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1028 C AVE.PDF1028 C AVE CITY OF EDMONDS SIDE SEWER PERMIT WATER -SEWER DEPARTMENT i PERMIT _G 1.,0 Call 775-2525 for side 'ewer inspections BEFORE covering any portion of the construction.N Inspec_tionwill be provided within 24 hours after requBt. NO Sat., Sun., or holiday inspections./ ADDRESS LOCATION OF CONSTRUCTION—JQ28 .... I T, S.tre.e.t ...............................I ............................ . ....................................................... .. ........ .... PROPERTY LEGAL DESCRIPTION; .................... Lot 3- Block 009--D-002. Yost let Addition ................................................................................................................................................................. .................................................. . ...................... . ............................................................................................................................ . .................................................. ......... : ....................................................... O*A*WER,41NDjOR BUILDER --- R01..."TATAINTSON ...................................... . ................... ............................... CONTRACTOR'S NAME & ADDRESS........ Q07-.1p .............................................. . .............................. . .. . ....................................................... Permission is granted ................. oc ' t - n - N ' tzr .... 2 n.; ....... 19.16, for repair and/or connection of a side sewer to the city sanitary sewer Win accordance with City of Edmonds ordinances. ATTENTION 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 roperty line and 12 inches inside property line; minimum grade of 2%. No bends 'in grade sharper than % will be permitted. ( - I NOTE -No. 5—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 - Bert the pipe into the wye. DISAPPROVED E] Date..._........ -.® By ................ Date ............... . .. * 'By ................ Date..............._................... . By ................ .................... . ................ APPROVEDDate... ,d_1M;Vr1 7-:1 ............... .0110V BY ... ..................... .. . ........................................................................................ Remarks: ------- - ---------------------------------- - ---------------------------------- P, ........................ . ........................................................................................................... ..................................................................... . ... ........................................................................................................................ . ............................................. ......... 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) was installed in accordance with all governing ordinances of the City of Edmonds. Dated this ............................day of ......................... ........ P 19......... VV. Check BEFORE you dig for: Water E], Gas[-), TelephoneE], Power Sewer b, Other E] v V ADDRESS: = l , ,� ldld TAX ACCOUNT/PARCEL NUMBER: Uo 19 40? ?!W BUILDING PERMIT (NEW STRUCTURE): l' :;? r K ) 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 PLANNING DATA CHECKLIST DATED:trV SCALED PLOT PLAN DATED: ()1 Z7-1!12 SEWER LID FEE $: SHORT PLAT FILE: S • `T - -+5 LOT: SIDE SEWER AS BUILT DATED: I I 11 1 7% SIDE SEWER PERMIT(S) #: P5U GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DATED: 10 2°� i� (0 OTHER: LID #: BLOCK: DbZ-P-do2 CG L:\TEMP\DSTs\Forms\Street File Checklist.doc :31 ---PER `) NUI ER L use ©Ti �%v`-`•' ZONE � j BUILDING D ARTMENT PERMIT APPLICATION Heavyi L Inside Heavy Li ,oB t l� ADDr.Ess NAME TOR NAME OF BV SIN ESS) I�O !J CO LOT AREA SUBDIVISION NO� LEGAL LOT ((�� L ; ' L) NO 000 1 E I („/ ,YES ADB NO. L� MAl LI ADD E55 VARIANCE OR CON7, USE NO. U S 1O 6-Leii1 o TELEPHONE NUMUER IT / �J ¢- ) - ` PROPOSED 'FAR �L�I^ % Z HEIG HTt Z I t' ( �!'IZd S 7/ G�l3� 51 E f�J REAR a�j FRONT 1 � NAME _ ALLOWABLE PROPOSED a - , SIGN AREA SIGN AREA i W ADDRESS 11 OTHER � ID( , REQUIREMENT, S(//*/I YYYY���v 1 i Z V TELEPHONE NVMBER a CITY DATE j PLANNING 0 E PTi APP OVAL t NAME y vI CI L STREET R/w / . DEFICIENCY CIENCV THIS PROPERTY EXISTING STREET R/W/l['0 FT ; FT. C J V COMP. PLAN ST. R/W�0/0 FT. O q AD E55 ` I nottto exceed those <� O` S TELEPHONE NVMBER M CITY V REfdARKSpriveway.slopes indicated on Standard a ii ' No_1OJ W p ,2 j& /S'o Z cPS C 1EG KE Y Z tt{II1 _iN GM OU STATE LICENSE UMBER [ITV LICENSE NUMBER v JJ Z - ��) Gp W330 W i STREET AND/OR UTILITY YES Legal Description of Property Show 13elow or Attach Four Copies) WORK REQ'D ❑ NO _ O 7" l S UNDERGROUND YES �6Ct 1 WIRING REQ'D ❑ NO VERIFIED BY I CONNECTION (9' J ,Alf +t (_Jl' S TTYYnPE U 4/ 3 ❑ YE^ 'PERMIT 1•IUM BER ; U V /�� O Z O v G N SEPTIC SYSTEM APPVD BV CITY ENG. 11 (�. _�.- W 1 1, li�NO' N W G G__An/n REMARKS t, W METER SIZE $ERV SIZE CLEARANCE [NECKED B 1 el J .� / � < I S 3 • ��----yy ,7��1� NEW Ir RESIDENTIAL ❑ GA$ LINE FIRE ZONE YpE OF 1 RUCTION CODE T ' 15C 7 v `�-" ❑ NON-RESIDENTIAL ❑SIGN AREA OCCUPANCY OCCUPANT , ❑ ADD RETAINING ❑ DEMOLISH WALL REQUt LINSPECTO REQUIRED G`'P LOAD , f a ❑ FENCE •— ALTER ❑ EXCAVATE (--- X OR FILL FTl ❑ YE NO PLAN CHEC [ By THIS SITE IS OCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX . W D PR E•MOVE SWIM ❑POOL ❑ ❑ H D o , z I O {1 1� REPAIR INSP, MA J NUMBER Off• TORTES NUMBER OF DWELLING U m , I�� L UNITS NATURE OF WORK TO BE DONE W VALUATION FEE' ' PROPOSED USE PLAN CHECK ZNO.� ° �^ - �! ;• r PLOT PLAN NOICATE BUILDING SETBACKS, ABUTTING STREETSI BUILDING - _ Q � Ir GP i — U W PLUMBING _ ., D HEAT & GAS LILAC r — FENCE _- SIGN -- RETAINING WALL ---- SWIMMING POOL DUE ' I hereby aeknowled;;e that I have reed this sppllcatfon: that the fn- the duly author• TOTAL AMOUNT G�6 . formation given Is correct; and that I am the owner, Ith city nd late t eT eperson ATTENTION APPLICATION APPROVAL Ized contra tllnent of the � nd In doingthework authorlred thereby.t no the Labor Code of the Biala of wsahm gton THIS PERMIT ' This application is not a permit until �I well employed Violation of l0 Workmw. en's Cempineatlon IneBiMee, AUTHORIZES - signed by the Building Official or his Dep- A