1008 C AVE.PDF1008 C AVE
ADDRESS: l0 ( ` 8 r 26YIGC_P_
TAX ACCOUNT/PARCEL NUMBER: rjb 4 I -I q:Doz m D I
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: _ LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: 51 7 Z
SIDE SEWER PERMIT(S) #: 46` r5
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSTs\Forms\Street File Checklist.doc
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NAM _indicated on Standard i)raerin
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STATE LICENSE N11MY.EIR 1 C1T7 CENeE NUMBE,Y
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9YECIAL INSPECTOP. REQUIRED I OCCUPAN R 'P
❑ I 1 Tf9 'ter "1 �i� •� IJl•
GAB YE9 O - k �t 1•r"`k' - '7ti ( .
❑ RESIDEN LIL ❑ LINE PLAN CUEC
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! I NEW I� NON-RESIDENTIAL ❑ arcx THIS SITE IS LOC'rTfJ�IN 7H... n T _rrL t`at-�• fir'.
j U J RETAIxINa RF�:.L. rma CITY ,)f ilt ,.,�,
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DEMO zea ❑ WALL TAX SHOULD Sf- COCEO'31:04._ • f°CRt ` ,� 9 1 Yi
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OR. FILL (..._...�_...._..M.) (7�J\s{o tt't T '.
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N"11 TR OF STOR1Etl NUMBER 08 J�p' F��V { !mil Q�� )F� �/� {w 1 3 ��`•J �y
DWELLING
UNITE JJ s Vgr •,y�r !u f t I
ValuallOn Fee .Receipt No.-,
NATURE OF -WORK TO BEDONE -- t ,•,
Plan Cheek No...._..___.__ "`c` f t
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PROPOSE tlE PLUMBING ` t=`= • pxl
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_ SIGN WE'b •'
RETAPrING WALL
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BWD&MIIHfi POOL
.DEMOLTTION
PRE MOVE INHPECTIo:•! l •t p'3 .
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EXCAVATION OR FILL
T-oTAL AMODNT
I thereby acknowledge tbat I bava rend thle aPP11eeUOo; that the 1n- _ 1,.•. ,'+t.I,^,t 5 •.i ;. y ye t r
Imma"on n
glum lr coret; and that I am the owner, or the dilly aumor- wTT�TNT7ox APPLICATION.: -APPROVAL
I.ed trot of the owner. I agree to eampt7 with eIV end .torn aws nzu- •,
.tort eoostmet, r,; and a do1nZ the work tutmr!na thereby. no Wrenn . - - - r \• tJ 5
w'IU a .IDDIoye6 In .7loatton of the LnD.L Code of lien etete of Washagton. TIIIa PETtMl'r This application not B pernilt 11atQ�
eDTBOFizrl+ 4�?
'nl►ttnz to Workeoen•s Compensation Insurance. elgatl3 by the BIil1t11ag,JSISCiai Or hf' Dep-.
oNLY THE uty; and fees are paid;'and receipt is [Lc-.
NOTE: Permit Limit.One Year (E—Pt DEMOLITIONS wblcb WORE NOTED knowlt n space
ed in provided.
Sf lti 4
.hall be-.vleted a ninety daYs: MOVED IN BIIII.DLYOB shall be eom- g
plated to ex month..)
DATE BtaNED INSP&CTION DIRECTO 916N
ql A/T.U�RE (OWtjj1R OR AGENT)
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Crrl: OF DATE I xrJ�y.yA.�x'w 3 0„
EDMONDS
NOTE: APPl+cant Subject to Plan Check Fee PR e-I167 ! - l
Tbl. Permlt oven wort to be done on private pnpeA7 o''lLY. i•' .,.
drlvewV - Fad:
Any tua.trnctlaa on the pubtle domain`( fie tpelm4den.
nu+Va et.) w111 rea e e
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a CITY OF EDMONDS — SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
I.
PERMIT L
rCall 776-1107 for side sewer inspections BEFORE covering any portion of the construction.)
\Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections./
CUE>>
F�
ADDRESSLOCATION OF CONSTRUCTION ....... ........--.............................--..:-.............................--.........-..-....----....----............---------•-----.............
PROPERTY LEGAL DESCRIPTION....--'�... °= a_/'2-- of - of - block----- --host ° First Addition
.................................................. _.................................................. -............................. -...............................................................................----------........................--...
OWNER AND/OR BUILDER ....... ....� .... t _-!%IG-- -- _ -----------------------------------------------------
Boo Aiclir. Baekhoe Scrvice 9 24006 - 92nd Ave.3
CONTRACTOR'S NAME & ADDRESS--- - - ------------- -------------- ------•----•--.............----•---... ......-......------•----------•---------.......---.....---•--------........-
system
is granted .....--::'. _::l'. k-:):.................... .............. 19..!:*.M-, for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
NTION IS CALLED TO THE FOLLOWING:
10.1
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 i,¢ will be permitted.
NOTE No. S—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 ................ Date------------.........------......... By -------------_ Date .................................... By ................
APPROVED. Date..,�- .. :..--,Z................................ By - ��, is -.-.f �.....- - -'-----------------.....--•--------.........--.................
Remarks: ..............................................•----•---•-----............................................---------..............----..............................................................................................
— BOTH Permit 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
(Owner of Contracting Firm Performing Construction)
•3 installed in accordance with all governing ordinances of the City of Edmonds.
Dated this ..... tS....................day of.....---!'Lr'.................................
J J Check BEFORE you dig for: Water ❑, Gas ❑, Telephone ❑, Power ❑, Sewer ❑, Other ❑ J J
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION e"' REPAIRS E3
OWNER..... Ro?Y .......... ...........................................................
ADDRESS............. #4.pd .................................................
Al c /,Q V
U.
ILLJ
I LJ
TREATMENT PLMT
EASEMENT No'.
\0 74
CONTRACTOR ...... ......... 2.6z"Of . .......... ......................
PERMIT
LEGAL DESCRIPTION: LOT No. —....../ 2-
. ................................... BLOCK No . ............................................
5,0.-14 1 -7r,
K 2-
NAMEOF ADDITION ............................................................................................................
Approved:
.............. By .... .. ..........
..... 7,;a- -----------
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