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1005 7TH AVE S11111111111111 14755 1005 7TH AVE S _.,_. CITY OF EDMONDS - SIDE SEWER PERMIT WATER -SEWER DEPARTMENT PERMIT ^ T m 4344 /Call 776-1107 for side sewer inspections BEFORE covering any portion of the construction.1 \Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections./ � Vent"' �0U.t.. : ADDRESS LOCATION OF CONSTRUCTION........I90" .................................................................................... _.._.......... .......................................... Lot IC . !'os t.s First Addition 0 Ecicrands PROPERTYLEGAL DESCRIPTION .................... jI7Cf--4...................................................................................................................7........................... ...................... ............................ _........... ....................................... ............................................... ...................... _.......................... _.................................................. ................................---................OWNER AND/OR BUILDER-.-..... r£'t S@ � 5i i ...... Ow a£:r - ACTOR'S NAME & ADDRESS....................................................................................._.............................._.._....................................................... Permission is granted ...` 1..'..' .....::. ............................... 19---7: , for repair alyd/or connectiqu,9f a side sewer to the city sanitary sewer system in accordance with City of Edmonds ordinances. TION IS CALLED TO THE FOLLOWING: 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—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office. NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 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 grade sharper than % will be permitted. NOTE No. 5--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. 0—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 appurtenances except to in- sert the pipe into the wye. DISAPPROVED O Date-.._ ................................. By ................ Date.. APPROVED �.-Date..._ _.. ....... �� ........ By..._ 00-01 Remarks: .............................=------................. .. . ...................................,/4 ph....., ............. By ................ Date ............... -................... By................ �....,r!" ... 4 .44 f — BOTH P Wffi Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection — I ................. ..............., hereby certify that the side sewer installation constructed under this permit (O o sting Firm Per Construction) natalled in accordant with all governing ordinances of the City of Edmonds. Dated this....:i' Al --- ........... day of.......%��.�:/....1.............................. �< J V Check BEFORE you dig for: Water p, Gas ❑, Telephone p, Power ❑, Sewer p, Other 0 V d CITY OF EDMONDS - SIDE SEWER PERMIT WATER -SEWER DEPARTMENT PERMIT /Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction. \Inspection will be provided within 24 hours after requst. NO Sat., Bun., or holiday inspections. ADDRESS LOCATION OF CONSTRUCTION........... 5... ..." "'.-1-T-r4 - '" ^= ,........=..e........................................................ PROPERTY LEGAL DESCRIPTION........... ............ Q' ............ ra .....�t. '1.4 ►..................................... .......................... _............................................................................_.................. ................ .................................... .................................................... ................................................................OWNER AND/OR BUILDER ........ <:Z .� . .. ..... ME........................... .'.y.i c .Q............................................. CTOR'S NA & ADDRESS...........................S�Jss��.....................� _ ` ...................................... Permission is granted ............ ............................ _.._............ 19......... for repair and/or connection of a side sewer to the city sanitary sewer SULM In accordance with City of Edmonds ordinances. A-6NTION 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—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office. NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 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 grade sharper than % will be permitted. NOTE No. 5—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. 