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CITY of EDMON DS
For Inspection Call 771-3202
AUG 2419811 S I D E S E W ER PERMIT
PERMIT NO. 07759
PUBLIC WORKS
Address of Construction:
Propert� Legal Description (Include all easements):
7�' e 7
Owner and/or Builder:
a e_
Contractor & License No: /VC3
FLYNNWWD. LtRF�A
Singl.e Family Residence I - —
Multi -Family (No. of Units
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No z.� Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No 6z Yes (If Yes, easement required,
attach legal description and county easement number.)
PLLEASE RE ID THE ITUEMSI'STED ON THE BACK
IAcerti y t-h-V I have read and shall comply
3, a
wl'ilth items listed on the back.
Permit Fee:
Trunk Charge:
Assessment Fee:
-30.00
_Z5-- 6V
Partial Inspection:
Issued By: -76
Date Issued: g1Z ;7
Receipt No.: 7q
6
0 —aq— 6-7
Date
Comments Date Initial
Final Inspection Approved:
Rejected:
Date
eason
Initial "
lb,4 �,-
\J Date —in i —ti a 1
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy - File Green Copy - Inspector
Buff Copy - Applicant 'f �
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 these 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).
I
The City of Edmonds
Side Sewer Drawing
EASEMENT NO - ------------------------------------------
NEW CONSTRUCTION REPAIRS F-1 LID NO . .................. . ASMT. NO - ------------------
* �-, � e-
OWNER ... ----------------------------- CONTRACTOR -------------------------------------------------------- -------------------- PERMIT NO. D-77
JOB ADDRESS -------- ---------- LEGAL DESCRIPTION: LOT NO. --5-
- -------------------------------- BLOCK NO - ------------------------------------
A
CAV-S —Ic> !2�?,A v i-
PWW-0001 -11/75 (REV. 11/78)
�<).A'�,� -----------------------------------------------------------------------------------------------------------------
NAMEOF ADDITION ---------------------------- --------------------------------------------------------- --------------------------------
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L to.
E�
- 4"P-Y-e, 00 IXA FL
P Q%o W!�,- 9' )
Approved:
'n DATE ........ .... ........... By .......................
bj -C- k L 4410 -
CITY OF EDMONDS
NEW
ADDITION
RETIREMENT
EET. FILE ASSET INFORMATION SHEET
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION
D�%N�
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
PROJECT NUMBER
PROJECT COMPLETION DATE
COST
B.A.R.S. ACCOUNT NO. 411-000 - 0
ESTIMATED LIFE
INITIATED BY
DATE
APPROVED BY
**SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
ZDEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE DATE
&P) INITIAL
DEPARTMENT FILE
VERIFIED BY
PROCESSED
BATCH NO. -
7- 1, � I I
I'll - - -11 �%w
PROJECT ADDRESI
Applich?TC)N
Reviewed n ial
PLANNTNG
WM/SWR STREM ENC2,MG
77777//777777//
FIRE BUILDING
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/////
7
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VARLANM/SMnkX
CONDITIONAL LM 177171
7-7R7777/477--77ql
ADB
7777TIT11
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TR77TITI-7
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-------------
ENV:rRcNmanAL 177777
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CALCULATE PFurm ry-w
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BOND RBODD FMOR PR(
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ITIONS
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STWMT NAME SIGN I I I
aL.RECID
21
777777777
7777777777
071LER SICNING REM
22
-SIDE SEWER AVAIIMITlTy
23
-
T7771TI
T7771717
ID(ISTIM W1`01 MAIN SIZE: 111fil W7"7w
/////////
24
---llum
MTER M WER SIzE 777777
1717771177
-
25
7
TM
-
SEWICE LINE SIZE
XT177
7 7 7
////////
7TI 77177
26
-
27
HYDRANT RsourRED
/////////
7T/77777
////////
77TI777777
SIZE EXISTING
TrffTIT17
7TI-I-IT171"7
-
28
CROSS CONNDCTION INSPECTION REQD
7TTITTR77
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29
30
'AIM MM CHARGE REM
1111-ITI-I
////////
-ITI-FI-17-17 *
FIRE LINE CHARM pl= SPRrNKLFR
17TR77-1-TR711
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TMEET C[rr
32
)PFN DITC[i EX.TSTM ITIT17 P17TI111
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REQD T17TI7 7
/1/////// 34
-77
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///////// 35
SIZE TITI-1 T1 7 7 TITITI Ti
36
l7al BAS ni 7/77
///////// 37
IT177 I-ITI-TI-17 7
INDICATED ON SITE PLAN ///////// ///////// 38
';','iOULDER
DD�i�Mjj�� �nN 77TTff 71-[177 T177777
SHALE OPfN RUNOFp ///////// ///////// 39
-77
,IISC: 7 TF1 17TI T 7777 77 T
140
WIEM BY:
-WR
PLANN ENGINEERING MGR. UBLY( %)ORKS
"SR.
