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305 FIR PL.PDF11261 305 FIR PL TUWAY MILSSAGE TO FROM enl�:-Ajr L 19 e, SUBJECT: F/ra/ le .3 DATE ,�ee e-)1 oor J- 61 & m E s s -A G .401 E - - — ------- s I G N E R El� fr E p Lv 1 DATE' P CAS SENDERx PETACIi T LLOW LIN HIS PART AND FILE FOR FO SIGNED PRINTED IN U.S.A. CITY OF EDMONDS 0 ASSEAFORMATION SHEET P--- NEW ADDITION RETIREMENT DESCRIPTION LOCATION "PURCHASE ORDER NO. - PURCHASE ORDER DATE COST B.A.R.S. ACCOUNT NO. ESTIMATED LIFE ASSET NO. oc, 947 ADDITION TO ASSET NO. 6% DEPT. NO. p -s-c> *PROJECT NUMBER Z's PROJECT COMPLETION DATE COST -7 INITIATED BY DATE APPROVE6 BY--� "SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY El DEPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT 0 G.L. ENTRY REFERENCE DATE l-a V �ARIFIED BY PROCESSED BATCH NO. INITIAL m DEPARTMENT FILE CITY OF EDMONDS A im NEW FIADDITION RETIREMENT DESCRIPTION () ) 4 I-f) pi, 5 f-Tf2 V . c-ij Z- LOCATION DEPT. NO. /V(K PL.1 C A *PURCHASE ORDER NO. *PROJECT NUMBER c4j 1 1 PURCHASE ORDER DATE PROJECT COMPLETION DATE J 6- COST COST -7/.70 q t7 B.A.R.S. ACCOUNT NO. AM& ESTIMATED LIFE -�,r ASSE&FORMATION SHEET ASSET NO. �t;- :7 ADDITION TO ASSET NO. INITIATED BY DATE APPROVED BY "SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY DEPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT - G.L. ENTRY REFERENCE DATE VERIFIED BY PROCESSED BATCH NO. INITIAL IMP) GITY OF EDMONDS r FOR INSPECTION CALL.. PUBLIC WORKS DEPARTMENT Permit 011 � JI, PUI 775-2525 Ext. 220 Issue Date DE SEWER PERMIT Sil W. AWMWMWMWMWAqVMWAWd b*-PERMIT MUST BE POSTED ON JOB SITE *A 1 . 2. 0 Address 0 S truc Jon Property Legal Description (include all, easements tj 3. Single Family Residence Multi -Family No. of Units Commercial 4. Owner and/or Builder 5. Contractor & License No. 6. Invasion into City Right -of -Way: No Yes (If Yes Right-of- way Construction Permit Required Call Dial Dig (342-5344) before excavation). 7. Cross other private property: Yes No Easement required - attach legal description and county easement number. READ THE FOLLOWING AND SIGN: 44 P4 4 a. Property owners must obtain a permit to install side sewers on >4 their property. A licensed side sewer contractor must be employed to construct side sewers in the public right-of-way. b. The side sewer contractor assumes full reponsibility for each installation for one year. C. Commercial establishment requires a minimum of a six inch (6") a4 :E: side sewer line. 0 d. Side sewers may not be installed closer than thirty inches (30") to any structure. 0 e. Side sewer lines must be laid at a minimum grade. of 2% (1.15 0 and maximum grade of 100% (450). 0 f. No turn in side s8wer greater than 45 (1/8 a] -lord between cleanout. All 90 turns must be constructed 49-KM bend) and Wye with removable cap. Dr-cf%n g. No down spouts, footing drains or floor draFH�X XPqoD to side sewer system. I nn'Gected 1- 800 - 562-6478 h. Pea gravel is required for bedding when installing sewer lines through other than granular s.oil. i. Cleanouts are required at 30"-60" from each plumbing exit line and at minimum intervals of 1001 along sewer 'line run. j. Trenches within City right-of-way must be restored to original conditions. Contractors shall be responsible for right-of-way failure due to poor compaction of fill. k. Side sewer must be left uncovered until inspected and approved by the City. 1. Inspection during normal working hours on1y. Two (2) working days notice required. J�7 , 1114 DATE: certify tha.t'-I have read and shall comply With the above -D BY: PERMIT FEE: DISAPPROVE Date: By: Date: CONNECTION FEE:.