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645 PINE ST
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STREET FILE
CITY of EDMONDS --- PUBLIC WORKS DEPARTMENT
Routing of Building Permit Applications
Proposed Property Address of Application: 645 Pine St.
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DEEA C RTMENT 1 :11
COMMENTS
DATE
W A T E R
S T R E E T
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S E W E R
N 0 T E S
BUILDING
DEPARTMENT COMMENTS
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USE -PERMIT
90ftDING DEPARTMENT
Applicant Fill
ZONE NUMBER
AnD .9 R 1979
PERMIT APPLICATION
Inside Heavy Lines
JOB
ADDRESS
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Plirl&r"Fvc
NAME JOR NAME OF BUSINESS)
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LEGAL LOT
D YES D NO
LOT AREA
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SUBDIVISION NO.
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MAILING A50DRESS
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VARIANCE OR
COND. USE NO.
ADB NO.
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CITY
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NUM13ER
71
PROPOSED YARDS
FRONT SIDE REAR
HEIGHT
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NAME
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ALLOWABLE
SIGN AREA
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PROPOSED
SIGN AREA
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ADDRESS
OTHER
REQUIREMENTS
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CITY
ONE NUMBER
PLANNING DEPT. APPROVAL DATE
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NAME
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STREET R/W
EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W FT. FT.
ADDRESS
REMARKS
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CITY
TELEPHONE NUMBER
CHECKED BY
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
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Legal Description of Pro tv (Sh Elelowgr Altach Four Copies)
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STREET AND/OR UTILITY El YES
WORK REQ'D El NO
UNDERGROUND, 0 YES
WIRING REQ'D 0 NO
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W_- C_C>rk-. or-, %4144 1/+
P - K'
TYPE CONNECTION
VER IFIED BY
7. 5
SEPTIC SYSTEM YE S
0 NO I PE$?MIT
APPVD BY CITY ENG.
NUMBER
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REMARKS
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METER SIZE
SIZE
BY
ISE"VICE
ICLEARANCE
ICHECKED
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REMARKS
GAS
NEW RESIDENTIAL LINE
Eli ADD El NON-RESIDENTIA L SIGN
DRETAINING
El DEMOLISH WALL
F1ALTER EXCAVATE FENCE
OR FILL I — X —FT)
D REPAIR PRE -MOVE swim
INSP. DPOOL
FIRE ZONE
TYPE OF CONSTRUCTION CODE
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SPECIAL INSPECTOR JAREA
REQUIRED
El YES C3 NO
JOCCUPA.Cy
GROUP
OCCUPANT
LOAD
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PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31,04,
REMARKS
NUMBER 0 JSTORIES�.Ift
$A s' s
NUMBER OF
DWELLING
UNITS
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NATURE OY WORK TO BE DONE
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PLAN CHECK
VALUATION
FEE
PROPOSED USE
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NO.
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PLOT PLAN INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
BUILDING
PLUMBING
HEAT & GAS LINE
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FENCE
SIGN
RETAINING WALL
SWIMMING POOL
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STREET FILE
DATE: ILI
MEMO TO: Harry 14hitcutt
Building Official
FROM: Richard H. Allen
Assistant City Engineer
SUBJECT: eez' 4-
After review of the subject building permit application, we have the following
comments:
L
PEPMIT ADDRESS,,
LEGAL DESCPI PWA gnh Oe24 ty=nCN
BUILDING PERMIT REVIEW ENMNEERING DEPARTMENT CHECK LIST
Instruction:
Check Accuracy of Leqal Description
Check Anainst Assessor's Map for Lenal Subdivision
Does it conform to City Approved Subdivision?
Reviev:er's
Initials
1. This lot included in Suhdivision/Plat No.:
2. Site Inspection made on:
3. Uhat are pround watpr and soil conditions?
4. Site Drainage Checked? eZ4 7-2.1 11 — /
5. Storm Sevier Avai 1 abi I i ty: —Sht. of D%,1q. No. F�O-S roject
Roadside Ditch k ) ��
6. rrading & Final Contours: -z�fw
7. Septic Tank System Desinn Appr_oved:
8. Sanitary Sevier Availability Slit. -1 0 f rX.1 No rojectW D
ty: -(OF
Side sevier availabili
9. Sanitany Sevier Connection Fees?
10. Uater Mains A Fire HYdrants (Indicate Size 1!ain)&1/&WAJ I ev->
Check Fire Dept.'s Comments TNA= %
11. Sii ewalL
101
12. Cu -r—b —s.- - - -4
grade an
13.
14.
lks as follows)
Ys for safety, lncation,
Underoround 11irinn- # 'S. Street Lights:
-.1%) rN
Street Right-of-way A Rldq. setbacks: A4-C Sht. JlLf nfficial Street Map.
