20308 84TH PL W15415
20308 84TH PL W
CITY OF EDMONDS
VF FOR INSPECTI
PUBLIC WORKS DEPARTMENT ON CALL Permit
fb 775-2525 Ext. 22.0 Issue Date
SIDE SEWER PERMIT
PERMIT MUST BE POSTED ON JOB SITE_�_I__
,"l. Address of 70,nM`stMWr`u`c71r
2. Property Legal Description (include a11 easements)
3. Single Fami ly Residence Multi -Family No. of Units
Commercial EDMONDS
LR !�T
TREATMENT PLANT
4. Owner and/or Builder
5. Contractor & License No.
6. Invasion into City Right -of -Way: No Yes (If Yes Right-of-
way?hstruction . Permit Required Call Dial Dig (13,012,��5,714�Aj) before
excavat-lon) .
7. Cross othet'-p-rivate property: Yes No Easement required -
attach legal"description and county easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain a permit to install side sewers on
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
installation for one year *
C. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
d. Side sewers may not be installed closer than thirty inches (30")
to any structure. 0
e. Side sewer lines must be laid at a minimum grade. of 2% (1.15
and maximum grade of 106% (450). 0
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 seweX lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' 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 hours only. Two (2) working
days notice required.
DATE: e(" fx, 457�-1
I certify that I have read
and shall comply With the above,
P ERMIT FEE:
C6kN*E'cT'ION FEE:
P4
0
44 *,.PERMIT MUST BE
DISAPPROVED BY: Date:
By- Date:
10 __1eLA._..
APPROVED By:,J. Date:
ON JOB SITE * 41401-77.
NOTICE:
... wa rra
'0 ntyOT -d-U-Ut
on the a ttached
The information shown
map(s) was cc)mpiled for use by the City of
Edmonds; its Employees and Consultants.
Th.le City of �Edm.onds does not - wa rra nt ti i�_-
accuracy of anything set forth on t ' hese
Map(�_). Any person or entity -requesting a
copy should conduct an independent
orm'ation shown on
inquiry regarding the inf
_tRe -map(s), including, but not limited to/
th'e 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 Edmo-nds. nor its
empl-o-yee-s o-r offi-ce.rs shal-1 be Via.b-Fe for the
information given on this map(s), nor for
tation provided based
any one represen
upon said map(s).
APPLICATION 11
The City of Edmonds for EASEMENT NO - ------------------ ------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION 2q REPAIRS F� LID NO . .................. ASMT. NO . ..................
OWNER------------------ ------------------------------ CONTRACTOR ........... ................................ ...................... PERMIT NO. ro 9
JOB ADDRESS ... 2-03-0-8 --- ........... LEGAL DESCRIPTION: LOT NO. ............................ BLOCK NO - ------------------------------------
NAME OF ADDITION
30,
Z030 8 - 84-rI4PL.
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a 1047
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T"A
MR,
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0 A
E EDMOND7S
TREATM7ENT PLA�;
Approved:
DATE _.A-ZG-sB ............. ...........
............................. By .... ...... ..............
11/75
%TREET FILE
CITY OF EDMONDS HARVE H. HARRISON
MAYOR
200 DAYTON ST. - EDMONDS, WASHINGTON 98020 * (206) 771-3202
DEPARTMENT OF PUBLIC WORKS
August 9, 1983
SUBJECT: 20308-84th Pl. w. 'Legal Description: Lot 7,
Pine Ridge Estates. According to the plat
thereof, recorded in Volume 43, pages 114
and 115, records of Snohomish Countv.
To Whom It May Concern:
This is to inform you that all public improvements for
the above address are perpetually maintained by the
City of Edmonds.
Sincerely,
BOBBY R. MILLS
Acting Supt. of Public Works
RM/ml
iXR—Cl D T
STREET FIL"S I-o7— 7,
Te4 )Edl�7 dll+�
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il
93 ,
ZO N E i—S-4
ca
4
-JZI D E
PEAR
OTHER
HEIGHT -
FdcR CEIVED
191 3 3
L J
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CITY OF EDMONDS
NEW
ADDITION
FiRETIREMENT
STREET FILE ASSET INFORMATION SHEET
ASSETNO.
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION
DEPT, NO.