6—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 appurtenances except to in- sert the pipe Into the wye. DISAPPROVED ❑ Date .. . ................................... By ................ Da APPROVED VDale...,Qa �.2.I ............... By Remarks: By................ Date ................ ................... By ................ BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection — h-------••wn-------.Co ----- -- act-ng..•---•-•-------------------Con-_.__-....____ ..., hereby certify that the side sewer installation constructed under this permit ` (Owner of Contracting Firm Performing Construction) r, installed in accordance with all governing ordinances of the City of Edmonds. Datedthis............................day of................................................................ ) 19......... 4 J Check BEFORE you dig for: Water ❑, Gas ❑, Telephone ❑, Power ❑, Sewer ❑, Other 0 -*/ N1 TEET FILE CITY OF EDMONDS 250 - 5TH AVE. N.. EDMONDS, WA 98020 • (206) 771-0220 • FAX (206) 771-0221 COMMUNITY SERVICES DEPARTMENT _ Public Works • Planning . Parks and Recreation . Engineering 890.199i LETTER OF TRANSMITTAL Date: June 5, 1992 To: Greg Selvidge 1005 7th Ave. S. Edmonds WA 98020 Subject: Critical Areas Checklist Transmitting: For your information: X As you requested: For your file: Comment and return: Note attachments: Comments: LAURA M. HALL MAYOR PETER E. HAHN DIRECTOR Planning Division Diane Cunningham, Secretary Planning Div. • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan . 0/) 4"-�p RECEIVED EET FILE MAY z s 1992 <+'a PERMIT COUNTER 1e90 1,9 City of Edmonds Critical Areas Checklist. The Critical Areas Checklist contained on this form -is to be filled out by any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of a developmentpermit to the City. The purpose of the Checklist is to enable City staff to determine whether any potential Critical Arras are or may be present on the subject property. The information needed. to complete the Checklist should be easily available from observations of the site or data available at City Hall (Critical Areas inventories, maps, or soil surveys). An applicant, or his/her representative, must fill out the checidist, sign and date it, and , submit it to the City. The City will review: the checklist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. With a signed copy of this form, the applicant should also submit a vicinity map of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant is encouraged to include any other pertinent information or studies in conjunction with this Checklist to assist staff in completing their preliminary assessment of the site. I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner / Applicant: — aq Name AJ eA-- Title Street Address City, State, ZIP Phone Applicant Representative: Name Title Street Address City, State, ZIP Phone Signature Date Signature Date Critical Areas Checklist . Site Information Project Name: (5 11199 ��l U �Ye. Permit Number: Site Location: 106LS' % -Itn Acl e-. S, Property Tax Account Number. Approximate Site Size (acres or square feet): /2 6 " x ) Sr / 615LI-- 6641,01a --OZ Have you filled out a Critical Areas Checklist for a project on This site before? General Site Conditions 1. Has the site been cleared or logged? Date of most recent action .L Soils / Topography .. . 2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? 1V &ZWa (-�U6,gA) 3. Describe the general site topography. Check all that apply. ('oN,p teK 2- -I-c f jv�7G�S Flat: less than 5 feet elevation change over entire site. _K^Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a horizontal distance of 66 feet.) Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 10 feet of horizontal distance.) Steep: grades of greater than 30% present on site. Comments Hydrology/Vegetation 4. Site contains areas of year-round standing water. 410 5. Site contains areas of seasonal standing water: /c1 J Approx. Depth: 6. Site is in the floodway 1Jv floodplain AZ & of a water course. 7. Site contains a creek or an area where water flows across the grounds surface? �1 flows are year-round? Flows are seasonal? Cuv 8. Site is primarily: forested ; meadow tiy ; shrubs /UU ; mixed A-)O 9. Obvious wetland is present on site: Ad-0 10. Wetland inventory or map indicates wetland present on site: K_)-0 11. Critical Areas inventory or map indicates any Critical Area on site: ti>O For -City -Use Only Rev 3127192 b DATE Z PERMIT ADDRESS -1 TH ArftS • LEGAL DESCP. Se R E ETZILER,MIT REVIEW - ENGINEERING DEPARTMENT CHECK LIST Instruction: Check Accuracy of Legal Description Check Against Assessor's Map for Legal Subdivision Does it conform to City Approved Subdivision? Reviewer's Initials F al f 1 �i I i r i I 6 : n T— d 3 L 1. This lot included in Subdivision/Plat 2. Site Inspection made on: �iN'Z ... 