6526 170TH PL SW (2).PDFIII lill
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6526 170TH PL SW
PUBLIC WRKS DEPARTI. IT
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BUILDING PEMIT
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Street Right -of -Way Existing 0
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Access Easements F-,dst*
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Utility Easement Existing Er, P M
LJ n W REQD
Lot Per Subdivision .,Plat Assessor mono
Site Plan Checked for Accura cy
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Underground Wiring Reqd.
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Check Accuracy of Legal Description
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Review by_
Date '7>
,,*,��4��sting
Water Main Size
Wate!� Required
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Service Line ed
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Hydrant Size Exist*
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Hydrant Reqd Per Fire Code
Size
etect Chec� Itter
Detector Check Meter
Cross Connect' spection
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Fire - artamt Connients
Fire�ent Comnents�_
Water Meter Charge Reqd.
Review by.
Date
T ank De
tic Tank Design Approved
t sign r ov
'S� App
Date
S T ank P Re
Sept Tank Permit Reqd.
ep t e t qd
Permit No.
an 3 ary ewer Availabl_lity—
Sanit r Availability
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Proj .
Draw g No.
M 0
File No.
3_ 1
Side Sewer Availa
Sanitary Sewer Connect Fee Reqd.
:3:
3_
Review by.
Date
Open Ditch Existing
Reqd.
Culvert Reqd.
-Size
P4
Catch Basin Reqd.
te on Site Plan
0
Shoulder gemaintain collection on
swale open f
Manhol reqd.
Indicate on Site Pl
S;* --Cond:ittions and Ground Water Field Checked
Review b)�
Date
Revised: lvlO-1977
Page 2
qet Paving Reqd.
Curb and �er Reqd._.
Sidewalk !Re�qd.
Curb Cut for Driveway Reqd.
iv
p4 Right -of -Way Const ermit Reqd.
on lic Improv=tR
s
:Zon or Public Inprovements
Street Name Sign Reqd.
Other Signing Reqd.
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FM--l�e=1 1 e spec 3-on an
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BY: SEWER
W T.
ATER
P-4
z STREET
ENGMEERING
Special Requirements listed in merm to Commmity Development Department,
Building Division
> BY Date
c) All item filled in m Building Permit Application
C4 BY A�P-M - Date
04 Dr awings Starrped and Notations Made
P4 BY Date
-4
Approved by Public Works Department
Revised: lv 10-1977
)4( APPLICATION
for
The City of Edmonds
SIODE SEWER PERMT
EASEMENT No . ..................
CONSTRUCTION REPAIRS 0
PERMIT No . .............
OWNER .... V44: ..................... M.Ng" .................................................... CONTRACTOR
C=ff::)rZG - V-7<=)"T" Fl_bhx:�E =--. \.-,J.
ADDRESS.......................................................................................................... LEGAL DESCRIPTION: LOT No__. ......................................... BLOCK No . ............................................
NAMI� OF AI)PITION...— _X:S"p-F- Ust�4s t-4ume=ap; CF>
...................................... ..........................................................................................
. . . . . .....
APPLICATION
for
The City of Edmonds SIODE SEWER PERMIT EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS E]
/9/
CONTRACTOR ...... ..... PERMIT No. Yq,�..7 ....
LEGAL DESCRIPTION: LOT No . ........ le� --------------------------- BLOCK No . ............................................
Z,q. . ...................................................
O'V*rNER ............. .............................................
ADDRESS...... ----------------- ------- ---- - --------------------
................. By ......................................................................
NOTICE:
No warranty of accuracy.
The information shown on the attached map(s)
was compiled for use by the City of Edmonds,
its Employees and Consultants. The City of
Edmonds does not warrant the accuracy of
anything set forth on the se map(s). Any person
or entity requesting a copy should conduct an
independent inquiry regarding the information
shown on the map(s), including, but not limited
to, the location of any sewer stub shown. Such
sewer stubs may or may not exist and may or
may not exist at the location shown. Neither
the City of Edmonds nor its employees or
officers shall be liable for the information given
on map(s), nor for any one representation
provided based upon said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
_7� 4US
PERMIT , 0
Call 7,76-1107 for side sewer inspections BEFORE covering any portion of the construction.1
(Inspection will be provided within 24 hours after request. No Sat., Sun., or holiday inspections.1
ADDRESS LOCATION OF CONSTRUCTION ...... 6526 --- ----- 1.7-0-th .... P.1-a-c-e ... S214 ------------------------------------------------ -------------------------------------------------------
SquireLane ffr.5, Lot 106 .................................................................................
PROPERTYLEGAL DESCRIPTION ........................................... ........................... ..............................
.................................................. - ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- : ...............
0-*-*WERMLNDIOR BUILDER ....... &eR..M4ryP.! ............................ ............... . ......... .............................................
Chambers & DeHaven Construction. 17169 - 67th Me. W., Edmonds
CONTRACTOWSNAME & ADDRESS ----- - -------J------------------- - ----------------------------------I L -------------------------------------------------------
Permission is granted ------- 5��R.4�pikr ... 14, .................. 19.D., for repair and/or connection of a side sewer to the city sanitary sewer
system In accordance with City of Edmonds ordinances.
A IS CALLED TO THE FOLLOWING: ide property line. A licensed Side . Sewer Contractor must be employed to construct
�,__jko. 1—The owners of the property may obtain a permit to construct sewer ins
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 % 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 .......... Z ----------------- 1000B Date --------------- - ------------------- BY ----------------
-_:7 ........... B . ...........................................................................
APPROVED jr Dt.00� .7 .... 11 ;eoe
.... ...... y OW10
..........................................
................ . .............. ..........
Remarks: ....... . .................................. . .. . ................................... --------------------_-------
..................................................................... . ............. ....................... .................................................. . .................................. . ............................... .............. I .........
BOTH PerwAtMoPies MUST )4�diigned By_owner of Firm Performing Construction PRIOR To Request For Inspection
... .... hereby certify that the side sewer installation constructed under this permit
------ i�eri.r_QnW'Coosiruciio.)
C__ i�lrrn
tree ni����
i !�n
V. -istalled in accordance with all governing ordinances of the City of Edmonds
Dated this ...... ZY, . .......... y of -------
......................................
V V Check BEFORE you dig for: Water F], Gas E], Telephone, [], Power [], Sewer 0, Other E] V V