543 HEMLOCK ST.PDFIIIIIIIIIIIIII
11462
543 HEMLOCK ST
) m
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
TO:
LU
0
ix
LU
SUSPENSE DATE:
SUPERINTENDENT
Investigate
and Report
Take Appropriate
Action
Prepare
letter/memo
for my signature
For Information
Previously Ref'd
Status of Action?
Return to:
W11104WIFIM1011' &
Aw.t.l.dr.1 ?_0 ,
/,%)�
01
BUILDINGS & GROUNDS DIV. SUPERVISOR
EQUIPMENT RENTAL DIV. SUPERVISOR
STREET DIVISION SUPERVISOR
WATER/SEWER DIVISION SUPERVISOR
TREATMENT PLANT DIV. SUPERVISOR
COMMENTS:
00
P-
F R Om(—�
DATE:
CITY OF EDMONDS
E� NEW
ADDITION
RETIREMENT
DESCRIPTION
ASSET INFORMATION SHEET
ASSET NO.
ADDITION TO ASSET NO.
SERIAL NO.
LOCATION DEPT. NO.
C v I LJ.2— ttj 'd tie "Y' - S-5-0
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
411,,
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE 2
*PROJECT NUMBER w zz-1--ts, q 9
PROJECT COMPLETION DATE
COST -7
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
IN DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT -
0 G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO.
INITIAL
typ)
DEPARTMENT FILE
The City of Edmonds
Side Sewer Drawing
EASEMENTNO . ............................................
NEW CONSTRUCTION REPAIRS 0 LID NO. .............. ASMT. NO . ..................
OWNER . ...... Naklot.0—T .............................. CONTRACTOR e.-OCIVet....
............. PERMIT NO. .6 ..
JOB ADDRESS ......... ........... LEGAL DESCRIPTION: LOT NO . ............ 6 ........ ........ ----- BLOCK NO . ......... ..........................
a
PWW-000 1 - 11175 (R EV. 11/78)
40
4
............................................ /4/
ee!�!tig�:Z
. ............ .
...........
E
NAME OF ADDITION ........... .............................................. TREATMEN-r pLMT.
......... ....................
19
Ale- i lo exf
�, e, " e- c—
4
Z 3'
Approved:
DATE --------- Byt" �- ........... ......
r. 41
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT FOR INSPECTION CALL Permit 1"J30
775-2525 Ext. a,5L
SIDE SEWER PERMIT ?t Issue Date
PERMIT MUST BE POSTED ON JOB SITE
L__ ANWIdEw 1�1�
l.. Address of Construction _s-,v-3
2. Property Legal Description (include all easements)
vMeEA 'MENT PtAh
"a
3. Single Family Residence Multi -Family No. of-K-WovED
Commercial
4. Owner and/or Builder
JAN 5 11983
PUBLIC WUKK5
5. Contractor & License No. A'A ,yk ( #
6. Invasion into City Right -of -Way : No Yes (If Yes Right-of-
way Construction Permit Required Call Dial Dig 'i342-5344) before
excavation) .
7. -Cross other private property: Yes No E t required -
attach legal description and county easement nu e�r. ^
READ THE FOLLOWT.NG AND SIGN
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 reponsibility for each
installation for one year.
C. Commercial establishment requires a minimum of a six inch (6")
side sewer line. I
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). 0
f. No turn in side s8wer greater than 45 (.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 100' 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 (2) working
days notice required.
DATE: 01. /) Ao_,_,�
I cdrtify tha-t:-'I' have read
and shaft comply With the above
PERMIT FEE: ��C). (7)(D DISAPPROVED BY: Date:
I'T ., IAK ", hmru, e, __2 ��, 0 0 By: Date:
CONNECTION FEE: Date:/,?
134 :::) APPROVED By:���_
PERMIT MUST BE POSTED ON JOB SITE
0 0
PUBLIC WORKS DEPARM4EM CHEC[CLIST
BUnZING PERMIT REVIEW SY3 4&
(address) e)
Street Right -of -Way Existin� �30
Z
Access Easeam ts Existing
REQD
H
pd
Utility Easement Existi%.
REQD
W
Lot Per Subdivision --Plat
Assessor MP_2j;L_
W
Site Plan Checked for Accuracy,
Z
Underground Wiring Reqd.
0
Check Accuracy of Legal Descriptia�
Z
Review by.
Date &0 -
94.
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing,
9
Hydrant Reqd Per Fire Code-
Size
94
Detector Check Meter Reqd. &
Cross Connection Inspection
Fire Department Conments
Water Meter Charge Reqd.=#',/5
Review by,
Date.
Septic Tank Design Approved
Date /0
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability. S
Pro*.
DrwAng No. L-1 N
File No.
C4
Side Sewer Availability R 1%,
94
Sanitary Sewer Connection Fee Reqd.
