20020259.pdfRECEIVED
WDATE
D'i
PERMIT EXPIRES
CITY OF EDMONDS
USE
ZONE PERMIT 'n
run NUMBER _0Z<'
CONSTRUCTION PERMIT APPLICATION
B
JOE
ADDRESS IUITEIAIT�
AM E I I M I I I
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PI NAME/SUBDIVISION NO.
LOT NO.
LID NO.
MAILING ADDRESS
LID FEE
CITY
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
t�
T—P AAp—d D
R
ZIP ITELEPHONE
EXISTING PROPOSED-
REOUIRED DEDICATION IT
0
METER;
LINEIFIIE
I NO. Ol[JES
UIRED
NO 0
't OGRESS
REMARKS
Y -S'/,-,, �
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAIN—E
Cp ZIP
TELEPHONE
'990,20
NAME
--27-
Y-'� '-f
cv,At, -6%Jellee Co—l" n —7-
ENGINEERING
ADDRESS
A
1.26,161 �/h'/
06L � (N
CITY ZIP
T�LEPHONE
FIRE REVIEWED BY DATE
STATE LICENSE NUMBER EXPIRATION DATE
VARIANCE OR CU
SHORELINE 04CW _T
INSPECTION
I BOND
492
SEPA
REOG
YES ONO
I POYD
PROPERTY TAX ACCOUNT PARCEL NO. ------
REVIEW
COMPL;Zj EXEMPT
SIGN AREA
ALLOIYEED �PROPOSED
HEIGHT
ALLOWED I PROPOSE
[?�,Gw
'B""E"TAL
....
LO COVERAGE
ALLOWED PROPOSED
REOUIRED SETBACKS JFT.) PROPOSED
FRONT SIDE lll�
SETBACKS (I
C3 ADDITION
C] COMMERCIAL
0
C3 C MPUANCEOR
CHANGE OF USE
k
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UP SIDE REAR
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FENCE
RED. PA KING
C, I PROVIDED
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DATE
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0 REPAIR GRADING
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DEMOLISH TANK OTHER
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6a -Fwth r or /ac-
E IETAIIIN
G RT ROD G WALL 0 RENEWAL
PC 'KEJ Y
P (TYPE OF USE� BUSINESS OR ACTIVITY) EXPLAIN:
CHECKEDBY
ITYPEOICOISTRUCTION Ca-GCCUPANTiM/(3
GROUP
NUMBER t
OF
4115fk�
DIN
Sp ECIAL tNf
JAPEAQ-6"V 4(Dq PANT
STORIES UN
DESCRIBE WORK TO BE DONE
YT,.,.
REMARKS
PROGRESS INSPECTIO41S PER UBC 1OWFINAL INSPECTION REO'D
Fffg=�
larrl+ fl�
C4
VALUATION
FEE
PLAN CHECX
SOURCE GLAZING %
HEAT L,
LOT SL�F
FEE
IN
BUILD G
G , s /-PL
PLAN CHECK VESTED DATE
PLUMBING
N�,
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE W RK NOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON T EPUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILLH REQUIRE
GRADINGIRLL
m ctl r)
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATION: 180 DAYS
T PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
END. REVIEW FEES
SEE BACK F PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALFOP HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
ENG, INSPECTION FEE
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS HE CITY OF
LANDSCAP AS
EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND CENTS FROM ANY AND
INSPECTION FEE
56,1-
A LCILAIMS FOR DAMAGES OF WHATEVER NATURE,ARISING PECTLYOR INDIRECTLY
DI
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
RECEIPT
DEEMED TO MODIFY. WAIVE OR REDUCEANY REQUIREMENTO, ANY CITY ORDI ANCE
PLAN CHECK DEPOSIT
0 NOS LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
A;z
TOTAL AMOUNT DUE
INEREB ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. T AT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPL APPROVAL
T E OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION. AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WIL EMP DYED
'RE
CALL
I -- b
Su" T 0 0"'.., `X h,� a pa'm I "I
DI'll F
IN VIOLATION OFPTHI F THE STATE OF WASHINGTON RE LATING TO
FOR INSPECTION
FN;J�=
WORKMEN�S DOM OF AND RCW 18.27,
VVNO
V
SIGNATURE'( SIGNED
OFF CfALS SIGNATURE
VR�;*_ 1
(425)
�2
�1�
771-0220
R A AT
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
Z__
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI�
OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORIGINAL FILE YIL�O - INSPECTOR
CATE
FAX
PLNN-OWNER GOLOWASSESSOR
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Height Calculation Worksheet
Address:
Date:
Inspector(s):
1. Datum Point:
2. Datum Point Elevation: 00
Z
0.