-, APPROVED By: Date: :ZT-Fl, 0 PERMIT MUST BE POSTED ON JOB SITE 1! The City of Edmonds Side Sewer Drawing EASEMENT NO . ............................................ NEW CONSTRUCTION El REPAIRS F] LID NO . .................. ASMT. NO . .................. OWNER CONTRACTOR NO. 61�44. JOB ADDRESS --------- 3-0.4�7 ...... c— ............... ................... LEGAL DESCRIPTION: LOT NO . ........ ....................... BLOCK NO . .................................... PWW-0001-11/75 (REV.11/78) .................................................................................................................................................................. NAME OF ADDITION ------ I—A)YA ..... .4nr 3��:r.K ................................................ JEASeeweni- GO T, 8 ' C e9?,P )1-7-- y 4" pvc- ax:s � "!�J- Approved: DATE ........... ------ 12fFlmyl I G) Lr) 1� 0 z z w u 0 n Q t U) z 0 u \e I Lr) -i I a 31 Ln CD 1131 PERMIT SUBMITTED BY oil L a us S Illms a PMES 0 ROAD BORES OVERHEAD LINES lJL UTILITV PO C3 LIG TRENC- T R.O.W. EOP THE FOLLOWING INFO TO 13E PROVIDED RICHT OF WAY LINES,EOP OR FACE OF CURB, EXISTING SIDEWALK, POLES, ROAD CUTS AND THE UTILITY LINbElli" OAD- CUTS ABOVE GROUND FACILITIES.(Ie.-) PEDS.BOXES.CABINETS. ETC..UNDERGROUND TRENCHING AND OVERHEAO LINES. FOOTAGE OF WORK IN R.O.W. BUILDING DIVISIW Applicant Fill 70NEE�. Inside Heavy Lines --PERMIT APPLICATION 7 JOB NA a JOR NAME OF. BUS ESS) ADDRESS 71 7 ' � 71 NNWER t i < , f_1 LEGAL DESCRIPTION SUBDIVIS19N SHORT SUB NO. __'XILING w M ADDRESS /J__ ? cl- z S7 7 44 PUBLIC RIGHT OF WAY PER OFF STREET MAP CITY TftL HONE NUMBER 61 EXISTING A"I 7--gr PROPOSED A4 NAME DEFICIENCY OF RIGHTK WAY U PUBLIC IMPROVEMENTS R 1 0 13Z�A6i t 9 Ell ZZ:4— 6 7Rq DRAINAGE IMPROVEMENT RE DRAINAGE PLAN REQUIRED A 0: CITY TELEPAONE NUMBER 61 4 P­tf�:P� i4 UNDERGROUND WIRING REQUIRED CONNECTION TO SANITARY SEWER NAME SEPTIC TANK PERMIT REQ'D NO. ELEVATION OF PROP ERTY CORNERS El 0 ADDRESS I- U & FOOTINGS REQ'D CITY TELEPHONE NUMBER Z --,)P / SEE ENGINEERING MEMO WE 0 —5 ' 0 fe STATE LICENSE NUMBER CITY LICENSE NUMBER CHECKED BY _j V_ Legal D I escript I ion of Property NShow Below or Attach Four Copies) METER SIZE BUILOI1qG SUPPLY SIZE 0 REMARKS OT SIGN AREA ENV. REVIEW ADD NO. ALLOWED PROPOSED COMPLETE EXEMPT IA a< -SHORELINE W J REMARKS W J VARIANCE OR CU PLANNING REVIEW BY DATE YARDS LOT COVERAGE GAS FRONT SIDE RIE.Rj NEW RESIDENTIAL LINE FIRE ZONE TYPE OF CONSTRUCTION HEIGHT S,r ADD NON-RESIDENTIAL F_� N 1 ICODE SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP OCCUPAI LOAD RETAINING DEMOLISH WALL ALTER EXCAVATE FENCE 0 YES NO I I EJOR FILL I— X—F*T) PLAN CHECKED BY THIS SIT E IS LOCATED IN THE CITY F_j PR I-MIOV E swim OF EDMONDS. LOCAL