* 6
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
*PROJECT NUMBER Le-V3 J-ASO 0 33
PROJECT COMPLETION DATE 4 3 c3 -9-3
COST
B.A.R.S. ACCOUNT NO. el.-r - -3 -a c> - (b
ESTIMATED LIFE ?- 's
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
13 DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT -
0 G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO. -
INITIAL
(�np
DEPARTMENT FILE
IN
BUILDING PERMIT RE'VIEW� Multiple
Commercial
BUILDING ADDRAR ,�0309> 2qY-/h,- 00C_Q�
BLDG. DEPT. SUSPEN I S . E DATE . Z12_4� _� INITIAL DATE
[:IOFFICE,ADMIN, — PUBLIC WOR�S 'LOG IN
;D)CLTY ENGINEER (check)
0 Access Slope and Vehicle Access
Lk I t5kDrainage Plan
UFO" 0Street File
E]Legal Descripti6n
E]Quit Claim
E]Ease.me nt
1JCa:l'&�*ilat*e Siewe�r. -Connection
WATER/SEWER DIVISION
Determl P
--Pe'rmit,,,Rev w
BuAlding:i ie'
PISTREET'DIVI SION
Compi te��Building Review ------
DOFFICE 'ADMIN. LOG OUT' -TO BLDG-.-'.DEPT.
---------------------------------------------- -------------------------
afi-i—LDI G PERMIT APPLICATION,(COMPLETE).
IP2 COP'IES OF SITE PLAN
2 COP'IES OF FIRE PROTECTION PLAN
(PREVIOUSLY REVIEIIED BY FIRE DEPT.)
3 COPIES OF DRA-INAGE PLAN WITH CALCULATIONS
REQUIRED BY SUBDIVISION 0
GREATER THAN 2,000 SQ. FT.
IMPERMEABLE SURFACE
LESS THAN 2,000 So. FT.
0"
.,CHECK ZONING'REQUIREMENTS (SETBACKS)
/1/'COPY, OF ENGINEERING CHECK. LIST
01/1-'COPY OF PUA":LIC'140RKS MEMO
MULTIPLE OR COMMERCIAL
YES `(AMkCH:CoPy OF ADB APPROvAL INCI,. ALL DRAT,TIWS),
NO
SUBDIVISION YESE]
DATE15 RECORDED,
NUMBER
No (ATrAcH -COPY OF REQUIREMNM)
"CHECK SEWER DRAWING AND ATTACH COPY
IS DEDICATION REQUIRED YESU (OBTAIN nUIT CLAITO
CITY CODE
J, NO
60ES CITY HAVE EASEMENT ON PROPERTY
YES (ATTACH COPIES OF DRAWINGS)
tjl]
NO
CH
ECK LEGAL ACCESS INGRESSE] UTILTTIESE]
YES YES
NO NO
HAS SEWER ASSESSMENT BEEN PAID
id YES L.I.D. NO.
PLAT NO.
SUBDIVISION
lq
X
..IF MULTIPLE: 8F 'UNITS'"
JNCLUDE NUMBER
_x 3.1
flIF' COMMERCIAL:'j INCLUDE NUMBER OF FIXTURE U14ITS
DATE
.4
MEMO TO: Building Division
Planning Department
FROM: Engineering Division
Publ ic Works Department
SUBJECT:
71
After review of the subje"ct Building Permit application, we have the following''..'"''
comments:
1. Connection to Citv watpr rv,,tom ra'nI141-AA
2. Connection to City sanitary sewer system required.
3. Right-of-way perm -it required for any work on City property.
4. Drivewa.X.slope not to exceed 14%
5. Backwater valve requ ired if downstairs plumbing is below elevation of
upstream manhole.
6. Water and sewer lines to be separated by 10 foot minimum.
KI
BD 6/82
V 9
21,50-KO �14- 4
I ;M ONMIM 01 e1wit a 1920
(address) (date)
Street Right -of -Way Existi
REQD
Z
Access Ease = ts Existing
REQD
Utility Easemmt Existing___�
REQD
Lot Per Subdivision Plat
Assessor Map_
94
Site Plan Checked for Accuracy,
Z
Underground Wiring Reqd.
0
Check Accuracy�,,of Ie -1 Descripti
.ga ion
Z
Review by 'Z
Date
Existing Water Main Size
Water Main Required
Service Line Required
Hydrant Size Existing,
c4
Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd.
