20000962.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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STATE LICENSE NUMBER
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REMARKS
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TH,S.pERMIT AUTHO.RAIZTE.S ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
E .�E ON PR PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
ETC.) WILL REQUIRE
GRADINGIFILL
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DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS. MARQUEES,
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 18D GA'S
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PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFOR IIION
A PPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. A SIGNS AND SUCCESOPS
WLIMITIN
ENG, INSPECTION FEE
IN NTEREST. AGREES TO INDEMNI Y DEFEND AND HOLD HARMLESS THE CITY 01
EDIMCNOS. WASHINGTON. ITS OFFICI�!_S. EMPLOYEES, AND AGENTS FROM ANYAND
E
ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
OF THIS PERMIT SHALL NOT BE
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PLANCHECKDEPO T
RED IT
x FR M THE ISSUANCE OF THIS PERMIT. ISSUANCE
0 2 ITY ORDINANCE
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY C
T 0 ENFORCE ANY ORDINANCE PROVISION.-
0 NOR ANY WAYTHE CITY'S ABILITY
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INEREBY ACKNOWLEDGEIHATI HAVE READTHIS APPLICATION ' THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DuLy AUTHORIZED AGENT OF
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THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTAUC
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TION; AND IN 10 NO THE WORK ALITH EDT BY, NO PERE N WILL BE EMPLOYED
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OF WASHI
TION
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IN VIOLAT ON OF THE LABOR CODE OF THE STATE
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WORKMENS =NSATIOq INSURANCE ANDACW 18.27.
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771-0
-EASED By
ATTENTION
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TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221 1
IT IS UNLAWFUL
AND APPROVAL OR A CERTIFI-
ORIGINAL FILE YELLOW.INSPECTOR
INSPECTION HAS BEEN MADE
A FINAL I
OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 09
FAX
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IIAOMUM ALLOWED--= 369,7 NOV 0 7 2000
DEVELOPMENT SERVICES CTR, rAY AccouNT AXCPJ_ NO: li3q6-coo-o3G-ot�w
CITY OF EDMONDS
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STA NADARD DRAINAGE DE71ENTION SYSTEM
WORKSHEET
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OWNER
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DATE:
*-'**DESIGN DATA*****
IMPERVIOUS
AREA
PIPE DIA
PIPE LG ORIFICE
3�716
7/0
LOCKING LID
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DETENTION PIPE LENGTH
FINISHED
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MINIMUM
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—c- OF
TIGHTLI PE_
CONC BOX OR RISER
OU LET CONTROL
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UPPER CATCH BASIN
GRIFICC
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CATCH BASIN
SYSTEM CROSS
SECTION
2'X2'X6' DEEP, 4-6- SPALLS OR EQUAL
FROM CONTROL CB 2'X 2'X 3' DEEP, 3/4' CRUSHED ROCK XIS$NG GRADE
FROM CONTROL OUTLET WASHED ROCK
CuIrLOW TREN MIN 10' LUNG.
P F le
ER PIPE TO Ca LEVCL
PERF P E W/ END CAPS
TRR�N 'AC NEW `D`RFAiN ROCK
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RiPRAP ourLET,
RUNOFF SPREADER. TRENCH
FOOTING DJUINS SHALL NOT RE CONNECTED 710 DETENTION SYSTEM
NOTES.
1. Call Engineering Division (771-0220) for a tightline and detention system inspection
before backfilling and for find inspections.
1/110�
APPROVED BY
2, Responsibility for operation and maintenance of drainage systems on private property is the
Material accumulated in the storage Pipe must be flushed
responsibility of the property owner.
out and removed from the catch basins to allow proper operation. The outlet control orifice
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Name Title date
VERIFIED BY CITY BUILDING INSPECTOR-YvS ':;-- Y-1—
Name Date
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
Ut (-,g &rT ENGINEERING DIVISION DATE
PLANNING DIVISION DATE --
PROJECT
SITE ADDRESS rqo:� Iertl' ky.
PERMIT# c:P00— qb:)- ADB#--------PATE INSPECTED
DESCRIPTION OF WORK TO BE INSPEC
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of:
Final approval of the described work
GRANT FINAL PROJECT APPROVAL
___GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
I
AILED FINAL INSPECTION - OUTSTANDING ISSUES
1.
2.
3.
----RE-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
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wall..........................
Pier/Porch .................
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Retalnlng Wall ...........
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Slab Insulation ..........
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FINAL APPROVAL FOR
OCCUPANCY ..................
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CITY OF EDIV16NDS
NUMBER
CONSTRUCTION PERMIT APPLICATION
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LID NO,
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CITY TELEPHONE
NAME
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FIRE REVIEWED BY
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PLUMBING
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MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
1:
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON TH E PU BLI C
DOMAIN (CURBS. SIDEWALKS. DRIVE , MARQUEES. ETC.) WILL REQUIRE
M AYS
GRADINGIFLLL
SEPARATEWPERMISSION.
PERMIT APPLICATION: 180DAYS
PERMITLIMIT'. I YEAR. PROVIDED WORK ISSTARTE. WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. REVIEW FEES
END INSPECTION FEE
-APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEI.S. ASSIONS AND SUCCESORS
IN NTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS HE CITY OF
IN
["HIS
a EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND A ENTSFROM ANYAND
A CLAIMS FOR DAMAGES OFWHATEVEA NATURE, ARISING DIRECTLY OR INDIRECTLY
THIS PERMIT SHALL NOT BE
DEPOSIT
FEC
FLAL I
OM THE ISSUANCE OF T ISSUANCE OF
PERMIT' 'YA
9 - DEEMED TO MODIFY, WAIVE OF REDUCE A EQUIREMENT OF ANY CITY ORDINANCE
0 -NOR IN ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
P NCHEC
AEC
LIMIT
ii
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT: HAVE READ THIS APPLICATION; THAT THE INFO MATION
APPLICATION
APPROVAL
GIVEN I CORRECT.ANDTHAT AMTHE OWNER. OR THE DULY AUTHORIZED AGENT OF
S CONSTRUC
LAWS REGULATING
T ` ,C, 1. nal a pij �Jil Igl.d by ih,
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE
TION. AND IN DOING THE WORK AUTHORIZED THEREBY, No PERSON WILL BE EMPLOYED
RELATING TO
CALL 'g� Olpjp�'I.j ., hl,M., O.puly: .�d F... .1. P_. Ild
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FOR INSPECTION
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27,
OFFIOALS SIGNATUR�,
Tj
7TE SI NED
(425)
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T I �l - (0) fo
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771-0220
-FIELEASM13Y OATV
ATTENTION EXT/333
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
, _� .
Z
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL 'ILE YELLOW INS PECToR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK OWNER GOLD —ES-A
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