17161 SEA LAWN DR.PDF11111111111111
12986
17161 SEA LAWN
DR
40
I
TAX ACCOUNT/PARCEL NUMBER -
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRIT ICAL AREAS: DETERMINATION: E] Conditional Waiver Ej Study Required [-] Waiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DA:
EASEMENT(S) RECORDED
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMrF(S) #:
SOILS REPORT DA
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DA
OTHER:
LID
BLOCK -
LATEMP\DSrs\Fbmis\Suwt File Checklistdoc
da
4 61
Der j<
09
PI Z6
K
41
cd f,
Cr
vmi
f C,
'Eat /( EIVED
ch- 2 3 20Ul
23-466. B DING DEPT.
-,PLAN
�VA - A /V ji
]"RE
509 'fe -- ,
S(JNOII(13 z10 Alto
S301AUIS
IN-3N613A-30 >'Z'79d- 4A--7 '70OW-01,00V
AVIV CD
-f.- Y,3 -X&//
4 XF C7.0,/
N=G
N!
9, 0 A OTd V
D -4 ci
ru oh
v-1.1,YC7 V'j
0
ol
" .O.t
i�oyv, zv7
if 4 h
14� vo woob'Nins.
�d �Qwd i
s ,p v ap.-A -10 -b Wo
B-Sl
ED
Ap
0' Q-Z C 1 -7 V r7 >V
0 1
+ CJ
I (:j
1 4-
al v
J. v A4
POO
W!;,F 17-7
7 VVS -',67V
4AjY(f NAV
.9 -a-)Vd6MS SnOIAY5rdltil
bl.7A,P-7 AJAV"S
—LO 7cj
STREET F1LEw=jmVm' CHMMS?
-/ A V
APPUMMON RaC= DM: 'Yllproe
Reviewed by- (iriitMi7date)
CaMENTS
PLANNING
WIR/SWR. STREET ENGNRNG
FIRE
BUIMING
/77T/////
1111117711
SnCEZ FAMI�Y/MMTME/CM�WCIAL - (Circle One)
SMW,CKS CMD=F(ED - Plaming
117111111,11111711
1111111711
VARIM,XE/SETFACK AW.
/////////
////////
I
TR-17T-
771111111
1111-177T
CONDITIONAL USE PETMT
/////////
////////
2
�777777-77
7TIl-1717
I-ITI-171-TFI
ADB CHECKED
////////
3
7TF17T
111TITff
77T777TI77
OTHER ZONING RE=REMENTS
.............
4
.
7-
ENVIROMAENTAL FEATURES
"7T
5
ACCESS SLOPE & VEHICLE ACCESS
/T=777/7T/7
6
DRAINAGE PLAN (On Site) ej a4g�24��
7
f V
7 7
7 47 7 T1 /W
7 1771 TW
7-1-1771-1
STREET FILE
/////////
/////////
////////
8
LEGAL D&SCMPTION VFRIFICATICtq
TTIT17W-ITITTITIMITITITIT
9
TI-7111111
177-ITIW
QUIT CIAIM/DEDICATIONS —77
10
EASEMW - PUBTIC/LFE221�:2
77777777777777777
/////////
////////
11
4,
7777-7
TF111111
//// 77T
77TTIT17'
CALCULATE SEKTR CONNBCTION IF NO LID#
12
177777Tff
7777TI I I
PLAT/SUBDIVISICN REQUIRU-aM
13
777777
Rigtrr-g-my coNs�tumoN Pm*uT REQD
14
BOND REQD FOR PUBLIC IMPROVEMNTS
177777
//////
117177111
/////////
15
SOITS MMITIONS & GROUND
11111T
77777777T77777777
WATER FIU-,D CHECKED
//////
/////////
16
/77777
T/7777777
