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23731 80TH CT W
ADDRESS: �237-3 /
TAX ACCOUNT/PARCEL
BUILDING PERMIT (NENN
COVENANTS (RECORDED)
=0
CRITICAL AREAS:&,.3,_
()!�3_ pq�-PETERMINATION: E] Conditional Waiver Study Required/"Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DA
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:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED: -7-7, pr2
OTHER:
BLOCK:
LATEMP\DST's\Fomis\Street File Checklist.doc
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OWNER/CON TRACTOR SCALE 1"=20- /, TER
MKING PROPERTIES, INC.
P.O. BOX 1034 ACCEP"TA T TLINE
LYNNWOOD, WASHINGTON 98046 ATE AL 0' 10' 20' ROF c
M4 I ED
SDR 35 S
PHONE : 425-670-2711 SCH 40 PLOT PLAN OCT 1 92004
N - 12
BENCH MARK F81 0 HANCOR FOR PERMIT COUNTER
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT THE LOT 13, 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
APPROVED AS NOTED
BY ENGINEERING
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DATE RE
I HIGA,BURKHOLDER
TUMASSOCIATES, LLO
P�=j LAND Uall PLANNI"G" CIVIL ENGINERRING
1721 HewItt Avenue 0 Sur4e 401 0 Evwett. INA 98201
phone (425)232-2=6 fax (425)252-9551
-C. lb-7
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 o �:?
City Receipt#: 1 "�4 (', -_� 0
Critical Areas File #: V_ 00'3-�W2_0
Critical Areas Checklist Fee: $45.00
Date Mailed to Applicant:
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 prelinuinary assessment of the site.
The undersigned applicant, and his/ber/its heirs, and assigns, in consideration on the processing of the application agrees
to release, inden-mify, 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 berewith submitted are true and correct to the best of my
knowledge and that I am authorized to file t is plicat3on_9n_tJie behal e owner as listed below.
SIGNATURE OF APPLicANVAGEENT DATE 't>
P
or. tjo
Property Owner's A thio�r* ati
By my Signature, I certify I e 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
Owner/Applicant:
" 0 a WCP40 r-i
14ame I
-25c3z Y± � X !?f 4 L- F -:
Street Address I
4�6VOW5 V_;A r2�bz ell
city State zip
Telephone:
Email address (optional):
Applicant Representative:
Name
1 -77, / HL;c)i -rr- Al-E �q/
Street Address
.,6;6&r qT—
City State zip
Telephone: 7-5-2, -Z2�0,6
Email Address (optional): )Ohrx,� okp_bt
Oitical Areas Checkfist.docJ3.19.2001
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
Fax: 425.771.0221
The Critical Areas Checklist contained on this forrn 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 piupose 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 10!2
City Receipt#:_ 2- (to .3 C)
Critical Areas File #: -2003 -(-0C)2-j
Critical Areas Checklist Fe� _ �45, 0 0
Date Mailed to Applicant _3
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 thesigned 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 th e 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/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 plication 9D*e behalf"e owner as listed below.
SIGNATURE oF AppucAww/AG DATE XZ /0::�>
r
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 application,
and grant my pern-�issi 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/AppHcant:
"JLv J-)/
Name
Street Address
4;6VOW5 V-4 �Z ell
city State zip
Telephone: 4/' Cr7
Email address (optional):
DATE
Applicant Representative:
Name
-77, / Hc;,,J/ 77—
Street Address
city State zip
Telephone: IYZ5' - 7-572-
Email Address (optional): joht-pj okst-bi
V -
Critical Areas Checklist.doct3.192001
0
E
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).
51JV1 07?
Date Received:
City Receipt#: 7-i V?
1 50
Critical Areas File #: ;—;, cn�3 - -00Z -X,
Critical Areas Checklist Fee: $45, 00
Date Mailed to Applicant 44-14-eZ3-
A property owner, or lus/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. The City will review the checklis� 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, 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 fiirnished 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 plication 9A#ie behal owner as listed below.
