23414 76TH AVE W.PDFlill 11111111
6423
23414 76TH AVE W
1-1/4" P.E. W/
TRACER
GARAGE
-1 () F EDk_
0
N011CI: NO WARRANTY OF ACCURACY The Information shown on the
attache J map was compiled for use by the City of Edmonds, !',� eml !oyees
and co isuqants. The City of Edmonds does not warrant thc'accu NY of
anythir j set forth on the map. Any person or enIfty reaucsiiig i copy
should ;onduct an independent Inquiry regarding tho inforinittionshi v.,,n on
the ma 3, including, but not limited to, the loca�lckn of amy S,0;vri r stub
shown, Such sevier stubs may ol may not cxJ,-t and may or rr:-i nct )j.ct at
the loc lion shown, Neither tho City of Edrnond�i rcr its crnplo� os or
ofticers sha!) be liable for the infermabon civen on this map, nor f'o'r a y oral
121
<I
CITY OF EDMONDS WATERLINE AS -BUILT
A
z::� ADDRESS: PERMIT
Lr� 23414 76TH AVE W NO. 980569
CONTRACTOR1 HOMEOWNER, SCALE:
xxxxxx xxxxx NTS
DATE INSPECTED: INSPECTED BY: DATE DRAWN: DRAWN BY:
08-21-1998 SAIGHLAND 1 07-18-07 J.TRIEU
APPLICATION
,;Mli SE for
The City of dsA.
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS E] BASEMENT No . ..........................................
O'VVN-ER,
.............................. .......... ......... .............. ............... CONTRACTOR ..... t4 ..... 1 --- �, ............. ------- PERI�11T-No.��:!
ADDRESS- 14 — -7c:a;r"' tsNeEt-Au C--=. WqSm-r.
.................. ....... ...... .......... . . ... ............................... LEGAL DESCRIPTION: LOT No. --------------------- ------ BLOCK No.
..........................
NAME OF
lAl
V& # hgB)D-
Vowrmp) 4 %,-.-
2 - c-m V= P)
x'!
I c � r---m P)
F.
IT
7,5
Approved:
DATE B
.......... ..... .. ....... ..................
C bVIC -CENTER —,NV.A-T-Elt-.SENVER,,�,DFPAIRTM-EN.T*
37.!Alo'ns 8*-a,t.ii�*r,(Ia�,,�;skjfl(llty,o,r iiolldnyst)
PER MT
IDE SEWER- M
S.
.$414- 76,
2— ....................... �.b.,.AvOrj
................................... nt, ... ............. ..........................
7 . ......
A
rM
�0 ext _j ......
......................
4�
.......... T ...........
...................... A
............ i'M.%, 70,
corda, Ifee 'witif,app
liettlolljolli
.0,
.'A .'T-EN�l"O'NilS�,CWLLED-'TO'THEIFOLLOWING�,;.
T
NOTE No.; 1,-Th!
o,..cons ruct se y. linc� A, liccnsed�`Side Se%��r,:IC6ntractor 'must'
C' a iohtaln%a� perm
'sewer 41n:'str6et larea., -Dol-not�icoier.iany,portibi;�.6f,,,,se,,i�ef;�l�efo�e'�;i� �has,,been Afispect6dl.
bejcmplo�edi to,iconstruct.,sld'02
btaln, Tulll.1nfor cdAT.'16'.030, and,RegU'&tiOffSLgOVpijN*ni�lsid*dis6kv��s��wh6h�:you,:get-� ermif.4
vo-TE�,No. �;o' mdtion,�r.karMn -(O�r�dinan' p
N TE Wo.. _�a 30
i'lie� nd.,12!�ric6s:�`inslcle,.pr p t mumV grad evof, 12:%d.
0 :T arst, ,inches,4coyerage,,at',property�line,�a
No,beh(ls-'In'lgrad�Ish'ai'p6r'thafi wlll*�be;:Permitted� r .0. er . y14 , ine';! mini
NGTE`1�1.o: watbr., settled, a"nd, fs�rfac6"o restoredc�to,'�'origiiialicdiidition�
4 Trenchesiw:street,�,rnust ibe V�kreet�!.
faIlur6,due-)toAmpr6per work wfiA rna Aevelo' �one.year of. completion.,".,'
-Y P, within
-�fUl p In, the, perrnit,, �or",�tb�do,��n�'��work*i�onl:the�.rh�in-
,NOTE. No., 5—It is1iunIwWfuIAo)- alter or4cclorany, �othe�, wo�ktt�'an r
' ' I . . - s, . * 1 : . " , I" . . '. " , " %
-.tenhnces,.exdept,to �In�sert ithe,bipe, into'.th .,sewer,or,li s,appur
e wye., Y'
Ae
0 CITY OF EDMONDS AS
PUBLIC WORKS DEPARTMENTj ENGINEERING DIVISION
APPLICATIONJOR RIGHT-OF-WAY COINSTRU�TIO,,w . W W�_ FILE
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION,PURPOSES
Applicant to Complete -Parts A and B
A-1 Permit to be issued t o
For Work at:(address or vicinity)
Type of Work to be done: I` .f Z_ e- -1 1,
c;p
(attach drawing when applicable)
Time Required -- Start:
Owner:
Name
A
Mailing Address
5 Z�77--- ,-- I �Q�/ e 5� _5 -5
city State Zip
Contractor: 0,LOS 0/_
Name
P-0 Z-J,) C)
Mailing Address
4k�4,&rzZ'&' er Lo
City State Zip
Finish:
Telephone Number
-21:�-'3 - 0 16 /-- - Q -7- o — 3 / 7
State License Number
? -> F_ _3> /-> ��
Telephone Numbet"
NO WORK TO BEGIN PRIOR TO PER11IT ISSUANCE **
B-, INDEMNITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages, or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including or not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until
the final street patch is completed, at which time a debit or credit will be
processed for issuance to the applicant.
Work is subject to inspection and restoration in accordance with City Code. A
24-hour notice,is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this permit must be available at the job site for inspection
purposes at all times.
S i g n a t u r e D a t e
Owneror_AE�ent L/
TO BE COMPLETED BY ISSUING AGENCY:
Date Issued: Permit No. Fee:
Security Bond:_',::�
Time Authorized: -36 cl�vs
APPROVED B
I r I - I 1 1 " f T, , , . ; - - A ) r -7 V .11 - f - - . - -; " - .7 )
D a t e