21726 85TH PL W.PDFIIIIIIIIIIII
8101
21726 85TH PL W
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CITY OF EDMONDS
BLDG. DEPT.
CONDITIONAL PERMIT
WORK- AW179W
ADDRESS- 71726g5-OW10Z
OWNER -
APPROVED DATE -
BY
BLDG. OFFICIAJ��
KEEP THESE STAMPED
PLANS ON JOBSITE FOR
ALL INSPECTIONS
PERMIT NO.
SHEE'U
7OF
NOV 14 REM
ZONE /'?S-
SETBACKS:
FRONT
SIDE --
REAR
OTHER
HEIGHT 2,6444
STREET FILE
CITY COPY
--p
'As
NOTICE:
No-warran
T . he -information shown on the attached
map(s) was compiled for use by the City Of
Edmonds', its Employees and Consultants.
Th.e City of �Edm.qnds does not . wa rra nt t, ie
accuracy of anything set for.th on t hese
rnap(�_). Any person or entity -requesting a
copy should conduct an independent
orm-ation shown on
inquiry regarding the inf
ImIted to
m a p (S) / including, but not h
er stub shown, Such
the loc'ation of any sew
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
ice-rs'sha`l be 111a.b..'Fe for the
emplfo-yee-s o-r off' i
i n on this map(s), nor for
information give-.
ovided based
any one representation pr
upon said map(s).
Jk
City of Edinonds
RIGNIT-OF-WAY CONSTRUCTION
PERMIT Permit Number.
m
Issue Date:
A. Address or Vicini' ;Df -Construction: 21726 85 P1 W (9604230)
ty
8 9 0 C� Q) B. Type of Work (be specific): Install Service
C. Contractor: - Wanhington Natural Gar,
Mailing Address: 1122 75 St SW Everett
State License #: 98203
D. Building Permit # (if applicable):
Contact: Mariamne KjAgsbuKy
Phone: 356-7500 X7596
Liability Insurance: Bond:$
Side Sewer Permit # (if applicable):
E. C-] Commercial E] Subdivision El City Project []I Utility (PUD, GTE, WNG, CABLE, WATER)
E] Multi -Family 0 Single Family n Other
INSPECTOR: INSPECTOR: )k;AL'm
F. Pavement or Concrete Cut: 0 Yes OkNo G. Size of Cut: x H. Chargq_$
APPL*ICANT TO READ AND, �46N
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City ofEdmorulgharMle88frOM injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense ofany legalproceedings including defense Costs, and attorney fees by reason ofgranting thispermit.
THE CON TRA C TOR IS RESP ONSIBL E FOR WORKMA NSHIP AND MA TERIA L� _FOAA � fERIOD 0 F ONE- YEA`R1 FOLCO WIWP- THE FINA L
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITYFORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
T�-affic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of thepermit will be
available on site at.all ti r ii;nspectt n purposes.
Signature: Date:
(C' 5� rrac' to r 0- r Ag�n t)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY �USEI ONLY
,APPROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER DAYS DISRUPTION FEE/FUND Ill:
SPECIAL CONDITIONS: IVA_ RESTORATION FEE:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES 0 NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
AWWWIgbnErWWQx"V
Addendum to: City of Edmonds
Right of Way
Permit Application
t"J
Watermain depth I-IIAI
gas main
Submitted by: Mariawne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
SIB COT <:2MJ -
J05 9(.o+Z-3<
21+2-(o �3S 9(
Key: -W- Water
-G- Gas
-SS- Sever
Water hydrant
0 Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
Watermain depth 11-1/14
gas main
Addendum to: Ciq of Edmonds
Right of Way
Permit Application
Submitted by:.Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
I
'ZI COT (:23-w
J C)5 9 0 --3(
+Z(,O �3�5 AOL
Key:
-V- Water
-G- Gas
-SS- Sever
Water hydrant
0 Water valve
Washington Natural Gas Company
1122 75th Street S.W.. Everett, Washington 98203, (206) 355-3331
N a ft OM G a s"M��
AWM-gbon&eWCarMy
Addendum to: City of Edmonds
Right of Way
Permit Application
tIJ
I
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
J 05 9 Gocz --N
21+2Jo SIS PL
Key:
Watermain depth -w- Water
-G- Gas
-SS- Sever
gas main Water hydrant
Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
4 -v.�
PUBLIC WORKS DEPAR� CHEacLisT
BUILDING PM;&aT
miWREU FMP?-6- as PL-W,
(address) tLe*
Street Rig�it-of-Wqy Existing 6�0
/(f6<D QD
Z
Access Easement s Existing
QD
Utility Easement Existing_
REQD
Lot Per Subdivision MMMMMW Plat Assessor
Site Plan Checked for Accuracy_
P LA-N
Z
Underground 14iring Reqd.
