20020122.pdfDATE RECEIVED
PERMIT EXPI
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLICATION
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35% 7,9% 12-5- .5' 133' ?-g'
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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Grading
Recording Fee
DOULUN (CURSS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
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SEPARATE PERMISSION,
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4�-City Surcharge
PER ITAPPUCAHO.: ISODAYS
PERMIT UMM. I YSAR.PROVID D WORK IS STARTED WITHIN 180DAYS
SEE BACK OF PINK PERMIT FOR NOR INFORMATION
Engr. Inspection
state surcharge
-PLI . ON BEHALF 01816 OR HER li'OUSE. HEIRS ASSIGNS AND SUC ESORS
Traffic Mitigation
Plan Chk Deposit
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IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS I I ,,, OF
IDMONDI*WAIHIIIGTON, ITSOFFICIALS*IMPLOIEEE, AGENTS FROM ANY AND
AND
Fire Review
Receipt #
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15.71?1
ALL CLAIMS FOROAMAGESOFWHATEVEA NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE
Fire
TotalAmountDue
DEENIEDJO MODI WAIVE OR REDUCE ANY REQUIREMENT OF MY 017Y ORDINANCE
Inspection
o NOS IM T IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
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I Receipt #
1 HEREBY ACKNOWLED E 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 OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
This appli-lo, Is net a penent-11,19had
by the
TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATI N OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
8.11ding Offid.] ., �Islhhrr Deputy: and Fees are paid. and
FOR INSPECTIO14 11 "Iellwhithirid ',,Pace P—Ided.
WORKMEN'S COMPENSATION INSURANCE AND ACAN 18.27,
DATE
SIM�NER ONED
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771-0220 RELEASE D BY
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ATTENTION
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7210
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 YELLOW -
IhSPE � R
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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EX SITING RESIDENCE 1559. SQ FT
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EXIST. ATTACH. GARAGE 333.5 SO
23816 101' AVE WEST
TOTAL 1892.5 SQFT 204%
EDMONDS 98020
206 5428824
PROPOSED ADDITION 769 SO
TAX 00615800000700
NEW TOTAL 26813 SO FT. 29.3 5�
3ALDEsCRIPTION:
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HEAT- OILF/A (1999)
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SCOPE OF PR
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HEIGHT CALCULATIONS: CITY OF EDMONDS
SINGLESToRYADDITIONOF 788-SQFT-
REFERENCE: BOTTOM OF TELEPHONE POLE - IOW --v
DINING ROOK MASTER BED AND BATH.
A. 100.1
B. 1002 OWNERicoNTRACTOR IS RESPONSIBLE
C. 100 ': FOR EROSION CONTROL AND DAMAGE
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35 FT TOTAL: 400' 4- 100.' MAXHEIGHT.' 12V
FRONT 25 FT
SIDE 7.5 FT 73 1 11-2" IrR—QJ�6--S—EDIIElai 115!1.
REAR 15 FT 32 FT.
LOTSIZE: ZONE
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ISTING RESIDENCE (PRE 1960) 1559 Q
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FINAL PROJECT APPROVAL FORM
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DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROK FIRE DEPARTMENT DATE —
ENGINEERING DIVISION DATE...-7L
PLANNING DIVISION DATE—
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RE-INSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ....................
Wall ...................
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Retaining Wall ...........
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Slab Insulation ..........
PLUMBING:
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Gas Piping .................
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FINAL APPROVAL FOR
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