21216 80TH AVE W.PDFV176
21216 80TH AVE W
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(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
-fh-e -map(s), including, 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
emp-1-o-yees or offi(cer-s Shall be liab-,le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS
C1VIC CENTER - WATER -SEWER DEPARTMENT Can PROsPect 6-IL107 when work
Is ready for inspection. (No Ins
tions Saturday, Sunday or holl Pee
SIDE SEWER PERMIT days.) N2 1056
ADDRESS ............... 604 21s
............. t ... A n South
... y4p ... q4p ...... .................................................. ............................................................. .........................
OWNER ........... . John ... W-, .... C.arl -son---, ---- ------------------ CONTRACTOR ..... Alm-er CO
....... ............. Tpj�T�y ........................ I ..............
Perndssion Is granted .............. N�!y ............ 19 .... - 4 for ...................... days, to REPAIR or CONNECT a side sewer
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CAT-TED To THE FOLLOWING:
NOTE No. —The owners of the prope Obtain a permit to construct sewer Inside property line. A licensed Side Sewer Contructor must
be employed to construct sid'e mseawyer in street area. Do not cover any Portion of sewer before It has been inspected.
NOTE No. 2--Obtain full Information regarding Ordinance 11-16-030 and Regulations governing side sewers when you get permit.
NOTE No. 3—Top of side sewer must have at least 30 Inches coverage at property line
No bends in grade sharper than % will be permitted. and 12 Inches Inside Property line; minimum grade Of 2%.
No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors Bhall 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 Is provided for In the permit, or to do any work on the main sewer or its ap-
ilurtenances except to insert the pipe into the wye.
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41
The City of Edmonds
IN
APOLICATION
SEDE SEVVIM PEIUM
OUTSIDE E] INSIDE [] REPAIRS E]
CARD No - --------------
EASEMENT No . .....................
OWNER .......... J ......... K ...... .............
........................................... ..... CONTRACTOR ............. ... ................ c .. vu --------------- PERMIT No.
........ . ........... ........... TREET IJO .. . ......... BLOCK No. ..13 ...................
HOUSE No. ')IVENUE T No. ........... 4id ...... / ......... .....................
NAME ADD . ...... .......................................................................
A0 '4
)- 0 4- 1, 1 � I -
Jo'
APPROVED
. ................
wil
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
/0/ ...... . . . . ................
SEWER WORK ORDER ISSUED .......................................... DATE ..... .. .... ................ By
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 �Eclmonds do -es not warrant the
accuracy of anything set forth on these
map(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
th-e -map(s), including, but not limited to,
th I e 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
emp-l-o-yee-s o-r offic"ers -13ha III be I-ia-b--11-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
any f the construction.)
Call; 775-2525 for side sewer inspections BEFORE covering portion 0
(In I sppction will be provided within 24 hours after requst. ',NO Sat., Sun., or holiday inspections.
Ev
.................
ADDRESS LOCATION OF CONSTRUCTION .............. .. . ......................................
.......................................................................................................
PROPERTY LEGAL DESCRIPTION ............ -----------
.....................................................................................................................................
..... ................ . ........ ................... .......... . .......... . .......... ..............................
.... OWNER AND/OR BUILDER -_-------- ....... ------------------ - -------------------------------------------------------
....... . ...................................................
-TTRA4(7r0WS NAME & DRESS ---------------------------------- - .............................. .............................. . .. . .......................................................
.. . ............ 191.5et� . for repair and/or connection of a side sewer to the city Sanitary sew-
Fission Is granted ............ �. - -
S _hn in accordance with City of Edmonds Ordinanees-
NTION IS CAIJXD TO THE FOLLOWING: must be employed to construct
k_,& perty line. A licensed Side sewer contractor
NOTE No. i—The owners of the property may obtain a permit to construct sewer inside Pro
side sewer in street area. Do not cover any portion of sewer before it has been inspected.
NOTE No� 2—All work performed in city right-of-way requires an Invasion of Right-of-W&Y Permit obtainable from the City Engineer' a office.
NOTE No. 3--Obtain full information regarding ordinance 11.16.030 and Regulations governing side sewers when you ge . t permit -
NOTE No. 4—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. t restored to original condition. Contractors shall be responsible for failure due to improper
NOTE No. 5—Trenches in street must be water settled and surface of stree
work which may develop within one year of completion. ork on the main sewer or its appurtenances except to in -
NOTE No. 6--It is unlawful to alter or. do, any other work than is provided for in the permit, or to do any w
sert the pipe into the wye.
..... Date ............ By -------------_ Date --------------- - ------------------- - By ----------------
DISAPPROVED E] Date --- - ---- .............. BY ------------ ----------
APPROVED A
Date --- - ---- 7AW ---------- By-_�--
..................................
.. . ...................................... . ............... ................
Remarks: ....... . ...... . .......................... . .. ......... . ............................................
z
................................................ ................................... . ............................................. .........
est For Inspection
BOTH Permit Copies ST,#e; Signed By -0�vner of Firm Performing Construction PRIOR To Requ
hereby certify that the side sewer installation constructed under this permit
(Owner of Contracting Firm Perfrrmtng Construction)
installed in accordance with all governing ordinances of the City of Edmonds.
------------------------------------ *-,**--* --------------------
Datedthis ............... . ........... day of ................................................................. 1 1.9 .........
Check BEFORE you dig for: Water E], Gas E], Telephone E], Power [:], Sewer El Other 11
If APPLICATION
The City of Edmonds for EASEMENT NO . ......... - ---------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS jC LID NO - ------------------ - ASMT. NO. (P
OWNER---------------------------------------------------------------- CONTRACTOR - ----------------------------------------------------------------- PERMIT NO.
