7106 176TH PL SW.PDFiiiiiiii lill1134
7106 176TH PL 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).
STREEr FILE APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT PLA.N-f EASEMENT No ...........................................
NEW CONSTRUCTION &/ REPAIRS ❑
PERMIT No. OWNER ..... AlIV, ........ C ........................... CONTRACTOReL-7��-� ........................
7 SS ......
ADDRESS .......... . ..................................... LEGAL DESCRIPTION: LOT No. ---- ----------------------------- BLOCK No . ..................... ...
0
NAME OF ADDITION .....
/$7.(f .LW,.S . . . . ...................................................
Approved:
AIPROVEO
FEP 2 7 .19-70,
DATE*.................................. . . . ...........
CITY OF EDMONDS
Can
CIVIC CENTER -'WATER -SEWER DEPARTMENT y for 6-1107 when work
n
is ready for inspection. (No inspect �T Q-86
��®� SEWER,
������ t[ons Saturday, Sunday or ho)idays.) 1®
ADDRESS......... 7.1J 6....-...17.6.th..2.1a ce...S...W..-----;...........................................................................................................................
OWNER ............ ,Me...! rSP 9hP!Y' ......................................... CONTRACTOR........... WeSteX'.►?...SeWer..........................-•----
g Februar 27.... 19..70. for ........................ days to REPAIR or CONNECT a side sewer
Permission Is ranted ..---•-----• -•---...-.....X-.... ,
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—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. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 3—Top 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 1/s will be permitted.
NOTE No. 4—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. 5—It 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 appur-
tenances except to Insert the pipe into the wye.
T_
roar FILE
PUBLIC WORKS DEPARTMENT
---"Single Fam ly�:�
.TWEET
BUILDING PERMIT REVIEW
Multiple
Commercial;�L!
BUILDING ADDRESS 7/ 03 � 0 410111,1
BLDG. DEPT. SUSPENSE DATE
/to INITIAL DATE
UTE: ❑ OFFICE ADMIN. PUBLIC w6i& LOC., IN
CITY ENGINEER (check)
(3Access Slope and Vehicle Access Ok-
13 Drainage Plan pK 0-28-9
E3 Street File
13Legal Description
OQuit Claim,
13 Easement
OCalculate Sewer Connection
❑ WATER/SEWER DIVISION
Wbetermine Meter Size
DComplete Building Permit Review
DaSTREET DIVISION
OComplete Building Permit Review
E30FFICE ADMIN. LOG OUT TO BLDG. DEPT.
X
ONE 8111.61 M i M iciiii 1= on Mae=
03--BIfILDING PERMIT APPLICATION (COMPLETE)
&
13-,Y'COPIES OF SITE PLAN
0 2 COPIES OF FIRE PROTECTION PLAN
(PREVIOUSLY REVIEWED BY FIRE DEPT.)
E3 3 C0$jBS OF DRAJNAPE PLAN WITH CALCULATIONS
REQUIRED BSIIVISION ❑
GREATER THAN 2,000 SO. FT.
IMPERMEABLE SURFACE t3
LESS THAN 2,000 SO. F-L.13 A -5
1
PHECK ZONING REQUIREMENTS (SETBACKS)
L6dXic,opy OF ENGINEERING CHECK LIST
1 1 COPY OF PUBLIC WORKS MEMO
❑ MULTIPLE OR COI-DIERCIAL
YES COPY OF ADB APPROVAL INCL. ALL DTW-DINGS)
NO
ETISUBDIVISION YESE3 NAME 9e
DATED RECORDED C/
NUMBER joy-,g-
7el
NO 0. (ATTACK COPY OF REQUIRRIENTS)
VECK SEWER'. DRAWING' AND ATTACH COPY fe,-
_ili I DEDICATION YESF A S REQUIRED (OBTAIN QUIT CL R 1)
CITY CODE
NO
DOES CITY�,,H:hVE EASEMENT ON PROPERTY
1Z
S ❑ (ATTACHtOPIES OF DRAWINGS)
4"
,CHECK'LEGAL- ACCESS INGRE�UTILITTESff
YES 11 YES
NO [3- NO E3 V!,
iJ`HAS
SE .WER,,ASSESSMENT'BEEN PAID
L. I. D., NO..
PLAT I NO.
k-'!'SUBDIVISIO
NO.
0
F-M14ULTIP INCLUDE -NUMBER, OF:,UNITS
F; COMMERCIAL: INCLUDE'NUMBER OF FIXTURE UNITS
2.
PLOT PLAN \
FOR \1
. . h ...' Milo
/� ' •'
LS.A,AP 8'—
.
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„
DATE
MEMO TO: Building Division
Community Development Department
FROM: Engineering; Division
Public Works Department
SUBJECT:
After review of the subject Building Permit
application we have
the following comments:
1_, Connection to City water system required
2._ 'Connection to City sanitary sewer system
required.
3. Rtfht-of-way Permit required for ,any work on City property,
4, Driveway slope not to exceed 14%.
j, Backwater -valve required if downstairs plumbing;
is below
elevation of upstream manhole.
6. Water and sewer lines to be separated by
10 foot minimum _
r
? /%i // %% i9l
_
�'
/ .. ,
PUBLIC NOW DEPARIM= alEamisr
BUILDING PERUT REVIEW
'71e 7
(address) (crate)
Street Right -of -Way Existing �2.
