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FPERMIT EXPIRES
UOSI
PERMIT 7-00800
CITY OF EDMONDS I
NE NUMBER
CONSTRUCTION PERMIT APPLICATION 'AODRF.S
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OWNER NAME/NAME OF BUSINES
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NO. OF FIXTURES
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REMARKS
OWNERCONTRACTOR RESPONSIBLE PON EROSION CONTROUDRAINAGE
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AFANOl 01, GO
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_BISI�CTION
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BOND
POSTED
STATE LICENSE NUMBER EXP19� 1 . DATE
CHECKED BY
SERA REVIEW
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SIGN AREA
AL 'ED PROPOSED
HEIGHT
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PROPERTY TAX ACCOUNT PARCEL NO.
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e`NEW E!jEEStDENlNAL i MECH
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FRONT SIDE REAR
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PROPOSED SETBACKS (FT.)
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PLANNING REVIEWED By DATE
0 PENCE FT,
REPAIR I
MARKS
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NUMBEROF
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DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER USC 1081FINAL INSPECTION REO'D
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PLAN CHECK IES
VALUATION
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU BLIC
DOMAIN (CURB% SH]EWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
GRADINGIFILL
STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT, 1 YEAR � PROVIDE. WORK IS STARTED WITHIN UM DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. REVtEVV FEES
ENO. INSPECTION FEE
'APPUCANT. HIS OR HER SPOUSE, HEIRS. ASK ANDSUCCESORS
ON BEHALF OF 'GNS
IN INTEREST AGREES TO �NQEMNIFY. DEFEND AND HOLD HN 1 ESS THE CITY OF
2 EDMONDS. WASHINGTON, TS OfFJCIALS� EMPLOYEE& AND AGENTS FROM ANY AND
- OF WHATEVER NATURE, ARISING D IT
AUCLAIMSFOR AMAGES S PE�,.,, - ��,�i
FROM THE ISSUANCE OF THIS PER -IT ISSUANCE OF THI E IT T
DEEMED TO MODIFY,WAIVE GNFECLCl ANY REQUIREMENTOF ANY CITY ORDINANCE
NOR LIMIT IN ANYWAYTHE CITY�SASILITYTO ENFORCE ANYORDINANCE PROVISION�-
N.FEE
I)Lk
PLAN CHECK DEPOSIT
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TOTAL AMOUNT DUE
IRECEIPT/&
50
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION� THAT THE INFORMATION
RRECT A D THAT I AM THE OWNER. OR THE DULY AUTHORIZED
GIVEN AGENT OF
CC CONSTRUC-
IS LATING
THEOWNER, AGREE NTO COMPLY WIT. TY AND STATE LAWS AEGU
IN DOING TH K AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOY ED
TION; AND HE STATE OF WA HINGTON RELATING TO
IN VIOLATION OF TH LABOR CODE OF T
WORKMEN S C TION INSURA AN RCW 18,27�
P IFA�I�N APPROVAL
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FOR INSPECTION
CIALS SIGNATU DATE
(425)
771-0220 NE-LEASEDBY DATE
SIGNATU WN
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I DATE SIG ED c'
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EXT 333
771-0221 ORIGINAL - FILE - YELLOW INSPECTOR
PINK � OWNER - GOLD . ASSESSOR
FAX
�10 N
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
5198
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A ENG ERING. Inc.
LOT 1 8506 ROWDOIN WAY
18609 76th Avenue West, Suite B
1
GROSET CONMUCnON
Lynnwood, WA. 98037-414Q
325 3RD AVENUE SOM
Phone: (425) 697-5108
drawn
app'v'd'-----2KR-
EDMONDS, WA 98020 - 778-4824
Fax: (425) 697-4506
dwg. angnzze=
. DATE: 8/15/2000
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OWNER
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ADDFLIESS
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AlpRAp OUTLEr
FOOTING DRAINS SHALL
NOTE"
1. Call pagineering Division (771-MO) for a
before b..kf.IU-g and fe" find Inspeetim's*
2, ResponsibifitY for operation and maintenanc
Mate
responsibility of the Property ovmer*
the catch basins to at
and removed from
=t be knt pim—at al
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APPROVED lBlY
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bei flushed
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DATE
Detinflon Pi a Sizes
Impermeable
Required Pipe Diameter
16" 18" 24" 30'
1
Area Sq. Ft.
