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7104 175TH PL SW.PDF111111111111 1065 7104 175TH PL SW -CIT� OF EDMONDS ® NEW • ❑ ADDITION ❑ RETIREMENT ASSET INFO' 'N TION SHEET ASSET NO. C= C3 ,3ca 5 y ADDITION TO ASSET NO. DESCRIPTION /lam tl�cd � r rQ SERIAL NO. LOCATION DEPT. NO. **PURCHASE ORDER NO. _ PURCHASE ORDER DATE COST `PROJECT NUMBER t62 3 J .S 6 5' PROJECT COMPLETION DATE /2-'3t "5� COST �% -7 B.A.R.S. ACCOUNT NO. 40 1 • ESTIMATED LIFE Z INITIATED BY DATE APPROVED BY. **SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY © DEPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT • G.L. ENTRY REFERENCE DATE w VERIFI D B PROCESSED BATCH NO. INITIAL ttnp DEPARTMENT FILE CITY OF EDMONDS FOR INSFECTION CA7,L permit PUBLIC WORKS DEPARle SIDE SEWERPERMIT 775-2525 Ext. 220 Issue Date'=' * PERMIT MUSS' BE POSTED ON JOB SITE ice► 1. Address of Construction_ f � `.7 [',. 2. Property Legal Description (include all easements v i ncr. i ME 3. Single Family Residence Multi -Family No. of Units Commercial 4. Owner and/or Builder, 5. Contractor & License No 6. Invasion into City Right -of -Way: No Yes (If Yes Right-of- way Construction Permit Required - Call Dial Dig (342-5344) before excavation). 7. Cross other private property: Yes No Ve" Easement required - attach legal description and county easement number. READ THE FOL140WI,.NG 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 requires a minimum of a six inch (6") side sewer line. d. Side sewers may not be installed closer than thirty inches (30") to any structure. e. Side sewer lines must be laid at a minimum grade of 2% (1.15°} and maximum grade of 100% (450). f. No turn in side sewer greater than 45° (1/8,bend) is0allowed 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 100' 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. Inspection during normal working hours only. Two (2) working days notice required. DATE:4 1.,certify t I have read 'and shall comply with the above PERMIT FEE: : DISAPPROVED BY: Date: w .w` 4� By : Date: APPROVED By��O I�NEC�I FETE: �— � Date: ""' -""`7`-*"—� W * PERMIT MUST BE _POSTED ON JOB SITE * ��"T-- 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). The City of Edmonds Side Sewer Drawing A,41�� EASEMENT NO . ............................................ NEW CONSTRUCTION REPAIRS 0 LID NO ................... . ASMT. NO. .................. OWNER .... ZWIMA?4! ..... OW r ............................................ : CONTRACTOR ......................................... PERMIT NO. JOB ADDRESS .1.11Y ...... 17 ............................................... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO. .................................... 0 lb I I 71 tic PWW.0001-1 1175 (REVA 1/78) ................................................................................................................................................................... NAME OF ADDITION Approved: DATE ..A BUILDING ADDRESS PUBLIC WORKS DEPARTMENT • BUILDING PERMIT RE W - .% IN BLD!Gr.EPT.SUSPENSE DATEJTE: FICE ADMIN. — PUBLIC WOIKS L06 IN CITY ENGINEER (check) ❑ Access Slope and Vehicle Access ❑ Drainage Plan ❑ Street File ❑ Legal Description ❑ Quit Claim ❑ Easement ❑ Calculate Sewer Connection ❑ WATER/SEWER DIVISION ® Determine Meter Size 3,*" )Single Family Multiple Commercial DATE ❑ Complete Building Permit Review []STREET DIVISION ❑ Complete Building Permit Review ❑OFFICE ADM IN. — LOG OUT TO BLDG, DEPT. 7rBUILDI PERMIT APPLICATION (COMPLETE) 9 2 / C`�' S O) PIES OF SITE PLAN ❑ 2 COPIES OF FIRE PROTECTION PLAN (PREVIOUSLY REVIEWED BY FIRE DEPT.) ❑ 3 COYJEESS Op INAG 'N WITH CALCULATIONS REQUIRED�SUDT SION ❑ GREATER TITAN 2,000 SO. FT. IMPERMEABLE SURFACE ❑ LESS THAN 2,000 SQ. FT. Q S y RCHECK ZONING REQUIREMENTS (SETBACKS) 1 COPY OF E14GINEERIIIG CHECK LIST ffl COPY OF PUBLIC WORKS MEMO MULTIPLE OR C011MERCIAL YES ❑ (ATTACH COPY OF ADB APPROVAL INCL. ALL DRAT-aNGS) NO ❑ SUBDIVISFON — YES❑ NAME DATED RECORDED IL NUMBER NO ❑ (ATTACH COPY OF REQUIMIENTS) CHECK SEWER DRAWING AND ATTACH COPY PQr /u/- IS DEDICATION REQUIRED — YESQ (OBTAIN QUIT CLARI) ( CITY CODE ) No DOES CITY HAVE EASEMENT ON P OPERTY YES ❑ (ATTACH COPIES OF DRAWINGS) j NO =-1CHECK L GAL ACCESS — INX[3/1� S UTILITIES YEYES 0-_ NO N (36' HAS SEWER ASSESSMENT BEEN PAID YES L.I.D. NO. PLAT N0.�-3 7 SUBDIVISION NO. IF MULTIPLE: INCLUDE NUMBER OF UNITS 0 IF COMMERCIAL: INCLUDE NUMBER OF FIXTURE UNITS USE PERM( CITY OF ONDS ZONE NUMBER BUILDING PERMITAPPLICATION JOB NAM[ (OR NAM[ OF BUSINESS) ADDRESS ' LEGAL DESCRIPTION I SUBDIVISION SHORT SUB NO. K MAI 2NG ADDRESS j 0 —V PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP h U W ADDRESS h I U C CITY NAME f 0 ADDRESS < 7 [ CITY h Z 0 U ERTATIE LICENSE NUMBER Legal Description of Property �. �.7-� Z L C U IA W 0 J < 0 W J ELEPHONE NUMBER /] EXISTING :3 A PROPOSED_�� W DEFICIENCY OF RIGHT OF WAY W Z E KE Y V t SEE ENGINEERING MEMO DATED Z A,/ J W (TELEPHONE NUMBER ?te- krwy Ak :LEPHONE NUMBER 7. 