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1010 DALEY ST.PDF1010 DALEY ST .. ADDRESS: TAX ACCOUNT/PARCEL NUMBER: O04::�42-og3n- 00 BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): OEM � U to (�� l PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: 43 SIDE SEWER AS BUILT DATED:_ SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DATED: �b t OTHER —R. W — ( IC5 1 Lac) LATEMP\DSTs\Fonns\Street File Checklist.doc r. v T . t J -05 APPLICATION for The City of Edmonds SIDE SEWER PERMIT EASEMENT No . .......................................... NEW CONSTRUCTION O REPAIRS O 118-04050 OWNER...........Banger-.T....COnran......................................................... CONTRACTOR....---------------------...----.......................-----.....---.........------............... PERMIT No....................... ADDRESS....... 1Q1.0 --- Daley ...S.t................................................................. LEGAL DESCRIPTION: LOT No............................................... BLOCK No............................................. • E NAMEOF ADDITION......................................................................................................................................... Dye Tested On Sever 1972 Approved: DATE................................................ By...................................................................... '�'�rvn,Fjv':a�es+aw�'�;��1t,� - 'fir ,�•4r'�' 3i�' ,fir- �r' Rta,'',�r�r`'r'y+"c�-ya`u++r�e= a+"„a{'•rh'`�„f°3'�3:4- �'` } ' City of• Edmonds RIGHT-OF-WAY CONSTRUCTION c �� PERMIT — Permit Number - #. AY M1 3 1996 - Issue Date: of Construction: 1010 Dal eX t' GTE top ace, operate, and maintain a buried service wire 18 C) 0 9 B. Type of Work (be specific): from existing pole #1544 located at 1010 Daley then north 9 0 to a residence at.1010 Daley. GTE to plow 70 feet, push no roads. R.O.W. 4 feet Mary,A Bower, Permit Coord. C. Contractor: GTE Northwest incor orated Contact: Dennis Alexander 771-9036 or mobile 388-1358 Mailing Address: C W Casino Rd Fvara,rt, wa gR704-1LL00 Phone: Mary g96�1100-16�� State License #: Liability Insurance: Bond: $ s D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑Subdivision ❑ City Project] Utility (PUD GTE)WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other 2100-9P001DB 242310 INSPECTOR: INSPECTOR: �,1.� ;� LAA-A F. Pavement or Concrete Cut : ❑ Yes X No G. Size of Cut: x H. Charge $ r APPLICANT TO READ A r SIGN 4.. ! INDEMNITY: Applicant understands and by his signature to this apa plre'`tion, agrees to h9fil the City of Edmonds harmless from injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be mad4against the City of Edmonds, -or any of its departments or employees, including or not limited to the defense of any legalpi•oceedings including defe se costs, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE -FOR -WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF fHE'WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Construction drawing,oh&opo d ork„requ�ired\4ith perimi4pplication. A 24 hour ndtice is required for 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 ditches 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 understand the permit requirements and the pink copy of thepermit will be available on site at all times (f'0 tion purposes. Signature: Jo n Stewart Date: May 7, 199F (Contractor or Agent) Oprns Supv-OSP Engrg. CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: t�� t RIGHT OF WAY DEPOSIT _ TIME AUTHORIZED: VOID AFTER F"Q(SDAYS DISRUPTION FEE/FUND 111: SPECIAL CONDITIONS: N A, RESTORATION FEE: . COMMENTS: PERMIT FEE: ,�n . C� C- TOTAL FEE: (f>(7) RECEIPT FEE: DATE: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994 MID PERMIT SUBMITTED BY GTE LEGEND PFOS POLES O ROAD BORES -- OvERHEAO LINES- I.D. UTILITY POTHOLE IM LIG TRENCHING---{JGT 1 v,� t R.O. W. r-------------------_---- ^----------bass.------------ EOP DALE V ��' WATER 31 1OrJ - --------- --------------------- CUTS, L' PEWIT SUBMITTED BY GTE 101 D LEGEND POLES O ROAD BORES ----- OVERHEAD LINES---- I.U. UTILITY POTHOLE I=) UG TRENCHING ---UGT R.o.w. ------------------------------ ---- - - - - -- `_---- --------Nos-------------- ESP DALCV sT IAJATER �� or� --------------------------... __ _ - - N Ln m - CUTS, e;7 Oct ..................._.......District City of Edmonds ---Water Department TAP CARD DAT .................. ...... * ............... MeterNo ............................... Tap No......................................... Size.............................. Size......................................... Mfgrs. >Tg..., ........ , Style ............................................. k-,.. ....... . ...................... . ........ j .... For ................... .................................................................................. ............. ..... .................................. ..................................... .................................................................................................... LotNo ........................................... Blk. No...............:.................................. * .................................. Add......................................................... . ........ . ...... ....................... Service Location . ...... ....................................................................................... ................................................ MeterLocation .......................................... ...................................................... .......................................................................................................................................... MakeTap ................................................................................................................. ......................................................................................................................................... Pressure .............................. lbs., Test ..................................... % SendBills to ......................................................................................................... .......................................................... .. ...... ............ Dateof Work .................. .............................. Z2� .............. ............... I ........................ . . ....................... Foreman Guar. Voucher No ........................................... $ .......................................... Remarks: .................................................................................................................. .......................................................................................................................................... ............................... ..... ............... 8-T-REET .... FJtE ........................... ........................................................................................................................................... OUTGOING Index .......... Reg ....... Route Bk ......... Stencil ...... Card ........ INCOMING Index .......... Reg ....... Route Bk ......... Stencil ...... Card ........ N,,,.;rial Chargeable to Installation, N.,"-,,rs N6 '.'SIZE DESCRIPTION RATE AMOUNT ........ lr-% ..... Meter iox X . .. ......::� ..... f ........... Meter............... .............. ....... ............... ...... Meter Plate ............................ ............... . . ......... .......... ................ .......... Check Valve .......................... .............. . ......... .......... ........... ......... Pipe, Galv. Screw .................. .............. . . ......... .......... .............. .......... Nipples .................................... .............. . ......... .......... .............. .......... Bushings .................................. .............. ............. .......... ......................... Plain Ells ................................ .............. ............. .......... ........ . ... ...... ... St. Ells .................................... .............. ............ .......... .......... . ... .............. . .............. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......... .......... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tees .......... .............................. ....................... .............................. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............... .............. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ............ ............. . . . . . . . . . . . . . . . . . . . . . . . . . . .......... ......... . . . . . . . . . . . . . . . . . . . . Material Chargeable to Taps Connected NO. SIZE DESCRIPTION RATE , AMOUNT ... .......... .......... Pipe, Black Screw .................. ............. ............. ......... .............. .......... Pipe, Galv. Screw . ... * ............. ........... ------ ..... . Lead Connections .................. Curb Cocks ............................ ............. .............. I.__............ ....... .. Corp. Cocks ........................... ............. ........ .............. .......... Unions .................................... .............. ............. ......... .............. ........... .Saddles ................................ ... .............. ............ . ........ .............. ......... I Nipples .................................... ............... ... . ..... . ......... ........ I ...... ......... Bushings .................................. ............ I .. ............ .......... ............... .......... Plain Ells ................................ ..... ....... ............. I ......... ............. .......... Street Ells .......................... ... ............. ............. .......... ............. .......... Tees .......................................... ............... ......... . . .......... .............. .......... Curb Boxes ............................ .............. ............. .......... .............. .......... S. O. Extensions .................... .............. ............ .......... ............... ......... Gates ........................ . ............ ........... ...... ............... . 