525 FORSYTH LN.PDF11111111 lill 11
11343
525 FORSYTH LN
CITY OF EDMONDS SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 775-2525 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.
ADDRESS LOCA17ON OF CONSTRUCTION ........... 4-- . ... .......................................................
......................
. ...........................................................................................................
PROPERTY LEGAL DESCRIPTION ........... ........... ..... .. !0J,1
....................... ........................... . ...................... . ........................................................................ .......................................................................................................
N
................................................................ O-VAIINERANDJOR BUILDER .......... L�P�.-N.J I .... C., ............. ...... . .......................................................
'ACX� ........
CONTRACTOR'S NAME & ADDRESS ......... P .....
0611ion Is granted .......... . .................... . .............................. . .. . .......................................................
n san se
... ..... ' . . .................... 19.77T., for repair and/or connection of a side Sewer to the city itary wer
'NEIn accordance with City of Edmonds ordinances.
TION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer Inside property 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, 'A 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 maJn sewer or Its appurtenances except to in-
sert the pipe into the wye. I
DISAPPROVED Date. By ................ ;Date ........ . ... ............. By ----_--------- Date ............... . ................... . By ................
Z�7;7 By 04,
APPROVEDW .... - ----- ----------------- By---- . .................... . .......................................................................................
X/ * ------------------
Remarks: ........... . .............................. . .....................................................................................................................................
..................
,e ...... A ------- . ........................ . ...........................................................................................................................................................
BOT rmit opi s ST e igned By Owner of Firm Performing Construction PRIOR To Request For Inspection —
I .. .. .. ....... ..... .................. .................................. ... I hereby certify that the side sewer in7lation constructed under this permit
wn r Co tmcting FIrm erforming Construction)
1nStal, , ' �o i� � Irm V i.
it Pin ac �brd eme with'al Tgoverning ordinances of the City of Edmonds.
�# I / Dated this. -",46/ --------------- day of ... A ----- ----------------------------------------------
&eck BEFORE you dig for: Water E], Gas E], : Telephone [3, Powepo0o, Sewer E], Other 0 V V
CITY OF EDMON
:A- , FOR INSPECTIONA9�LL
%C.UBLIC WORKS JOARTMENT
775-2525 Ext.
�_�iS!I,DE SEWER PERMIT
Permit P"Yjn. 0&22
Issue Date
PERMIT MUST BE POSTED ON JOB SITE
Address 077onstruction A A14111 9MONDS
Property Legal Description (include all easements) FTR�TMENT PLANT-
�5L_C& P�-eoir X -,), " � LD / 4g
CC3. 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 FOLLOWT.NG AND SIGN:
0 W
a. Property owners must obtain a permit to install side sewers on
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 repon§ibility for each
installation for one year.
c. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
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
and maximum grade of 100% (450).
f. No turn in side s8we I r greater than 45 0 (1/8,bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
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 only. Two,1(2, working
days notice/required. / / .
DATE:
I 'certify�,_.t Ld
and shall comply with the above
PERMIT FEE:
CONNECTION FEE:
* PERMIT
DISAPPROVED BY: Date:
B !7K
Date:
APPROVED By: Dat
T BE POSTED ON JZ0B �SIT
The City of Edmonds Side Sewer Drawing EASEMENT NO - -------------------------
NEW CONSTRUCTION Ig REPAIRS E] LID NO - ------------------ - ASMT. NO - -------------
owNER - ----------------- CONTRACTOR — ------------------------------ -------------------------------------------------- PERMIT NO. (09.8.4.
JOB ADDRESS .... 5.2-5 .... F -5-YTH ....... LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO. — ---------------------------
NAME OF ADDITION -------------
52S
Z500P.
wt.*�WyLr
xi'%cimb
104
------------------- ---------------------------------------------------------------
.................................................................... ------
FORSYTH LANE 7' PZ4,
&5,0P.
1.
S' —fl*
fL5 CA-C^P 1.5'OP
S I t:OF— WALK
V
FoRSYTH Approved:
PWW-0001-11175 (REV.11/78) DATE -46-297-8-3 ......... - Byj-- ------------------------
_ell _el(n�
STREET' FILE
/U
2,n �/ /
CITY OF EDMONDS, PLANNING DEPART11TES.
