540 MAPLE ST.PDFIIIIIIIIIIIIII
12131
540 MAPLE ST
P,
APPLICATION
The City of Edmonds for EASEMENT NO - ------------------------------- ............
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID No - ------------------ - AsmT. NO - ------------------
-j
OWNER................................................................................................ CONTRACTOR .................................................................................... PERMIT NO . ....................
-IV_-- �7-
JOB ADDRESS ...................................................................................... LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
0
.............................. I ....................................................................................
-----------------------------------------------------------------------------------
Approved:
DATE ��7 -------------- ------
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.
AbDRESS LOCATION bF CONStRUCTION ........ 5.4.0 .... HaDle .... StrAet ................................................... . .......................................................
.. ... .. ......... .. .. ......... .. ......
PROPERTY LEGAL DESCRIPTION ....................... L.ot.s .... 17 ... L; .... 1.8 ........ B.19-qk .... 1.2.2 ........ C.i.tv..'.o.f ... E.dmo.n.d.s ...............................
... ...... .. ...... .... .. .. ... .. .. .. ... . .. .. ...... . .. ... ... ........ ... .. ..
.................................................. . ....................... ........................................................................ . .............. . .................................. . ..................................................
................................................................ OWNER AND/OR BUILDER ......... JA.C.K --- JACPBS.En ......................... . .......................................................
CONTRACTOR'S NAME & ADDRESS ........ Ru-s.s ---- Johns.on ......................................... . .............................. . .. . .......................................................
Permission Is gTanted ............ ...... May 13.
------- ...... ... ....... 1 19.77', for repair and/or connection of a side sewer to the city sanitary sewer
in a4ccordance, with Cit;y of Edmoi4s* oWi�.nces.
OM
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—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 regaxding 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 �fi 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 madn sewer or its appurtenances except to In-
seft the pipe into the wye.
DISAPPROVEDDate ... . ................................... By ................ Date ---- ... By ---------------- Date .............. . ................... By ................
APPROVEDDate.—//*.. ------------------- By.—� . ........ ... . .. . .. . .......................................................................................
i n of Rieht-of-Wav) Permit Reauired.
Renliarks: 0 ................ . ........................................................................... ...........................................................................................
.......................... z"O.-
---------- ....... 0 ....... . ........................................................................................ . .................................. . ............................................. .........
B0 F e rnmn opi T Be * ed By Owner of Firm Performing Construction PRIOR To Request For Inspection
I— ... .... ........... .................... hereby certify that the side sewer installation constructed under this permit
w r o Cc racting Performing Co'ns't'r-uct'ion')
i r
wl gov
:tTt
was install in ac rd ce wit 1 governing ordinances of the City of Edmonds.
C—
Dated this ..... . . ............. day of ...... ///;/W ................................ . 19-72
V V Check BEFORE you dig for: Water 0, Gas 0, Telephone 0, Power of, /`Swel�6, Other 0 V V
The City of Edmonds
APPUCATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS El
EASEMENT
LID
�VPMM11 �� 4 49
ML4 -
OWNER
....... \j -c 49,06 A2 CONTRACTO
-- ------------------ IL
40.. -------- PERMIT NO
JOB ADDRESS .... --------------------- ---- LEGAL DESCRIPTION: LOT NO - ----- ------- ., BLOCK NO. /g;;�2 ------------------------
------------------------------------ .................. ......... ............. ----------------- I ------------- --------------------------------------------------
NAME OF ADDITION ---------
MAY I j IV7
Jwom VORL
Approved:
DATE-------------------------------------------- By --------------------------------------------------- fi7.yg
CITY OF EDMONDS
L
ENGINEERING DEPARTMEO
APPLICATION FOR RIGHT -OF -,,!AY CONSTRUCTION PERMIT
(AvrZicant to Cc.-,-7plete A and Subm.,t in Du:)Zicate)
....... .....
