660 DAYTON ST.PDF11111111111111
10839
660 DAYTON ST
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:-0'04!��120%6�) 19 (3c)
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: Ej Conditional Waiver E] Study Required 0 Waiver
DISCRETIONARY PERMIT #'
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT
SIDE SEWER AS BUILT Dj
SIDE SEWER PERMIT(S) #
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
OTHER:
: I q 4 94-10b BLOCK: q6
LATEMP\DS'Ps\Fonm\Street File Checklist.doc '. 16,
7,4
IT NO: 9850
City -of —Edmonds. PEI
PERMIT EXPIRES ?11,qkz'-1
SIDE SEWER PERMIT
Address of Construction: a661.- &45�ZZ2e LID # /1,0'
Property Tax Account Parcel No. ez�IlAk 4V2 0
Attach copies of affaccess and utility easements Verified and Approved b- 1%114
(owne-)rand/or Contractor:., vep-^ V.4�
Building Permit
Contractor License
[�Single Family, ,Invasion into City *Right -of Way: F� Yes &�INO
y .. __%, I I
*RW Construction. Permit
F� Multi -Family (No. of Units
Commercial (No -of Units, Cross other "Private Property:. El Yes 'o
**Attach legal description and copy of recorded)e�aement.
Owner/Contractof
Ownet/o-r ntractor-'signature and acknowled Date
C gement statement:
1 10
`Y-11signinj fot,this permit I certify that I hdveread the City's.public handout entitled'
ide Sewer Specification§, and shall comply with,alf City requirements outlined therein.,
is CALL DIAL A -DIG (1 -800-421'4�5555) BEFORK ANYEXCAVATION W
2-W
W FOR INSPECTION CALL 425-771-0220 extensionda
24. HOUR NOTICE REOUTRED. FOR ALL INSPECTION REOUESTS.,
.. . . ........... FOR OFFICE USE ONLY .. . ....
. ... .. ... . ..... .... .
Rermitf%e $ e Issue
Repair Fe' 1�, 4�)` d By:
Date Issued!
Assessment Fee Receipt No.
City Permit Surcharge Fee 45.00 Total, Fees Paid
NOTE: IF JOB SITE IS tNOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A: $45 RE -INSPECTION FEE WILL BE CHARGED.
Job.Site Ready YES NO� Date: Initial:
Partial Inspection:'Pidee 'e.; ever PYC Date:.-5//g) Initial:'JA4
P p
artial Inspection: 04V Ar AhAt 'd-1?A&XhM: 4f. Date: Initial:
a rtj
FINAL INSPECTION APPROVED: Date: S_Z4-�Ia4(-, Initial: _T�-t As -built to Street File: -
PERMIT MUST. BE. POSTED ON JOB. SITE�l
White Copy: File Gr6en Copy: lnspector� Buff Copy:. Applicant
L;tcmp;bl�g,forms;sspertnitjlg4/00
DAYTON ST
C)
1,D
W--C/O 4' PVC CONNECT TO
EXIST. 4' CONC. W/FERNCO
C/o IS 2'---`� 38'-C/O TO BACK OF S/W
OFF PAVED EDGE
ALLEY
of ED *CITY OF EDMONDS SIDE SEWER AS -BUILT
0
ADDRESS
660 Dayton Street
HOMEOWNER CONTRACTOR SCALE
Wermus I I NTS
DATE DRAWN PERMI
NO,
1890 6-8-2004 �By K. Haney 9850
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
-NEW CONSTRUCTION 0 REPAIRS EASEMENT No . ..........................................
/ 0,�L () Fcgo/,p
OWNER..... ............................. ............................ CONTRACTOR .................................................................................................. PERMIT No . ........... ..........
ADDRESS --- 4?.b.0 .... Alf& ................................................ LEGAL DESCRIPTION: LOT No . .............................................. BL4DCK No . ............................................
NAME OF ADDITION
0
A4Iq 74
pp,,v -
DATE................................................ By .........................................
The City of Edmonds
APPLICATION
for
SME SEWER PERTNaT
NEW CONSTRUCTION 0 REPAIRS 0
EASEMENT No . ..........................................
OWNER.............................................................................................................. CONTRACTOR .................................................................................................. PERMIT No. ...
ADDRESS ........ .. 0 ...... .......................... LEGAL DESCRIPTION: LOT No . ............................................. BLOCK No . .............................. .............
NAMEOF ADDITION .........................................................................................................................................
uj
j
U.
i--
ui
Approved:
--6
DATE ..... .......... ? ...... By