17141 SEA LAWN DR.PDF11111111111111
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17141 SEA LAWN
DR
TAX ACCOUNT/PARCEL NUMBER: 6 6 &/ dw 00 *1V
BUILDING PERMIT (NEW STRUCTURE): —
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: F] Conditional Waiver 0 Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER): I I 10 - 4 1-'.? Z I 440"-(.t,) I I rQ
Z- z ZZ, - j =
PLANNING DATA CHECKLIST DATED:
S CALED PLOT PLAN DATED:
SEVV'ER LID FEE $: LID#:
SHORTPLAT FILE: LOT: BLOCK --
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) M
SOILS REPORT DATED:
STREET USE ENCROACHMENT PERMIT #:
FOR-.
WATER NMTER TAP CARD DATED:
9,111), a2�, / -7A 1�1;,94�
LATEMF\bSTs\Fonm\Sftrct File Checklistdoc .
POSTED UN KROLL M" NO.; PER�
710040
BUILDING DEPARTWENTWApplicnt'rili,
Inside Heavy Lines 7'oHADBjtxhS 0
PERMIT. APPLICATION 1 7-
-7;5r /,7 0 47 SIDE YARD* BETBACIC STREET B—BACK mE� YARD SETBACK
41 -
MAILING ADVRVUS f -64 0
us
NE )IC�ES ONO
Cit I
7711-17 HEIGHT AREA VAJUANC� NU—s- 16
7V
NAJ�E
Uj �1 -16 4-- PLOT 2LAN APPROVED
ADDRESS r-
STREET H/W
TELEPHONE NUMBER EXISTING STREET R, 3��FT. DEFICIENCY TMS PROPERTY
CITY
COMP. PLAN ST. R/W
REMARKS
NAME
Driveway slopes not to ecee e
on Standard Drawing #103.
CITY TELEPHONE NUMBER
RAN
METER S CLEA CE
STATE LICEN NUMBER CITY CICFNBE —NUMBER �11 SERV CE 1117.1;
CHECK" 1Yj
.%3 - o REMARKS
Lee.] De cription of Property (Show Below or Attach Four Copies)
4
TYPE CONNECTION VERIFIED BY
4 -4 er 4z-,e
4-eee7.� ed Pl-f-Z-e- C617 -6,0-c Or,
PERC. TEST PERMIT
f
REMARKS
'13
F]t�7:1 TYPErSTR ION STREET IMPROVED Z9
Tr
'S [3 No
SPECL%L INSPECTOR REQUIRED OCCUPANCTUF
RESIDENTIAL Cj YES 1)6 0
2/NFW GLIANSE PLAN CHECKED BY
J. -
NON-RESIDENTIAL
ADD R.l—NTNG Rf-M—AnKS
DEMOLISH WALL
E] ALTER EXCAVAT FENCE
E
OR FILL
REPAIR PRF-MOVE
POOL
INSP. S,'VI I
NUMB�� NUMBEIL OF
DWELLING
UNIT
NA:rj WORK DONE Vithuttl.. Fee Recelpt No.
Phi. Cheek No ....................
BUILDING
R
Z
PROPOSED USE PLUMBING
Q
MES
PLOT PLAN (Indicate Building setbacks, abutting st—ts) HEAT & GAS LINE
FENCE
SIGN
V
�ETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In.
fo given Is correct: and that I are the owner, or the duly author-
L
—sit..
Iz1d agent the owner. I agree to comply with city and state law. rezu- ATTENTION APPLICATION APPROVAL
ation of the Labor Code of the State of Washington
cobeftZlon; and In doing the work authorized thereby. no person
will be employ� in vtol This application is not a pernIlt until
.d TRIm reaurr
retailing to Workmen's Compensation Insurance. AUTHORIZES signed by the Rulldingofficial or his Dep�
ONLY TIIE
NOTE: Permit Limit One Year (F—pt DF-MOLITIONS which VrORK NOTED Uty; and fees are paid, and receipt is ac-
.hall be completed In ninety days: MOVED -IN BUILDINGS hall be cam. knowledged In space provided.
pleted in six months.)
AGENT) INSPECTION DIRE
BAT HIONED CTO t's sio
DEP RTMF24T
CITY OF
'Awi
EDMONDS
rl
NOTE: Applicant Subject to Plan Check Fee
PR 6.1107
This Permit coven work to be done an privet, property ONLY.
con.truetlo. .. the p.bIle do..]. (c-b.. .1d —Ik., d,N—alre,
Any .111 reeirilie separate
marquees, rte.) perml..Isri.