Vol Cu Ft
J�z'
2000
60 40 28 16 10
2500
62 50 35 20 13
60 42 24 15 Required pipe
3000
75
87 70 49 28 18 length in feet
VNI�
3500
4000
100 so 56 32 21
90 63 36 23
4500
112
125 100 70 40 25
NO,
5000
U
11 able Pipe Materials: Reinforced Concrete
Note: A ow
M
Aluminized Steel
Aluminum
V5 -4�
CMP Asphalt Coated
N — 12 ADS (Not permitted on roads)
C o
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-401
0
T Is 2 —outlet Orifice Sizes
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2500
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3000
3/4
3/4
0
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3500
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mot
1
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4000
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4500
7/8
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5000
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Table 3 — Rectal !Iguiai Catch l3asH i 1,equirements
Z
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Detention
max. size Catch Basin
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Ty
knockout pe
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1
< 18"
2 0. Type 1, CB 15
181 to 24'
26. Type It, CB 16
36" Type 11, CB 19 19 (48" Basin)
t
24, to 36*
36" to 42"
42" Type 11, CB 19 19 (54- Basin)
*Source: Assoc. Sand & Grav at Co. standards
5
1�gvised 3/16/95
FINAL PROJECT APPROVALTORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: -FIRE DEPARTMENT DATE�_
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ENGINEERING DIVISION DATE- 0
PLANNING DIVISION DATE_.�� :4 ffi
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PROJECT- co
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SITE ADDREP. K
PERMIT #
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PDA 0
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DESCRIPTION OF WORK TO BE INS? :�
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to the granting of:
there are no objections from the above signed Department x
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inal approval of the described work 0
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......... ;��GRAM FINAL PROJECT APPROVAL Z
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED z
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2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
ocaprvl.doc.l:temp.bidg:fonns6/98
FINAL PROJECT APPROY�ALEOL-RM
TO:
DATE: —
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
DIVISION DATE W—Ied—o
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PLANNING DIVISION DATE—
e) 0 W kl 6 9?-+
PROJECT '�=/
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PERMIT #—A 0 0 —R0 0 ADB#__________PATE INSPEC M
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DESCRIPTION OF WORK TO BE INSPEC
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there are no objections from the above signed Department to the granting of n
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Final approval of the described work
0
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GRANT FINAL PROJECT APPROVAL C: Cn
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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0
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2.
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RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
ocaprvi.doc.l:temp:bldg:forms6/98
Project Review Cheddist,
ProjectNarne: Plan Check #:
Project Address: -Aw4z,;, UO&^-t— Receipt Date*
CJ
41�b
Underground Wiring Required
Hydraulics Permit
Plat/Subdivision Requirements
Street Dedications
Z
Easements - Public/Private
Engineering Storm Drain Review Feel
M
Engineering 2.2 Inspection Fee -,P
Drainage Plan (On -site)
Setback - Storm Drain Line
F0 :0
open Ditch - Existing
a In
In
Culvert Required
-40
0
Culvert Size
Shoulder Drainage/Shale Open Runoff
C::
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X ifl
Catch Basin Required
in 2;
to
Driveway Slope& Vehicle Access
C: —
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Sid ewalk Required It
Curb & Gutter Required
0
0 -n
Curb Cut for Driveway Required
street Paving Required
Right -of Way Construction Permit Required *4
X
in M
Bond Required for Public Improvements
0
0
0
FEMA Map CheckfWater Table
Side Sewer -Availability
C
0
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Calculate Sewer Fee if No LID#
Water Meter Size
water Meter Charge Required
Hydrant Required
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Street Cut
-4
Miscellaneous
z
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R Permit # Date Issued /0 v
W
Receipt # 37
q-1110 Date Issued
Receipt #
SS Permit #
Fire Connection$ Date Issued
Receipt #
Meter Size Paid $ Date
Receipt #
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Feeling ......................
Wall .......... ...............
110/1-1 /171
Pier/Porch .................
Z,
Retainirig Wall ...........
Slab Insulation
0
PLUMBING:
OL
Underground .............
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Rpugh-In ...........
In
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commercial Final
-40
OC
NEATING:
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Gas Test ..........
Gas Piping .................
JD
Equipment .............
Co morcial Final
m
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EXTERIOR SHEATNING
MAILING ............
M
0
FRAMING ....................
------
7- 00
C
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FIRST FLOOR FRAMING
1 2;31
INSULATION ...................
Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
2z
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SPECIAL INSPECTION
0
MISCELLANEOUS ..........
FINAL APPROVAL FOR
I —I-bt
OCCUPANCY ..................
DATE RECEIVED -
7_1
t RMIT EXPIRE%,
US PERMIT
ZO E
CITY OF EDMOND&. -20,
JOB
CONSTRUCTION PERMIT APPLICATION ADDRESS
'.5,T31,6 1;i �
OWNER NAMFJNAME OF BUS NESS
LOTIO, LID 0
PLAT.NA;Si
U. FEE I
I
MAILIN 0 FEES
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PUBLIC RIGHT RF,,FICIAL
7,Y 0
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CIT� ZIP TEl
EXISTING
a .I- (. i - j!
