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7114 177TH ST SW
CITY OF EDMONDS
PERMIT
NUMBER
UCTION PERMIT APPLICATION
72AME(ORE OF BUSINESS)
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LEGAL DESCRIPTION CHECK
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
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RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED ❑
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STREET USE PERMIT REQUIRED IJ
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CITY TELEPHONE NUMBER
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REMARKS
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STATE LICENSE NUMBER CITY LICENSE NUMBER
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Legal Description of Property - include all easements
SIGN AREA ENV. REVIEW ADB NO.
ALLOWED PROPOSED COMPLETE EXEMPT
(show below or attach four copies)
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VARIANCE OR CU PLANN NG EVIEW BY DATE
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El.i NEW RESIDENTIAL PLUMBING
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REMARKS
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ADDIALTER NON-RESIDENTIAL El MECHANICAL
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REPAIR RETAINING WALL SIGN
EXCAVATE FENCE
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CHECKED BY TYPE OF CONSTRUCTION CODE HEIGHT
DEMOLISH OR FILL ( xFT)
PRE -MOVE INSP.I SWIM
COMPLIANCE INSP. POOL
SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
REQUIRED GROUP
SIDE SEWER El
LOAD
REMARKS NO
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WATER LINE
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OF STORIES NUMBER OF
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NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
VALUATION FEE
PLAN CHECK FEE
BUILDING
PLUMBING
This Permit covers work to be done on private property ONLY.
MECHANICAL
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
harmless the City of Edmonds, Washington, its officials,
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employees, and agents from any and all claims for damages of
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DATE:
MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Public Works Department
SUBJECT:
After review 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. Right-of-way permit required for any work on City property.
4. Driveway slope not to exceed 14%
5. Backwater valve re wired if downstairs plumbing is below elevation of
upstream manho e.--
b. 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 an"ay.
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PUBLIC WORKS I)EPARTMEN CHECKLIST
BUIIDIM PERMIT REVIEW
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Street Right -of -Way Exist*
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Access Easements Existing
REQD
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Utility Eas erg t Existing �9 �^ �'v
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Lot Per Subdivision ,sue'`--� Plat
Assessor Map
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Site Plan Checked for Accuracy
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Underground Wiring Reqd.
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Check Accuracy of Le scripv on
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Review by
Date .�
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Existing Water Main Size "
Water Main Required NIA
Service Line Required
Hydrant Size Existins
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Hydrant Reqd Per Fire Code ,�/,q
Size
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Detector Check Meter Reqd. —
Cross Connection Inspection —
Fire Department Comments
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Water Meter Char e Read. ,j ��, e^ CD
Review by _
Date
Septic Tank Design Approved Date
Septic Tank Permit Reqd.
Permit No.
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Sanitary Sewer Availability
Proj .
Drawing No.
File No.
Side Sewer Av ilabilityc/
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Sanitary Sewer ection F e Reqd.
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Review by
Date
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Open Ditch Existing_)
Reqd.
Culvert Reqd. Q
Size
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Catch Basin Reqd. �1141)
Indicate on Site Plan
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Shoulder drainage maintain collection on
swale open runoff
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Manhole r d. eq Ae?)
Indicate on Site Plan
Soil Conditions d Ground Water Field Checked
Review by
>nsed: lv10-1977
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IESIiII I,F.,MA Post office Box 578 Edmonds, Washington 98020 Phone 776-3569
I � BDING CO., INC.
LEGAL: Lot 2, Cherry Hill Lane Short Plat,
Snohomish County
SCALE: 1" = 20'
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J U N 1 1983
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NOTICE:
No warranty of accuracy.
The information shown on the attached map(s)
was compiled for use by the City of Edmonds,
its Employees and Consultants. The City of
Edmonds does not warrant the accuracy of
anything set forth on these map(s). Any person
or entity requesting a copy should conduct an
independent inquiry regarding the information
shown on the map(s), including, but not limited
to, the location of any sewer stub shown. Such
sewer stubs may or may not exist and may or
may not exist at the location shown. Neither
the City of Edmonds nor its employees or
officers shall be liable for the information given
on map(s), nor for any one representation
provided based upon said map(s).