607 3RD AVE N.PDF111111111111
4905
607 3RD AVE N
APPLICATION
for
The City of Edmonds SEDE SEWER PERMT EASEMENT No . ..........................................
NEW CONSTRUCTION C] REPAIRS E]
113-05700
OwNm .......... �Rhn Wallace
.......................................................................................... CONTRACTOR .................................................................................................. PERAUT No . ......................
ADDRESS ....... 6-0.7 ... 3,r.d ... ............................................. ......... LEGAL DESCRIPTION: LOT No - -------------------------- ................... BLOCK No . ...... .....................................
11
0
NAMEOF ADDITION .........................................................................................................................................
Dye Tested On Sewer 1972
Approved:
DATE................................................ By .................................. ...................................
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6? 9 0 . 1 9 9 -
Ly V IJLJLUJLJL a
RIGHT-OF-WAY CONSTRUCTION
TRE ET FILE' 'PERMIT Permit Number:
Issue Date:
A. Address or Vicinity of Construction: 607 3 Ay, N. (9317798)
A
B. Type of Work (be specific): Install New Service
C. Contractor: -Washington Nat'l. Gas Co.
MailingAddress: 815 Mercer St.Seattle, Wa.
981il
State License #:
D. Building Permit # (if applicable):
E. - 0 Commercial . EJ Subdivision
F-1 Multi -Family E] Single Family
INSPECTOR:
Contact: Frank Swan
Phone: 224-227A
Liability Insurance: Bond:$
Side Sewer Permit # (if applicable):
El City Project 6D.�Jtility (PUD, GTE, WNG, CABLE, WATER)
Other
INSPECTOR:
F. Pavement or Concrete Cut : D Yes XMNo G. Size of Cut: �___xl H. Charge$
APPLICANT TO READ GN
INDEMN17T. Applicant understands and by his signature to this application, agrees ho I Chy of Edmonds- harml4p_ft i affeZ*40ages, or
claims of any jUnd or description whatsoever, foreseen or unforeen, that may be made,,a tat I City of Edmonds, or any of its de artments or employ-
ees, including or not limited to the defense of any legal proceedings including, deffennsi c , �attorneyfees by reason of Gf- ryiryhts p�e�wt.�3
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIPAND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC77ON
AND ACCEPTANCE OF THE WORK ES77MATED RESTORA77ON FEES WILL BE AEE", N77L THE FINAL STREET PATCXq COMPLE7ED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISS&RCP TO THE APPLICANT. U-j- 73
Construction drawing of proposed work required with permit application.
A 24-hour notice is required for inspection; Please call the Engineering Department- I
Work is to be inspected during progress and at completion. 771-0220
Restoration is to be in accordance with City Codes.
Street shall be kept clelan at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City k�gineerr'.
All street cut ditches shall be patched with asphalt or'City appeoved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be available
on site at all limesfor inspection purposes.
Signature: ��� Date: June 2. 1993
(Contractor of"A " if-"'y '.
gent)—i
CALL DIAIA-DIG PRIOR TO BEGINNING WORK
.... ............ ..
. .. ..............
.... - I..., .; �::: FOR:CITY. USE ONLY
........... .. ...... ...
IM . E : :AUTHOR . IZED: VOIDAFTER:.::.::: _)t i�A ^t DAYS: DISRUPTION. FEE/FUND. 111.
...... ....... .......... ........
PECIAL,CONDrrIONS:.:. ORATION:FEE:::
�T .... ....
. . . . ...... ... ........... ... . ....
COMMENTS:,
�DATE::::� :::::.. ISSUED BY:
SHALL BEGIN PRIOR TO PERMIT
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.)
Comments:
Diagram:
S:141f--f.r�
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
-Eng. Div. July 1985
Addendum to City Of Edmonds
Riffh+- P &,
cly
Permit Application
by: Guyla Connors
Engineering Ai . de
Washington Natural Gas
521-5248
&0 -7 S /
\�KC- \�,j KI
NP WNG to Window
Water main depth
unknown
Zto
L gas main
IQC> C(J-t <�
-w-
water
9-
gas .
-ss-
sewer
19-
water hydrant
0
water valve
815 A4=cr St' (Po' Box 1869)- Scaldc. WA 9811, ,.)