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17109 SEA LAWN
DR
TAX ACCOUNT/PARCEL NUMBER: ff-2
BUILDING PERMIT (NEW STRUCTURE):_...Aoc�
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: 0 Conditional Waiver [j Study Required E] Waiver,
DISCRETIONARY PERMIT
DRAINAGE PLAN DA
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED
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PERMITS (OTHER):. Iff-1) - 41-)Z 643 k,_I�doaj 1 dy-3 - e9l �5
SCALED PLOT PLAN DATED:
SEWER LID FEE LID#:
SHORT PLAT FILE: LOT: BLOCK -
SIDE SEWER AS BUILT DATED -
SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED -
STREET USE / ENCROACHMENT PERMIT #:
FOR_
WATER METER TAP CARD DATED:
OTHER:
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APPLICATION &( VILDING PERMIT
CITY OF EDMONDS Building Department
L/
'appl. No ...
Pe-aut limit, 6 n6 year.
APPLICATION is hereby made for a permit to construct the following work� in accordancl. with the acOOM.-'
panying plans and specifications. Two sets are submitted herewith for approval.
nevf-"'� alter Off -St.
............................... Parldrig ......................
Work addn repair --------- e_
Occupancy .... Const. type ..................... * ....... Use_zone.:S'.:�L�71 ........ Fire zone ............................
---------------
aed
711, 2 .............. AdPn ..... ........ a&.Lae�__
Address;4ZTr� ...
Lotfrontage ----- * ................................... Area -------------------------------------------- Septic tan
f'__ -7Z-
......................
......... rear
Bldg. set-baclo front ..... r. side ......... & ............... 1. side . .......
,I.
....................... .... T,
Owner.-., -1. NX ....
Address............... .................................... Tel. No .............................
Builder --------------------------------------------------------------------
Plansby ------------------------------------------------------------------ Address ..................................................... 'I'el. No .............................
Thi......... ..................................................................... .
Remarks ... 6 ...... s..Peri-lit..r,-o-ver.s---wo-r-k --- t 0 --- be�--dur.�-i -------------
.. ...............
n private pro -,rty ONLY.
. rL . y4-
Ar ......... ............ ....
---y const3"-
....................
'-.0' Si
d-i- owayo, marquees,
.............
r ........................ -------- ------- ---------- ------------
................................................
T ith all applicable Codes and State laws reg�ulatin :-.this
The above is a correct statement, and agree to comply w 9.
work.
V V
.. .. ......
Signed -------- Address .............. Dat
PERMIT for the above work is,hereby approved, subject to the above conditions, and to compliance with'the ap
proved pLv-,s and specifications, and Building Department notations thereon.
1111V I
........ . .... .. ... .... .. ..... t ........
Valuation ........... 1.2,!5 ------------- Permit fee ...... 3.4 ............. Recd.
....................... .. ..
Building Department, By ......................................... ..... et./47 4-r ......... Date ...... .. . :n.&
This Permit does not cover Plumbing, Sewer or Electrical installationS. t'X1
STREET FILE 0
LA
SIDE /0'
REAR 2t-
OTHER
1-!rlG:T --
CITY OF EDMONDS
BU4DING DEPARTMENT
WORK -j�QQ)TADA)
ADDRESS 1210
OWNER
APPROVEDDATE: 2-177PZ-
BLDG.OFFICIAL
PERMIT NUMBER
STBEET FILE
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Aft(-W-T CAL�S-
+ 411. YX
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FEB 0 5 1992
PEW COUNR
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CITY.OF. EDMONDS STREET FILE
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Submit in Triplicate)
ADDRESS OF PROPERTY .... t. 7.1 t ....... Sea Lawn Drive ................................... Lot No ........ 6 ............. Permit No .... 1.7.6 .......
.....................................
Owner_ Stewart Petersen 9521.Edmonds Way Edmonds PR 6-4843
Address . .. ................... Phone ........................
It It is It to it
Builder--------- ----------------------- ....... ........... ...... ....... . Address .............. --------- ------- .................. ................ Phone ... ....................
20019 Iiiway§ 99 Lynnwood ........ Phone ... PR ... 8-.310.1
Designer..M.. B. Mey.ring .... Address ----------------- ........... .................... .... .. . ...... ..
