7011 176TH ST SW.PDFiiiiiiii lill
1150
7011 176TH ST SW
CITY OF EDMONDS property of- AS S§Tf ffe HEET
CITY OF EDMONDS
N'/NEw N2 05356 ASSET NO.
El ADDITION ADDITION TO ASSET NO.
D RETIREMENT
DESCRIPTION
Z/
Aj
SERIAL NO.
LOCATION
--2 -76
,,1211
DEPT. NO.
4�2�z
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
*PROJECT NUMBER
PROJECT COMPLETION DATE
COST
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
ODEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT -
iG.L. ENTRY
REFERENCE
�p�" �
�) INITIAL
UP)
DATE
6c
VERIFIED BY
PROCESSED
BATCH NO. -
DEPARTMENT FILE
4
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a:
CITY of EDMONDS
For Inspection Call 771-3202
Address of Construction:
RECEIVEQ S I D E
k)
D -.� A 1q9'
Property Legal Description (Include all easements):
S E W E R
,.#'OfERMIT NO.
P E R M I T
07461
Owner and/or
Builder:
Contractor &
L i cense No:
Single Family Residence
Multi -Family
Commercial
(No. of Units
(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 X Yes — (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
I certify t read and shall comply Date
with the items listed on the back.
Permit Fee:
Trunk Charge:
Assessment Fee:
Issued By:
Date Issued:
Receipt No.:
Partial Inspection:
Comments Date Initial
Final Inspection Approved:
Date Iniltiz-1,
Rejected:
Reason _75 t _e 7 n i —ti a I
PERMIT MUST BE POSTED ON JOB SITE
White Copy - File Green Copy - Inspector Buff Copy - Applicant
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).
N
Side Sewer Drawing
The City of Edmonds EASEMENT NO . ............................................
NEW CONSTRUCTION REPAIRS f-� LID NO. .164 ..... . ASMT. NO . ...... ........... .
OWNER AtJ-o.a.QC,.RA,,V=-T -------- kok-'e-s .......................... CONTRACTOR Lu.T.z . ........ I-
...................... PERMIT No.7
.............
JOB ADDRESS .. 701-1 ......... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO.
'7 1 sT &%-4 e- \^/.
NAMEOF ADDITION ...................................................... 0 .............................................................
S
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PROP.
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7011
PW W-0011-11175(REV.11/78)
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Approved:
DATE&I ... 3, 1. Y. 8..(* ...... By, lia .. C5r . . .... ... . ... ...................
USE
CITY OF EDMUNDS ZONE gs-o
CONSTRUCTION PERMIT APPLICATION joB
NAME (OR NAME OF BUSINESS) AL)UhtbS 708
I -nc- jp 1\ V-T �A D yn E�s I t), 42, ILEGAL DESCRIPTION CHI
.50 -3,
-dITY TELEPHONE NUMBI
/P j f?
UME
k,Al J(JAV--�I'w
ADDRESS
C'TYC.ij trio r)() 8 -
(7(2 C,
ITELEPHONE NUMBER
NAME
a,W1)CW,q,--r
ADDRESS
_32 A,0,4vy
CITY TELEPHONE NUMBER
-7
STATE LICENSE NUMBER
WiD T) C14r19V Q
Legal Description of Property - Include all easements
(show below or attach four coDles)
Ja/--3 139117-Z PllqT
. (�a
EW
RESIDENTIAL
PLUMBING
ADDIALTER
COMMERCIAL_
MECHANICAL
REPAIR
RETAINING WALL
SIGN
EXCAVATE
FENCE
DEMOLISH
OR FILL
( x -FT)
PRE -MOVE INSP.1
swim
11:1 WOOD STOVE/
INSERT [:1 APT. BLDG E] RENEWAL
NUMBER OF STORIES NUMB"UP
Uwt:LLINU
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
NUMBER
/ 76 ftt- -ST 5 W
UBDIVISION NO. I LID NO, . .
