20010935.pdf11 '1 DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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ITELEPHONE
C'A'MYE
PERMIT EXPIRES
L US E PERMIT
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NUMBER/201
08 SUrTVAPT#
ADDRESS I ]L42_1 ("7 Ot '0L W
PLAT NAMEISUBONISION NO
LOT NO,,
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FEES
LID FEE S
PUBLIC RIGHT OF WAY PE OFFICIAL STREET
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PRV REQUIRED
YES E3 NO 13
REMARKS
WNERICONTRACTOR RESPONSIBL!._FOR EROSION CONTROUDRAINAGE
CITY ZIP
TELEPHONE
NAME
ENGINEERING AMCWEDIDATE
ENG' EIR'NG
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FIRE REvIEWED By DATE
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OSTED
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STATE LICENSE NUMBER EXPI—ON BAT CHECKE=Y
APr PfI67 C14f De- Ii
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(TYPE OF USE, BUSIN21; �O EXPLAIN:
CHECKED By
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NUMBER
OST'ORIES
NUMBER OF
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UNITS
CRITICAL
AREAS n—
HUM..
SEECVUE�.�.IE.T.. JAREA
put.
R YEE
UPAW
- 7
ESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 10alIFINAL INSPECTION REGO 2
CM 15 d�) C—
VALILIATION $
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Cleiscription
FEE
Des.ription
FEE
G�NG LOT SLOPE -Building
PLAN CHF.CK NO: DATE
PLPl
_LTM
Mechanical
THIS PERIMPT AUTHORIZES ONM�E WORK NOTED. THIS PERMIT CMR8 WORK TO
BE DONE On PRIVATIE PROPERTY OHM AlrY CONSTRUMON ON THE PUBUC
Grading
Recording Fee
0 M EV
ORANN (CURBS, SIDEWALIKS. ORRIEWAYS UE11,UC,)W1LLREOU1RE
—
SEPAlUTTEPERM16=102'.
:rg , R.v,..
r
City Surcharge
P11BUTIAPPLI.1 IS0-AY-
YEAR-PROVIDEBW RKISSTAFTEDWITHIN —DAYS
Engr. inspection
State Surcharge
SEE BACK OF PINK PERMIT MR MORE HIPORMATIO
T,".c Mill"811on
Plan Chk Deposit
S I 8 AN' SUCC' 0 FS
'APPLI"I"N" ON BEHALF 01 HIS OR HER SPOUSE, HEI81, ASSIGNS ANI SUCCISORS
A M LESS THE C' 0 F
IN INTEREST AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
0
Fire Review
Receipt III
IS
ADEN Te OM — AN
EDMONDS. WASHINGTON, US OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
D n 'N"RECTL Y
0 Y OR
ISFOHDAMAGE CFWHATEVE NATURE. ARISING DiRECTIMOR INDIRECTLY
ALL CLAIM S
a
FROM THE ISSUANCE OF THIS PERMMR ISSUANCE OF THIS PERMIT SHALL NOT BE
Fire Inspection
Total Amount Due
F C NANCE
DEEMED To MODIFY. WANE 08 BE UCE My REOUIREMENT OF CflTYORO1NAJI[
1 NOR MIT IN ANY WAY THE CITyS ABIUTY TO ENFORCE ANY ""'NANCE P.-,E,.N
Landscapoinsp.
Receipt III
HAV READ THIS APPLICATION; THAT THE INFORMATION
BY Ef
1 HERE ACKNOWI-EDGE THAT
APPLICATION APPROVAL
ENT 0
..EN 15 CORRECT. AND THAT AM ME OWNER. OR THE DULY AUTHORI.D AGENT OF
I
Thl, Itpplitibn I.... by IT-
ON'TRUC
S
THE OWNER. I AGREE TO Ca EG T 0 , TRUQ_
ULA No C 'f
PLY WITH CITY AND STATE LAWS REGULATING C up E
BE EMPLOYED
CALL
CALL
B,Ilftg offi,,I 0, dSft Dep.ty: wd Ft,a. we paid. a
TION. AND IN MING THE WOMRK "THoruzzo THEREBY. NO PER ON WILL
IN VOLA THE CODE OF THE STATE OF SHINGTON REILATING TO
N To U R LATI C
WA S G
AMURANCE
FOR INS P'.Id,,d-
PECTION
FOR I NSPECTIOI
WO"2;t§M"SA_T1GNO AN. Raw 1.21.
