700 BIRCH ST.PDF11111111111111
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700 BIRCH ST
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
STREET FILE
PERMIT
Call 775-2525 for side sewer Inspections BEFORE covering any portion of the construction.)
Inspection will be provided within �4 hours after requst. NO Sat., Sun., or holiday inspections.
ESS LOCATI ......
ON OF CONSTRUCTION --- ....... ................. . .......... . ...........................................
.......... Lr� —�-,
PROPERTY LEGAL DESCRIPTION ...... . . ...... . ........ 2_... ...... ....... Q.
-=t ... V�:,- . .1 . .27*1;;�T_ ;..I ...... A ........................
.................................................. . ...................... . ........................................................................ . .............. . .................................. . ..................................................
................................................................ O1*7*71SiER,00MjOR BUILDER .............. ............ . ........ i�,1_t ..............................................
CONTRACTOR'S NAME & ADDRESS .............. ...... M, ....... . ........................ . .. . ........................................................
PeT�9,�on Is granted ------- 1AA 197T.77., for repair and/or connection of a side sewer to the city sanitary sewer
I -V ....... "', ' ------- - ----- * ......
wit &
accordance h Edmonds ordinances,
E,�TION IS CAT I D TO THE FOLLOWING:
NOTE No. 1-m—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
. side sewer in street area. Do not cover any portion of sewer before It has been inspected.
NOTE No. i—All work performed In city right-of-way requires an Invasion of RJght-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 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 maJn sewer or its appurtenances except to in-
sert the pipe into the wye.
_10'PROVED Ff Date. By ---------------- Date ......... By ---------------- Date ................ ................... Illy ................
.. .... ....
D /�-rDate. ..................... B y
APPROVE
........... :7 ................. . .. . ........................................................................................
Remarks: .................................. * ......... . .. . ........................... .......................... . ...................................................... ....................................................
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
------ ...................................................................... ; ... ... I hereby certify that the side sewer installation constructed under this permit
(owner of Contracting Firm Performing Construction)
w installed in accordance with all govirning ordinances of the City of Edmonds.
Datedthis ............................ day of ................................................................. 19 .........
you dig for: Water F], Gas'E], Telephone 0, Power 0, Sewer C], Other C] A/
00
00
ADDRESS: 700 (T/,�ph —Vyld,
TAX ACCOUNT/PARCEL NUMBER: Mo,,.:�) 5(p ODI) w,-3-00
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:b L- 9, 1 DETERMINATION: E] Conditional Waiver E] Study Required 0 Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #: Lg I V-
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DST's\Fomis\Street File Checklist.doc
PLANNING DATA
NAME: -z-oc, DATE: �0 0
SITE ADDRESS: -1 00 QLa-c'14 4�_2� PLAN CHK#: Oa - a Co I
PROJECT DESCRIPTION:
e--
REDUCED SITE PLAN PROVIDED?.6jLNoj
MAP PAGE: CORNER LOT: (Yes FLAG LOT: (Yes
Z.ONING:_12�-(-o —CRITICAL AREAS DETERMINATIONM 0@- Ckt
Ll Studv Reauired:
ElWaiver
UConditional Waiver
SEPA DETERMINATION:
El Fee
U Checklist
L3APO list w/ notarized form
L3 (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
Exempt
SETBACKS:
Required Setbacks:
Street: ��O' LeftSide: Right Side: Rear:
Actual Setback
Strec Side: Right Side: Rear:
Street map chocked for additional setback required? s/No/DRAI
Ll DETACHED STRUCTURES:
Ll ROCKERIES:
U FENCES/TRELLISES:
L) BAY WINDOWS / PROJECTING MODULATION:
STMRS /DECKS:
PARKING: Required: Q- Actual: rv--o
LOT AREA:
LOT COVERAGE
Calculations:
BUILDING HEIGHT:
Datum Point: Datum Elevation:
Maximum Allowed: �ctual fielght:
A.D.U. CREATED?I& / Yejs
A D�
SUBDIVISION: rL
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes / No
I
a IMIZI: ' .1 , 1110 l�iii I'll, - __ -
Plan Review
NewBPPla.mingDataForm.D0C
0 0 CA File No: oa
Critical Areas Checklist
Site Information (soils/ toppgraphy/hydrology/ vegetation)
1. Site Address/ Location: ."300 BLX*ck, S+- E(jm on d.S
2. Property Tax Account Number: 00 L96S10 0 00 CDO S p 0
3. Approximate Site Size (acres or. square feet): —4440�5
4. Is this site currently developed? X�es; no.
If yes; how is site developed?
5. Describe the general site topography. Check all.that apply.
Flat- less'tha'n 54eet elevation diar4o"'over entire site.
Rolling: slopes on site generally less than.15% , (a vertical rise of'10-feet over a horizontal
distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 10-feet
over a horizontal distance of 33 to 66-feet).
