21210 96TH AVE W.PDFiiiiiiiiii lill
15539
21210 96TH AVE W
- CITY OF EDMONDS
ASSET INFORMATION SHEET
NEW ASSET NO.
ADDITION ION TO ASSET NO.
RETIREMENT
00 3CYbl
DESCRIPTION
u
SERIAL NO.
LOCATION DEPT. NO.
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
*PROJECT NUMBER 6,1 a -:7-x
PROJECT COMPLETION DATE 12
COST - J Ile
B.A.R.S. ACCOUNT NO. (lit o
ESTIMATED LIFE
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 -
0 G.L. ENTRY
REFERENCE
DATE
U
VgNVWIPI D BY
i
PROCESSED
BATCH NO. -
INITIAL
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DEPARTMENT FILE
CITY OF EDMONDS
FOR INSPECTION CA1,L p
PUBLIC WORKS DEP RTME T ermit N?
SIDE SEWER t&2525 Ext. 220 Issue D"C5
PEP -MIT MUST BE POSTED ON JOB SIMI� 0 C i I
1. Address of construction al,21(�2 p:; Ut Riihfic Works
2. Property Legal Description (include a11 easements)
Z19 _/ I? /1� 2 J11- ;�PA Lla -� -
3. Single Family Residenc'je Multi -Family No. of Units
Commercial
4. Owner and/or Builder
5. Contractor & License No. Z�
6. Invasion into City Right -of -Way: No,)5� Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation) . C
E-4 7. Cross other private property: Yes NoZEase nkitrouNURS
MORE YOU DIG
U attach legal description and county easement number.
H 1-800
�4 READ THE FOLLOWI-.NG AND SIGN: -562-6478
a4
a. Property owners must obtain a permit to install side sewers on
>4 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
E-4 installation for one year.
N
0 c. Commercial establishment requires a minimum of a six inch (6")
P4
z side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
U to any structure.
N 0
M e. Side sewer lines must be laid at a minimum grade of 2% (1.15
0 and maximum grade of 100% (450). 0
E-4 f. No turn in side s8wer greater than 45 (1/8;bend) is 0 allowed
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 1001 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 ho Z nly. Two (�) working
days notice required.
DATE: " /
'certi:fy -that 'I h-a-v7 r-ead
and shall comply WIP the above
PERMIT FEE: J20-
E — DISAPPROVED BY: Date:
o W fru By: -Date:
W cw7 6_1 APPROVED By: Date:
* PERMIT MUST BE POSTED ON JOB SITE *
STREET FILE
DATE:
TO: - guilding Division
Corununity Development Dopartmenc
Engineering Division
Public Works DeparrnenL
ECT:
After revi . ew 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. Ripht-of-wav Permit -LL�Luir�d for any work on City property.
4, Dj;iveway slope not to exceed
5. 11ack-water valve req1i d j.[
r is 1)010
elevation of upstream manhole.
6. Water and sewer lines to be separaced_hy 1.0 foot minimum.
11 V
!�ignaLure
Open Ditch Exist* /Vz/�- Reqd.
Size
CulverL Req Z-Z
Catch Basin Reqd.
p z- Indicate on Site Plan
�r J,*
Shoulder drainage maintain collection an swale open runofi:__,eyL.,,
Indicate on Site Plan
�bnhole reqd.
Soil Cmditions and Ground Water Field Checked
Date �/�2
Review b ----- - ;1--7
7�-
Revised: MO-1977
g
PUBLICUORKS DEPARTmm CHEMIST
BUJIDING PEM-UT REVEEW STREU RLE
A7,
(addres;) 7i�*te
r
Street Rig�it-of-Way Existin&___,:�O REQD
Z
Access Easements Existing /)P,-- REQD
Utility Easement Existing-___ REQD
w
Int Per Subdivision C- 5 - Plat Assessor Map_,6�4
I
Site Plan Checked for Accuracy—
Z
Underground Wiring Reqd.
0
Check Accuracy o� Legal DescWption el(,' j",,
Z
Review by i"Mz� Date
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existf
in4
Hydrant Reqd Per Fire Code Size
W
Detector Check Meter Reqd.