0 DATE
E
, SIGN .
E
(425)
( 5
2 ?e .9
/
l2ell
1 0
'jUME
QAT
771-0220
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
F"
PINK - OWNER - GOLD - ASSESSOR
10101
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71,
10 20 30 40
ACCEPTABLE TIGHTLINE
5CALE: P . 20.00'
MATERIAL
SDR 35
TAX 10 NO:
004 00 0'3
LOT SM40
'3,"099'MCOR
FOOTING DRAINS60 000
TO BE TIED I E
LOT COVERAGE
DETENTION SYUT-1-1—w,—Lsoi��--
2141 50. FT.
SITE ADDRESS:
LOT5LOFE
—
1-1421 6-3TH F-L. U EDMONDS
5-19.
so,
- - - - - - - - - 13=93"
EX15TING HOUSE 11. GARAC
...
rx
-CONCRETE�
PECK
4-4 "1""
t 9
T
9
IMINERICONTRACTOR IS RESPONSIBLE FO
D
EROSION CONTROL AND DRAINAGE
1MFERVIOUS SURFACEAREA
EXISTING 5UILDING FAD: 13e5 sq. rt..�CON5T. IS74) 1. -.-um F.T. --i
EXISTING IDRIVEWAT% 1400 sq. ft. (coNST. 11314) 55 100, ,
CENTE1 � OF
F-ROPOSED GAP -AGE ADDITION: "14ro sq. ft. SEU)--R M.W.
GARAGE IS OVER EX15TING DRIVELLIAT AREA.
IF Pr-w Mw" WtU tx gfa9sr--D cul-cie sac
W4%( MUST-
&Sth pl. W.
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IietuAM raW69X!� A U5PD--Xt> 4r
C" a W
RECEIVED
04bw-- I
IA-Y
AfA.O,,�Ar r-be
2 2 2001
GUTTERS/DOWNSPOUTS
TO CONNECT To EXIST. SYST.
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
0 KI(NTrn
APPRuVuv A
`kPPROYED BY PLANNING 13Y ENGINEERING
Q-4a,"i �10)01 a;,, — —,%C., I T Y C 0 P Y
Date:
m
co),
0
n
?S rn
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
�SETBACKS ....................
FOUNDATION:
Footing ......................
wall ..........................
Pier/Porch ................
Retaining Wall ...........
Slab Insulation ..........
0A
PLUMBING:
-4
Undergtound .............
oc�
Aough-In ....................
M
Commercial Final:
HEATING:
GasTest ....................
Gas Piping .............
Equipment ..........
Commercial Final
E)CrERIOR SHEATHING
NAILING ..........................
FRAMING ...................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
o
M
SHEETROCK NAILING
SPECIAL INSPECTION
iN
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
PERMITEXPIRES
CITY OF EDMONDS
FEDMONDS
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USE
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PERM T
'UM.EFI
N PERMIT PLICATION
CONSTRUCTION PERMIT APPLICATION
'A'OBDAESS 7 L4) I -IL 6AJ Surr"Al"
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PLAY NAMEISUBDIVISION NO.
