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STAKDARD 'DRAINAGE PLAN -
INFILTRATION SYSTEM
PAGE ) 0 2
for
r
location '1142-6 - 25 Y " 47VIJ—
plan by (7.Vtc, /-Coe
phone
date
DESIGN DATA
Trench Perc LF per Imperm Trench
Number Rate 1000 sq.ft. Area Req.
I I. Ill/ -,I Wr31I7%-;&01xx
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals (at least
twice per year).
CITY OF EDMONDS
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CITY OF EDMONDS STREET FILE ASSET INFORMATION SHEET
E9eeN E W ASSET NO.
ADDITION ADDITION TO ASSET NO.
RETIREMENT
DESCRIPTION
c4l
SERIAL NO.
LOCATION DE
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
PROJECT NUMBER &),�5--Z� /,o o
PROJECT COMPLETION DATE
COST log, e,-I-o
B.A.R.S. ACCOUNT NO. -0 LcZ---y44z:5—, 06, el-3
ESTIMATED LIFE Z—
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
dDEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE DATE
ktnp INITIAL
DEPARTMENT FILE
VERIFIED BY
PROCESSED
BATCH NO.-
mmry REVIEW
PROJECT NAMEr PRwEcT.ADDREss: 2110 2 0
nhqw.
PLANNING
Reviewed ini
WTR/SWR j_Sn=,,kENGNRNG
-FIRE
PAMJiY/MMTIP1-E/ One
FUILDING
1///////: 1 /1/ /11 A /11, 40
,,(Circle
SETBACKS CHECKED Planning
VARIANCE/SETRMX AW.
IT177TI7
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111illh I/
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CONDITIONATj."USE PERMIT
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ADB�REQUIREMENTS, CRECM
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ENVIRCNMEWAL'FMTURES
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'DRAINAGE PLAN (On-&te)
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QUIT CLMN/DEDICATICNS
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CAi�iE SEWER CONNECTION IF NO LID#
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REOD 1i PUBLIC IMPROVEMENTS
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BOND
SOILS CONDITIONS &,GROUND
WATER FiErD'cHBcKED
W/W/t
I
STREET PAVING REQUIRED vo
V/1777
CURB AND GUTTER RE)QUIRED
�Vmllw 4�01?
777/77
7777 =.,
SIDEWALK REWIRED
ITRII
1/7 77"7
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%)
CURB CUT -FIOR RE)QD'
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STREET NANE'SIGN REQ
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OTHER SIQM4G ROM-
SIDE SEWE� AVAILABILITY
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EXISTING WATER MAIN SIZ E
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WATER MEVER SIZE
--/r/i x
SftdCE LINE 'SIZE
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HYDRANT SIZE EXISTING
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#73
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BYSINESS) 0.�
�A-k AVL Vj
LTELEPHONE NUh
A F14G-1
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CITY h
NAME
ADDRESS
I CITY TELEPHONE NUMBER
cc
Z
0
L) STATE LICENSE NUMBER CITY LICENSE NUMBER
Legal Description of Property - Include all easements
(show below or attach four copies)
Z
2—
cr
9 -1 3 --3
USE 14WPERMIT
ZONE NUMBER
JOB
ADDRESS 2- Q t4ltl4e
_EGAL DESXRIPTION CHECK SUBDIVISION NO. LID
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING 1112 REQUI RED DEDICATION -
0
Z
RIGHT OF W;Y CONSTRUCTION PERMIT REQUIRED
STREET USE PERMIT REQUIRED 0 Uj
Z
Z
SEE ENGINEERING MEMO DATED
SEE PIW DEPT. REVIEW CHECK LIST DATED
REM�� - Z
7
METER SIZE
REMARKS
SUPPLY SIZE . IFIXTURE UNITS
SIGN AREA ENV. REVIEW
ALLOWED PROPOSED COMPLETE EXEMPT
VARIANCE OR CU
YARDS [LOT
Z' FRONT / AZ SIDE REAR
REMARKS,
I -), n.� 0 W
NEW RESIDENTIAL E] PLUMBING
6M
L_J ADD/ALTER
REPAIR
El DEMOLISH
L_J NON-RESIDENTIAL
RETAINING WALL
1:1 EXCAVATE
OR FILL
PRE -MOVE INSPJ
COMPLIANCE INSP.
L_J MECHANICAL
SIGN
FENCE x _FT)
E (
I
SWO011L
CHECKED BY
TYPE OF CO
1/-/Y
SPECIAL INSPECTOR
REQUIRED
0 YES 0 NO
ARE
SIDE SEWER
WATER LINE
REMARKS
7 14orp/ Zml-
1?V,14AU_ —6-inwe A
NUMBER OF STORIES
NUMBEROF
UWhLLINU
1UN115
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
I 1?e5JevVe1_ I I
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
GRADING/FILL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year- Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
w
02
successors in interest, agrees to indemnify, defend and hold"
harmless the City of Edmonds, Washington, Its officials,
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employees, and agents from any and all claims for damages of
whatever nature, arising directly or Indirectly from the Issuance
of this permit. Issuance of. this permit shall not be deemed to
modify,.waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
r/fIr Chic &Pt
TOTAL AMOUNT DUE
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
state laws regulating construction; and In doing the work authoriz-
ed thereby, no person will be employed In violation of the Labor
THIS PERMIT
AUTHORIZES
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
tiv Insurance..
INSPECTION
S1 RE (OWNER DATE SIGNED
DEPARTMENT
CITY OF
�O/G 3
EDMONDS
771-3202
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL
OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-78 .
CODE
IVIZ
OCCUPANCY
GROUP d,
VALUATION
cc
W
ADB NO.
e-
SHORELINE #
D
:0VER
0.
