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23215 77TH PL W
T
STREET FILE
CITY OF EDMONDS SIDE SEWER PERMIT
8 9 0 9 PERMIT 8412
Address of Construction: Z3Z 15: 72 t� �LALL-
Property Legal Description (Include all easements): -3 (0 r L_ 0 2—
o F- ab ei uO IV) 0 Vb8 3 S q 0 a T-
A k)l c) iie f L—L��
VIA BALLINGER
LIFT STAI CF.IIVF.D
OCT 1 2 1992
PUBLIC WORKS DEPT.
O\Ainer and/or Contractor: 0 r/) E
StateLicenseNo. E3,uilding Permit No.
Single Family Invasion into City Right-of-Way:ANo. 0 Yes
Multi -Family (No.ofUnits-) RW Construction Permit No.
El Commercial Cross other Private Property:
A No 0 Yes
El Public Attach legal description and copy of recorded easement
Z_
I certify that -I have read and shall complyVwith all city requirements Date/,/
as indicated on the back of the Permit Card.
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE USE ONLY
*FOR INSPECTION C'AL PUPLIC WORKS DEPT.
Permit Fee: — _30 00 711 ""1 d B
Tru n k Charge: Date Issued:
Assessment Fee: A) /22 Receipt No.:
Lid No.:
Partial Inspection: Date —Initial
Comments
Reason Rejected:
Final Inspection Approved: Date//), Initial
Date —Initial
**. PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Re�ised 3!90
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), in cluding., but not limited to,
the location of any se : wer 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 liab-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
11
The City of Edmonds
Side Sewer Drawing
EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION Y' REPAIRS F-1 LID NO - ------------------ - ASMT. NO - ------------------
OWNER ------------------------------------------------------------------------------------------------ CONTRACTOR ----------------------------------------- ------------------------------------------ PERMIT NO. L�t ?---
- ------------
JOB ADDRESS --2-3 .. Z-15 --- - ---- T-7 ?( . . ..... LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
-7 -7 r" � (- -
..*- - vAl V�-
I
------------------------------------------------------------------------------------------------------------------------------------------------------------------
NAME OF ADDITION ------------------------------------------------------------------------------------------------------- ...............
4"Pv.c. C-0.
T
31, 341
CIA9 V
Approved:
b - 13 -
PWW-0001-1 1/75 (REV.1 1/78) DATES ......................... ................ Bj� ........ ---------- z� -------
A --
RE ET FILE�
Building Permit
Applicati.on"...Inf ormation
Application% .9.20720BLDG..'-�.:.'*:*:*D'ate.-.-'. -8/12/92"'-. Permit.. -4 P :920720BLDG
Sit,6 -Address..-. 23215 .77th'Pl W�-
Job fiam6. -1elt.',Homes. Unit
Owner -Informa tion.
ATA# 8075 `000 003 00
omes
1 "'; i 11�1" �A
9t 'Ve S'..
Name,', ....... Belt H'
Address........ 917: t a
t
City/'St/zip..�. Edmonds.,.fWA 0
A,-_._W6jrk, �ph6fie 778Z02
Home Phone.... -776--�2829 Vp
1;o
f
fto
.;:! a,
Name ............ Bel
'xt
Address ...... 917 9th�,Ave�:.*-S.�
-city/ St/ z ip:.e-. �:Edmondg 0:21
Contact_.�... lior g
A
76' 282
.t,BELTTE3480
745-6,569
Name .... Des-!Ori�<ConsUltant
Ai'd
9. 50, -0
Addres'sl�
. ........
City/ St/Z.ipr.f'. . "98108""'
Phone... 745 656-9--"`*:'
Contact .......
Engi.
'&,rmation
664kRAnf.;
Al
4,
Name.
Address . . . . . . . ...
City/St/zip. . .
1pho e...
Contact ....... .
w
Heat... 0
atio
New ...... X Add- r
XS_1fi_9'Ie11'fFifiq
Nature of Work.. :New"'.,' Residend
-Vi c6s,tY. SqF,t* ''6S-A2':.1
Building Type' qode'!�
Idin4;,Ar, 6a':
2607'.
Basement ........
Second Story ..... 1451 Third -Story
-Over 3.Stories....- Gariaige; 484
N
Decks .......... Sfiell-
"p,
.Total Uare ootage ....... 4058-
.Building Va ua ion ......... 272,000.96
�q
Building Pe'rth'it F e e 1,111'.35 -1-5
Plan Review Fee ......... $
Total Fee's ............ $ 4--,-�84+r6-a
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PROJECT REVIEW CHECKLISTSTRF.F—T FILE
PROJECT -NAME: vv�EL_-r PLAN CHECK #:
PROJECT ADDRESS:__2 32 L-S- - _27 1`94 A) RECEIPT DATE:
...RE
IEW7_D8Y:-(lnitiaI/Date)
PLAN.