Fit, 505 BELL STPERT
EDMONDS, 14A .98020
775-2525
Name of Applicant:
Mailing Address:
APPLICATION FOR STREET USE PERMIT
�)6-9_/ CoRP
C-D140,4/DS
Telephone Number: 7N - 2-2121 Date: 01-110
Description of Public Place or Portion thereof desired to be used: (exhibit may be
attached)
S66 �-fXQ-HV7- /F/TAcNCZ>
Type of Use desired to be made of Public Place: 705 _S-11,46K 1_00�6) 114 ?,+RK1H6-
57R/F) + TC-MP CLe)SC-Zi OF 617X-WAtW aA1H(,_ CogS
if applicabl.e, attach plans and specifications for any utility or structure to be erected
and/or maint'ained on the Public Place:
TEMIPORARY PERMIT: Unless otherwise designated herein, this permit is,understood by
applicant to be wholly of a temporary nature, that it vests no permanent right whatsoever.
If the permitted use becomes dangerous or such structure shall become insecure or unsafe,
or shall not be constructed, maintained or used in accordance with the provisions of this
title, the same may be revoked and the structure ?nd obstructions ordered removed by order
of the City Engineer. lf,th)� application is foi- a spe5Jfie0 period of time, the terms
of said application As:-_ �/q/13 7 _0 4?;Z0 X c6'11 Li 143
INDEfCITY: Applicant understands and by his signature to this application, agrees to hold
the-Cif-t—yof Edmonds harmless from any injuries, damages or claims of any kind or descrip-
tion whatsoever, foreseen or unforeseen, that may be made against the applicant or 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, court costs, and attorney fees by reason
of granting -this permit. In addition, applicant understands that the City shall bd provided
a certificate of insurance to indemnify and hold the City of Edmonds harmless from all
claims and/or property damage, naming the City of Edmonds as an also insured.
APPLICATION OF CHAPTER 6.40 OF THE EDMONDS CITY CODE: Applicant warrants that he has read,
or had the op�_o_rtunity to read, Chapter 6.4U_o_f__tT_eEdmonds City Code, attached herewith,
and understands that all terms of that Ordinance are incorporated herein.,Is if set forth
in full and this application and permit therefore are subject to the term's of that Chapter
of the Edmonds City Code.
6;1
11/7/74 rev.
"tity-of Edmonds ' Planning Department
APPLICATION FOR STREET USE PERMIT -- Pa2e 2
�Approval (and Agreement, if applicable) of Abutting Property Owners:
Sionature Printed Name Address Date
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
City CQuncil Approval (Attach Minute Entry):
Permit Fee: ,2C-00 Annual Fee: due January 1, 19
Amenities De sign Board Approval (if applicable) Attach Minute Entry:
Building Official Approval (if applicable):
Signature Date
Provision for Indemnity:
i
Terms and Provision of Performance Bond, if applicable: (Reference 6.40.050 of applicable
Ordinance)
PERMIT AUTHORIZATION BY 112- 57/ 13 -.�
4S�ignature Date
PERMIT NO. DATE
MW NOR "MON mh"'K?
11/7/74 rev.
� 4
-%
��k _11�u �Su U UQ�ul U�� UU U U U U �__) �Ei U (-Ii U U
C� 00AJ
WC�3 P QOACD /�@ CA WTT[p, (29 @TIVI? rkl(wo cag�w�.@ rkloo MWV�3 WPM VW- wagga
I
_V
%Vg� VM ��� t� �OD M L V_ L, �O
AME AND ADDRESS OF AGENCY
SMITH, MARTIN & LEWIS, INC.
CGROPANIIIES AFFORDONG COVERAGES
310 Columbia Street
Seattle, Washington 98104
COMPANY
LETTER UNITED PACIFIC INSURANCE COMPANY
COMPANY M0
LETTER LLD)
(206) 623-4920
NAME AND ADDRESS OF INSURED
PUGET WEST CORPORATIO14
COMPANY
LETTER
P.O. Box 669
Edmonds, Washington 98020
COMPANY
LETTER
COMPANY
LETTER U=3
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. Notwithstanding any requirement, term or condition
of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the
terms, exclusions and conditions of such policies.
