6920 174TH ST SW.PDFiiiiiiiiii . 11
1047
6920 174TH ST SW
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).
APPLICATION
rl
for
The City of Edmonds r !1- EASEMENT NO. -7-7092 8 ntS
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID NO . ..... ------------ ASMT. NO - ------ I .......
OWNEP - ----- ------------------------------- CONTRACTOR ----------- --- ------------- PERMIT NO.
JOB ADDRESS ---------- LEGAL DESCRIPTION: LOT NO - ---------------- I ............ -------- BLOCK NO - ------------------------------------
Ll I A r, � i E::-,1N, =- I � t�-
L--*A--
--- ----------- ---------------
Approved:
DATE --- Byr, W -----------
AV, C1,
T �.o
"Y.
-m s1bE,`tt WY,'Ek PEA)MAIT
DEPAIRTMENf,"
W�
P MIT" 8,
ER
".t,Caii, 775-2525. for slde� inspections. BEFORE
covering any poition of. the construction
n.:24 hours after reclust. 'NO Sat., Sun., or holiday Insp
X-Inspection I I b e provided withl ection
D R-E, SS LOCATT OF �CONSTRUCTION .......
........................................................
','PROPERTY LEGAL DESCRIPT10N ........
................. ................................
........................
.. ................................... 7 .........
............................. ..................................................................
.................................... ...... ........ ........ ...................... ..................
........... ...........................
........ ........ OWNER 'A'Njj/,OR BU1j,'DE
R .......... . ... ... ...
................. ............ ............
INAME & D
GONTRACT6*8'�'_' RESS:�.-A-
J..........................
.................... .
n,
I ssion4s ........... : .......... 1'977.1 ..'for repair "and/. - or connectio n of a side sewer to the city sani tary sewer,
-C
�,iern -in'accord9fice.' With ay'Of Edmonds �ordinanees.
ATTENTION IS CA�LLED TO, THE� FOLLOwING:
NOTE No. I —The owne rs, of the 'property m
ay obtain a permit to construct sewer Inside 'property,llne� A licensed Side Sewer Cont�actor must be employed to- construct
side sewer'�iwsfreet' area. ',I)o not cover.any portion of sewer before It has beenInspected.
-NOTE No. - 2—Al I work-, j;erform6d. I n city. ri ght-of-way� requ I res an Invasion. 'of Right - of-W
NOTE: No. 3 ay Permit obtainable from the City Engineer's office.
—Obtain IW LlPformation- regarding Ordinance 11.16.030 and Regulations gpverijink side sewers,.when you get permjt.�
NOTE No. 4—Top of side,sewer,MUSt have at least 30 inches. coverage at property line 'ad' 12; Inches, Inside Property line; minimum grade -of 2%. No -bends In grade
sharper than % will: be, Permltted�
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, o� to do any work on the main sewer 0 . r Its . appurtenances except to in-
sert the pipe -Into the,wye.
DISAPPROVED 0 Date ... . .................... ............... By ................. Date ........
.......... BY ................
............ A3Y ................ Date .....................................
.................. .......... B .............. 1.
-A . PPROVED Date: .......
......................................................................................
Remarks: ....... . .........
.......... ....................... 777* .......... .................... : ...........................
. ........................................
............................. .............................
........................... ......... 7 .............................. .............. .................... . .. ....... 7.
.............. I ....... .........
lWiTH, P-14, fll.-�_;
d
asinstalle
............
Owner- of.. Cc
ifi-Accordit
V V
ITJLVOJL Z-6 zagned.By Owner of Firm. Performing Construction, j�w
OR To Request For Inspection
............. * ......... side,sewer installation constructed' under,this pe . rmit
rming Construction)
--- Z. hereby certify that the.
.... W�_z
th, all governing ordinances of the -City of EdmondS.
Dated this .............................. day, of .........
...............
Check BEFORE you: di -f . 11 % .. I � I ., ' * * L
. g or:� W . ater Telepfiona�Ej,- Power.01
.................................. L 'j9 .........
Sewer,[], Other
APPUCATION
The City of Edmonds for EASEMENT NO. � ------ ------------------------------------
SIDE SEWER PERMff
NEW CONSTRUCTION El REPAIRS F� LID NO - ------------------ - ASlvff. NO - ------------------
OWNER ------------ ----------------------------------- CONTRACTOR . .... PERMIT NO.
JOB ADDRESS LEGAL DESCRIPTION: LOT NO. -------------
.. .............. t:�jt.t - -- -------------------------------------- ---------------- --------- . BLOCK NO . ........... ----------
-------------------------------------------------------------------------------------------------------- - ----------- -- ..... ------ ---------
NAME OF ADDITION ... 644-�.- ....... . .................................................
Approved:
DATE-------------------------------------------- By --------------------------------------------------- riwir
60
14
P1 Fj jJ-TC LS P!:PT. MECK LIST OW-174f
LIMLDING, PYII�UT PT.VT 17!
low-
C)
P4
0 -N�FT
1' F119
.()T)
Street Pdpht-oF-1.-:aN I-aisting
Access Fasements Existins,
Utility Fascinont I-aisting pjrn
Lot Per Siiidiv;sjon
Sitc Pl.;m n1ccl.-ccl for Accuracw
Pfl(kn-,-round "cod.
