20020263.pdfDATE RECIII�� PERMIT EXPIRES
... PERM T ')')"
CITY OF EDMONDS 'ONE NMI'ER,97 71-CQ�
CONSTRUCTION PERMIT APPLICATION JOB SUIT AIT,
ADDRESS
O�NE,R NAMEI'NAMI O��SINEIS
PLAT NAME/SUBDIVISION NO� LOT NO� LID NO,
LID FEE S
111CI —A"
MA LING ADDRESS 0
PUBLIC RIGUH: PER OFFICA STREETMAP A��_ F.-
EXISTIN03 PROP BE
CITY ZIP ITELEPHONE
S� REOUIRED DEDICATION IT
73—
.ETE;
"7 EOUIREO
NAME L E No OF FIXTURES By
I YESRV NO
REMARKS
t ADDRESS NERICONTRACTOR RESPONSIBLE FOR EROSION COITP—DRAINAGE
OW
CUT ZIP TELEPHONE
NAME
6 c ENGINEERING
ADDRESS
FIRE REVIEWED BY
CK DATE
CITY N:
INSPEC�ION PBONDO
VARIANCE OR CU SHORELINE OQ �D# RED 0 OB
S E LICENSE NUMBER 'XPI TEA 7 " 6 NO
QI 2 ol SERA REVIEW H51GHT
SIGN AREA
ALLOWl D ALLOWED PROP SID
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE I EXEMPT
6 Oo 209 gov 'rylov EXP 41-
70
LOT COVERAGE REQUIRED SETBACKS (FIT PROPOSUO SETBACKS (FT.)
2-<EW Ef"PtEIN. I ECH ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE FEAR
E3 ADDITION c3 COMPLIANCE OR
CHANGE OF USE PARKING LOT AREA INNING REVIEWED BY DATE
I D jq�&
REMODEL SIGN REO'D PROVIDE V
FENCE Z_
rl REPX� C3 ( X FT)
VCA... LIE. C] TANK rl OTHER
GARAGE 0 RETA.10INGWALL RENEWAL &I
.P.R' ER [3
0
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: CHECKE08Y ITYPEOICONITRUCTIO GCCUP
'ROUPA\
NUMBER %K� RUM R OF "'"CA JAREA OCACJUPANT
k�
OF DWEI; EAS SPECIAL
ME, RE
LINE QUIRE"
STORIEA+ UNIT D &r Ft Im QVI 2A (0 R 4'0
DESCRIBE WORK TO BE DONE KS
PROGRESS INSPECTIONS PER UBC 1081FINAL INSPECTION REO'D
PLAN CHECK FEE
aAl VCE 1.5 GLAIIIG I BE %
PLUMBING
t�� MECHANICAL
I *" _F S�
PLAN CHECK NO: VES D DATE PLUMBING
Cf�
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLt ANY CONSTRUCTION ON T EPUBLIC BF UI G 'LL
BE
D I H BE Ul A N IF
E GRADINGIFILL
FTC.)
ETC) W
OMAIN (CURBS, SIDEWALKS DRIVEWAYS, MARQUEES, WILLIE LIFE
SEPARATE PERMISSIOK
STATE SURCHARGE
PERMIT APPLICATI N: 1800AYS
PERMIT LIMIT: I YEAR , PROVIDED WORK IS STA TED WITHIN — DAYS ENG, REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION FEE
ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. D55END AND HOLD HARMLESS THE CITY Ul LANDSCAPING
EDMONDS� WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND INSPECTIONFEE
ALLCIIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT I SSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOURFEMDNTOF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY RDI..— TOTAL AMOUNT DUE
IHEREBYACKNOW EDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT AND THAT I AM THE OWNER. OR THE DULY AUTHORIZGED ANSTRUCE
0 C
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC, CALL
TION, AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYTED I
IN VIOLATION OF THE L 80 DE OF THE S E OF WASHINGTON RE ATING 01 FOR INSPECTI(
WOR DOM AT�
1�
KMEN S PENS JN5U ANCE AND RCW 18,27 1 DATE SIGNED (425)
EP_
771-0220
XftENTION 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-
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 FAX
5198
VALUATION I FEE
4
9�01
�v=11wle-SLI,
APPLICATION APPROVAL
T'I. � 1 - P-Inal aatli �,qd by In.
P, o, "ILne, GaIPay: and A— MP an-d, and
�IALS SIGNATUREf) A
DATE
'Fall 11— INSPECTOR
PINK - OWNER - GOLD - ASSEES.R
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PLAN CHECK FEE
aAl VCE 1.5 GLAIIIG I BE %
PLUMBING
t�� MECHANICAL
I *" _F S�
PLAN CHECK NO: VES D DATE PLUMBING
Cf�
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLt ANY CONSTRUCTION ON T EPUBLIC BF UI G 'LL
BE
D I H BE Ul A N IF
E GRADINGIFILL
FTC.)
