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21241 PIONEER
OSTREET FILE
r, I T Y Q F F-: 0 Ff A 1-1 1\1 M- -9 HARVC H. HARRISON
MAYOQ
CIVIC.CENTEP EDMONDS, WASHINGTON 98020 - (206) 775-2525
COMMUNITY DEVELOPMENT DEPARTMENT
March 27, 1978
Bob Pantley
936 Maple St.
Edmonds, Wa. 98020
CHANGE OF ADDRESS FOR LOT 9 - SHELL PARK DIV. #2 _
The address of-8827 Shell Place was given to Permit
#770473when it was issued in July of 1977. We find
that the address of-21241 PiQueer-WA-y- would be more
appropriate.
Harry Whitcutt
Building Official
HMW/ae
CC: Utility Billing
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reqllil,cd ---.T)iJ,-'Lca',+.(- on Sito Plw
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BUIL'DING DEPARTMENT
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Applicant Fill
ust- PERIft ifT
U SF
ZONE NUMBER
Z 0 N E
PERMIT APPLICATION
Li nes
Inside Heavy Lines
a vy
B
JOB
JO
ADDRESS
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N A R N�A F 8 1
"GAL LOT
LOT AREA
SUBDIVISION NO.
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F40
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I G AD RESS
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STREET R/W
R
EXISTING STREET R/W FT.
DEFICIENCY THIS PROPERTY
CI
B
ELEPHONE NUMBE 0
COMP. PLA FT.
FT I
1E
REMARKS
1 1-
u
W ADDRESS
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it CITY
01N
ADDRESS
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CITY
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imion of PropertY
EP ONE UM E R
ELEPHONE NUMBER
H N B
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R . EQ'D.
R Q '6* ' " '_'MYES
I&YES
0 N . NUMBER
TELEPHONE N
..P'
CITY LICENSE NU M R
RGR D
0"
UNDERGROUND
U NO E
0 ,
WIRING REQ'D.
W R NG REQ
TYPE CONNECTION
TYPE CONNECTION
SANITARY SEWER
SANITARY SEWER
_ SYSTEM
SEPTIC SYSTEM
SE r,�
APPV'D BY CITY ENG.
A-V D By CITY NG.
REMARKS
BUILD
C
tielow or Attach ur C pies)
WORK R/W PERMIT
0 N
MYES 0 No
iaYES VERIFIED BY
NO
0 YES MI
MN 0 TZ"
Y SIZ
RED
ONO
ADS NO.
2, SIGN Aj::j: ENV. REVIElp'' NO.
S
ALLOWED FCINIP!E�TE XEM
REMARKS
VARIANCE OR:CU
::
PLANNING REVIEW BY
DATE
_
.S
YARDS
/ FRONT oe SIDE 55 REAR
011 7/R.AR
LOT COVERAGE
LOT COVE.'
EW RESIDENTIAL
NON-RESID
ADD
D
DEMOLISH
ALTER EXCAVATE
F� F OR FILL
PRE -MOVE
REPAIR INSP.
GAS
LINE
SIGN
RETAINING
WALL
FENCE
X—FT)
swim
POOL
FIRE ZONE
TYPE OF CONSTRUCTION
L
CODIE
SPECIAL INSPECTOR
REQUIRED
0
0 YES 0 N 0
AREA
OCCUPANCY
'CCUPANC
GROUP
OUP
OCCUPANT
LOAD
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS
cc
-7--7 2-
NUMBER - OF
STORIES
NUMBER OF
DWELLING
UNITS
NATURE ORI� TO BE D QNE,,; C
AB - UTTING STRE TS)
PLAN CHECK
NO.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
VALUATION I FEE
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'I-Tho City of Edmonds
APPLICATION
for
SIDE SEWEit PEwff
NEW CONSTRUCTION 0 REPAIRS
EASEMF,NT NO - --------------------------------------------
LID NO - ------------------ - AShfT. NO - ------------------
OWNER
--- ------------------------- ---------------------------------------------------------------- CONTRACTOR .. cr-- t-,
JOB ADDRESS ----------- ------ ------------- PIERMIT NO.