ST1M PAVING REQUIRED
/////////
17
777771111
CURB AND GUTTER MQUIRED
18
777777T/7
SIDEWALK REQUIRED
/////////
-777777777
19
T7-7777
CURB CUT FOR DRrMAY REQD
20
777777777777777
STREET NAME SIGN REQD
/////////
/////////
-
21
-
77777777777777
77T/777-77
OTHER SIGNING REQD
22
SIDE SEWER AVAILABILITY
23
EXISTING WATER MAIN SIZE
11111711
////////
7Trl=
24
7TR11111
TT17717U7
WATER METER SIZE
25
SERVICE LINE SIZE
7=
77777TIT
/////////
177TT17T
////////
26
1111111111177111111111111111
/7T/T=
HYDRANT REQUIRED
/////////
/////////
////////
-7TTI='
27
77-77=7777
11171177
HYDRANT SIZE EXISTING
//////
/////////
��IA
////////
28
111711
f177T7T17
777177
777 7 7 / 7 7
CROSS CIONNECTION INSPE=ION RMD
JML
////////
29
WATER METER CHARGE REIM
77FITI-1
////////
77-li777V7
-
30
FIRE LIM CHARGE REQD - SPRINKLER
11111117-7T11111171
STREET CUr
32
OPEN DITCH EXISTING
33
171171771111111
R=
//////
/////////
34
-777777777T/77-77-
ajLVERr PIM
-17TIT
135
SIZE
1111ifIll
CATM BAsm K=
7
477-7 -T
71777,-ii T, -ii7P.
na)TCATM CN SIM PIM-
SHDUUXR IMOMWE
MW Ulm PUR"
lilyl 1. /M/
77
4C
misc:
F&VIsm BY:
PLANNING MGR.
EVGINEERING MGR. PUBLIC WORKS MGR.
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
eL t- C, t,
MAILING ADDRESS
/03-�to 64-
CITY TELEPHONE NUMBER
EJ,-M C> t4 /I t2t- Yo63
CITY
CL "Al t- a_ 5 0 1-0 '-Zcf I -
TELEPHONE NUMBER
USE 'MWPERMIT
ZONE NUMBER
JOB
AUUMtOD Z,1W/V
-EGAL DESCRIPTION -CHECK [SUBDIVISION N
1;541- ,
C
0- T
PUBLIC RIGHT OF Y PER OFFICIAL STREET MAP.
EXISTING EiH��AEOUIREO DEDICATION
PROPOSED (9
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED V---
STREET USE PERMIT REQUIRED 0
SEE ENGINEERING MEMO DATED
,7- 4-1
REMARKS
METER SIZE IBUILDING SUPPLY SIZE
REMARKS
STATE LICENSE NUMBER
SIGN AREA ENV. REVIEW
ALLOWED PROPOSED I COMPLETE I EXEMPT
I egal Description ol Prope"y - nclude all easements
,spow. below or attach ourcop1jW A
Lot 6" 5(--CL-Pak##j Uel�'t-cxce
VARIANCE OR Cu
YARDS
FRONT SIDE
r _5;7t /0
REMARKS
NEW RE'SIDENTIAL 1:1 PLUMBING
ADDIALTER D COMMERCIAL 1:1 MECHANICAL
EIREPAIR RETAINING WALL 1-1 SIGN
REAR
0
Z
cc
Uj
W
Z
Z
W
UNITS
Uj
ADB NO.
I SHORELINE#
REVIEW BY DATE
-T—HEIGHT I LOT COVERAGE
DEMOUSH
EXCAVATE
OR FILL
FENCE
x —FT)
CHECKED BY
E OF CONSTRUCTION
E : V —14/
CODE
I ae7-
HEIGHT
REMODEL
PRE-MOVE INSPJ
COMPLIANCE INSP.
