7110 164TH ST SW.PDFiiiiiiiiii909
7110 164TH ST SW
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ADDRESS: �'1(J Dq
TAX ACCOUNT/PARCEL NUMBER: ��6, 15 13 Nj�^no 0 Q!
BUILDING PERMIT (NEW STRUCTURE): I Vlni s'
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #
DRAINAGE PLAN DA
PARKING AGREEMENTS DA'
EASEMENT(S) RECORDED FOR:
PERMITS
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT
SIDE SEWER AS BUILT DATED: 111,5117
SIDE SEWER PERMIT(S) #: 6 57
GEOTECH REPORT DA
STREET USE / ENCROACHMENT PERMIT
0
LID #: / 3
LOT: BLOCK:
FOR:
WATER METER TAP CARD DATED:
OTHER: 1 z- w
L:\TEMPMSTs\Fonns\Street File Checklist.doc
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I hereby acknowledgo th-'.t I have real this apDllcatlor: that tho In•
formation given Is correct: and that I am Lle owner, or the duly oulhor-
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Ig d agent of the owner. I agree to Comply with city end ■tat. law■ retru•
thereby, to
ATTENTION
APPLICATION APPROVAL
laung construction: and In doing the work aulhort:ed person
will he employed M vlolatlOn of the Labor Coda of the State of Washington
THIS PERMIT
This application Is not a permit until
I
relating to Workmen's Compensation In■uranee.
AUTHORIZES
signed by the Building Official Or his Dep-
i
NOTE: Permit Limit One Year !Except PE7fOLITIONS whlCh
ONLY THE
WORK NOTED
Uty; and fees are paid, and receipt 1., aC-
uty; e s
.hall be completed in ninety days: MOVED-Ilv BUILDINGS shall be com-
edgf space provided.
pleted I ■ months.)
INSPECTION
SIGNA E!�(,O WAN/•J��} GEN
DATES ZED`
1, �•'
DEPARTMENT
CITY OF
DIRECTO 3 SIGN ATIf'@E ' /
�'/(r/�
EDMONDS
DATE
N TC: Applicant Sub%act to Plan Check Fee
775-2525
�� 7
This Permit covers work to be done on private property ONLY.
Any construction on the public "main (curbs, sidewalks, driveways,
ORIGINAL - File YELLOW - Ina,oC;rn
marquees, etc.) will require separate permission.
PINK • Owner GOLD - A--o,
APPLICATION
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The City of Edmond �,. Ar-1 SIDE SEWER PERMIT for EASEMENT NO. _
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NEW CONSTRUCTION REPAIRS ❑ LID NO...-,L73f.-: O. _-._�-_..__..--
OWNER G�g�( �1�1 �------------------------------ CONTRACTOR�.-YNN\N09(� �IJEF� PERMIT NO.G:.._._�.....
JOB ADDRESS -?lIQ -ate'-I?!S`�`._ —------------------- LEGAL DESCRIPTION: LOT NO. `--��--�Z�b�� BLOCK NO._._...._-___-______-__________._._..
----------------------------------------------------------------------------------------------------------------------------------•-...-------•---------..--
NAMEOF ADDITION-----------------------------------------------------------------------
Approved:
DATE - �J'.,�5W`7�.....--•--- By
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).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER-SAX
ATER-S DEPARTMENT
' PERMIT
rr5-2525 for side sewer #bspecti s BEFORE covering any portion of the construction. \ion will be provided within 24 hours after requst. NO Sat., sun., or holiday inspectlons.y
V
-7110
ABDRESS LOCATION OF +CONMUMON.--... .. .. _ tr} S
..._ 5 ....... ..... ......•__•_................ -..................
MOPERTY LEGAL DESCRIMoN ......................... _ L ticked
........................................... ....... ...... --....................... .................................... ..... .............
- - -....................--------
-----------
•...,.•......
.._._,.._.._.........
.
