517 PARADISE LN.PDFiiiiiiiiiiiiii
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517 PARADISE LN
APPLICATION
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS E] LID NO - ---------------- - -ASMT. NO - ------------------
OWNER . ..... E?'K-JP;::f �- .............................................. CONTRACTOR PERMIT
JOB -ADDRESS - ----- L- - --------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
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U. NAME OF ADDITION ------------------------------------------- ---------------------------------------------------------------------------
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APPLICATION
for
The Cit� of Edmonds EASEMENT NO - ------------------ --------_---------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS R LID NO - ------------------ - ASMT. NO
OWNER -------------------------------------- CONTRACTOR PERMIT NO.'572��_.
7 ------ LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO.
JOB ADDRESS� --- ------------------------- ------------------------------
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NAMEOF ADDITION ----------------------------------------------------------------------------------------------------- --------- -------
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CITY OF EDMONDS SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
A_
PERMIT
Call 773-2525 for side sewer inspections BEFORE covering any portion of the construction.
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday Inspections,
ADDRE&LOCATION OF CONSTRUCTION_F::�)1_71 ----_----- pio�,nf.�Aik.
..........
.......... ................. . ........... ........................ .............
PROPERTY LEGAL DESCRIPTION ........
... .....
.................. .......................................
................................................... . . ...... . .......... .................... ........ ........................ ...... ............ . .................................. . ..................................................
.............. ................................
---------------- .01#49TUMPAND/OR BUILDER ........... (7� . ....... <e . . .......
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........... ....................... .........
-CONTRACTOR'S NAME ADDRESS ------
............................
Permission is granted ..........
19-71, for repair and/or connection of a side sewer to the city sanitary sewer A:�
in accordance with City monds ordinances.
------------ ----------
ATTENTION IS CALLED -TO THE FOLLOWING:
NOTE No. 1—The owners of the property may obtain a permit to construct sewer Inside Pmperty line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been Inspected.
NOTE No, 2—All work performed in city right-of-way requires an Invasion Of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3--Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4�Top of side sewer must have at least 30 inches coverage at property line and 12 inches Inside property line; minimum grade of 2%. No bends In grade
sharper than % will be permitted.
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of,completion.
NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the maln sewer or Its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED Date ... . ................................... By ................ Date ------ .. BYo --------------- Date ............... ........
........ By--
..............
"PROVED
Pate._
JO y . .... .. . ............................... ............... ....... ........... ......
B
Remarks: ...... ...... ........
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........................ .................................. . . ......................... ...............................
BOTH Permit C
pp S MU i e Owner of Firm Performing Construction PRIOR To Request For Inspection
(Own ontra ing rm Per r st' hereby certify that the side sewer installation constructed under this permit
ruction)
was installed in a or ance with all governing ordinances of the City of Edmonds.
Datedthis --------------- . ....... ... day of ........... ...... ............. ................................ 19 .........
V_-V Check BEFORE you dig for: Water Gas Telephone Power
Sewer Other 0 V V
711
STREET FILE
C I T Y 0 F E D M 0 N D S
- PUBLIC WORKS DEPARTMW
Routing ofT,Bu—lildi-ng—Pqpwf Plat, or Subdivision Applications
Proposed Property Address: 517 Paradise Lane
DEPARTMENT
CONW.NTS
INITIAL
& DATE
W A T E R
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S E W E R
S T R E E T
B U I L D I N G
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P L A N N I N G
ADDITIONAL INFOWTION:
BUILDING DEPARTME
AJSE PERMIT
Ipplicant Fill
ZONE NUMBER
PERMIT APPLICAT1010 Inside Heavy Lines
NAME
JOB
ADDRESS
(OR NAME OF BUSINESS)
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VARIANCE OR COND..USE NO. NO.-
W ADDRESS I
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JADB 1HEIGHT
PROPOSED YARDS LOT COVERAGE
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CITY TELEPI-!ONE NUMBER
FRONT SIDE REAR
SIGN AREA ENVIRONMENTAL REVIEW
ALLOWED
NAME
PROPOSED
COMPLETE ExEmPT
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REMARKS
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PLANNING DEPT. APPROVAL DATE
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LEGAL LOT, LOT AREA SUBDIVISION NO,
NAME
ElY ES E] NO
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STREET R/W
0 DRESS
EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY
U /,37/0 Heric'(10--n
COMP. PLAN ST. R/W FT. FT
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CITY
TELEPHONE NUMBER
RE ARKS
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STATE LICENSE NUMBER
GIW� 61 _R E R
CHECKED BY
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Legal Description of Property (Show Below or Attach Four Copies)
STREET AND/OR UTILITYWORK
R/W PE RMIT REQUIRED
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1- '77.
