1010 CASCADE DR.PDF1111111111111110541
1010 CASCADE DR
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER: C)Z),5R2 b O'00'00 QO
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT
SIDE SEWER AS BUILT DATED: G7I �iI l0 Z
SIDE SEWER PERMIT(S) #: q4
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED: +1 Q I lQ Z
LID #:
LOT: to BLOCK:
L:\TEMP\DST's\Forms\Street File Checklist.doc
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tIPPLICATIO BUILDING- PERMIT. AppL'No. z2-. l'
CITY.- OF EDMONDS. ,Building Department Pr: dc' limit one year
APPLICATION is hereby made for a permit to construct the following -,ork, in accr—A& a w4 h the accost•:' f a
panying plans and specifiations, Two sets are submitted herewith for approval. I
~ L
^� new �altcr
................_ P5r6n - E!
-
•........................._-.. ....- tsa
7-..-
Work addn repair ..............Tr... / •:.. g _"- � :
Occupancy... ........, C,onst. type ...................:........ Use zone.
—( Fire '+
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Address.%DID.-...:...................._..-..-_ Lot__.CP__....---. Blk........... -_.....: Addn..._:
Aa 9,00,t /Ve. 1� t'
1 t t w4
Lot frontage-:.. ................... Area9. i` !X_ �P.t..%O...Y_. ieptic tank..�I�E�PF.I�
Bldg. set -backs — front- ----../—Q...... ... r. id .......... ... 1. side-/--e:.7........ .......... 'ream
own !.! C"/y. Y � ...... .fit.... Address..7.OL�S s./U.. Tcl.
Buildcr..e - .... Address .................. -- - ............... - .- Tel. No .. v
' 2
Plans by ..................... Address ........-_ Tel. No._... .... i 't i fit• `. *. ;.�, -
Remarks..................................--.............................................-... t h w
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.............................. ..........to .�
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. ...... ........................... `
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FSWS¢ti
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The above is a correct statement, and I agree to comply with all app!iable Codes and State laws regulating,
work.
..................................:...
Signed Owner/Agent. Date .. ''. ✓
PERMIT for the abovz work is hereby approved, subject to the above conditi to oomp
notations
proved plans and spe ifieations, and Building Department
Valuation���.-c.7r� d................ Permit fee-....c:;, 47.'-�.........
_. R •- ........ ....: ,." � �a �•��^�"�`' ,�
Budding Deparanent, BYi�✓"G�/�.G=�:fC�G✓-•--------- .. '. -
,r
This permit does not cove, Plumbing, Sewer or Electrical installations
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'�; � .• r t.:`�r:e13'-� ,ram.
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PAID
Date r' . Approved: t
BACKF ILL WORK ORDER. ISSUED ............................................ DEPOSIT, #............. ........
SEWER WORE ORDER ISSUED ...................................._........... .:, 4�`nTr fii4, DATE..,,�....-t.+ �r < 'r ............ ,.:
" `B............ .
ENTO
MAY
............................District
�C"ty of Edmonds ---Water Department
-ty
TAP CARD
Date..PIDAPP ..
(No.................
No ..... ................
Meter ... Tap .......... SizeSize......... ..... I
... ..............
Mfgrs. NO... ....... . ........................ Style ...... W.7, ................................
................
For ......
............
...................... ..................... 7-- ....... .........
............ ... / . . . . . .....
. . .........
LotNo ........................................... Blk, No.....................................:..............
Add. ..................................
............................. a ................................. ..................
Service Location ......................
.........................................
............................................................................. ............................. I .............. . ... aw .........
MeterLocation .................................................................................................
.................................................................................................... I ....................... . ..............
MakeTap .................................................................... I ........ ............................
f-'................................................................................................... w-.— ... . ...........
Pressure ............................... lbs. Test ....................... I ...........
SendBills to ........................................................ I .................. ..............................
............................................... ..........
Dateof Work ...... .. ........................................................
................................................................................................................ Foreman
Guar. Voucher No ..................................... $ ............................................
Remarks'! .. .......................................................... ...... ............................... ..........
. ................ .........................................................
............ ................................
...................... ................................................................................... . .....................
....... T
MEET ....... ................................................................................................ .................
.................................... I ....................................................................................... ...............
............................................................... - ----- ------ - ------
OUTGOING Index -.........Reg....... Route'` Bk ......... Stencil- ..... Cardi....—
INCOMING Index ......... keg ....... Route'Dk ..........
Stencil ...... Card ........