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23729 80TH CT W
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW
COVENANTS (RECORDED) FOR:
15 0q1 4
Lfy-/
CRITICALAREAS: ocj::� -:)
L/L� 4� I �ETERMINATION: Ej Conditional Waiver [] Study Require� aiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (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\DST's\Fonns\Str-eet File Checklist.doc
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q INSPECTIONS REQ'D. co�
-0220 EXT. 132 ER
j- 3 N CALL, 425-771
OWNER/CONTRACTOR SCALE : 1"=20'
\AKING PROPERTIES, INC. W E
P.O. BOX 1034
LYNNWOOD, WASHINGTON 98046 0' 10, 20' 4
PHONE : 425-670-2711 PLOT PLAN R
BENCH MARK FOR OCT 19 2004
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT THE LOT 12, VIKING HERWIT5011AI-l-r-,
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
r
Date:
�SMN LoveU-Sauerland & Associates, Inc.
&tgineers/Surveyors/Planners/Development Consultants
L�m m e-mail: info@L-Aengmeuiag.com - web: Isaengineezing.com
INN 33rd Avenue T., Suite 200 Lynnwood. WA 98036 - (425)775-1591 - (425)672-7998 fax
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ASSOCIATES, LLC
LAND USE pLAmNI"Q I CIVIL ENGMERRING
172.1 hovdtt Avw"m 0 SuRe 4(M III EverrM WA 95M
phone (425)252-20n ftx (425)252-9551
_V. JD7
City of Edmonds
Development Services Department
Planning Division
Phone:
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 subn-,dttal of the application to the City.
The purpose of the Checklist is to enable City staff to
deterinine 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).
L�3
Date Received:-,
City Receipt#:
Critical Areas File #: oCY_3,--W2_0
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant- 41—,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. ne 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 ham-dess from any and all damages, including reasonable
attomey's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information fumished by the applicant, his/her/its agents or employees.
By my signature, I certify 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 plication Mo"e beehalfe owner as listed below.
SIGNATURE OF APPLicANT/AG DATE AZ 0
Property Owner's Author* ati
By my s . ignature, I cer* 1 10 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
Owner/Applicant:
I —
"0&
14ame
C3 Z
Street Address
,�;6vOW5 fez: >Z 6
city State zip
Telephone: (-', 'r7
Email address (optional):
DATE
Applicant Representative:
Name
1 -77,
Street Address
. Z—f 4-67 q7_�
city State zip
Telephone: 1Y Z! 5 -2-
Email Address (optional): )ohtV �okp_bl
V W
Critical Areas Checklist.doc/3.192001
0
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: 0�2
City Receipt#:_ --5 6)
Critical Areas File #: -7003 1
Critical Areas Checklist Fe 0
Date Mailed to Applicant I
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, inderrinify, 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/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 authorize to file e owner as listed below.
SIGNATURE oF APPLicANwT/AGENT DATE t::,
Property Owner's Author' ati
By my signature, I c i I e authorized the above Applicant/Agent to apply for the subject land use applicaticn�
and grant my perrriissi 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/Appficant:
"OW
14arne
.2 .3 C - 3 Z F
Street Address
4��wok/95
city State zip
Telephone:
Email address (optional):
AppUcant Representative:
c:WT
Name
1-701
Street Address
city State zip
Telephone: 1Y 7-5-2- -
Email Address (optional): )ohty o4sbt
Oitical Areas Checkfist.d=5.192001
0
0
-C. 157-
City of Edmonds
Development Services Department
Planning Division
Phone:
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 area inventories, maps, or soil
surveys).
Date Received: 311 V 1 o_-_Z2
1 7U (&7'�SO
City Receipt #: - I
Critical Areas File#: 00z-�-, I
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant: -0�-ivgZ3
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 firiding and locating the
specific piece of property described on this form. In
addition, the applicant shall include other pertinent
inform * ation (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 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 ftimished 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,2� on o e belialf"e owner as listed below.