REQUIRED DEDICATION F
NAME
METE SI LINEISIZE NO. OF FIXTURES PAY REQUIR 0
YES V NO 0
ADDRESS
REMARKS
EWCONiRACTOR RESPONSIBLE FOR EROSIOWCONTROL/DRAINAGE
ZIP EPHONE
CITY
V ITEL4 _
G 'I
NAME
vJ m 104
ENGINEERING ?DATE
Cil
ADDRESS
Cl 6 115
1111� Fil BY DATE
CITY ZIP
TELEPHONE
0
OR CU
STATE LICENSE NUMBER
SERA REVIEW
COMPLETE EXEM
SIGN AREA
ALLOWED PROPOS D
HEIGHT
ALLOWED/ PROPOSED
PROPERTY TAX ACCOU14T PARCEL NO,
fs 11 0
Exi
DENTAL ING Y MECH
2—P-Lumef
LOT COVERAGE
ALLOWED PROPOSED
R D SET ACl
SQUIRE AR
FRONT SIDE RE
FRDPOSE..ET.ACKSI-)
FRONT Li E RE AR
o COMPLIANCE OR
ADDITION CHANGE OF USE�
I
PARKING
RED �D
PROVI ED
LOT
PLANNING REVIEWED by
C3 REMODEL 0 SIGN
REPAIR -GRAOING
[5 CYDS _X, FT)
E ARKA
DEMOLISH 0 TANK o OTHER
04
;a 'GARAGE [3 RETAINING WALL RENEWAL
CARPORT cKil
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0 1 1 11 1 c E OCOUPA
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NUMBER NUMBER F<,,,-I,, Z
Is DWELLING ARE
i I _REAI . Ni I OCCUPARI
- is
'u'.'1 ig 7 LOAD
OF iC PER
i NUM
o STORIES
HE YES
a
DESCRIBE WORK TO BE DONE
All
REMARKS
PROGRESS INSPECTIONS PER uBc loolPINAL INSPECTION REQ'D
6\1 �AA oa.L
(C)t,
10 Du�
17N,
VALUATION FEE
PLAN CHECK FEE
, LA NO LOT 1LfE.,*
BUILDING
o
-E I i. ,�,
b
::::HEAT
SGU1:1rE OR
PLAN CHECK Nil IVESI ED DATE
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
::1 BE DONE ON PRIVATE rRAOLPKESRToyilONFLY-,�ANY=UTERUCTION ON THE PUBLIC
ES, ETC.) WILL REQUIRE
GRADINGIFILL
91 DOMAIN (CURBS, SIDEW IV _W YS�
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICAIR N: 180 DAYS
15
PERMIT LIMIT. I YEAR. PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
PEE
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, i ASSIGNS AND SUCCESORS
'S To G�I�NO AND HOLD HARMLESS THE CITY OF
IN' MTR=
END, INSPECTION
LANDSCAPING
jq
:TNSOEMNIII,
E isi . T-11. OFF CIALS. EMPLOYEES. AND AGENTS FROM ANY AND
ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY ORINDIRECTLY
PERMIT SHALL NOT BE
INSP JON�FEE AI
RECEIPT
OEF I q
m FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS
REOUIREMENT OF ANY CITY ORDINANCE
PLAN CHECK
I DEEMEDTO MODIFY, WAIVE OR REDUCE ANY
Y'S ABILITY TO ENFORCE ANYORDINANCE PROVISION.'
REC wT
0 K)RUMITINANYWAYTi
TOTAL AMOUNT DUE
15
ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
I HEREBY
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THEOWNi I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CO�STRUC-
CALL
This 'Poi -,on I. - . P-1 Wfilhg by Ilh.
Buill shKA.,..puIy:.ilhJF "I ss1d..rd
`g O"s
TION THEREBY, NO PERSON WILL BE EMPLOYED
AND IN DOING THE WORK AUTHORIZED L
OF THE STATE OF WASHINGTON RE ATING TO
FOR INSPECTION
1-1,01 is h_-Ndod M.P_ P., Z.
IN ";
DILATION OF TH�LABOR CODE
WORKMEN'S qDtF�EN�ATIW�INSURANCE_ANO HCW 18,27.
0�q'CtALSSIGNATURE I DATE
SI.NATU7i_.Owl DAI SIGNED
(425)
771-0220
RELEASED BY
EXT 333
ATTENTION
�A
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
ORIGINAL FILE YELLOW - INSPECTOR
A FINAL NSPECTION HAS BEEN MADE AND APPROVAL OR A CERl
OWNER - GOLD . ASSESSOR
CATE OFIOCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
5/96
FAX
PINK -
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