WATER
FIRE
BLDG.
SEWER
STREEY'.
ENg....'
SetbacksNariance/Setback Adjustment
A
Conditional Use Permit
ADB Requirements
Other Zoning Requirements
4
Underground Wiring Required
5.-
Lot Slope IS%
SEPA Environmental Checklist/Hydraulics Permit
Tree Cutting Plan
Plat/Subdivision Requ rements
Legal Description Verification
........ ---------- -
Quit Claim/Street Dedications
Easements - Public/Private
.... .... u.,
12
Engineering Storm Drain Review Fee
. . . . . . . . . .
Engineering 2.2 Inspection Fee
. . .
Drainage Plan (On -Site)
Setback - Top of Bank, Stream, Water Courses
...............
. . . . .. . . . . . . . . . .
Setback - Storm Drain Une
Open Ditch - Existing
Culvert Required
9"
Culvert Size
Shoulder Drainage/Shale Open Runoff
Catch Basin Required
221,
Driveway Slope & Vehicle Access
Sidewalk Required
�OA
Curb & Gutter Required
v 26:�
Curb Cut For Driveway Required
Street Paving Required
Right -Of -Way Construction Permit Required
. . . . . . . . . . . . . . . . . . ............. ........... ---------
Street Name Sign Required
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... ............ .
Other Signing Required
M . ....
. . . . . . . . . . . . . . . . . . . ... .. ...........
Bond Required For Public Improvements
31
FEMA Map Check/Water Table
Side Sewer Availability
.. ............. .
Calculate Sewer Connection Fee If No LID #
. . . . . . . . . . . . . . . . . .
4,
Create Street File
Existing Water Main Size
- - - - - - - - - - - - - - - - - - 8"
Water Meter Size
........ ..
V I
. .. ..
F
Service Line Size
Water Meter Charge Required
375.
Hydrant Required
. . . . . . . . . .
. . . . . . . . . . .
.. . .... . kv
46"
Hydrant Size Existing
.
Fire Une Charge Required - Sprinkler
Street Cut
...... .
43
Miscellaneous
44..
Reviewed By:
FIRE
PLANNING
ENGINEERIKE C E I VFffjGLIC WORKS
AUG 1 1992
PUBLIC WORKS DEP�
STREET FILE
.sc,q /- e / it =.ZO I
HEI&M-r cAICS
A -
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6
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J77.
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ro'r*g/-
/ ,,r6 9, J, 4 4ol.
I
5 & 9-"*,
,-.470
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CITY 0+ 70ma N �7 73
S/yo mon I's J+ Coo ff
-BELT— Mome's, /ffd-.- -
9'17 -f-n Aye-, -50 g-"dMeN&j '*/y
'77eo -,geA�
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EIE T F L E
Critical Areas Checklist RECEIVED
Site Information
AUG 1 0 1992
Project Name: -hl-).L Li,!Ll �ee_' 14114A llmd_� Permit Number: PERMIT COUNTER
Site Location: 2JA1_61 Y -7 M 11/ Property Tax Account Number: ?,Q 75 -OCV,
Approximate Site Size (acres or square1eet): 7,Z 'C- 13 0000
Have you filled out a Critical Areas Checklist for a project on this site before? yto_s
General Site Conditions
1. Has the site been cleared or logged? ClepP-ed Date of most recent action:
Soils / Topography
2. In the Snohomish County Soil Survey, what is the mapped soil type(s)?
3. Describe the general site topography. Check all that apply.
-Flat. less than 5 feet elevation change over entire site.
Rolling- slopes on site generally less than 15% (a vertical rise of 10 feet over a
horizontal distance of 66 feet.)
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise
of 10 feet of horizontal distance.)
Steep: grades of greater than 30% present on site.
Comments
HydrologyNegetation
4. Site contains areas of year-round standing water: hyd
.5. Site contains areas of seasonal standing water: -.Approx. Depth:
6. Site is in the floodway floodplain of a water course.
7. Site contains a creek or an area where water flows across the grounds surface? flows
-round?
are year AP —Flows are seasonal?
8. Site is primarily: forested meadow shrubs _; mixed
9. Obvious wetland is present on site:
10. Wetland inventory or map indicates wetland present on site:
11. Critical Areas inventory or map indicates any Critical Area on site:
-------------------------- — -- --For City Use Only
STUDY REQUIRED: Critical areas study is required.
CONDITIONAL WAIVER: Critical areas study not required if specified conditions satisfied.
,,.-�WAIVER: Critical areas study is not required.