�Ov i C.., LT
:",!ill Pecz!ircd
Hydnwt Si-::c V-1iisti-n!,
If-(Inint
11ctector (1ec'K "ClIter Rcciiired
Vj
e
qptic rl;ll:
smpti.c T�nll. Pen,"'it
Plat Ansessor I' n
tc.
-0.
File
side Sev..Cr AV111i) bih-L? %AAw
Sallita
r) cr Corm�(,�,e �TlcniLrcd
----Datc.
Pongit �7o
y )
. roi
Rmric,.! by Pate
Nell Ditdi _N 4 S t ]ZO(aJ 1-00
Culvert PCO.1 I i re d Size
re (I 1,110i Cate oil 7itc Man
n)Cv1,1"`--,--F-,- -fC-
-I! I * , , . -.)I �41,bn
Opt-�fl run
Nallhole required
Soil Conditions
by
F, Growid 1,,'ater Field OicclLed
Indicate oil Site 1,11rul
Rate
77
Strcct llivjLll,(', Rccluircd
(lirb and (.".i-Ltcr Rcquirc(I
Sidcl!l Pcc�llirccl
Curlb rut for I)rivc,,.,'a\r RcqUircd
Pj-lit-o'j-1,':ay Construction Pcinit Raiuircd
Bond licquired for Riblic Imlprovcmc�,'Plts
strcct Nm-,-,c Sicji Rc(iiired
Otlicr Signing Pcouirocl
T,rc I)cn.lit Sitc Inspcction madc on
BY: Sci,:cr
ti'ater
Strect
Enginccrinp
--mo to Builclin,(� !�-,pnrti�ccnt
Drod, cuim.�cnts li,stcd in
I)a t C,
j. - C_; F, j. 1 C Cl j], oll )�,,14 1 (Ij I(; )'Cl-, n
Tdt A]),,)I.iC, jo
Patc
By -T)a t
Approvc(I by Pulk)l.ic Worl:s Depal-tric.-It
mm
BUILDING DEPARTMENT
Applicant Fill
USE PERMIT
PER
ZONE NUMBER
NU"
PERMIT APPLICATION
Inside Heavy Lines
IDS
ADDRESS 01Z 0 / 7 �
NAME
G-
.(OR NAME OF S)
Le"IVlav'l S -41
GA;RTt9T
LEG YES 0 OTL
0 T AREA
SUBDIVISION NO.
W
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0
MAILING ADDRESS
q"2;,
CITY EWHONE NUMBER
)�J yj
.1
STREET R/W
EXISTING STREET R/W 30 FT_ DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W -:150 FIT. 0 FT.
U
NAME
T, 90'W,'-
(te-y-' -:Y�'
R
_WARKS
A LL- -Y M d 9 IF I K tft�J C C--
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ADDRESS
16f
4pt0f65" PLA--(
CKED BY
_r
W
Z
4
CLA
V1 V1Uz'nyf'
TELEPHONE NUMBER
1271 - 4t
STREET AND/OR UTILITY WORK
REQ'D. YES
R/W PERMIT REQUIRED
YES PKNO
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it
UNDERGROUND
WIRING REQ'D.
ES El NO
xy �
0
u.
ADDRESS
0_7 i-�3rd
TYPE CONNECTION S
SANITARY SEWER KY E
El NO
VERIFIE��
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0
TELEPHONE NUM13ER
':z L45- - (- ir, 1)
SEPTIC SYSTEM PERMIf
11 YES
APPV'O BY CITY ENG. �
J/A-ONO
NUMBER
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STATE LICENSE NUMBER
-bo - * _;'Ll fbi
CITY.LICENSE NUMBER
REMARKS
NO tlmo To ff -yak&_
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0
Legal Description of Property (Show Below or Attach Four Copies-)
METE IZE
BUILDING SUPPLY SIZE
W
REMARKS
I --
SIGN AREA
ENV. REVIEW
ADS NO.
U
W
a
At t OWED PROPOSED
COMPLETE EXEMPT
J
W
J
REMARKS
VARIANCE OR CU PLANNING REVIEW BY DATE
NEW RESIDENTIAL GAS
LAJ LAJ LINE
ADD IE] NON-RESIDENTIAL SIGN
El DEMOLISH RETAINING
WALL
F� ALTER EXCAVATE FENCE
ED OR FILL I— X—FT)
M REPAIR PRE -MOVE swim
1:1 INSP. POOL
YARDS LOT COVERAGE
;t 5- /
FRONT SIDE REARI
FIRE ZONE
TYPE OF CONSTRUCTION ICODE
7
SPECIAL INSPECTOR
REQUIRED
1:1 YES I I
AREA
OCCUPANCY —_
GROUP
I
OCCUPTkNT
CC
[L-0AUP'0
PLAN CHECKED EY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
z
W
NUMBER OF STORIES
7—
NUMBER OF
DWELLING
1 UNITS
REMARKS
NATURE OF WORK TO 93E DONE
z
2
z
PLAN CHECK
NO.
VALUATION
FEE
PROPOSED USE
9
M--= C_
—
W
0
PLOT PLAN (INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
BUILDING
0
PLUMBING
HEAT a, GAS LINE
FENCE
SIGN
z
RETAINING WALL
0
U
SWIMMING POOL