MEMO TO: Building Division
FROM: Engineering Division
SUBJECT
After review of the subject building permit application, we have the
following comments:
1) Connection to City water system required.
2) Connection to City sanitary sewer system required.
3) Right-of-way permit required for any work on City property.
4) Driveway slope not to exceed 14%.
5) Back water valve required if downstairs plumbing is below
elevation of upstream manhole.
6) Water and sewer lines to be separated by 10 foot minimum.
7) Builder/owner responsible for containing all temporary runoff and
erosion on site and may not impact neighboring properties in any
way.
8) Construction hours from 7:00 a.m. to 10:00 p.m. on weekdays and
10:00 a.m. to 6:00 p.m. on weekends and holidays.
-- - - - - - - - -
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
z DDRESS
0 z
oa�2 C/
CITY TE EPHON NUMBER
NAME
ADDRESS
NAME
ADDRESS
CITY
STATE LICENSE NUMBER
ELEPHONE NUMBER
071( 76e
NUMBER
-.Include all easements
P241
USE r
NZi�' "PERMIT
ZONE NUMBER
JOB
ADDRESS C�
,*') a-- �5
.FGAL UE:5GHIPTION CHECKI SUBDIVISION NO7_
A, r r" -,LA , (��,
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING - Wo REQUIRED DEDICATION
PROPOSED�
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
STREET USE PERMIT REQUIRED 0
SEE ENGINEERING MEMO DATED
METER
SUPPLY SIZE
.� /0
I
RE UNITS
/.-S
SIGN AREA ENV. REVIEW
ALLOWED PROPOSED COMPLE E EXEMPT
MINI —
VARIANCE OR CU PLANNING REVIEW BY
YARDS HEIGHT LOI
S45 1
FRONT '4, SIDE 10 REAR'i
; R ARK
ri
NEW
RESIDENTIAL
PLUMBING
E] ADD/ALTER
El COMMERCIAL
E] MECHANICAL
E]
IE:34k Wif, U 141- P15
L 3;0k Wk�
REPAIR
RETAINING WALL
SIGN
DEMOLISH
EXCAVATE
OR FILL
FENCE
x _FT)
CHECKED BY
FREMARKS
TYPE OF CON
REMODEL
PRE -MOVE INISPJ
COMPLIANCE INSP.
swim
POOL
S PECTOR
PECIAL INSP
S
REQUIRED
AREA
WOOD STOVE I []
0 YES 0 NO
INSERT
APT.BLDG
RENEWAL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
—
'r'p-'X '
r7jvlo, 1 :rn
7C1H1EC7KFEE
PLAN
BUILDING
PLUMBING
This Permit covers work to be done on private property ONLY.
MECHANICAL
GRADING/FILL
Any construction on the public domain (curbs, sidewalks
driveways, marquees, etc.) will require separate permlssio� .
STATE SURCHARGE
mit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENERGY CODE
successors In interest, agrees to Indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
<
whatever nature, arising directly or Indirectly from the issuance
x
of this permit. Issuance of. this permit shall not be deemed to
PLAN CHECK DEPOSIT
3,
modify,.walve or reduce any requirement of any city ordinance
0
x
*41,%provision."
nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
hereby acknowledge that I have read this application; that the
given is correct; and that I am the owner, or the duly
ATTENTION
-d agent of the owner. I agree to comply with city and
qgulating construction; and In doing the work authoriz-
THIS PERMIT
AUTHORIZES
%.person will be employed In violation of the Labor
ONLY THE
N,\,.%.Of Washington re g to Workmen's Compensa-
M
WORK NOTED
\""A
ENT) DATE SIGNED,
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
771-3202
E50
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ORELINE 0
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OCCUPAN�� OCCUPANT
GROUP 1 _3 1 LOAD
--1oo.xM_ )!
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged In space provided.
OFFICIAL'S SIGNATURE DATE
RELEASED BY:
DATE
1�6, OR OCCUPY A BUILDING OR STRUCTURE
,TION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector
OCCUPANCY HAS BEEN GRANTED. UBC
PINK — Owner GOLD — Assessor
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