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BUILDING PERMIT (NEW STRUCTURE): go(
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COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DETERMINATION: E] Conditional Waiver F] Study Required F] Waiver
DRAINAGE PLAN DATED: 1-::�: 7��
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
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PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATEE?:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DST's\Fonns\Street File Checklist.doc
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21127 SHELL VALLEY ROAD
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21127 Shell Volley Road
Edmonds WA 98026 STREET FLE JUN 1 0 '20-10
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DEVELOPMENT SERVICES CT"
('ITY OF EDMONDS
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SIANDARD DRAINAGE PLAN
INFILTRATION SYSTI EM
PACE I OF 2
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date=-4'-4—/66
NOTES
1. Call Engineering Division (771-3V?)
for prebt0fill and final iAspections.
2. Responsibility for operation and
maintenanse of drainage systems on
private property is the responsibility
of the property owner(s). Preventivt
maintenanne consists of preventing
soil and other iaaterials from enttrinb�
trerch during constrvction as well as
after construction. Catc;i basins shottid
J>e cltanL-d of flc3ting material or.-S
sedi:3ent at regular intervals (at least
twice W yatr).
Wa
OF EDMONDS
DATE: rz- r? 17)
HFMO TO: Building Division
CommuniLy Dove'lopmenL Department
FROM; Engineering Division
Public Works Department
SUBJECT: al 17-77 — --:51�1 I
After review of the subject building permit application, we have
the following comments:
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PUBLIC UORKS DEPARTMENT aiE
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EfffiTiEw. 5-01146*101127k,
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'(address) ' -- I " - - (date)
Street Right -of -Way Existir���..._REQD
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Access Easements Existing__pa__2QD -_Z REQD�_
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Utility Easement Existi
Lot Per Subdivision Plat Assessor
Site Plan Checked for Accura
Underground Wiring Reqd.
Check Accuracy of Legal Descriptiomn
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Review by 044,70.0� we Date 2 !7
It
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing _
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Hydrant Reqd Per Fire Code AIIA Size
Detector Check Meter Reqd.
E-4
Cross Connection Inspection
Fire Department Conrnents
Water Meter Charge Reqd._
Review by 12v-e--24 -15Z Date 7-1,,,)-79.
Septic Tank Design Approved Date Aj
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availability &A= S -Proi U 10
Drm,7ing No. jr_S File No. IL -2 :7 SOA
Side Sewer Availability
Sanitary Sewer Connection Fee Reqd. W_cv
:3:
Review by Date --Z/- 74P
Open Ditch Exlips�,* Reqd. 41,.-,r
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Z
Culvert Reqd. _e
,w� :ao Aw
1:4
-
Catch Basin Reqd. 1��,e Indicate on Site Pla�n
0
Shoulder drainage maintain collection on swale open runoff
&A&
E-4
Manhole reqd. Indicate an* Site Plan
Soil Conditions and Ground Water Field Checkedon&- /-V-
Review by, Da
Revised: lvlO-1977
Page 2 00 40 0 1*.'%
Street Paving Reqd. Z",
Curb and Cutter Reqd.,
Sidewalk Reqd.
Curb Cut . for Driveway Re4T
r4 Right -of -Way Construction Permit Reqd.
P Bond Reqd. for Public Inprovements
to Street Name- Sign Reqd.-- XPV
Other Signing Reqd. NAV
P, Pre Pennit Site Inspection mode on
z
C) BY: SE14ER
WATER
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H z STREET
H
ENGINEERING
Special Requireuents listed in mem to Coumnity Development DepartTent,
Building Division
> BY Date
o All items filled in on Building Permit Application
f4 BY Date
P4 Drawings Stanped and Notations Made
P4 BY Date
Approved by Public Works Department
Revised: lv 10-1977
7 , 0:11
(Aly, U;-, Ebl.:�A'W `
0 NUMBER
CONSTnUCTION �&WIT MUCATION
IN 5 1W _1W
NAME (OR NAME OF eUSI TES ADDRESS
&yw, kq— LEGAL DESCRIPTION CIEZ11 I D NO
ZMAILING ADDRESS .0 7_ Awl'
q2- 02,14A
CITY E NENUMBEA PUBLIC RIGHT OF WAY PER OFFICIAL STREtT MAP.
REOU:P-_DDIEDICATIC,,=P9_ ev �5
'67",eZ I?
E ISTING 7'
�NAME 70 7_7k_ hA PxAOPO,3ED_6,V_.
RIGHT OF WAY CONSTRUCTION PERMIT AEOUIRED'hl'�'
JADDRESS STREET USE PERMIT REQUIRED C
SEE ENGINEERIWG MFMO DATED
5 x Z-Ar,
NUMBER
I
easements
,��Iocrnej*� 1ocwm_R,6Wtr2,eP
7ER SIZE BUILDING SUPPLY SIZE
IFIXTURE UNITS
y
SIGN AREA
_E�N_V_o
E V I E
ADEI NO.
ALLCOVED , PROPOSED
COMPL . .
E.PT
VARIANCE OR CU
Y AR
G�rl r
FR 16
REMARKS
RESIDEWAAL
AGOIALTER COMMERCIAL
PLUMBING
MECHANICAL
I
PEPAIR RETAINING WALL
DEMOUSH EXCAVA,,5
OR FILL
SIGN
FENCE
El I x
CHECKED BY IT'
INSP1
=L
S SCIAL INSPECTOR
=C
REM0015L .P.