SALES TAX REPAIR INSP. DPOOL SHOULD BE CODED 31.04. REMARKS z NUMBER OF STORIES NUMBER 0 0 DWELLING I UNITS NPATURE Jbr WORK TO 13E NE Zed) U W PLAN CHECK FEE VALUATION FEE 0 PLOT PLAN BUILDING PLUMBING MECHANICAL FENCE SIGN "Applicant, on behalf of his or her spouse, heirs, assigns and W .J successors in interest, agrees to indemnify, defend and hold harmless I the City of Edmonds, Washington, its officials, employees. and a agents from any and all claims for damages of whatever natu re, i ( arising directly or indirectly from the issuance of this permit. Islu- RETAINING WALL SWIMMING POOL o ance of this permit shall not be deemed to modify, waive or reduce �1 inv reniiirement nf inv ritv nrifinanre nor limit in -inv wav the #0 .00 PUBLIC TAORKS DEPARTMENr CHEacusr BUILDING PERNIT REVIEW 3 m , r, � � A- , (address) tpo Street Right -of -Way Exist' REQI�__ Z Access Easements Existing 1701?el REQD H pd Utility Easement Exist W Lot Per Subdivision Plat Assessor Map Site Plan Checked for Accuracy, at Z Underground Wiring Reqd. U-40- 1-4 0 Check Accuracy of Legal Descr tion et Z Review by Date Existing Water Main Size- D11 Water Main Required Service Line Required Hydrant Size Existing 91� Hydrant Reqd Per Fire Code 4A Size Detector Check Meter Reqd. A 1A Cross Connection Inspection &1A Fire Department Comments Wa t er Me t er Charge Req d. -4 S-0, OF S 22 Review by_ )7��Ot- _Date Septic Tank Design Approved A00111,,V Date Septic Tank Permit Reqd. &7 `00� Permit No. Sanitary Sewer Availability 44c---S: -PrOj gaw, ',a.. &4 -9 A-. Dra:wing No. File No. Side Sewer Availability Sanitary Sewer Connection Fee Reqd. :3: Review by. Date Open Ditch Existing_Z&,e Reqd. Culvert Reqd._ Z(42ZZ Size C4 Catch Basin Reqd. &&2ae- Indicate on Site Plan 0 Shoulder drainage M . tain collection on swale open runoff ME I'Zo"le reqd.6r 67 ' Indicate on Sli te Plan Soil Conditions and Gro d Water Field Checked Review I by Date "a Revised: lvlO-1977 Page 2 I oft 11 i. Street Paving Reqd. Curb and Gutter Reqd. Sidewalk Reqd. NA Curb Cut for Driveway Reqd._ Ajg Right-of-way Construction Permit Reqd. Bmd Reqd. for Public Inpravements Street Name Sign Reqd. Aj Other Signing Reqd. P* Pre Permit Site Inspection made an z 0 f.4 �-4 BY: S&4ER W WATER z STREET ENGINEERING P4 Special Requirements listed in memo to CoTmunity Development Department, Building Division BY Date All items filled in an Building Permit Application BY Date Draw-ing,s Starrped and Notations Made BY Date Approved by Public Works Department, . t Revised: Iv 10-1977 .VNI 1029 99t h S. E. Bothell, Wa. 98011#44P-0080 CONSTRUCTION INC. LOT LAU 'A'P'K to -tONIE jkqq sPLjr �FV�=L ij "J" t r PLAC F- I MEMO TO: FROM SUBJECT: DATF: Building Division Community Development DepnrtmenL Engineering Division Public Works Department After review of the subject Building Permit application, we have the following comments: 1. Connection to- City water system required. 2. -Gonnection to City sanitary sewer system required. 3. Right-of-way Permit required for any work on City _property. 4, Driveway slope not to exceed 14011 0 5. Backwater valve required if downsLairs phimbinp is below elevation of uostream manhole. 