20020316.pdfPERMIT EXPIRES
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CITY OF 7EDM�ONDS
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CONSTRUCTION PERMIT APPLICATION
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REMARKS
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OWNERICONTBACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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ENGINEERING RE71DM
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FIRE REVIEWED BY DA!TE
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COMPLETE XEMPT ALLOWED PROPOSED ALLOWED PROPOSED
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RESIDENTIAL LOT COVERAGE REQUIRED SETBACK5 (FT.) PROPOSED SETBACKS LFT)
NEW LUMBING I MECH ALLOWED PROPOSED FRONT SIDE REAR A I E E
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ADDITION O.FL NCE OR
COMMERCIAL U _0 5'/5' 7,
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CHAN GE OF USE
�A.KINV I LOT AREA I PLANNING REVIEW to BY 6ATE
REMODEL 0 APARTMENT SIGN REOM PROVIDED
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FENCE
REPAIR CYDS 0 ( - X Fn RE
DEMOLISH 0 TANK 0 OTHER
W.-Ol 11-N WALL
FORT 0 ... Ka'R`Y' RENEWAL.
(tYPE OF USE, BUSINESS OR ACTIVIT
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S OCCUPANT
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STORIE U.NER RE LOAD
DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 1001FINAL INSP N REaD
ECE-110
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VALWUATION $
Description
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FEE Description FEE
P an
lan Check
HEAISOURCE
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Building
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LED DATE
Plumbing
310.—
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Mechanical
CIO - —
THIS PERMIT AUTHORIZES ONLY THE WORK NOT ED. THIS PERMIT COVERS WORK TO
2 BEGONE ON PRIVATE PROPERTY 0 I.Y. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN SIDEWALKS,
Grading
Clo. Recording Fee
3 JCURSS, DRIVEWAYS EES, ETC.) WILL REQUIRE
S EPARATE PER MISMSAI ORNU
Engr. Review
City Surcharge
PERMIT APPLICATION: INDAYS
PERMIT IUMPE I V, - PROVID 0 WORK IS STARTED, WITHIN 180DAYS
Engr. inspection
Z State Surcharge
SEC SACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES 10 INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHIN N. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF My CITY ORDINANCE
Fire Inspection
Total Amount Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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INEREGY ACKNOWLEDGE THAT I HAVE REM THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER, on THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
Thl-ppilft, l-, n V-1-10.1p.d by In.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR TDE OF THE STATE OF WASHINGTON RELATING TO
WORKMEaION q(, RANCE AND HCW 18,27,
1I11Id1ngOff�nU.,hjIqn,, rnny:.rdF.P ... pnid,.Ad
FOR INSPECTION '_ipl Is ack,oMadDqed In �Fnce proAdedk
WNT) SIGNED
(425)
10CIALS SIGNAE DATE
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771-0220 ,�7ASEO BY
ATTENTION
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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.
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
ORIGINAL -FILE - YELLOW. 11,19PLSTOR
PINK -OWNER - GOLD -ASSESSOR
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LEGAL DESCRIPTION OUT 393 CUBIC YARDS
FILL 33 CUBIC YARDS
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LEGAL DESCRIPTION HEIGHT CALCULATION
LOT COV AGE CALCULATION
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APPROVED BY PLANNING,
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EDMONDS
ITY OF
LEGAL DESCRIPTION tttT CALCULATION
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LOT COV AGE CALCULATION
--------------
--------- COPY
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Height Calculation Worksheet
Address:
Date:
�6;
hispe�to--,(-)
1. DatumPoint:.M t4-
2. Datum Point Elevation:
0
Ni�
3. AveraReGrade:D3B,-I5-
4. Maximum Elevation Allowcd:�-"�averag. grade) 25'-
a in:
0
5. Reference Point Elevation Shot to House:
80
(datum elevation) + to transit.level line shot to house)
X M�,
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-�--124(grade
6. Measurements from line shot onto house to roof ridge:
Z,
10-41,
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Total
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7. Actual Elevation: �?16'qZ(reference Point elevation) (measurements
from #6)
Conclusion:
33 (actual) is greater ess th V3 r, I S �ijlowed); therefore the house is/
iner
is not over the height requireme. ECDC 16.20.30 requirements
LATEWBUILDINGWISOHeight Calculation Worksheet.doc
FINAL PROJECTA�PPROVAL FORM
TO: I
DATE:
M[EMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: ---FIRE DEPARTMENT DATE—
&/"(M nt&—.-.ENGINEERING DIVISION DATE 'T tS� L02
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PLANNING DIVISION DATE--
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PROJECT
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SITE ADDRESS
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DESCRIPTION OF WORK TO BE INSPECTED-OLI,�C%OeW - J�VIG� �5:rl
A fleld inspection was conducted to determine final compliance with approved plans. n4nal approval
6
denotes that there are no objections from the above signed Department to the release of
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PERFORNL4,NCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL ATIH CONDITIONS NOTED
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a Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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u Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Si
ocaprvi.doc.l:tenip:bldg:fomisIO101
FINAL PROJECT APPROVAL F01111
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTMENT DATE—
(d)
GINEERING DIVISION DATE
DIVISION DATE
PROJECT�--
SITE ADDRESS
PERMIT # qh0q,-04 ADBk —DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED---4��
A fleld inspection was conducted to determine final compliance with approved plans. Tinal approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
--&RANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WrIH CONDITIONS NOTED
Copy of CONDITIONS given to owner/contractor by inspector
4 0 ks VP- � 1WJ % )W- V, rb,
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign_
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing
......................
Wall ........................
Pier/Porch .................
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Retaining Wall ...........
Slab Insulation
PLUMBING:
Underground .............
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Rough -in .... ...............
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Commercial Final
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HEATING:
Test
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Gas ....................
Gas Piping
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Equipment .............
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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 ..........
Floor Insulation
Wall Insulation
Calling Insul,01on
SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
SideSewer#
Awout Paid $ 71f;,
Date Issu e d-4ft6&.1
WaterMeterSize
Amountftid _—RecelptV
DatePUMbased
Amount P—old $—Receipt I;—
Da- le Tam 2,1. n'