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CITY OF EDMONDS
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I H1815Y ACKNOWLIDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
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GIVEN IS CORRECT. AND THAT I A. THE OWNER. OR THE DULY AUTHORIZED AGENT OF
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ED THEREBY, NO PERS N LILBE EMPLOYE
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WASHINGTON RE ATING T o
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FOR INSPECTION
IN VIOLATION LABOR CODE OF THE STATE OF
WORKMEN S GIqMPENSATION40M;�k� NCE AND RCW 18.27
OFFI ALS 5 - I NATURE ATqk
DATE SIGNED
(425)
IL . A
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771-0220
RELEASED By
EXT 333
ATFiKTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
1
771-0221
FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
OR,, INAL-11LE
ASSESSOR
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CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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OWNER
Mr. Michael Mar and Mrs. Jodi Mar
1860 78' Place West
Edmonds, WA 425-776-8319 "79
OCT 0 3 2000
15 e66Z \X0
BUILDING DEPT.
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APPRC)'VED Sf 1s*'N'1NG
LEGAL DESCRIPTION
Montebello Park
Block D, Lot 19
TAX ACCOUNT
5177-000-019-00
RECEIVED
R ErE I VEDE
OCT 0 3 2000
BUILDING DEPT.
PLIL14L -
AN
Lot SIR -9,-434 s.f
SF-4;3()+ sf
M. owed@ 3�9/o
Existing Residi& SF 2,598 sf
Proposed Addition SIF 324 sf
TOTAL SF 2,922 sf
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE—
EN.11,1EERING DIVISION DATE
PLANNING DIVISION DATE —
PROJECT M A -PI
SITE ADDRESS. 9- 30 -7
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PERMIT# c�) 01-0q(5e-ADB#------PATFINSPECTEID
DESCRIPTION OF WORK TO BE INSPECTED —
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that,
the granting of
there are no objections from the above signed Department to
—Final approval of the described work
GRANT FINAL PROJECT APPROVAL
—GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
I
—FAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
-RE-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Fooling ................
Wall ........... ..............
Pier/Porch .................
Retaining wall ...........
Stab Insulation ..........
PLUMBING:
Underground
Rough -In ..............
Commercial Final
HEATING:
Gas Test ....................
r Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ......................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor insulation
vy\
Wall Insulation ...........
Coiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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USE PERMIT
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CONSTRUCTION PERMIT APPLICATION '2BRESS
OWNER AM INAME OF BUSI"MES
PLAT NAMEISUBDIVISION NO, LOT NO, LID NO�
LID FEE S
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NAME . _ -, - I- - so NO 0
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STATE LICENSE NUMBER EXPIRAHUN ED By
0 0 P�STED
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SIGN AREA HEIGHT
PROPOSED
COMPLETE I ElE"PT ALLOWED PROPOSED ALLOWED I
IlZjj Aobl�T PARCEL
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EXP V"
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LOT COVERAGE REOUIRED SETBACKS (M. PROPOSED SETBACKS (Fr.
0 NEW RESIDENTIAL, PLU.-IN- I ME-11 ALLOWED
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COMPLIANCE OR
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[�8,A..ITQN CHANGE OF USE
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PROGRESS INSPECTIONS PER UBC 108/FINA
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VALUATION FEE
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. HIS PERMIT COVERS WORK TO
CONSTRUCTION ON THE PUBLIC
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,.F.S. BIG
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SEPARATE PERMISSION.
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STATE SURCHARGE s
PERMIT APPLICATION: ISO DAYS
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PERMIT LIMIT. I YEAR PROVIDED ORK IS STARTED WITHIN lOODAYS
ENG. REVIEW FEES
SEEBAC K O� PINK PERMWIT FOR MORE INFORMATION
'APILIOAIT. ON BEHALF F His OR HE'6 SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
0 NIPY. DEFEND AND HOLD HARMLESS THE CITY OF
ENG. INSPECTION FEE
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IN INT R ST, AGREES TO EM
WASHINGTON. TS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANYAND
EDMON'DE.
% ALLCLAIMSFORDAMAG OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
. CES ERMIT SHALL NOT BE
ISSUANCE OF THIS P
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PLAN CHECK DEPOSIT -2
FR TIE AN THIS PERMIT.
1. D M To "'SU I 0WOF ' A TOFANYCITYORDIN INCE -
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LIMIT INAN . . . I T LITY TO ENFORCE ANY ORDINANCE PROVISION.
R CEIPT
TOTAL AMOUNT DUE I Q_ W o
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN N ORATE, DULY�AUT80TR,1�1.E. AGENT OF
IS CORRECT. A D THAT I AM THE OWNER.
LA. E.ULA CON STRUC-
TI,lPII N pq �bl Sig- by
CALL O.puly: .�d F ... - d.
THE OWNER. I AGRE To COMPLY WITH CITY AND ST
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TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYTE 0
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FOR INSPECTION _.,P'_'. �wl.dg.dimo ... ... v,d.d.
IN VIOLATION A CODE OF THE STATE OF WASHINGTON RE LATING
THE
— DATE
KMEN PENS CE AND RCW 18,27.
WOR S C;
Ea
DATE SIGNED
—si
OFFICIALS SIGNATURE
1(425)
GNAT uRV60NERO(AGEO)
771-0220
17PTION
By
FULEA�
EXT 333
A
"4�T
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL,
A FINAL INSPECTION HAS BEEN M ADE AND APPROVAL 08 A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL FILE YELLOW:'INSPECTdR
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