6. Water and sewer lines to be separaced by 1.0 foot minimum. V V 4-n— CA 413 041� ". 44ev, k p ol o Irf AA (n 4� :3 0 M na u iu7r—(e .­�AILDING DIVIS1W TER MIT APPLICATION NA It JOR NAME OF. BUS ESS) /7j4 7/7 115 )4 JJ M W z li: ;2 0. - W I-z 1 T M CITY N A M E 0 ADDRESS I­ U CITY z 0 �STA E LICENSE T —/ V— 4� j Leaal Descricition USE ; L Applicant Fill ZONE Inside Heavy Lines 0 Ps JOB -fA D D:R E SS N-1 , . . . , .S.. EGAL DESCI PER'MiT NUM13ER .S- T__ I, Y_ f � C141 I! 1Q_1 ION I SUBDIVISION I SHORT SUB Nu. s7F. I r - / I PUBLIC RIGHT OF WAY PER OFF[ �AVSTREET MAP C JTE�LEPHONE NUMBER EXISTING 04?+e' e?,& r PROPOSED F 14 &CE - DEFICIENCY OF RIGHT OF WAY PUBLIC IMPROVEMENTS ZZ I - 6 Z98 Rq;rED DRAINAGE IMPROVEMEN Ulf C3 DRAINAGE PLAN REQUIRED -rELEP14ONE NUMBER UNDERGROUND WIRING REQUIRED CONNECTION TO SANITARY SEWER SEPTIC TANK PERMIT REQ'D 0 NO ELEVATION OF PROPERTY CORNERS & FOOTINGS REQ'O TELEPHONE NUMBER SEE ENGINEERING MEMO WED IdUMBER CITY LICENSE NUMBE—R CHECKED BY if Property '(Show Below or Attach Four Copies) METER SIZE BUILDI(4G SUPPLY SIZE REMARKS z 0 40T �_.75 �44xl Amj U W < 0 W 0 .J W SIGN AREAPOSED �COMENV. REVIEW ALLOWED I PRO PLETI EXEMPT REMARKS VARIANCE OR CU YARDS GAS New RESIDENTIAL E] LINE ADD NON-RESIDENTIAL SIGN DEMOLISH RETAINING WALL ALTER EXCAVATE FENCE OR FILL I— X—FT) FRONT FIRE ZONE TY I SPECIAL INSPECTOR REQUIRED 0 YES El NO PLAN CHECKED BY REPAIR PRE -MOVE swim INSP. POOL REMARKS z NUMBER OF STORIES NUMBER OF DWELLING UNITS WA TURE bF WORK TO 13E PjbNE it U 0 -Z4 w W M 0 PLAN CHECK FEE PLOT PLAN rBUILDING PLUMBING MECHANICAL FENCE SIGN In "Applicant, on behalf of his or her spouse, heirs, assigns and 0 RETAINING WALL III .J successors in interest, agrees to indemnify, defend and hold harmless 2 the City of Edmonds, Washington, its officials, employees. and agents from any and all claims for damages of whatever natu re, x arising directly or indirectly from the issuance of this permit. Isu- SWIMMING POOL PLANNING REVIEW BY DATE LOT COVERAGE SIDE REAR I F CONSTRUCTION ICODE HEIGHT AREA OcCUP7kNcy OCCUPANT IGROUP LOAD THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. VALUATION I FEE al ance of this permit shall not be deemed to modify, waive or reduce .J 0 any requirement of any city ordinance nor limit in any way the WORKS DEPARTIEPCHECKLIST BUIIDING PE109T REVIEW "L�address) (date) 0 Street Right -of -Way Exist' I-L REQD Z I Access Easements Existin We/V1 REQD 1-4 Utility Easenient Exist Lot Per Subdivision Plat Assessor Map_Cr Site Plm Checked for Accuracy, Z Underground Wiring Reqd. 1-4 0 Check Accuracy of Legal Description '(9e Z Review by_ Date Existing Water Main Size, 9 Water Main Required Service Line Required Hydrant Size Existing. iX Hydrant Reqd Per Fire Code �XLA Size Detector Check Yeter Reqd. N A Cross Connection Inspection A E- Fire Departumt Conuients F .4ater Meter Charge Reqd. a- 7 Review by Fgj—e--- Z Date Septic Tank Design Approved Date Septic Tank Permit Reqd. Permit No. Sanitary Sewer Availability Pr 03- Drawing No. - =_ File No. Side Sewer Availability Sanitary Sewer Connection Fee Reqd. :3: Review by Date W - Open Ditch Existing. &2.