21821 82ND AVE W.PDF111111111111
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21821 82ND AVE W
NOTICE:
N�o-warrantyof a-1ccuracy.
The information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edm.qnds does not * warrant the
accuracy of anything set for.th on these
map(§-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
tHe 'm a p (s) . including, but not limited to,
th-e location of any sewer stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the c-ity of Edmonds nor its
1-1
ern p4o-yee-s o-r off iCe-rS Sha 11.1 be Il a-b'Fe for the
information given on this map(s), nor for
ion pr 'ded based
any one representat' ovi
upon said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
611/ WATER-SEEWER DEPARTMENT",
PERMIT
Call 775�2525 for side sewer inspections BEFORE covering any portion of the construction.)
Inspection will be Provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.
ADDRESS LOCATION OF
smi5,7 . . . . ... .........................................
PROPERTY LEGAL DESCRIPTION .............. 4"
........... .... . .....
...................... . .......................... ............ ........... ........................................................................ ............... . .................................. . ..... ............................................
OWNER AND/OR BUILDER ...................
..........
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CONTRACTOR'S NAME & ADDRESS .......................
................
...................................
Permission is granted ............ .... ..... .. . ............ . 19ZF�for repair and/or connection of a side sewer to the city sanitary sewer
SYstelin in accordance With City of gdm7o—nds ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—The owners of the Property may obtain a Permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-wav requires an Invasion Of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3--Obtain. full Information regaxding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 Inches inside property line; minimum grade of 2%. No bends in grade
sharper than % will be permitted.
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE) No. 6—It is unlawful to alter or do any other work than Is provided for in the permit, or to do any work on . the main sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVEDE] Date ... . ................................... By ................ Date ........ -- -------- * .... By ................ Date .............. . ................... . By ................
.... BY --- — --- . . ... ............ . .. . ... .......................................................................................
APPROVED Date, -------------------
Remarks: ....... . ...... . .......................... . .. . .......................................................... . ...................................... . ............... ...................................................
. ............................................................ . ............................................................................................................................ . ............................................. .........
BOTH Permit Copies MUST� Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
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... Z,6 .................. .... —.1 .......................................... .... hereby certify that the side sewer installation constructed under this permit
i wner of Contracting Firm Performing Construction)
was installed' n accordance with all governing ordinances of the City of Edmonds.
Datedthis ............................ day of ................................................................. 19 .........
N/ V Check BEMRE you dig for: Water E], Gas E], Telephone [3, Power E], Sewer [], Other E] V V
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'Nothing in this Per"n't approvul process shall be
interpreted Ri allov4ng -or peryn.itting the
illegal,
aintenance of &ny _tly disting * tM
nonconforming or �ip �d, building, st ruc
- - - the scope of the
or gite condition whil IAB.Outfle
Permit application, r�&d
leas of �,Ieth6r such
building structure or'coxidition is--s.h6viOlon the i
I ildipgi, strdeture 4
site plan or drawl---4- SuF,� bui ras
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conjition may be thestib ect cl.
enforcement action,"
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OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROWN CONTROL Ai�0` GRAINAGE
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OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROWN CONTROL Ai�0` GRAINAGE
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Sides -7.9
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)�No r"" RECEIVED
AUG 10 2012
DEVELOPMENT SERVIOES CTR.
APPROVED BY PLANNING C11Y OF EDMONDS
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a i REET FILE I
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PERMIT COUNTER
RE E—T FILE
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USLE PERMIT
U I L D I k G DEPARTM NT Applicant Fill ZON Nr.
E 780374
N Inside HeItyy Lines
PERMIT APPLICATIO7 ADDRESS r)
17AME (OR NAME OF U%jSZNESSj cp
SUBDIVISION NO. PLAT NAME ASSFSSO�. MAP NO.
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MAILI— ADDRE55
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PUBLIC RIGHT OF WAY 111-11 I�RUINANCE NO.
