7008 174TH ST SW.PDFiiiiiiii lill
1050
7008 174TH ST SW
CY 9 0 1 9 9 -
RECEIVED City. of Edmonds
RIGHT-OF-WAY CONSTRUCTION
2 41992 PERMIT Permit Number:
1 it
NE \V105",
Issue Date:
6 IREETR 0
A. Address or Vicinity of Construction: 7008 174 Street Southwest
B. Type of Work (be specific): Install New Service
C. Contractor: Washington Natural Gas Company
Mailing Address: 815 Mercer Street,
State License #: Seattle, WA 98111
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone:' 224-2278
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. E] Commercial E] Subdivision El City Project R] Utility (PUD, GTE, W`NG, CABLE, WATER)
R Multi -Family El Single Family F-1 Other
INSPECTOR: INSPECTOR: f; o-( VV
F. Pavement or Concrete Cut M Yes LJNo VI)G. Size of Cut: Z x 4_ H. Charge$
@ Gas
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City a dmondshar'l-liessftom injuries, damages, or
1 .1 1 . �, ?f F
claims of any kind or description whatsoever, foreseen or unforeen, that may. be ti'jae 'against Me by �f 6nl�nds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including'def��se costs, and attorneyfees by reason of granting this permit.
OR.
AD MA 7EhA ) 0
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP A '4 2 . F, _XJ,9R-FOLLOW[NG 7HE FINAL INSPEC77ON
AND ACCEPTANCE OF THE WORK ES77MA7ED RESTORAYTON FEES IKIt LD UN77L Y&FIN4LATREETPATCHIS COMPLETED BY
I
CITYFORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESS D FOR ISSUANCE TO THE APPLICANT
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Department- 771-3202.
Work is to be inspected during progress and at completion.
Restoration is to be in accordance with.City Codes.
Stre elt shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City ieguia�tions'islrequired by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved, material prior. to.the,end of the working"dAy;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be available
on site at all timesfor inspection purposes.
Signature: M46M41A.4 4 Date: January 15, 1992
(Contractor or,,AgV)�/7'�
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
.0
Q
NO WORK SHALL BEGIN PRIOR TOPERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund I I - Route copy to Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1985
WashlngtLn
Natural s�
AW-hrgton D)ergy CcMDaW
Addendum to City of Edmonds
Right of Way
Permit Application
Submitted by: Kerry Walsh
Engineering Aide
Washington Natural Gas
622-6767 x2761
IOD6 r4 . CDT 'S�-kj pager 969-1686
WN
Wa
un
q
815 Mercer St. (P.O. Box 1869), Seattle, WA 98111 (206) 622-6767
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
The City of Edmormis for EASEMENT NO - ----------------------
SIDE SEWER PERMIT --------------------
NEW CONSTRUCTION REPAIRS F� LID NO. � ----------------- ASMT. NO - ---------
OWNER — 7 w
- --------------------------------- CONTRACTOR
............... ----------------------- --------------- ------------------ PERMIT NO.
JOB ADDRESS ---- ...... --5 - ------
------------ LEGAL DESCPUPTION: LOT NO - ------------- -�-> ------------------ BLOCK NO - ---------------
------------------------------------------------------ ---------------------- ----------------------------------------------------------------------------------
1— --N NAMP. OF ADDITTON
Approved:
DAT- - - --------- By .. ................... ----
7'
IVE, WER PE
NO
CITY' -OF "EM, S SE
WATER -SEWER, DEPARTMkNY'
ERMIT N
,P
tcaii, 7.75-2525 for side
sewer insp�ctioni. BEFORE covering any, p6rti n',of: the construction:
VTne6ection wii
1: be Provided within '24 hours after requ.9t.. No Sat.,':Sun', or holiday Inspec
tions.).
6C
. ...... ....................................
ATION, OF CONSTRU, CTION .. .......... .
............ ......................................
P LEGAI; DEScRipnom...
................ Z-7 ...... ........ .................. ......... ... . ...
...................... I ......................
............................. ......... ...... I .........................
............................................... ...................................................
