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PERMIT EXPIRES U
CITY OF EDMONDS- :aE PEZR=�a/_d1l
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THE STATE OF wAExlxoiox RELATwD TO
FOR INSPECTION
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771-0220
ATTEN N
EXT/333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL'
771 0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
APPLIGATIUN APPNUVAL
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City of Edmonds
890 19�)
C. Contractor:
Mailing Address:
State License #:
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number.
Issue Date: a - 9
A. Address or Vicinity of Construction:
B. Type of Work (be specific): (1 t e�0 is C U f
Contact: J' l M W u l 4
Phone: -7 7 ff -7 % /
Liability Insurance: Bond: $
D. Building Permit # (if applicable): /J 1/-1 Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project ❑ Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family Single Family ❑ Other
INSPECTOR: INSPECTOR:
F. Pavement Concrete Cut - Wes ❑No G. Size of Cut:_ x la i� H. Charge $
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from 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 its departments or
employees, including or not limited to the defense of any legal proceedings including defense 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 THE 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 of proposed work required with permit application.
A 24 hour notice 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 the permit will be
available on site at all times for inspection purposes.
Signature: Date:
(Contractor or Agent)
CALL DIAL-A-DIWPRIOR TO BEGINNING WORK
f�, FOR CITY USE ONLY I
APPROVED BY: `- � /� RIGHT OF WAY DEPOSIT 1 �` A
TIME AUTHORIZED: VOID AFTER Al fA DAYS DISRUPTION FEE/FUND III:
SPECIAL CONDITIONS: A"— t O oe- 4 70,44E RESTORATION FEE:
COMMENTS:
DATE:
PERMIT FEE:
TOTAL FEE::pp ,r
RECEIPT TiiBd:�%%rS
ISSUED BY: J
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES
Comments
Diagram
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
(Fund 111 - Route copy to Street Dept.)
❑ YES
Date:
Date:
❑ NO
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
EASEMENT No . ....................... ....................
NEW CONSTRUCTION ❑ REPAIRS 0
108-0Q400
OWNER.......... b1nma-ter., ... Joe .... ......................................................... CONTRACTOR .................................................................................... PL MAVT
.............. No. ......................
ADDRESS ...... 1050.Aalnut...St; ........................................................... LEGAL DESCRIPTION: LOT No . ....... ...................................... BLOCK No . ..................................
NAME OF ADDITION ........ . .........................
Dye Tested On Sewer
1972
Approv�d-
DATE.-, ... ........................................... By .................................... ............ ... .........
890 19C!I_
CITE' OF EDMONDS
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-3202
COMMUNITY SERVICES:
Public Works • Planning • Parks and Recreation • Engineering
CERTIFIED%MAID;
April 4, 1991
James Hurley
1050 Walnut St.
Edmonds, WA 98020
RE: Problems with venting of your plumbing fixtures
Dear Resident:
LARRY S. NAUGHTEN
MAYOR
PETER E. HAHN
DIRECTOR
The City's sewer cleaning records show that the home at this address is
experiencing problems with the venting of some of your plumbing fixtures
when the City crew is conducting cleaning operations of the City sewer line
in front of this address.
The City's cleaning operation is essential for both you and your
neighbors. It cleans debris in lines to prevent plugs, prevents corrosion
and potential future collapse, and achieves a better flow characteristic in
the public sewer lines. We need to do this often -- perhaps even 3 times a
year -- in some critical areas. The City's cleaning operation typically
involves the utilization of a high pressure water jet.
The problem which occurs at the home is the result of a high pressure surge
through your internal plumbing system. A properly constructed plumbing
system is designed to easily vent this additional pressure without any
visible impact at your residence. An undersized venting pipe (or not
having enough vents) cannot handle the pressure surge, and the only release
that's available is then through your toilet (or another fixture). The
Uniform Plumbing Code typically requires a 2" vent, and further requires a
separate vent for each plumbing fixture which is connected to the sewer (a
toilet, a sink, a shower). Your home clearly does not have an adequate
venting system (you either have--a'1-1/4" vent, or'not enough of them)., and
you therefore may continue to experience the pressure surges.
The City does not have a choice as far as discharging its responsibility in
cleaning the public sewer line. It is therefore up to you to take
corrective measures as to how to properly vent your own plumbing system.
The City has come up with two options that will remedy your problem:
Option 1: Upgrade stack vents for toilets and other fixtures which
are experiencing problems to required sizes.
e 1-1-olporatca' Atx..: j 1 1F.y(t e
Sister Cities International — Hekinan, Japan
Page 2
Option 2: Install a clean -out outside of house per attached
specifications. Enclose box so it can vent properly when
excess pressure is put on house lines. This option would be
the cheapest and simplest way of correcting this problem.
At the same time, it would allow access to sanitary sewer
lines if stoppage should occur. This vent clean -out would
allow a place for backup in lines to go before entering your
house and causing costly damage.
The City would appreciate your expeditious cooperation in this matter. The
City must continue proper maintenance of its sewer lines, but we obviously
do not wish to see continued problems occurring on your property because of
poorly designed vents. It is your responsibility to correct these
deficiencies.
