17130 SEA LAWN DR.PDFIIIIIIIIIIIIII
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17130 SEA LAWN
DR
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ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):_
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: Ej Conditional Waiver 0 Study Required F] Waiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DA
PARKING AGREEMENTS DA:
EASEMENT(S) RECORDED FOR:
Willi;
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $- LID#: '
SHORTPLAT
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED -
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
LOT: BLOCK --
I R NO w- i It m(] W, k. 91"NMA
LATEMP\DSTs\Fomis\Shvd Filc Checklist.doc
APPLICAT-16AW WORK PERMIT.. ,*,,on 'No.
CITY OF EDMONDS Building Department Permit Limit, One.Yeai
APPLICATION ishe b mad for apermit to construct the following work, in accordance with the accompanying plans.
re e
and specifications:
Stories —
WORK — New ...... ................................... Ground Are&__._--..--.. NO
IA#ft . ..... ......................................... ....
PlansSubn-dtted ............................................ ....... ......... Const. T)rpe . .................................. Height. .....
'Use Zone. Fire Zone.-.—
..... .... . .. . ... . ... .......
LOCATION — Address ........ ...... .........
. .............
Recorded Lot ............ BIOCIL . ........... dd'n ........ . ............... X�� .................. .
';�P4 .. Side,_Z�'_
Lot Area_R.2� ... /-7( ......... Width ..... L!2 ............ Min. Bldg. Setbacks, Front and Rear
Owner. . . ........ ........................................... ............. I ........ ........ Address..
I �/ 2-z
Plansby . . . ................... & ..................... ....... .. ........... ph. LAS�7
Bldg. by ........ . ............ ..... .... ............. ....................... ........ Addres&--_.._------ .....
PIbg. by .........................................................
Heating by.
... Address ------------ ---------------------------------- -------- -- Phone —
Address ........................... ...
Phone.__.__-
Elect. by ....... ........................................................................ *,*-*-****" Address ..................................................... ..... . ........... Phone .... . ....
Remarks......................................................................
The above Is a correct statement and I agree to c�,Mply with all applicable Codes and State Laws regulating the work
arem.
Signed: Owner/Alent...141 .. . . ... ............. ..........
PERMIT for the above work Is hereby approved, subject to the above conditions, and to compliance with the approved p1ma
and specifications and Building Department notations thereon.
VALUATION &NEIT FEES
00 Bldg.
-0
.. ...............
00
PIbg.
APPROVED:
�G
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Date .......... ...
BUILDING DEPARTMENT
Byl....� .................. .
NOTES
Heat .... ----- -
Elect. ................................
-I-
Others... S ......................... . ..... =
TOTAL FEE ....... . ....
No work requiring7ullding Department or City Engineer's inspection shall be covered before inspection and approval.
Twenty-four (24) hour notice requested. Contact the City Engineer prior to construction of all site utilities, such as
curbs, paving, driveways, sewer, water and street connections.
APPLICATION
The City of Edmonds for
SIDE SEWER PERMIT EASEMENT NO.
NEW CONSTRUCTION REPAIRS LID NO. .. ......... ASMT. NO
t�f= I _ __ 1. - � - - _ . - - _ - - -------------
ONTRACTOR .........
OWNER F___
------------------------------------------------------- C
........................... ...........................
............... PERMIT, No - ------
JOB ADDRESS 1.7 1--5 (Z-14=111.
--- - --------------------- : -------------------------------------- .......... -LEGAL -DESCRIPTION-:- LOT NO.-.,: ---------- BLOCK
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NAME OF"ADDITION, .-5E
.................................................................... .......................... ----------
Approved:
DATE ------- ....... BY .......
J
.............
a
APPLICATION
for
The City of Edmionds SIDE SZWVR PFJUVM EASEMENT No . ..........................................
NEW CONSTRUCTION 0 REPAIRS
TA.M
0 . .... .......................... cowmAarm s o�Amws 7p-munT q..
............
...... ......... A
OWNER ,4.- . .......
ADDRESS --------- :5-k6tf ....... ....... Df.�.... LEGAL DESCRIPTION: LOT No - ------------ ------- ...................... BLOCK No . ......
I--,L� C- e.-�
NAME OF ADD17ION ............... SAa ......... k.R!IrA..�s ....................................................................................
ApprovW:
DATM------------------------------------------------ BY ----------------------------------
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lFrmit No. 3
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT S Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMIT FILE
A. *Address or vicinity of Construction
17130 So-alawn Dr.
Owner: Washington Natural Gag Co.
Name
805 156th Av. N.E.
Mailing Address
11
Bellevue, Washington 98007
City, . State, Zip Code
0 Contractor: same as above
Name
Mailing Address
City, State, Zip Code
0 Permit Issued To: 1,A) A
e Type of Work to be Done: Leak Rapairy hole to be
ope ed at 345' W. of 171 St. S.W.
e Work in Connection With:
El Sub or Plat 0 S31 ngle Faml ly
0 Comml. / Ind. 0 Apt. Condo.
9 Pavement Cut: El Yes 0 No
State License Number
285-9101
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, d.amages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be madc
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, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by'the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, al:
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&Q" site for inspection purposes at all times.
Signature: Date 9-2-83
Owner or Ag/nt
THIS PERMIT MUST BE POSTED AT THE JOB SITE FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Void after days
Special Conditions:
Ammendments:
Permit Fee: (0 n
Security Deposit:
Receipt No.:
Fund Ill Fee:
Street Cut Dimensions
X
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
FIELD INSPECTION ME-S
(Fund. 111 - 1
e conv to Street Dent.
Comments:
Diagram:
Contractor called for inspection Yes .-no
Work Disapproved By: Date: By: Date:
Work Aporoved By: Date:
Inspector:
EnQ. Div. December 1978
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41.
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"44"
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_fir;
CITY OF EDMONDS STREET FILE
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
F mit No. V7 — 16 7
Issue Date 1--l-el A7Z
A. *Address or v 'c ' n ty of Construction Permit Issued To:
17130 Sealawn Dr Plat 158-70.003 1
Owner: Wasbingf-cin Nal-iirgl r..qQ rn
Name
90 9" 156 All NE
Mailing Address
Bellevue, Washinaton 98007
City, State, Zip Code
Contractor: Same As Above
Name
0 Type of Work to be Done: Trstnl I Npira Spr-giep
Work in Connection With:
0 Sub or Plat IN Single Family
El Comml. / Ind. D Apt. Condo.
Pavement Cut: El Yes 0 No
Mailing Address State License Number
Z
< City, State, Zip Code Telephone Number
U
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
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.
0
U
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
0
0
0
1-
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 permi
I I
Signature: --A
Owne
�t, be available at the job site for inspection purposes at all times.
V A 10/17/79
THIS PERMIT MUST 13E POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:�
Time Authorized: Vold after —days
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit:
Receipt No.: —
Fund Ill Fee:
Street Cut Dimensions
X —
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
-Eng. Div. December 1978
FIELD INSPECTION-18ES (Fund 111 - Ae conv to Street Dept.
Comments:
Diagram:
W,
Contractor called for inspection Yes (no.)
work Disapproved BV: Date: Bv: Date:
Work Aporoved Bv.: Date:
Inspector:
Ena. Div. December 1978