..�REQEL_
Access Easements Existing Z:�e,/vV_REQR
Cd
Utility Easement
W
IDt Per Subdivision Plat IWO 3 - 7s Assessor Map e e.,
W
Site Plan Checked for Accuracy
Z
Underground Wiring Reqd. a
0
Check Accuracy of.Legal.Des ption e
Z
Review by
Date
Existing Water Main Size- '0
Water Main Required *1A
Service Line Required -MY
101/
Hydrant Size Existing
od
Hydrant Reqd Per Fire Code A'1A
-Size
Detector Check Meter Reqd.
Cross Connection Inspection
Fire Department Comnents
Water Meter Chare Reqd. 767 150r_
Review by,
Date V.2 9Z9_
Septic Tank Design Approved
Date
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability__4LeC_
Proj•
Drawing No. &r alaI4 C/
File No.
Sewer Availability f
aSide
94
Sanitary Sewer Connection Fee qd.
:3
Review by
Date
Open Ditch Existing���..�Reqd.
Culvert Reqd._/�� Size
ad;
Catch'Basin Reqd.'
Indicate on Site Plan
0-
Shoulder drainaze Tmintain collection on
swale open runoff /t11_1hX
s
[LEGAL
E PERMI
CITY OF EDMONDS NE NUMBER
BUILDING PERMIT APPLICATIONB �—
NAME/ (OR NAME OF BUSINESS) DDRESS
1/s�^t-r— //. . — /t DESCRIPTION I SUBDIVISION ISHORT
W MAILING ADDRESS v,
Q CITY
A E
h ADDRESS
x
U
It CITY
NAME
C �r ✓ r-+ v
Q ADDRESS
F
V
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E CITY
F
Z
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�, 5 14/
TELEPHONE NUMBE
��T S 4V
LEPHONE NUMBER
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING _
PROPOSED 30
DEFICIENCY OF RIGHT OF WAY n
CWKED`BV
�iA SEE ENGINEERING MEMO DATED
REMARKS
METER SIZE I BUILDING SUPPLY SIZE I FIXTURE UNITS
E NUMBER REMARKS
rSE NUMBER SIGN AREA ENV, REVIEW ADS NO.
ALLOWED I PROPOSED 1COMPLETE1 EXEMPT SHORELINE
of Property (Show Below or Attach Four
VARIANCE OR CU IPLANNIPi.s RENEW BY
F
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U
0
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V
W
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L V/
/ /,y, (/
YARDS
FRONT SIDE 3 REAR
LOT
REMARKS
NEW
RESIDENTIAL
Io PLUMBING
CHECKED BY TYPE OF CONSTRUCTION I CODE
NON-RESIDENTIAL
6
MECHANICAL
ADD
DEMOLISH
❑ SIGN
SPECIAL INSPECTOR A
REQUIRED
ALTER � EXCAVATE
OR FILL
FENCE
( X FT)
❑ YES ❑ NO
REMARKS
REPAIR PRE-MOVEINSP./
COMPLIANCE INSP.
swim
ET POOL
Z NUMBER OF STORIES
O
F
NUMBER OF
DWELLING
UNITS
/
4 NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
tt
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W
W
f0 n
O
FEE
BUILDING
PLUMBING
MECHANICAL
°.A -"„ k 1?
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
Permk,Application: 160 Days
Permit Limit: 1 Year- Provided Work Is Started Within 120 Days
RETAINING WALL
In,,'Applicant„on behalf of his or her spouse, heirs, assigns and
SWIMMING POOL
: successors in. interest, agrees to indemnify, defend and hold harmless
J
2 the City., of Edmorids, Washington, its officials, employees, and
aagents from;, any and all claims for damages of whatever nature,
x arising' directly of indirectly from the issuance of this permit. Issu-
O ance of ihis'permit shall not be deemed to modify, waive or reduce
TOTAL AMOUNT DUE
p any requirement, of, any city ordinance nor limit in any way the
x City'S'ability+, to`enforce any ordinance provision."
ATTENTION
I hereby, acknowledge that 1 have read this application; that the in-
formation given'Nis'6correct;-and that I am the owner, or the duly author-
THIS PERMIT
ized agentlof�04the�owner'14,� l *agree to comply with city and state laws regu-
AUTHORIZES
lating'Construction; and in'doing the work authorized thereby, no person
ONLY THE
willbe',employred i odation of,the Labor Code of the State of Washington
WORK NOTED
relatingjto,LW,orkmems;Compensation Insurance,
SIGNATURE OWNEROR*AGENT) Ii DATE S GNED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
-'!' rl- - ' n t'THIS SITE IS LOCATED IN THE CITY
TAX
775-2525
'OF EDMONDS.; LOCAL SALES
wr g SHOULD BE CODED 31.04.
ATTENTION"=
IT IS UNLAWFUL TO USEoOR OCCUPY A' BUILDING OR STRUCTURE
UNTIL A FINALiNSPECTION HAS BEEN,MADE AND APPROVAL OR
A CERTIFICATE+OF�OCCUPANCY HAS BEEN GRANTED. UBC 304, 306.
1 0 2 7 9v ,< ., I
i
VALUATION FEE
Z
C
W
W
Z
93
Z
W
IE
W
Q
W
Z_
Z
Z
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a
OCCUPANT
LOAD
17
Z_
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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 pro-
vided.
1IRECTOR'S SIGNATURE
I,
)ATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
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