I I
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
"N
EXISTING 10 REQUIRED DEDICATION 69
PROPOSED7,�.
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
STREET USE PERMIT REQUIRED 0
SEE ENGINEERING MEMO DATED A6
METER SIZE IBUILDING SUPPLY SIZE
REMARKS
RE UNITS
SIGN AREA ENV. REVIEW
ALLOWED I PROPOSED I COMPLETE I EXEMPT
ADB NO.
VARIANCE OR CU PLANNING REVIEW BY DAT
IV
YARDS HEIGHT I LOT CQYEaAg(E
I FRONT14-1; SIDE REAR 8- 7-41 -61%
I Ale "J C�71V-5 Aoe & C IV-41 I
SPECIAL I
REQUIRED
0 YES
A
By TYPE OF CONSTRUCTION I
NSPECTOR AREA OCCUP
T GROUP
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
R
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, Its officials,
employees, and agents from any and all claims for damages of
whatever nature. arising directly or Indirectly from the issuance
of this permit. Issuance of. this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify,. waive or reduce any requirement of any city ordinance
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
state laws regulating construction; and In doing the work authoriz-
THIS PERMIT
AUTHORIZES
ed thereby, no person will be employed In violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
tigginsurance..
I NSPECTION
DEPARTMENT
3IGNATURE (OWNER OR GENT)
DATE SIGNED
CITY OF
)Z4A4A4,e',j,0,,,—� 1,2 EDMONDS
MENTION 771-3202
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
ly
U OCCUPANT
4"') ILOAD
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.
OFFICIAL'S SIGNATURE DATE
RELEASED BY:
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
3:
PFMECT REVIEW CHSM(LIST
&dewit 14AWkm r �;6 57 5W,
PROJECT NAME ppWECr ADDRESS: :710
Reviewed by:- (initial/date)
COMMENIS
PLANNiNG
wrR/swR sTREEr I ENGNmG
FIRE
FUILDING
17TIM11
1177777711
SDME FAMILy/MLjLTI3nE/Ca4MrjAL - (Circle One)
MMACKS CHEM(ED - Pl�—ming
T1111111
11111T11U
VARIANCE/SETPACK ADJ.
XMITIONAL USE MVIIT
7ITrl7-----
JaDB CHECKED
3
77T17TR7
77777777
77777=
MMM ZCNING REQUIPTI-OM
/////////
////////
1111,t11111
4
777777
11TI—Tlw
ENVIRMMMITAL. FEATURES
5
777777777
.bnCESS SLOPE & VEHICLE ACCESS 0�
/////////
6
I I .
IIIIITFIT711111111
1117T17T
:
DRAI14AGE PLAN (On Site)
111)f11
/////////
/////////
////////
-
V Y
STREEr FILE
77TFIT711111111
777777777
8
11111111T
LEGAL DEscRip-rim wRiFicATicy
9
77T77-7fl
OUIT CIAIM/DEDICATIONS
10
EASEMENT - PUBLIC/PRIVATE
11
2ALCULhTE SEWER CONNECTION NO LID#
711111777777777
//////
/////////
12
777777
7 T7777777
7TFI /777
?LAT/SUBDIVISICN REQUIREMENTS
13
//////
77TfHRI
RIGM-OF-WAY CONSTRUCTIM PERMIT REQD
14
3= REQD FIOR PUBLIC IMPROVEMERM
3011S CONDITIONS & GROUND
,ATER FIEID 01ECKED -
111171
//////
16
7TITff
111111171777777777
3TREE?r PAVING REQUIRED
//////
/////////
/////////
17
CM AND GU7vIW REQUIRED
ITRII
////'//
IlAro 1///
//////
18
3IDEWkX REWIRED
771117
111171111
//////W
/////////
- OV/
19
7W//
111177W
-AM CUT FOR DRIVEWAY REQD
/////////
20
7 T1 T17 T77
7777T9 T
-:�AZ
1111177TF
STREET NAME SIGN REOD
/////////
/////////
A-�>
21
7TT17TR7
MM SIGNING RECD
22
SIDE sEwER AvAiLABiLm
23
Exismc WATER M*AIN SIZE
ffTI7
//////
7TR 7 7 7 7 7
/////////
Y 1,.P, I -
//////t/
////////
77MI1111
24
WATER METER SIZE
777T77
77P 7 7 7 Y
/////////
TR1111111
25
11 T177
7TWI 777
SERVICE LINE SIZE
/////////
26
1111777777
HYDRAur REQUIRED
27
W.