R E Q'D. YES NO
YES ONO
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UNDERGROUND
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1 WIRING REQ'D. YES ONO
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TYPE CONNECTION YES BY
SANITARY SEWER N 0 ]VERIFIED
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SEPTIC SYSTEM PERMIT NUMBER
0 YES.'
APPVD BY CITY ENG..
REMARKS.
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MET,7R SIZE SERIJICE SIZE CE 'CHECKED BY-
ICLEARAN .
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NEW WRESIDENTIAL GAS
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LINE FIRE ZONE TYPE OF CONST, :TION E
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SIGN
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DEMOLISH RETAINING
EIWALL
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INSPECTOR OCC A
SPECIAL JAREA U;fCY ICICCUPANT
REQUIRED GROUP LOAD
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MALTER EXCAVATE FENCE
OR, FILL
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YES NO
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-P N CHECKED BY THIS SITE IS LOCAT`ED IN THE CITY
OF EDMONDS.
PRE-MOV9 swim
REPAIR El
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LOCAL SALES T:AX
INSP. POOL
�SHOULD BE CODED31,04.
NUMBER OF STORIF 'R OF
REMARKS
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NATURE OF WORK TO BE DONE
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P ROPOSED USE
VALUATION.
FEE
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PLAN CHECK
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(L PLOT rLfN (INDICATE BUILDINGF SETBACKS,
ABUTTING STREETS)
BUILDING
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PLUMBING
0 HEAT GAS LINE'
FENCE
SIGN
RETAINING WALL,
SWIMMING POOL
I hereby acknowledge that I have.read this application; that the in-
TOTAL AMOUNT DUE
formation Riven is correct: and -that I am- the nwne-r —or thp diflu—th—
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City of Edmonds" PermitNo: 01-0011
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date: C:�2—
A. Address or Vicinity of Construction: —537Paradise Ln/517 Paradise 1n
B. Type of W*ork (be spe'cific): Verizon to place, operate and maintain a buried service w6re f rom
existing pedestal #8493 located at'537 Paradise Ln then EAST to a residence at 517Paradise
C. Contractor: Verizon
ContactPermit Coordinator —Sherry JOnes
Mailing Address: 2312—C W. Casino Rd.' Phone: 425-710-4133
State License #: Liability Insurance:— Bond: $
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D. Building Permit # (if applicable): __.—Side.Sewer Permit # (if applicable)::"
E. F-1 Commercial Subdivision CityProject [:] EUC(PUD, PSE; CHAMBERS, OVWD)
r_1 - Multi -Family Single Family F� Other %Mzotj
H. Charge: $
F. PAVEMENT: YES X-NO G. SIZE OF CUT x
CONCRETE CUT: YES NO
APPLICANT TO READ AND SIGN
IDEMNITY. Applicant understands by his/her signature to this -application helshe holds the City of Edmonds harmlessftom 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 e ' loyees, including but not limited to the defense of any legal proceedings including defense costs and
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attorneyfees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP 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 B Y CITY -FORCES, A T WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
+ 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) 2.96-155-305 and must have certification verifying completion of the
required training in their possession.
* Restoration is to be in accordance with City codei. 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 dra . wings of proposed -work are required with the permit application.
I HA VE READ THE ABO VE STA TEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS A NDACKNOWLEDGE
THA T I MUST MAKE THE P51COPY OF THE PERMITA VAILABLE ON SITE ATALL. TIMES FOR INSPECTIONS
Vignature:__ Date: 1-167-01
YConlractor or Agent)
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
FORCITYUSEONLY
Apr6yM*,b 6 (in n -of-way Fee -
An", V Right
&iT4 After 0 1 -Disruption.Fee/Fund Ill:
flW Adthbrized,.` Noid,
S,p.eciaI-_.Cbnditions:,- Restoration Fee:
ee:
DK Z�i -OQS Receipt No:
e&F_z> 4&J22f,6�e&, Ag 42
Ira, -1A
10 D171-I)AJ Issued by:
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UPON COMPLETION OF PERMITTED WORK9 AN ENGINEERING FINAL
0
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE ED; (..NE
COMMUNITY DEVELOPMENTCODE.
A�
FINAL APPROVAL OF PERMITTED WORK,
POR'S SIGIVA TURE DATE:"-
INSPEC
For inspection requirements see Engineering Information Handout. -;2