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TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
Lf Y - t L".3
CRITICAL AREAS: DETERMINATION: []Conditional Waiver E] Study Required>, Waiver
DISCRETIONARY PERM[IT #'S:
DRAINAGE PLAN DA
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERM[ITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DA
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
WATER METER TAP CARD DATED:
OTHER:
LATEMP\Dsrs\Fonns\Street File Checklist.doc
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SCH 40 N - OCT 19 2004
N - 12
IT C6
PE IT C NTER
OWNER/CONTRATIVANCOR PERMIT 66MM �20�
VIKING PROPERTIES, INC. W
E
P.O. BOX 1034
LYNNWOOD, WASHINGTON 98046
0' 10' 20'
40'
S
PHONE : 425-670-2711 PLOT PLAN
BENCH MARK FOR
THE PROJECT BENCH MARK IS THE CONCRETE
LOT 10, VIKING
HEIGHTS
MONUMENT IN CASE LOCATED AT THE
CENTERLINE OF 238TH STREET S.W. AT
APPROXIMATELY THE MIDPOINT OF THE IN SE1/4, SECTION 31, T.27N.,
R.4E., W.M.
PROPERTY. CITY OF EDMONDS
ELEVATION : 200.00 SNOHOMISH COUNTY, WASHINGTON
DATUM : ASSUMED
APPROVED AS NOTED
BY ENGINEERING
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LAND USE PLANNING I CIVIL ENGINEERING
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City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
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 the application 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).
Date Receive4.— I -
. 0-"2
City Receipt#:_ (a 0
Critical Areas File #: cDo3--W2-0
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant:—,V--,/-03 —
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, inderrmify, defend and hold the City of Edmonds harmless from any and all damages, inc , luding reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information ftimished by the applicant, his/her/its agents or employees.
By my signature, I cerfify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authornized to file t plication 9D*e behal
!!f"e owner as listed below.
SIGNATURE oF APPLicANTIAGENT DATE
ho t.1
r a
Property Owner's Author atio
0
th d t]
By my signature, I cerfi*� I e au�thorized the above Applicant/Agent to apply for the subject land use application,
ffi
I ai
and grant my permission for e public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER DATE
PLEASE PRINT CLEARLY:�.
Owner/AppUcant:
I —
"06� J / rAP6PA�$Z:J
14ame
Z
Street Address
4��VOA/95
city State zip
C q
Telephone: '�� rl !� 4;3
Email address (optional):
AppHeant Representative:
-Name
-77, / Rc;cvi -rr—
Street Address
. 1 -41-1 Y qT— ��,4
city State zip
Telephone: 1Y 7-572-
Email Address (optional): )oh0;P oks-bi
Critical Arms Checklist.doc/3.19.2001
City of Edmonds Date Received: f I/
Development Services Department City Receipt#: 111- A r)
Planning Division Critical Areas File #: -7-00-3 -002-i
Phone: 425.771.0220 Critical Areas Checklist Fee: $ 5.00
Fax: 425.771.0221 Date Mailed to Applicant: �L�3
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 the application 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).
A property owner, or his/her authorized 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
infbrma�on (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.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harn-dess from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file t is plicatio e owner as listed below.
to file Zts
SIGNATURE oF AppucA�w/AG DATE
jol
Property Owner's Author* ati
By my signature, I cer* I authorized the above Applicant/Agent to appl' for the subject land use application,
y
and grant my permission for e public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER DATE
Owner/Applicant:
42 0
Name
2-3c3z
Street Address
4;bv,1JV95 YCA mc>
26
city State zip
Telephone: 4/0!;7- 4 1
Email address (optional):
Applicant Representative:
11:VT
Name
-77,
Street Address
47�
city State zip
Telephone: 1Y Z'5' 7-572- &�,Z
Email Address (optional): johoy oko-bt
Oitical Arms Checkfist.doc/3.19.2001
0
City of Edmonds
Development Services Department
Planning Division
Phone: '425'771.0220
Fax: 425.771.0221
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 the application 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).
Date Received: V I 0�2
7U (g,*:SQ
City Receipt#: I
Critical Areas File M Z—cr-,�3 — 00Z -2-
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant -5ZJ/--eZ3
A property owner, or his/her authorized representative,
must fill out the checkli - st, 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.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indernnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/herlits agents or employees.
By my signature, I cer* that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to 4ffilei:splicatio7n goAffie behal e owner as listed below.
SIGNATURE oF APPLiCANT/AG DATE
or.