HYDRANT SIZE EXISTING
--.7,7,777W
28
TITITITR
7 /7
CROSS CONNECTIM INSPBCTICN REQD
29
WATER MMIM CHARGE P=
30
1111111177
FIRE'LINE CHARGE PMD SPRINKLER
STREET CUT
32
77 W7TIWII
OPEN DITCH EXISTING
111/11
33
7=777777T
f
34
77777
T
7T/77///7
1
CUL%7ERT, F=
//////
/////////
35
1111-7777TFITII
SIZE
//////
/////////
36
77777
U V
CATCH BASIN RBQD
37
INDICATED CN SITE PLAN
38
SHOULDER DMURAGE MAIN!rAIN
SHALE OPEN.RUNOFF
TIT111111
139
140
REVIEWED BY,
PLANNING MGR. ENGINEERING MGR. PUBLICYWORKS MGR.
0-, 1 F'R;'%S7PM,
ld.417h
ve/Lo/lb c4eele
DATE: �F e—.--
MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Public Works Department
7all / -7� r';v /
SUBJECT: " "Al
After revie,.-i of the subject Building Permit 3PPlication, vie have the following
cotrunents
Connection to City water system required.
2, Connection to City sanitary sewer System req0red.
I
3. Right-oF-way permit required For any work on City property.
4. Driveway slope not to exceed 14%
5. Backwa*er valve required i f downsta irs plumbing is below elevation oF
upstream manho e.
6. Water and sewer 1 ines to be separated by 10 foot minimum.
t
I ?d � h, C� /11P I
BO -6/82
%
WN
N
CATC.H BA51X:
-30(ok
L- Or NG-rH
WGUAL.) )111� "C "
I .. � / 4-�L,
4F.IrILF pipw
-rr= F- w/ 40Low, LF-
"NktfA COVIM
...........................
L1rVWL 77tWNC.N
CAP
SYSTEM CROSS-�SECTION
MIRAFI .500X
OK E!�IUIVF—LF4,41- -
T 15 _
0 15 LAYED oOKI
lrvls�cw COVER
3/45- 0/2" WASUED
GRAVEL
14�01AM F'F;tF PIPE
J1
TRENCH CROSS+SECTION
Ce
W
0
U
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2
for
location'-7011-
plan by 112/ke p"j,7V-�VjLA1V
phone—'7,4,�- U..4,v
date --
DESIGN DATA
Trench Perc LF per Impem Trench
Number Rate 1000 sq,,ft. Area Req.
NOTES
I. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floatinq material and
sediment at regular intervals (at least
twice per y r).
0
op
TRENCH SECTION_
CNATIVE i3AC#<F-ILL -)
140 OR EQUAL ON
TOP Or GfZAVEL
6" FIER F PIVC.M? 0-/.
7-L
'Y2"wA5p4Eo,
TA
'INFILTRA-r/()N TRENCH C>ETAIL
N-T5.
e
WRAP SUPAC e NR ON TOP
AND 507TOM Or TEE AND
SECURE WITH STAINLESS
STEEL BAND
S"RVC TEE
NOTE: i��RAINAGE SYS-rEM -rO BE MAINTAINEP
BY 1-40MEOK/NE;;Zs. CATCH E3A5ftJ SHALL- BE
CLEANEP OUT PE R 100't CALLY.
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