REOUIRED
L) YES C NO
E] 000 STOVE/
W .�Emr APT.BLDG
El . ENEWAL
REMARKS
1�11i,14L -71
NUMBER OF STORIES
NUMBER OF
DWELL NO
UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
LOT
AREA
JOCCUPANCY
GROUP F3
OCCUPANT
LOAD
l!
Pet
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1!t17jWj
A�', 1,�&__ 30-5-
--7
If
PLAN C!'Z,-,K FEE
P A N
BUILDING
BU 'L D
P M
PLUMBING
L U
H
MECHANICAL
EC
This Permit covers work to be done or. private property ONLY.
GRAD:NGIFILL
A
Any construction on the public durnaln (curbs, Sidewalks,
drivewayq, merquees, etc.) will requi.,e separate permls3lon.
STATE SURCHARGE
ST A TE
[Permit Applicallon: 180 Days
ENaRc
ENERGY CODE
jPermit Limit: 1 Year - Provided Work Is Started Within 180 Days
n*
"Applicant, on behalf of his or her spouse, hoirs, assigns an*
successors in interest, �:gr"'s to indemnify, defend and hold
I harmless the City. of Edmonds. Washington, its officials,
2 employees, and agents from an') and all claims for damages of
n c e
Whatever nature , arising directly or Indirectly from the Issuance
to
o! this pormit. Issuance of this permit shall not be doomed to
11nY
PLAN CHECK DEPOSIT
PLAN I
ce
modify, waive or reduce any requirement of any city ordinance
-
nc.
nor limit in any way the City's all[Iity to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I herety ackn(;Yjlodge that I have read this application; that the
information given I correct; and the, I am the owner. or the duly
ATTENTION
7 authorized agel;t ol the owner. I agree to comp;*y wIth city and
THIS PERMIT
state laws regulating construction; and In doing the work authoriz-
AUTH0912ES
ed themby, no person will be employed In violation of tl�e Labor
ON'.f THE
C Code of the State of Washington rslating to Workman's Compensa.
WORK NOTED
don Insurpncq.
INSPECTION
N TURE Z(OER GE T) JIJAIE SIGNED
P
DE ARTMENT
CITY OF
EDMONDS
771-3202
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GPAN1ED. UBC
CHAPTER 3.
APPLICATION APPROVAL
Thif, . .:';cation is -lot a permit until
signed ay the Building Official or his
Deputy; Rnd fees are paid, and receipt Is
acknowl6dged In space provided.
iG
OFFICIAL'S S: ZNATU DATE
'M
RELEAWR-: ATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
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CITY of E400NO F- E 11 r- DOPIDIDSEWER PERMIT
For Inspection Call 771-S202 PERMIT NO. 07569
J%8p�'�qop
Address of Construction:
Property Legal Description (Include all easements):
EDMONDS
TREATMENT PLANT
Owner and/or Builder: f
I e' �L
Contractor & License No: 1-14 7*2,
Single Family Residence
Mul ti-Family
Commercial
(No. of Units
(No. of fixture Units
STREET FILE
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 Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
a
I certify that I have read and shall comply Date
with the item listed on the back.
'2
Permit Fee: Issued By:
Trunk Charge: 45. CO Date Issued:
Assessment Fee: Receipt No.:
Partial Inspection:
Comments Date Initial
Final Inspection Approved: 9 -23-8(o'
,AAk
Date Initial
Rejected:
Reason Date —Initi-a—1
** PERMIT MUST BE POSTED ON JOB SITE
White Copy - File Green Copy - Inspector Buff Copy - Applicant
Sid Sewer Drawina
The City of Edmonds EASEMENT NO. --- ----------------------------- ......
NEW CONSTRUCTION REPAIRS LID NO - ------------------ - ASMT. NO - -------- ---------
OWNER ------ 140me-s ----------------------------- CONTRACTOR --- L -L-.)-: T Z - ----- B-PC-X,-V.A-0--F - ---------------------- PERMIT NO.
JOB ADDRESS ZI-11-7 ------ S-RSAA�VAI,-LE�:J ------ FAOQC� LEGAL DESCRIPTION: LOT NO. --a ------------ 15-39--az BLOCK NO - ---------- EDJ�WNDS----,
TREATMENT PLANT
.................... ----------------------- ------------------------------------------------------------------------------------------------ ------
NAMEOF ADDITION ------------------------------------------------------------------------ ----------------------------------------------
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4"WSE
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BY
DA
PWW-0001-11/75;;;.11/78) 23z,486. ------ ---- ------------------
0 111$1k
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9
0
The City of Edmonds Water Service Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION 0 REPAIRS (9 LID NO . .................. ASMT. NO . ..................
OWNER .............. LRUR& .... M#s.!5A�A ....... .. . . . ...... CONTRACTOR A=UR1.64-19 ..... ........................... PERMIT NO.,�51.9.0'5.��k
JOB ADDRESS .... ...... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ........... ........................
ALL �'CoPPSR
PWW-0001-11/75(REV.11/78)
A.B.S.
CASr.tmG
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L
Approved:
DATE��..
By..................
15VAELL VALLr---j ;ZOAOD
P�- -7c) - 0 1 -'
AN
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FOR EROSION COMMOL AR ORN
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DEVELOPikNTSERVICE3 C-1 R.
CITY OF EDMONDS
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