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EXISTING WAY
RIGHT OF
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P170POSCO RIGHT OF WAY
DEFICIENCY OF RIGHT OF WAY_
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ADDRESS STRFE'./U7ILITY WORK REQUIRED Dyes jF'N 0
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PER-11T FOR WORK IN PUBLIC R/W 0 Yes 6. 0
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CITY NE NUMBER UNI�IrRGROUNO WIRING REQUIRED OYES DNO
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ITC4EIN
CONNECTION TO SANITARY SEWER =YES 0.0
SEPTIC TAN K PER":T RE.Uln.. L�YES
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SEPTIC TANK PERM T NO.
ADDRESS
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SCII MEMO DATED
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CITY T LE —ONE NUMUCR REMARKS
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STATE LICENSE NUMBER CITY LICENSC NUNIBER CIKED,
IUILE
Legal Description of Property (Show Below or Attach FOUr Copies) ME C )INo SUWLY SIZE
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SIGN AREA U !'NV. RE%A)EW AOB NO
ALLOWED PROPOSED COMPLET.: EXEMPT
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VARIANCE OR CU JDATF
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L;,A,& FIRE ZONE 11"11TID" HIII T
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'ALIEJC I IT111
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IAL St.- -3 C) IM A)(
R.T. I Nl�r- SPIECUIA4eltNSPECTOR '�EA Ncy OCCUWANT
DEMOLISH IR GROUP LOAD
WALL. REQ 17
ALTER E] EXCAVATE E] FENCE 0 YES - t IOCCO'A
0 IS 3' I-
0 R FILL PT) P IN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
REPAIR PR. -..VC '0 j3PL- H OU LO BE CODED 31.04.
INSP. EIS 0&
1EMARKS
NUMBER OF STORIES _11"81ER OF
UWELLING L-OT D aR --71zi) -174
NITS
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MATURE OF WORK TO Be DOME
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PLAN CHECK FEE FEE
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PROPOSED U 1E
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PLOT PLAN (iNCICATE EMILOING SETBACKS.
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ABUTTIN-, STREETS) numl—C. 39 1 3 1
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PLUMBING
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I her by acknowledge fl-t I hav, rcad this appliciti,T, that the ;n- TOTAL AMOUNT DUE
'y
formation given is correct; and that I am the owner, or the dil 1%, author-
" hc "
ized agent of thc owner. I agree to comply with city and state laws r"u- PTTENTION APPLICATION APPROVAL
lating construction; and in doing the v.-ork auth(irizv.,,' thereby. ::o person
Icy
will be c hiployed in violation of the Labor Cod, f -IwSlaie of Washin,�t-i TIIIS I'L—IT Thi, applicatt�,.i i� it( :I pernlit
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relating' Workmen's Compen ion lasur lice.
"o,k "t AUTHORIZES Mild Sil! Official or
,Tlt!d by iho li;;i1rib,
it
NOTE: Permit Limit One Yearwxcepi DI.-MULI I 10"'� .1,! 1.11 1 ONLY THE hi� Depilly; An;: te", .,Ill. -Ind
PERMITS withokil conditional Ilse I)ertni;. which '11311 1-V ,I ,I-, 'WORK NOTED fc,cIpt iS I)h
dayi; MOVED-i.,: BUILDINGS shall be completed in �ix nionths.)
vided.
jll��XA URE (OWNER OR AGENT 0 Tr SIGNED INSPECTION
ID bEPARTMENr DIRECTOR'S SIGNAT
4,/
1-2 31-�L' CITY OF
EDMONDS DAIC 4
Th'3 Permit covem'work to he done on private Property ONLY.
775-2525
Any construction on the public domain (curbs, sidewalks, driveways, 7-40-7f
marquees, "tc.) will require sopariste permission .
ATTENTION ORIGINAL - FiII! YELLO
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE PINK - O—.j GOLD
UNTIL A FINAL INSPECTION HAS 13EEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS CEEN GRANTED. UBC 304. :,M.
