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626 ALOHA WAY.PDFiiiiiiiiiiiiii 10152 626 ALOHA WAY 'JAN 9 ID/00 ............. .. ...... Distzict. IF City of Edmonds --- Water Department TAP CATUb 1-9-1964 Date..................... ... ....... Mete........ ............ Tap No .................. ..... S 3/41" ............................ Size ....... . .... . . . ................. Mf9rs. No .................................................... Style ......................... For............................. 62.6...Aloha-..Way ................ ............. . ....... ..... .. ............... ......... Harold Duciley . ..................................................................... . ................ . ................. ....... . ................ ...................................................................................... . ....... . ... . .. ...... . . . . ..... — LotNo .............................................. Blk. No ......... ...................................... Add . ........ ............. ............................................................ ......................... Service Location ................................ w ......... ........................................ .................................................. . ..................... I .............. . ...... . .... . ....... . . ........... — MeterLocation ............................................................................. ......... . . MakeTap ............................................................ . ........ ....... . .......... . .......... .................................................................... . ................ . ....... . ... . . ....... --4- Pressure .............................. lbs. Test .............................. I ...... % Send Bills to .......................... . .... . ....................................... 7 ........ .... . ..... . .. Date of Work ........... 0-3 ................................................. .......... / .......... . .................. .................. . Foreman Gu.ar' Voucher No ........................................... $ .................................... . ..... Remarks: ......... . .................................................................................... . ..... . ..... ..................................................................................................................................... ....................................................................................... v . ................ . ....... . ............... ...................................................................................... ....................... ... .... . ......... . . OUTGOING Indm ......... Reg ....... Route BL ..... . . Stencil.. -.Car&.. — INCOMING Indem ......... Reg ....... Route Bk .... . ... Stencil ..... Mate*Chargeable to Installation Mete NO. 8IZE DESCRIPTION _i7,7er RATE AMOUNT -------------- . ....... ........ .............. .......... Meter Box ........ * -------------------- ------------ ....... . . ............... .......... : . Meter Plate ............................. ... ------ I ------ - ............... .......... Check Valve .......................... .............. ............ .... ::-.. Pipe, Galv. Screw .................. .............. . . ......... .. . ......... .......... Nipples.................................... .............. - --------- .......... -- ----------- ---------- Bushin'O ........ ------------------------- 11-11 ......... - .......... ---------- ........ --- ------ --- ---------- Plaii.1 Ells . ............... ................ .............. .. . ............... .......... St. Ells ............ .......... .............. .......... i------------------------ --- Tees .1 ----------------- ...................................................... -------- 11 .... .............. .. . ........ ............ . . ....... ......... -------------- ............... ---------- ....... .......... ........................................ ........... ...................................... ........ I ------- ...................................................... .............. -------------- .............. . -------- .. ............ ......... 0, ........... . .......... ...................................................... .............. -------------- ---------- ------------------------------------------ .......... ...... 'i"' Material Chargeable to Taps Connected -NO'f .... DESCRIPTION RATE AMOUNT ......... f ...= �'SIZE ..... Pipe, Black Screw ................. .......... ........ ......... . .. .......... Pipe; Galv. Screw ........... .............. ...................... -------------- -- : ........ Lead Connections ....... ........... .... ......... ............... Curb Cocks ............................ .... .......... ----------- ------ .............. ............ .......... I Corp. Cocks ........................... ............... ............ ............. ......... ......... .............. .......... Unions . .................................... ............... .......... .............. .......... Saddles ................................. ... ............ .............. .............. ....... .... Nlj')"ples ........... * .......... ............. .. ............... ............... ...... ;.. Bushings .................................. .............. .......... . ......... ............... .......... Plain Ells ................................ ----- .......... . .......... .............. .......... Street EN-..- - " � '-" . ........................ ... ............. ------ i_'_ Tees .......................................... ............... ............. ..... .......... .............. .......... Curb Boxes ....................... . .... .............. ............. .............. . ......... I S. 0. Extensions .................... ........... ........... .......... ............... .......... Gates ...................................... .. .............. ............ .......... .............. .......... Plugs ............................. .......... ------------- ------------ .......... .......... ------------- ---------- Couplings ................................ .. ............ ...... ...... ......... -------------- .............. .............. .............. ------------- ............ 7 .. ----_--- .......... .......... .......... .......... .......... Gate Boxes ............................ ................................... : ----------------- ................................ L ................... ........................................................... ........................................................... ... TT ...................................................... ............... .............. ............... .............. .............. .............. ............. ............ ............ 7 . ......... .... . ............ .. I ------ - ........ ........... .......... .......... ............... -------------- .............. .......... ... ........... :. .............. ........... ......... .......... ..... =111"_ . ........ ............................................................ ....... :t ........ : ..................................... -- . . .......................... a .................... ............................................................ ........................................................... ":"" ..... I -------- 11 ..................................... Hours Time —Day Men ..... .. .............. --------------- ............... .............. .............. ............. f . ............... ............ ............ ...... ....... . ... ............ ....... . ... ... . ... ......... - -------- .......... . ........ . ........ ...... . .. ........... .............. .......... Hours Time —Monthly Men .. ............... ............ ........... ........... 7 ... ...... ---- Hours Time ....... ... —Auto ..... .............. ....... . ... .......... ................ .......... Superintendence ---------------------- -------------- ------------- ---------- ............... ........ Total -----... ............... ------- . ... .......... 0', 46 ADDRESS: TAX ACCOUNT/PARCEL NUMBER: BUILDING PERMIT (NEW STRUCTURE): t 9 311,2 5 COVENANTS (RECORDED) FOR: I Q CRITICAL AREAS:. bini ,,/ I — DETERMINATION: E] Conditional Waiver Study Required F] Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DA EASEMENT(S) RECORDED PERMITS (OTHER):- / PLANNING DATA CHECKLIST DA SCALED PLOT PLAN DATED: SEWER LID FEE $: SHORT PLAT FILE: SIDE SEWER AS BUILT DATED: -11kolL05 SIDE SEWER PERMIT(S) #:—. GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DA LID #: LOT: e(j) BLOCK: LATEMP\DSTs\Fonns\Street File Checklist.doc -!EPWIT: 'Appllcs� C!T-(- OF WIdIng Dep�irtrnent Permit Ljjnit� .0pite EDMONDS 'APPLI ATION'is hereby made Ani a epe C ili �ccordsnt:e 'With. to construct the follow14 vmr,k, and'irlectfications: NO. StO New/Addn. L;round Areo---- WORK., Helght-:� Plans Subm:tted ..w ........ Const. U tire se Zen--.. Loll N R arded Lo Add'n �7 ldth..� ' ; d Lut W Min. Bldg. Setbacka, Frant and Rear—/-�:�— ',v % On Address.. C. plan z ....... . ...... . ..... Add� A, .13ldg. by Plbg. Ph6ne .. . ....... Heating by A(1&8� y- Meet Address--__..-- Phone-;.:i—:.-- Renlar ks The above in a correct ntatcatent and I agree to comply with all applicable Codes and State Laws regulating the work.', V Signed: Ownpr/A Addresa.—�- "S, ontiltions, And to compliance vdth Pans', -�,�14 -PERMIT for the above work is hereby approved, subJect to �116 abavO 0 tba alp and specifications and Building Depw -tment not1tlOnA there0a. VALUATION P1301IT FIMS Bldg. 4"), -7 "A� ribg. APPROVED: .... ... . ............... 0ect..... . . .............. 13U=ING DZPA-RT.%W- ctlicts ... S.. N"r Em., ;t' Hezbert Bldg TOTAL I=, By............................... ............... . . .. ... r City Engin approval NOTES: No work requiring Bull j Depirtmerito eeT's inffpecUnn ehalll be covered before inspe�tiun and conriructiftn utilities', Twenty-four -(24) hour notice requested. Contact the City Enginmr prior to 0: all st*,e sucl, as exubs, paving, driveways. sewer, water and street Connections. iA. _�.j V�t �z_ V", li�ca: 1,4 -n-_ rim �J3 ..—LA, 16J, 4M 21 --e-z _01 ORD OF oa .0 5. T' Frd rn 0 FurjaCe 406; -THe Idity of Edmonds 7/ APPLICATION for SEDE SEWER PERYaT OUTSIDE E] INSIDE 0 REPAIRS CARDNo . ...................................... EASEMENT No . ...................................... ERI../ ele- . ..... .. ................ / — ...................... k ............. ... CONTRACTOR -WJN ... PERMIT 04 �.Yl LL. STREET HOUSETTO - ----- 409 ... ......... AVENUE WT No . ...................................................................... BLOCK No . ............................................... LuNAME ADD . ...................................................... ....................................................... ..................................... ........ uj 0 d , )A /'T L y Date Approved: BACKFILL WORK ORDER ISSUED .... ...... ........................ DEPOSIT, $ ............................................. 1�9 / ...... -!/ ............ SEWER WORK ORDER ISSUED ---- ........................ ............ DATE7. .... ..... ......................... BY --- 72)