. .......... ................................. ................... OXXVNER AND/OR BUILDER ........... .......
.............. .........
.;��TRACTORIS NAMIE & ADDRESS� ....... I .... . ... .....
...... ................... ........ . ..... .......
.......................... ...... .................
�,�PerniissiqnJs granted Cl)
. . ................................................ for repair and/or connection of side:sewer to -the city
sy-�'Ivn in accordance with C1 a sanitary
tk of Edmonds� ordinances. Sewer
A��TION 1S CALLED TO THE FOLLOWING:
NOT
E -1
No. —The owners of the proper�y may obtain a permit to construct sewer inside- property linei A licensed Side Sewer Contra�ctor must -be e ployed7 to
side sewer Instreef,area. Do not cover any Portion, of, sewer before It has been Inspected., 'm construct
--NOTE�,,No. 2--All work pe�i�rrned in, city right-of-way requires an invasion of Right-of-Wa� Permit obtainable from the City Engineer's office',
NOTEINo, I—Obtairl full" I Af'orniation, regarding Ordinance 111.16:030 and' Regulations governing side sewers N�hcn- you,'et Permit
9
-,NOT'E'No. 4—Top of side sewer must have at least 30 inches1coverage at property line
No� be'nds,:in grade
sharper. than" %_will, be. permitted. and 12 Inches inside prope . ky line,; mlnimum� grade of 2%.
NOTE, 0
�—Tre'nches in, street must be water settled said surface of str
w f completion. eet restored to orlgina1 condition. Contractors sha.11 %e reponsible. for. failure due tw improper
ork which may develop within one year o
NOTE No. 6-1t Is unlawful'
to alter or do any other, work than Is provided for In, the permit, or to do any work on the main sewer. or Its appurten
sert the'pipe,into the'wye. ances except to In-
t7DISA_,PPR6VED Date ... ...... ........ By ..... : . ..... . ......... .......... . Da,
6��PPROVED
-.,Date .........
. ...... �-77 ............ 'Bi ............. .......... ..................
Remarks: .............
.....................................................
... . . .. . ... ..........................
.......................................... ............................................
.....................................................
........................................................................ ................. ....... 11 .................. ......................
...................................................... .........
ROTIM�rmi.t C6pieS,�IUST-Be Signed By Owner of -Firm Performing Construction PRIOR To Requ - est For Inspection
V, �/Vv L,
hereby certify that the side sewer installation constructed under this permit
'n
'6o
-�Wk9 (pwn r of con t n 1r;
a -11h/stalled in accordance with all -governing ordinances of the City "of Ednionds.,
Dated, this ........................ ... day .of 7 ....... A ...................... ;19 ..........
r, ther.'
V_V Check, BEFORk you dig for:,.W.ater .'E];:,- Gwas E3,% T olve
eIephon e P i -0,
STREET FILE 3 03 - 04:/,5-0
LIST 77
i 14TA 9. - 40-
13�111LWNG P111'UT pj- �'f! 7
Strcet Pdrht-(-F-1,:av E-xisting 7f) T L
TZI 'D
Acccss Fisements Existing M7 I
n)
Utilitv Easement Yxistin U.09
Lot rcr Sui)div;sion Plat Assessor 17!.11)
Sit,-, J)].,m n�ccl-cd for Accuracv 6o
c,
Uncicrrrcuncl "Cod.
7— —;;1
Low -
Ex i t in- 1,,atcr !-Iain
Ow
/7
V�U, i C�
11% dn!! t
Py(1 rant Rcr!,,, --C,(! r,,Cr hrr Cok,
Si ze
1-:�tcc'Lor (lic cl: "Cter
Scp"ic Tzm!: 1), It C:
Scptic T�nij, Pen!"it Pe 71,61 t "0.
Saninn, ',C*,..:C, r0i.
Drrdn"', "o c :0.
Jj!) 4 J.j
cr
co;,.,I,�Ctian !,ce Pequired
t C
'Di Uji 1:x-
C, I I vo r !-- l,cic,. I I i ru, I S i.