I ... ...... .... . ... ........... .
Installer- - LYARwQ0J .. SeVlic Tank ...... .... Address.026 - 212th__V1J_'�yAWq94 ....... PR 6-71*37
...... ..... ........................... ----- _ Phone ........................
I hereby certify the accompanying drawing is an accurate representation of the system installed at the listed
address. I also certify all recommendations and restrictions (concerning plumbing stub elevations, maintenance of
grades, fills surface drains, etc.) listed by me on my sewage disposal system permit application dated ................
. ....... . � W7/44_ ............... have been complied with.
7/14/64
Sign a t u re of D e Date
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted .............. ....... ....... _ ................ ....... .. .... Date.... 7.
NotAccepted ..... .... ................... ......... .......... Date .......... ........... . ..... .........
Signatureof Sanitarian ............................................ _ .................. ......................
Remarks: ............................................................. . ................................................................. ........................................................
INSTRUCTIONS: Use the reverse side of this form for the drawing. Use a scale which will permit the greatest
detail and still contain the entire site on one page.
ATTENTION HOME OWNER:
Your septic tank has limitations! It was designed and installed to care for an average -size family. Over-
loading the septic tank or disturbance of the drain -field may seriously impair satisfactory operation. Points to
remember:
1. Have your tank checked periodically to see if pumping is necessary (2y2-3 years).
2. Do not channel ground water, surface water, footing drains or downspouts into the tank or drainfield.
3. Do not excavate, fill, place a structure, driveway or,patio in, on, or ove'r the drainfield.
4. Limit toilet fixture disposal to sanitary wastes and toilet tissue.
5. Detergents and bleaches used in normal household quantities will not liarin the action of the* septic tank and
disposal field.
Z11
210 Lin. Ft. Tile
3 Ft,, Trenoh
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AS BUILT SEPTIC TANK & DIRAINFIELD
lot 6, Sea Lawn Terrace, Division A
City of Edmonds Wash.
July, 1964
Permit 176
Issued 7/7/64
.Builders
Stewart Paterson
95,21 Edmonds Way
Edmonds, Wash.
Designers
M* Bo Mayring
Box 32
Lynnwood, Wash.
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SEWAGE DISPOSAL PERMIT No . ..... .........
Septic Tank ............ ----- gals. CITY OF* EDMONDS
Department of Public Works
Disp. Field ------ ....... sq. ft.
Other------------- ---------------------- ---------- -
A tall/
is hereby a —or ze
---- ----------------------------------------------------------
Name ------------------- -------- repair sewage disposal -system at
40�r!< --------------------------------------------------------------------------------------------------------
----- Qj
Date issued on ------------- I ------ - ---
Permit expires one year from aate of issue
cy-mVIR OR SANITARIAN
DO NOT COVJ�R'BEFORE APPRI11111
sions of the City
d under my supervision and control and complies with all provi
I hereby certify this system was installe
oi- Edmonds Resolutions.
Date-----------------------------------
Signature of Installer --------------------------------------------------------------------
.... . ..................
------------------------ By -----------------------------------------------------
Approved F1' Disapproved Date --------------------
-------------------------------
--- -------------------------
--- --------- ------------ -------------------
..... .......
Remarks: ------ I ------------------------------------------- --------------------
Date------------- : ---------------------------------------------
GNER ------------------------------------------------------------ * ------- ---------------
SANITARIAN OR DESI ed.
lace on e job until inspection has been complet
This pe mit ihall be post . ed in� a reasonably consP cu-- V
04,
*I* *I*
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to:_.$tj4MXVt..PAt8Mfin ......................
For installation at: (street address) ---------- .......... C>�'::� . ....
...............................
Addition or Subdivision ..... .......... Sea lawn.-Mbrilm. Xv- -A -------------------- ........... Lot ---- 6 ......... Block ................
Type of Building: New ............ Existing. - _ X .. Single family residence ..... X ....... Number of bedrooms ---- 3 ....................
Other: (specify type or use) ..................................... .......... ------------------------------------ ___ .................................................... .........