rtlatlng NOTE: Permit limit One Year (Eicept DEN- OL"'c"N' Lull Da which cum- ONLY THE WORK NOTED uty; and fees are paid, and receipt is ac- in space provided. completed fn Nnety days: MoYED•IN BUILDINGS knowledged - shell be peeled In els months.) DATE SIGNED INSPECTION DEPARTMENT DI C 51 NAT RE fIF.R OR AGENT) $IGfj TVR �OW-�� CITY OF - EDMONDS DATE NOTE: Applicant Stt6%er-t to Plan Check Fee 775-2525 This Permit covers work to be dons on prive to property ONLY. ORIGINAL -File YELLOW InSPt'C for the publicdomaindriveways, I PINK - q�l�,lcr GOLD • A:;•.rsua Any construction on separate permission marque", KIJU I 1°IVU' JL 1 r �, ,- �"�_—?'—"-'"/"�°�/sr�"^..�•.. �;�t.As'7llr,U,� �.,� ,. ;.NEW; SERVICE INSTALLATION /�,.�ti Y �ADDRESS�� t ���' •C � z City of Edmonds ---Water Department i TAP CARD Date ........ _..... __.... ..._.... __....... IAL A DIG# Note. S. No ...................................... P . U . D . Meter Tap Size... --•• . Size......... TELEPHONE. Mfgrs. No: .9 ....... ..... Style... i For =- 1 FOREMAN f i CABLE T.V. GAS . -STORM SEWER OTHER LotNo------------------------------------------- B1k. No...........---............._. Add. ................. _...•••••................... _... - .... Service Location ....Q....., ......� ....__ ...-.:.....__.---•---.. __.__ Meter Location .......... --........ ........................ ....-- ...... ......... MakeTap ........................ ....................... ... ...--•-•- .......... ....---••--.......-•••-------•--...----•---- ............._......_.....•----_ Pressure.... �.. ...... .•---..lbs. Test ........................ ............ % • � ' - k SERVICE INSTL:. YES ^.- .71 d Bills Send i to ........................... .... _... BORE: CUT: ..................... .............................. .... ........ ....... _ M Date Wok O SURCHARGE: YES` o.. of .... .�� .. _... �........._.............. r :. , ,...,. �,..• ,... - i - Foreman CRE[J DATE • + INITIAL � . ,�.,- Guar. Voucher No ......_..-.............. ................ ............... .._..... UNLOCK i � y Remarks: RP.�A.........�....._!3-.T.F.......__ +g C't �2 SG-b DATE: ACCOUNT NUMBER:. INITIAL: ,_:. _.. a /0 7 .0 7430 > .............................................._ ..............la ._..�.:?_....._.._........ T _ ..__...... t METER SHOP . ............................... -••••--•-•-••••. _..... ... _. --------••..-- SUPPLIER: TREATMENT PLANT SIDE -SEWER PERMIT��?� _....... ................._....a.._. J� ...................................... W*`' CIVIL ENGR. DRAFTSMAN ® ' B L T r " INITIAL: s� . DATE: /--/•9,= 7(�' 1 ........................................ __....... - ..... .......... _ ........... ._ ...... ......_.... � �,. SUPERINTENDENT �- , . ..•. ... ,. a TAP CARD IMETER SHEET APPLICATION'';" .....................................•- •_.............•-•........------..........................-------•-•... TGOING __Index .•_--Route Bk.........5 acil::_...Card .....» Z� -170 �- •t - , . �21 O - �Iv , v - - �Bo di 1-7a.-05, APPROVED 8Y PLANNING ' . �� - • , /�•i1. - •AIM � � �': � � � � •fit` -�y �•: • . .