COMPANY
POLICY
Limits of Liability
in Thousands (000)
EACH
OCCURRENCE
AGGREGATE
LETTER
TYPE OF INSURANCE
POLICY NUMBER
EXPIRATION DATE
GENERAL LIABILITY
BODILY INJURY
$
$
A
COMPREHENSIVE FORM
PREM IS ES—OPERAT IONS
PROPERTY DAMAGE
$
$
EXPLOSION AND COLLAPSE
HAZARD
El
UNDERGROUND HAZARD
EPRODUCTS/COMPLETED
d
OPERATIONS HAZARD
BODILY INJURY AND
CONTRACTUAL INSURANCE
LP 4 84 78 54
4-26-83
PROPERTY DAMAGE
s 500
s 550
BROAD FORM PROPERTY
COMBINED
DAMAGE
INDEPENDENT CONTRACTORS
PERSONAL INJURY
PERSONAL INJURY
s 500
AUTOMOBILE LIABILITY
BODILY INJURY
$
(EACH PERSON)
$
COMPREHENSIVE FORM
OWNED
BODILY INJURY
(EACH ACCIDENT)
PROPERTY DAMAGE
$
E] HIRED
BODILY INJURY AND
$
NON -OWNED
PROPERTY DAMAGE
COMBINED
EXCESS LIABILITY
UMBRELLA FORM
BODILY INJURY AND
$
$
PROPERTY DAMAGE
F] OTHER THAN UMBRELLA
COMBINED
FORM
WORK ERS'COM PENSATION
STATUTORY
and
EMPLOYERS' LIABILITY
$ (EACH ACCIDENT)
-1
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES
Applies to job shack at 521 Forsyth Lane, Edmonds, Washington.
It is understood and agreed that the City of Edmonds is named as additional insured
and held harmless from all claims and/or property damage as pertains to the named permit.
CanceftVon: Should any of the above describ4epolicies be cancelled before the expiration date thereof, the issuing com-
pany will endeavor to mail 3Q. ays written notice to the below named certificate holder, but failure to
6b il
mail such notice shall impose no) 6b igation or liability of any kind upon the company.
Notice of Cancellation to be sent by certified mail.
NAME AND ADDRESS OF CERTIFICATE HOLDER:
WU=FPTt ISSUED: JanU&ry 17. 1983-,0
City of Edmonds
r.
Edmonds, Washington 980 oic,
2 0 AUTHORIZED REPRES109"WeL
ter E. Brewe, CPCU
17
ACORD 25 (1-79)
CITY of EDMONDS --- PUBLIC WORXS DEPARTMENT
Routing of Building Permit Applications
Proposed Property Address of Application: 527 Forsythe Lane C/
f-/7
DEPARTMENT
W A T E R
COMMENTS
DATE
S T R E E T
S E W E R
N 0 T E S
BUILDING
DEPARTMENT COMMENTS
�BTILDING D'ERARTjAjENq App licant Fill
USE T41
ZONE NUMBER
RECEIVED
PERMIT APPLICA410N Inside Heavy Lines
I.B
ADDRESS 18 1976
NAME (OR NAME OF BUSINESS)
LEGAL LOT
ARAI
SUBDI�ISION
WO(Kpoept.
0 .
/L YES NO
ILOT
15— 0
Pub IC
I
w MAILING ADDRESS
Z
3: Z Y3 z Vto q-7
0
VARIANCE 0 R
COND. USE NO.
A D8 NO.
CITY
NUMBER.
/7LEP;ONE
PROPOSED YARDS
FRONT S I.D E _12^R E A R
EIGHT
Zz
NAME
ALLOWABLE
SIGN AREA
ROPOSED
SIGN AREA
1P
CL
U tv & it/ C z
W ADDRESS
t
0 HER
'U
RT REMENUQ,,V'
L
U 7'
M CITY
TELEPHONE NU"ER
PLANNING DEPT. APPROVAL DATE
�j
0
NAME
STREET R/W
T L)
EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY
0 ADDRESS
F. I
COMP. PLAN ST. R/ 49V-110 FT. FT.
Ir CITY
TELEPHONE NUMBER
REMARKS
Driveway slopes not to exceed
0
those indicat�d on Standa�d Owg. No. 193
W
U STATE LICENSE NUMBER5j -or
CITY LICENSE NUMBER
CHECKED BY
I I 7'V' k ).
