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21318 93RD PL W
CITY OF EDMONDS
ASSET INFORMATION SHEET
�-ZrNEW ASSET NO.
ADDITION ADDITION TO ASSET NO.
RETIREMENT
DESCRIPTION
Wo-t" Senz "c.:e "-p-
SERIAL NO.
LOCATION 21-11S q3rA
PLa-ce, UJ
DEPT. NO.
* * PURCHASE ORDER NO
PURCHASE ORDER DATE
COST
PROJECT NUMBER WOTS
PROJECT COMPLETION DATE (0
COST
e
B.A.R.S. ACCOUNT NO. 03
ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
kZ/DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE
kvp) INITIAL
DATE
4�&
VERIFIED BY
PROCESSED
BATCH NO.
DEPARTMENT FILE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME QF BUSINESS
4
N A M�S %-- 5' fe� — t-- clru
NUMBER
NAME
. pow-s &W
CITY ZIP ITELEPHONE
Legal Description of Property - include all easements
(show below or attach two copies)
11-07- 1-1/ OkInjoil- /*11114a
Tax Account Parcel No.
.,CX NEW
RESIDENTIAL
PLUMBING
ADDIALTER
COMMERCIAL
MECHANICAL
REPAIR
APT. BLDG.
SIGN
DEMOLISH
REMODEL
EXCAVATE. FILL
OR GRADE
E] CARPORT
GARAGE
FENCE
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swim
ETPOOL
E WOOD STOVE/ RETAINING WALL/
INSERT ROCKERY
RENEWAL
(TYPE.PF USE.BUSINESS OR ACTIVITY) EXPLAIN:
,5f-R-rjd-wq
NUMBER OF STORIES
2—
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
Ft:HMII 0
ZONE NUMBER
joB
ADDRESS
'73rd
SUITE/APT
W-
LEGAL DESCRIPTION C117UBD;310N NO,
LID NO.
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7 Z/ 3-9,3
t -se-
PUBL!C RIGHT OF WAY PER OFFICIAL STREET MA p,
TESCP
APPROVED BY
EXIST NO —41-0— REQUIRED DEDICATION —6�—
PROPOSED
RIGHT OF WAY CONSTHUCIIUN FEHMI I REOUIHEU
0
STREET USE PERMIT REOUIREU 0
Uj
SEE ENGINEERING MEMO DATED
REVIEW BY z
REMARKS
Accillileelt W6
17041k4lb
METER
SjfPLY SIZE
FIXTURE UNITS
IBUILDING
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REMAMS
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SIGN AREA
ENV. REVIEW
ADB NO.
ALLOWED I PROPOSED
COMPLETE a
EXEMPT
I
VARIANCE OR CU PLANNING REVIEW BY ATE
HEIGHT LOT COVERAGE z
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S FRONT SIDE REAR---r z
ETBACKS - FEET
REMARKS
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CHECKED BY
OF CONSTRUCT17N
CODE
HEIGHT
ITYPE
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SPECIAL INSPECTOR
AREA
OCCUPANCY
OCCUPANT
REOUIRED
GROUP
LOAD
n YES C. NO
REMARKS
PROGRESS INSPECTIONS PER UBC 305
MeMez-
A(A 6WA 6 V orAmF
FINAL INSPECTION REQUIRED
VALUATION
PLAN CHECK FEE
BUILDING
PLUMBING
Plan Check No. 111q
MECHANICAL
This Permit covers work to be done on private property ONLY.
rt y0 N L Y
Any construction on the public domain (curbs, sidewelks,
ew k s
I ' -
driveways, marquees, etc.) will require separate permission.
rmiss on.
GRADINGIFILL
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Worh is Started Within 11 80 Days
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"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, Its officials,
employees. and agents from anv and all clairrIs for damacies of
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TO: Permit Coordinator, Building Division
FROM: Dan Smith, Engineering Inspector
ADDRESS
OWNER PLAN CHECK #
After review of the subject building permit application, we have the
following comments:
Construction hours are: WEEKDAYS ........... 7:00 a.m. to 10:00 P.m.
WEEKENDS/HOLIDAYS..10:00 a.m. to 6:00 P.M.
