20020278.pdfPERMIT EX ES
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CITY OF EDMONDS ,2
CONSTRUCTION PERMIT APPLICATION 10. SUITEIAFT�
ADDRESS
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PLAT NAMF,SUUOIVi5ION NO, LOT NO. L NO.
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MAILING ADDRESS 0 FEE $
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CITY EXISTING — PROPOSED
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NAME METER SIZE
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NO. OF FIXTURES
RV REQUIRED
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YE 0 NO
ADDRESS R MARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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STATE LICENSE NUMBER
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VARIANCE OR DO SHORELINE OR ADBJ0 INSPECTION No
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ALLOWED PROPOSED FRONT SIDE REAR FRONT UPSIDE REAR
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REMARKS
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REMARKS
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VALUATION
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PLAN CHECK NO: 11EIT11 11
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES NLY THE WORK NOTED. THIS PERMIT COVERS WORK
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t: BE DONE ON PRIVATE ROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
.
GRADINOFFILL
DOMAIN
:3 (CUBES. SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATI N: 180 DAYS
PERMIT LIMIT. 1 YEAR - PROVID D WORK IS STARTED WqH;N 180 DAYS
SNG� REVIEW FEES
SEE SAC OF PINK PERMIT FOR MORE INFORMATION
PLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG, INSPECTION FEE
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N NTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY F
LANDSCAPING
M EDMONDS. WASHINGTON, ITS OFFICIA,L�, EMPLOYEES. AND AGENTS FROM ANYAND
INSPECTION FEE
ALLCLAIMSFORDAMA E OFWHATEVER NATURE, ARISING DIRECTLYOR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT 8:
PLAN CHECK DEPOSIT
IRECEIPT
0 5MEDT0 MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OFANY CITY ORDINANC
ANYWAYTHE
0 NOR LIMIT IN CITY�SABILITYTO ENFORCE ANYOFICIINANCE PROVISION.-
TOTAL AMOUNT DUE
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I HEREBY ACKNOVVLEI�GIZ THAT: HAVE READ THIS APPLICATION, FILAT THE INFORMATION
GIVEN IS CORRECT. AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVA
THEOWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
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TION, AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMI DYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTION ,pt i, ,kF,,JodgQ_ Np...
==?APEN±S tANCE AND RCWIS.27.
OFF1 LS SIGNATURE
DATE
T) SIGNED
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771-0220
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A17ENTION
EXT 333
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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-
ORIGINA L PILE
YELLOW WSPECTZR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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GOLD - ASSESSOR
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Height Calculation Worksheet
Address:
Date: D
Inspector(s):
1. Datum Point: SS
2. Datum Point Elevation: L) C-" -
0� f
3. Average Grade: 0 5,
0
K
4. Maximum Elevation Allowed: Ll��"—�-Verag, grade) + 25' -1 S
ro
in
5. Reference Point Elevation Shot to House:
in
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(datum elevation)+ tO.dq (grade to transit,level line shot to house) (0
in
6. Measurements from line shot onto house to roof ridge:
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in
a as,
or,
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35
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Total 5L,
9
0
in
7. Actual Elevation: (reference voint elevation) + easurements
from #6)
Conclusion:
0
65 (actual) is greater hfe—s—s —thb-, lowed); therefore the house is/
is not over the height requireme.1—p—er ECDC 16.20.30 requirements
L:\TEMP\BUILDlNG\MlSC\Height Calculation Worksheet.doc
IMPERVIOUS SURFACE C.4,11CS
Existing Re-sidence: 9 10 SQ. FT.
Existing Back Covered Deck 260 SQ, FT, /10
7
T-Nisting Back Patio. 270 SQ. FT. /9-sD
Existing Garage: 1000 SQ. FT, 190f
NORTI
E'.xisting Shed: 240 SQ, ff. 1-7,SV
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EUTRANCE REQUIRED
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Date:
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APPROVED BY PLANNING
EDMONDS, WA
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FINAL PROJECT APPROVAL FORM
TO -
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: --FIRE DEPARTMENT DATE�—�
ENGINEERING DIVISION DATE—LAI�
PI, G DIVISION DATE—
PROJECT -
SITE ADDRESS- A/
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PERMITO ADBO DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTE
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:
4GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITTI CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
1.
2.
3.
RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date_ Sign_
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a--ENGINEERINGDMSION DATE
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—PLANNING DIVISION DATE --
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DESCRIPTION OF WORK TO BE 1 NSPECTED
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denotes that there are no objections from the above signed Department to the release of.
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FAMED FINAL INSPECTION - OUTSTANDING ISSUES
c Copy of CORRECTION NOTICE given to owner/contractorby fiWector
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3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date— Sigil—
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INSPECTOR
DATE APPROVED
\YNS
SETBACKS ....................
FOUNDATION:
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Footing................
wall ................
Pier/Porch .................
Retaining Wall ...........
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Slab Insulation
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PLUMBING:
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Commercial Final
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Gas Piping
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Commercial Final
EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ................
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FIRST FLOOR FRAMING
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INSULATION ............
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Wall Insulation ...........
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Ceiling Insulation
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SHEETROCK NAILING
SPECIAL JVSPECTION
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MISCELLANEOUS