LOT NO-
I'D NO
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MAP
MAILING ADD78S
FE
PUBLIC RIGHT OF WAY PER OFFICIAL
"OP
EXISTING — PROPOSED
STREET M�
—
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CITY
LEPHONE
IT
7
N—
REQUIRED DEDICATION—
REQUIRED DE-'CAT'O
FT --
U�
ZE
MEMR SIZE
LINE
LINE SIZE
1 110. 01 FIXTURES
PRV REQUIRED
YE.13 No 13
jgj
ADDRESS
REM Ke
REMARKS
RESPONSIBLE FOR EROSION CONTROVDIANNAGE
E.P(
CITY ZIP ITELE-1-
NAME ENGINEERING
A11�6J�_ Ve J\j t) PFIRE REVIEvMD By
Ive I �111)
CITY ZIP TELEIHONE
m6ySVIII/c 16271 3k &5`Y-135S
VARIANCE OR CU
STATE LICENSE NUMBER ... I ION DATE I CHECKED BY
/-I I eC- r 11167 Cl 4f 1��C I i I (>�' \-� -A Ew
8
PRIP7AIg PARCEL NO
COMPLETE EXEMPT
EXP
A�LOWED "No
0 NEW f6-PLUMEIIN. (!5�)
ADDITION 0 C MPUANCE OR
CHANGE OF USE
ALL
IWT.ED
or
FVONTt SIDE
en COTU
REMODEL 0 SIGN
RE
U lava space&
UNIC
REPAIR GRADING Cy.. p FENCE
X Fn
REM
0 DEMOLISH [:I TANK OTHER
GARAGE, RETALINING WALL 0 RENEWAL
CARPORT ROCKEAY
(TYPE OF USE. SUSIN EXPLAIN: -7
CHECKED By Typ F Z�b'�T1211
MBM OF .
MLLING
I"
CRITICAL
A
NREAS P,
..BE
SPECLM- INSPECTOR
REQUIRED 0 YES
AREA
REMA KS
RnGRIESS INSPECTIONS PER UBC
0
/ I q //
12
VALLIATION $
Description
F
Plan Check
H GLAMN� % LOT SLOPE %
Building
-STED DATE
PLIJI CI?C
Plumbing
-
Mechanical
THIS PERMIT AUTHOnDBES ONLY THE WORK NO=. THIS PERMIT COVERS WORK TO
t BE DOME ON PRIVATE PROPER" ONLY ANY CONSTFORMON ON THE PUBLIC
Grading
2 DOMAIN (CURBS, SIDMALKS, DRIVEWAYS, MARQUEES, UC.) WILL. REQUIRE
SEPARATEPERRISSION-
Engr. Review
a—
PERUPT APPLICATION; IN DAYS
PERMIT USNT , YFAR. PRCMDEB 16'0RKU1STAffnEDWiiHIN INDAYS
Engr. Inspection
SIDE BACK OF PINK PIFW.q FOR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Traffic Mitigation
IN [MEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMILESS ]HE utly -
EDMONDS. WASHINGTON, US OFFICIALS. EMPLOYEES, AND AGENTS MOM ANY AND
Fire Review
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
M 12 1111 OF THIS PERMIT ISSUANCE IF THIS PERMIT SHALL NOT aE
Fire Inspection
ANY C C
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF TTYGRDINAN E
NOR UNIT IN ANY WAY THE CffY`S ABILITY 10 EAlu— -10-1— -
Pe Inep.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
ONEN IS CORRECT. AND THAT I AIA THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE To CoMpO, WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATI BOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
WORKMEW2E� INSURANCE AND RCW 18.27,
BIGNA71(( R"�IRA.0�60 IATE 617ED, , 11
(425)
-7, 7
771-0220
ATTENTION
Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
OR A CERTIFI-
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL
CATE OF OCCUPANCY 14AS BEEN GRANTED. USC SECTION 109
10101
FAX
DATE
13YES E3NO
HEIGHT
OSED ALLOWED , PROPOSES
"Tr IS IT
REAR FROM UR E REAR
xtor. I
OGCUPANT
GROUP
OCCUPANT
LOAD
FEE
Recording Fee
City Surcharge
State Surcharge
Plan Chk Deposit_
Receipt #
Total Amount Due
Receipt#
"W 61=bPy':.
.dft
'P.. W.'idw.
- —DATE
__j
ORIGINAL. FILE YELLOW - INSPECTOR
PINK OWNER GOLD . ASSESSOR
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