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341 CASPERS ST.PDF10569 341 CASPERS ST "0 � 0 TAX ACCOUNT/PARCEL NUMBER: Ll 0 00 BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) CRITICAL AREAS: DETERMINATION: E] Conditional Waiver 0 Study Required E] Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): .1,9 g 1 D PLANNING DATA CHECKLIST DA: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: U SIDE SEWER PERMIT(S) #: um �N GEOTECH REPORT DA' STREET USE / ENCROACHMENT PERMIT #: FOR: WATER METER TAP CARD DATED: LATEMP\DSTs\Fomis\Street File Checklist.doc 7' -W31- 1*1 t 20 14.3-6 ERN AppIlcation r4o. & WORK Pr p�rrnjt Limit. One Year Building Department ITY C OF EDMONDS plans in accordance with the accompanying work, a permit to construct the following ON is hereby made fo ...................... No. Stories. New Reside C ...................... .................. ............ Ground Area. I, n e ............... ,W�Addrt. Helght.- ................ Const. Type .......... . . ....... ----- ed.. . ... .. ............................................ . . . . . . e ................. . . Use - ----------- Fire, 7on' 3 A. .............. .... ........... . ... T dress / ............... . ..... . Sewered ewerage ... . ............................... S See attgh ....................... . .......... g� 4 .......... Add'n ........ ....... .............. ...... .................. 251 + Ix dI Rear 7. ........ Sides. .......... Min, Bldg. Setbacks, Front aa .. . ......... Width. PR 8-W444 Phone........... . ....... . . . dh�iid Fi i ......................... . . . Address. --------- - --- - ---- .. . ...... . . ....... . .. . ............ Phone--.4 .................. ... IT Address ...................... . ...... y................ ............ ............. . 4 . ....... Phone.............. .. ... . ... ............ ......... ... Addres&.-----------* ........................... ...... ,'Bldg It ....... . ....... . ........ . ........ �Z Y- Phone ........... . .. . ..... . ....... U hl. W. Address I.: plbg. by 4 ........... . .......................................... 4 .......... Phone ............... Address .......... - ------ ................. .......................... Heating by 4 ............. .. .......... Phone.. . ................... ........ Addr, s Elect4 by ................... - - ---------- ............ ....... ................... . .. . .... 7 1'-7 - Remaiks .............................. . ......... .. ......... . . . . . ... . ... . ............... . ..... . ....... ... . ....... ............................ ... .... . ......... .............................. ................ .... . .. . . . ................ 4....., ............ .... . ...... ............... .. . ...... . ...... ................ ............ 4 ................. .................................... ..................... .......... . . ....... ... ................................. ......... .. - ----- . ....... ............ : ............... . ....... ....................... and State Laws regulating the work. agree to comply with all applicable Codes The above is a correct statement and I IN' .......... lzte.-V!/`�"� . . ............ . .. ddrels.—.�� ....................... Signed: Owner/A ce with the *app ed' Pla�! ve conditions, and to comPll6a ."e. PERMIT for the above work is hereby approved, subject to the abo and 3pecifictitions and Building Department notations thereon. PER39T FF VALUATION Eldg- .......... 5� Plbg. ........... Heat .... APPROVED: 07 C, Elect. ....... ......... Date 7 / ......... ......................... others . . . BUILD G DEPARTMENT ............................ TOTAL FEE By i approval. before inspection anc inspec "I be coverec. Building DepartMe ?0 ity 91 Twen S: No work requiring ,-N o TE' ty-four (24) hour notice requested. 'ontact e City Fngi r prior to construction of all site utilities. such as curbs, paving, drivCNvaYs. sewer, %%mter and street connections. t 0 APPLICATION CARD No . ....... .......... ............... for The City of Edmonds SIDE SEWER PERMff EASEMENT No . .. ...... .................................. OUTSIDE 0 INSIDE 0 REPAIRS 0 -5 66 0 OWNER ......... --- - ------- ......................................... CONTRACTOR . . ........ No. .......... .... ;� ............................ ........ PERMIT STREET HOUSE No . ........ 3 ...... �.( ............ ................................ AVENUE LOT No. ....... ...... .................. ..... BLOCK No . .................. ... .. .................................. .. .... .. . ............ ................... .................... ... ... . ....... ............................... ......... \1 I * t- - � Ar APPROVED 10 1963 Date Approve BACKFIILL WORK ORDER ISSUED ............................................ DEPOSIT, $ ..... ................................................ SEWER WORK ORDER ISSUED ................................................ DATE. . .. ..................................................... ... ..... BY ...... .... . ... 'A, /00 .................. . ....... District City of Edmonds --- Water Department TAP CARD Dat M� ................. . .......... e er No. Tap Size..... :7/ ............ Size ...................................... .. . . Mfgrs. No .... ............ Styl .............. 'For ............ -.1 ........................... . . ......... , ................. .......... . ........ ... .................... . .............................. . ...... . .............. ................. .......... ; ...... .. . . . ... . . . ..... . .. .... . ..... . ........... . . LotNo ........................................... Blk. o ................................... . .............. Add. ..................................................................................................... . ... ServiceLocation ............................................................................................. ................................................................................................................. . ..... . .............. MeterLocation ................................................................................................ ........................................................................................................................................ MakeTap ...................................................... w ....................................................... ................................................................................ 