7005 175TH ST SW.PDFiiiiii iiiiii
1072
7005 175TH 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
for
The OY of Edmonds EASEMENT NO . ............................. ---------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS F1 LID NO - ------------------ - ASMT. NO . ..................
OWNER ..... �t,-A(—Zt ----------- CONTRACTOR ---
.... ..... . . .......... PERMIT NO.
JOB ADDRESS . ......... LEGAL DESCRIPTION: LOT NO - --------- t�c� ---------------------- BLOCK NO . ....................................
..................................................................................................................................................................
NAME OF ADDITION ..... - --------- ................................................................
Approved:
;4w
.............. B y . .................
DATE l;w::,5 ................
11/75
SEWER,.., "PERMIT
CITY OF: EDIMNONDS, �SIDE"�,
"W'.Al
WATER7SEWER 'DEPARTMENT'
PERNIT
Call. 176-2525 for side sewer.. inspectionsi 'BEFORE 'covering. �in rr� of,. the,'coristructl n-
pbrti,o,
(Inspection -will he, provided, withirr 24' hours after rpqust� NO. Sat., Sun.-, or holiday inspectl6osj%.
L!.-A D DRESS -LOCATION DIP CONSTRUCTION ...... .
—5-
........... ........................ . ....... ..... .....
.................... ................... ............................... ......... .............
/151
P110Y ................... ............ .....................................................................
PROPERTY -LEGAIL,:DESCRI ............. . ..... ........... .........
..... .................................. .................................................... .......... ............................................................ . . ......................................... .............. ............. ........
................ UILDER ......... 4�e_
................ ............................... 0-*-*7N,,EIV ANWOR B ....... ;. ...... ......... ................. ......
CONTR CTOW&NAMY& ADDRESS ............ .........................
............................ ................... ...............................
PernAsslini anl%,,, 19 �for�repalr and/or connection of a side sewer to� the city an
5" r ... w .................... ............ s itary sewer
—tem, in1ccg1d. City, of, Edmonds ordinances.
XfTENTION IS CA-LLED TO, THE FOLLOWING:
NOTE' No. I —The owners',of the property may obtain a permit to- construct, sewer inside property,line. A li6e�sed',Slde, Sewer.Contractor,:must,be employed'. to construct
side sewer in:street. area. Do riot cover any portion- of sewer before it has,heen Inspected
� N 2—All, work,performed' In city right. -of -way requires,, amInvasion of�RJght-6f-,Way,,Pe'rniit obtainable,from, the City, Engine �s
NOTE, o., of f ice..,,
er
,-,,,NQTE No..,3—Obtafn. full Information,regarding Ordinance 11J6.030 and., Regulations - govern - Ing,side; sewers when. you get permit.
"I NOTE No.A—Top.�of- sit[Y_sewer�,musthaveiat least 30 inches 'coverage at -.,property, line. and,:12-Anches Inside, property 'Jine minimum, grade of'2 No,jbends, Ini �grade,
sharper Ahad, 'A. will,bb permitted.
ai re ue improper
,NOTE. No;'5�Trenches,in`street must be water settled and surface ob street restored to originaJ'.condition., Cbintraetors,"'shall be'responsiblb 'for f lu' d to
work which may develop within one year of completion.
........ ..
NOTE No. 6—It is unlawful. to �alUr or do any other work than Is provided for in the permit,- -orAo do any work on the, main sewer'or -Its..appurteriances -ek cept to,l
sert the'pip�e-into the wye. % a
DISAPPROVED Date ......... ....... L .......... By .............. Date ..... . By .... ............ Date ...... ........... ;�! ............ 'By ..........
----------
74F —2c:
APPROVED Date..77y: ..... . ............. ..7 ................ . .. . ....................
........ . By,_j
................ ................. ..............
Remarks: ....
......................................................................... ............. ................... ........................................ ...................... .............................
.......................................... ............................................................. ....................... ....... ........
..............
................................
BOTH- Pei-mit',-Copibs MU)ST -B lConstruction PRIOR To: Request: For Inspect -ion
e. Signed By. OWner.0f; Firm Perf orming,
............ ... here�y7 'ceftif y, that the side sewer installation -constrttcted� under" -this, permi
t
(Owner of'C6ntracting Firm Perfdr'rning Construction,),
-Wks installed in. accordance With all governing ordinailcos:O& the!City' of:EdInbrids.
W,
......................................... ...... ..
'Dated thi s.. ........................ day of...
V.V oCheck�BEFORE yoiudig for:,Wa
ter E]," 0��; Telephon6o:o, .,wer'E]; Sewer 'Other E]:
APPUCATION
The City of Edmonds for
SIDE SEWER PERMff EASEMENT NO - --------------------------------- ----------
NEW CONSTRUCTION REPAIRS LID NO. � ------------ NO. ____ ------------
_J4 ......... CONTRACTOR ---------
OWNER
-------------------------------------------------- PERMIT NO.<:�;�__
JOB ADDRESS 71 --------- LEGAL DESCRIPTION: LOT NO. j�� ---------------------- BLOCK NO - -------------
........... .. - -------------------
------------------
�A ------------------------------------------------------------------------------------------ I -----------
NAME OF ADDITION.-.. ------ -----------
Approved:
DATE
01
rol
By--------------------------------------------------- iiyfg
ZONE
T 73 A 0, S:
S
OTHER
HEIGHT 30
CITY OF EUNIUM4.1
IT
ELDG. DEP
CONDITIONAL PER IT
RK. &4j 22
�RESS--7 00 9- 1-7
,IER-
'ROVED DATE-
BLDG. OFF!C ik�
KEEP THE t STAMP D
PLANS ON JOSSITE OR
ALL INSPECTIONS
--ISHEET
rRM I T N =07.