Cross Connectfon Inspection
Fire Department Conbmts
'dater Yleter Reqd.:T 9-6-,
Review b ;Z--
y4Q
Date -&Ag��k 3
Septic Tank Design Approved
Date
Septic Tank Permit Reqd.
Permit No.
'Sanitary Sewer Availability,
Pro*
Drawing No.
File No.
Side Sewer Availability
Sanitary Sewer 'Gonnettion Fee Reqd.
Review by
Date
Open Ditch Existing___
Reqd.
Z
Culvert Reqd.
Size
94
Catch Basin Reqd.
Indicate on Site Plan
0
Shoulder drainage maintain collection on
swale open runoff
E-
Ln
Manhole reqd.---
Indicate on Site Plan
Soil Conditions and Ground Water Field Checked.
Review by
Date a, Ir-- 3:
Revised: lvlO-1977
J
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loov
'bit
17� fy/
-V v
ZONE
v Tos
SETBACKS:
00 FR'ONT
17
0)
co REAR
uj
OTHER
HEIGHT c,2-.5 -Inaf)(
4
IWERMIT
CITY OF EDMONDS ZONE .0 NUMBER
CONSTRUCTION PERMIT APPLICATION. joa
IINAME (2R NAME OF BUSINESS) I AUU�CSS tll . dE:
N�_- /-- 1, / -_ f-7 // ff/ e--
MAILING ADDRESS
IFYJO,57—,,L4�-7;� A16,
TELE PHONE NUMBER
7 7
NAME
ADDRESS
E NUMBER
E
ADDRESS
CITY TELEPHONE NUMBER
STATE LICENSE NUMBER CITY LICENSE NUMBER
Description of Property - include all easements
below or attach four copies)
NEW
RESIDENTIAL
PLUMBING
ADDIALTER
NON-RESIDENTIAL
MECHANICAL
REPAIR
RETAINING WALL
SIGN
DEMOLISH
EXCAVATE
OR FILL
FENCE
I— x _FT)
PRE -MOVE INSPd
swim
SIDE SEWER WATER LINE
NUMBER OF,STORIES UMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
/re— it/ P & -5 / 0"& /),-d C I
.tU.L UCZ1LH1eJ1UN UHLCK SUBDIVISION NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION r_1
PROPOSED
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED EJ
STREET USE PERMIT REQUIRED 1:1
SEE ENGINEERING MEMO DATED_' -12-3
SEE PIW DEPT. REVIEW CHECK LIST DA`(ED /
�*� U j 117 �� e --;,, 7- / � , �
METER SIZE IBUILDING SUPPLY SIZE IFIXTURE UNITS
REMARKS
SIGN A REA I ENI. REVIEW
ALLOWED I PROPOSED COMPLETE I EXEMPT
VARIANCE OR CU
YARDS
FRONT SIDE
NING REVIEW BY
KED BY ITYPE OF CONSTRUCTION
SPECIAL INSPECTOR
REQUIRED
I -A YES 1 1 NO
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADING/FILL
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
U harmless the City of Edmonds, Washington, its officials,
E 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
modify,.waive or reduce any requirement of any city ordinance
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; 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-
THIS PERMIT
AUTHORIZES
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
tion InsrUrance.
SIGNAT E (OWNER AGENTVI DATE
INSPECTION
DEPAM MENT
CITY OF
THIS SITE IS LOCATED IN T EDMONDS
OF EDMONDS. LOCAL SALES TAX 775-2525
ATTENTION SHOULD BE CODED 31.04.
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102-78
OCCUPANCY
GROUP
ADB NO.
ORELINE #
DAT�E
LOT COVERAGE
Z
Z
FEE
HEIG
OCCUPANT
LOAD
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his
Deputy; and fees are.paid, and receipt is
acknowledged in space provided.
OFFICIAL'S SIGNATURE
DATE
ORIGINAL — File YELLOW — inspector U
PINK — Owner GOLD — Assessor
- �, - E�, — -
[41) 00 100 V M Z1441 IV a "120
(address) (date)
Street Rig�ht-of-Way Existin�
Access Easements Existing
REQD
1Z
. . ......
