21325 93RD PL W.PDFiiiiiiiiiiii
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21325 93RD PL W
PREET FILE
CITY OF EDMONDS SIDE SEWER PERM[T�'",
9 0� 19 PERMIT 0
8 2 Cl
Address of Construction: 2-5; R3
Property Legal Description (Include all easements): D ken4 121 r- 0-(— !L
Owner'and/or Contractor:
State License No. OA 0L_ 41 Building Permit No.
La"Single Family Invasion into City Right -of -Way: trNo El Yes
El Multi -Family (No. of Units-) RW Construction Permit No.
El Commercial Cross other Private Property: ErIN"o E] Yes
11 Public Attach legal description and copy of recorded easement
I cet_fy th/ i have read and shall'c'omply with all city - requirements
as indicated on the back of the Permit Card.
6,_ /I- ?d
Date
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE.ANY EXCAVATION " -
Partial Inspection: Date-Initial-
com,�
Reason Rejected: Date -initial
Final Inspection Approved: Date_7Z-�-_�& lnitialo�,P_
I i
PERMIT MUST BE POSTEP ON JOB SITE
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3.190
The City of Edmonds Side Sewer Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION El REPAIRS F� LID NO . .................. ASMT. NO - ------------------
OWNER-------------------------------------- --------------------------------------------------------- CONTRACTOR ------- -------- — --------------------- PERMIT NO. 011.01(
-D
JOB ADDRESS --------- 9V ----- PL ------- W-.� ............. LEGAL DESCRIPTION: LOT NO - ---------- 7 ------------------------ BLOCK NO - ------------------------------------
PWW-0001-11/75 (REV.11/78)
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
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Approved:
ByDATE.�.�I- ................ -----------------------------------------------------------
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CITY OF EDMONDS STREET FILE ASSET INFORMATION SHEET
NEW ASSET NO
ADDITION ADDITION TO ASSET NO.
RETIREMENT
DESCRIPTION
SERIAL NO.
LOCATION 3
DEPT. NO.
* * PURCHASE ORDER NO,
PURCHASE ORDER DATE
COST
PROJECT NUMBER '7
PROJECT COMPLETION DATE
COST 1'7S-, on
B.A.R.S. ACCOUNT NO. L4 I i COn, n I Ll
ESTIMATED LIFE 2-S'- cars
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE
(tnp INITIAL
DATE
-qvt-.
VERIFIED BY
PROCESSED
BATCH NO
DEPARTMENT FILE
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NOTIC�-
0 T -a- Uk..., U -1..cl "' Y.
No,
The -inform ation'shown on the attached
'led for. use 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
n these
accuracy of anything set for,th o
r entity'requesting a
map(s). Any person a I
copyshould conduct an.independent
1 nf 0 rm'a tion shown-o
inquiry regarding the
tfT�� -map(s), including, but not Jimited to,
-er stub shown. Suc
the location of any sew
sewer stubs may or may not e.xist and may
or may not exist at the location shown,
of Edmbnals nor its
Neitheir the "'I
e m pl- o-y e e-s o -r o ff i -c e -r s -s h. a I. I b e I..I a. b-Ii.-e f c r t. hE
n on this map(s), nor for
information g ve
any one representation provided based
upon'sald map(s).
TO: Permit Coordinator, Building Division . I-tq -qo
FROM: Dan Smith, Engineering Inspector
ADDRESS g 3-a 01 0ez
OWNER A'a // VL—AN CHECK #
After review of the subject building permit application, we have the
following comments:
1. 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 required;. obtain separate'
permit. Fees paid.
5. Water and sewer lines to be separated by 10 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.
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
E
4-A
CITY
NAME
ZIP TELEPHONE NUMB
P-) L.—)
P TELEPHONE NUMBE�
- I I I S-4i 6 — 2.11
ADDRESS
9 2 2 L(
CITY I TELEPHONE NUMBER
q
90LO 676-2yo I
STATE LICENSE NUMBER
Legal Description of Property - include all easements
(show below or attach two copies)
ZONE NUMBER
JOB
ADDRESS n2/3
.EGAL IESCIIP�N CHECKI SUBDIVISION NO. LIU NO,
"et /13
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. zSCP
EXISTING _-AL_ REQUIRED DEDICATION.-&-)-- PPROVED BY
PROPOSED
RIGHT OF WAY CONSTRUCTION PERMIT REQUIREUK,
STREET USE PERMIT REOUIRED 0
SEE ENGINEERING MEMO DATED f R', EW BY
!�y46 _W
oWeWlyle _Z7Z 4V4,�,�
IBUILDINGSYIP . LY SIZE FIXTURE UNITS
SIGN AREA I COMP ENV. REVIEW '
ALLOWED I PROPOSED LETE I EXEMPT
VARIANCE OR CU IPLANNING REVIEW BY I DATE
SETBACKS - FEET
HEIGHT
COVERAGE
FRONT SIDE REAR
ILOT
REMARKS
Tax Account Parcel No.
ErRESIDENTIAL
NEW
PLUMBING
ADDIALTER 0 COMMERCIAL
El
MECHANICAL
APi. BLDG.
El
SIGN
__7
REPAIR
EXCAVATE, FILL
FENCE
CHECKED BY
TYPE OF CONSTRUCTION
COME
HEIGHT
DEMOLISH OR GRADE
I— x _FT)
Men-
A)
1120
CARPORT
SP WO
SPECIAL INSPECTOR
AREA
OCCUPANCY
OCCUPANT
REMODEL GARAGE
01ML
REQUIRED
I'l YES L: NO
GROUP,,e-,3
LOAD
WOOD STOVE/ RETAINING WALL/
RENEWAL
REMARKS
INSERT ROCKERY
Z
PROGRESS INSPECTIONS PER UBC 305
0 (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
OF
nalWl 3;r,5I� OCR_ /f6%646+1e;*rM6y Owk-c-
f)51 NUMBER OF STORIES NUMBER
W DWELLING
NATURE OF WORK TO BE DONE
V 4r
UNITS- — _ -
TTACH PLOT PLAN)
V41 co-�_ FINAL INSPECTION REQUIRED
VALUATION
PLAN CHECK FEE
BUILDING
PLUMBING
Plan Check No.
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewelks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE,
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Wor0s Started Within 186 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
u) successors in interest, agrees to indemnity, defend and hold
harmless the City of Edmonds, Washington, its officials,
2 employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance
PLAN CHECK DEPOSIT
of this permit. Issuance of this permit shall not be deemed to
waive or reduce any requirement of any city ordinance
modify,
0 ability to enforce any ordinance
nor limit in any way the City's
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read.this application; that the
information given is correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction', and In doing the work authoriz-
AUTHORIZES
ed thereby, no person will be employed In violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
n lasurance.
INSPECTION
AT— E S N E;D
DEPARTMENT
;IG
C)
6
CITY OF
EDMONDS
CALL FOR
ATTENTI
INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771-3202
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL
OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-87
APPLICATION APPROVAL
This appli cation is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
OFFICIAL*S SIGNATURE DATE
RELEASED BY:
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
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