7/-- L/,37© TY LICENSE NUMBER or Attach Four Copies) REMARKS SIZE I BUILDING SUPPLY SIZE I FIXTURE UNITS SIGN AREA ENV. REVIEW ADB NO. ALLOWED PROPOSED COMPLETE EXEMPT SHORELINE VARIANCE OR CU PLAN REV BY DATE J YARDS LOT COVERA E Z �r FRONT � SIDE A->/ REAR REMARKS I I/j NEW 1 � RESIDENTIAL ❑ PLUMBING CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT NON-RESIDENTIAL ❑ MECHANICAL I ❑ ADD DEMOLISH ❑ SIGN SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT ALTER ❑ [:]EXCAVATE FENCE OR FILL ( X FT) REQUIRED ❑ YES ❑ NO GROUP LOAD REMARKS REPAIR 1-1 SNSP. DPOOL COMPLIANCE Z NUMBER OF STORIES NUMBER OF 0 DWELLING F UNITS 4 NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN) N W ' 0 E� L C� PLAN CHECK FEE VALUATION FEE BUILDING PLUMBING MECHANICAL M w h < (3 Z Z Z < J a 13 Z a 7 m This Permit Coven work to be done on private property ONLY. Any construction on the public domain (Curbs, sidewalks, driveways, FENCE marquees, etc.) will require separate permission. SIGN Permit Application: 180 Days Permit Limit: 1 Year -Provided Work Is Started Within 120 Days RETAINING WALL in In "Applicant, on behalf of his or her spouse, heirs, assigns and SWIMMING POOL W successors in interest, agrees to indemnify, defend and hold harmless i Jthe City of Edmonds, Washington, its officials, employees, and a agents from any and all claims for damages of whatever nature, iarising directly or indirectly from the issuance of this permit. Issu- o ance of this permit shall not be deemed to modify, waive or reduce TOTAL AMOUNT DUE J any requirement of any city ordinance nor limit in any way the City's ability to enforce any ordinance provision." ATTENTION APPLICATION APPROVAL I hereby acknowledge that 1 have read this application; that the in- formation is correct; and that I am the owner, or the dilly author- THIS PERMIT This application is not a permit given ized agent of the owner. 1 agree to comply with city and state laws regu- AUTHORIZES until signed by the Building Official or lating construction; and in doing the work authorized thereby, no person ONLY THE his Deputy; and fees are paid, and will be employed in violation of the Labor Code of the State of Washington WORK NOTED receipt is acknowledged in space pro. relating to Workmen's Compensation Insurance. vided. SIGNATURE (OWNER OR AGENT) DATE SIGNED INSPECTION DEPARTMENT DIRECTOR'S SIGNATURE Zy^I �3 G_[ CITY OF EDMONDS DATE THIS SITE IS LOCATED IN THE CITY 775-2525 OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. ATTENTION ORIGINAL — File YELLOW — Inspector Ll IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE OR SEP 2 "Al RECb PINK — Owner GOLD — Assessor UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 304, 306. 1 0 2-7 a DATE: er MEMO TO: Building Division Community Development Department FROM: Engineering; Division Public Works Department SUBJECT: _%��LLLVI ___ After review of the subject Building Permit application, we have the following comments: is Connection to City water system required, 2. 'Connection to City sanitary sewer system required 3. RiPht-of-way Permit required for .any.., work on City property '. 4, Driveway slope not to exceed 14%. S. Backwater valve required if downstairs Plumbing is below elevation of upstream manhole. 6. Water and sewer lines to be separated by 10 Foot minimum Z Ad 0/ ,,/e le ley,��,wlel 026�;4�� �''" Signature t: •'1 �;JI' 1 I:%jj • 1 M BUILDING PE UT REVIEW 0 %5 L (address) Street Right -of -Way Existingt c7 REQD Access Easaikm is Existing REQD H a Utility Easement Existing REQD�._ w Lot Per Subdivision Platt Assessor w Site Plan Checked for Accuracy x Underground Wiring Regd. n H 0 (heck Accuracy ,�f Le ga Descr tion z Review by Date w• Existing Water Main Size ro �� C Water Main Required NIA Service Line Required Hydrant Size Existing a Hydrant Reqd Per Fire Code N/,4 Size w r Detector (heck Meter Reqd. A Cross Connection Inspection �— Fire Department Comnents a 3 Water Meter Charge Regd. Review by /2&Date Q Septic Tank Design Approved Date Septic Tank Permit Reqd. Permit No. Sanitary Sewer Availability Proj. Drawing No. File No. Side Sewer ilability �y w Sanitary Sewer Fee deqd. 3 Xctio Review by - Date ' L ' w N Open Ditch Existing &l ,v Read. Culvert Reqd. i�� rl �'„,�, Size a Catch Basin Reqd. 12 f,z. Indicate on Site Plan O Shoulder drainage maintain collection on swale open runoff H Manhole reqd. �.2 �/ �. Indicate on Site Plan Soil Conditions and Ground Water Field Checked / _ Review by Revised: lv10-1977