620 DAYTON ST.PDF11111111111111
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620 DAYTON ST
TAX ACCOUNT/PARCEL NUMBER: MU
09(p o-c)-TY�
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: E] Conditional Waiver E] Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $.: LID #:
SHORT PLAT FILE: LOT: BLOCK: LO
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSTs\Forms\Street File Checklist.doc
NO: 9805.
0/09
Ci* of Edmond','
y PERMIT. EXPIRES
SIDE SEWER PERMIT.
Address of Construction: 'u, 'D C-1 4-0 VN LID*
Property Tax Account Parcel No. 6Oq3,q ?.-'6 q(P 66-700
Attach copies of all access and utility easements Nerified and Approve'd:b
Owner and/or Contractor*
Contractor License#: L) 6quildin' Permit #:
ingle Family -of Way- El Yes
Invasion into City'*Right HrNo
Ers
r-1 Multi -Family (No. of Units .:.*RW Construction Permit
E] Commercial (No. of Units.: Cro I ss other "Privat'o Property: El Ye's EB-N-o
F� Public **Attach legal description and.copy ofrecorded easement.
dm Owner/atot
6wner or contractor signature,and acknowledgement statetnent:,�, Date
By signing for this permit I certify that I have read the Cit" s'public handout entitled
y
Side Sewer Specifications, and shall comply with all. City requirements'outlined therein.
2 CALL DIAL -A -DIG (1-8004YT4,1-55'55) BEFORE ANY EXCAVATION 2'.
;9 FOR INSPECTION CALL 425-771-0220 exten'sio'nf. i3a am
24 HOUR NOTICE REOUIRED FOR ALIL INSPECTION REQUESTS
White Copy:, File Green Copy: Inspector Bulff Copy: Aplblic�nt
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DAYTON ST
back of house
Chain link fence
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Bend
3�' 6' Deep
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REPAIR
E.D* CITY OF EDMONDS SIDE SEWER AS— BUILT
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620 DAYTON ST NTS
HOMEOWNER CONTRACTOR
ROTO ROOTER
DATE DRAWN PERMIT
12/30/03 By. 1. ABILA NO. 9805
CITY OF-EDMONDS Permit No.
PUBLIC WORKS DEPARTMENT Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMIT TRIEET FIE
A. *Address or vicinity of Construction
620 Da:�tChn Street
0 Permit Issued To:
• Owner: TRashinaton Hatural Gos 0 Type of Work to be Done: Job # 813-140
Name . Main Extention — See Attached
805 156 AV NE 9 Work in Connection With:
Mailing Address 0 Sub or Plat El Single Family
Bellevue, Washingtpn 9800 11 Comml. / Ind. 0 Apt. Condo.
city, S ta te, Zip Code 0 Pavement Cut: 0 Yes 1:1 No
• Contractor: Same As Above
Name
Mailing Address State License Number
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el City, State, Zip Code Telephone Number
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NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
INDEMITY: 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 it's 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.
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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.
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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.
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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 perpqt �hust be availabi V,
Signature: Ay&__�Aut
0 7-
wrier r AAEnt
site for inspection purposes at all times.
June 30, 1581
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: C.
Time Authorized: Vold after days
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
X
RE-CEIVEL)
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE *NOV 10 1981
Eng. Div. December 1978
FIELD INSPECTION NOTES (Fund 110 RoMe cony to Street Dept.
Comments:
Diagram:
Contractor called for inspection Yes No
Work Disapproved By: Date: By: Date:
Work Approved By: Date: --r 82
lnspectorj�
Eng. Div. December 1978
APPLICATION
The City of Edmonds for
SEDE SEWER PERYaT EASEMENT No . ..........................................
NEW CONSTRUCTION C] REPAIRS C]
OVVNER...... ................................................................ CONTRACTOR -------------------------------------------------------------------------------------------------- PERMIT No . ......................
..... ,S�t ----------------- w ................................ LEGAL DESCRIPTION: LOT No . .............................. ............. — BL0CK No . .............................................
ADDRESS
NAMEOF ADDITION .........................................................................................................................................
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DATE............................................. — By ......................................................................
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A VA%hrigtryi &vNw Ginvam
COMMUNITY DEVELOPMENT DIVISION
CIVIC CENTER
505 BELL STREET
EDMONS, WASHINGTON 98020
Gentlemen:
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Washington Natural Gas Ccrrpany hereby applies for permission to:
Permission is requested.to install 801 of 2" Plastic Gas Main in the
alley bounded by Dayton Street on the north, maple street on the South and
6th Avenue on the west. Installation to extend from 1621 to 242' East
'-� 2 0
of the centerline of 6th Avenue. To serve the address of�- --._Dayton Street
Per Attached Drawing: 813-140
We would like to begin constzruction about julM and will require
approximately days to ccnplete the worR. If we have your
a.0
approval to proceed, please sign and return the original of this form.
(Please enter any special ccr-ditions.)
,7PP-lication Date-'-.77unp '40,-1981
�A=TC-rGN NATURAL GAS CCMPPNY
A
jrDouglas V. Darrrn
Distribution Engineer
Eastern Division
Washington Natural Gas is hereby authorized to perform the Work described
above in accordance with their franchise responsibilities and are further
subject to all applicable federal,state,county and/or municipal ordinances
and specifications.
Approval Date. RECEIVED
NOV 10 1981
805-1561h Avenue North East. Bellevue, Washingto t;8(91- Tt:1'-Ph;'11e(206) 289w.CQ%-011Cj_
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1TEM IQUANT.1 IDESCRIPTION STQCK N6.
BILL OF MATERIAL
408
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LAY DETIECT WAMING VVIRE OVER -AM'
WASHINGTON NATURAL GAS COMPANY
D.
PERMIT G.'R. 7
PERMIT 1/4 SEC:
PERMIT Op. MAP
TAX CODE PLAT NO. 16,3-66
AREA SEO. NO. -,::P0Q5
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DESCRIPTION
DATE BY APP �D C H EK'D DRAWft4b
SC L
REVISIONS S ALE APPID 0
NOV 0 1981
Dir. Of Public Works