314 CASPERS ST.PDF11111111111111
10567
314 CASPERS ST
ADDRESS:
'i %
TAX ACCOUNT/PARCEL NUMBER:.... Z-1 1332LL06206-27780
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS DETERMINATION: E] Conditional Waiv er Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
'IA14ev) 9940151 ��p
PERMITS (OTHER): 60LAJL-,�)
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: jw.,
SIDE SEWER PERMIT(S) #: . .....
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:-
LATEMP\DSTs\Fomis\Street File Checklist.doc
4
0
APPLICATION
for
The City of Edmonds SEDE SEWER PERMIT EASEMENT No . ..........................................
NEW CONSTRUCTION E] REPAIRS r-1
al5-o5850
OWNM........... ---------------------------------------------------------------- CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ....... 31A .... C�a-u-QX .... S.t . ........................................................ LEGAJ, DESCRIPTION: LOT No . .............................................. BI.�OCK No . ............................................
NAMEOF ADDITION ......................................... ...............................................................................................
Dye Tested On Sewer 197?
Approved:
DATE................................................ By ............
Q5
C�
Cit
y of Edmond
'R
RIGHT -OF WAY CONST CTION
Permit Number, qz
Ktt: i. mc J'!k,1cv'JL IL
c' -2.7 ;k5l
Issue Date: 1,.;;e , ';� - �7/_/
A. Address or Vicinity of Construction: - 114 Gnqpprg St (9503870)
B. Type of Work (be specific): Install New Service
C. Contractor: Waghington Nntiiral raq
MailingAddress: 1199 79 St SW, Everett
State License #: 98203
D. Building Permit # (if applicable):
Contact: Frank SwAn
Phone: 356-7503
Liability Insurance: Bond:$
Side Sewer Permit # (if applicable):
E. F] Commercial Subdivision El City Project 60 Utility (PUD, GTE, WNG, CABLE, WATER)
F1 Multi -Family Single Family F] Other
INSPECTOR: INSPECTOR: i-
F. Pavement or Concrete Cut El Yes []No G. Size of Cut: x H. Chargq�_$
APPLIC ANT TO READ AND 01G-'
/ /_ 0 - i
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold DO-ty ofEdmoluis harmless from infiii-ies, 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 or not limited to the defense ofany legal proceedings including defense costs, and attorney fees by reason ofgranting lkspermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR-,4-(PC�NOD OF ONE YEAR fllL��
4NG THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMA TED RESTORA TION,�EES� WILL aE HELD UNTIL TH, FIN LSARi�+PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS `/ i
Ihaue read the abouestatements and understand the permit requirements andthepink copyof thepermit ivillbe
auailable on site at all ' f '
.U.wtyr or inspe7ion purposes.
Signature: Date: Novemer 29, 1994
I Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY:
TIME AUTHORIZED': YOID AFTER FF 5 j,5 DAYS
SPECIAL CONDITIONS: 4�
— Tr,* FF -'c- 4,-ol ge- '.51,t t Co de-
- S�e
COMMENTS:
DATE:
ISSUED, BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. I)iv. 1991