W
K
Z
STREET AND/OR UTILITY El YES W
Legal Description of Property (Show Below or Attach Four Copies)
WORK REQ'D MNO
UNDERGROUND YES
z
WIRING REQ D El NO
TYPE CONNECTION
IVERI IED BY
IL
SEPTIC SYSTEM YE S
APPVD BY CITY ENG. _aNO
IV A.,
RMIT NUMBER W
W
V)
REMARKS
W
MET[TtIZE
SERVICE SIZE
CLEA RANCE —7CHECKED,BY
W
REMARKS
NEW
ADD
RESIDENTIAL
NON-RESIDENTIAL ID
GAS
E] LINE
SIGN
FIRE ZONE
I I
TYPE OF CONSTRUCTION ICODE
DALTER
r_1
REPAIR
Li DEMOLISH
EXCAVATE
OR FILL
El
PRE -MOVE
INSP.
RETAINING
WALL
FENCE
X FT)
swim
POOL
SPECIAL INSPECTOR
REQUIRED
YES
AREA OCCUPANCY
GROUP
JOCCUPANT
LOAD
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY W
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31,04,
REMARKS
z
NUMBER
OF STORIES
NUMBER OF
1 DWELLING
13
UNITS. -
NATURE OF WORK TO BE DONE
PROPOSED USE
Z
2
F-
a: PLOT PLAN (INDICATE BUILDING SETBACKS,
m ABUTTING STREETS)
U
0
W
0
PLAN CHECK
NO.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
VALUATION I FEE
SWIMMING POOL
7s-
A7 I
71
-3cl -L
(L �q
17-
*0 5
ic'a -3 O'c>oq-
rj
rl I
cl a
17/1 lo
va,f x-eq-1
.-t- Y3
P?
0- 0
STREET FILE RECEIVED
JUI 2 2 1982
Dir. Of Public Works
July 21, 1982
MEMO TO: Fire Department
Engineering
P-66-1`,tc,,:�No.r-k-s
Planning
FROM: Buildi'ng Division
SUBJECT: EDMONDS 20 UNIT CONDOMINIUMS @ PINE AND FORSYTH
Due to an error in the address book, the address of 527
Forsyth that was assigned. to Building B for the above
project is changed to '5215 Forsyth.
Please indicate this change on documents you have for this
project to avoid any confusion in the future.
lk�
0
9
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION..
PERMIT Permit Number.
V2, Al-
Imue Date:
A. Address or Vicinity of Constructiow. Z S F6 P, 5 Y _r H L W -
B. Type of Work (be specific): PUPLACE brFEC-7�VE 06 DIST CA
'�CE Ar7AQ4#_D D2AW[KI&
Contractor: Q4Ar (3U51SU17ffP_16L CA Contact: 7bM A�NDEP-SOhJ
Mailing Address: 5-3 3 M Al N ST_
State License #:
8 90 - 199
D. Building Permit # (if applicable):
Phone: 774 514-f-
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
10
E. E] Commercial E] Subdivision El City Project [ja Utility (PUD, GTE, WNG, CAI� WATER)
E] Multi -Family EJ Single Family Other
INSPECTOR: 114SPECTOR:
F. Pavement or Concrete Cut 0 Yes §4No G. Size of Cut: x H. Chargq-$
r
APPLICANT TO READ AN441D�'IGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds harmless from fnjudes, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made a0ihs! vkPty of Edmonds, or any/ olf its?d4xult�t;nts or
employees, including or not limited to the defense of any legalproceedings including defense&sts, and attorney fees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAWFOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice ig+equired 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.
Ihave read the above statem nts and understand thepermit requirements and thepink copy of thepermit will be
available on .
,,Off�t all ti s �br inspection purposes.
10 -
Date:
utlult�.
,J(-- I (C(T'n7t6raW,Cor o-r A7gent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOP., CITY USE ONLY
APPROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER" ,DAYS DISRUPTION FEE/FUND I I I:
SPECIAL CONDITIONS: N A,
COMMENTS:
RE§TORATION FEE:
PERMIT FEE -
TOTAL FEE:
RECEIPT FEE:
I �DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments:
Diaaram.:
CONTRACTOR CALLED FOR INSPECTION YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
F L) f;�- L
IO8NNiVTf-A
5EC ZS-27--? Kwi4
1�
I
LU
FORLSYTH LANE
10 - 31 -95-
APPLICATION
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS F1 LID NO . .................. ASMT. NO./..
�Q� (,a zm��
OWNER ----- -------- <:> ----------------------------------------- CONTRACTOR ------ -)C�H-t-A ---- �t--4
---------------------------------- PERMIT NO.
JOB ADDRESS .5i�ga -- - --- ..... LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
"%--L-- F=t=*;p,--n<:>" <:)r= Tv-4ta- 114 !:5p t4.w.
