'
Partial Inspection:
Comments Date Initial
Final Inspection Approved: -92
Date Initial
Rejected:
Wh-ite Copy - File
el
son
** PERMIT MUST BE POSTED ON JOB SITE **
Green Copy -�Inspector
—Fa t _e Initial
Buff Copy - Applicant &j
1�
t
ra,
The City of Edmonds
Side Sewer Drawing
EASEMENT NO - ------------------------------ ------------
NEW CONSTRUCTION REPAIRS F-1 LID NO - ------------------ ASMT. NO - -------------------
OWNER .. RA.r3 ------ vs-w� -------- �AT� ............. CONTRACTOR _q04- W%--G -------------- -------------------------------------------------- PERMIT NO. 97716-Q
JOB ADDRESS z-ul -------- ;� �% --- 0 ---- - -----
4
q?
lra, ft e-
PWW-0001 -11/75 (REV. 11/78)
LEGAL DESCRIPTION: LOT NO. ---------------------------- BLOCK NO - ------------------------------------
DIP
---------------------------------------------- 77n ------ ---------------------------------------------
NAME OF ADDITION
:Z7 .1
E=DMONDS
TREATMENT PLANT
-Xtu,%v,& cr A, -
Approved:
DATE ------------- By
0
0
IFREET ADDRESS FILE
CITY OF EDMONDS BARBARA FAHEY
MAYOR
7110-210TH ST.S.W. - EDMONDS, WA 98026 - (206) 771-0235 - FAX (206) 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION
t"s t . 18 9 k)
July 22,1997
CERTIFIED FINAL NOTICE ,
PAULHARPER
21117 PIONEER WAY
Edmonds, WA 98020
Subject: Backflow Prevention Assembly Testing - Account #425861
I
On June 2, 1997, you were notified by letter that your backflow prevention
assembly was due for annual testing.
On July 1, 1997, the second notice was sent which stated that you had. 15 days to
take care of this matter. Failure to comply, according to the City of Edmonds
Ordinance Chapter 7.20 and Washington State codes WAC 246-290-490, water
service to your premises will be discontinued if test results are not sent to me
within 20 days from the date of this letter.
Should you have any questions or concerns, please contact me at 771-0235,
extension 644.
Sincerely,
Linda McMurphy
Water Quality Control
wordaWwateAfinal
* Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
COPY
CITY OF EDMONDS BARBARA FAHEY
MAYOR
7110-210TH ST.S.W. - EDMONDS, WA 98026 - (206) 771-0235 - FAX (206) 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORK& DIVISION
4C�' S t . I 89\j
June 2, 1997
Paul Harper
21117 Pioneer Wy
Edmonds, WA 98026
Account #425861
SUBJECT: BACKFLOW PREVENTION ASSEMBLY TESTING
Our records show the backflow prevention assembly(s) in your water supply system is due
for annual testing as required by state code WAC 246-290-49d. Please have the testing
performed by a person holding a certificate of competency as a Backflow Assembly Tester,
issued by the state department of social and health services (telephone 1-800-525-2536).
If your assembly(s) fails its test, please have the necessary repairs made. Upon completion
of a satisfactory test, have the certified tester fill out the enclosed test and maintenance
report (see attached form) and return it to this office within thirty days from receipt of this
letter.
Additional information relative to this matter may be obtained by contacting me at 771-
0235, extension 644 between 7:30 AM and 4:30 PM Monday thru Friday.
Sincerely,
Linda McMurphy
Water Quality Control Specialist
Enclosures
BKFL I ST.WPS
* Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
I
0
CITY OF EDMONDS
7110-210TH ST.S.W. - EDMONDS, WA 98026 - (206) 771-0235 - FA� (206) 744-6057
COMM.UNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION
4�'S-913
t. is
July 1, 1997
Paul Harper
21117 Pioneer Wy
Edmonds, WA 98026
Account #425861
SECOND NOTICES
BARBARA FAHEY
MAYOR
A previous letter was mailed to you requiring testing of existing backflow prevention
assembly(s) installed in your water system.
Our records show that to date, the necessary inspection test report has not been received. In
order that such assemblies continue to operate properly in protecting water quality, they must
be tested and serviced when required. Accordingly, you are required to have your assembly(s)
tested within 30 days from the date of the first letter. The tester must complete the enclosed
inspection test report(s) and return them to our office.
If the required test report(s) are not received within 15 days of this letter, water service to the
premises may be discontinued as provided in the city of Edmonds ordinance chapter 7.20 and
WAC 246-290-490.
Additional information relative to this matter may be obtained by contacting me at 771-0235,
extension 644. Please disregard this notice if you have already submitted your test result
form(s).
Sincerely,
7-d-j
Linda McMurphy
Water Quality Control specialist
Enclosures
GKFUND.WPS
e Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
----S-TREET FILE
CITY OF EDMONDS ASSET INFORMATION SHEET
0"NEW
ADDITION
RETIREMENT
ASSET NO
ADDITION TO ASSET NO. -
DESCRIPTION
SERIAL NO.
LOCATION
0
D� , �TN
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
INITIATED BY
DATE
PROJECT NUMBER
PROJECT COMPLETION DATE
COST
APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
CO/DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
9 G.L. E
REFERENCE DATE
e�v� -
VERIFIED By
PROCESSED
BATCH NO.-
k�np INITIA
DEPARTMENT FILE