A. Per�mit to be issued to: -
For work at: (address or vicinity)
Type of work to be done:
(Attach Drawing When Applicable)
Time Required -- Start:
Owner:
Name
Mailing Address I
City State
Finish:
Telephone Number
Contractor: "ito
X
Nanfe State License lNumber
MaiAg,odress
City State
7�z - �� �? 5--'
Telephone Number
F F'7 Z.
B, 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 of any legil proceedings including 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 following the final inspection and acceptance
of the restora�;�� the Engineering Department. I
Vork subjec� to insp A
Vti�n and restoration in accordance with City Code.
24-hour no ce 1 irer//r inspection by the Engineering Department.
Call 775-2 25.
Signature:
or #ge9ft — Date Signed
C, DO NOT WRITE BEdOW/THISLfNE (To be completed by Is8uing Agency)
Permit Is ued (Date). Permit Number2.7- lif
Fee: 112i'50 Bond:
Time Authorized:
INEER'S AT
o2 IR /,�, I�Z—
MIDIO TO:
F RO'I :
SUBJECT:
Harry �,!hitcutt
Buildinq Official
Richard H. Allen
Assistant City Engineer
b?t�2- c--,r-->P\r
After revie,,.� of the subject building permit application, we have the following
comments :
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Pc(p/ircd ��r��� r-'"lo �i
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Petcctor (1cck �'Cter Rem oired
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Fire l��`n/coin. [oncic2t,"—
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-- scntic Taill-,
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! x Septic T.nm:
.C/i|n! A�`rnvcJ l\'tc
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�. �OrPlit
11(!ViCl,.r by Pate
Culvort
�
Tndic,!te on Site Plzm
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4TIUTr
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.t- 0 111MLIC 1%'OTZJ2S P!:PT. 0 R?
n' LIST
u
F-H
ra:
Street Right -of- Ilay Existing b Q6 1
7
U-: D
Access Easenicats Existinp D
Utility Easement J.'aisting urn
P3 at
Lot Per Subdivision Assessor 11,n)
Site Phm (-lecked for Accuracy
1hicicr-mind I.Viring Raid.
pla�� 14wafaq of Le-qui Lluripl-Ibm
Exis,ting, 1�iatcr �Mllin Size
1'07ater �Iain Required—
Ser�i&e- lifie-Rkypep(A .
Ilydrailt Size Existin2
Ilvdrant Pcquired - re
P1?r.h , Code.
Detector (11c6- 1'ictcr Rcquired
Crc6,; Gmfiedibn fw�pejibn
Fire IN-m'ITUalent C.Op.ncits
=A 11ate
TRT
--.—Size
VOL%- Ale 6- chr-Im,le
Reviev., )ntc
<
Scntic Taffl, Dcsj�T. APproved Date
Scptic Tanlk Penat Renuired ;16� .'To. �S/A
Sanitary Sewer Avail.ability Proj.
I I - u -0 e.�
V4 Alsi -- --
Fil.c �!O. C)�-O a5!
Side F;ewer Availabiht�;Im*--
r, Smitary Sewer Connection Fee Pcquirccl--
Review I
In? Pate
1� I �A�
y led
I
q)en Pitch !xisting �j n K) ZK- Recuire(I
Culvcrt Pequire 7�,�,/, Size 41,0&ZAN
0 �t -,e4w4
Catdi Basi.n.Renuired ve < Indicate oil �7itc 111m
ColliK C--
T16n i n 5w
0 Pen rct ri D
Indicate oil Site Pll,)
Soil Conditions F, Ground Water Fi eld Giock-ed
F Review bv Date
r
0
rA
E-
Street Ilaviiin Requircd
Curl) -and Gutter Reouired 49NI 4%
Sidev.,alk Pequired L—CE 5
Curlb ait for Driveway TZc(iuired-_
Pj.rht-of-I,',av Construction Pei-mit Rmuired
Bond Required for Public Improvements
Street Name Sip-i
Other Sig
,ning, Required
Pre PciTait Site Inspection made on— , . -S I ) 4�--j 1 -7 -7
BY: Scv,,er
Water J4
Street--
'Enginecring
Special Requirements listed in. memo to I'Milding T\-,p,-irt)ncnt
By�— Date
All i tenis filled in m Building Permit Application
By-- Patc
Drawings St.-uripod and Jotations Hadc
N Ritc,
Approved by Public 1,orks Department
MOMEMM!=
INTER -OFFICE COMMUNICATIONS
DATE April 18
TO Dorothy Drobner
Utility Billing Dept.