C:3� 2r=- , -*0=�%,"t'4z-:-"t;:p ?-7 t-4CX:2� 25, r-- -
---- -------------------------------------------------------------------------------------------------------------------------------------------------------
NAMEOF ADDITION .......................................................................................................................
Ull
J
DATE ..........
B........... ;14 .....
117fg
ak
of Edmonds
OWNER ...... .. g.. --------- -----------
JOB ADDRESS ------ s -7 --------- ------
z —7
z /I
APPUCATION
for
SIDE SEWER PERMff
NEW CONSTRUCTION Pl-� REPAIRS E]
<7 t —.1 — --4—
CONTRACTOR -------- \,JC?
EASEMENT NO - -------------- -------- --------------------
LID N01i ------------------- MT. NO. -)
LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK No .. ........ -----------------------
....... c—.1-eP--.PKt IV . .......... .. . ... .............. .
NAME OF ADDITION ----- - -- --- ---- ... ........ T
JAN 2 0 1977
Approved:
DATE-------------------------------------------- By --------------------------------------------------- Yi7ye
%
Date August 9, 1976
� e'
�mofo:- Director of Maintenance & Operation
Public -Works
From: City Engineer P c orxs L)eVC.
Subject: sewer Connection Charges
Legal Description: See Attached
Commonly known as: 527 Forsythe Lane
Z.F.F. Calculation:
67.70 Z.F.F. x $5.50
1 Lateral X $100
s1vt Unit S x $25
0�7 -7 "�T—
CC: Bon Construction w/Bldg Permit
Owner: Arne Olsen, Bon Construction
$ 372.40
connection tee
$ 100.00
Lateral Charge
$ 150-00
Trunk Charge
10.00
Permit
$ 632.40
TOTAL'
N
2108
d. 2
e JU,S"f,- _c; Ilk
14'
r4
77��
01,
ot
k p
t7-_,�Ii C, R T XT F 0 71 �1_11
ALL OF 74�-( ?c%�_7top_) Or- \Ij. I -
r OF: "4='�C-Tl
vJ
T-0 P A ri C, E�
f t-i u I I\j 0" F 7. C)F 7
W. vi C, 0 P_ Ak I D 's 0 p V TH E
-"Ij r�E--3eS i--,- 1�:-,oFT,
�J, _�Z>0.0 FT T-r-iE.-JCE, VJ �,T, b FT. THI':J ��,iNjkj
tt E; P T '7H S 0, .2- 0 F7, - T'�A eP. So F
T &T �i
OF
c C_
C.
STREET FILE
DATF: Aunust 9, 1976
HEM TO: 11arry lfhitcutt
Buildinn Offic-ial
RON:. Richard 1!. Pllen
Assistant City Fnnineer
SUBJECT: Bon Construction P� Olsen 6-11nit Anartments at 527 Forsythe Lane
After review of the sub,inct huildinn nermit anplication, we have the fol-
lov,,inq comments:
1. Connection to sanitary sevier reouired; �P�P-ier Connection Charge
due on this propert.y in the amount of �,F32.40.
2. Underground k,,,iring required..
3. nriveway slope not to exceed 14 percent.
4. Lot,drainaae to he contained on site in proper dry I'lell'
5. Right-of-wa.y permit required for curh cut and drive�.'Iays'.
Rl IA: mj r
CITY OF EDMOND'S
ENGI . NEERING. DEPARTMEO '08TREET FILE
APPLICATION FOR RIGHT-OF-WAY*CONSTRUCTION PERMIT
(A=1i'cant to C�:rplete A & B and Subm.,t in Dur7ZZcate)
Permit to be issued to: 91,:9 IV CO 5
For work at: (address or vicinity) 15-2 7 '-0-0 '+-V .5
Type of work to be done: LU '0
(Attach Drawing !-.Then An -
,plicable)
Time Required �tart:
Owner:
Nam�
Mailing Address
: VA 5
City State
Contractor: 90,V C'C' 5-
Name
Mailing Address
— I .. S f
City State
Finish:
Telephone Number
State License Number
Telephone Number
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, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including but not limited to the defense ofany legal proceedings incl ' uding defense
costs, court costs, and.attorney fees'by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year follow*ing the final inspection and acceptance
of the restoration by the Engineering Department.
Work subject to inspection and restoration in accordance -with City Code. A
24-hour notice i eq inspection by the Engineering Department.