------------------ LEGAL DESCRIPTION: LOT NO.
-- ----- -------------- BLOCK No . ........ -------
------------------------------------------------------------------------------------------------------------------------------------------------------------------
uj
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I - F:, I
Approved:
1001
DATE ... -1c
It, 2-
---------- -
-11, VIC;,
4
45 Yf�m��
-2
t
EWER PERMIT
SIDE S
CITY OF EDMONDS
WATER_SEWER. DFXAp.TJVMNT
P RMIT
E
construction.
P.
wer inspections BEFORE covering any portion of the
sat., sun., or holiday insPections %
for side Be
Call 115-2525 rs after requat. NO
(inspection will be provided within 24 hOu
.......... - - --------------------------------------------- .......
.......... ..............................
GNWTBU()TION ........ D&
CATI[Ox OF C
DRESS LO ......
.............. ................
............. .......................
AD ....... ..... . .....
---------- . ................
PROPERTY LEGAL DESCIUMON ........................ . .............. ..................
... . ........... ................................................ ...... ........... . .....................................
. .......................... . ....... ......................... ...........
. . ....................... ILDER --------------------------------- 7,
ANIVOR BU ---------------------------------
....... OWNER
.................... - ------------------------------ - --- -------
. ..................................... ............ to the city sanitary sewer
of a side sewer
S NAME & ADDRESS ----------------- t
CONTRACTOR' ._ for repal, and/or connection
--------- . .. . . ..........
ted t ............. ordinanceS-
'��: �-;Ion is gran ------------
ance WitiT—City of Edinonds d to construct
1 1, accord- Must be employe
ed side sewer contractor
A itcens
FOLLOWING: b an inspected -
a
property May obtArin, a 1� portion of sewer before it h a city Engineer's office
A—],NTION IS CALLED To THE ermit to construct ewer inside property line.
obtainable from th
The owners of the
NOTE NO- I— �et area. Do not cover any nvasion of Right of -way Permit vers when you get Permit- of 2%. No bends in grade
-wa, I mum grade
side sewer in stre of y requires an I , a governing side sel line; Mini'
Aii work performed in city right nace 11.16.030 and RegulatiOl I
NOTE No, 2— line and 12 inches inside property le for failure due to Irnproper
sin full information regarding Ordi fit property
—Obt
NOTE No. 3 have at least 30 inches coverage Contractors shall be responsib
ver must to original condition. o in
NOTE No. 4-_ToP Of side sev ill be permitted. tied and surface of street restored ewer or its appurtenances except t
shaxper than 'A w et any work on the Mal" 5
rest must be water 5 a permit, or to do
--Trenches in at ear of completion th
ITE No. 5, Ch May develop 'within one Y provided for In
NC work whi any other work than is
—It is unlawful to alter or do ................
NOTE NO. 6 Bert the pipe into the wye. --------------- - -----------------
By------------- -- Date
.........................................
......... BY ---- 00e ......
Date
. . . . . . . . . . . . . .
Date—_7 ............. ------- ...
DISAPPROVED
7 ------------
...... By_ --------------------------
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date-.1/1
APPROVED.... . ...... ...........................
.. .......................
// ----------------------------
. ....... . ..... ....................
Remarks: ...... ................................ ............. For Inspection
............................... st
..... . .......................... trction ppjOR To Reque
....................
4s, ...............
rm Performing C
.................
.. . . ............
signed By owner ot
this permit
CO]
BOTH F rml pies MUST Be ation constrLieted under
certify that the side sewer install
hereby
---Iction) ds.
y of Edmon
n
(owner erning ordinances of the Cit
g Firm
&n. - - .........
with all gov
alled in accordance ....... day Of ----- X_�o -- — --------------- ii�
_4nst Dated --- ------ ---- ====—
ewer other 0
Power
------------------------------------ ---------- — -- — -----------
T Re t For In,11
o que,
on
Water 01 Gas 0, Telephone 0,
Check BEFORE you dig for,
M
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