15. Existing Utility Easements?CINSY- V-4;;F!26Mj 101F
16. Access Easements: 1L'1e01WW— ��j
17. Site Plan checked for accuracy? —,2 lvz, 11-1
18. Special Requirements listed in Memo to Bldg. Dept. tSm,
19. Commercial & Apt. Rpauirempnts form completed?
20. Drawings stamped & notations made?
21.
All Items filled in on Pildg. Permit Application?
22.
Bonds posted
for site work?
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INJC
23.
Right-of-way
Invasion Permit
required?Rm VZ)TZUJ 01
COMRIFINTS:
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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.
ADDRESSLOCATION OF CONSTRUCTION .......... ............ - ------------------------------------------------------------------------------------- - -------------------------------------------------------
PROPERTYLEGAL DESCRAFTION ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
...................... . ........................... ....................... .................................................................................. ...... .................................. . ..................................................
............................................................ OWNER AND/OR BUILDER ------ z ............. .................... . .................................... .......................................................
CONTRACTOR'S NAME & ADDRESS --------------------- : .......................................................... ...... . .............................. . ... .......................................................
PejqVission is granted ........... ...................... ------ - -- ------------- 19 ......... for repair and/or connection of a side sewer to the city sanitary sewer
S r In accordance with City of Edmonds ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —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 regarding 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 'A 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 main sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVEDE] Date.._- ----------------- By ................ Date.... . .......... By ------------_- Date ............... - ------------------- By ................
-jr D .................. ...... . ... .. . .......................................................................................
APPROVED By .. . . ... ..........
............................................... ................................
Remarl&ll ... . ................................... . ... ............................... 4 ............. ......... . ..........................
........................
........... *4 ....... . ................. . ........................................................................................ . .................................. . ...............................
B T e Co s ST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
.... .... hereby certify that the side sewer installation constructed under this permit
. . . . . ..... .............. . .......................................
Owner ontracti Perfcrming Construction)
was ins in anc all governing ordinances of the City of Edn�nds
Dated this...,,5 . ..... Vday of ----- . ........ ... .............. . ...........
Other F1 V V
Check BEFORE you dig for: Water E], Gas [], Tele�hone E], Power [:]I, Sew
_j V Prld
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II - - 'The City of Edmonds
OWNER I - -------
JOB ADDRESS ------------- Ce ------
APPUCATION
for
SIDE SEWElt PEItMff
NEW CONSTRUCTION F] REPAIRS E]
EASEMENT NO - ----- ---------
,-711
LID NO. /--T -------- - ASMT. No - ------------------
...... CONTRACTOR
------ LEGAL DE�CRIPTION: LOT NO - ----------------------- ---------- BLOCK No - -----
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--- /50
----- 6k--�
NAME OF ADDITION --46,;w,7
--RECF"n
MAY 2 1977
Pow *0,*, t)tpt.
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DATE------------------ - ------------------------ By --------------------------------------------------- Vi7ye
0
. STREET FILE
Permi t AddresscOA-95 P(kla
Legal Description
BUILDING PERMIT RFVIE1A - FNIGINURTNG DFPARTI,4FNT
CHECK LIST
Reviewer's
Intials
Septic Tank System nesign Approved NJ 044-
of Dwo. No.
2. Sanitary Sewer Availability'
Sht.
Project: L Side Sewer Avai I abi 1 i ty:3m 7) ;:>L
..�Any Sanitary Sewer Connection Fees
,A Site Drainage Checked
Storm Sewer Availabilit,v: Sht. f Dwq. No 1450t
Project: U Roadside Ditch
6. Grading & Final Contours
-7.
Sidewalks (Site Inspection shows condition of existin.n vialks as follows):
Curbs
%I V/11
9.,/ Curb Cutsv,&!:�
10. Underground Wiring A Street Liolitinci
f) o
rd.
of Dwg. Ndl.-��� of Official Street Map. L-rc./ I . .
Existing Utility Easements 0V W(5-r 7,15 of:�_rgj S to 70
Access Easements
Water Mains & Fire 11
.4 11 h, lk . A . t 4
.., �-Bonds for Site 14ork
ants (Indicate Size 9ater Main)
16. Special Requirements listed in memo to Bldg. Dept.
<!;59: Im mellcs
Commercial & Apt. Requirements form comnleted
Drawings stamped & notations made
. I I
.0100.11* Site Inspection made on
,,WO.000AII items filled in on Bldg. Permit Application M56 T1 4
Y"271�' This Lot included in Subdivision List any special
3/9/76
req ui remen ts ) :