6919 163RD PL SW.PDF878
6919 163RD PL SW
CITY OF EDMONDS
FILE ASSET INFORMATION SHEET
dNEW
ADDITION
RETIREMENT
ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION --;7
,T. N . /
DEP 0
64-s-v
*PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
*PROJECT NUMBER
PROJECT COMPLETION DATE
COST
B.A.R.S. ACCOUNT NO.
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
U//D/EPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
0 G.L. E
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO.
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DEPARTMENT FILE
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CITY of EDMONDS' S I D E
For Inspection Call 771 -80TREET FILE
Address of Construction:
W
SEWER PERMIT
PERMITNO. 07225-
Property Legal Description,(Include all easements): 4e?r /7 V
y3
Owner and/or Builder:
Contractor & License No:
Single Family Residence X
Mul ti-Family (No. of Units [�ENNWOOD LINE
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No 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 Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
-FT- 9 7
�I�ce r t �if y t�6'� havel��eadand shall comply Date
with the items listed on the back.
Permit Fee: 30. co Issued By: _Z6,
7 Trunk Charge: 29. 00 'rDate Issued: 2
Assessment Fee: Receipt No.: :7/90
Partial Inspection:
Comments Date Initial
Final Inspection Approved: 1,3
Date 7 Initial
Rejected:
Reason [Ta—te Initial
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy - File Green Copy —Inspector Buff Copy - Applicant
i�
The City of Edmonds
Side Sewer Drawing
EASEMENT NO - --------------------------------------------
4
NEW CONSTRUCTION REPAIRS r-1 LID NO - ------------------ - ASMT. NO - ------------------
OWNER .......... 40 --------- - -------------
... CONTRACTOR-5 --------------------------------------------------------------------- PERMIT NO - --------------------
JOB ADDRESS kc Q"UD: ............. LEGAL DESCRIPTION: LOT NO - ------ ------------------------- BLOCK NO - ------------------------------------
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NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
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Approved:
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ADDRESS
METER SIZE
UILDING SUPPLY SIZE
FIXTURE
UNITS
TELEPHONE NUMBER
REMARKS
STATE LICENSE NUMBER
4ojZ-rPffjLZ2cc,-
IFRONT
SIGN AREA
ALLOWED
PROPOSED
ENV.
. COMPLETE
w IV14
REVIEW
EXEMPT
ADB NO.
Legal Description of Property - Include all easements
(show below or attach four copies)
SHORELINE#
A0
VARIANCE OR CU
PLANNING REVIEW
BY
DATE
'YARDS
SIDEW
HEIGHT]
LOT COVERAG
4-,
NEW
RESIDENTIAL
PLUMBING
ADINALTER
COMMERCIAL
MECHANICAL
REPAIR
RETAINING WALL
SIGN
DEMOLISH
REMODEL
EXCAVATE
OR FILL
PRE -MOVE INSPJ
COMPLIANCE INSP.
FENCE
El ( x _ FT)
swim
POOL
WOOD STOVE/
INSERT APT.BLDG
RENEWAL
NUMBER OF STORIES NUMBER OF
DWELLING
1UNITS il!�
NATURE OF VYORK TO BE DONE (ATTACH PLOT PLAN) I
t,-FCJ(-
�HE TYPE OF C�N HEIGHT
CKED BY 5TR CTION CODE
SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
REQUIRED GROUP LOAD
0 YES 0 NO
RE RKS
lkai_
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PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Perm * it covers work to be done on private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
ENERGY CODE
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
,n successors in interest, agrees to indemnify, defend and hold
'.n harmless the City of Edmonds, Washington, its officials,
I
m employees, and agents from any and all claims for damages of
cr
< 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
0
-, modify,, waive or reduce any requirement of any city ordinance
0
nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
information given Is correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
AUTHORIZES
ed thereby, no person will be employed In violation of the Labor
ONLY THE
Code ojW9 State of Washington relating to Workmen's Compensa-
WORK NOTED
tion tatura Ace.
I NSPECTION
DEPARTMENT
OR A�E
DATE SIGNED
�SI�AT�U/(OWNIER
CITY OF
EDMONDS
I 1 771-3202
ATTENT104
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-78
VALUATION
FW�gj
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.
DATE
OFFICIAL'S SIGNATURE
DAN
RELEASED BY:
ORIGINAL — File YELLOO — PMW*Ctorl
led &A"
PINK 9!! M.-
0.
MEMO TO: Building Division
FROM: Engineering Division
SUBJECT: 4/1 1 / I ? 11r, ?--W ez
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)
f.
/0
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.
P
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).
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