Loading...
1035 DALEY ST.PDF11111111111111 10721 1035 DALEY ST 9, 0 ADDRESS: TAX ACCOUNT/PARCEL BUILDING PERMIT (NEW STRUCTURE): I JW T)rJ&S 3 � S —r4 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): 2MD)4-`0 (±Cj 'gQ PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DA' SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: O GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DATED: OTHER:':�)O"10 �� — ✓ ✓ I t U��� i i1/�G� I �I(/t�� i D� L:\TEMP\DSTs\Forms\Street File Checklist.doc h RECEIVED �. CITY OF EDMONW 2 71993 8'1 D E 8 90 9 PUBLIC WORKS OtPI Address of Construction: Property Legal Description (Include all easements): 011 Owner and/or Contractor: G 7cA State License No. z4e- e ZZ gk C Building Permit No Single Family ❑ Multi -Family (No. of Units ) ❑ Commercial ❑ Public rr SEWER. PERMIT PERMIT N2 UO 544 Invasion into City Right -of -Way: 2-K'o ❑ Yes RW Construction Permit No. Cross other Private Property: D-No ❑ Yes 1 Attach legal description and copy of recorded easement I &ratify that I have read and shall comply with all city requirements as indicated on the back of the Permit Card. i" 7-�3 Date * CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION OFFICE USE ONLY * FOR INSPECTION `�k's, PUBLIC WORKS DEPT. Permit Fee: � TAT- � �a Issued By�i2. Trunk Charge: Date Issued: �"1 1�r-� /5 Assessment Fee: Receipt No.: J 1413 0 Lid No.: Partial Inspection: Date -Initial - Comments Reason Rejected: Date Initial i j Final Inspection Approved: Date%(-24Initia ** PERMIT MUST BE POSTED ON JOB SITE White Copy: File Green Copy: Inspector Bull Copy: Applicant dy 0 Revised 3!90 i 1 14 The City of Edmonds Side Sewer Drawing EASEMENT NO- ------------------- ---------------------- V/ NEW CONSTRUCTION ❑ REPAIRS Z LID NO- ------------------ -ASMT. NO..---.-----.------- OWNER------------------------------------------------------------------------------------------------ CONTRACTOR-----------------------------------------------------------------------------------. PERMIT NO. JOB ADDRESS � b 3 s ) �i-�� �--------------------------------- LEGAL DESCRIPTION: LOT NO. ...................................... BLOCK IVO.------------------------------------ PWW-0001-11/75 (REV.11/78) -------------------------------------------------------------------------------------------------------------------------- ..................................... NAMEOF ADDITION----------------------------------------------------------------------------------------------------------------------- 44 �{'Occp C• L 1.\D �*L IA vJC. � t�•V• G COK�I..N G ATV Approved: DATE l/ Z?- �3................ By --a --. ....................... `.rr per �f� � � •,> v � ,i � - .gauaawxamr Lam.. Y ti.i .oOieaV:i�amab+Mea41: CITY OF EDMONDS, WASHINGT( x BUILDING PERMIT tot hereby ce_--tifies that a plot, plan, drawings, and sufficient details to indicate iaon•;to`fuifill'illl requirements of 'this code are attached hereto. ttion is `hereby made for permit to do the following work: s:.! Lot..... Block........... .............. _ _...._....--................_..........-•--•-•--.._.._....--- A a xx ..........._--..........................-..--.. _..... .. ............ :i..a...........,�7 ..-t:...:;1:...... 7 f _i^ :Building dimensionss/ ...... ' Loi dimensi as .....fC'.0 ......x...... /1...I C.. ... f M2 hy. .3 Building will.be .1....:...I� .....stories. 4 Basement .72:L'........... tT S Occul.incy of building will be.....C:.21(.�:�...`US:>!'!!✓�t j.... ....... ......... G ........ .--_ feet from the nearest . d'oining ine. 7. ,Owner.:..__'�rL 1.�. /1�:�t.z_.._. IC,G:j 2r. =... . S. Owner's Adda:........... _... 9. Builder.. ._. ...._.ev 2�.. /. .. 1....................... ........ 10. - Ruilder's' Address.._9%-Y......... ... f..... ih�..r..._. ..................................................................... Date-..a`a._3........................19.c5. 4? (' r /) I • / J (Owner or. his agent) Permission ii hereby granted to do the work described hereon, according to the approved subject to compliance with the ordinances of the City of Edmonds. PERMIT N4 583 Estimated cost 3_Ll.L?l.''.......... This Spac6 Is • For City Inspecior. Only Y i prip;� _ •t r(:" 7 � plans and specifications pertaining hereto, �k.uG j; t ! �d i -�e•t rt�r .J1f e •li.f.:.'.!.:....... ..... _............. y- Ret®ev� b <Laning officer) Depietnient' of Buildings; y' l: 1j City' of Edmonds r �S[:1 T r 1. The building If permit fee which applicant pap when permit is issued shall be based on estimated cos[ of the - t proposed rtrvtture,•atthente of S2.00,for each", fia.•.,y,,,,� >` _ $t0$2 00 of con. If the actual cost of the structure, when finally determined, exceeds the estimated cos[ by more Than M appligm�sgrm to pav'u additional fee'": of $200 for etch $1000.00 of such excess con. ., ;ti>r. r- - 7,,.'�5�;,'`x,•5�. 3. Whenever a con[ntt for consrruttion is execvn_d for any structure costing more than $f00opu for which a !iceoxd archiem or mginar is not. regalted by the B. Wing Cod of the City of Edmonds, [he apPlica[ion for a building permit shall be semen xniedCamara" _t i1 p by a copy of the C mtnct sod a copy of the dealled . c . , 3. Prior [o employing any Tabor oi.mmmencin}. work, notify th2•Indn$tiai tnsurance'Division of the Department of Labor sod Indmala, kivl'sd esdtnito.of(: ":,<�• '.;± ttls{y�*z.