SIGNATURE oF APPLicANT/AG DATE
r
Property Owner's Author* ati
By my signature, I cer *i 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
Owner/Appflcant:
I —
" J
Name
125c3z
Street Address
4;�DWOJV95
city State zip
Telephone: C/' '�'l
Email address (optional):
DATE
Applicant Representative:
S/T
Name
1-77,1 A1c;,--,t7T—Aa;;-
Street Address
err -
city State zip
Telephone: 1Y 15' - 7-572- ZQ�0
Email Address (optional):. johrv_j
Oitical Areas CheckfisLdocJ3.19.2001
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soils/topography/hydrology/vegpta.ti,on),
4a
1. Site Address/Location: �3,47LA S;7— SW,
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet): 3S L/f
4. Is this site currently developed? _k��Yes; no.
If yes; how is site developed? 1jftCe— 5/775 ow _S Aw T"Wa &1=7* /14��
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation *Change over entire site.
A///F Rolling: slopes on site generally less than 15% (a vertical rise of I 0-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
I 0-feet over a horizontal distance of 3 3 to 66-fe e*t).
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: Approx. Depth:
7. Site contains areas of seasonal standing water:
g�AZj5_7 Approx. Depth:
What season(s) of the year9
8. Site is.in the floodway AJQ floodplain—No of a water course.
9. Site contains a creek or an area where water flows across the grou nds surface? Flows are,year.-
round? AVW,�E'_ — Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow ;shrubs mi xed
urban landscaped (lawn,shrubs etc) gylW c4,0cg— 7zg
11. Obvious wetland is present on site:
- — -------- — -------------- — -------------- — ---- For City Staff.Use Only ------------- --------
,I.:: s.ite.is Zpned?eft A
2. S mapped soil type(s)? Y&4d
W&Iand invent*ory*or C.A*. map indicates wetland present on site9
4. Crii - icalAreas inve n*tory or
P.A. map indicates Critical Area on site
5. S ite )wthin designated earth subsidence landslide hazard area?
p
i6. Site designated on the Environmentally'Sensitive Areas Ma *? b
DE I T . E . I I R . M . IN . ATION
DY RFQUIRED.
Reviewed by:
fts-chkAoc: Rev 1010',
CONDITIONAL WAIVER.'
0
City of Edmonds
REC51VED
JAN 0 6 1999
COMMLIN17Y SERVICES
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 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 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 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).
O,v'smer/Applicant:
-7_oojq A'Loaev
Name
Street Address
-S U�4sll ��67.;� —
city 11 State Zip
Applicant Representative:
Name
Street Address
city State Zip
Telephone Telephone
S i' ri��e
9
.—DAe
Signature
Date
(over)
U R
OjjVMF CTOR IS-0,P00
_RICONTFA�,,
' �� DA jRESIDENCE oil I RE'
FoR EROSION CCyqi�1101.. N 237J9 80th COURT W.
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ALL aPOSED SURFAOE9'(T
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PW t9 7L/? )4 5, 0 7 INSPECTIONS REQQ.
�-o 02, 6 CALL, 425-771-0220 EXT.
6? 'r jTLfE �-3
0 0 3, ACCER"IABLE TIGI
MATERK N CITY COPY PEI 2004
SDR 35 C
SCH 40 SCALE : 1"=20' ONIA�(,rr, R
OWNER/CONTRACTORN-12
VIKING PROPERTIES, INC. F810 HANCOR W E IV
P.O. BOX 1034 0, 10, 20' 40' 1 V -D
LYNNWOOD, WASHINGTON 98046 0C
S T '19 2004
PHONE : 425-670-2711 PLOT PLAN PERMIT COUNTER
BENCH MARK FOR
THE PROJECT BENCH MARK IS THE CONCRETE
MONUMENT IN CASE LOCATED AT THE LOT 13, 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
Lovell -Sauerland & Associates, Inc.
APPROVED AS NOTED En&eer3/Surveyors/Planner-s/Development Consultants
L�11111111 0 e-mak infoolsmengineeiiing.com - web: Isaengineering.com
BY ENGINEERING . INN 33rd Avenue W.. Suite 2DO LYnnwood, WA 98036 - (44)775-1591 - (425)672-7998 fax
1"""I" e_na'a Za DIM I CHECM I DATE FB. SC=_____T_FUN0.
Date: -7 /7 CO# JTT I JTT 3.6.03 - I 1"= 2b' 1 4656-0-04
LIU & ASSOCIATES,. 4862746
P.02
9L �-1
Ck 5LAJ
DAILY FIELD REPORT
J-a No.
Field Rep.