Property Owner's Author* ati
By my signature, I cer* I authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for e public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and posting attendant to this application.
SIGNATURE OF OWNER DATE
I - PLEASE PRINT CLEARLY
Owner/Applicant:
0A1 J) I (H)Cpzo z:J
Narne
-Z 1; C -3 Z F - 50�
Street Address
4�6wOW5 rebz ell
city State zip
Telephone:
Email address (optional):
Applicant Representative:
Rep,
Name
1-77, 1 Alc;4t'ar- Acl-:r
Street Address
. Z---4&r M—
city State zip
Telephone: 1Y Z 5' - Z! 52- - 2, E� 0
Email Address (optional): johty,� o4p-bt
Critical Areas Checklist.doct3.19.2001
WILE NO. q9
Critical. Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
,ee-)6NOS 4d 9 Age
1. Site AddressALocation: .117,3421A
Property Tax Account Number:
2.
........ .
3. Approximate Site Size (acres or square feet): 35.
4. Is this site currently developed? _ZYes; _ no.'
If yes; how is site developed? AINS,,r- 5/77� &AI -S,6- ��Ml 04,8&*7e7X
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
_6AIA- 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 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: A&Al,---- Approx. Depth:
7. Site contains areas of seasonal standing water: AleAl, Approx. Depth:
What season(s) of the year?
8. Site is in the floodway AjjV floodplain_AZLIQ of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are,year-
round? AVIV255'_ — Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc) (,�Vd7W Z�e� -7V APWA-,
11. Obvious wetland is present on site: AeAl,!S�
------ — ------------------------ — --------------- — ---- For City Staff Use Only ------------- ---- — -- --
Site is Zoned? A
Sol
SCSmappeA
Wetland inventory.or C.A. map indicates wetlaDd present on site?
4. Critical Are*as'invenloryorCA. map indicates Critical Area on site?
5. Site within designated earth subsidence landslide hazard area?
'Site desi-nated oil the Environmentally Sensitive Areas Map
CONDI'nONAL WAIVER-7
Am-chkAoc; Rv 10103
0
0
City of Edmonds
RE C E* IV ED
JAN 0 6 1999
COMMUNIly SEWCES
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
deten-nine 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/her 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 complet�,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 infor m-ation (e.g., site plan.,,topography
map, etc.) or studies in conjunction with this Checklist
to assist staff in completing their preliminary
assessment of the site
* i
I have completed the attached Critical Areas Cbecklisit andattest that the an§'Wers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Ovi,ner/Applicant* Applicant Representative:
-7—ovcd b L � �aVA I %a Z/, o
Name Name
3 te 7 /ft
Street Address
Street Address
b
city State Zip city State Zip
q2 �5 gl,'7,q
Telephone Telephone
S i 9 nt�,e Signature
77
Date
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2372 80th COURT V.
2370§ 80th
n
E WATER & SEWER
oce, 7 d-o�, 9�-WVVED INSPECTIONS REQ'D.
g -- H 6,.)- CALL 426-77 -0220 EXT. 1326
h 1A P Lt � 9 �- OCT 1 9 2004 1
D d-O ACCEPTABLE TIGHTLINE PERMIT COUNTER RE�:IEf�iEb
SDR 35 MATERIAI- jUL 2004
I
SCH' 40 N CITY COPY PER
N - 12 M UNTER
OWNER/CONTRACIFF HANCOR SCALE : 1-=2V
VIKING PROPERTIES, INC. W E
A,.O. BOX 1034 0. 10' 20" 40'
LYNNWOOD, WASHINGTON 98046
S
PHONE : 425-670-2711 PLOT PLAN
BENCH MARK FOR
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT THE LOT 10, VIKING HEIGHTS
CENTERLINE OF 238TH STREET S.W. AT
APPROXIMATELY THE MIDPOINT OF THE IN SE1/4, SECTION 31, T.27N., R.4E., W.M.
PROPERTY. CITY OF EDMONDS
ELEVATION : 200.00 SNOHOMISH COUNTY, WASHINGTON
DATUM : ASSUMED
�Mmj Lovell —Sauerland & Associates, Inc.