Call 775-2525. V U�5" — -
Signature,: 4 Z2 �, / / -
. OXner or Agent
Date Signed
DO NOT WR I TE BELOW TH I S L I NE (To be ccmpleted by Issuing Agency)
Permit Issued (Date) q n, o7 Permit NumberIG 212-0
Fee: Bond:
Time Authorized: 'r%ktdn
INEEIR'S. AP(PRVVAL
E
loo - � 0
TO
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FILE
ENONEERING REQUIREMENTS FOR COMMER
AND APARTMENT 13UILDING PROJECTS
NA re--�Mn �rnns tructi on 01 sen 641nitt Apartments at 527. Forsythe Lane
Date August 9, 1976
STREETS AND ACCESS
1 1. Right -of -Way Requirements: 50 ft existing
2. Road.Bed Width: 36 ft existing
3. Turn.Around: Required on site
4. Sidewalks: 5 ft existing
5. Parking Strip: None
6. Access Easements: None
UTILITIES
1. Water Mains: 6-inch main existing
2. Fire Hydrants: Existing
3. Sewers or Septic Tanks: Connection to sanitary sew I er required.
4. Drainage: Install all necessary.storm sewers and drainage facilities
per drainage plan and City Standards. Where drainage is across adjacent
private property, all parties having any ownership interest in the lands
being developed shall provide, as a restriction on the title running with
the land, that the City of Edmonds shall be held harmless from any and all
claims for damages which may be occasioned to adjacent land by reason of the
cons�truction-and operation of the drainage system, unless, releases of
damages and/or drainage easements are obtained from the other property owners
affected by said drainage. Any drainage.problems created by change of contour
during development.must be corrected prior to occupancy permits or release
of performance bond. 'Final approval (or release*of bond) will be withheld
until actual drainage as installed has been inspected by the City Engineer.
2123a.
- - -----------
'Enigi.neering Re quirements for Commll &
Apartment,Buildi!$ProjeSe - Page 2
5. . Utility Easements: None
6. Underground Utilities: To be provided in accordance 'with Ordinance No. 1387.
Street Lighting shall also be provided with the necessary street light
standards.and Underground wiring. Street lighting not required.
TnPnC,PAPRV
l.. Excavation and Grading: Excavation and grading shall conform to the requirements
outlined in Chapter 70 of the Uniform Building Code,.latest adopted'edition,
Vol. 1. Where extensive grading and fill 'are involved in the development, a
grading plan And specifications shall be prepared.
QUOTATION FROM THE CITY CODE REGARDING IMPROVEMENTS
11.02.025(f) Utilities and Street Improvements. No building permit shall be
issued for -the construction of any building or structure of any kind or
description unless the plans and specifications include the construction for
curbs, gutters, sidewalk s, paved streets, necessary water lines, sewer lines, and
storm drainage necessitated by the new construction or improvement, to be built
to,applicable CitV standards, provided, however, if found by the City Engineer
to be impractical to construct at the time -of application for said building permit,
construction may be waived by the City Engineer and in lieu thereof a performance
bond filed with said engineer to cover the 6stimated cost of construction to City
standards for said improvements, provided further, in areas zoned single family
residential at the time of said application for building permit in which the
applicant has received final approval for a plat or sub-division,and has compiled
with -requirements therein compliance with this subsection shall be deemed by
compliance with the sub -division or plat requirements.
MI
IUMMM
Rev. April 2, 1971
L
ty Engineer
2123 b &2124 a
V./.0
4
tREET FILE
Dal-e--'Aug-ust 9, 1976
o to: Director of Maintenance & Oneration
From:
Subject:
Public Works
City Engineer
Sewer Connection Charges
Legal Description: See Attached
Commonly known as: 527 Forsythe Lane
Owner: Arne Olsen, Pon Constructioi,
Z.F.F.'Calculatio.n:
67.70 z - T" - 1' - X
$
372.40
Connection Fee
f-ateral- X
s
ion.00
Lateral Charge
st Yk Unit S X
$25
$
15n.00
Trunk Charge
$
in.00
Permit
632.40
TOTAL
CC: Pon Construction w/FldQ Permit
2108
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-7
FILE
DATF! ALMUSt 9, 1976
HEPO TO: 11arry 11hitclitt
Ruildinn Official-
FROM: Richard P. Men
Assistant Citv Fnnin(.,(,r
SUBJECT: Bon Construction ?, Olsen 6-1.1nit Apartments at S27 Forsythe Lane
After review of the huildinn.permit anplication, we have -the. fol-
lo�-,,inq comments:
1. Connecti.on to sanitary sevier reouired; �-Pwer Connection'Charge
due on this property in the amou-nt of �,632.40.