FORM 41 - LITTLE'S
FROM Building Division
SUBJECT: Jacobsen - 4 Plex
540 Maple St.
A'review of the plans for this installation indicates a
plumbing installation of 26 fixtures with a total of 34'
fixture units, pressure of 60 PSI and a distance of 100
feet. Table 10-2 of the Uniform Plumbing Code indicates
a need for a 3/4 inch water meter and a one inch building
service.
��a - �_ 19 --7
BlUg. Off DT.
PS/ae
Bldg. Ind�,. Dt.
1977
4W_
11
-,BIJ,RLDING DEPARTMENT
Applicant Fill
USE PERMIT
ZONE N U MBER
PERMIT APPLICATION
Inside Heavy Lines
JOB I
ADDRESS
NAME JOR NAME OF BUSINESS)
VARIANCE OR COND. USE NO.
r
D8 NO.
HEIGHT
I
W
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MAILING ADDRESS
PROPOSED YARDS
LOT COVERAGE
0
FRONT SIDE REAR
CITY
4!�d'lm
TELEPHONE NUMBER
SIGN AREA
ALLOWED PROPOSED
_7c
ENVIRONMENTAL REVIEW
0 COMPLETE El EXEMPT
a
Z
i
U
NAME
9&6 A) if S� 7"'V,
REMARKS
z
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W
t
-AbDRESS
I
U
PLANNING DEPT. APPROVAL DATE
0:
C Y JTELEPHONE
2- VX11V U-� 40 Cke-//
NUMBER
LEGAL LOT
[:1 YES NO
-7 AREA
SUBDIVISION NO.
-0/7
NAME,
STREET R/W
EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W FT. FT.
0
F.
U
<
ADDRESS
z
CITY
TELEPHONE NUMBER-
REMARKS
Driveway slope not to exceed those
0
indicated on standard Drm
U
STATE LICENSE NUMBER
CITY LICENSE NUMBER
Z
Legal Description of Property (Show Below or Attach Four Copies)
24, 0 7" 7 a /X K&
STREET AND/OR UTILITY WORK
REQ'D. 10 YES 1:1 NO
1
R/W PERMIT REQUIRED
iMYES NO
-0
W
W
Z
0
UNDERGROUND
WIRING REQ'D. NO
19YES E
z
ILI
F_
IL
(t
U
V)
W
W
j
TYPE CONNECTION yESIVERIFI
V
SANITARY SEWER NO
D BY
'T 1)
SEPTIC SYSTEM
APPVD BY CITY ENG. YES
NO
RMIT NUMBER
REMARKS
METER SIZE
SERVICE SIZE
RANCE
BY
7
ICHECKED
a:
W
GAS
NEW E'RESIDENTIAL LINE
ElADD 11 NON-RESIDENTI]AL SIGN
D DEMOLISH RETAINING
WALL
DA'LT E R EXCAVATE FENCE
F� OR FILL
0 REPAIR PRE -MOVE swim
r INSP. POOL
REMARKS
FIRE ZONE
TYPE OF CONSTRUCTION
I
ICODE
SPECIAL INSPECTO AREA
REQUIRED
El YES C1 NO
OCCUPANCY OCCUPANT
GROU P LOAD
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31,04,
'W
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
REMARKS
.J
NATURE OF WORK TO BE _QONE
ItICIV 7�-
Z
0
PROPOSED USE
X ?;S le-lef Al 11,4
PLOT PLAN (INDICATE BUILDING SETBACKS,&
PLAN CHECK
NO.
VALUATION
FEE
Ir
u
0
W
ABUTTING STREETS)
BUILDING
PLUMBING
-
0
HEAT 8, GAS LINE
L10)
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
7'