SIGNATURE oF AppucANT17/AG Z DATE Zo
hor.
Property Owner's Autholr* ati
I
T
By my signatm, I certify A r! authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the 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.
Name
-2 �
Stred Address
16;bWow?5 �<A_
city State zip
Telephone:
Email address (optional):
Applicant Representadve:
")Ou&) I / �/
Name
1 -70 / Hc;4,)tTr- AV-:r
Street Address
qT—
city State zip
Telephone: 7_570
Email Address (optional): joht-,yj kPt-b,_w11,cz>x,
V W
Oitical Areas Checidist.doc/3.191001,
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegetation)
1. Site Addre.ss/Location: 900,�'� 1,3,47A S,;7— SAI - -----
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet): 35- 2a
4. Is this site currently developed? _&�yes; — no.
If yes; how is site develop d? 617�s ON AMT
e
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
Hilly: slope's 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 30% 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: AIIAI,.--- Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year? A/ ZA
8. Site is in the floodway.- A10 floodplain__AjjQ of a water course..
9. Site contains a creek or an area where water flows across the grounds surface? Flows are.year-
round? AVIVA5-- — Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc) 7W ;e-� cf .7V
1. Obvious wetland is present on site:
------ — -------- — -------------- — -------------------- For City Staff.Use
-- ---------
L� . SiteiszoneO
;2.. SCS mapped soil type(s)?
Wetland. inventory or C.A. map indicates wetland present on site?
4. Critical Areas inventory or C.A. map indicates Critical Area on site�
5. . Site within designiiatied earth subsidence landslide hazard area?
Site designated on the Environmentally Sensitive Areas Map? Mb
:Dffg�k MINA TION
DY REQUIRED
CONDITIONAL WAIVEk
WTA14RR
Reviewed by.
Planr#j
- h
ca—c k.doc; Re� 10/03
RECEIVED
City of Edmonds JAN 0 6 1999
COMMLINITY 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
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).
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 completd,a4evelopment
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 cor�junction with this Checklist
to assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
-7-0 Al Aae
AVIVZ�p
Name _/ �_/
Street Address
City State Zip
Applicant Representative:
Name
Street Address
city State Zip
q
Telephone Telephone
>--I-
�igna.*'e
Signature
Date
(over)
X4.
—C
. I S,)z
S PERMIT NO:
City of Edmond' PERMIT EXPI . RES,�,�/
SIDE SEWER PERMIT . r
Address of Construction. LUD #
Property Tax Accou nt Parcel No.
Attach copies of all access and utility easements -,�Verified and Approved b
Owner and/or Contractor: &i;y
Contractor License #:
L��ingle Family
F� Niulti-Family (N o. of Units
F� Commercial (No. of Units
Public
-Building Permit #Z_,�_a?C52
Invasion into City *Right -;of Way: Yes �o
*RW Construction Permit #
Cross other "Private Property:. El Yes E3-Ko
"Attach leg al description and copy of recorded easement.
Owner or contractor signatur-And acknowledgement statement:
or this p( rrtify that I have read the City's public handout entitled
y signing f
ide Sewer Specif; cations, and shall comply with.all City requirements outlined therein
Dat6
;1,15555) BEFORE -ANY EXCAVATION 9
2 CALL DIAL -A -DIG (1-800-4
W FOR INSPECTION CALL 425-771-0220 extensionrf=
24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REOUESTS
...................... .............. ......... ........ ........ ...
FORDFIFICE USE ONLY . . .. .............. ...... .