2. Underground %-Jri-nq required.
3. nriveway slope not to exceed 14 percent.
4. Lot drainage to be contained on site in proper dry well.
5. Right-of-way permit required for curb cut and driveways.
RHA: mj r
Dat
PEPHIT ADOR
LEGAL DESCRI N
BUILDING PERMIT REVIEW - ENGINEERING DEPARTMENT CHECK LIST
Instruction: 0 IT" Af PT
Check Accuracy of Lenal Description
Check Anainst Assessor's Man for Lenal Subdivision
Does it conform to City Approved Subdivision?
Reviewer's
Initials
1. This lot included in rtjhdivi iogimat No.:
2. Site Inspection made, on:At, 77f.4
3. What are pround water and soil conditions?
4. site Drainage Checked?_O 10KETAb
5. Storm Sewer Availabilitv_:
M Sht.
Roadside Ditch -0-OF.P-
6. Grading & Final Contour s: AA dAm P
7. . Septic Tank System nesion A proved
P 1
8. San i tar ' v Spwer Pvailahilitv Sh
Side sewer availability: 4Z6
9. Sanitary Sevier Connection Fpes?'
10. Uater Mains P, Fire Hydrants (Indicate S
Check Fire Dept.'s Comments '10
1.1 - SH2.�/Jilk�:__L,�itejnspVtion shows condi
MOM "WE
1 g1v
tions of sidevialks as follo,,qS)'
12. Curbs: Curb Cuts/Priveways (Check driveways for safety, location,
9rade and v,,idth):
13.. Undergroun d Uirinn:—W.010
14. Street Right-of-way ?, I'lidg. setbacks:
15. Existing Utility Easements?— H
16. Access Easements- Kf
N-Ow la Us —Street Lights:
.R)&jf,
j5t::!Fq4" lit. of rifficial Street Map.
17. . Site Plan Ichecked for accuracy?_-o P5
18. Special Requirtvients listed in Herro to
19. Commercial & Apt. Ponuirempnts form co
20. Drawings stamped A notations madp?_t
21. All Items filled in.on Dldg. Permit An
22. Bonds posted for site %q*orl,? kvin
23. Piflht-of-way Invasion Pprmit reQUired?
COMMENTS:
0
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0
LINE:
PINE STREET
.. . ........
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M(D N U M E: N 7- L 1 �,J E
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LEGAL DESCRIP710N
ALL THA-r PORTION OFTHEWE
QUARTER OF THE NORTHWE5T �
TOWNSHIP 27 NORTH,. RANGE 3�
P-OLLOWS:
BEGINN!NG 145.50 FEET EAST,
THE NORTHWEST CORNER Op-'e
SOUTHWES-7 0UAPTEP_ OF' -rHI`
THENCE SOUTH 300TEET.1 r,
THENCE, NOR-J-H 30(7P-EET;
COUN-FY ROAD 123 r=EE7- MO
EXCEPT THE SOUT 25 FEE-
OP- EDMONDS UNDEPAU'DII-OP
'N"FORSYTH 112-ANE -2 1, OCAT101-1
703 TPAU
I2�3-00 i .
N 89 3e' 09 E
v
PLAT'01
LEGEND
0= EXISTING IQ -ON P::'IN VVITH, No, C-1,
CA'
0= EXISTING IRON P>IN \,A, T�! CD. 9161-5
0= ExiS-FtNG IRON P>IN
(D= EXISTING Nj SAI=�E OP- r_>0s_F
I CERTIFICATE
CORRECTLY REPRESENTS A SURVEY MADE BY ME OR
C:TION IN CONFORMANCE WITH THE REQUIREMENTS OF
:ORDING ACT. AT THE REQUEST OF QIC HARE) S L"�/ E---
OF NOVEMBE��_ _19 8!
989 i
L.S. NO.
F
RICHAR
IN SW 1/4 OF NW 1/4 OF. Si
SNOHOMISH COUNTY, . %.
Lovell -Sat
SURVEYOR§
23106 100THAVE.
DRAWN CHE-CKF()__ I DATE
1,
L��CN I G\,A,/L 11-19- 61
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