6 ..... . ......................... . ... . . . .......... Pr essure .............................. lbs. Test .................................... % SendBills to ......................................................................................... ......... . ..... ................................................................................................................. . ....... . .......... . . Date of Work L1,4,r-4 .......... 41 ....... 4;� .......... . ...................... ............ 7 .............................................................................................. Foreman Guar. Voucher No ........................................... $ .......................................... Remarks: ......... . ....................................................................................................... ...................................................... E .... FILE ....... . .............. ................. .................................... . P.IR .............. ................................................................................................................. ...................... ................................................................................................................. . ....... . .............. .................................................................................................................. . ....... . .......... OUTGOING Index .......... Reg ....... Route Bk ......... Stencil. ..... Card .... . . INCOMING Index .......... Reg ....... Route Bk ......... Stencil ...... Card ....... /a City of Edmonds RIGHT-OF-WAY CONSTRUCTION PERMIT A. Address or Vicinity of 15 � Permit N Issue bate: C. Contractor: 1�110_,�,,,Wv��,Ic Contact: SLu-'s,18.1 Ic Mailing Address: �,3�C)4L-, G,, XJ Phone: -26i� S 3q 4()(.o -L/JS L/,) State License #: 0__ T_ lc� I I'V1. A Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. r-1 Commercial El -'Su roj ect EUC (PUD, VERIZON, PS E, AT& T, OVWD)' bdivision city P; Multi-Famil Sin&�Family F1 Other y INSPECTOR: L, Ck PAVEME . NT CUT: R] YES El NO G. SIZE OF CUT x CONCRETE CUT: LJ YES El NO INDEMNITY. Applicant understands by his/her signature to this applkationfielshe' holds. the City of Edmonds harmless from injuries, damages or claims of any kind or'description whatsoever, foreseen or unfpreseen, that may be made againsi'-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 CONTRACTOR is RESPONSIBLE -FOR WORAM414HIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLL097NG THE . FINAL INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES 07LL BE HELDUNTIL THE FINAL STREET PATCH IS ,,COMPLETED BYCITYFORCES, AT WHICH TIMEA DEBITOR CREDIT WILL BEPR6cEssED FOR ISSUANCE TO THEAPPLICANT Traffic control and public safety shall be in accordance with City regulations as requited by the City Engineer. Every flagger must be trained as required by :(WAC) 296-155-305 and must have certification verifying, completion of the required training in their possession.' Restoiation 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 6�d of the wo'ikday.- NO EXCEPTIONS - Three sets of construction drawings of proposedwork are re uired with the permit applic' tion., q a CALL DIAL-A'DIG (1-800-424-5555) PRIOR TO BEGINNING WORK IHAVEREAD THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE 14, THAT I MUST MAKE THE PINK COPY OF'THE PERMITA VAILABLE ON SITE A TALL TIMES FOR INSPECTIONS ".Signature: Date: 6 3� (Conitactor or Agent)-, FORCIITYUSE.-ONLY Approvedby, Time Authorized: Void After 'Special Conditions: Rer.Maff R61011) (Jkjff a Errrne n 6Q n m a N c. , - R 041'Ti) EE LA 0 1) -<Z- A 0--- TO I tv_r_- Ab rt-TON-n A & IC KIAM-MI KN C!, WMEIMER7,22.30". I I Right-of-way Fee: I tAl+ I 1q+ 103 Disruption Fee/Fund Ill: Rest oration Fee: Total Fee:, al Receipt Nor"� VTissued b UPON COMPLETION, OF PERMITTED. WORK, AN ENGINEERING FINAL INSPECTION IS REQUIRED, PER CHAPTER. i8.00OF THE EDMONDS' COMMUNITY DEVELOPMENTCODE (Phone 425-771-0220, Ext. 1326) FINAL APPROVAL OF PERMITTED WORK.- DATE:' Inspector's Signature For inspection requirements see Engineering Inspection Information handout. DAMy Documents\Forms\Engnrng\ROWpermit_.doc. Notes, 1. Ail s6nsaaiid- spiicing. sh'allbonform 0( tdAhe"MUTCD-and Clty:ofEdrnonds�sp JI:SR'524at' ZWork,z6h`eis.15!Wo.`c Im 3. F.1ag6ir,s�.will�o6hti�61':alt6mating one-way.tra c�:'. 4. Alert affected residents;. 5. Cfianhelklng� de�lces�are 287. cones. .. 6,� Ti�ers wili, b� 56' 7' 100, 1 a ndmu s - t -6*'d contaiin at least evioes. r� All iIjni4ri'4F_x_484�B/0 CL unless otherwise,spe cifi6d 4' /9d Av� -%el A Ina cm 7- gil I A 4 Z�OW�0- 2W 'f cli, 1211 g- 91 C*4 r%) IA' 12: 0' Cx Ln U_� p Pilchuck Contractors, -Inc. Job #887000634 13 Jul� 03 Sheet 1 If 1 NO DEVICE SPACING (FMT) J.,Buss =APMER I TANGENT National Banicade.Co 20 1 WBrookmeie'DR LEGEND WTRAFFICCONE —i EXISTING TRAFFIC FLOW SIGN LOCATION' FLAGGI N G STATION , I f.. � IR=EVENICLE 0 VEHICLE UlbZL)bb_ltile://N\sg_qnamsl\maps\(3as\Plat\TIF\Ql62066.TIF -.�,.aqe 1 of 1�lxi LLI 15L- ZS4, N — M-70 ta ui * I k, r-w 7 CL k ROPM ly�� I Ya,FE if 5F-?,V Y. 3 lal O� 5 .6. t4 F J-Z3 r4 00) N - 0 14 --W G15L-r co 1994 ZOC) 307 313 52t' 12.5� t4 Cu F w 7015 74* Ju ;4� IX in 7 -,�c Ln tA %9 '0 dASPFR In 1 p 4" Sil W I I a j,,,-. ST t 9r. 6 j 85r, UFF N 8sr AI-ZS,E 3 , i S- S.,Lq 7!�- ec P ?;v z w IL .UJ uj co a\ w 04 -0 1-5--, r- 90L. 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