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C 17 Y o f E DA 0 N OtTREET FILE-,..S I'DE S E.. WER FERMIT
For Inspection Call 771-3202 PERMIT.NO.
Address of Construction:
Property Legal Description (Include all easements):
Owner and/or Builder:
Contractor & License No: 0(� 4q'
Single Family Residence
VIA EDN-110INDS W:IA]Y
V
Multi -Family (No. of Units �E
LTRUNK LINE
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No )6 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 easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
le
I certify that I e read and sha:ll comply DaYe
with the items listed on the back.
Permit Fee: U Issued By:
Trunk Charge: '!Date Issued: Cl -
Assessment Fee: Receipt No.:
Partial Inspection:
Comments
Final Inspection Approved:
Rejected:
Date Initial
- \V-6 nlu�otv tp)o� 04i r-� ec
eason
** PERMIT MUST BE POSTED ON JOB SITE **
ffa—te Initial
Initial
Wh.ite Copy - File
Green Copy - Inspector
Buff Copy - Applicant
71 711�'11:,TM7W
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The City of Edmonds Side Sewer Drawing EASEMENT NO. - ...... ------------- ---------------
NEW CONSTRUCTION REPAIRS F-1 LID NO - ------------------ - ASMT. NO
OWNER ----------------------------------------------------------------------------------------------
CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO.
............ LEGAL DESCRIPTION: LOT NO - ------- ------------ --------------- .. BLOCK NO - ------------------------------------
JOB ADDRESS
PWW-0001-1 1/75 (REV.1 1/78)
NAMEOF ADDITION ----------------------------------------------------------- ........................... ...............................
Approved:
DATEI ...........
'VT
1
... By ------------------------------------------------------------
As Built Sketch
inspeciortsl
Type of Pipe
Test: Ai
Water
Date Job Complete and Accepted —.2 6
NOTICE:
No warranty of accuracy.
The information shown on the attached map(s)
was compiled for use by the City of Edmonds,
its Employees and Consultants. The City of
Edmonds does not warrant the accuracy of
anything set forth on these map(s). Any person
or entity requesting a copy should conduct an
independent inquiry regarding the information
shown on the map(s), including, but not limited
to, the 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 City of Edmonds nor its employees or
officers shall be liable for the information given
on map(s), nor for any one representation
provided based upon said map(s).
LA
CITY OF EDM,O.NDS
USE
ZONE E
ET FILE
CON!-TRUCTION PERMIT APPLICATION
p
J013
ADDRESS -S 110 1 ostcj PL� Lf)
NAME (OR NAME OF BU"NESSI,
LU
0
�> M A
Po�
4417&V
ID NO
MAILING ADDRESS
PUBLIC RIGHT F WAY PER OFFICIAL STREET MAP.
CITY TELEPHONE NUMBER
e57j
A 12< A44
NA
EX 19 REQUIRED DEDICATION
PROPOSED-60,&-4-
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
a:
LU
U-j
STREET USE PERMIT REQUIRED C
ADDRESS
S ENGINEERING MEMO DATED
EE
..jTELEfHC�ENLtIMBER
REMA
T7
ADDRESS
METER SIZE
r77;7G7PPLY SIZE
FIXTURE UNITS
0
cc
z
0
CITY
TELEPHONE NUMBER
REMARKS
ST TE L CENSE NUMBER
AelDe'-, 1-7 1 _b
SIGN AREA
ENV. REVIEW
ADB NO.
PROPOSED
COMPLETE EXEMPT
SHORELINE N
Legal Description of Property - include all easements
(show below or attach four copies)
z
2
T #J#4W -
0
U)
VARIANCE OR CU
PLANNING REVIEW BY
DATE
W
<
YARDS
FRONT SIDE 1/21 REAR
HEIGHT
LOT COVERAGE
z
z
REMARKS
CL
NEW RESIDENTIAL PLUMBING
ADDIALTER COMMERCIAL MECHANICAL
REPAIR RETAINING WALL El SIGN
EXCAVATE FENCE
DEMOLISH OR FILL I x _FT)
CHECKED BY
TYPE OF qp;),STRUCTION
I -��
CODE
tqc� 5
HEIGHT
PRE -MOVE INSPJ swim
E] REMODEL COMPLIANCE INSP. -POOL
SPECIAL INSPECTOR
REQUIRED
AREA
OCCUPANJ,.