3"e ... .. ... Plugs ........ -- ------ ---------- * ........ Couplings -�X .. ......... — ----------- .... ........ * ... ......... .......... .............. .......... Gate Boxes ............................ ............... ............. ....... -------- ....... . ... .... . .. ... .............. ............... ..... ..... .. I .. .. . ........... .............. .......... .......... ........................................................... ........................................ .................. ...... ............. . ------------ .............. .............. . ........ ......... .. . ....................................................... ............. ........................................... — -- ....7 . . ......... .............. .............. .......... .......... ........................................................... ......................................................... .. .............. ............ ...... .............. ............... .......... .......... .... .... . .......... . . . . . . . . . . . . . .- ............ ............ .......... .......... . . . . . . . . . . . . . . .............. .. 2 4 ..2 ..... Hours Time —Day Men ........ Hours Time —Monthly Men .. ............. .............. ............... ------- ....... . . .... ' ............... .............. .......... Hours Time —Auto ............ ... .............. ...................... ............... .......... Superintendence ...................... Total................................. a ' PEOMIT SUBMITTED BY GTE 1010 LEGEND PFOS POLES O ROAD BORES OVERHEAD LINES--- I.D. UTILITY POTHOLE LO UG TRENCHING ---UGT R.O. W. ---------------------------------------- ------------------------ EOP DALEV 5?` MATER 3' 1 0rll)� ---- - - - - -- �m N �m " CUTS. CITY OF EDMON➢S. , WASHINGTON BIRL®ING PERMIT ant'hereby certifies that a plot, plan, drawings,.and sufficient details to indicate. ention to fulfill all requirements of this code are attached hereto. ition is hereby, made for permit to do the following w.;rk: s i/ ................................. Block.43:�- .V a jOAcl.......... . (r.✓A,l'�. •fY:,a lr'..--• _.-_................_....................--_..__.................................._..__........_.._...._. ,at r F�,r(`;•,a'� ...._....--.......-._..-._...- .. .. .......... ..................................... ......................__...._.. 1. Building dirnensions -..........4.�2............ x. i? 2. Lot dimensions ...:......: �•O c.-..... �� .-.- ........ .. SP............. 3. Building will be ......0. f.G.....storiek'. ... ,. .�. hX 4. Basement .....C..s5........ e f 01 i. occupancy of building will hc..... r S JC_ -. _............................................. r . 6. - ..5...-. feet froin the nearest ad oining line. I....... ^'S r 7: Owner .................. k-.01,................................... A J + 8. Oner's Address...............%R�.......... ..............._.........._. l�nt� lc�a.rl 9. •Builder. .._.-.._......................_.........---- .......--.-.-......-... -..: � w � 1 � 10. Builders Address.;.._..... .,5.�4 �..- -I� -..:._ �✓-..--.:... .....--.....------•............ r /.. S.................................... y� ........ // " Date �..�.......... ..t/P-rxc...._19.J..��// _ ...... .............. ....--....-..-L.i��l-^C......••••••............. `' - iJ.iYtt ® (Owner OV nis agent) Permission is hereby granted to do the work described hereon, according to the approved plans and specifications pertaining hereto, subject to compliance with the ordinances of the City of:Edulonds:' PERMIT N° 628 • i l'.t c- �Iitf _tom >ttF f 3 5.-..-. 5..... g Rece'ved .( ring ofBarl f.m - ,; 4, h'f. "' ft,•. Department+of•'Bliildingaa ,�fiYL;i`}'%%:'�.:' City of Edmtmds' 'r M 1. The building permit fee which applicant pays when permit is issued shall be based on estimated cost of the proposed structure, at the me of^Si 00 for eei•L�!"f�y"� i1000.00 of coal. If the actual cost of the structure, when finally determined, exceeds the estimated cost b more than S r5j r t.r,t1 i^x?' of 3=.00 for each $1000.00 of such "etas cost. - y �. applicant agrees [o•pay ee'addltfotsl. fee=.„•--�t:--• : 2. Whenever a contract for construction Is executed for any structure costing more than 51000.00 for which -a licensed 'architect or a tsin 1s not. rcqutred, bf, RE, thBuilding Code of the City of Edmonds, the application for a building permit shall be nctnmpanied by a copy of [he coettaa and n 1! 'specifications. cop? of.the detailed•i� 3. Prior to employing any labor or commencing work, notify the Industrial Insurance Division of the Department of Labor and Industries, giving Im "— ire of the payroll and make monthly reports of payrolls. Full instructions should be obtained from the nearest office of the Department of Labor end Induarrlei.:°Before final payment, the owner should obtain a release from the general contractors who in turn should obtain release from all sub -contra ton. The ,rcleaxa'shou tTld •be ��••;`• •At,' ' ~• ,ti:-pS'`.a aested by the Department of Labor and Industries. he above procedures are requirements of the $t:,re Industrial Insurance Art. 4, �r