20020256.pdfDATE RECEIVES
[PERMIT ��) 2
EXPIRES
CITY OF EDMONDS
PERMIT
NUMBER 2alz-C?qL�
CONSTRUCTION PERMIT APPLICATION
JOB
ADDRESS�j SUIT11AP)
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PLAT NAME/SUBDIVISION NO. LID N
MAILING A IS
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P BLIC RIGHT OF WAY PER OFFICIAL STREET MAP TES
CITY
EXISTING — PROPOSED
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NAME
METER SIZE LINE III PRV REQUIRED
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or
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1: ADDRESS
REMARKS
OWNERMONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDMINAGE
17
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NAM
ENGINEERING REVIEWED
AUD
j"d 710
FIRE REVIEWED BY DAT E
CITY
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ITEL11HON
112'5 ("7
STATE fJCENSE NUMBER
EXPIRATION CH
1ARIANCE OR rU SHORELINE OR ADS# INS�ECTIONI
PROPERTY TAX ACCOUNWT RCM No�
0o 14K"33 0,;IL-6
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IPBOND
REQ-D CITED
OY- % NO
SEPA REVIEW SIGN AREA 'HEIGHT
ROPO
COMPLETE EXEMPT ALLOWED , PROPOSED ALLOW ED I P 1111
EXP I t -,)
NEW ja RESIDENTIAL PLUMBING I MECH
LOT COVER BE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FI)
ALLOWED PROPOSECD FRO SIDE BEAR FRONT UR Sit. BEAR
OR
CHANGE
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46 "o
ADDITION 0 COMMERCIAL
E:i COMPLIANCE
OF USE
REMODEL APARTMENT
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REDD I PROVIDED
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NUMBER OF. CRITICAL SPECIAL INSPECTOR JARFA
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1 BE . -apq REMARKS
I,- geA,Ad C Id I ....... INSPECTIONS PER UBC 108MINAL INSPECTIC
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VALUATION$ 0-�76q7l -1
Description FEE Description_ FEE
Plan Check
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S;r I Gr�Nd�_ I LOT SLOPE %
Building
VESTED DATE
Plumbing
—
Mechanical
THIS PERMITAUTHORIZES ONUTHS ORK NOTED. THIS PERMIT COVERS WORK TO
111"10"Pllll"OPEM...CO..II.Tl....THIPUBuc
Grading
Recording Fee
DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS. MARQUEES. FTC.) WILLREQUIRE
SEPARATE PIERMISSIONL
Engr. Review
City Surcharge
PE MaAPPLICATION: ISODAYS
PERMIT UMIT. I YEAR - PROVI ED WORK IS STARTED WITHIN '80 DAYS
Engr. inspection
0�2- State Surcharge 2�2
SEE IIACK OF PINK PERMIT FOR MORE INFORMATION
_J0
-PLICAVT ON BEHALF 01 HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREES TO INDE.NIFY, DEFEND AND HOLD HARMLESS THE CITY 01
Receipt #
EDMONDS' WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
AM CLAIMS FOR DAMAGES OF WHATEVE NATURE, ARISING DIRECTLY 08 INDIRECTLY
ISSUANC ISSUANCE BE
Fire Review
FROM THE OF THIS PERMIT. OF THIS PERMIT SHALL NOT
"A" "' "
HY ORDINANCE
DEEMED TO MODIFX INA V` OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
Total Amount Due
0 NOR LIMIT IN ANY WAY THE CJWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.�
x PROVISION *
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Receipt #
I FORMATION
I HEREBY ACKNOWLEDGE THAT I HAVE HEAD THIS APPLICATION; THAT THE INFO MATION
APF LICATION APPRbvAL
I - AGENT OF
GIVEN is CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE I ABBE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
' C.N-TRU-
Thi� Appli-I.P I� r— p—h unfil,igmd by th.
OWNER.
E EMPLOYED
IN D BEEMP
TION, AND DING THE WORK AUTHORIZED THEREBY, NO PERSON WILL G LOVED
CALL
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LAT To
IN VIOLATION OF THE LABOR ODE OF THE STATE OF WA:SHIN:GTON RELATING TO
FOR INSPECTION
,J�Ipl I—In-ledod I. IIP— p—ided
WORKMEN
,�S,CCMPTSATION IN URANCE AND RCW 18.27,
SIGNATurkC---, DATE
DATE SIGNED
(425)
:AT#'
771-0220
RELEASE Y
ATTENTION
Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
Tfiihlilut— 11,
--T— - -N"
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGI AL - FILE YELLOW - INSP' T
CATE OF OCCUPANCY HAS BEEN GRANTED. UBG SECTION 109
FAX
PINK - WNE GOLD - ASSESSOR
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Height Calculation Worksheet
Address:
Date:
Inspector(s): V�J
1. Datum Point:
2. Datum Point Elevation:
3. Average Grade: 4 5 Lf
MI
grade) 4 go.0
4. Maximum Elevation Allowed: -26'—
_(average
5. Reference Point Elevation Shot to House:
MC
0
(datum elevation) + = (grade to transit.level line shot to house)
m M,
6. Measurements from line shot onto house to roof ridge:
q-
0,
m m
V5
0
0 Fn
z
Total
z
9
0
m
7. Actual Elevation: Ag�L (reference point elevation) + 104( (measurements
from#6)=
Conclusion: e the house is/
(actual) is greater /te"n 6 (allowed); therefor
is not over the height requiremenf -per ECDC 16.20.30 requirements
L:\TEW\BLTlLDjNG\MlSC\Height Calculation Worksheet.doc
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE—
T ENGINEERING DIVISION DATE—� �163�
PLANNING DIVISION DAT
PROJECT
V
SITE ADDRESS— qo14 2461L ksyJ
PERMIT# J&3:61< __ADB# L
INSPECTED I'A 103
DESCRIPTION OF WORK TO BE INSPWTED—f-tl��..�
A fleld inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date— Sign_
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
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SETBACK$ ....................
FOUNDATION:
Footing .....................
Wall
z
Pier/Porch .................
Retaining Wall
=4
Slab Insulation
PLUMBING:
Tit
C
0
Underground
0
C
Rough -In ...................
Commercial Final
HEATING:
Gas Test ..........
Gas Piping
n
Equipment . ................
ITI ITI
Commercial Final
0
0
EXTERIOR SHEATHING
C
NAILING .......................
FRAMING
ITI 0
Z
....................
FIRST FLOOR FRAMING...
INSULATION
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Floor Insulation
co
Wall Insulation ...........
z
Coiling Insulation
P1 S
0
ITI
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR...
OCCUPANCY ...............
Pwer
AmolitPuld $ Receipt ft
Date Issued_______Exph-tz_
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