N'Aq
Check Accuracy of Legal Description
UM�ArL
Review by
Date 31-Z
Zy_i�sting Water Main Size
Water-Maiu-Required
Service Line Re d
c
Hydrant -Size Exist,
P4
Hyd3�f-Reqd Per Fire Code
Size
Detector Check Meter Reqd.
Cross Connection Inspec�
Fire Department ts
W�a�t�ter Charge Reqd.
Keview by
Date
Septic Tank Design Approved
Date
ank 't Reqd._
tic Tank Permit Reqd.
e p *c T P
Permit No. z<
i , ,
t Sew
San Sewer Availability
7
San r Ava lab 1
Yro
braawm No.
File No.
d Sewe va ab
Side Sewe ilability
I jl jlit
S S ry S r ct..
anitary Sewer ection Fee Reqd.
:3:
j
Review by_
'�te
Open Ditch Existing
Culvert Reqd.
-"'�Indicate
Size
P4
Catch Basin Reqd.
on Site Plan
0
Shoulder dr �e maintain collection on
swale ff
En
Manho�reqd.
Indicate on S lan
;S:*-Conditions and Ground Water Field Checked
Z-
Review by.
Date
Revised: 1vl0-1977
Page 2
Revised: lv 10-1977
g)
C>FF
/Vo ppao�-LE-VVN
STREET. FILE
CITY OF EDMONDS JAN 3 0 1974
Engineering Department FAUds EW. BePL
ACTION REPORT
Date: January 18, 1974
Sketch Yes
on back 0 No
Subject: Driveway not completed from overlay work
Rsth P1 - W
Routing
Initial Da te
1. George Johnson
2. Abe Blandin
3.
4.
5.
6.
7.
Name Mr - Gilgan Person/Group initiating action
Address 21726 - 85th Pl. W.
Telephone No. 778-6430
ACTION
1. Mr. Gilgan stopped in to say that his single drivewaV was dug out
and never finished after the crews came through to put on the
overlay. I assume he was referring tothe driveway apron.
2. Referred to Abe Blandin for action —as this was performed under the
1973 Summer Maintenance Program. He feels that he has been forgotten.
Please call him and advise what action the City intends to take-
'9
&A
kip=
61�
r
I,
'0�r
-tll &4e.. e,,
All concerned noiffied Action Completed
CAF E'DMONDS ENGINEERING DEPOENT ACTION REPORT
Date . Z, STHO"'EFt"I" FILE
Subject
File ;zw./y �
AttacEments Yes
HNo
ROUTING:
Name
Initi-a-T—.
Date
Name
1 InitiaT--Ca—te
5
2
3
7
4
INITIATOR:
ACTION:
Name Phoine
Address j
- C,
av
klop-k- ot-;'t>17—E --5�E�A/7- 7-0
P--or— P—S L-0 d 0 A/—.
1-5. 1-5 9 E�JPJ e - -P
KI. 1/1,/AW 77S I-Zv )Qj o t:/ T-- J?A7-c-� -7-0 Ln��
7-14-1 ZE-7 < P &=
n 7--
All concerned notified
Action Completed, 0
j
APPLICATION
for
1rhe City of Edmonds
SME SEWER PERMIT
EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS E]
L-
OWNER ..... N. M. -M-.L'C-T'CX-A ...... <%=>
........................................................................................................ CONTRACTOR ..... 5ONS' 7
.............. PERMIT No . ......................
ADDRESS .�k!7 P-Co -ru ;=)L. W.
..................................................................................... ..........
All
LEGAL DESCRIPTION: LOT No . .................. 4 ........................ BLOCK No.
NAME OF ADDITION . ..........
..................................................... ...........................
(41 r->WGP,)
-=671
218 -T," S-TFNIIE
1.2;
w
u
ul
00
Jwiaawep, mhawe-�
45.w.
Approved: az
44, 1, za-
4
DATE ... "tow . ..... By ............
NIDS'..-�-- "SIDE �SIEWER` I RIV-,"
CITY'* OF` 1ED11M, 10 PERM
�WW�iT;k�EWEW-
Dt A*,kTMENT.,,'
-PERMIT 42i 7
7
%
qv. ng.iany, p'ortio . n�, -,of, the eonstruction�
(Call" 746-1107"ifor. sjdei',seAr Anspe�ctlons, IBEFI�04E�,p " 6ri
�Ihoursjafte;7, request. -WO, Sat.� :i�u n., lor,hoilday, ffispections.�
'VInspectl6n wlll(,be�
a:t! f,-
ADDRESS�,t'OCAnON,',OF,,CONS-T-RUI OTION ........... ...... . .
........................... ............................................. ...................... ............................................
PROPERTY LEGAL ��DESCRIPTIEON ..............
......................... .................... ................. .................................... ...... ...........................................................
............. ............................ ...................... ................................................... ..........
"...7 ............... ................................. ................ ....... ......... .
].at
ILD . ...........................................................
.................... 'ZO" . .....
