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CITY of E DM ON DS SIDE SEWER PERMIT
For Inspection Call 771-3208TREET FILE PERMIT NO. 07512
Address of Construction: -2 3 � 6 --/- --1611 Aup �AJ-
IA BALLINGER
LIFT STATION
Property Legal Description (Include all easements):
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Owner and/or Builder: 0�*'p r" "
Contractor & License No: bJ rn A ) 1A (3 -'�* _2 W& - 0
Single Family Residence
Multi -Family
Commercial
M
(No. of Units
(No. of fixture Units
Invasion into City Right -of -Way: No ,-' 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 �X' Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
I certify that I have read and shall comply
with the i,tems listed on the back.
Permit Fee: 3a 00
Trunk Charge: 2�5_, 00
Assessment Fee:
Partial Inspection:
Issued By: J767 .
Date Issued: 4M61 Y46
Receipt No.: �-_3& ;z
Comments
Final Inspection Approved:
-4 21
Date Initial
Rejected:
Reason
** PERMIT MUST BE POSTED ON JOB SITE **
Date
6 1)&A 'S.
Initial
Na—te _Tn—itial
White Copy - File Green Copy - Inspector
Buff Copy - Applicant
C/)
The City of Edmonds
Side Sewer Drawing
EASEMENTNO . ............................................
NEW CONSTRUCTION CS REPAIRS [:] LID NO. -1.0.8 .... - -ASMT. NO . ............ : .....
OWNER ...... ...... ...... CONTRACTOR .................................................................................... PERMIT NO. 7-519L-
JOB ADDRESS9-3.(2).0.9 ---------- 7.8. " lt ......... 0 OF
.... .. W LEGAL DESCRIPTION: LOT NO. 3 . ...... ....... BLOCK NO.
/ 2.5
IT
30 1\3 , OP.
T710 2-3W
IPWW-0001-11175 (REV.11/78)
YlA BALLINGER
............................................................................................................................... .... UFT-STATION ---
NAMEOF ADDITIJN .......................................................................................................................
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Approved: G-10-IBG U3 P, N S t.-% % -V-
DATE ......... ............ By,-40'- y . ......
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 ofEdmonds 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 this map(s), nor for
any one representation provided based
upon said map(s).
-�A' 4Y.QF EDMONDS Permit No. Rl= "�';Q �
—MMUNITY SERVICES DEPARTMENT RECEIVED -7—,Q,;,) S I
RIGHT- OF- WAY CONSTRUCTION PERMIT Issue Date
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A. * Owner: C144A(4*-Rs (CA-r,,/) ENG11WJErLRWQctor: .5'a�ary efu'e- 0_4"Ve_�
Name 5_3 3 AfA-IAJ Name J90 13 d)-( 7 11
MailIgg Address Mailing Address
&,6A422&L1_:M s7ict/Ew U14 m!r&
State Zip City State Zip
ST%)'YET FILE -supy-k- cx, 101 Q A 534- 9311--
State License Number Telephone Number
C. * Address or Vicinity of Construction: Z 3 4 17 rd Z-34 af 7 8 7'#4 A ajC w
Type of Work to be Done: /#JS-rA(.L li(a ' " (a 06 CA Mi 1WCccA3C_ 1V
0 W '51 A- C_
D. 0 Work in Connection With: 0 Sub or Plat X Single Family 0 City Projects
0 Commercial El Multifamily 0 Utility
E. 0 Pavement Cut: El Y B'*N' F. 0 Size of Cut: — X
APPLICANT TO READ AND SIGN
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, forseen or unforseen, that may
be made against the City of Edmonds, or any of its departrile I nts or employees, including or not limited to the defense
of any legal proceedings including defense costs, court coga", and"Attor7eLfeq reason of granting this permit.
I - _ �'Ibr
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Estimated restoration fees will be held until the final street patch is mpleted by City forces, at which time a debit or credit will be
processed for issuance to the applicant. �_Jl(o L/
• A 24 hour notice is required for inspection; Please call Engin4i44T-fX01
• Work is to be inspected during progress and at completion.
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS. -
I understand the above and that t i p mit must be available at the job site for inspection purposes at all times.
1.
__7116Y91
S i g n i a t u re�:/' iz' v Date: -
Owner or Contractor
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY: 2TMZ
Time Authorized: Void after / Ye--4-0- days.
Special Conditions: ALA_
PERMIT FEE:
Restoration Fee:
Receipt No.: -
Fund I I I Fee:
Street Cut Dimensions:
RELEASED BYA Date_1__PA_ 91 INSPECTED BY
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
Date
Eng. Div. March 1989
r--
FIELD INSPECTION NOTES
(Fund I I I - Route copy to Street
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1985
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NAME: PRaJECT ADDRESS:
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Reviewed by-.,(initial/date),,,,.:
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PrANNING:
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BUILDINGI
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SING —LE FAMnY/MMTIPLE/CCMMERC1AL'f!-, (Circle, one),,
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SMACKS! CHECKED:-: Planning.