3. 11hat are ground water and soil conditions?_ 4. Site Drainage Checked? 4 5. Storm Sewer Availability: Roadside Ditch of nwg. No. Proj 6. Grading & Final Contours-: 7. Septic Tank System Design Approved: 8. Sanitary Sewer Availability — Sht. of Dwq. No. ..% Project Side sewer availability: 9. Sanitary Sewer Connection Fees? 10. 11'ater Mains & Fire Hydrants (Indicate Size Plain)�cis,a Check Fire Dept.'s Comments 11. Sidewalks: (Sit inspection shows conditions of sidewalks as follows) 12. Curbs: Curb Cuts Pr'veway (Check driveways for safety, lncation, grade and width): r 13. Underground Miring: Street Lights: 14. Street Right-of-way & Bldg. setbacks: Sht. of official Street Map. 15. Existing Utility Easements? 16. Access Easements: 17. Site Plan checked for accuracy? 18. Special Requirements listed in Memo to Bldg. Pept.HMO 19. Commercial & Apt. Requirements form completed? 20. Drawings stamped & notations made? 2 21. All Items filled in on Bldg. Permit Application? 22. Bonds posted for site work? 23. Right-of-way Invasion Permit required?� COMMENTS: t Rev. 7/1/76 r 1 -0 - CITY OF j✓ I�1j? ,.S IFIL COMM�� Y' S ENT RIGHT- - A STRUCTION PERMIT I►i Permit No. 1Y Issue Date A. • Owner: =z �` e_ v r) B. • Contractor: J 4 ,-- Name ;,, Name Moling,.Addres ,sr . M �h , "p's C� ` �� i ,r,(1)? City State Zip City State Zip State License Number Telephone Number • Address or Vicinity of Construction: Type of Work to be Done:���f�' Work in Connection With: ❑ Sub or Plat ' Single Family ❑ City Projects ❑ Commercial ❑ Multifamily ❑ Utility Pavement Cut: ❑ Y ;� N APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages, or claims of any kind or description whatsoever, forseen or unforseen, that may be made against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal proceedings including defense costs, court 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 INSPECTION AND ACCEPTANCE OF THE WORK. Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed by City forces, at which time a debit or credit will be processed for issuance to the applicant. • A 24 hour notice is required for inspection; Please call Public Works: 771-3202 • Work is to be inspected during progress and at completion. • Restoration to be in accordance with City Code. • Street to be kept clean at all times. • Traffic Control to be in accordance with City regulations. • All street -cut ditches must be patched with asphalt or City approved material prior to end of working day; no exceptions. I understand the above and that this permit must be available at the job site for inspection purposes at all times. ��` ate'" Signature: a �r ' � .r/ � �� Date: Owner or ontractor This Permit Must Be Posted at the Job Site For Inspection Purposes Call DIAL -DIG Prior To Beginning Work ISSUED BY: Time Authorized: Void after _1io days. Special Conditions: Amendments: t , PERMIT FEE: Security Deposit: iz Receipt No.: 9 '71 1 Fund III Fee: Street Cut Dimensions: X = r`J NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. July 1985 FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.) Comments: Diagram: CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P. W.: Work Disapproved By: FINAL APPROVAL BY: Date: Date: Eng. Div. July 1985 7 / If A L-Lr-1 Lela L vos+ }A 40 Wand S P 4 CV Bloc � �y 63� STREET FILE L�tz� 5!�lvItea� 7 pM�� 9�?0 The City of Edmonds APPLICATION for SIDE SEWER PERMIT NEW CONSTRUCTION ❑ REPAIRS ❑ OVPNER 11. :.....-.- ?.E /.......................................... ADDRESS.....l..QQ..S.............7.... ........................................................... • • 0 Ll EASEMENT No ........................................... -7V- CONTRACTOR ................ � F�............... .................................... PERMIT No. LEGAL DESCRIPTION: LOT No . ............. Z ...................... BLOCK No........... .......................... 1 N. ............ s.-r---........4 7 _.......... To-- APR 2 3 1973 G4�y Approved: DATE................................................ By------....---------.............---................................... The City of Edmonds APPLICATION for SIDE SEWER PERMIT NEW CONSTRUCTION ❑ REPAIRS ❑ EASEMENT NO .. .............. ............................... LID NO ................... ASMT. NO. .................. OWNER --------- --Y-e-j--•------ P/Ui C-C�----------------------------------- CONTRACTOR .-------------- D ........................