swim
[Ej POOL
SPECIAL INSPECTOR
REQUIRED
0 YES 0 NO
_-
AREA
OCCUPANCY
GROUP R_.3
OCCUPANT
LOAD
EJWOOD STOVE 1
INSERT
APT.BLDG
RENEWAL
REMARKS
. A&MAL JNSiJL N�A- 19.F5--!V^k-6>de-
5 NUMBER OF STORIES NUMBER OF
DWELLING
71 UNITS
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
-</,C
/- 01Z a,
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the puolic domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Wit'hin 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns anck
ENERGY CODE
successors in interest, agrees to Indemnify, defend and hold
ow
harmless the City of Edmonds, Washington, Its officials,
j
5
employees, and agents from any and all claims for damages of
tr
<
whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of. this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify,.walve or reduce any requirement of any city ordinance
0
x
nor limit in any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge 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 with city and
THIS PERMIT
state laws regulating construction; and In doing the work authoriz-
AUTHORIZES
ed thereby, no person will be employed In violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
tiq
_n lnsursinc@,
I NSPECTION
SIGNATURE (0 NER 08 AGENT) DATE SIGNED
DEPARTMENT
r 7121!R 6
CITY OF
EDMONDS
ATTLNITION
771-3202
IT IS UNLAWFUL TO USE 08 OCCUPY A BUILDING OR STRUCTURE/j>.6
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
Z �f -27U
VALUATION
-5-
-/A9.0 o
M,
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
OFFICIAL's SIGNATURE DATE
RELEASED BY:
DATE
ORIGINAL - File YELLOW - Inspector
PINK - Owner GOLD - Assessor
a
Z
Z
Z
0
Z
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
/1, � b /b /
I�AILINE ADDRESS
10,4�0
-61TY TELEPHONE NUMBER
L-IL4 9 1 "9-Y2 - Y6 t< 3
TELEPHONE NUMBER
NAME
.5,
CITY I TELEPHONE NUMBER
STATE LICENSE NUMBER
on of Property - Include all easements
attach four copies)
I e5 N c 1, /o-. I
NEW
rw
161 RESIDENTIAL
PLUMBING
ADDIALTER
COMMERCIAL
MECHANICAL
REPAIR
RETAINING WALL
El SIGN
DEMOLISH
rUn EXCA��
OR,�
FENCE
( X_ FT)
REMODEL
PRE -MOVE INSPJ
COMPLIANCE INSP.
swim
P040L
WOOD STOVE I
INSERT APT. BLDG
RENEWAL
NUMBER OF STORIES
NUMBER OF
DWELLING
[UNITS
'A,
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
USE MWPERMIT
ZONEX_� 1 ^21 NUMBER
JOB
ADDRESS
_EGAL DESCR[FtrION CHECKI SURDIVISION' N6 I LID NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING- REQUIRED DEDICATION
PROPOSED _
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED 0
STREET USE PERMIT REQUIRED C
SEE ENGINEERING MEMO DATED
REMARKS
AVxa, C
METER SIZE ///j IBOILDING SUPPLY SIZE IFIXTURE UNITS
REMARKS
SIGN AREA I COMPENV. PEVIEW
ALLOWED I PROPOSED LETE i EXEMPT
VARIANCE OR CU PLAt
YARDS
FRONT SIDE REAR
CHECKED BY ITYPE OF CONSTRUCTION
REVIEW BY DATE
_FHEIGHT I LOT COVERAGE
SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
REQUIRED GROUP LOAD
0 YES 0 NO I I I
V
PLAN CHECK FEE
700/- &A BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done or) private property ONLY.
GRADING/FILL
Any construction on the public domain (curbs, sidewalks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
ENERGY CODE
"Applicant, on behalf of his or her spouse, heirs, assigns an6
successors In interest, agrees to Indemnify, defend and hold
20
harmless the City of Edmonds, Washington, Its officials,
5
employees, and agents from any and all claims for damages of
<
whatever nature, arising directly or Indirectly from the issuance
of this permit. Issuance of. this permit shall not be deemed to
PLAN CHECK DEPOSIT
modify,.walve or reduce any requirement of any city ordinance
TOTAL AMOUNT DUE
0
nor limit In any way the City's ability to enforce any ordinance
provision."