0
'i ca-cc,11, 1"!sill 'A..'alired 111d; catc on te Plan
-73N�W
nn it �Luals
11.111,1ole roquirc(! 1110acniu, o! 1 sito jljrj,.
�;(Iij C1)11C1jt.ioj-,F, F, CO-OL11-1d 1:,1'LCj' FjOld (310C,,.ed
'evi c
Rite 6 - !X 9- 77
B.UILDING DEPARTMENT
OERMIT APPLICATION
Applicant Fill
inside Heavy Lines
I USE PERMIT
ZONE NUMBER
— 4 y
JOB
ADDRESS ).6J
N AME (OR,NAME OF��SINESS)
I
k.", I Z6:4:
Q0LEGAL
LOT
10 YES 1:3 NO
LOT AREA
SUBDIVISION NO.
P
MAILING ADDR-ESS
STREET R/W
EXISTING STREET R/W Fr. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W :30 FT. jo FT.
CITY
ELEPHONE NUMBER
L1 5-- o
U
NAME
fe
VQ, 1411
REMARKS
W
W
I-
i'?_
ADDRESS
C' 0 -,)- &A
CHECKED BY
W
E
U
m
VILLA-, O-bd
TELEPHONE NUMBER
L41
STREET AND/OR UTILITY WORK
REQ'D. 11 YES 15NO
R/W PERMIT REQUIRED
1:1 YES ISNO
ILI
6 Ire!
UNDERGROUND
WIRING REC-D. 10YES NO
0
F.
U
4
z
AbCr-NESS
17, 0 1 — n rd
TYPE CONNECTION EYES IVERI
SANITARY SEWER
D NO
EDIBY
ku
CITY
TELEPHONE NUMBER
SEPTIC SYSTEM 0 YES
APPV'D BY CITY ENG.
WNO
PERMIT NUMBER
I
0
q45--ocotl
STATE LICENSE NUMBER
CITY LICENSE NUMBER
REMARKS
F: 14
Legal Description of Property (Show Below or Attach Four Copies)
METER 5 BUILDING SUPPLY SIZE
REMArms
z
SIGN AREA
ENV. REVIEW
ADB NO.
U
th
W
13
Al I WED PROPOSED
COMPLETE EXEMPT
.J
REMARKS
W
VARIANCE OR CU
PLANNING REVIEW BY
I
DATE
I
.
YARDS
-2!';-" FRO '7 S. . E g-IR EA
LOT COVERAGE
RI
AS
NEW RESIDENTIAL rL,NE
FIRE ZONE
TYPE OF CONSTRUCTION
ElADD NON-RESIDENTIAL SIGN
R TAIP41NG
DEMOLISH WEA LL
0 ALTER EXCAVATE FENCE
F� OR FILL I— X—FTI
ICODE
I
SPECIAL INSPECTOR
REQUIRED
1:1 YES 0.140
OCCUPANCY
GROUP
OCCUPANT
LOAD
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
0 REPAIR PRE -MOVE swim
El INSP. POOL
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
I -
z
W
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
REMARKS
NAT.VRE OF WOR 0 Br NE.
0
L
W
a
PLAN CHECK
NO.
VALUATION
FEE
z
0
I-
z
W
R PO ED USE
Ir
U
0
W
13
PLOT PLAN (INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
BUILDING
1>
0
J
W
PLUMBING
HEAT & GAS LINE
m
0
W
FENCE
z
SIGN
RETAINING WALL
SWIMMING POOL
E_
911
BUILDING DEPARTMENT Applicant Fill
Imide H ... y Lines
PIERMIT APPLICATION
NAMIC (OR NA.ME
y t
Z
TELEPHONE NUMBER
TY
0.
C CITY TE r—ONE NUMBER
I- i
L>
Ij 'CITY LICEN—
egal Deso-ription of Properly (Sho. �-e. Attach Four Copies)
Ix
U
J,
W
[XRE�I-.�SNTI.L IF -L,A
DEMOLISH ALI
x FENCE
R FILL x_r
D F� - CA'A'r
��IAIR POOL
INS�.