APPROVED AS NOTED L ftgmeem/Surveyors/Planners/Development consultants
BY ENGINEERING 0 Im-1 id-01-e4i--�..m - web: Isaen&eening.eom
INN 33rd Avenue W., Suite 200 LYnnw00d- WA 98036 - (Q5)775-1591 - (425)672-7998 fax
T—
DRAVN CU= DM
"9,'56 O�04
FU
Date: JTT I JTT 1 3.6.03 F-B' -::J�1'=20�'4(�6 �O-
L
LIU AS.S.O.CIATES- 4862746 P.02
DA101 FIELD REPORT
LRJ & ASSOC] ATESj M". 4AD85
.... .,-- — - . .— 'C 'Miles
24
19213 KenlAc Placc NE 7 ravel 7 Irrie (H
Kcnjitorc. Washington 99028 1
Plionci (425) 483-9134 Fax: (425) 486-2746 Vehide Hr3 on
8 WRI 113
@I Contractor
a ProDerties
Job Location
Sunrise Ridge
General Contract(
Ted Coleman
J. Llu
I oft
2
ay 0 C'L'
T"—eon —SRe
12:05P
Date
I I /I 0/9A
Time Off S'qe
12:45P
Weather
loua
Hrs Charged
1.75
visitors
rties
-c;ajun t:xcavaunq -. I I -
The footing trenches for the bomes to be constructed on the.3 no.ri.hern.lo.1s.of..the..s.u-bje.,ct lots have also been
completed down to the footing level today. The. footing trenches are all excavated into the gray fresh till of very -
dense, silty fine to medium send with some gravel and occasional cobble. Groundwater has not buen Cri-WW'10red
and there is no standing water within the footing trenches.
it is m opinicn that the undisturbed fresh till soils will be able to render an allowable beading capacity of at least
s�. Loose disturbed soils pushed into the footing trenches by constrLiCtion traffic should be removed down
to undi—sturbed fresh till soils prior to poudng concrete for the footing foundations.
7
XP
hr
r R
x =Pilk S' 117
104
...... .. ..
............
1) Ted Coleman/Viking Propedies
2)
El Contirwod
on Noxt
Paae
LIU & ASSO.CIAT8.S.. 4862746
DAILY FIELD REPORT
� 1. Z�-
LAU & ASSOCIATES9 I-N(:. - 4AD85 J. Liu n-S I to— I of I --"- 2
e6io�,-'g rirne 0 Date Day 6f'W&
24 1 2:05P 111101A Wed.
19213 KcilliVc Placc NE Travel Time (14,$) Time Off Site, Weather
Kcrtatore. Washingtort 98028 1 12:45P ciou(�y
Photic: (425) 483-'9134 Fax: (425) 486-2746 Vehicle H rs on 5 $e— Hr5 Charged sifors
8 thru 13 Sunrise Ridge lViking Properties
at Contrwtor General Contrector Superintendent erle rc le. ked By
Properties Ted Coleman --- R
i, e,—t—m— Earlhviork Contracto-'SUPI- I ecelved checked By
The footing trenches for the hornes to be constructed on the 3 norlhern lots of the subject lots have also been
.. .. ... ....... .. ... I .. .
completed down to the footing level today, The footing trenches are all excavated into the gray fresh till of very -
dense, silly fine to medium send with some gravel and occasional cobble. Groundwatcr has not been encountered
and there is no Standing water within the footing trenches.
.. .... ------
it is rn opinion That the undisturbed fresh till soils will be able to render an allowable beadng capacity of at least
4,000 List. Loose disturbed soils pushed into the footing trenches by construction traffic should be removed down
to undisturbed frtsh till soils prior to poudng concrete for the footing foundations.
0
0
-7-
1) Ted ColemanNiking PropeTlies on Noxt
A� Paae
PERMIT NO:. 9930
city* of Ednionds
PERMIT EXPIRES
c!ir'nu QUAVUID 1DUDX41rr
"i7c.
525: Z,7 LID #
Address of Construction A 742
Prbperty Tax Account Parcel
Attach copies of all- access and utility easements Verified and Approved b
Owner, and/or Contractor:
Contractor Li . cense #:.Vt �/,p 1-14- 3 7 L�,�5, Building Permit
Z�engle Family Invasion into City *Right -of Way: El Yes 2-M
R Multi-Fdi-hily (No. of Units *RW Construction Permit.#
Commercial (No.'of Units Cross other "Private Property: El Yes �o.
F� Public **Attach legal description and copy of recorded'easement.
Owner/Contractor 0y
. . OFOwner or contractor signaty�e and acknowledgement statement: Date
y signing for this permit4/certify that i have read the City's public handout entitled
Side Sewer. Specifications, and shall comply with all..City requirements outlined therein.