Permit Fee S Repair Fee $ Issued By:
Date Issued:— /41"alz2�Z
Assessment Fee $ Receipt No:
City Permit Surcharge Fee 0.00 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 —Datem. Initial:
irpPartial Inspection: Date: Initial:
rtial Inspection: Date: Initial:
aalFINAL INSPECTION APPROVED: Date: Initial: As -built to Street File: E]
1,� PERMIT MUST BE POSTED ON JOB SITE t-
White Copy: File Green Copy: Inspector Buff Copy: Applica.nt
L-,temp;bldg;forms-,ssperinitjlg4/00
23721
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23727
23729
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HOMEOWNER CONTRACTOR CALE
. VIKING PROP. INC. VIKING HEIGHTS NTS
DATE IDRAWN PERMIT
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CALL. 425-771-0220 EXT. 1326 jtjt
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SCALE : 1"=20' C
OWNER/CONTRACTOR
VIKING PROPERTIES, INC. W E
P.O. BOX 1034 0' 10, OCT / 92004
LYNNWOOD, WASHINGTON 98046 20' 40'
PHONE : 425-670-2711 S PLOT PLAN PEROT COUNTER
BENCH MARK FOR
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT THE LOT 12, 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
�Nmj Lovell -Sauerland & Associates, Inc.
En&eers/Surveyors/Pl=ner3/1)evelopment Consultants
APPROVED AS NOTED e-mail: info@I:men&eeriag.c= - web: Isaengineering.com
BY EN-QINEERIN INN 33M Avenue T., Suite 200 Lynnwood. WA 98036 - (425)775-1591 (425)672-7998 fax
A DRAWN COD= DATE Fa Sal
I FU No
Data- L JTT I JTT 1 3.6.03 1 20 4656-0-04
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UIu nSapczArEa. *8e2746
.. ,
DAILY FIELD REPORT
p'a2
- �
,
ASSOCIATES,��
' ����6�]��- -miles
-'- - -
24
1928KeulAe Plao%£
Kcomunc, Washington98028
as
Ted Coleman
Sunrise Ridge
General Contract(
Time Off Site �Vealher
1.75
es
The footing trcnohoufor \hohomeoto�beco^��m�ed_Vnthe3nm1henn|�a�oftheau�e���hovna�obnoo
down to the level today, Th hxX trenches aroaUox*ava<e�|nW\�ogmyymuA�U|oyye�-
completed*�u _ _ �� � � � ay._ e� / _
-'----si ./otomodkx�aundv��hsomo�ruv*)andoccasionalcobb� '�mundwatcrhunnot been encnu,�o*d
n��a��ax���- ' -- '- -'� - --�' �
and there isno standingwab�w�hin*ho�mUnQ trenches.
''_---__- - ' -'�
It is that the undb�urbndfn�hdU�� soils able korwnderonaUowub�beahnQoopnc�yoyN|eu�
� ------'-----' 'k� okwUiNm1he/und �anoh�sbycnn*hv��ntm#��ho�dboremoved down
O0D »m�l�/ '
toundisturbed fresh hUom|apno/'u� for the footing fOUnda�ons.__
�
�_-' ---__--� '-_-_ ---_--- ----�_ ---_
|
-_-__-
� 0q
..... ......
1)Ted Coemuo8/ik|nQPrnpmMieo
onNoxt
LIU & ASSOCIATES 4862746
DAILY FIELD REPORI
t-. laz
a
LAU & ASSOCIATES, fN(:.
4AD85
J. Liu
I of 1
- - " .. - --:- - -- -i " I "-. " -
Miles
24
Tine On Vto -
1 2:05P
Dala
11/1014
'�ravel Time (Ws)
Time Off Sde
Weather
19213 KcalAe P13CC NE
Kcriniore, Wishington 99028
Phone: (425) 483-9134 Fax: (425) 486-2746
1
12:45P
Lo—u—�_Y_
Vehir le H r3 on �i—te
sifors
1.75
thru 13 ge
Contractor General ontrector superintendent
T
Prooerties Ted Coleman
ies
2
6fW&-1V — "
Wed.
cajun E:xcavating - -. L - .1
The footing trenches for the homes to be constructed on the 3 norlhern lots of the subject lots have also been
completed down to the footing level today, The. roo,inq trenches are all excavated into the gray fresh till of ve.ry-
dense, silty fine to medium send with some gravel and occasional cobble. Groundwater ha5 not been encountered
and there is no standing water within the footing trenches.
it is rrly opinion that the undisturbed fresh till soils will be able to render an allowable beadng capacity of at least
. ..........
e disturbed soils shed into the footing trenches by construction traffic should be removed down
- >0s
to undisturbed fr9sh till soils prior to poudng concrete for the footing foundations.
s.- -
-7117
1-0 %—r..
