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21734 84TH AVE W
2iii 2E EPM2ERS
POLIC WORKS EMINEERING
E"RRAEFT EN TUPIFTILE
N9 2566-
SUSPENSE DATE:
Date: Time: File #
Attadnents
SUBJECT:
REQUESTOR:
NAME: f
ADDRESS.
PHONE:
REQUEST RECEIVED BY:
TELEPHCNE
CONTACT IN OFFIC.---n
OTHER:
RECEIVED BY:
MITF Tn
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ACTION:
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All Concerned Notified
Action Completed/File
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ide, li`�spe tio'ns 1B V, FORE cov��In`g;,an� por.�Idn
alli 17,75-2525: 'for,,,!..-,
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'I ion"-wilb-be providej.,-,�vktl�j�,24-� I -� i - ,
n 6.1 day,inspee ions.
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-Ff4TI6N1 IS ;6AL D:�TO' THE FOLLOWING':
I—The,qowners, oft�the '�ropert�,,.`rna.�-'obt�Lin A, permit;,�o%pn'sti�uc0sewc* inside.property, -line. —A'11cens . ed, SidE
0 r., �-,Se�v�r�(ioni'rabt'6iir�us�2be,�empl6�,ed�i6�66ngtr ct
Aref � area..
-sideheiV6rin, t Do not cover.,.any poftion,of,,sewer befo.re It has been inspected..
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NOTE Vo,�2klh.w rk��erfor dd'lln, city� right-of-way -rC i e -,an I�vasi6n,.ofRlgtit-of-WELy.i�errritt�ob�adilable..ii,6m�th*e* Cl y. ingiln'�.r's
qui�_ S'
_difiancidz 6.030,,,and"Regula�tioiisrgoVerning,sI li,se"
bta!;i,,fu!,11,,,�15irmation�-regaxdirii:';Or ai wers whefi;yoiu'
�NOTU�,No?3--O �'get'perznit:
-sid& s- wer;must n
e rh�4,4' at' 41c�.t`30�i bes:'coverage, at 'iir6perfyj1lind! aijfd--12,, i�ch`e4,1n�i&� proii�rt�, Ijne:`;minimuni gradlel,of.2�),'. .No��bends`,lh,:krkde.1.','
2NOTR No., —Top,of c
`sh&rper,,than '/a will -be permitted��, % -
er",Lsettled,an& suria:6l;.of1'9�reet'iesf6red to lorIgInal'.cohdlti�n'.-1'., ccnfr�a,c,tors %shal bIc;for.1-failure:;du
','NOTk 146!,�6-,—"I'renche's�in�str�et,iiiust.be'.v��Lt I :be-'rlis'ponsi'�'
I .. � I, � . . . � I e �to. inipro�ei,"
work. %vfiichl zriay �cv614- ;�Ith n one' �ear, &f,� I
61
',NIOTBi,Noi t -isunla%�fulhtc�-* other* w�orkth�:Is,,provided, for -in. the �eryilt�;. in,,,
Ar�ork �orv.th6 mafhl,�ewe`r :6r,4 -its: a,
serfthe*�plpe fntp:the�wye.
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DISAPPROVED iia e ... ...... L to . ...... ....... ................... ................. B
Y
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�.APPROVEO 1. 411, .....
W., .. ........ .. . .....................................................................
x ...... By.... ........
S_
Remark
. ............................. ............................... ..... ......................................... .............
............. ... ... . ....................................
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. . . . . . . . . . . . . . . . . . . . . . . . . . . . . ! . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .
Co�ies:�'M'U 9T. �BeT Sikii6d Firm "Per'ibr,
equest�!For; IhsPectibh;!--:,--,
tion, c . o n s
................ the�
.... ........... -7 / I / 1, _V1 :ki�i '�A'dei,4 is'permit.
... .... / ......... hereby., certify that ;sidei'�ewer, installa t
4,
(Owncr*,,oY !Con racting Firm Perf�irrilng' Cpp*str6ction.
l;,,g6ve�ning,rordiri'a,ii6esi,:oi.,fh'6', 'City:�d,'Ed 0 ds..`.-
St-a-lib�d�iiiiac6ordance,Avith-aI hi Il
.... ....... .. .................. .. ......... 49.l;',
4� . ' ' 1
Datedl,-this...-
BEFOkE
W V�
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT EASEMENT No . ..................... ....................
NEW CONSTRUCTION C] REPAIRS E)
c- -c F,1?
ONVNER, .................................................................................... CONTRACTOR ....... ..... ............................................. .............. ............... - PERMIT No.
rl '-3 ------ ------- LEGAL DESCRIPTION: LOT No . ...... ....................................... BLOCK No . ...................... ...................
ADDRESS ..................... .... . ... - - ----------
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NAMEOF ADDITION .........................................................................................................................................
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To
RECEIVED
MAY 3 1974-
I ........................................... By ...... .............................. .......... .
.... ........ ........
APPLICATION
No for
TWe City of EdmondsC'
SIDE SEWER PERMIT EASEMENT NO. _ --------_--_------------- .............
NEW CONSTRUCTION -REPAIRS E LID NO. A��!;;�_ ASMT. NO.:_��
CONTRACTORF_- Ea -'-
OWNER =Af ........ ---- — ------_--------------------- .......................................................... ......................... PERMIT NO.
