7110 177TH ST SW11111111111111
15665
7110 177TH ST SW
USE PERMIT
CITY OF EDMONDS ZONE Rr�_ NUMBER
CONSTRUCTION PERMIT APPLICATION
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NAME (OR NAME OF BUSINESS) ADDRESS 7110
CSC -\( .Ck j C ). LEGAL DESCRIPTION CHECK
SUBDIVISION NO. LID NO.
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CITY ` TELEPHONE NUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
C EXISTING �-`?L REQUIRED DEDICATION
NAME PROPOSED_
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED ❑
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ADDRESS STREET USE PERMIT REQUIRED [7
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SEE ENGINEERING MEMO DATED
CITY TELEPHONE NUMBER
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( � SEE PIW DEPT. REVIEW CHECK LIST DATED
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NAME / C , I?Q, Wl
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ADDRESS
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METER SIZE BUILDING SUPPLY SIZE FIXTURE UNITS
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CITY TELEPHONE NUMBER
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REMARKS
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STATE LICENSE NUMBER CITY LICENSE NUMBER
/:�,-S 4 C 4 1 (.�)? & ` -S SIGN AREA ENV. REVIEW ADB NO.
Legal Description of Property - include all easements ALLOWED PROPOSED COMPLETE EXEMPT
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(show below or attach four copies)
SHORELINE fl
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�` `� VARIANCE OR CU PLA/f/�IINNG REVIEWBY DAT
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LOT COVERAGE
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REMARKS
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NEW RESIDENTIAL PLUMBING
EiADDIALTER LEI
NON-RESIDENTIAL MECHANICAL
REPAIR RETAINING WALL SIGN
CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
FENCE
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ORCFILLTE
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0 PRE -MOVE INSPJ a SWIM SPECIAL INSPFCTOR AREA OCCUPANCY OCCUPANT
COMPLIANCE INSP, POOL REQUIRED GROUP
LOAD
1.7 YES 1 I NO
SIDE SEWER 0 WATER REMARKS
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LINE
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NUMBER OF STORIES NUMBER OF
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NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
VALUATION FEE
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY. GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
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harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
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MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Public Works Department
DATE : 53
SUBJECT: //0 1`7 � :d �_
After review of the subject Building Permit application, we have the following
comments:
Connection to City water system required.
2.
Connection to City
sanitary
sewer system required.
3.
Right-of-way permit
required
for any work on City property.
4.
Driveway slope not
to exceed
14%
5.
Backwater valve required
if
downstairs plumbing is below elevation of
upstream manhole.
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6.
Water and sewer lines
to be
separated by 10 foot minimum.
7. Builder/Owner responsible for containing all temporary runoff and erosion
on site and may not impact neighboring properties in any way
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BD 6/82
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(address)
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Street Right -of -Way Existing .�T REQD
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Access Easements Existing REQD
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Utility Easement Existing REQD
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Lot Per Subdivision Plat Assessor Map
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Site Plan Checked for Accuracy
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Underground Wiring Reqd. ,P
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Check Accuracy gal Des iption
Review by Date
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Existing Water Main Size
Water Main Required
Service Line Required 3 '
Hydrant Size Existing S
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Hydrant Reqd Per Fire Code 1ti��_ Size
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Detector Check Meter Reqd.
Gross Connection Inspection —
Fire Department Comments _
Water Meter ge Regd. , `9—
Review byDate S 3
Septic Tank Design Approved Date
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Ava' ility i Proj.
Drawing No. File No.
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Side Sewer 4 ilabili
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Sanitary Sewer ect,jRn iee Req .
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Review by ' Date
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Open Ditch Existing Regd.
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Culvert Reqd. �xK<,./— Size
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Catch Basin Reqd. , i Indicate on Site Plan
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Shoulder drainage maintain collection on Swale open runoff
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Manhole req. dIndicate on Site Plan
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Soil Conditi and Ground ter Field Checked
Review by , rDate
:�-vised: 1v10-1977
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INEIL ESHLEMAN
BUILDING CO., IN
�7-7 �� "f, S•li'.
Post Office Box 578 , : Edmonds, Washington 98020 Phone 776-3569
FEGAL: Lot 1, Cherry Hill Lane Short Plat,
Snohomish County. Da{v\
SCALE: 1" m 20'
NOuK ISM
Rrc Ptak = _7 M nj)cr inc{�
J U N 1 1983