2. A Right -of -Way Construction Permit is required for any work on
City property.
3. Connection to City water system required. Fees paid.
4. -Connection to City sanitary sewer system reqgired; obtain separate
permit. Fees paid.
5. Water and -sewer lines to be separated by lo foot minimum.
6. Driveway must be paved a minimum of 20 feet back from -City
right-of-way; separate permit required.
7. Driveway slope not to exceed 14%.
8. Back water valve required if downstairs plumbing is below
elevation of upstream manhole.
9. Builder/Owner responsible for containing all temporary runoff and
erosion control on site. Construction may not impact neighboring
properties in any way.
10. No burning of construction refuse without approval from Fire Dept.
11. Street to be kept clean of debris, dirt, mud, and construction
materials. Contractor responsible for dust control.
12. Inspection required on drainage system, catch basin installation,
driveways, and sidewalks. A final engineering inspection is
required prior to the building division granting occupancy.
13. Repair or replace all defective existing curb, gutter, and
sidewalk. If intersection is involved, installation of wheelchair
access may be required.
:;k
BLGPER/TXTFORMS
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CITY of EDMOND 1IDE IEWER PERMIT
'STREET FLE -V�
For Inspection Call 771-3202 PERMIT NO, 72'%
Address of Construction: _L�)5)& tA/
Property Legal Description (Include all, easements):
Own
Contractor & License No:
E�;'. ADS
Single Family Residence TREATWI.NT PLAN.T
Multi -Family (No. of Units
Commercial (No. of fixture Units
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
�10 -It
1 tertify that I haVe'read -and shall comply
with the items listed on the back.
APR 3 0 wu '4�3o Yo
P �' 1, Date
L"r?, in 11"Op"KS
n
Permit Fee: �Issued By: 2;� �/_
Trunk Charge: �,Date Issued: V - 36 — 5? 6
Assessment Fee: Receipt No.: Z 2 2 5-3
Partial Inspection:
Comments Date Initial
Final Inspection Approved:
Date —Initijl
Rejected:
White Copy - File
eason Date 7—nitial
** PERMIT MUST BE POSTED ON JOB SITE "
Green Copy - Inspector Buff Copy - Applicant
The City of Edmonds
Side Sewer Drawing
EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS F� LID NO - ------------------ - ASMT. NO - ------------------
OWNER------------------------------------------------------- ---------------------------------------- CONTRACTOR ........ ------------------- PERMIT NO.0.81.7-1.
JOB ADDRESS .. . .... 9,S-' ------ W -------------- LEGAL DESCRIPTION: LOT NO - -------- ----------------------------- BLOCK NO - ------------------------------------
PWW-000 1 - 11/75 (R EV. 11/78)
------------------------------------------------------------------------------- --------------------------------------- .................................
EDMONDS
-TRE-Al"VE --Pj�A-N- T
NAME OF ADDITION ------------------------------- ----------------------------- --------- 9§ Wr 9
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Approved:
............ By --- ----
..... .......... ..... V ----- --------------- - -----------------------
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NOTI. E:
No..Wa r-ra nty-.-o.. -a- ...........
The information sh(:)wn on the attached
'led for u-se by the City Of
map(s) was com ' pi
Edmonds/ Its Empl.oyees and Consultants.
Th,.e City of �Edrn.onds does - not " warrant the
these
accuracy of anything set for.th on
M a P (S"). A n . y person or entity.requesting a
copyshould conduct an independent
orm . ation shown-o
--inquiry regard*ng the infi imIted to,
_tT�e -Map(s), including, but not J
the location of any sewer stub shown. Suc
sewer stubs may or may not e.xist and may
or may not exist at the location shown.
ts
Neitheir the City of Edmon(JA(Sl nori
mp-,-O-yee-s o*r off i-ce-rs -sha-H be 1--iab-lfe for thE
on this map(5), nor for
infor mation g'Ve' Id ed based
any one representation prov
upon said. map(s),
PMIEW KIBERS, INC
I
Lake Oswego, Oregon Redmlond, Washington
t5O3) 620-5244 (206) 883-1 / 00
(800) 444-5814 t8OO) 444-5844
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