Z9
Review by,
Date—/#
Open Ditch Exist'
1%
R eqd.
Culvert Reqd._ =:±4
Size
ad
Catch Basin Reqd. A)
Indicate on Site Plan
0
Shoulder drainage naintain collection on
swale open runoff
Manhole reqd. ALL:)
Indicate on Site Plan
Soil Conditl and Ground Water Field Checked C)/<�:_
Review b 7 f
Date
Revised: lvlO-1977
Page 2 0 0
Street Paving Reqd.
Curb and Gutter Reqd.
Sidewalk Reqd.
Curb Cut for Driveway Reqd.
ad Right -of -Way Constructim Permit Reqd.
Bond Reqd. for Public Inpravenents
Street Name Sign Reqd.
Other Signing Reqd.
Pre Permit Site Inspection made on
z
0 BY: SM4ER
WATER
H z STREET
;L4 ENGINEERING
$4
0
ad
P4
Special Requirements listed in memo to Com=ity Development Departrim t,
Building Division
BY Date
All item filled in on Building Permit -Applicat im�
BY Date,-..,
Drawings Starrped and Notations Made
BY Date.
Approved by Public Works DepartmEnt
FeAsed: 1v 10-1977
"LOT G 140MVL4"V
'42AT�y Or G'F>"oK>D5
A
OCT 1 11982
7 0
711;� 3
rZ ON E 7-SS:—
S T
SETBACKS:
F-) L A-- t-J 2 0 cf 7
FRONT A-5 r% L A. P")
SME
R REAR 90
EAR
0 T .44
THER
T
HEIGHT o,2z'
T
f --�flnl-ffeveas
UPMR /-4-Y ADS 42M Aae e0r,
Cx-rcm, 52. 41r llr�*t Ab 5
anwriow FI!X LAWTH cawrvzt. ex-ric"
Mow, g.-M" COVrA
% SLOPE -a-
To Me-- n".%;
'TO OLFTLXT I
("VW" -VW
4"marva ,
SYSTEM CROSS SECTION
SEE PAGE 3 FOR OUTLET CONTROL DETAIL
2' - 2' - V'CP2:r-r, 4t. a.' SP^LLS (M WOLKL)
r- Arm— I
RIPRAP OUTLET
-OW TRENCH, MIN 10' LONG,
T01' 4 4" PirmF PIPE -To sE 6&vwL.
TRDM
DVTLLrr
RUNVFF Rj Fbft WITH CkF5
RP A OUTLET
ARD DRAINAGE PLAN
--r—
DETENTION SYSTEM
PAGE I OF 3
for --agimr: 66M.&N-C,
location A&yewm WA
plan by MiN
phone - V 77/-giW—V -
date- A& �2-02!
DESIGN DATA
System Imperm Pipe Pipe Orifice
Number Area Diam Length Diameter
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the resDonsibility
of the property owner(s). Material
a ccumulated in the storage pipe must
be flushed out and removed from catch
basins to allow proper operation. The
outlet control orifice must be kept
open at all times.
I
.9i
CITY OF EOMONOS
PART S-i CROSS SECTION
BRING CAP UP NEAR TOP OF CATCH BASIN
3" SUP I ", SWA
3"PIPE, LENGTH VARIES
3" MALE ADAPTER
3" FEMALE ADAPTER----.,,,
1/4 BEND WITH HEEL
INLET (3" - 2"
SPIGOT END UP
2" LONG. 2" DIAM
PIPE SECTION
TEST CAP WITH ORIFICe-�,
3" A e REDUCING COUPLING
WITH I of LONG SECTION
OF 3" PIPE IN END
3 " SHOWER DRAIN STRAINER,
STAINLESS STEEL
fit SW - SOLVENT WELDED JOINT
so
THREADED JOINT (GREASE)
SW*
SW^,
SW
ALL JOINTS
WATER INFLOW
CUT CLEAN, ROUND HOLEIN CENTER OF
TEST CAP TO DIAMETER SHOWN ON PAGE 1;
SOLVENT WELD TEST CAP INTO REDUCER
STRAP FEMALE ADAPTER
TO CATCH BASIN
3 of OUTFLOW PIPE:
21 MIN OF 31' ABS
OR PVC; 3" MIN
RIGID OR FLEXIB'-E
PIPE TO OUTLET
SAMPLE ASSEMBLY
AT ENGINEERING DIV
STANDARD DRAINAGE PLAN
DETENTION SYSTEM
PAGE 3 OF 3
OUTLET CONTROL'
CITY OF EOMONDS
ASS OR PVC MATERIALS EXCEPT AS NOTED
0
PUBLIC W%KS DEPARU= CREaCLIST
BUIMING PERMIT REVIEW sy? 4M 6de,
(address) _Otef
0
Street Right -of -Way Exist
Z
Access Easements Existing,
fEQD
Utility Easement Exist
94
Lot Per Subdivision
Plat
Assessor �lap
W
Site Plan Checked for Accuracy
e,
Z
Underground Wiring Reqd.
qe�
0-4
0
Check Accuracy of legal Descriptio�
jc,
Z
Review by
Date /,4 Ar A�
Existing Water Main Size 17Z C i
Water Main Required 4V
Service Line Required
Hydrant Size Existing
Hydrant Reqd Per Fire Code
Size
94
Detector Check Meter Reqd..