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VARii��/SRMCX:ADJ.--�-
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CONDITIONAL USE PERMIT
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ENVIROMMAI� FE
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DEsCRIPPION VERIFICATION
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WATER FIELD CIfECKED
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STIUMT PAVING REQUIRED
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CURB AND 61MIER REQUIRED
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
USE NWPERMIT.
ZONE 'P< NUMBER
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ADDRESS Z30,qq . 78rH At��- P�
Idnondsi Wa.
EGAL DESCRIPTION CHECKI SUBDIVISFON-NO: ID NO.
17
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NAME (OR NAME OF BUSINESS)
�h. R. Hanson Const.
MAILING ADDRESS
19519 99th Ave S.E.
PUBLIC RIGHT OF WAY PER OFFICIAL- STREET, MAP..
EXISTING �0 REQUIRED DEDICATION
PROPOSEE:�
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CITY TELEPHONE NUMBER
Snohomish, Wa.98290 4,91-1521
NAME
Design Consultants
ADDRESS
903 10th
RIGHT OF WAY CONSTRUCTION PERMIT REQUIREW
STREET USE PERMIT REQUIRED 0
FE
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SEE ENGINEERING MEMO DATED
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CITY
Mukilteo
TELEPHONE NUMBER
745--6569
REMARKS
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NAME
Same
ADDRESS
METER SIZE
BUILDING SUPPLY SIZE
FIXTURE UNITS
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CITY
TELEPHONE NUMBER
REMARKS
STATE LICENSE NUMBER
W1RHAB*246ko
SIGN AREA
ALLOWED i PROPOSED
ENV. REVIEW
COMPLETE EXEMPT
/IDS NO.
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Legal Description of Property - Include all easements
(show below or attach four copies)
SHORELINE#
VARIANCE OR CU
PLANNING REVIEW BY
1 DATEI
0
YARDt5 y4
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FRONT SIDE��
HEIGHT I LOT
74-
COVER4E
57
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REMARKS
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r-x] NEW RESIDENTIAL PLUMBING
ADWALTER COMMERCIAL MECHANICAL
1:1 REPAIR E] RETAINING WALL SIGN
EXCAVATE FENCE
DEMOLISH OR FILL X-FM
PRE -MOVE INSPJ swim
REMODEL COMPLIANCE INSP. POOL
CHECKED BY
TYPE OF CONSTRUCTION
-Y-N
CODE
HEIGHT
zs/
SPECIAL INSPECTOR
REQUIRED
0 YES ONO
AREA
OCCUPANCY
GROUP
OCCUPANT
LOAD
WOOD STOVE/
INSERT APT. BLDG RENEWAL
REMARKS
NUMBER OF STORIES �[NUMBLEJR OF
WEL ING
Tri-Level 'UNITS One
U
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
Construct and build new
VALUATION
FEE
residential house.
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private property 5NLY.
Any construction on the public domain (curbs, sidewalks,
driveways, marquess, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
ENERGY CODE
"Applicant, on behalf of his or her spouse, heirs, assigns anck
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
MEMO TO :
FROM:
SUBJECT:
Building Division
Planning Department
Engineering Division
Pub] ic Works Department
3 C/
LQ--
DATE
'�5--S-Ag
After revie-ei of the subject Building Permit application, we have the -following
coriaments :
1. Connec t ion to C i ty via ter Sys tem requ i red.
2. Connect ion to Ci ty San i tary sewer Sys tem requ i red .
3. P"ght-of-way permit required For any work on City property.
4. Driveway slope not to exceed Idel,
5. Back-.-iater valve required if do-.-instairs plumbing is below elevation ol:
upstream manh—o-Te '
6. Water and se,,.ier lines to be separated by 10 Foot minimum.
— 17 - . /I
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00 6/82
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CATCH VS A,5 I N:
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............................. . ..........
_n C. U W 1E . L CV X-L Tlk r.: . NCjq Ti
4 PEP,F PIP9 C 1kP
-rF- E W/ 4"LONG LEGS
SYSTEM CROSS—SECTION
�A I PAff I
�So 0 X
C OV E R
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G P-AVE L -
--v 01AM
P—=PF PIP1
1-0
TRENCH CROSS-SECTION
A,
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2.
for
We 2. HWHS6 11 e ON
location-2 3 1; 08 Pt.&/
F-Imtj,dt,
plan by C k4Ar k Lor 11, 11 1;
phone L4 0 1- 1 T.2 I
da te LJ-
DESIGN
Trench Perc
Number Rate�000
DATA
LF per
sq.ft.
Imperm Trench
Area Req.
2_EJ
2 A&V
973
NOTES
1. 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 from entering
trench during construction as well Is
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals (at least
twice per year).
CITY OF EEDIVI.
o -3
KI (A VOe 5 ko 0-f p ICA
Fdmolld-rl LOce.
SITE PLAN, SCALE:
DO NOT USE INFILTRATION SYSTEM
LOPEES OVE—m 15 PERCENT (15
RISCE PER 100 FEET HORIZONTA L
-7), 0 '
- - - - - - - - - -
gr I o ; f er p .,Po
wl,fk luyrds
Ll 4. 0
-7 1.0 '
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE 2 OF 2
STREET FILE
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