�Z Reqd. Culvert Reqd._ _ Size 04 Catch Basin Reqd. Indicate on Site Plan 0 Shoulder dra' ge tain collection on swale open runoff �bnh7ole reqd. C. Indicate an Site Plan Soil Conditions and Ground Water Field Checked L Review by, Date 13- Revised: lvlO-1977 Vit nf Fdmnnde Permit No: 2C00 .7 RIGHT-OF-WAY CONSTRUCTION PERMIT Issue D ate: e�2�2COO A. Address or Vicinity of Construction: 305 fir P1 B. Type of Work (be specific):GTE to place, operate i and maintain a bu,ridd service w6re f rom existing PEDESTAL # 0931 located at 1100 4th'Aye S. then SOUTH to a ragldAnna at 305 FIr P1. GTR to pinw 900 fept,v�iqh I driuPwavn, 60 feet , and push 0 roads. Pavement or Concrete cut needed -yes size of cut 2-2'x5' . R.O.W. footage is 260 feet. C. Contractor: GTE NOWTHWEqT TNr Mailing Address: 2312-C W. Casino Rd Everett Wa 98204 State License #: D. Building Permit # (if E. Commercial Multi -Family Terry Anderson 425-771-8683 Contact: Sherry Jones -Permit Coordinator Phone: 425-710-4133 Liability Insurance: Bond:$ Side Sewer Permit # (if applicable): Subdivision F] City Project a EUC (PUD,(2JTE PSE, CHAMBERS, OVWD) Single Family F� Other GTE W.O. #2100-9POOlDB 2423.10 fNSPECTOR- F. PAVEMENT: [:]YES G.- SIZE 6F CUT 2' x 5' H. Charge: CONCRETE CUT: M YES NO APPLICANT TO READ AND SIGN IDEMNITY. Applicant understands by hislhe r signature to this applica ' tion helshe holds the City of Edmonds harmlessfrom injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or any of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs and attorneyfees by reason ofgranting this permit. THE CONTRACiOR IS RESPONSIBLE FOR wbRkmANsHiP—AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND A CCEPTANCE OF THE WORK ESTIMA TED RESTORA TION FEES WILL BE HELD UNTIL THE FINAL STREET PA TCH IS COMPLETED BY CITY FORCES, A T WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. ­1 * Traffic control and public safety shall be in accordance with City regulations as required by the City Engineer. Every flagger must be trained as required.by (WAC) 2967155-305 and must have certification verifying completion of the required training in their possession. * Restoration is to be in accordance with City codes. All street -.cut trench work shall be patched with asphalt or City - approved material prior to the end of the workday - NO EXCEPTIONS. * Three sets of construction drawings of proposed work are required with the permit application. IRAVEREAD THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE THA T I MUST MAKE THE PINK COPY OF TIIE A VAILABLE ON SITE A T ALL TIMES FOR INSPECTIONS Signature: Date3-14 - (�OX (Contractor or Agent) CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK FOR CITI .�pproved,,,by % Thime A,uth1)rize.1--'Void'4,ft r (d 1- 60 , 7 -6 I:;;,. rie%<& .,v, &r �AAWIVTI rot avimn ,n SE. ONLY Right-of-way Fee: -10'-' 4 5 Disruption Fee/Fund 111: Restoration Fee: Total,Fee: Receipt No: Issued by: '1''_1 41 UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS COMMUNITY DEVELOPMENT CODE. -FINAL APPROVAL OF PERMITTED WORK. 641F INSPECTOR'S SIGNATURE DATE: I 1� I . I . � -6% 06 For inspection requirements see Engineering Information Handout. lil.VA41 to t