Steep: grades of greate I r than 30%. present on site (a vertical rise of 10-feet over a horizontal
distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing Water: V1 0 Approx. Depth:
7. Site contains areas of seasonal standing water: 116 ;Approx. Depth -
What season(s) of the year?
8. Site is in the flo6dway 11V fl6odplain AID 'o f a water course.
9. Site contains a creek or an -area where water flows across 4ib grounds surface? Flows are year-round?
'Flows - are seasonal? 11(mm, t tim� of Y, ?;
pie). ear
00
10. Site is primarily: forested meadow ;'s'hrubs X mixed
urban; landscaped, (laWm;shrtibs,et�),
11. Obvious wetland is"p'r iesent on site:
Critical Areas Checklist.doe/3.19.2001
City O*dmo'nds
Development Services. Depgitment-o f, i
Planning Division
Phone: 425.77Lbiid-"
Fax: 425.771.0221
.. . '"W"
Date Received: 00
City Receipt,#:.. 9�:G -19.-
C r i b c ail ' A r*-e a's—Fi I e` #:- ' ' ' ' I -
Crit'ic'�al�Ar.-'e'-Ias-�.C,h'e�c'.�k'list.iF6e:,:- $ 48.00-,
Pate,Mailed to. ADDlicant:
The Critical Areas Checklist contained on this form is to A prooi�rty-owner; or his/her authorized representative,
be filled out by any person preparing a Development must� ��ll 0 ut tht'c"hecklist, sign and date it, and submit it
Permit Application for the City of Edmonds prior to to.,ihe City;� The, C-ity-- will -review the checklist,'make a
his/her submittal of the application to the City. precursory site visit, and make a, determination of the
'j-"-Ii�lbsequent steps necessary to complete a development
The purpose of the Checklist is to enable City staff.�q
-y�.-,permitapolication-.
determine whether Atenti5il-
may be, present on the subject property. The information
needed to complete the Checklist should be 'easily'
available from observations of the site ordata availabfe�,at
City Hall (Critical areas inventories, maps, or soil
surveys).
I". , � - I '.
Please submit a vicinit� map, along with the signed copy
of thi , sfform,to.assist City, staff in,finding and locating the
specifig,piece ' o ' f.,-prbpqty -described on this form' In
addition, the applicant shall. include other pertinent
information (e.g. site plan, topography map, etc,.) or
studies in conjunction with.this Checklist to assistant staff
in completing their preliminary assessment. of -the site.
The undersigned applicant, and his/her/its heirs, and assigns' in consideration on the processing of the application agrees
to release, indernnify, defend ind hold the City of Ed rmiiids harmless from any and all damages, including 'reasonable
attorney's fees., arising from any action or infraction based in whole or'part upon false, misle "ading, maccurat . e or
incomplete information furnished. by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this appl. cat. o the behalf of the owner as listed below.
SIGNATURE OF APPLICANVAGENT /0 f DATE
Property Owner's Authoriza on
By my signature, I certify thit I have authorized the above Applicant/Agent to apply,for-the subjectiland use application,
and grant my permission for the public officials and the staff o5f th* e City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER
Owner/Applicant-
Xur4 [+-,rzi
Name
--400 Zao,�L.. ��4-
Street Address
City State Zip
Telephone:142,5 -:IL41-3L�
Email address (optional):
DATE
IF
ApplicabtRepresentative:
bave'Ki,eve*v-
Nwne,
Street Address
Lan n(A) 1,A—A
citya State Zip
Telephone-:4D6-,--T--+1-2W5-
Email Address (optional):
Critical Areas Checklist.doc/3.19.2001
STREET FILE
C I T Y 0 F E D M 0 N D S
PUBLIC WORKS DEPARTMENT
Routing of 'WUM7ng-7��-miltq, Plat, or Subdivision Applications,
Proposed Property Address: 700 Birch Street
DEPARTMENT
COMMENTS
INITIAL
& DATE
W A T E R
7,�
S E W E R
t")t 4F h A-
),Z 7- 7
/57
c 7c-,
B U I L D I N G
0 R
P L A N N I N G
ADDITIONAL INFORMATION:
61
VIA EDMONDS VMY,
Side, Sewer Drawing TRUNK LINE
Tho-, onds
QY EASEMENT NO - ------------ --------------- ------------------
NEW CONSTRUCTION REPAIRS
we f ... 149---AWT. NO - ----------
LT
OWNER ------- 13 . ......................... ......... ..........
-- CONTRACTOR .... B-4- ........... PERmrr NO.
rio,c) B;rc� C-Ztl .3
JOB ADDRESS ..... - - ----- --------------------------------------------------------- LEGAL DESCRIPTION: LOT NO - ------ — ......... ................ BLOCK NO . ....................................
PWW4Ml-ll/75 (REV.11/78)
.................................................................................................... ..................................................... ---
NAME OF ADDITION ......... AaJa--'&i.4'kq-.41--.Jl ..................................
