20030119.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
RW Permit Required
street U18 Permit Roq'd
EXISTING — PROPOSED
Inspection Required
Sidewalk Required
REQUIRED DEDICATION— FT
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Wiring required 13
METER SIZE LINE SIZE NO. OF FIXTURES
PRV REQUIRED
YES [3 NO
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDR, AINAGE
BY
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBUC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPUCATION: 160 DAYS
PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 1130 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
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 MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE 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 AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKjjN;S,j�N INS�� �DRCW 18.27.
SjGt GE DATE SIGNED
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Description
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State Surcharge
Building Permit
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Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
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Total Amt. Due
Receipt #
Recording Fee
CALL
FOR INSPECTION
1A9
771-0220
APPLICATION APPROVAL
This application is not a permit until signed by the
Building otticial or hisfher Deputy: and Fees are paid, and
receipt Is acknowledged In space provided.
OFFICIAL$ SIGNATURE DATE
RELEASED BY DATE I
ATTENTION I I CA I I 0a
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL I
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR
D4/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 * (425) 771 -0= FAX (425) 771-0221
Website: www.dedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
8'91� Planning A, Building * Engineering
March 5, 2003
GARY HAAKENSON
MAYOR
Mr. Roy Cotton
9118 185" PI W
Edmonds, WA 98026
RE: Final Engineering Inspection of Waterline — Permit #2003-0119
A building permit was recently obtained for a waterline repair at 9118 185h PI W.
According to the asbuilt provided, the entire waterline was replaced from the
meter to the house with a continuous run of pipe (no joints) and was . backfilled
prior. to inspection. The City of Edmonds, Engineering Division requires that all
waterline repairs and/or new installations be inspected prior to backfill. At this
time, theCity is requiring that both the connection at the house and at the meter
be exposed for inspection. In order for your permit file to be closed, you will need
to call for a final Engineering inspection.
Please call to request an Engineering final inspection at 425-771-0220, ext 1326.
An inspection request shall be made prior to March 19, 2003 to prevent code
enforcement action. Please feel free to contact me with any questions you may
have at 771-0220, ext 1338.
Thank you,
Jeanie McConnell
Engineering Technician
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Permit file
Incorporated ALIgUSt 11, 1890
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CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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YES 13 N 0 13
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THIS PERMIT AUTHORG= ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPEM ONLX ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMITAPPLIOATION: ISO DAYS
IL PERMIT LIMM I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON 13EHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
NOT BE
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL
Landscapoinsp. Total Amt. Due
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
WAY CITYS ABIL17Y TO ENFORCE ANY ORDINANCE PROVISION."
NOR LIMIT INANY THE
Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION A PPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC*
This application Is not a permit until signed by the
CALL
TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO
Building Official or hisftr Deputy: and Fees are paid, and
FOR INSPECTION receipt Is acknowledged In space provided.
WORK�&K8jQ0"SAAON INS4PNCE )No ROW 18.27.
OFFICIA SIGNATURE DATE
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ATTENTION EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW- INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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