OF
GLF-Ni:)AN CONST.
P.O. BOX 393
E:DMONDS. wN. 98020
0,`77 /
LoT- 1) NA5B!� PLA7
CITY OF EDMONDI9
P. W. DEPT. ENGINI-ElEBINO DR.
EXAMINED
BY DATE
REMARKS.
Tr� T 7,Tr-7-
.DECK
44, k
oll
-,�\ I -
2.
N.
-1-75 7 li -fi I ,s
RECE lVtt)
DEC 2 9 197-7
CITY O� t�ONIONOS
PUBLIC EMKS DEPAMENi CHECKLIST
-- 0 1 rM 100 t2-2 11M
"�UILDING PERZiffi-,M, FIM AS - 115TH is- 11
(address) (dat&Y
Street Right -of -Way Existing,
REQD_
Access Easements Existing____ALOAjr,,
REQD
p4
Utility Easement Exist'
REQD
W
Lot Per Subdivisiols��-I��lat
Assessor Map___�..
Site Plan Checked for Accuracy�__
Underground Wiring Reqd.
o
Check Accuracy of Legal Description
—ye;
'v;
Review by 0-1Q
Date_
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing
Hydrant Reqd Per Fire Code
Size
Detector Check lvhter Reqd. N-3-0
Cross Connection Inspection K..� 0
Fire Department ConTrLents
I vlater Meter Charge Req
Review by
Date
Septic Tank Design Approved
Date
Septic Tar& Permit Reqd.
Permit No.
Sanitary Sewer Availability
proj. )PLA 7—
Drawing No.
File No. 77-/-2-,
P4
Side Sewer Availability -r—c--> P-62!�cr-- r:> I-j
14
Sanitary Sewer Connection Fee Reqd.
Revia,7 by (Z-4-
Date
Open Ditch Existing
Reqd.
Culvert Reqd.
Size
r4
Catch Basin Reqd.
Indicate on. Site Plan
0
Shoulder drainage maintain collection an swale open runoff
Manhole reqd. 417-
Indicate on. Site Plan
Soil Conditions and Ground Water Field
Checked
Review by,
Date
Revised: lvlO-1977
B U I LD IN',G DEPARTMENT
USE ----------
PfiRmif APPLICATION
Applicant Fill
Inside Heavy Lines
NA (OR NAME OF PSINESS)
ADDRESS 00
11 'S <
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W
MA L AD SS
LOT AREA 15UEJDIVISION
NO.
z
3:
YES
0
-
CITY
STREE R/W
TELEPHONE NUMBER
EXISTING STREET R/I
FT. DEFICIENCY THIS PROPERTY
zl_
COMP. PLAN ST. R/W
FT.
NAME
REMARKS
U
W
ADDRESS
Z
Ir
CHECKED BY
W
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u
T CITY
�j
I[ I-LEPHONE NUMBER
-1—/UK UTILITY WORK
R
R/W PERMI
REQUIRED
N
SYES
No
YES ONO
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UNDE
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WIRING EQ'D.
it YES NO
0 AUUHESS
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TYPE CO NNECTION
S ANITARY SEWER
QYES
VERIFIED By
F
V CITY
1:3 NO
Z
TELEP
SEPTIC TEM
E
APPV'Dby5 ITY
13Y C ENG.
YES
PERMIT NUMBER
0
U S AT LICENS
NUMBER
-0 (oil
0
t-ITY LICENSL NUMBER
REMARKS
-
G - tq _�* - -L _ZA
Legal Description of Property
Ow elow or Attach Four Copies)
METER SIZE
3/�
it
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MARKS
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SIGN AREA
�NV. REVIEW ACB NO.
(A
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ALLOWED PROPOSED
COMPLETE EXEM PT
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VARIANCE OR CU
PLANNING REVIEW 13Y
DATE
NEW RESIDENTIAL GAS
0
YARDS
7AR LO T COVERAGE
RONT -7�
95 F z SIDE
LINE
RE
NON-RESIDEN IAL
ADD SIGN
FIRE ZONE
TYPE OF CONSTRUCTION
CODE
HEIGHT
DEMOLISH RETAINING
EIWALL
El ALTER
SPECIAL INSPECTOR AREA, OCCUPANCY
REQUIRED
OCCUPANT
EXCAVATE E] FENCE
FIOR FILL I— X
13 YES N 0
GROUP
LOAD
FT)
El REPAIR PRE -MOVE
1:1
PLAN CHEC ED BY
THIS SITE IS LOCATED IN THE
CITY
INSP. swim
OPOOL
OF EDMONDS. LOCAL SALES TAX
NUMBER OF S TORIES
SHOULD BE CODED 31.04.
NUMBER OF
REMARWS—
DWELLING
UNITS
th
N'�TVRE OF WORnTO V'L� DONE A
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1"UVU5E:D,USE
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PLAN CHECK
NO.
PL T PLAN (INDICA TE UIL_UING SETBACKS,
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ABUTTIN STREETS)
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BUILDING
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PLUMBING
In
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HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
�wlm ING POOL
VALUATION FEE
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