1013 3RD AVE S (2).PDF111111111111
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1013 3RD AVE S
ADDRESS: M�
TAX ACCOUNT/PARCEL #:
BUILDING PERMIT (NEW STRUCTURE) M
COVENANTS (RECORDED) FOR:
CRITICAL AREAS M DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
CRITICAL AREAS M DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER — list permit #'s):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED: 9
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED: M67
SIDE SEWER PERMIT(S) M �uC"
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
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CITY OF EDIMONDS
BLDG. DEPT.
CONDITIONAL PERMIT
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OCT 5 1983'0
T
e City of Edmonds for
STREET FILE '""c"'
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SIDE SEWER PERMIT EASEMENT NO- ----------------------------- --------------
NEW CONSTRUCTION REPAIRS LID NO_ ------------------ - ASMT. NO - ------------------
OWNER.... -1 - ------------------------------------------------------------ CONTRACTOR ----------- o,.,"
------------------ --------- ------ --------------- PERMIT NO. -4-152
JOB ADDRESS -1013 ------ 3--W--A-v ----- 6a,_ ........................................ LEGAL DESCRIPTION: LOT NO. -------- BLOCK NO.------------------------------------
40-r-
....................... ---------------------------------------------------------------------------- I ----------------------- .....................................
NAME OF ADDITION -Sc? ------ P4ev - ----- Aow-nau ------- .MIZ5 .............................. ------
Approved:
DATE ------ 4M ------------------------
BY
ER PERMIT
W
CITY OF.! EDMONDS, SIDE SE
WE
W.ATEP At;,DEpARTMENT
'Sp
PERMIT 6152
Call 7.75-2525 for side sewer Inspections BEFORE covering any portion of the construction.N
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.)
DRESS LOCATION OF CONSTRUCTION ........ !.C.N.73D . ...... ........... .......�`:._ ........................................................
............. . .... P.P.,OPERTY LEGAL DESCRIPTION......... ..................................................................
..................................................................... . ...................................................................................................................................................................
LD . . ....... ...........................
.......................................................... 0147NER,��D/OK-BUI ER ............ ................. ...........................
-%NTRACTOWEL NAME & ADDRESS.........:..:........ :��A. ................................................... ............... .......................................................
11_2 e.Wsslon is granted ......... ............................... or repair and/or connection of a side sewer to the city sanitary sewer
sy-�-an in accordance with City of Edmonds ordinances.
A'I�4.TION IS CALLED TO THE FOLLOWING:
NOTE 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 % will be permitted.
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be res)onsible 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.
X"
BDate .................. DISAPPROVED Date ...................................... ZB ............ Date.............:........ .By ................
APPROVED D� Date......... . ....... BY ......
... ... .... . ....... .. .. ... ............... .............. . ........................................ ..............................................
Remarks: .......................................... .............................................
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
............ ...
......................................................................... .... hereby certify that the side sewer installation constructed under this permit
(Owner. of Contracting Firm Performing Construction)
��j nstalled in accordance with all governing ordinances of the City of Edmonds.
Datedthis ............................ day of........................:....................; ................... 19.........
V Check BEFORE you dig for: Water 0, Gas Ej, Telephone [], Power Sewer C], Other Ej V j