2X-17f;-4 'EW I _�;T
. ........ BLOCK NO - -------------_---------------
JOB ADDRESS ..................... ---------------------------------------------------------------- LEGAL DESCRIPTION: LOT NO. .>E�—:F7 --- -----
NAMEOF ADDITION ......................... ------ ......................... ............................................................
pproved:
,ATE ....... .
........... By ... .. ..................... ..............
NOTICE:
F -cy=
a
N'o wa r-r a - t
The 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.onds does not * warrant the
accuracy of anything set for.th on these
map(§-). Any person or entity -requesting a
copy should conduct an independent
-ation shown on
inquiry regarding the inform
-map(s), including, but not limited to,
t
the lociation of any sewer stub shown. Such
sewer stubs may or may'not exist and may
or may not exist at the location shown.
�;ty of Edmonds nor its
Neither the %.-,I
emp]-o-yee-s o-r office-rs -shal-1 be l'ila-b-IFe for the
i n
information give' on this map(s), nor for
any one representation provided based
upon . said map(s).
The City of Edmonds Water Service Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION El REPAIRS [yr LID NO . .................. ASMT. NO . ..................
OWNER -CARIG ....... ............................................ CONTRACTOR ............. : ............................... ....................................... PERMIT NO.%0.26.8
..................
JOB ADDRESS .2-3.734 ............ 84"... 4 . . ..............
............... A. ........ LEGAL DESCRIPTION: LOT. NO . ...................................... BLOCK NO . ........... ..... . ..
El
PWW-0001-11/75 (REV. 11/78) DATE B, TFRk';� .... .
0
CITY OF EDMONbs
USE PERMIT
ZONE NUMBER
CONSTRUCTION PERMIT APPLICATION
,B I , SUI�E/APT I
ADDRESS
7 t&-
OWNER NAMEINAME OF BUSINESS
LEGAL DESCRIPTION CHECKI
SUBDIVISION NO. LID
NO.
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MAILING ADDRESS
39
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
TESCP Approved 0
0
CITY Zlp�
TELEPHONENUMBER
RW Permit Required 0
Lb M N <�
EXISTING —REQUIRED DEDICATION —
Inspection
Street Use Permit Req*d 0
Required 0
NAME
Sidewalk Required 0
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
uj
YES 11 NOO
ADDRESS
REMARKS
L)
cc
W
W
CITY ZIF-77FHONE
NUMBER
NAME
cc
ADDRESS
ENGINEERING MEMO DATED REVIEWED BY
0
L)
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cc
CITY ZIP
TELEPHONE NUMBER
FIRE MEMO DATED REVIEWED BY
Z
0
U
Lu
!K
STATE LICENSE NUMBER EXPIRATION DATE
SIGN AREA
PROPOSED
SEPA REVIEW
COMPLETE
ADS NO.
Legal Description of Property - include all easements
SHORELINE 0
1EXEMPT
Z
EXP
VARIANCE OR CU
PLANNING REVIEW BY
DATE
U
SETBACKS — FEET
HEIGHT
L6T COVERAGE
_j
FRONT SIDE REAR
Z
Z
Property
REMAR KS
Tax Account
Parcel No. 0
XPLUMBING
NEW RESIDENTIAL
0
ADDITION COMMERCIAL MECHANICAL
1:1 El APT. BLDG. El
REMODEL SIGN
CHECKED BY
TYPE OF CONSTRUCTION
-
I
CODE
1
OCCUPANT
�GR -P
GRADING FENCE
F-1 El
JYSI-REPAIR CYDS. x _FT)
Az - &
1? /
�ZU
DEMOLISH WOODSTOVE SWIM POOL
El INSERT HOT TUB/SPA
SPECIAL INSPECTOR
AfREA
OCCUPANT
REQUIRED YES
LOAD
1:1 GARAGE RETAINING WALL/
El RENEWAL
REMARKS
C ROCKERY
PROGRESS INSPECTIONS PER UBC 305
Z
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
iE
0
Lu
(0
III- C-0 (n � 17 - 9 (a o e!g
D
NUMBER
NUMBER OF
CRITIC
0
OF
STORIES
DWELLING
UNITS
AREAS
INUMBER
VAO-j*aS40"
DESCRIBE WORK TO BE DONE IATTACH PLOT PLAN)
T%G
FINAL INSPECTION REQUIRED
VALUATION
FEE
PLAN CHECK FEE
BUILDING
HEAT SOURCE:
GLAZING
0
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks
-driveways,- marquees, etc.) will require separate permissio�.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
ENG. INSPECTION FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors I n interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
M
<
whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify, waive or reduce any requirement of any city ordinance
0
I
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
�11
X
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 APPLICATION APPROVAL
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 This application is not a permit until
ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
ion Insurance and RCW 18.27. INSPECTION acknowledged in space provided.
IGNATURE (OWNER OR AGENT) ATE SIGN7D DEPARTMENT
FOFFIqITL:S DATE
.,,SlGp4AT E
2 CITY OF
t
EDMONDS
M— CALLFOR RELEASED BY: DATE
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3. PINK — Owner GOLD — Assessor
102-67