............... - ------------------------------ OWNER Air/OR BUILDER ...... CX '.Y-alBREE
CO"MMACTOR'S NAME A ADDRESS ..... L}'MII2 7 d ?E`T Ci3m1S�
76 -... ... .
eemiseion is granted .------•--__--..v�i19.. , for repair and/or connection of a side sewer to 1lie city terry sewae
tl tl/em in aceordauce with C1ty of Edmonds ordinances, y ty sftd
A—INTION 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 QQnatrult
Bide sewer. in street area. Do not cover any portion of sewer pefore it has been inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineers office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.03o and Regulations governing side sewers when you get permit.
NOTE No. 4—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 graft
sharper than % will be permitted.
NOTE No. 5—Trenches in street must be water settled and surface of street restored to original condition. Contractors shell be responsible for failure due to Improper
work which may develop within one year of completion.
NOTE No 6—It 1,p unlawful to alter or other work than is provided for 1n the permit or to do any work on the madn mower or Its s pipe into ttt�wye. appurtenances except to in.
DEMPPROVED p Date.___ ................... /
APPROVED Date. �•- ••
Remarks ........ _.....................
BY-• ............. Date- .......... -.....
_............... By.......
............................................... .
— BOTH Permit Copies MUST Be Sighed By Owner of Firm Performing Construction PRIOR To Request For Inspection —
' hereby certify that the side sewer installation constructed under this permit
� �Install(Owner of c�once with all governing ordinances of the City of Edmonds.
Dated this.......... -_.. ........... day of........
d J Check BEFORE you dig for: Water E], Gras [], Telephone p, Power p, Sewer 0,
,_ -
......--•-•-. --
APPLICATION
The City of Edmonds for EASEMENT NO . ............................................
SIRE SEWER` PERMIT
NEW CONSTRUCTION REPAIRS 0 LID NO. ../J.a—,ASMT. NO.'__________________
OWNER ------ ------ ------------------------------------- CONTRACTOR ................... PERMIT NO.
JOB ADDRESS —11 ............ LEGAL DESCRIPTION: LOT NO- -------------------------------- ..... BLOCK NO.. ......... ..........................
.1
.......... ............................................. ---------------------------- ................................................ ..........................
NAME OF ADDITION .............. .1( .kI4 ............................................................
•
A 14 14 1976
Public
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4prove�
..... ................. .... ............... By ........................... . ........................
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RECEIVED
NOV
CITY OF
REVISION
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DATE
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P20J ARCH::>,
SHEET
CITY OF EDMONDS
250 - 5TH AVE. N. • EDMONDS, WA 98020 • (206) 771-3202
COMMUNITY SERVICES:
Public Works • Planning • Parks and Recreation • Engineering
�890-199
September 27, 1990
Ray Smith
7110 - 164th St. S.W.
Edmonds, WA 98026
Dear Mr. Smith:
LARRY S. NAUGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
I have reviewed your account and will allow a credit to your account
according to our City policy: the average consumption for the same
period during the previous year charged at normal customer rates, plus
the excess usage charged at the City's cost, plus a surcharge of 15%
applied to the excess only.
Should you have any additional questions, please contact Ilene Larson,
Utility Billing Clerk.
Sincerely,
Ron. Hoi`lan-d
Water/Sewer Supervisor
BM/lk
cc: Ilene Larson
Utility Billing Clerk
#305775/TXTWATER
• Incorporated August 11, 1890 •
Sister Cities International — Hekinan, Japan
I -%ft�' O
890 _ 19oi
City of Edn*ds
RIGHT-OF-WAY CONSTRUCTION
STREET FILVIRMIT permit Number:
Issue Date:
A. Address or Vicinity of Construction: 7110 164 St. SW (9308582)
B. Type of Work (be specific): Install New Service
C. Contractor: Washingtnn Nat'l -rAs CA
Mailing Address: 815 Mercer St.Seattle Wn.
State License #: 98111
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 224-2278
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project q Vtility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut : QYes []No G. Size of Cut:(1) 2 x4 Cut H. Charge $
Over Water
APPLICANT TO READ AND SIGN
INDEMNI7T.• Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from injuries, damages, or
claims of any land or description whatsoever, foreseen or unforeen, that may be made against the City of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC17ON
AND ACCEPTANCE OF 7HE WORK ES77MA7ED RESTORA77ON FEES WILL BE HELD UN71L THE FINAL S7REET PATCH IS COMPLETED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED 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 Departme
Work is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes. € '.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required 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.