6411,
Cross Connection Inspection
--
Fire Department Comments
4ater Meter a -Large Reqd.
7
Review by
Date__
Septic Tank Design Approved
Date A9
Septic Tank Permit Reqd.
Permit No.
Sanitary Sew7er Availability
Pro*
Drm4ing No. L, I r)T
7 q,
File No.
Side Sewer Availability tk
1%�
Sanitary Sewer Connection Fee
Reqd.
:r.
Review by
Date__L# -/f
0
Open Ditch Existing
R eqd.
2:
Culvert Reqd._
Size
94
Catch Basin Reqd. A) t/-')
-Indicate on Site Plan -
Shoulder drainage maintain collection on
swale open runoff
Manhole reqd.-
—Indicate on Site Plan
Soil Conditl and Ground Water Field Checked
Review by=,7�r_._U-
Date
Revised: lvlO-1977
0
0
MEMO TO:
FROM:
SUBJECT:
Building Division
Planning Department
Engineering Division
Public Works Department
DATE: 10-4�-YZ,,
After review of the subject Building Permit application, we have the following
comments:
1. Connection to City water system required.
2. Connection to City sanitary sewer system required.
3. Right-of-way permit required for any work on City property.
4. Driveway slope not to exceed 14%
5. Backwater valve required if downstairs plumbing is below elevation of
upstream manhole.
6. Water and sewer lines to be separated by 10 foot minimum.
I-
7=2
4,
BD 6/82
CITY OF EDMONDS NW
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
i-
Z
U
�4
0
U
0
Z
0
0
RECEIVED Pwt No. Qr�)
Issue Date it) b7 1R.;7—
OCT 2 8 1982 f
A. *Address vicing 4 Construction
_r;4t - -3 4�C-MLOC-r- \1
e Owner: F2L0EPR1y11JT M:6<51
Name
7-9;'to(p I
Mailing Address
I-=VMONOS
City, I State, Zip Code
* Contractor:
Na,
'NO18 %3G Hwy 99
M III g Address
P WA
City, State, Zip Code
9 Permit Issued To:—PU)D
T
• Type of Work to be Don : S09-4&
1-IF—ENCH e—'k * 11\)STAU-
• Work in Connectionw 12:L-ECT121C 1-1 Q
El Sub or Plat ingle Family
0 Comml. / Ind. El Apt. Condo.
9 Pavement Cut: El Yes & No
State LiILTbet, -2
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
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 City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal
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 restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering.
Call 775-2525, extension 220.
I understand that this permit must be available at the job site or in tion purposes at all times.
�\ % & -- Date 10 -27-8?
Signature:
Owner or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SITE FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: 'M —10—tIOUS4�c'a
Time Authorized: Vold after days
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit:
Receipt No.: .
Fund Ill Fee:
Street Cut Dimensions
X
* * No WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
PLOT, PLAN)
SCA.LC-: I'=20'-0
<_ 140MEL,&"V
-;��-(N40Mtb" C-O.,
C�IT�r Opr ErFomop,)D5
Ad
Al
RL /s, Q 2097
L
o!
Q0
IZ A..(;C
M ELO LAJ
---74
HEMLOCK-
I ILI L t. I P I u-
Commercial
BUILDING ADDRESS: AJ0641 Iddak
BLDG. DEPT. SUSPENSE DATE d JOINITIAL DATE
OFFICE ADMIN.' — PUBLIC 14ORKS /LOG IN
�ITY ENGINEER (check)
L C3 Access Slope and Vehicle Access Iola—,
0 Drainage Plan
C]Street File
ElLegal Description
DQuic C laim
DEasement
::;.06a Uate -Sewer. Connection
TER/SEWER DIVISION
eterm ne'.-Meter. Size 10
el
313D" i
ldi�j Per'mit'.'Review' .4
mplete,,Bui
Co
[%TREDIVI
ET SION
IgComplete�:Buil'd"inilg Permit',Re'view
[]OFFICE ADMIN.. LOG OUT-Tb BLDG -.-' DEPT.
--------------------------------------------
------------------------------
UILDING PERMIT APPLICATION (COMPLETE).
COPIES OF SITE PLAN 2-
2 COPIES OF FI RE PROTECT110N PLAN
(PREVIOUSLY REVIEWTED BYFIRE DEPT.)