Builder. .... StSEW. ..Peterffen ..................... ....... _ ............. Address ------- 9521 -1khond&-Vw_Zftoud* .......................
Designer.. 11*B .. Ney101n ---- ........................... I ............. 1 ........ Address._ F0- Box--32-- -------------------- ------- -- -----
lqmlw*od
Soil Log Hole No. 1 ----- Oto .20,-SmAy. - grgral with traos of olaq
........ 2O.A030--sandy --- loan ---------------- W-to ... 5V'. - ss,314 --- o1v --- I ---------------_- _ ......... 1-1 ............................................
SoilLog Hole No. 2 ... ........ ........... ... Same ------------_--- ___ ___ ................... ------------------------------------------------
......... I ................................................................................................ ----------- ........... .......................................................................
Elevation of Water Table, if encountered. (Distance from ground surface) ...................... mme ----------------------------------
Corrections to control surface water if needed ............ Z..;' ale ............ /0/ .......................................
......................................................... .......................................................................................................... I .............. a ......................
Specify if any removing or grading of topsoil in field area.— ---- lw..g-nding ........... ..... ..................................................
............. Aw .. ........................................................................ ...........
Percolation:
Test Hole No. I —Average Rate ... 20 ..... . (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 2—Average Rate ... 60 ... tbis --- area ... no.t --- use. d.. (Fall in ininutes/inch-bottom 6" test hole)
..... ......... .........
Test Hole No. 3 —Average Rate ... le ............ ........... ....... ... . ....... (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design ......... 2D_ ...... I .............. Date Taken_.6/1/"*64 ......
Septic tank requirements based on present rules and regulations:
Septic Tank Size ---- 900 ................. gallons.
Amount of Square Feet of Disposal Field ... 630 ......... . .....
10
Date ................
--------- -------- .. ................. .... . 64 ..................
Signati s ner ..... .....................
pre — De ig
DO NOT WRITE BELOW THIS LINE (-j(o/e completeVb
y ISSUing Agency)
Permit issued (date) ............. -.51 .................... Permit Number ......... _/7c/o .....................
Remarks: . . . . . .. ... ... . . ........................ ... . ......... . ........... . . .........................................
................................... ....................................................................... ....... . .....................................................................................
APPLICATION
for
T!,�"ity of Edmonds SEDE SEWER PERrMT
EASEMENTNo . ..........................................
NEW CONSTRUCTION REPAIRS
. .........
PWNER .... jR.q..w ... ........... CONTRACTOR ....... ............ # ......... PERMIT No.,Z367-1
ADDRESS ... ........ . —5�e-tl ... zq..t, ....... LEGAL DESCRIPTION: LOT No . ......................... 6 .......
... ............ BLOCK No . ............................................
NAME OF ADDITION ........ ........
15S. 72-
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C)
co
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APPROVED
APR 23 1970
Approved:
DATE..... .......................... B .... ......................
Zo 7' Za t,..A ii so 4#, . 4, 1.2 r * ire C' 0 A C-AP,
2 z 0 r 00 /a I-S, k7 /:lot &tc '0C*
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77
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CITY OF EDMONDS
Call PRospect 6-1107 when work
CIVIC CENTER — WATER —SEWER DEPARTMENT is ready for inspection. (No Utspec-
N2 3678
tions Satm*day, Sundav or holidays.)
SIDE SEWER PERMIT
17109 .........................................................................
ADDRESS ---------------------------------------------- n ... Drimp,
.............................................. CONTRACTOR ........ 4Y�L!�� --- ............
OWNER ................................. Folsom 11'.S. ..........
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.pil 23
...... Ap
Perniission is granted . ........................... 19.7Q., for ------------------------ days to REPAIR or CONNECT a side sewer
file
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with City Sewers in accordance with application on and governing ordinances.
A
'I 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 nut cover any portion of sewer before it has been inspected.
NOTE No. 2 —Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permIt.
NOTE No. 3—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 20/0.
No bends in grade sharper than % will be permitted.
NC )o. 4—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. 5m—It is unlawful to aiter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appur-
tenances except to insert the pipe Into the wye.