Sld� �Vlllhe WO-4
P, W".1 t 0 f
pwc'
VIA EDMONDS WAY.
TRUNK LINE Approved:
DATE ----- . ....... By Az
CITY'OF EDMONDS
Permit
FOR INS(ECTION CAL 0 IL
4UBLIC , WORKS DEP 775-25 t. 220
SIDE 'SEWER PERMIT Ex Issue Date
F
PERMIT MUST BE POSTED ON,JOB SITE.*
I , 7w r7177777'7"w"wA
1 1. Address of 7onstruction rl-00
2. Property Legal Descript . !,on (include al 1
Aw"C'11 iW 1�� I 1P
3. Single Family Residence
Commercial
4. Owner and/or Buillder _rb
5. Contractor & License No.
easements)
Multi-iamily No. of Units
L+_
M Cky%n Ch V' 9 F
6. Invasion into City Right -of -Way: No L,,---Yes
way Construction Permit Required - C all Dial Dig
excavation).
(If Yes Right-of7.
(342-5344) before
7. Cross other private property: Yes No &o'o��Easement required -
attach legal description and cpunty-easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain a permit to install side sewers on
their property. A licensed side,.sewer contractor must be employed to
construct side sewers in the Public' right-of-way.
b. The side sewer contractor. -assumes full reponsibility for each
installation for one year..
C. Commercial establishment'requiresla minimum of a six inch (6")
side sewer line.
d. Side sewers may not be inst&.1led closer than thirty inches (30")
to any structure.
0
e. Side.sewer lines must be laid at a minimum grade. of 2% (1.15
and'maximum grade of 100% (450). . .
0
f. No turn in side s8wer greater than 45 (1/8,bend) is allowed
0,
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h.� Pea gravel is required for bedding when installing sewer lines
through other than ' granular soil. .
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 1001 along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors,shall be responsible for right-of-way failure
due to poor compaction of fill.
k. Side -sewer must be left uncovered until inspected and approved
by the City.-''
1 1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE: T__r-_a_r+_Tf +-Inn4- T hn"gm -p-eanA
V A/ ii _e and shall comply With the above
_7�) �— 0 V I L ? U M K_ �,
5.*39.Wm1TTF-E`h 25,04' 11% Fnifmit I DISAPPROVED BY.: Date:
Ty!"
OW By: Date:
"' CONNECTION FEE: AP�ROVED By: Date:
94:=)
PERMIT MUST BE POSTED ON JOB SITE
APPLICATION
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID NO - ------------------ - ASMT. NO - ------------------
L--T- �Fr, =—. �55-7 Z72.
OWNER ------------------------------------------------------------------------------------------------ CONTRACTOR --- !�k --- *-.-"
......... . --------------- ----- PERMIT NO - --------------------
c=c=
JOB ADDRESS -- ------------------------------------------------------------------------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
40
40
............................................................................................................................................................
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
Approved:
DATE......... By - - --- --------------
11/75
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS C]
VNER ..... L-T- ........... ........ " ......................
.......... CONTRACTOR ........ PERMIT No.
OV
.. k--C/a v
ADDRESS .... ........ E ...................... LEGAL DESCRIPTION: LOT No. a ..................................... BLOCK No . ............................................
......... / - / J(,--
..q
NAME OF ADDITION ... W . 7 ....... 4 ..... ........ / ....................
LL-
ui
uj
c/)
-&-pproved:
DATE................................................ By ......................................................................
-!5? �4 �- .5-
/ 0/1=:, /0,
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APPROVED BY PLANNING -
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SETBACKS:
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SIDE
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REAR
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OTHER
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HEIGHT-"-'o
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Val
ST I REE-T . FlLt
RECEIVED
JUN - 7 2002
BUILDING DEPT.
01/
'007 wsw 141"110 /-04--
OA 9W4,�//Ar Le
11�j CO
LOT LINE STAKES MUST
BE IN PLACE AT TIME OF
FOUNDATION INSPECTION
Any request for modification,, variance or other
841.0ninistrative deviation (hereinafter uvariance")
jOust be specifically called out and identified.
A#proval of any Plat or plan Containing
ovisions which do not comply with city code
aod for which a variance bag not been
,p
R . pecifically ldentifledg requested and considere
d
by the appropriate city O�Mcial in accordance
with the appropriate provision of city code or
state law does not approve any items not -to code
specification.
Uk.
0-1
Q�
APPROVED 8
Y PLANNINO
4ci v4— #eo-zrx�;
0 DOO 00
_Z?
S1%
0�,ITY OF EDMONDS
F3JILDING DEPARTMENT
M100% - __ ba=
AMPESS t-40
OWNER
APPROVED DATEV)
BLDG. OFFICIACL_7
I PERMIT NUMBER
700
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ZONE -
SETBACKS:
FRON'l
SIDE
____ _0 '0 1 N
OTHER
HEIGHT 2-
3-L