-6v to: [J Continuod
1) Ted Coleman/Viking Propedies 2) Oil Next
3) 4) PaP --
r
ATE RECEIVED
36 Ot
[PERMIT
EXPIRES
CITY OF EDMONDS
Ust
ZONE PERMIT
INUMBER 67(�
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/AP`t#
ADDRESS-
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TESCP Approved
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Street Use Permit Req'd
CITY ZIP
TELEPHONE
Y
EXISTING --e-- PROPOSED
REQUIRED DEDICAYION FT
Inspection Requirf
Sidewalk Requirec
.-Underground
VAnng required
METER 61ZE LINE
SIZE
NO. OF URES
PFI�QUIRED
YES Ab 0
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REMARks
OWNERMONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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ING REVIEWED BY
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INSPECTION
REQ 'D,
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POSTED
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CHECKED
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$
SEPA REVIEW
COMP TE EXEMPT
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HEIGHT
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PROPERTY TAX ACCQUNT PARC9L NO. Door- N
166 r�'
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CHANGE OF USE
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REPAIR GRADING CYDS FT)..
OTHER
REMARKS r -0�ve, 04y—,eaf S'rTe.
DEMOLISH 13 TANK
GARAGE RETAMING WALL FIRE SPRINKLER
CARPORT 13
ROCKERY F RE ALARM
OF USE, BUSINESS OR ACTIVP7
CHECKED BY
OCCUPANT
10-F
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GROUP
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NUMBER
OF
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CRITICAL
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NUMBER 03- C
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DESCRIBE WORK TO BE DONE
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PROGRESS INSPECTIONS PE6 UBC 111/18CIMFIC 09 FINAL INSPqPTION REO'D
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VALUATION
Dea scription
FEE
Description
FEE
0_(^)LASJt?- C6/ n_'V
Plan Check
State Surcharge
R'!
�V\JLAZIN9� *I,-
A
LOT SLOPE, I
Building Permit
I (D5
City Surcharge
PLAN CHECK NO
VUSTErf T
Plumbing
Base Fee
AUTHORIZES bNILi THE WORK NOTED. THI OV'RS WAD
THIS PERMIT TO
Mechanical
U
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2
BE DONE ON PRIVATE PROPERTY ONLY.ANY CONSTRUCTION ON THE PUBUC
DOMAIN
Grading
(CURes, SIDEWALKS, DRIVEWAYS ' MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
a
11
�'Ehgr. Review
15
PERMIT APPLICATION: 180 DAYS
a.
PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYb
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
;APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
N INTEREST, AGREES TO INDEMNIFY,
Fire Review
Plan Chk. Deposit
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
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp.
Total Amt. Due
��
0
zi
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
Recording Fee
Receipt #
' HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION
APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
This application is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COM NINSURA NCE AND RCW 18.27.
FOR INSPECTION
receipt is acknowledged in space provided.
'�BNIRAT�o
�OF�idIALS SIGNATURE A'E
S;1rGURq:
�NERO AGE7NT�
DAT SIGNED
(425)
.
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771-0220
T
'PILE
-ATTENTION
Off 1333
' ASED BY
DATE
,NLAWFULTO USE OR4 CUPYABUILDING OR STRUCTURE UNTILAFINAL
ON HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
,��BEENGRANTED. UBC109/IBC110/IRC110.
ORIGINAL -FILE YELLOW - INS
PINK - OWNER - GOLD - ASSESSOR
PRFqq 14ARn vni I ARF MAKINn A rnIPI _q
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ...........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation .......... 7
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 ..................