21224 SHELL VALLEY RD.PDFiiiiii iiiiiiii
13061
21224 SHELL
VALLEY RD
0 - 0
TAX ACCOUNT/PARCEL
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: F] Conditional Waiver F] Study Required F] 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 $:
LID
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: /LZ0777-6
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR
WATER METER TAP CARD DATED:
OTHER
LATEMP\DST's\Fomis\Street File Checklist.doc
APPLICATION
The City of Edmonds for EASEMENT NO - -----------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS LID NO . .................. ASMT. NO. � -----------------
OWNER ----- I-AGME:5 ---------------- ------------------- CONTRACTOR ..... EiZ --------------------- PERMIT NO.
JOB ADDRESS ..... 24 -Z-Z-e4 ------- LEGAL DESCRIPTION: LOT NO - ------------ 2-a
------------------------ BLOCK NO . ....................................
is
cc
cn
I
------------------------------------------------------------------------------------------------------------------------------------------------------------------
------------------------------------ .................................................................................
NAME OF ADDITION - A-4 V--- %-- L- r-> %-4 k -:-.I c� r'l # 2
Approved:
DATE.. ------ By
-,-YU!K
rk' WM��' -
'7t
CITY OF EDMONDS SIDE SEWER PERMff
WATzWSi&W= Dxr"TmMNT
so
G_ mmpscuous mrroxx covering any Portion of the coustruallm.
Inspectlop -111 be provided within 24 hours after requst, No W., Sm., or holiday
ftwec".)
AIDDRF-88 LwAnw oFcolvemumoiq ......
PROPmrr LwAL . Dzscan-moN ......... LQt___Ro, 28. Shell Park Divisfrin AA
- ------------- — -------- — .................
... . .. . ............ . ... . ..... . ........ ----OWN= AND/Olt 1RUUM=__..W,9.jAk9_r ... I
..............
CO"RACTOR'S NAM & ADDIMS .... Sol
Permission h granted ---------- Nov=her ... 9 L -- - ------------ 19.76, for repair and/or connection of a awe www to 00 ow sooftry
sr' tM accordance wtth City at Xdmonds ordWaucm
ATTRI'MoN is CAIAaD TO
Nr Vo. I owns" of the PrOPOVILY JrAy obtain a pernift to construct sewer Inside Property line. A licensed Side Sewer Coutnetw a
NX,_ � I
sewer III street are$' DO not *Over ADY Portion of sewer before it has been JappeeW.
-No, 2—An woj* perfornzed In city right-of-w&y requires an Invasion of Right-of-way poewlt obtainable from th C
NOTE NO. 3--Obtalft full Information r#Wding Ordinwee 11.16.030 and Regulations gow"uMS ame "were when r Office.
NOTLr No. 4—`r0j� of side sewer inust ba aq 9-
V* at least 30. Inches coverage at property line a" '12 inches Inside Property I . "Itaftnum grade at I%. No *40" kA,-,
sharper than % win be permitted. I
NOTE�No. Znehegs In street 1AUXt be, water settled Mod surface of street restored to o*UgXW cautitton. Contractoce sh" be yogganopow an"
w ich -&y dove" w"In one ~ of completion. to wootsw
No- 6—It Is unlawful to alter Or 410 any Other Wwk than is PrVvided for in the parlsit; or to do any work on the —,I- 4mm or It*
sert the pipe into the wye. A6 In-
DIS"VED 0, Date .. . ............. ------ Dal
--- - -------
APPROVED
Renvoks:
... . ....................... . .......
All,
BOTH Permit Copies P&V" Be signed;rly Owner of Finn Performing Construction PraoR To ReqAt For Insipectica
... ..... ------- --- hereby certify that thesidesewer installation
(own74 Irm ion) *04LiAracted under this permit
P'erf Co V
WPA installed��cordancewith all ordinances of the City of EdmondiL
Dated thijL ..... . ... .. . ........... 46W of ......
..................................................... .... . .......
V V Check BEFOBE Ye*,Alg for: Water Gas 0, Power 0, Sewer other�' E] q V
.. The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION 2-' REPAIRS 0
4e
OVINIER---------- i -- ----- ---------------------
JOB ADDRESS ........ . —P--/ .... 2.---.2. ... 574je-A .... 0-eltey ---- 6
0
I
EASEMENT NO - --------------------------------------------
LID NO . .................. ASMT. NO - ------------------
-V
CONTRACTOR .......... ............... -------------------------------------- PERMIT NO. -1
LEGAL DESCRIPTION: LOT NO - ------- ................ BLOqK NO . ....................................
..............
............................. I/ ------- ...... div -------- �3 - -----------------------------------------
NAMEOF ADDITION -------- ...................... / I ..................................................................................
-q��
Approved:
uj
U.
uj
uj
CD
IF
DATE
..... By .............
,Vilff
PEPMIT ADDRFSS
Date LEGAL DESCPI111-1�w
BUILDING PER111T REVIEW - ENGINEERING DEPARTMENT CHECK LIST
Instruction:
Check Accuracy of Le(ial Description
Check Against Assessor's Man for Lenal Subdivision
Does it conform to City Approved Subdivision?
Reviewer's
Initials
1. This lot included in Subdivision/rlat No.4
2. Site Inspection made on:
3. Uhat are pround viater and soil conditfons?cgai�;(-�O 20,1e! <e�ILe
4. Site Orainane Checked? ty W
5. Storm Sevier Availabilitv: Sht.=Of rvq. No Project
Roadside Ditch
6. Grading & Final Contours: �V�--Lyn)
7. Septic Tank System Desirin Approved:
8. Sanitary Sevier Availability S h t . of No
Side sevier availability:
9. Sanitary Sevier Connection FeeO
10. Uater Mains A Fire Hydrants (Indic'ate'Size Hain)a
Check Fire Dept.'s Comments
11. Sidewalks: (Site in�pc�tion shows conditions of sidpwalks as follov?s)
12. Curbs: - I t k
grade and width)--T!5
13
18.
19.
20.
21.
22.
23.
C-ur,b Cuts/Drivoways (Cho
�_riveways for safety, location,
Underground Uiring: Street Liqhts:
fht. of nffic
Street Riqht-of-way ?, 1'.ldq. setbacks 4&�)Vt-
ial Street Map.
Existing 11tility'Easements?
Access Easements:
Site Plan checked for, accuracy?
Special Requirements listed in Memo to Bldg. Pept.,��
Commercial & Apt. Renuirempnts form completed?
A A
Drawings stamped F( notations made?
All Items filled in on 131019. Permit Application
Bonds posted for site work?
Right-of-way Invasion Pprmit required?
COMMENTS