In INN
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Cityy,� of W
MRNT No.
NEW CONSTRUCTION REPAIRS 0
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CONTRACTOR .... .... ............................ PERMIT N6.
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AbI5hESS ...... ...........
...... .... V5. LEGAL DESCRIPTION: LOT No . ........... 17 ------------------------------ BLO�CK No . .................... I
...........
NAME OF ADDITION ........
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CITY OF EDMONDS
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SIDE
WATER -SEWER DEPARTMENT
PERMIT
Call 776-1107 for side sewer inspections BEFORE covering any portion of the con truction.
Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections)
ADDRESS LOCATION OF CONSTRUCTION ...................................................................................................................
PRO;ERTY LEGAL DESCRIPTION ..................................................................................................................................
................................................................ 0-*-*WERi%.ND/OR BUILDER ..............................
r-1 1,I),
Q.�'NTRACTOR'S NAME & ADDRESS ........................................ ............................. ......
17
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.....................................................
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............................................ ..................................................
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... ...........................................................................................
Permission is granted ........................................................... 19 ......... for repair and/or connection of a side sewer to the city sanitary sewer
system In accordance with City of Edmonds ordinances.
NTION IS CALLED TO THE FOLLOWING:
%
INI'6T' E 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.
J..;" 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 line and 12 inches inside property line; minimum grade of 2%. No bends in, grade
sharper than % will be permitted.
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original conditiom, Contractors sball 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 -
A
Eert the pipe into the wye.
DISAPPROVEDF-1 Date ... . ................................... By ................ Date .................................... By ................ Date --------------- . ................... By ................
Date .... !V
APPROVED
.............................. B -----------------------------------------------
y
Remarks: ........................................................................................................................... ...................................................................................... M__
----------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------- - -------------------------------------------------------
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
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...... 121 .............. ... hereby certify that the side sewer installation constructed under this permit
(Owrier of Contracting Firm PerfGrming Construction)
insWled in accordance with all governing ordinances of the City of Edmonds.
Dat
ed this .......... 6 -------------- day of.... 7 . .. ................. ..................
Check BEFORE you dig for: Water Gas E], Telephone Power E], Sewer Other 0
T,
TI _.- 7� .4:
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17
City Qf EdmondO
"RIGHT OF -WAY, CONSTRUCTION
PERMIT Permit Number. ��Z70
Issue Date:
A. Address or Vicinity of Constructiow. -17141 Sea Lawn Dr
9 0 B. Type of Work (be specific): Service Replacement 4�0
9 q I . . -
C. Contractor: _ Waghington Natur&l Bass
Mailing Address: 1122 75 St SW Everett
State License #: 98203
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 447-3284
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. [-] Commercial El Subdivision El City Project Ei Utility (PUD, GTE, WNG, CABLE, WATER)
C] Multi -Family [] Single Family Other
INSPECTOR: INSPECTOR: C_Jti
F. Pavement or Concrete Cut Yes 0No G. Size of Cut: H. Chargq_$
X
APPLICANT TO READ AND N 2--4
46
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City ofEdmondg harmlessfrom injuries, damages, or
claims of any kind or description whatsoever, f6rese'en or unforeseen, that may be made-againsiihW City of Edmonds, or any of its departments or
employees, including or n9t limited to the defense of any legal proceed migs including defense costs, and attorney fees by reason of -granting this permit.
THE CONTRACTOR IS RESP A �;Illpo_�R;PPERIOD OF ONE. YEAR)FAL6WING THE.FINAL
ONSIBLE FOR WORKMANSHIP AND M TERIAL
INSPECTION AND ACCEPTANCE OF,THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL. THE -FINAL STREET PA,Ti�H
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
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.
Ihave read the above -statements and understand thepermit requirements and thepink copy of thepermit will be
available on site at all ti r inspeptign purposes.
Signature: Date: 8-22-95
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY:
'TIME AUTHORIZED: VOID AFTER DAYS
SPECIAL, CONDITIONS:
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND III:
RESTORATION FEE:.
PERMIT FEE: 4 �F *4 �
TOTAL FEE: c,,�n. ep e-1)
COMMENTS: RECEIPT FEE:
DATE: ISSUED BY:
NO WOR K SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994