Page
rM--
0.
epo 0,
1AU & ASSOCAATE'S� fN(.-., 4AD85
J. Llu
I of 1
2
tc.11 J�og�mcnn& lingincering Gmle&v & Farth gdence miles
Date
24
12:05P
11/10104
we(1
19213 KenlaVe PlaCe NE Travel Time (Hrs)
Time Off Site
Weather
Kenntore, Washingtort 99028 1
11 2:45P
Cioudy
Photici (425) 483-9134 Fax: (425) 486-2746 ehide Hm on -Site
�V
Hr5 Charged
1
visnorr
1'
1.75
13
Sunrise Ridge
General Contrector
Ted Coleman
klnQ Properties
-ualun E:xcavaung -. I --- - — -1 --"-1
The footing trenches for the hornes to be constructed on the 3 northern lots of the subject 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, -,ilty fine to mediLIM send with some.gravel and occasional cobble. Groundwater has not been encounteereW
and there is no standing water within the footing trenches.
it is rrly ofYinicin that the undisturbed fresh till soils will be able to render an allowable beading capacity of at least
�10
R.Ls�. Loose disturbed.soils pushed into the footing trenches by construction -tralfic should be removed d w
to undi-s"urbed fresh till soils prior to poudnrj concrete for the footing foundations.
AV
... .... .. ....
. . .. ....... ..
.............
�;oov 10: (-'ontlnued
1) Ted ColemantViking Propedies on Next
Pane
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4#44'.'T __17Z_1
" C. 1 '67 -
PERMIT NO:— 9928
'City of Edmonds PERMIT EXPIRES&��
SIDE, SEWER PERMIT
Address of Constructionr-.P(,:2 4 121 4�61 -4 LID#
Property Tax Account Parcel No. 4111e!�_l �1621140"eQ:2
Attach copies of all access and utility easements �-�Verified and Approved b
Owner and/or Contractor: U1'k_1 . r74 42!�A`,P
Contractor License #:
-la'55gle Family
F-1 Multi -Family (No. of Units
F� Commercial (No. of Units
E] Public
Iding Permit
Invasion into City *Right -of Way: El Yes [�]-No
*.RW Construction Permit #
Cross other "Private Property: El Yes' �o
"Attach legal description and copy of recorded easement.
I jOwner or contractor signlr6re and acknowledgement statement:
signing for this permit I certify that I have read the City's public handout entitled
iyde Sewer Specifications, and shall comply with all City requirements outlined therein.
Date.
9 CALL DIAL-A7DIG (1-800-42f4-5555) BEFORE ANY EXCAVATION 2
R FOR INSPECTION CALL 425-771-0220 extensio
HOUR NOTICE REOUIRED FOR ALL INSPECTION REQUESTS
FOR OFFICE USE ONLY
. ........ . ....
Repair Fee $ lss64
..................
Permit Fee $ Bv
Datelssd'ed:
Asses�ment Fee $ Receipt No:
City Permit Surciarge Fee 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:
Partial Inspection: —Date: Initial:
F F
INAL I NSPECTION APPRO VED: Date: W657 lnitial:__J�.As-built to Street File: E]
t� PERMIT MUST BE POSTED ON JOB SITE t
White Copy: File Green Copy: Inspector Buff Copy: Applicant.
L;temp;bldg;forms;sspennitjlg4/00
N
23721
23723
co 23725
23727
238 ST SW
12'
0
0
VIKING HEIGHTS PLAT
0
c
:2
Li
ABS UNDER
CONCRETE SLAB
---;9'
' WYE WITH
45* @ 2' DEEP
CO @ GRADE
0
v
1 5' SDR 35 PVC
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m
EST T
3' DEEP
7.5�
4.5'
Of
CITY OF EDMONDS
WATERLINE AS -BUILT
0
ADDRESS
HOMEOWNER
,6
23731 80TH COURT SW
VIXING PROPERTY
CONTRACTOR
SCALE
CAJUN
N TS
At 1890
DATE
103-28-2005
DRAWN
13Y 1 ABILA
WATERLINE
NO. 9928
CITY'bF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME/NAME OF RISINESS i
-1
MAILING ADDRESS I V
P C>
CITY ZIP - ITEI[EPHONE
ZIP I TELEPHONE
CBL #
/I
XXI 11-11"M
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PERMIT EXPIRES /113/0
I f
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ZONE
PERMIT
N U M B E R
JOB SUITE/APT#
ADDRESS
PA T NAME/SL
LOT NOI
L D NO.