780374
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CITY OF EbMONDS
P. W.'DEPT. E,Nldf�E-:RI�G DIvo ri 1,
EXAMIN.ED
BY i- :DATE-j- Fk' E
REMARKS
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VVIP�00V-11 ulk: JUL 0 2 1990
PERMIT COUNTER
ST E--E-T FILE
APPLICATION
it for
The, City of Edmonds SIDE SEWER PERMIT EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS 0 LID NO . .................. . ASMT. NO . ..................
OWNER ---- r--XZ-�-I:�� ........ CONTRACTOR --- ....... NO.
JOB ADDRESS ----------- LEGAL DESCRIPTION: LOT NO . ........... -------------------- BLOCK NO . ....................................
---------------------------------------------------------------- .................................................................................................
NAME OF ADDITION ��tF= ............... �. =- ...... �- ......... .....
.................................
Approved:
D A T E - ---------------- � By
&15� -----------
I
APPUCATION
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMff
NEW CONSTRUCTION REPAIRS E] LID NO - ----------- ------ - ASMT. NO - ------------------
OWNER -------- 4 - ----- ------ --------- CONTRACTOR --ff-ot.h ------- -------------------- PERMIT NO.(:;�O'
JOB ADDRESS ------- -- — ----- ------ --------------------
77 ................ LEGAL DESCRIPTION: LOT NO - ------ --------------------- ..... BLOCK NO -- ----------------
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NAME OF ADDITION ------- P.O. & Pk-4 - Q, S. A -------
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STREET FILE
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TARTMaTr CHECOST
PUBLIC 14ORKS Dr
Date �
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arREET-
Street Right -of -Way Existing
REQD
Access Easements Existing
REQD
Utility Easement Existing
REQD
Lot per Subdivision Plat
Assessor Map
Site Plan Checked for Accuracy.. 2�
i
Underground Wiring Reqd.
Check Accuracy of Legal -Description
Environmentally Sensitive*Area.
Environmental Checklist Reqd.
Flood Hazard Zone
Shoreline Management Area
Slope, Soil, Vegetation
Stream, Creek, Drainage Basin
Existing Zoning Per Code
Amenities Design Board Approval Reqd.
ADB # Approval
Board of Adjustment Ap roval Reqd.
Review By: Date:
-7
-Existing Water Main Size
Water Main Reqd.
Service Line Reqd.
Hydrant Size Existing
Hydrant Reqd. Per Fire de
'e de
Size
Detector Check Meter Req
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Cross Connection Inspecti
Fire Department Camients
Water Meter Charge Reqd
Review by: Date:
beptic 'i-arik Lx-,sign Approveci - Va te:
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Ava' abili Proi.
Drawing No. File: No.
14-C
Side Sewer Availabili
W Sanitary Sewer Connec
Review By:
Reqd.
Date:
ass
AIL AK JL M mr mwr
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Open Ditch Eydsting.......Reqd.
Culvert Reqd. Size
C4 Catch Basin Reqd. Indicate on Site Plan
0 Shoulder drainage mimLaill coll ti n a swale open runoff
0
�(Xs
diolL
N Indicate on Site Plan
cu rcqd.
Soil Conditions and Grow.id 1-14ter Field Checked
Rex�ic-.,7 by Date
Street Paving Read.
Curb and Cutter Reqd.
all, Rcqd.
Sidew,
Curb Cut for Drive�,ay qd4.
r4 Right -of -Way Construct' n Pe R
Bond Reqd. for Public Irrp n
Str et Nam, Sign Reqd.