I hereby acknowledge 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 with city and
THIS PERMIT
state laws regulating construction; and in doing the work authoriz-
AUTHORIZES
ed thereby, no person will be employed In violation of the Labor
ONLY THE
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
tiorlInsurpricq..
INSPECTION
SIGNATURE (OWNER OR AGENT) DATEjSIGNED
DEPARTMENT
7
CITY OF
EDMONDS
ATTENTION
771-3202
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
104 On
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL
OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
i07).7P
VALUATION
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged In space provided.
OFFICIAL'S SIGNATURE DATE
RELEASED BY:
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
cc
W
0
Z
Z
5
a
Z
DATE :
ME140 TO: Building Division
Plann ing Department
FROM: Engineering Division
Publ ic Works Department
SUBJECT:
0
''After revie---i 'of the subject' Building Permit application, vie have the following
coraments
Connection to City water system required.
2. Connection to City sanitary sewer system req0red.
3. Right-of-way permit required for any work on City property.
4. Drivewa� 'slope not to exceed 1111,
5 . Back-rialter' v alve required i F downstairs plumbing is below elevation of
upstream manhole.
6. Water and sewer lines to be seoarated bv 10 foot minimum.
ME PRO
I
00 6/82
7,
Vi
-40,+
721
TVA
(—, Q-cl
WT.
75. f
yl 00 +
rT
aa
dh
'77
1-ko.
_ot
01 n
tv
41,
I f 'ry
0_ 4
I vv.
V
NK
Or
'r,"4
LU CITY of EDMIODS RliC;E I VED S#E SEWER PERmiT
For InsDection Call 771-3202 _1H1 P4. lqpp PERMIT NO. 07544
a
Tal
00
CD
a)
ABLICAORKS
Address of Construction: 7 6>1 > ea, V
Property Legal Description (Include all easements)
/* 5"
Owner and/or Builder: 15; 6 k 1/0
Contractor & License No:
Single Family Residence
Multi -Family
Commercial
X
(No. of Units
(No. of fixture Units
LYNNWOOD LINE
lo-I 5- 5�4t, Z4. wc,
Invasion into,.City Right -of -Way: No A Yes _ (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No /X Yes (If Yes, easement required,,
at tach legal.description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
I certify
that
I have
read and shall comply
with the
items
listed
on the back.
Pe'rmit Fee:
Trunk Charge:
Assessment Fee:
Partial Inspection:
Issued By:
Date Issued:
Receipt No.:
Date
I
Comments 1'V5P 13J Date Initial
jqFinal Inspection Approved: Rapi A64^-JO
Date Initial
Rejected:
Reason Nte —Tn i —ti aT
** PERMIT MUST BE POSTED ON JOB'SITE **
Wh-ite Copy - File Green Copy - Inspector
Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing EASEMENT NO - -------------------------------- -----------
NEW CONSTRUCTION [it/ REPAIRS [:] LID NO - ------------------ - ASMT. NO
OWNEP - ------ 2C(N-t ------- ------ 2��tscry --------------------------- -------------- CONTRACTOR ----- KF--41M-.--' -MZ
4 1 G- X-1 ----------------- ---------------------- PERMIT NO.
JOB ADDRESS ---- 17A4 A -------- A . ..... ------ 1ptr-lVt ------------- LEGAL DESCRIPTION: LOT NO - ---------- 5 ------------------------- BLOCK NO.
----------------- t�-04-c--v - ------------ c ---------------------------------------------------------------
By
CITY OF EDMONDS
ASSET INFORMATION SHEET
NEW
ADDITION
RETIREMENT
STREET FILE ASSET NO.
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION
DEPT. NO.
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
0
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
INITIATED BY
DATE
PROJECT NUMBER
PROJECT COMPLETION DATE
COST
APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
D�DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE
ktnp INITIAL
DATE
4"t
VERIFIED BY
PROCESSED
BATCH NO. -
DEPARTMENT FILE