V 0
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CITY OF EDMONDS
CONSTRUCTION , PERMIT APPLICATION
OWNER NAME/NAIVIE OF BUS14SS
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Z MAILING ADDRESS
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CITY ZI P TELEPHONENUMBER
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LUu ADDRESS
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< CITY ZIP TELEPHONE NUMBER
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USE
ZONE
JOB
ADDRESS
PERMIT
NUMBER
DIVISION NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — REOUIRED DEDICATION
PROPOSED
REMARKS.
X
�AME
* ENGINEERING MEMO DATED
ADDRESS
111 0c, 5E.4 4-A(,jAj L)pe. METER SIZE 1BUILDINC
ZITY ZIP TELEPHONE NUMBER
er). IS6260 1 TY3 7037 REMARKS
STATE LICENSE NUMBER
su
TESCP Approved 0
RW Permit Required
13
Street Use Permit Req'd
13
Inspection Required
0
Sidewalk Required
0
uj
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UAEW BY
X,*
'PLY SIZE NO. OF FIXTURES
T3
DO _5 ]�j ��t% . SIGN AREA SEPA REVIEW
Legal Description of Property- include all easements ALLOWED PROPOSED COMPLETE EXEMPT
0� Tiew EXP
VARIANCE OR CU PL94NING REVIEW BY
!12 1::� L__11 VO X-4
'71 k,-16C 0 116 SETBACKS — FEET
FRONT 7_S" SIDE
Tax Account Parcel No. 56 too - 000 - 6ao - CW4
ElNEW RESIDENTIAL PLUMBING
KOLTER COMMERCIAL MECHANICAL
E] REPAIR El APT. BLDG. El SIGN
GRADING FENCE
DEMOLISH CYOS. I X_ FT)
CARPORT swim
REMODEL GARAGE POOL
WOOD STOVE/ r7 RETAINING WALL/
INSERT I I ROCKERY RENEWAL
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
_qp- k k, 0 '1 Q c. 's VyA CG
NUMBER OF STORIES NUMBER OF
DWELLING we
UNITS_ ___
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
U; XjG
/4 kE.4 ;I- &x5 AIJ &EDe 0 044
N
IHEIGHT
12T /
Irel
DATE
U
k4elre
CHECKED BY
.
TYPE OF CONS AUCTION
CODE
HEIGHT
I
I
.
I _V —
I SF,
2-T
SPECIAL INSPECTOR
AREA
I
OCCUPANCY
OCCUPANT
REOUIRED
13
1
GROUP
1 3
LOAD
REMARKS
PROGRESSINSPECTIONS PER UBC 305
7?4r,fP"A/_ pex I'M
FINAL41NISPECTION REQUIRED
========I VALUATION FEE
PLAN CHECK FEE
BUILDING
R01 - 04)
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewolks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse hei�sj,'assigns and
successors I n interest, agrees to lndem�ifyr,�.-,;0repj-and hold
harmless the City of Edmond It ,'flts�officials,
employees, and agents from any VIS, for damages of
ENG. INSPECTION FEE
IL06
PLAN CHECK DEPOSIT
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of..this permit shall not be.deemed to
modify, waive or�reduqq aq� requirement of any cify�llirdinance
nor limit in any'way-the City's ability to enforce any ordinance
provision."
TOTAL AMOUNT DUE
I hereby kknow(edge that I have read.this application; that the
information given Is correct; and that I am the owner, or the duly
ATTENTION
authorized agent.Of the owner. I agree to comply +th city and
state laws regulating construction; and in doing the work authoriz-
ed thereby, no person will be employed in violation of the Labor
Code of the Stat� of Washington relating to Workmen's Compensa-
THIS PERMIT
AUTF40RIZES
ONLY THE
WORK NOTED
T
Si
D
tion Insurance.
I NSPECTION
DEPARTMENT
CITY OF
EDMONDS
a
R AC
FATE
is I G�N �ED
0 - CALL FOR
AttENTI(5N INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771 -;3202
0
APPLICATION APPROVAL
his application is not a permit until
gned by the Building Official or his/her
eputy; and fees are paid, and receipt is
cknowledged in space provided.
TURE DATE
3;� __7 69- �� 2-
nL/— / DATE
-7
ORIGINAL — File YELLOW — Insoector