1 have read the above statements and understand the permit requirements and the pink copy of the permit will be available
on site at all times for inspection purposes.
Signature: t,r.; .;. Date: Feb. 19, 1993
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY US11 ""n `r
APPROVED BY:
TIME AUTHORIZED: VOID AFTER DAYS
SPECIAL CONDITIONS:
COMMENTS:
DATE:
Engrg. Div. 1991
RECEIVED
FE B 2 2 1993
ENGINEERING
RIGHT OF WAY CONSTRUCTION PERMIT ROUTING FORM
DATE APPLICATION RECEIVED a�aa �G3
WORK ADDRESS O ��i��t/-'�`'"/ S C.�✓
CONTRACTORCj`--
1. DATE TO PUBLIC WORKS FOR REVIEEW,)
REV/APP BY STREET DIV.j�_ date
REV/APP BY WATER/SEWER LlP_)* date ;Z "Z Z
REV/APP BY PUBLIC WORKS�� date -1.2-
2. DATE TO ENGINEERING FOR REVIEW
REV/APP BY ENG. AID date
or //�� Z�
REV/APP BY ENG. INSPTR. e--- date
3. Return to Community Services front desk
DATE PERMIT ISSUED C PERMIT #
(Y90.199-
City of Edn&ds x.. -
RIGHT-OF-WnAY CONSTRUCTION
EETFIL ;----P-ERm1T—__1' Permit Number:
�p/✓I 3��� C.F" Issue Date:
A. Address or Vicinity of Construction: 7110 164 St, SW !9308582)
B. Type of Work (be specific):
C. Contractor: itnallifib9t1h Bat`i GAs C04
Mailing Address:81. rje:ceer St.Sea.ttl.e tIa.
State License #: 98111
D. Building Permit # (if applicable):
Contact: Swaii
Phone:�'24�2 ✓S
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project ❑,,.„Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut : QYes ❑No G. Size of Cut a 2 x4 Cut H. Charge $
0ver Water
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds har mlesS f)tmi injrojest-damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be made 6gainst r1V Ciry of Edmonds, or any of its departmen or employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECI70N
AND ACCEPTANCE OF THE WORK. ES77MATED RESTORATION FEES WILL BE HELD UN77L THE FINAL STREET PATCH IS COMPLETED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED 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 Depar
Work is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required 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 pe t require eats and the pink copy of the permit will be available
on site at all times for inspection purposes. � '�?l�.
�i
Signature: Date: 'P el) . 19, ;. -9911
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
fr FOR CITY USE ONLY
APPROVED BY: AiL
TIME AUTHORIZED: VOID AFTER � D YS
SPECIAL CONDITIONS: �
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND I11.
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE:
wmmnty t a: RECEIPT N0:
DATE ISSUED $Y::
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund I I I - Route copy to Streek Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P. W.:
Work Disapproved By:
FINAL APPROVAL BY:
Date:
Date:
mg. urv. Hwy
Submitted by:
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T-A I 2,:�j
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WNG to window
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City of Edmonds
Right of Way
Permit Application
(_-jUNUA, Go10.10RS
Engineering Aide
Washington Natural Gas
SZ(-524e)
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0VE7- WATER
�I Water main depth Key
unknown
" gas main
23 d
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water
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gas
-ss-
sewer
$
water hydrant
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water valve
815 Mercer St. (P.O. Box 1869). Seattk, WA 98111 (206) 622-6767
PLOT PLAN
1'=20'
Tax account # 00513100008509 m
p
x
Lot Size:.3 acres
J
House size: 1st floor 1980 sq ft
N
2nd floor 1980 sq ft
I <iE SIRIE5 f W'e
Chain link fence
F,F-CEDVIED
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
DENNIS HOPKINS PROJECT: SMITH KITCHEN & OWNERS MARTI AND RAY SMITH
PO BOX 1896 EDMONDS
R WA, 98020 7110 164th STREET SW A
6
RENOVATIONS PH4257749110 BED\BATHROOM REMODEL EDMONDS, WA 98026
FAX 425 774 9210
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