.051-COPIES OF DRAINAGE PLAN WIT=====�
H CALCULATIONS
REQUIRED BY SUBDIVISION [I
GREATER THAN 2,000 'SQ. FT.
IMPERMEABLE SURFACE E]
LESS THAN 2,000 So. FT.
CHECK ZONING'REQUIREMENTS (SETBACKS)
O'l COPY OF ENGINEERING CHECK LIST
1 COPY OF PU7LIC 14ORKS Maio
MULTIPLE OR COIZIERCIAL
YES 'WrACH COPY OF ADB, APPROVAL INCL. ALL DPA!,1INCS)
NO
SUBDIVISION — YES[] NAME.
DATED RECORDED
NUMBER - - :
NO (ATTACH -copy'o-r -REoIJIRF2,UjqTS)
CHECK SEWER DRAWING AND ATTACH COPY
IS DEDICATION REQUIRED YESQ (OBTAIN QUIT CLA120
No CITY CODE
DOES CITY 11AVE EASEMENT ON PROPERTY
YES (ATTACH COPIES OF DRAWINGS)
NO ------
CHECK LEGAL ACCESS' INGRESS[] UTILITIES[]
YES YES []
NO NO [3
HAS SEWER ASSESSMENT BEEN PAID
YES Lj L. I. D. NO.
PLAT NO.
0 El
0 1 F-MULTIPLE: INCLUDE NUMBER.OF UNITS"''
F". COMMERCIAL: INCLUDE NUMBER OF FIXTURE UNITS*
USE
CITY OF EDMON1% ZONE R's —
CONSTRUCTION PERMIT APPLICATIO)INjog
FSNAME (OR NAME OF BUSINESSY
't�ES
MAIL tIDD
Z 3S
0
CITY TELEPHONE NUMBER
7;71
ADDRESS
TELEPHONE NUMBER
NAME
ADDRESS
0
a: CITY TELEPHONE NUMBER
Z
0 7,7/
STATE LICENSE NUMBER CITY LICENSE NUMBER
le�4 LA-1
Legal Description of Property - include all easements
(show below or attach four copies)
Z
9
Cx
0 1k_-
5N CHELC!K MUBDIVISION
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING 3_192 REQUIRED DEDICATION
PROPOSED —so
RIGHT OF WAY CONSTRUCTION PERMIT REQUIREQ,00�_
STREET USE PERMIT REQUIREDF]
SEE ENGINEERING MEMO DATED ID
SEE PIW DEPT. REVIEW CHECK LIST DATED
REMARKS
METER SIZE IBUILDING SUPPLY SIZE
REMARKS
RE UNITS
SIGN AREA I COMPENV. REVIEW
ALLOWED I PROPOSED LETE I EXEMPT
VARIANCE OR CU
YARDS
21) FRONT SIDE
EI11
NEW [TRESIDENTIAL PLUMBING
ADDIALTER NON-RESIDENTIAL E] MECHANICAL
REPAIR RETAINING WALL SIGN
CHECKED BY TY
Li DEMOLISH
EXCAVATE
Li OR FILL
EPRE -MOVE INSP.1
] COMPLIANCE INSP.
FENCE
Li (_ x
swim
EIPOOL
—FT)
SPECIAL INSPFC
REQUIRED
F1 YES I!NO
SIDE SEWER
WATER LINE
REMARKS
NUMBER OF STORIES
NUMBEROF
DWELLING
UNITS
NATURE OF WORK TO BE DONE -,(ATTACH PWT PLAN),-)
G -REVIEW BY
OCCUPANCY
GROUP
ADB NO.
SHORELINE N
DATE
I
-RAILOT COVE. E
7,5% A=4,+k
OCCUPANT
LOAD
0
VALUATION
FEE
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
_�ermit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
'2 harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
a:
4 whatever nature, arising directly or indirectly from the issuance
3: of this permit. Issuance of this permit shall not be deemed to
0
modify, waive or reduce any requirement of any city ordinance
---
11
0
T nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision." I
1
I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or theduly
ATTENTION
APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
AUTHORIZES
This application Is not a permit until
ed thereby, no person will be employed In violation of the Labor
ONLY THE
signed by the Building Official or his
Codq of the Stateof W shington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
tion IlInsuranee.
INSPECTION
acknowledged In space provided.
,7y,7E,1tTI
I SMtutm V/
SIGNED
DEPARTMENT
OFFICIAL'S SIGNATURE
r _JDATE
CITY OF
V THIS SITE IS LOCATED IN THE CITY
EDMONDS
OF EDMONDS. LOCAL SALES TAX 775-2525
ATTENTION SHOULD BE CODED 31.04.
DATE
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORC� ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED.
UBV
CHAPTER 3.
PINK — Owner GOLD — Assessor
102-78
K-on .g - ld�ft W