!k11VISIO
yi L
L�D FEE $
PUBLIC RI&&F WAXJER OFFICIAL STREET MAP,
TESCP Appro
RW Permit Revedred
Street Use Permit Req'd
EXISTING %- PROPOSED
Inspection Required
Side�alk Required
REQUIRED DEDICATION FT
Underground
Wiring required
METER SIZE
LINE SIZE
NO. OF FI�RES
EQUIRED
WV
YE NO 13
REMWS
z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
CC
0
AD08ESS
0
elk
FIRE REVIEWED BY DATE
%
0
CITY ZIP
TELEPHONE
I qc;,S_t0Z,c)]
VARIANCEORCU
ORELINEORADB#
kINSPECTION
Liap
KESgN
ES Nos
BOND
POSTED
STdE LICENSE NUMBER EXPIRATION DATE I CHECKAJ BY
SEPA REVIEW
COMP�ETE EXEMPT
E X P(9/0
SIGN AREA 1
ALLOWED PROPOSED
HEIGHT
ALL.9WED PROPOSED
r
w5 45 1 R6
PROPEPTY TAX ACCOUNT PARUEL NU
(ocy
EW C /,(PLUMBING MECH
N RESIDENTIAL
ADDITION OMMERCIAL COMPLIANCE OR
CHANGEOFUSE
LOT COVER AGE
ALLOWE PROPOSE
15 a7d
REQUIRED SETBACKS (CMVI-PROPOSED
FRONk SIDE REAR
to 1
I
BACKS(
FRO LjR,1IDE /REAT)
0 to R
PARKING
IEI'D )ED
iql P'�'"
LOT ARF,9�1.j�
7171 7
ZING REVIEWED By
W11011flaq
REMODEL MULTIFAMILY IGN
REPAIR CYDS x Fri
OTHER
EMOLISH TANK
REMARKS
4(
j
0
ZI
E
rc
GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT 13 ROCKERY El FIRE ALARM
((TYPE OF USE, BUSINESS OWIVITY) EX
k- o h T"L A 0
CHECKED BY
TYPE OF fqjTFUCTION
1
1CODE
I OCCUPANT
NUMBER NUMBER 6F RITICAL
OF DWELLING AREAS PAN7
r SPECIAL INSPtCTION,&A,9EA' CU
UNITS NUMBER R LOAD
STORIES 1 (11 - V YES 1-0 oc
W
01
lz
z
DESCRIBE WORK TO BE DONE REMARKS 7.1 1 ;. . , . a
z
PROGRESS INSPECTIONS PER UBC 108/18CIO9./IRC109 FINALINSPECTION REQ-D
CA — �;O q I @
�%Iwfiad bu AkAff] W-30-n
PA vt,,. I I t k nA. --) 'IN. I f I - a - -.' �- " 1 -1
I fix If I
644;
VALUATION
CC*
$ 3
(X�) 0/
0 0_�
Description
FEE
Description
FEE
LA-.)
Plan Check
State Surcharge
(AEa LAZING,% LOT SLOPE %
tIRS UV(j.1 tm 4f
Building Permit
Cit�. Surcharge
PLAN CHECK NO:
Plumbing
Base . Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE %
13E DONE ON PRIVATE PROPER74i ONLY.- ANY CONSTRUCTION ON THE PUBILIC
a
Grading
DOMAI : N (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) VALL REQUIRE
SEPARATE PERMISSION.
2
Engr. Review
5 PERMITAPPLICAiION: 11111111DAYS
PERMIT LIMI1'1 YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review;�,
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY, OF
A EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Inspection
:Fire
Receipt # WL17 I
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
OEEMED TO MODIFY: WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE,
Landscaper1hivro,
Total Amt. Due low. 5z
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
x
Recording Fee
Receipt #
I 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_
dALL
This application Is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING Tj
FOR INSPECTION
receipt Is acknowledged in space provided.
WORKMEN'S COlt��ATION INSURANCE AND RCW 18.27.
I
LS SI N URE DATE
ATURE I NER GENT) D� SIGNED
(425)
f)l A
'It�
A—
771-022
LE BY IDATE
ATTENTION
Off 133
111210
ITISUNLAWFULTOUSEOR CUPYA BUILDING OR STRUCTURE UNTILA FINAL
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
PANIC Y HAS BEEN GRANTED. UBC109/IBC110/IRC110.
ORIGINAL -FILE YELLOW - INSPECTOR
'
I
PINK -OWNER GOLO-ASSESSOR
09/03
61 4
4
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBAcks .....................
FOUNDATION:
Footing ......................
Wall .......................... .
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
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 ..................