-� I L -------------------- PERMIT N0..........- JOB ADDRESS 1 vOs �.... �-- ------------------------------------------ LEGAL DESCRIPTION: LOT NO..------.....-f.................. BLOCK NO. -------- --f---------------.:..... -------------- - - .......... V NAMEOF ADDITION---------------------------------------------------------------------------------------------------------------------- Approved: DATE ..... -------------------------------- BY----------------------------------------------------------- :Llll� APPLICATION for The City of Edmonds tom+ - �IV SIDE SEWER PERMIT i �y� ��� ���L�. EASEMENT No. .......................................... EW CONSTRUCTION REPAIRS f_ LID ?4 OWNER ..0 REG............EL.V ►OCHE..... coNTRACTORW IVER PERMIT No. "�-`'!"?-. ADDRESS 15X:>5 —77 74 &Vat4UM SC I'U LEGAL DESCRIPTION: LOT No . ................. 10............-•---..... BLOCK No. -......-- !-........---•--•-.-••---..... I NAME OF ADDITION YOS—M FIRST &M%'T%ON TO EDMONM ............................................................. • la PI Nam. �TR��T C-2 I cumme P) 0 M r4ft"A6 R71t1T0� GGW N 5 rv=*A TD EXIST 4"40MC. UNE �LO� QV CEwlP> 24" 1c�13 —t W7 61 Approved: (Ahool'i"Id=N avLYi scam pmum MIT DATE ........ By - 2 - -ray tf. _ _ tv i i- 'as Ir \ CITY OF EDMONMu CONSTRUCTION PERMIT APPLICATION OWNER ME/NAME OF BU INESS ,P felv l,UsC_ MAILING ADDRESS /0oT a CITY ZIP TELEPHONE NUMBER Co%titoN� 9d'�Lo 7y3- NAME ADDRESS ZIP ITELEPHONE NUMBER NAME OWNet. ADDRESS CITY ZIP I TELEPHONE N STATE LICENSE NUMBER EXPIRATION DATE )erty - incll/Ude/� _all easements ACl/Q 1'7 rUTO �14-4 o� 6locfr O L' .. LA (O i Property Tar Account Parcel No. � 00 Lf — 0I l� (_/ O _ p NEW RESIDENTIAL PLUMBING ® ADDITION COMMERCIAL MECHANICAL APT. BLDG. REMODEL SIGN GRADING FENCE REPAIR CYOS. ( x _FT) DEMOLISH WOODSTOVE INSERT SWIM POOL HOT TUB/SPA GARAGE CARPORT WALL/ 'RENEWAL ROCKERYG Z (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: cc S/DftDELLING N NUMBER OF STORIES BER OF m S /yc O DES~ TO E DON (ATTACH LOT PLAN) PERMIT NUMBER %C)49 JOB SU ADDRESS LEGAL DESCRIPTION CHECKI SUBDIVISIQ'4)40. I LID NO N 5 :1 '1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved ❑ RW Permit Required ❑ EXISTING REQUIRED DEDICATION Street Use Permit Req'd ❑ Inspection Required ❑ PROPOSED Sidewalk Required ❑ 0 Z REMARKS W W Z a Z W ENGINEERING MEMO DATED METER SIZE (BUILDING SUPPLY REMARKS REVIEW BY NO. OF FIXTURES SIGN AREA SEPA REVIEW ADB NO. ALLOWED I PROPOSED COMPLETE EXEMPT SHORELINEN EXP I "`-- VARIANCE OR CU P NNING REVIEW BY DATE SETBACKS ��—FEET �^ /�/�/�y� HEIGHT LOT COVERAGE FRONT a(tj / SIDE.) ' 4 AA CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT Q C= 2,5) SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT REQUIRED GROUP LOAD ❑ YES REMARKS PROGRESS INSPECTIONS PER UBC 305 T�/?lnnL '°P2 /qq 1 W�"CJ FINAL INSPECTION REQUIRED LI X PLAN CHECK FEE V1W6 00 A. BUILDING HEATS URCE: � v�S GLAZING % PLUMBING Plan Check No. / n /. MECHANICAL This Permit covers work to be done on private property ONLY. GRADINGIFILL Any construction on the public domain (curbs, sidewalks, STATE SURCHARGE driveways, marquees, etc.) will require separate permission. Permit Applica)lon: 180 Days Permit Limit: 1 Year - Provided Work Is Started Within 180 Days . STORM DRAINAGE FEE--- . Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE I successors in interest, agrees to indemnify, defend and hold I 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 PLAN CHECK DEPOSIT modify, waive or reduce any requirement of any city ordinance nor limit in an way the City's ability to enforce any ordinance provision."/ OTAL AMOUNT DUE I hereby ac n edge that I have read t plication; that the" information given is correct; and that I am the owner, or the duly ATTENTION authorized agent of the owner. I agree to comply with city and state laws regulating construction; and in doing the work authoriz. ed thereby, no person will be employed in violation of the Labor THIS PERMIT AUTHORIZES ONLY THE Code of the State of Washington relating to Workmen's.Compensa- WORK NOTED tl n Insurance. INSPECTION SIGNAT E-(O ER" R 717 GATE SIGNED DEPARTMENT --! CITY OF EDMONDS ATTENTION CALL FOR INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771-0220 UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. 10247 W9 n /37 45_0 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his/her Deputy; and fees are paid, and receipt is acknowledged in space provided. OFF C L' SI ATURE TE 6 �6%9z--- RELE E � / DATE ORIGINAL — File YELLOW —'Inspector PINK — Owner GOLD — Assessor W f- a 3 0 Z O m