• .. .. `� .Z. 71 \�1 �'�. '' • - •- _ - a �F _ DtLNR: ��I'1►1''1?Y �f�F'b f?k-�clE;::(znc�� 77�} c��a I---� - 4CLb THA7 PORTION OF DOVE MENT LOT ; 1, SECTION 24,: TOWNSHIP = 2 7 -NOR-TH,, z'RANGE . -3 EAST, , - .W : M , : DESCRIBED: AS FOLLOWS : . THE EAST`-318:OL:FEET•OFiTHE-FOLLOW.ING,.`DESCRI:BED; TRACT ' 3EGIN,NING. AT. THE INTERSEkCTION OF': THE EASTERLY°.MARGINAL L-I'NE:_; JF .THE''GREA- NORTHERN• RAILWAY -COMPANY'S' -RIGHT .OF WAY-.441TN. a- L I N'E 66..0• FEET 'NORTH : O.F.- AND -.PARALLEL m I-TH `TfE SOUTH- BOUND-. 4RY.. L",I NE OF' SAID GOVERNMENT, L'OT, 1 . _. THENCE -SOUTH 881 541 2 6." 270` 78 FEET:'" TO `THE T•RUE: POINT. .OF' BEGINNING; . THENCE - r SOUTH• `26P20':30." WEST'1.10:.55 FEET,: THENCE SOUTH.88a54'26", ' .'=AST 4"95 .1 FEET;', THENCE NORTH- 1° 5:' 3.4.': EAST • 100 .FEET; THENCE r V:ORT.H 88°4 WEUET OF BE-`4POIM INNING aLSb,- :THE.` SOUTH 15' FEET OF .THE FOLLOWING -DESCR•I•BED` TRACT: '3EGINNI;NG_.AT:,THE:: LNTERSECTI�ON OF -..THE. EASTERLY, MARGINAL:-: ,LINE',; x. JF THE'' -GREAT- NORTHERN -RAILWAY. COMPANY;'. S-. R:IGHT-OF'!WAY .WLTH A } =' LINE{ 660 .EEE.T NORTH OF-.-ANDPARALLEL %WITH,tTHE SOUTH BOUNDARY ?-F�NE }OFrSAID GOVERNMENT, LO.T. 1 ;`THENCE. -SOUTH •88°54. 26".-'EAST j r ` 270:..7.8 .;FEET; : TO -THE. -.P.OTNT .OF,: BEG .I.NN.ING,- THENCE' SOUTH. 26°_20'"30"." WEST'_110 -56 FEET;;-THENCE''SO.U.TH- 88°54' 26'- EAST:.. . +95'. 16 FEET. ,•_ THENCE. NORTTH' 1_°5'34";_EAST 1.00 .FEET; "THENCE.:,__ + 1FEETTOTHE O.F BE=VORTH 88054' 2WEST 44:' 1 I NN i'NG, XCEPT: THE;;EAST 318 01..FEET THEREOF:: 7LTUATE IN._ THE COUNTY *OF SNOHOMISH, STATE OF. 4JASHINGTON r NM BAR • 21Z703'-Z lc �rcy✓E►6E; I:aT- ,A: :•,33= 2 I : r �lal j'P�Zltf XISTI Nl� _ Lb Y;. PAR NTH Wit- �/E t E . 8 ?R ll. H Rom• ' The City of Edmonds APPLICATION for SIDE SEWER PERMIT EASEMENT NO- .............. ----------------------------- r=- NEW CONSTRUCTION 0 REPAIRS F1 LID NO. ---74 ....... ASMT. NO . .................. OWNER -------g---------- --------------------- CONTRACTOR ----- 'N-- PERMIT NO. Col 1 ---------------------------------------------------- C�oCD (:.::> 7?-- - XD 7Z- JOB ADDRESS ....... �-"74' 1� -------- ------ - - ------------------------- LEGAL DESCRIPTION: LOT NO. -------------- :� ---c2------------------ BLOCK NO. ............... ------- ---------- 0, 0 NAMEOF ADDITION ....................................................................................................................... Approved: DATE... W .............. ........... The. City of Edmonds APPLICATION for SIDE SEWER PERMIT EASEMENT NO - ----------------------------------•--------- NEW CONSTRUCTION REPAIRS ❑ LID NO. __ -------- -ASMT. NO . .................. OWNER , r a =---1e�?•'Se�✓.. ............... CONTRACTOR�'eb� CG'------.C.._.. PERMIT NO.': e- << sr JOB ADDRESS ---f- ________ ______/ -------- ........... LEGAL DESCRIPTION: LOT NO.. .................................. BLOCK NO. ----___. r NAME OF ADDITION ...---------J--••-------------------•-----•--•-•---•-••------•- v RECEIVED OCT 2 0 1976 Public J:.10to Approved: DATE............................................ By ................................................... i.UY ,Y� .. 1. t ... '`'�.�c •.f 17, 1-.�+f F`�4N.L^!i i'�..r:dY�.-� yr. ,,.