• the payroll and make monthly reports of Payrolls. Pull instructions should be obtained•jrom the nearest office of the Department of Lahp_, and Itidnstries. Beforf� `' °'y'�r,'f-ay,`,'3�•t�7T,, ,r, finsl payment, the owner should obtain a relwx from the general coetrattori who in tum should obtain release from all sab•eontracton. The release should be a tuesiedlby the Department of Labor.a : Indust: . The above procedures are requirements of the State Industrial Insurance Act. i', `, Life of permit.6.].,no_:._........ due Plans filed: Yes jo/ No ❑ CITY OF EDMONDS `� PUBLIC WORKS DEPARTMENT RIGHT - OF - WAY CONSTRUCTION PERMIT A. *Address or vicinity of Construction 1035 Daley St • Owner: WASHINGTON NATURAL GAS CO Name 805 156 AV NE Mailing Address Bellevue, Washington 98007 City, State, Zip Code • Contractor: Same As Above Name Mailing Address JMit No.. Issue Date =' F .le • Permit Issued To: • Type of Work to be Done: Install a Main & Set.rir� See Attached Letter • Work in Connection With: ElSub or Plat {� Single Family ElComml. / Ind. El Apt. Condo. • Pavement Cut: ❑ Yes ❑ No State License Number H UCity, State, Zip Code Telephone Number a * * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE >. B. APPLICANT TO READ AND SIGN Q INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit. O WUpon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year G° following the final inspection and acceptance of the restoration by the Engineering Division. O H Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at which time a debit or credit will be processed for issuance to the applicant. Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call 775-2525, extension 220. I understand that this pe _ t ust be a ilabl# th site for inspection purposes at all times. Signature: ---------_Date — Owner Owner or Aert * * THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES CALL DIAL - DIG PRIOR TO BEGINNING WORK C. Issued By: s• Jam' ,.— -- . Time Authorized: Void after days Special Conditions: Ammendments: Permit Fee: Z/, Security Deposit: Receipt No.: w . Fund III Fee: Street Cut Dimensions X= * * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE'** Eng. Div. December 1978 FIELD INSPECTION N%k-S* (Fund. 111 R4o*e cony to Street Dent*.) Comments: Diagram: Contractor called for inspection., Yes Work Disapproved BY• Date: BY: Date: Work.Approved BY: Date: Inspector: Ena. Div. December 1978 ..................._.......District MAR __119ZVAID� City of Edmonds ---Water Department TAP CARD DatMAR .13 1956 PAID NO......................... Tap I No.................... Meter I Size .............................. Size.......................... Mfgo ....... ;; . . ...... .;,-/ ....................... Style................-----........ ................ For .. .. ... �9- .......................................................................... ................................................ . . .............................................................. . .............. .... I .................................................................................. * .... **-**",**",* ................ . .............. LotNo ........................................... Blk. No.................................................... Add. ........................................................ Service Location ... . . . . . ............ ... ................. ...... ....................................................................... 4 .......................................... Meter Location .......................................................................................................................................... MakeTap ............................................................................................................... ................................................................................................................... Pressure .............................. lbs. Test .................................... % SendBills to .................................................................................. ............................................................... ........ / . ......................... . .............. Date of Work ... ....... . ...... .............. .............................. ............................ Z 4 ...... ................................ . .............................. Foreman Guar. Voucher No ........................................... $ .......................................... Remarks: .................................................................................................................. .......................................................................................................................................... ET-.-.t"__4LE ............................ ............................................... ­b ........................................................................................................................................... ..................................... I ............... 7 ..................................................................................... ............................................................................... . ......................................................... OUTGOING Index .......... Reg ....... Route Bk ......... Stencil ...... Card—_ INCOMING Index .......... Reg ....... Route Bk ......... Stencil ...... Card ........ Ma/',al Chargeable to Installation Me,", NO. SIZE DESCRIPTION RATE AMOUNT ------ Meter .................. ....... 7 --- --------- r Meter Box'.:. ................ .............. ........ ............... .......... Meter Plate_ .---............... . ....... .............. .. . ......... .......... ............. .......... Check Valve .......................... .............. . ......... .......... .............. ......... Pipe, Galv. Screw .................. .............. ....................... .............. .......... Nipples ................................... .............. ) ...... .......... --------- .......... Bushings .............................. ............. : ............. ......... ............... .......... Plain Ells ................................ .............. ...... I ........ ............... .......... St. Ells .................................... .............. ............ .......... ............... -------------- .............. .............. ............... ............... .............. - ........... ......... . ---------- .......... . ........ .......... .......... .......... .......... Tees ......................................... ------------------ * ----- ------------ * --------------- * ..................................................... ........... .......................................... ...................................................... .................................................... . .............. ....................................... ...................... ��ftwft&��* ....................... ............... ------- .............. .............. ............... .............. .............. M. -------------- ...................... ............. ............. ............ ......... .. � --- �-44- ... W ........ I ------ .......... .......... .......... ........... a-�-mo ... I ........... Material Chargeable to Taps Connected NO. SIZE DESCRIPTION RATE AMOUNT .............. Pipe, Black Screw .................. ............. ...................... .............. .......... Pipe, Galv. Screw .................. .............. ............. ......... ............ Lead onnections .................. CurbCocks ............................ Corp. Cocks ........................ ... .............. .............. .............. ........... ....... ... W. ....... D .............. .......... Unions .................................... ............. ............. ........ .............. .......... Saddles ................................ ... .............. ........... . ......... .............. .......... Nipples .................................... ............... ............ ......... ........................ Bushings ................................ . -------------- ............ .......... ......... ..... .......... Plain Ells ................................ ............ ............. .......... .............. .......... Street Ells .......................... ... .......................... .......... ......... .......... Tees .......................................... .............. ...................... .............. .......... Curb Boxes ............................ .............. ............. .......... .......... S. O. Extensions .................... .............. ............ .......... ............... .......... Gates ........................................ ............... ............ .......... J ...... ------ .'-C,0,U1P,lin,'g­s'­ATa P................... - --- '— - -------------- - -------------- -------------- ------- ---------- .......... .............. .......... Gate Boxes ............................ .............. ............. ........ . . ............................. .... .......... a, ... ... . .... ........ .. ... ....... ............. .............. ..... . . . ... .... .............. .............. ....... ...... .............. .............. .......... .......... ........ . ........ .......... ............................................. ........... ........................................................... ............. .............................................. .................. ............................. .......... ........................................................... .............. ...... ..... ........... .............. .............. . . ...... ...... ... . W. ............. ............ ....... . ........ . ........ .............. .............. .... ............... .......... .......... ............................ T ....................... a ..... ;.... ....................................................... - Hours Tifife—Day-,�--en .......... t­. ............... -------- ....... !T ...... ............ --------- " --- ............ .......... ** ...... .......... ........... ......... t . ...... . Hours Time —Monthly Men ................ ............... ... -?"Aw ..... I iK4� ......................... 11 Hours Time —Auto ............. ... .............. ....... ......... ............... I .......... . superintendence ...................... .............. .. . ..... .. .......... . Total .................. ..... .... W e