Other Si
_piing Read._
Pre Permit Site Inspection rvide on
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BY: SE1-.1ER
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W [0 WATER
STREET
ENIGINT-ERING
Special Requirc-,:,.�-,nLs listed in mom to Comamicy Developnicnt Departrwnt,
Building Division
BY
Da te
o All items filled in on Building Perndt Application
P� 13Y Date
Drawings Stamped amnd tations I -tide
fit BY Dae
Approved by Public 'Porks DepartrKm:
Rc'vj..';C(I: IV 10-1977
FILE
STREET
9
DATE: Ca 1e28 / 74A
MD1O TO: Building Division
Community Development Department
FROM: Engineering Division
Public Works Department
SUBJECT: -A2N 0 A34S W
After review of the subject building permit application, we have
the following comments:
0
(1) Coordination of the location of any structure with respect to
utilities, streets, property lines and dr!Veway grades is tF—e
reUonsibility of the contractor.
(2) The contractor is required to keep the abutting streets clean-
ed of dirt and debris caused by the construction.
_(3) A "Right -of -Way, Construction Permit"'is required, from the
Engineering Division of Public Works, for any work within
the Public Right -of -Way or public easement.
_(4) Driveway slope not to exceed 1.4%.
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BUILDING PERMIT REVIEW
Street Right -of -Way Existing
on
Access Easements Existing Q nQA& . .. REQD
Utility Easement Existing q)K9— REQD
Lot per.Subdivision =imam Plat __X Assessor
Site Plan Checked for Accuracy (V [1-1
Underground Wiring Reqd.
Check Accuracy of Legal Description
Environmentally Sensitive Area
Envirornental Checklist Reqd.
W
Flood Hazard Zone
Shoreline Management Area MO
Slope, Soil, Vegetation
Strearn, Creek, Drainage Basin
Existing Zoning Per Code
Anienities Design Board Approval Reqd
Board of Adjustment
Review By:
6.
Existing Water Main Size _
M. I
Water Main Reqd. /Va
007,411//
Service Line Reqd.
Hydrant Size Existing
Hydrant Reqd. Per Fire Code
f
Date:
Detector Check Meter Reqd.
Cross Connection Inspection
Fire Department Cannents
Water Meter Charge,Reqd.
Review by: Date:
ADB #
Size
z)epric ianK uesi-gn ikppraveci .10—' ijar-e:
Septic Tank Permit Reqd. Ali Permit No.
Sanitary Sewer Availability Proi.
Drawing No. File No.
Side Sewer Availability
Sanitary Sewer Connection Fee Reqd.
Review By: Ao��� Date:
11ap
0 1. -
A
;� - led -
q)en Ditcl-i Exist,*-ng____&E&_T— Req d. V
Culvert Reqd. Size
J; ee X,, 1,71!!f? /:z
r4 Catch Basin Reqd. �7 Indicate on Site Plan
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0
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S,houlder drainage n-viintain collection on swale open rLmoff
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M '.1-ul-diole reqd. Indicate on Site Plan
s S 2_1 C -iditions and Ground Water Field Cliecked
oil Coi
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"10
TXI te go"
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Street Paving-Reqd.
Curb and Cutter Reqd.
::;ol
Sidewalk Reqd.
Curb. Cut for Driveway Reqd.
/?,Z C
P� Right -of -Way Construction Perndt Reqd.
Bond Reqd. for Public Iuprovermnts
Street Nam Sign Reqd.
Other Signing Reqd.
0 L/
DjPre "Pen -Lit Site Inspection made on
0
�_4 BY: SE1,,1ER
w w WATER
PL4 Act
STREE- T
ENGINEERING
Special Requireii-ents listed in mem to Conminicy Development Deparmpant,
Building Division
BY Da te—,O
o All items filled in on Building Permit Applica�-ion
911-' BY Da t e
Drawings Starmed and Notations Made
BY Date
< ,jApproved by Public Worl-u-, Deparment
I
Revised: Iv 10-1977
1NG PE&IUT MV-1EW
STREET FILr
Address
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Street Right -of -Way Existing 0 /45c): REQD 10
Access Easements Existing REQD
Utility Easement Existing _ Pj%Z PLPM- REQD
Lot per Subdivision -..Ww Plat Assessor Map
Site Plan Checked for Accuracy (0 ( 7,-1 ) -lQb
Underground Wiring Reqa.