N
Determination Number: Reviewer
Planner t Daw
'Rey 3/27192
890 .194-
City of Edmonds
Critical Areas Checklist
The Critical Areas Checklist contained on
this form is to be filled out by anyperson
preparing a Development Permit
Application for the City of Edmonds prior
to his/her submittal of a development permit
to the City.
1lie purpose of the Checklist is to enable
City staff to determine whether any potential
Critical Areas are or may be present on the
subject property. The information needed to
complete the Checklist should be easily
available from observations of the site or
data available at City Hall (Critical Areas
inventories, maps, or soil surveys).
An applicant, or his/her representative, must
fill out the checklist, sign and date it, and
submit it to the City. The City will review -
the checklist, make a precursory site visit,
and make a determination of the subsequent
steps necessary to complete a development
permit application.
With a signed copy of thi's form, the
applicant should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or studies in conjunction with
this Checklist to assist staff in completing
their preliminary assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
6L.r
Name
Title
917 el M fi "'S, �56
Street Address
'67dav #,C/�5, �rp.5 /Y
City, State, ZIP Phone
Si�-nature Date
Applicant Representative:
Narne
Title
Street Address
City, State, ZIP
Signature
Phone
Date
STREET FILE
CITY OF EDMONDS
9 0 . I c,
SIDE SEWER PERMIT
PERMIT - N 0- 8412
Address of Construction: 2.3 7 2 �LhLt�-
Property Legal Descript ion (Include all easements): P
oh,6- L:_:t PJA6 10 IV) 0 V16 2 -S
I f" DL--A�l "A 4) P I L-0- M tj
Owner and/or Contractor:'
State License No. Building Permit No.
,0 Single Family
Multi -Family (No. of Units
Commercial
Public
V�) 0 P
Invasion into City Right-.011-Way:)a No 0 Yes
RW Construction Permit No.
Cross other Private Property:)Q No 0 Yes
Attach legal description and copy of recorded easement
I certify that I have read and shall comply'%ith all city requirements
as indicated on the back of the Permit Card.
_/ 0 /1 �-_ A
Date,/ ,
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION *
01IFFICE:UISE, ONLY
FOR.INSPECTION CAL PUBLIC WORKS DEPT.
7 1-029 1
Permit Fee: Issued By a6
Trunk Charge Date Issued:
Assessment Fee: Receipt No.:- '5e?, QMI�
Lid No.:
Partial Inspection: ..Date -Initial -
Comments
Reason Rejected: Date -Initial
jFinal Inspection Approved: Date -Initial-
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3/90
UZI' lii�'Kqll A
Revised 3/90
SIDE SEWER PERMIT REQUIREMENTS
Side sewer permits.,.shal,l te posted apd:-64-11able to
inspector at time ff-inspectiod. lin�pection &r'1_n`g-_no-_rmal working
only. 0#6 ( 1 ) w o r k i ng, d ay *notice required. Side sewers
�mu'sfbe '16ft un'coverecr unt'i"I"i'nspected. A water test is required.
;,J
2. Wop;e'ft� own6v-s"'can obtain a permit t6 install Ode i6wert -on
-sed side,s.ewqr-:con�.r#ctors Wu,�t be
pr -ate prope..rty. -_�Jcen
;J v.
M—Plbyed to h o -way.
e constr6c"t side sewers in tfie' 6ty rig *'e-'Y "
Invasion into City right-of-way requires a separate permit.
3. The side sewer contractor assumes full re.sponsibility for each
installation for one (1) year.
4. Trenches within City right-of-way must be restored to original
conditions. Streq-�-... re,stor
ation fees.s�ha-lil be p�.id-5' "advance
under a right-of-way �e"r�ft. Con��a_'�ib:r*s' shali 6e'responsible for
right-of-way failure due to poor compartion
5. No down spouts, footing drains or floor drains can be connected to
a side sewer system.
k . X\
6. Pea gra'vel is required for bedding when installing sewer lines
through other than granular soil.
7. Cleanouts' , at property line and at house will have risers installed
to within 12" of surface grade with removable cap.
8. Commercial establishments require a minimum of six inch (6") side
sewer line.
$ i s ��Ors may not be installed closer,tha-'--,th�irty"inch4§ _(-36
to structure.
10. Cleanouts are required at 30"-60" from each plumbing exit line and
at minimum intervals of 100' along sewer line run.
11. Side sewer lines must be laid 0 at a minimum grade of 2% (1.15 0)
and maximum grade of 100% (45
12. No turn in side sewer gre 0 (1/8 ben'd). is -allowed
be Veen cleanout. All 90 turns must be constructed ofa,
45 (1/8 bend) and wye with removable cap for cleanouts.
13. No'cl6anout shall be paved over. If located in pavement, cast
iron lids will be installed.
14. All connections will be of gasketed type. No solvent joints
unless prior approval is granted.