9 CALL DIAL -A -DIG (1-800-42-1,1
1.5555) BEFORE ANY EXCAVATION W
R FOR INSPECTION CALL 425-771-0220 extension7IM01f
HOUR NOTICE REQUIRED FOR ALL INSPECTION REOUESTS.
... .......
FOR OFFICE USE ONLY
. .... ........ ...
Repair Fee $ Issu
Permit Fee $ L5� ed By:
T,
00 Date Issued:
Assessment Fee $ Receipt No:
City Permit Surcharge Fee k5. 0'0 Total Fees Paid
NOTE: IF JOB SITE IS NOT* READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED..
Job- Site Ready YES NO Date: Initial:
Partial Inspection: Date: Initial:
P PI Date: Initial:`
artial Inspection:
FINAL INSPECTION APPROVED: Date: Initial: As -built to'Street File:
'M PERMIT MUST BE POSTED ON JOB SITE 'M
White Copy: File Green Copy: Inspector Buff C.Opy:r Applicant
L;temp;bldg;forms-,ssperTnitjlg4/00
E-PAr-
64MM
-4-
CITY OF EDMONDS AS- BUILT
A
6 ADDRESS
HOMEOWNER
Vi
DATE N
Q IDRAW
) (, 0+
CONTRACTOR SCALE
9 /,? 1/1 A NTS
PERMIT
NO.
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23723
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CD 23725
23727
238 ST SW
VIKING HEIGHTS PLAT
SEWER MAIN LINE 6' CO ON MAIN
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CITY OF EDMONDS SIDE SEWER AS- BUILT
0
ADDRESS
23725 80th COURT SW
HOMEOWNER CONT ACTOR
VIKING HEIGHTS CAJUN
DATE DRAWN-
03-29-2005 13Y I, ABILA
LOT # 10
ISCALE N , TS
PERMIT
NO. 9930
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CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLIcATibN
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TESCP Approved
PUBLIC RIGWOF WAY OFFICIAL STREET MAP RW Pe i Required
Street Umset Permit Req'd
EXISTING R Inspection Required
P D Sidewalk Required
CITY zip TELEPHONE
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gas - (OM -C"/
REQUIRED DEDICATION y ........
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METER SIZE LINE SIZE NO. OF FIXTURES P QUIR
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OWNER/CONTRACTOR RESPONSIBLE FOR E OL/DRAINAGE
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SIGN AREA
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REMARKS
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FI �INSPEqTIONREQ'D,
PROGRESS INSPECTIONS PERUBC 108/ IBJ109 IRC109 NA
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Description
-
FEE Description FEE
EE
no q519 -cu - (�52d -DO
Plan Check
State Surcharge
L
Ir T §OURCE GIJKZING % OT SLOPE %
Building Permit
17 City Surcharge
j VfSTEJ) DATE I I
'r
P AN CHECK NO:
Plumbing -240
Base Fee
W_ �771 0
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) V61LL REQUIRE
SEPARATE PERMISSION.
Engr. Review
5 PERMIT APPUCATION: 180 DAYS
911. PERMIT LIMIT I YEAR - PROVIDED WORK 15 STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
0 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
9 IN INTEREST AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND]
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
T LL N OT BE
I SHA
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
MY
Landscapelnsp.
Total Amt. Due V-1
IT 0 R D IN ANCE
C Y
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NC E P R 0 V I SION, "
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
# Y
Recording Fee
Receipt
T HE INFORM ATION
I -HE . REBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
HORIZE D AGENT OF
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
0 T UC_
LATING C NS R
THEoWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-.,
A
CALL
This application is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
WILL BE EMPLOYED
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO. PERSON WILL BE EMPLOYED
TON RELATING To
IN VIOLAT16N OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt Is acknowledged In space provided.
WORkMEN'S CO3KP"ATION INSURANCE AND RCW 18.27.
Sill ATURE DATV
SIrnURE ( N AGENT) DATE SIGNED
(425)
&1ALS
DAT�
ATTENTION
EXT 133;C
E ED BY
ITISUNLAWFULTOUSEO OCCUPYABUILDING OR STRUCTURE UNTILA FINAL
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE. OF OCCU-
ORIGINAL -FILE YELLON- INSPECTOR
PANCY HAS BEEN GRANTED. UBC109/IBCIIO/IRC110.
PINK - OWNER GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ..................... .
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation .......... J')
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ......
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
-NAILING ................... : ......
FRAMING ........................
FIRST FLOOR.FRAMING ...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................