HEIGHT
OCCUPANT
LOAD
14 Z
.g q 21,6 1 -60,00
APPLICATION APPROVAL
This application 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
0
_j
D
co
ORIGINAL — File YELLOW — Inspector L
PINK — Owner GOLD — Assessor
K�Y� EomoN$. WA
DATE:
MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Publ ic Works Department
SUBJECT: /t)
After review of the subject Build'ing Permit appl ication, we have the following
comments:
1. Connection to City water system required.
2 Connection to City sanitary sewer system reqtiired.
3. Right-of-%qay permit required for any work on City property.
4. Driveway slope not to exceed 14".
5. -Backwater valve required if.downstairs plumbing is below eleVation of
upstream manhoT—e.
6. -Water and sewer lines to be separated by 10 foot minimum.
BO 6/82
STANDARD DRAINAGE PLAN
CAT" ISA.514:
A'Im 0 1 S-1,0 (OR.
WDUAL)
6.
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CAP
SYSTEM CROSS—SECTION
MIRArl =--0.0X
f7 "1".4 1 =L I—r
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TO f5r-- LAYED e
WA15L-:Ef0.F10--K
--rikF-NC" COVER
3/48- 0/2" WASVAED
GPAVEI
4!01AM FESW P
TRENCH CROSS—SECTION
�- fie
INFILTRATION SYSTEM
PAGE 1 0 a
for Zell
location 111,26 - 9 y
plan by (77.t&kc V I-c4e
phone
date
DESIGN DATA
Trench Perc LF per Imperm Trench
Number Rate 1000 sq.ft. Area Req.
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private*property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals (at least
twice per year).
CITY OF EDMONDS
STREET FILE
—mom I 11A 9"IZ 'VISIT OGdWZ 2ftes
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4? CITY of EDIVIOUS
For Inspection Call 771-3202
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Address of Construction:
SIDE SEWER PER_ -MIT
PERMIT NO.
ff,YJA BALLINGER
T :
LIFT STATION
Wes
Property Legal Description (Include all easements): 1107- __�l 1___7_ I
Owner and/or Builder
RECEIVED
NOV 1985
Z-16 BF11011
Contractor & License No: r6,'l-v le -
Single Family Residence >�'
Multi -Family (No. of Units
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No v' 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 easeme'nt number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
1 cert�ry_that_I have read and shall comply Date
with Vie items listed on the back.
Permit Fee: 30� 00 Issued By:
Trunk Charge: 2Y. 00 Date Issued: &5--
AssessmentFee: - Receipt No.:
Partial Inspection:
Comments Date Initial
Final Inspection Approved: 14-4�-gr
Date
Rejected:
eason
** PERMIT MUST BE POSTED ON JOB SITE
Wh.ite Copy File Green Copy - Inspector
Date Initial
Buff Copy - Applicant 4—
NOTICE:
No wa r-ra nty of
The -information 'shown on the attached
map(s) was compiled for use by the City Of
Edmonds/ its Employees and Consultants.
The City of �Edrn.onds does not ' wa rra nt t, ie
accuracy of anything set for.th on these
rnap(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform-ation shown on
-map(s), Including, but not limited to,
t on of any sewer stub shown. Such
the lociati
not exist and may
sewer stubs may or may
or may not exist at the location shown.
Neither the city of Edmonds nor its
empto-yee-s o-r offi-ce.rs shal*l be Via.b-'Fe for the
information given' on this map(s), nor for
tation provided based
any one represen
upon said ma.p(s).
The City of Edmonds
Side Sewer Drawing
EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION 2g REPAIRS F� LID NO - ------------------ ASM7. NO - ------------------
OWNER .... ?,1.6-Zo ----- 84TH ----- PL ..... wss.-r ...... CONTRACTOR .-F0..R'LPSN0 .... NO. .74-1-4--
JOB ADDRESS --S-IG-'VF - ------- R-e-ULSRe.-N- ---------------------- LEGAL DESCRIPTION: LOT NO. 3 ------------- S-71-718-1 BLOCX NO - ------------------------------------
-------------------------- ---------------------------- ................................. .................................. ..
NAME OF ADDITIO� ----- I LIFT STATION
---------------------------------------------------------------------------------------------------
I
SSWER
rc 64Tm AVE.
Lj
2
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?-�G2-0 84"' PL. W.
1-10\
i
2. S'-A
35',/
E22
4'0P
ea"CAMSE
suRFAcrr.
Sol
?Rap. L. P4 F- Approved: 4�*S.S. I
PWW-0001-11/75(REV.11/78) DATE� 16,19§5
*3 F-
11.5'DP.
4p�, Tee
( C WV
-ro 84r" PL.
---- -------- ----
By ......... 14"x --- ---- ---- 11 --------
� 6V, /�
Side Sewer Drawing
The City of Edmonds EASEMENT NO . ..............................................
NEW CONSTRUCTION REPAIRS F� LID NO. ASMT. NO . ...................
OWNER------------------------------------------------- WF-1,Ar-K. ..... ................... - CONTRACTOR ................... ..................................... PERMIT NO . ....................
JOB ADDRESS2-IGZ .... 84"r"..M, ... ---------------------------------- - LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ............ -.-- -------------------
. ...................................................................... - ................................................ Ylk-BALLINGElf,
LIFT. STATION
NAMEOF �DDITIOV ................................................... :: ..............................
-2110p 1-114G
T 84-to PL. 13'
2V it,
ev.%S-r I N C-v
80' 42' V,LpCM9pl%-
tz
PWW-0001-11/75 (REV.11178)
e'a - P.'j - c- -
3.5'DP
rb-MF
Wo,ved-* '7-29-85
T t_
DATE........................................... � By ..........................
411P.
ow, c .0. 1 zirazo 84T14
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