N U . —01 N!Illi —I-.IL
, z-Z 0
Z US E
0
-61 —C.S.
PLOT P— ON-1 ITT". .1151TW., �;ST
ABU
0
I
00
LEGAL LOT 11-0� AREA
Y r-- ONO'
I
--
:�-F` —RI11 FT. DCr1CII:NCY THI�; PROPERTY
�TREET R/W
cOMP. ,AN s-. Wiw FT.
11*11.1.1 ANOj.R RKEWIRED
.Co... Yes No oym 2-NO
----L—
u— GROUND
WIRING rIEQ'D. Q , cS 0,,,o
�Pc CONNECTION fA Y,
-1c. .1
SANITARY SEWER
Z::�I
0 Ycs
PERMIT NUMBER
�-Vlo BY CITY E,`IG CZNO
RC.A S
2e --2
METE,
UI1_DING 5—Y �--C
c
RC I KS
J
A4 4�,rz.(�4 14 47
SIGN 14-
E N REV,
vtc
ADD NO.
ALLOWED PP.qPosED
COMPI_rTr
..MARKS
VARIANCE T-�------TPLZNNING E BY DATE
YARDS
��R AR
LOT C!�O�RAGC
N S It):
T
FIRE TYPE OF CON U�.TION
T—,7— v_- —
c cc
SPECIAL INSPE11—
ARC —GICUPANC� ECCUPANT
P Do AD
.Eau RED
Cl YE, XN-
CH—K Y S SITE IS I.DCAILU IN I HE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31 . 04
PLAN CHECK
No.
c;�
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
L -L
!,WIMMING POCIL
M-81
1-
Z
W
C
I hcmb� cknoxlcdw� that 1� It -vd Illis anplication: that the in-TOTAL A 'UNT DUE
. I ' t'.
�h o'
aa%,c
- -
, 0 e 'u" —
p,en is znd that I arn the 0,mer, or the dulY 211"OZ-
t_. I " T`gu
to and e a-
the owner. I hgree to comply with city and st�te laws Tegkl-
i
ATTCNT:ON
APPLICAT!ON APPROVAL
iz,d agent of
by on
n ed th"L - pcis
laitang cons uiuction: and in doina he wcl� authorized thereby. no pcison
- h_ St _ 0 , h
a te " in'-."
Labor Code n I th� State of Washingt0l
Code n
THIS PERMIT
This application is Ilot a perini�
h
will be CnlPl0yCd.iTJ ViOlItiOrs of ille
c
Insurance.
AUT.O.-CS
muil sign,.,d by tl�ic- Building t Xficiat or
relating to Wotkmen's Compensation
'S a nd FI I,
NOTZ-- perM*,t UMit onrj Yegr(Except DEMOLITIONS and FILL
iM 1 "O�
ONLY —C
!its Depuzy; eeb �'Tc 'e'a id and
e c 0., . , �0
'np,e 'L ,
t which shall be comPlOwd In 90
CoB al L's P�rm. , d
PER',111's ,itho,il canZtional ose perm;
.ORK NOT..
-
icccipt is acknowledged in s�act' )to.
days; MOVED -IN PUILDINGS shall be completed in jj.\ monIhs.) -ECTIC, 11,
51:ATURE I.WqB OIJ
kj ?/ p I CiTy OF
-7-7
Ls��v �,,t--
J. ./j
EDMOND, A",
776-2525
A10TY: A�'[)IjCGnt St'lljC17t "0 P101? Check FCC
Thi, P-rrit -'I"' '" private pr�werly ONLY. ORIGINAL F�fle YELLOW I-Dec,o,
c'v*" -or" to be
Any ConS%1UCtI.R on 11. public e--ir, (curb,, vd-W-I", dri—yl,
IIt..) Will roqj;ro SGPaT3t8 PO—iiai�01. GOLD As0s,.,,r PINK 0—er
Mts IF
M Z"':
m I
770-1524'
............ .
i-j
E:—Q
DF, J
.-I
PT
CIj'YI c Diviv
E" f 11 in.r q
I L
LLL
7-*__-,
—7
46"