JOB ADDRESS ------------------------------------------------- -------------- LEGAL DESCRIPTION: LOT NO . ........ / -------------------------- BLOCK NO - ------------------------------------
------------- ................................ .................................................................................................................
— — -----------------
NAME OF ADDITION --------- 0 ........................................... ..................
Ll rY
- ----------
S
�'5aL
t�' 4e--
ved:
DATE............................................ By --------------------------------------------------- j-j75W
APPLICATION
for
Tge City of Edmon.ds EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID NO . .................. ASMT. NO - ------------------
OWNER ------ --------- CONTRACTOR ......... <Z�> ----------------------- ...................... PERMIT NO.
JOB ADDRESS -2-E-2 ............... LEGAL DESCRIPTION: LOT NO - ----------------- N --------------------- BLOCK NO - --------------- -----------------
I
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
Approved:
DATE --- --- Z(;� ....
-------- By -140 ---------------------
'r Y-"" YUY87
STREET FILE
1
7;E:Y;
'01
-----------
STCqffE
PUBLIC WORKS DEPARTMENT, ENGINEERING DIVISION
APPLICATION FOR RIGHT-OF-11AY CONSTRUCTION PFRMIT
THIS PERIMIT MUST BE AVAILA13LE AT THE JOB SITE FOR INSPECTION PUR.POSES
Applicant to Complete Parts A and B
A, Permit to be issued to:
For Work at :(address or vicinity) C;,) -ff
Type of Work to be done: .00
(attach drawing when applicable)
-9�
Time Required Start: Finish: 3 (0
Owner:_/<
Name
Ila * 1 dress
9-0
.City State Zip Telephone Number
Contractor:
Name
'�?03r /11� A-1
Hailing Address
— .. 4e"44,
.City State Zip
T
"- /11/10 - IZ14 -Z,::9 07c;10 CC-)
State License Number
:27-r- 5"0QL c�,
Telephone Number
NO WORK TO BEG114 PRIOR TO PERMIT ISSUANCE
B. INDEMNITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages, or claims of any
kind or description wha*tsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including or not limited -to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one *year following the final inspection and acceptance
of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until
the final street patch is completed, at which time a debit or credit will be
processed for issuance to the applicant.
Work is subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this permit must be available at e job site for inspection
purposes at all times.
Signature: Date:
Owner or Agent
TO BE COMPLETED BY ISSUING AGENCY:
Date Issued:
Permit No. Fee:/,S--
Security Bond:
Time Authorized
A P P R 0 V F D 13
ST�REET FILE
?,UBLIC WORKS DEPARMYM CHEacusT
BUILDING PERMIT REVIEW
Z (address) (&te7
Street Right -of -Way Existing_�����_REQ�_
Z
Access Easeamts Exist
Utility Easement Existi
Lot Per Subdivision Plat
Assessor Mz p
Site Plan Checked for Accuracy
Z
Underground 14iring Reqd.
CA')
H
0
Check Accuracy of Legal Descript ion
4_1--�7
Z
Review by_
'Date nd 2-co -4e)
s sting Water Main Size
ting Wate� in Size-_
R ed
Water in Required
Service Lin- quired
S.
S jz t
Hydrant ize Exist
r4
t
Hydrant Reqd Per Fire Code-
—Size
Detector Check Meter Re
Cross Connec 1 1 ispecti
�F' artment Conuents
C
Water Meter Chargp Reqd.
Review by.
Date
Septic Tank Design Approved
Date
t T P
tic Tank Permit,Reqd..
I an ermit ' Reqd._--
Permit No.
Permit No.
a itc Sew
S Sanit Sewer Availability,
er Availability—
Proj.
Proj.
D
Drawing N
awin 0
File No.
Side Sewer Availa i ity
Sanitary Sewer Connect*o ee Reqd.
:3:
Review by _
Date
Open Ditch Existijml_�
Reqd.
Culvert Re
:_J�
P4
LCatch si�n Reqd.
s
Indicate Site Plan
0
ulder drainage maintain collection on
)p ru
swale open runoff
Manhole reqd.
Indicate on Site Plan
Soil Conditions and Ground Water Field Checked
Review by
Date
Revised: 1vl0-1977
Page 2
Str Reqd.
Curb and Gutter
Sidewalk Reqd.
Curb Cut for Driv
p4 Right-0 struction Permit keqd.-
Reqd. for Public In-proven-ents
Street Naine�Sign Reqd..
Other.signing Reqd.
Pre Permit Site Inspection made on
z
0
�-4 BY: SEWER
WATER
H z S=T.
ENGINEERING
Special Requir . ernents listed in mew to Conmmity Developnp-nt Department,
Building Division
> BY Date—
o All items filled in on Building Permit Application 4--/
94 BY Date
P' Drawixigs Starmed and Notations Made
P4
BY Date
Approved by Public Works Department
Fzvis'ed: 1v 10-1977
'4
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.............. ..
-------------
A Of
E.D,ie_
I
80TH AVE W
CITY OF EDMONDS WATERLINE AS -BUILT
Ss
21216 80TH AVE W
SCALE
HOMEOWNER CONTRACTOR
NOT GIVEN. I NOT GIVEN
RAWN PERMIT
y
11/21/05 _�B 1. ABILA NO,
DATE
2005-1065
NTS
STREET FILE
June 14, 1979
MEMO TO: Building Division
ATTN: Jim Hunter
FROM: Engineering Division
SUBJECT: OFFICE BUILDING AT '21216 80TH AVENUE WEST
This is to notify your office that the office building
structure at the above address has.received Engineering
Division approval in the areas of water service, sewer
hook up and parking configuration.
Please pass the a*ttached plan -on to the applicant.
JLR: j ak
Attachment
Roberts dt.
in dt/ P.W. Dir. Dt.