Check Accuracy of'Legal Description
Environmentally Sensitive Area
Environmental Checklist Reqd.
Flood Hazard Zone " 0
Shoreline Management Area
Slope, Soil, Vegetation
Stream, Creek, Drainage Basin
Existing Zoning Per Code
Amenities Design Board Approval Reqd
Board of Adjustment Approval Reqd.
Review By: Date:
Existina Water Main Size
ZD
Water Main Reqd.
Service Line Reqd. -SA/
Hydrant Size Existing
Hydrant Reqd. Per Fire Code Size
Detector Check Meter Reqd. Ala
Cross Connection Inspection
Fire Department Camients
Water Meter Charge Reqd.
Review by:
Date: /�, - -�2 7-
ZE
Approval
Septic Tank Design Approved Date:
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availabl� Proj.
Drawing No. File No.
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Side Sc-,.7er Availability
Sanitary Sc-,,7er Connection Fee Reqd.
Review By: Date:
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BUILDING DEPARTMENT'
Applicant Fill
USE PERMIT
ZONE NUMBER
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PERMIT APPLICATION
Inside Heavy Lines
JOB
ADDRESS n
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NAME (OR NAME OF BUSINESS)
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bUBDIVISION
NO.
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PLAT NAME
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ASSESSOR MAP NO.
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MAILING ADDRESS J
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PUBLIC RIGHT OF WAY PER ORDINANCE NO.
EXISTING RIGHT OF WAY 53�D
PROPOSED RIGHT, OF WAY
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TELEPHONE NUMBE
NAME
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DEFICIENCY OF RIGHT OF WAY b
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ADDRESS
STREET/UTILITY WORK REQUIRED DYES ?AN 0
PERMIT FOR WORK IN PUBLIC R/W 0 YES WO
UNDERGROUND WIRING REQUIRED jxYES ONO
CONNECTION TO SANITARY SEWER JWYES NO
SEPTIC TANK PERMIT REQUIRED 0 Y ES *NO
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CITY
TELEPHONE NUMBER
NAME
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SEPTIC TANK PERMIT NO.
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ADDRESS
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SEE MEMO DATED
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CITY
TELEPHONE NUMBER
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REMARKS
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
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Legal Description of Property (Show Below or Attach FOUr Copies)
METER-SrZEU -BUILDING SUPPLY SIZE
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REMARKS
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SIGN AREA
ENV. REVIEW
ADB NO.
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ALLOWED PROPOSED
COMPLETE EXEMPT
REMARKS
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VARIANCE OR CU
PLANNING REVIEW BY
DATE
7�F
YARDS
FRONT REAR
)- SIDE
k /,S
ILOT COVERAGE
GAS
NEW TIAL LINE
ADD I - DENTIAL SIGN
D DEMOLISH RETAINING
DWALL
ALTER EXCAVATE FENCE
OR FILL X—F)
r El
FIRE ZONE
TYPE OF.CONSTRUCTION ICODE
EIG.T
SPECIAL INSPEETOR JAREA
REQUIRED
D YES 0 No
GROUP
I
OCCUPANCY
OCCUPANT
LOAD
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
REPAIR PRE -MOVE swim
El INSP. ET POOL
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS
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W
NUMBER OF STORIES
i�4
INUM13ER OF
DWELLING
UNITS
NATURE �F WORK TO BE DONE
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PLAN CHECK FEE
BUILDING
VALUATION
FEE
PROPOSED USE
I �e_',. J-e Ire -
PLOT PLAN (INDICATE BUILDIr4G SETBACKS,
ABUTTING STREETS)
PLUMBING
MECHANICAL
FENCE
Z
SIGN
RETAINING WALL
0
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SWIMMING POOL