•-LJ'.al�. -Lr� , ....ram'.-:. --,: _,• �r-.. .'- �t.l.. �� ._.. .: l,,.. :.. Edmonds STREET FILE RIGHT—OF-WAY CONSTRUCTION PERMIT Permit Number: Issue Date: A. Address or Vicinity of Construction: 1028 C Avenue... 1 O - B. Type of Work (be specific): install New Service 89.0 19•°' C. Contractor: Washington Natural Gas Company Contact: Frank Swan Mailing Address: 81.5 Mercer Street, Phone:, 224-2278 State License li: Seattle; W9 98111 Liability Insurance:. Bond: $ D. Building Permit # (if applicable): Side Sewer'Permit:# (if applicable): E. R. Commercial ❑ .Subdivision ❑ City Project gg Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ❑' Single Family ❑ 'Other INSPECTOR: INSPECTOR:. WN1TC.u'11 F. Pavement or Concrete Cut : ® Yes ❑No (1) G. Size of Cut: ' Z x 4' H. -.Charge $ APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application, agrees to hold..the Cry of Edmonds hatmless�fron; injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeen, that may be, made agai ,the City of Edmonds, or any of its departments or employ- ees, including or not limited to the defense of any legal proceedings including defense costs; and attorney fees by,reason'of granting i9p2rmit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FORA -PERIOD OF ONE YEAR FOLLOWING THE FINAL.INSPECTION AND ACCEPTANCE OF THE WORK. ES77MATED RESTORA77ON FEES WILL BE HELD' UN77L THE FINAL STREET P4TCH IS. COMPLETED BY CITY FORCES; AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Construction drawing. of proposed work -required with permit ari heation: �s ��, r A 24 hour notice is required for inspection; Please call the Engineering.Departm ' �IZh 3202: Work is to be inspected during progress and at completion.l 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 the permit will be available on site at all times for inspects urposes. Signature: Date: 'Se tember 8, 1992 (C trac or or Agent) CALL DIAIrA-DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY ., .::: R1GRT_OF:. WAY:. DEPOSE' E AUTHORIZED; -VOID AFTER-..NOV..,...Z 1........,.:DAYS, .:.:. DISRUPTION<F. CIAL:CONDITIONS: N R RESTORATION . PERMIT. FEE:.. - ......._.. __ ............. TOTALFEE:,_ COMMENTS RECEIPT.NO:.. DATE:;;:�.;:,;:,::ISSUED BY:. e NO WORK SHALL BEGIN. ANCE'.. Engrg. Div. 1991 FIELD: INSOtCTIO OTES and III - Route copy to Street Dept.) Comments: Diagram: CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. July 1985 r M M Gat Avoww mb gyConromw W] Water main uupt.0 �•J P unknown Z" gas main -0 0 Addendum to City of Edmonds Right of Way Permit Application Submitted by: RIC.AAP�,D �t'L-06,Qp Engineering Aide Washington Natural Gas 622-6767 X2761 pager 9(,.q - 1(,obG -g- gas -ss- sewer $ water hydrant Q water valve 815 Mercer St. (P.O. Box 1869). Seattle, WA 98111 (206) 622-6767 M M Gat Avoww mb gyConromw W] Water main uupt.0 �•J P unknown Z" gas main -0 0 Addendum to City of Edmonds Right of Way Permit Application Submitted by: RIC.AAP�,D �t'L-06,Qp Engineering Aide Washington Natural Gas 622-6767 X2761 pager 9(,.q - 1(,obG -g- gas -ss- sewer $ water hydrant Q water valve 815 Mercer St. (P.O. Box 1869). Seattle, WA 98111 (206) 622-6767