GROUP
3
OCCUPANT
LOAD
WOOD STOVE/ [_
INSERT APT.BLDG RENEWAL
0 YES 0 NO
REMARKS
PROGRESS INSPECTIONS PER LIBC 305
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cc
0 (n
7�e_rmcld Tfl!�xtd-py_r _'Pne_G�j (t-&,
NUMBER OF STORIES
NUMBER OF
Uj
2_�
DWELLING
I UNITS
0
-
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
n,_-_�-ech-on I
_T _Rec7 t6red,
Of-
W
AlwAl 1?eS1_401e416e_
VALUATION
FEE
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.
STATE SURCHARGE
Permit Application: 180 Days
ENERGY CODE
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
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m
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successors in 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
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
MEMO TO: Building Division
FROM: Engineering Division.
SUBJECT: 2610 A
(Aj
After review of the subjec.t building permit application, we have the
following comments:
1) Connection to City water system required.
2) Connection to City sa:nitary sewer system required.
3) Right-of-way permit required for any work.on City property.
4) Driveway slope not to exceed 14..
5) Back water valve required if downstairs plumbing is below
elevation of upstream manhole.
6) Water.and sewer lines to be separated by 10 foot minimum.
7) Builder/owner responsibl'e-for containing all temporary runoff and
erosion on site and may pot impact neighboring properties in any
way.
8) Construction hours from :7:00 a.m. to 10:00 p.m. on we�ekdays and
10:00 a.im. to 6:00 p.m. on weekends and holidays.
(VIrula
PLANNING
WrR/SWR
STREET
FNQMG
FIFX-
BUILDING
SnXMZ FAmny/Kn,, PIPLE/Ca4,0CIAL - (Circle One)
SEMACKS CHB= - Planning_
7///////
7/777777/7
MARIANCE/SETRACD( ADJ.-"7
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CONDITIONAL USE PERV=
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ADB REaJIR04= CHE=
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ENVIRONMENTAL F-FAWRES
5
ACCMS SLOPE & W-MCLE ACCESS
111777T'111111111
7777TT17
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117UTT17711RI
DRAINAM PLAN (On Site) 4s,�
//////
/////////
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1111IT-1-11MR-111
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STREET FILE
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LEGAL DESCRIPTION VFIUFICATI ON 62kt:� � -?m 11,
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QUIT CLAIM/DEDICATIONS
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EASEKWr - PUBII(.'/PRMTE st
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CALCULATE SEWER CONNBCTION IF NO LID# 0:12/ 1
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------
PLAT/SUBDIVISICN REQUIREKEMIS
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RIGIn-CF-WAY CONSUUCTION PERMIT REQD
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14
111FIT-111111111
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BOND REQD FOR PUBLIC IMPRDVEI�
//////
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15
SonS CONDITIONS & GROUND
WATER FIELD CHM(ED
I-ITI-17-17TrIT7777777TIT17-111
/////////
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16
TIII-1171-1
TI-1117111
STREET PAVING RM.UIRED
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CURB AND GWIER IMUIRED
18
7MIT111
SIDEWALK REQUIRED
/////////
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T/7777
11-FITI-17-1
CURB CW Foil DRIVEWAY REQD
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MWET NAME SIGN REQD
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MM SIGNING RED
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SIDE SEWER AVAIMBILITY
/////////
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77TFIIIII
EXISTING WPER KUN SIZE
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WATER MMWR SIZE
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25
SEWICE LINE SIZE
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WYDRAW REOUIRED
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CRMS . CONNECTIM I-NSPWPICN REQD
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MTER bMER CHARGE REQD
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FIRE LINE CHARGM REQD - SPRINKLER
31
WREW Cui!
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OPEN D170i EXISTING
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SYSTEM CROSS-SECTION
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TRENCH CROSS-SECTION
STANDARD DRAINAGE PLA14
INFILTRATION SYSTEM
PAGE I OF 2
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DESIGN
Trench Perc
Number Rate
DATA
LF per Imperm Trench
1000 sq.ft. Area Req.
NOTES
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 fron entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floatinq material and
sediment at regular intervals (at least
twice per year).
11 A J
7
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CITY OF EOMONOS
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N,
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SITE PLAN. SCALE: 1.11 =Zo
NOTE: DO NOT USE RUNOFF SPREADER ON SLOPES
OVER 15 PERCENT (WITHOUT SPECIAL DESIGN )
STANDARD DRAINAGE PLAN
DETENTION SYSTEM
PAGE 2 OF 3
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