830502.pdf_
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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NAME (OR AME QF1 ssBUSINE I
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CITY
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TELEPHONE"""'
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NAME
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ADDRESS
G CITY
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TELEPHONE NUMBER
zq19-9-21111
ADDRESS
rATE LICENSE NUMBE CITY LICENSE NUMBER
12- IS -l+{�
egat Description of Property. include aft easements
Ihow below or attach tour copies) 1
83US02
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING /b REQUIRED DEDICATION_
PROPOSED:___
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED I
STREET USE PERMIT REQUIRED I
SEE ENGINEERING MEMO DATED
SEE PIW DEPT. REVIEW CHECK LIST DATED/
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SIGN AREA
ENV. REVIEW
A06 NO
ALLOWED'I
PROPOSED
COMPLETE
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VARIANCE OR CU PLA N RE10 VIEW Y DAT
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YARDS �. L CO RA
Z�KSRONT �D SIDE ' REAR
REMAR
IWNEW LRESIDENTIAL
❑ PLUMBING
2 ! ' ✓LIrYIYL v�i &�u� AIIQc.�EO
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❑ ❑ NON-RESIDENTIAL
❑ MECHANICAL
ADDIALTER
..- 04 -''S
❑ REPAIR ❑ RETAINING WALL
❑ SIGN
EXCAVATE
❑ DEMOLISH ❑ OR FILL
FENCE
❑ (-.__x__FTj
CHECKED BY TYPE OF CONSTRUCTION CODE �1 HEIGHT
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❑ PRE -MOVE INSP.1
COMPLIANCE INSP.
❑ SWIM
POOL
SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
REQUIRED GROUPLOAD
I'YES NO
❑ SIDE SEWER ❑ WATER LINE
❑
REMARKS
❑ ❑
❑
T �R) 1 1 NS�� PER s rA CODI
w NUMBER OF STORIES NUMBER OF
o DWELLING
m UNITS
/
NATURE OF WORK TO BE DONE (ATTACH PLOTPLAN)
_---_- -_--_-
HECK FEE
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ING
NICAL
[GRADI
7
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This Permit covers work to be done on private properly ONLY.NGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
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Permit Limit: i Year- Provided Work is Started Within 180 Days
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"Applicant, on behalf of his or her spouse, heirs, assigns and
y successors in interest, agrees to indemnify, defend and hold
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J harmless the City of Edmonds, Washington, its officials,
s employees, and agents from any and all claims for damages of
;
a whatever nature, arising directly or indirectly from the issuance
x of this permit. Issuance of this permit shall not be deemed to
omodify, waive or reduce any requirement of any city ordinance
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x nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE
i�jZ�•
provision."
hereby acknowledge That I have read this application; that the
ATTENTION
APPLICATION APPROVAL
-.
information given is correct; and that I am the owner, or the duly
authorized agent of the owner. 1 agree to comply with city and rHls PERMIT
This application Is not a permit until
state laws regulating construction; and in doing the work authoriz- AUTHORIZES
signed by the Building Official or his
ed thereby, no person will be employed in violation of the Labor ONLY THE
Code of the State of Washington relating to Workmen's Compensa- WORK NOTED
Deputy; and fees are paid, and receipt is
Lion n e. INSPECTION
acknowledged in space provided.
SI ATUREI NER ! DATE GNED DEPARTMENT
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CITY OF
OFFICIAL'S SIGNATURE
t
EDMONDS
�, LI/tOY.dC m.
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HIS SITE IS LOCATED IN THE CITY
F EDMONDS. LOCAL SALES TAX 775.2525
ATTENTION SHOULD BE CODED 31.04.
DATE p,
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
ORIGINAL — File YELLOW — Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC ��pp��
CHAPTER 3. 1111 1 v� 1983
PINK — Owner GOLD — Assessor
10278
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N 89'- 30 057W 72.95
Will
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CD
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UPPER
C AT'tH
$ASIN DETENTION PIPE LENGTH CONTROL CATCH
�V6NT � Jr'— EA31N 1
2` M4x COVER —1 �//
OLrrLrr
C0V-
i CO N'T 0.0L�
I
= 1� SLOPE— - MI � 4
- TO OLr L.ET
SYSTEM CROSS SECTION
SEE PAGE 3 FOR OUTLET CONTROL_ DETAIL
FROI,'-
0 rrL E-r
C('r.N-r acL
V a 2 • in'DEEP/, 4= b" SPALLS 6 cowl)
r-2'. 2• 3' DFySP, %'- CRUSµED POCK
IPRAP OU
D GIU.VEL� rOLTFLOW T0.ENCH IN 10' LONG,
TOP 4" PE TO PIPE BE LEVEL
FnCM
0Lrr ET
CON-T-ROL
4" PERF E WITH GAPS
NOFF SPREADER TLET
fi r rn (Y f
F ryil .•yYg N
l�`• 1. 7
t
i
STANDARD DRAINAGE PLAN
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DETENTION SYSTEM
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PAGE I OF 3
5
fIZ,S/l
for
location 4 "' ICJ CIL-'+ ,.-r r.. (• I I.+• -I-'-
plan by 71Zt�,I rIoNSS, roc. `_,
phone
date 7 2i/a
DESIGN DATA
System Imperm Pipe Pipe Orifice
Number Area Diam Length Diameter
1. 4k:54 24" 4p,��
i
NOTES
1. Call Engineering Division (7'1-320?.
for prebackfill ar.d final ins^etti;�s.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Material
accumulated in the storage pipe must:.
be flushed out and removed from catch
basins to allow proper operation. The
outlet control orifice must be kept
open at all times.
rr .J.4, tC 160S3
CITY OF E®PVIDNDS