3. Average Grade: Ci (�p 1 0
CX
m
4. Maximum Elevation Allowed: Ci (a; 10 (average grade) + 25'
0)
5. Reference Point Elevation Shot to House:
C
m 0
2013.jdatum elevation); �1-?Z (g,,de to transit level line shot to house)= rF�
0
C
In
0
6. Measurements from line shot onto house to roof ridge:
z
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ca
V
MM
t3 as�
0
M
M
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Total:
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(reference point e
7. Actual Elevation: levation) + (measurements
In
from#6)= 1XIII04:
Conclusion:
194o - 0 6- (actual) is greater /IOLt-hI%fi I ?U - (allowed); therefore the house is/,
is not over the height requirement per ECDC 16.20.30 requirements
Mi. PROJECT APPROVAL I RM
TO:
DATE -
MEMO TO: PEFIMT COORDINATOR, BUILDING DIVISION
FROM: ME DEPARTNMNT DATE_
rottg-&�r -ANGINEERING DIVISION DATE !U,2-7,103�
P G DIVISION DATE—
PROJECT—kA,9P
SITE ADDRESS� 610
PERM # L29 AS ADD# —__-----PATE INSPECTED 'S/V 1 101
DESCRIPTION OF WORK TO BE INSPECTED F100A —L-
A field inspection was conducted to determine final compliance with approved plami. 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 wrrH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
FAMED FINAL INSPECTION OUTSTANDING ISSUES
a Copy of CORUCTION NOTICE given to owner/contractorby inspector
1.
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Si
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FIN,,, PROJECT APPROVAL I JRM
TO -
DATE:
mEmoto: PERmIT COORDINATOI?� BUILDING DIVISION
FROM: _FIRE DEPARTbffiNT DATE —
ENGINEERING DIVISION DATE—
���.-EZALAI::��PLANNNGDrVISION DATE
0'1D &TrA6L e-:,
PROJECT
SITE ADDRESS tell
St
RE S St M Z- Q B 2���UPfCd�TED
PERWro—IL2Z2
DESCRIPTION OF WORK TO BE INSPEC
A field Inspeeflou,w8s conducted to determine imal compliance with approved plans. Final approval
denotes that tilere are no objections from the above signed Department to the release of,
PERFORMANCE BONDS and the granting of:
-GRANT FINAL PROJECT APPROVAL
rNTPROJECT APPROV, IMH CO ONS NO D r
Copy.f ITIO git __/=M
COND NS nactor by �t.
1
t-A �4 ID �, C,4'-P) rt
I &STANDING ISSUES
FAILED FINAL INSPECTION - 0
(3 Copy of CORRECTION NOTICE given to owner/cOntractOr bY insPect"r
2.
3.
RE_INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date Sign�
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SETBACKS .....................
FOUNDATION:
Footing
vy')
....................
Wall ..........................
0
Pier/Porch .................
0
Retaining Wall ...........
Stab Insulation ..........
PLUMBING:
YY)S
M
C
MO
0
Underground ... ..........
0
Rough -in ...................
M
Commercial Final
ITI
10
HEATING:
GasTest ...................
Gas Piping .................
0,n
n
Equipment ................
ITIM
Commercial Final
0
0 fn
EXTERIOR SHEATHING
7
C 0)
K ca
prav L4W
NAILING ..........................
FRAMING ...........
Qov,vp
ITIO
FIRST FLOOR FRAMING...
-4
INSULATION ...................
Floor Insulation
Wall Insulation ...........
z
Calling Insulation
0
SHEETROCK NAILING
SPECIAL INiSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................
dverL,