We cannot keep notifying you each time we come out to clean the line. It's
up to you to have a plumbing system that conforms to code. Option 2 is a
relatively simple one to construct.
Should you have any questions on these options, please call Everett Akau,
Scott Highland or myself at 771-3202, extension 317 or 318.
Sincerely,
Ron Holland
Water/Sewer Supervisor
Enclosure
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CA FILE NO.
Critical Areas Checklist
----------- - -------------------------------
Site Information (soils/topography/hydrology/vegetation) —
1. Site Address/Location: / 6 S (' "
2. Property Tax Account Number: 1__� 3 1-1 -a 05 5015 ODD 8
3. Approximate Site Size (acres or square feet): G,, OCU, ti
4. Is this site currently developed? X yes; no..� 'd
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of
10-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: ; Approx. Depth:
7. Site contains areas of seasonal standing water: ; Approx. Depth:
What season(s) of the year?
8. Site is in the floodway —A2floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? (What time of year? ),
10. Site is primarily: forested ; meadow ;shrubs : mixed _
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
��_��---•------------�.'--�"' ..:-�:forCty`Stati':[JseOnly.�� .. ---- .--------- ~--------
L Site is Zoned? :. :-- ,
SCS ma ed-soil -type s: ? .. .11 1y'T T- Gn 12 A V - ' i 1�1b L6AM Z b az
2: RP (.)
3; Wetland inventory or C A : ma olds
wetlan' present on site?
4. Critical Areas inventory: or C.&4h in tcates.Critieal Area on site?.
5. Site within Aesig'W :earth:Pbsidence landslide. hazard area.
6. Site:designaied on thi Eaviroamentally. Sen§i ive... ... Map?
DETERMINATION .
STUDY MVIiiED CONDITIONAL WArVER :
WADER ..
Reviewed.by; 1,
Planner..::... Date.
-q cek.dw- Rev 10/03/97
°4 °"'� City of Edmonds
. �d
Q ..' Development Services Department
Planning Division
Phone: 425.771.0220
j Fax: 425.771.0221
DATED RECEIVED:
CITY RECEIPT #: /694 6`0
Critical Areas File #:
Critical Areas Checklist Fee: $45.00
DATE MAILED TO APPLICANT:
CRITICAL AREAS CHECKLIST
The Critical Areas Checklist contained on this form is
to be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of a development permit to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The
information needed to complete the Checklist should
be easily available from observations of the site or data
available at City Hall (Critical areas inventories, maps,
or soil surveys).
An applicant, or his/or representative, must fill out the
checklist, sign and date it, and submit it to the City.
The City will review the checklist, make a precursory
site visit, and make a determination of the subsequent
steps necessary to complete a development permit
application.
Please submit a vicinity map, along with the signed
copy of this form to assist City staff in finding and
locating the specific piece of property described on this
form. In addition, the applicant shall include other
pertinent information (e.g. site plan, topography map,
etc.) or studies in conjunction with this Checklist to
assistant staff in completing their preliminary
assessment of the site.
I have completed the attached CRITICAL AREAS CHECKLIST and attest that the answers provided are
factual to the best of my knowledge (fill out the appropriate column below).
PLEASE PRINT CLEARLY
Owner/Applicant:
Name
Street Address
1AA- ((20D3
City State Zip
TelephoneL51Q — ��
Signature U
Date: /Z
S— O
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Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Signature
Date:
PLANNING DATA
NAME: DATE: C - P-� - n-
SITE ADDRESS: 1 O 5 PLAN CHK#: O q - t4 c�C�
PROJECT DESCRIPTION: _ �- ,'�c� �,L� �,, ,�, e- ',_.k —o,.,_ +N LDIF\-Z-
REDUCED SITE PLAN PROVIDED?: es / No
MAP PAGE: `LO Li CORNER LOT: es / o FLAG LOT: Yes N
ZONING: CRITICAL AREAS DETERMINATION M
❑ Studv Reauired:
J4& Waiver
❑ Conditional Waiver
SEPA DETERMINATION:
❑ Fee
❑ Checklist
❑ APO list w/ notarized form
❑ (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
Exempt
SETBACKS:
Required Setbacks: o 0
Street:�Left Sider Right Side: Rear: l�
Actual Setbacks: a
Street: Left Side: 2' ' 215 Right Side: Q Rear: �JId
Street map checked for additional setback required? Yes fNtl DNA
❑ DETACHED STRUCTURES:
❑ ROCKERIES:
❑ FENCES/TRELLISES:
❑ BAY WINDOWS / PROJECTING MODULATION:
❑ STAIRS / DECKS:
PARKING: Required: Actual: iw 9 c
LOT AREA: � Gj co bra �Z� i k (n-a�o
LOT COVE
Calculations:L_ 4 g
BUILDING HEIGHT:
Datum Point: Datum Elevation:
Maximum Allowed: Actual Height: �` 1
A.D.U. CREATED . o) Yes
SUBDIVISION:
LEGAL NONcgNFORMING LAND USE DETERMINATION ISSUED: es
Plan Review By: _= e� A e- C (-� Pr�, Z1,
NewBPPlanningDataForm.DOC