......................................... .. I JEM AWD/OR IBU ........
ir ..p
.5s la`11400(1: Afto:
S t V U C ta; C', I
............... ..... .............. .............................
ZOXTRACTPR',�;� I�AWEIXADDRESS: ...............
.............. ..... .... ..
...............
aipary
RernlIssibn4s,grant;6d ............................................................. 191 .......... j4r�rqp -,.,andVoi,conne46t1ow:bfa �ide` seWer ;fo.%he �_'l r,
oc ty'sanitary sewe
��tem��in,a;ccordance,,with-�Cit�..'�6f-,hdmonds�o.rdiiiances.,.,"
7
I ��TENTION- -MiCALLED TOoTH-t�,FOlEOWIN'G,.'�
cCsewer jnslde'�Propeky�!In6�- A' -licensed �Side.,! Sewer 'Conf�_adtor -must be,empjoye . d to 'construct
side:sewerin stre�ttarew.,,-i:�o�:not,cover'�any,,I�orifon,�df-isewer.,.before::it'�hasibeeii�i'ns�eetedt
No.,,I—The -owners of the �property-,rnay,obtalnoa �Permit. jto�.tcbfiUtrU7
NOTE' No�, 2—Allf work �perio,
i-ffied,in,city,,iightof�Way.'reqiiires am -Invksion, �of.,Rjght-of-Way,�-Pe�mit.,,obtainable,f�om -the ICIty Engineer's,�offi��e;
*6 aiid",�!Re' I governin I g;fsi - dei I se ers I '�w I hen you� get, permit' "
NOTE 'No. 3—'Obtain,,full- ln'forniation,,r-�gardfng.,Ordt nance� 11.16:03 gulations.
NOTF� -No. '4—,Tpp,f6fMde -sewer im 4t,ie"t:30'Anches 1coveragei,at 'pralierty'-4ine -;and(
lgset,,have 12,4n hes Inside.tproperty iline; minimunr.,grade 6f`2*%: No �bends dn grade
b
sharper ithan _,permittled.
v,
Trenches An street mtistibe"�watersettled',and�,surface-of,itreet resitored:-Ao 6rIkInaX, c6iidition.'jContractors. Ishallt-'Ilb��'-�ei�ons'lble'�f6r "failure �,due
is-1 . . - . - - , I . -1 - - to timproper
�w.ork,which,,may.ltd.evelop�,,%�ithin �6ne� year �oficornpletibn,.,. i
NOTE,No 41�—It,is-,unlawfuli 46-4i]0W�or �doj dny,,other iKork,,jth!�n, 4s, , qjroyidedt1m:�int.i,X�e� perrnit,,(or�;to,,�d . o! . lany, �vork on. . the�,mair�,.'sewerki*or,,,�ifi,,,�itppurtenances e I x . cept to In"
'seft the,.lJI*pe,,into �the -wye;
y .....
Date:.': .......
MXSAPPRqkl�p �Datei__, .... .. [i, I -
.. ........ ..............
APPROMED— -Matoe ... 0,0. .........
:'777- ....... .................................. 7 .................. .........
............
Aeinarksr,.; ... ................ I .............. ..................... �.7 ............... ............... * ............... ..................................................... ......................................... ........
W
............ .............................. .......... .... .......................... .......................
........... 7: ........... ......... ....................... .. . ....... I ........... ..... ..... ......
�00,.TU,,,P.!etmft.":Copi6s',M,UgT',Be bkn'er,,'6fFirm Peif o*r'm-i'ng C t c ioh.,PRIOR, T(j...Req�iest�-,-.Fo"r',i'ns'-' -Alon`
on-S -ru,.t
pec
...... . ... .
.................... ........ urider- -this permit
iAv
(owner!,
of dontracting tFirm' Perfbrrning,iConstructiow)�
le ;An,faeQor4a. c6,.,withA116zovernin dirfalioe& 6f,Ahe Qtyoifi�Eilmonds�,
.9 Or
N
.... Lt..' 19�
Aa�.-�qf ................ ................... 0.� ...... ............. . . .........
APPLICATION
for
The -City of Edmonds SIDE SEWER PERMIT
EASEMENTNo . ..........................................
NEW CONSTRUCTION REPAIRS 0
OWNER ..... .......... ................................ ... ....... CONTRACTOR ...... #0 ....... 6�-.P
.......... . ............ �- .6 -------------- ...... PERMIT No . ......................
.. ..... )z ti . . . . ................
ADDRESS ........... e ..... Z-7 ... ?e�. ....................................... LEGA-L DESCRIPTION: LOT No . ................. .......................... BL,0HCK No. ..3. 7-2 . .....
NAME OF ADDITION ...... Z. ............ .........
. ...... ... ....
(�n
IN
c�
,4— 2
C�
s--L- P<, &).
Approved:
Z
DATE................................................ By ..................................... .....................