ETC) W
OMAIN (CURBS, SIDEWALKS DRIVEWAYS, MARQUEES, WILLIE LIFE
SEPARATE PERMISSIOK
STATE SURCHARGE
PERMIT APPLICATI N: 1800AYS
PERMIT LIMIT: I YEAR , PROVIDED WORK IS STA TED WITHIN — DAYS ENG, REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION FEE
ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. D55END AND HOLD HARMLESS THE CITY Ul LANDSCAPING
EDMONDS� WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND INSPECTIONFEE
ALLCIIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT I SSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOURFEMDNTOF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY RDI..— TOTAL AMOUNT DUE
IHEREBYACKNOW EDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT AND THAT I AM THE OWNER. OR THE DULY AUTHORIZGED ANSTRUCE
0 C
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC, CALL
TION, AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYTED I
IN VIOLATION OF THE L 80 DE OF THE S E OF WASHINGTON RE ATING 01 FOR INSPECTI(
WOR DOM AT�
1�
KMEN S PENS JN5U ANCE AND RCW 18,27 1 DATE SIGNED (425)
EP_
771-0220
XftENTION 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-
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109 FAX
5198
VALUATION I FEE
4
9�01
�v=11wle-SLI,
APPLICATION APPROVAL
T'I. � 1 - P-Inal aatli �,qd by In.
P, o, "ILne, GaIPay: and A— MP an-d, and
�IALS SIGNATUREf) A
DATE
'Fall 11— INSPECTOR
PINK - OWNER - GOLD - ASSEES.R
z
m
X
c m
MO
0
80
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3: M
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ch
0 -n
—ni
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z
71
X
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CA
z
0
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0
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VALUATION I FEE
4
9�01
�v=11wle-SLI,
APPLICATION APPROVAL
T'I. � 1 - P-Inal aatli �,qd by In.
P, o, "ILne, GaIPay: and A— MP an-d, and
�IALS SIGNATUREf) A
DATE
'Fall 11— INSPECTOR
PINK - OWNER - GOLD - ASSEES.R
z
m
X
c m
MO
0
80
c
3: M
M z
jo --I
z
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0 -n
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0
m
Height Calculation Worksheet
Address: (0 &J9k
Date: -L3'Z
Inspector(s): yyk S
1. DatumPoint:
2. Datum Point Elevation: 01-32
Z
3. Average Grade:
4. Maximum Elevation Allowed:C) (average grade)+ 25
C
5. Reference Point Elevation Shot to House:
0
(grade to transit level line shot to houso
m M
6. Measurements from line shot onto house to roof ridge:
> Z�
0
r, rM
0 rf
mo�
Z F,
ZI
55,
Z;
0
Total
0,
m
7. Actual (reference point elevation) +
Elevation:'O'\-7* 5 (measurements
from #6)
Conclusion:
VX- U (actual) is greater A ess �Ffih P-9 10 (allowed); therefore the house isl
is not over the height requirement per ECDC 16.20.30 requirements
FINPji, PROJECT APPROVAL 1, oRM
TO:_
DATE:
mEmo To: PERmrr cooRDINATop, BUILDING DIVISION
FROM: FIRE DEPARTWNT DATE-
6tL&Ey--r ENGINEERING DIVISION DATE -V S� --77./03
z
GDIVISIONDATE—
ui
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a
SITE ADDRESS 4,f R-e-11
0
M 0
-10
0
__---PATE 19SPEC
PERMIT # —_O. &:3 ADB# TED,--.
DESCRIPTION OF WORK TO BE IN SPECTED -rlA)A
>
A field inspection was conducted to determine rmal compliance with approved plans. Final approval
0 -n
denotes that there are no objections from the above signed Department to the release of
PERF ORMANCE BONDS and the granting of:
M M
ui
FINAL PROJECT APPROVAL
M
--L:��GRANT
z 0
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
Cl)
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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_
ocaprvi.doc.l:temp.-bldg:formIO/OI
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
L
SETBACKS ...................
FOUNDATION:
Footing ..........
wall ...........
Pier/Potch ..............
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
3:
0
Rough4n .................
M
Commercial Final
0
HEATING:
M
Gas Test .....................
M z
10-4
Gas Piping ; ................
Equipment .................
CA
0 -n
Commercial Final
EXTERIOR SHEATHING
M M
NAILING ................
Vhl
0 C—A
0
0 Fn
FRAMING ...................
FIRST FLOOR FRAMING...
a ca
C CA
ITI 0
z
"I
INSULATION .................
Floor Insulation
Wall Insulation ...........
z
-4
Ceiling Insulation
SHEETROCK NAILING
2�7
z
SPECIAL INSPECTION
0 -2-0-2
ITI
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY
...............