Utility EaseTmt Existing
REQD
W
1,ot Per Subdivision Plat
Assessor p
Site Plan Checked for Accuracy
Underground Wiring Reqd.
1-4
0
Check Accuracy�bf Legal Description---
Z
Review by
Date
Existing Water Main Size
Water Main Required
Service Line Required all
Hydrant Size Existing
0�
Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd.
Cross Connectim Inspection
E-4
Fire Department Comnents
.4ater Meter a-,ar Reqd.4!�
Review by
Date
Septic Tank Design Approved
Date
Septic Tank Permit Reqd.
Permit No'.
Sanitary Sewer Availability—'
Proj.
Drm4lng No.
File No.
Side Sewer Availability—.L
8Y.,
94
Sanitary Sewer Fee Reqd.
'"t
Review by
Date
Open Ditch Existing___,�...Reqd.
Culvert Reqd.
Size
Catch Basin Reqd.
-Indicate on Site Plan
0
Shoulder drainage maintain collection on
swale open runoff
Manhole reqd.
Indicate on Site Plan
Soil Conditions and Ground Water Field Checked- (- 4?
Review
Aw
Revised: lvlO-1977
k;,
x.s.,
1. 17
4�
C.,
L
3 k. ,
4P..
9F
IV
'14
.�! 11
4-
"in
A&
C.
_77_�
'04
City bf Eftonds
RIGHT"OF-WAY CONSTRUCTION
PERMIT J P,.it N.b*e,.
Lssue Date:
iA. Address or Vicinity of Construction: 20908 84th Place West
GTE to plime, operat & maintain a bur6dd service rjire from
Ii7c1-S9'�xisting pedeszt�lli)iWBVTlo'cratb7,2ri6TiO 84 M. vq., thfarl wo ience at zusug-B"]. VJ.
GTE to'plow 81 feet, push 2 driveways, 40 feet, and pash tin rands- 11-0-11- fnnt-.A0A J9 R1 fAF)t.
Contractor:GTE NORTHWEST INCORPORATED Contact: Lfnda Price;,Permit Coordinator 425/710-4133
Mailing Address: 2312C West, Casino Rd. Everett.WA Phone: ENGR: Terry Ander son 425/771-08683
1 98204-1440
State License,1: Liability Insurance: _ Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. F1 Commercial El Subdivision E] City Project [R Utility (PUD(aT� WNG, CABLE, WATER)
Multi -Family Single Family er GTE -9POOlDB -24R.69,1�, SIVA., 11
E] Oth Y?p
&
2100
INSPECTOR: INSPECTOR: I— "A
F. Pavement or Concrete Cut: [I Yes 5dNo G. Size of Cut: x 14,'� qa
9
APPLICANT TO READ AND SIGN
GLEASE SEE ATTAHC,5,D PR I NTJS5ETCP,'
INDEMNITY.- Applicant understands and by his signature to this app ication to ol tEhe ty of Edmonds harmlessfrom injuries, damages, or claims ofany
kind or description whatsoever, foreseen or unforeseen:'It'hat may be made against the City of Edmonds, or any of its departments or
employees, includingornot limitedto the defense ofany legal pro�eedings including defense costs and attorney fees hyreason ofgranting thispermit.
ii \
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND�IATERIALS'FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK ESTIMA TED RESTORATI'ON FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED
'��CESSED FOR ISSUANCE TO THE APPLICANT.
B Y CITY FORCES, A T WHICH TIME A DEBIT OR CREDIT WILL BE PR
Two sets of construction drawings of proposed work required with permit application.
A 24 hour notice is requiredfar inspection. Please call the Engineering Division,.771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall " be- kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut trench work shall be patched with asphalt or City' approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and
available on site at all timeAfor inspot
Signature:
the permit requirements and the pink copy of the permit will be
Date.- 10-05-98
DAVE HAWK I NS, A�ffghagKffi�'M& DES I'GN
CALL DIAL".A-DIG PRIOR, TO BEGINNING WORK -
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY FEE:
TIME AUTHORIZED: VOID AFTER DAYS
SPECIAL CONDITIONS:
DISRUPTION FEE/FUND I I bi�
RESTORATION FEE:
T OTAL FEE:
50 . 00
RE�FJPT NC
I SSUL BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997
FIELD INSPECTION NOTES
I Comments:
I Diagram
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION D YES NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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