E4
Cross Connection Inspecti
Fire Department ConTnents
:3:
Water Yeter Charge Reqd. 5C9,
Review by____ Date 91111-ZIfl
Septic Tank Design Approved Date 4(--
Septic Tank Permit Reqd.--- Allll�_ Permit No.
I
Sanitary Sewer Availability Proj
Drawing No. I- / D r-, A File No.
e3
Side Sewer Availability eles . W//,41
Sanitary Sewer Qonnection Fee Reqd.----Iva
:3:
Review bX_ Date
14�4�
En
Open Ditch Existing_____L��..._Reqd. - — --------------- —
Z
Culvert Reqd. tq Size
C4
Catch Basin Reqd. —Indicate an Site Plan
Shoulder drainage maintain collection on swale opcn runoff_ A-Z AL7:7
1^41
�lanhole reqd. Indicate on Site Plan
Soil Conditions and Ground Water Field Checked
RMew by. Date
Revised: lvlO-1977
iFwl
I NA�GE
. I J� _:�.: . . . V:Oiz
MARk/ McNAUGHTON
EDMOW0b,, vv.,46WINGTON
SuFwEYOFtS 0 utvm�. -,-- P"Ot4E 775-15W
06 ,,T, W. EDMONM WX 2W20 * -
FLAE I
'a I -77AZ
IOT I . I A 11660' 81 ,
—7--7
kM
iCEIVED
AU G 4 1981 PU"OLIC WORKS-DEPASP&ET Rg�ingle Family
B :::::: U :::::: I ::::: L ::::: D :::::: I :::: N :: G P :::: ERMIT REVIEW Multiple
BUILDING D�'D%f&b�?Vork!,p Commercial
BLDG. DEPT. SUSPENSE DATE INITIAL DATE
IOUTE: OFFICE ADMIN. — PUBLIC WORKS LOG IN
CITY ENGINEER (check)
0_�� — iE6 olt-,",
(3 Access Slope and Vehicle Access
13 DrainaAe Plan --- ------- 1__T-.__
13Street File ell
OLegal Description
OQuit Claim
by
13 Easement
C3Ca.1culate Sewer Connection
Lid-CATER/SEWER DIVISION
93-Petermine Meter Size
C)"Complete Building Permit Review L4
10-5—TREET DIVISION
EO'C'O"mplete Building Permit Review
[]OFFICE ADM
AIN. LOG OUT TO BLDG. DEPT.
low I= me
am
BUIL�;NG PERMIT Ai"PLICATION (COMPLETE)
2 COPIES OF SITE PLAN
2 COPIES OF FIRE PROTECTION PLAN
I:r(PREVIOUSLY REVIE14ED BY FIRE DEPT.)
3 COPIES OF DRAINAGE PLAN WITH CALCULATIONS
REQUIRED BY SUBDIVISION 0
GREATER THAN 2,000 SO. FT.
IMPERMEABLE SURFACE.
LESS.THAN 2,000 SO. FT.
CHECK ZONING REQUIREMENTS (SETBACKS)
K1. COPY OF ENGINEERING C11EC'K LIST
l COPY OF PUBLIC !qORKS MEMO
MULTIPLE OR COIDIERCIAL —,12-5
YES E] (ATTACH COPY OF AD-B APPROVAL INCL. ALL DRN,TINCS)
NO
V
.0 SUBDIVIS ION YE5�Ej NAME
DATE RECORD
1�
NUMBE 'yo
0
NO 0
(,ATTACH COPY OF REQUIRE2,1ENTS)
El CHECK SEWER DRAWING AND ATTACH COPY /
IS -DEDICATION REQUIRED YES (OBTAIN QUIT CLA121)
11 4�� 1411ve �59
CITY CODE
ZIA
�NO
JatOES �CITY, IIAVE� EASEMENT ON PROPERTY
YES (ATTACH COPIES OF DRAWINGS)
NO
!i-M, CK-,'LEGAL ACCESS INGRESS-
UTILITIES-E]'
IV,
YE�_Ej'
NO, [3, NO [3
'SSMENT BEEN PAID,,
ISE
'I.I.D. NO.
T T NO*,
U
15,UBDIVISION NO.
.NCLUDE NUMBER OF UNITS
i,��1NCLUDE NUMBER OF FIXTURE UNITS