20020336.pdfP�d�4 DATE "C"W'D
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PERMITEXPIRES
CITY OF EDMONDS
USE 'MT
ZONE 'UMB
N�_ �E
CONSTRUCTION PERMIT APPLICATION
JOB 8 ITE/APT#
ADDRESS T,-1 rc, to
OWNER NAME/NAME OF BUSINESS
140� L:D NO.
LOT NO3
MAILINO ADDRESS
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7 D FEES
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP del.".
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ATOR
RESPONSIBLE FOR EROSION CONTROUDRAINAGE
CITY
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NAME
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FINE REVIEWED BY DATE
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STATE LICENSE NUMBER
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SHORELINE OR ADD#
INSPECTION
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REMARKS
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RT ROOKERY RENEWAL
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ITYPE OF USE, SINESS IVITY) EXPWN:
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DESCRIBE WORK TO BE DONE
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PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION IREQD
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Description
FEE
Description
FEE
Plan Check
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Building 1_;D�a SC (00
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PLAN CHECK NO: VESTED DATE
P lumbing 2--q(D
0
Mechanical __70
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THIS PERMIT AUTKORGUES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: HE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
Grading Recording Foe
D ONUUN JCURRS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
30 City Surcharge
PE 7MITAPPLOATIOW 110DAYS
PERMITLIMM I YEAR PROVIDED WORK'S STA 0 WITHIN ISO DAYS
Engr. Inspection 2 state Surcharge 5D
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON OEHAL 01 HIS OR HER 11OUS1. 111111. ASSIGNS AND 110caS.-S
Traffic Mitigation Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS MOM ANY AND
Fire Review Receipt #
R2_457.
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE ARSING DIRECTLY 09 INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANC� OF THIS PERMIT SHALL NOT BE
Fire Inspection Total Amount Due 2_457.
9 !31 DEEMED TO MODIF)6 WAIVE OR REDUCE ANY REQUIREMENT 0, ANY CITY ORDINANCE
a NOR LIMITINANY WAYTHI CITY1 ASK. YTO ENFORCE ANY ORDINANCE IEOYSION�'
Landscapeinsp. I Receipt # jq1
I ERESY ACKNOWLE BE THAT I 14AVE READ THIS APPLICATION; TRMAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRSCr. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REQU TING CONSTRUC-
This app! catkut!s not a permit until signed by Unt
CALL
TION: AND IN DOING THE WOPPUTH.EIZT�&T.Eftf�-QN. PER. . WILL BE EMPLOYED
IN VIOLATION CBS . STA , WASHINGTON RELATING TO
out] ding OlZat , Weiner Deputy: end rude did pine, end
FOR INSPECTION —.1p, i—ke—I.dged in ern. pkuni
a U
WORKME 39MMN? SURANCE AND RCW 16,27.
0 DATE
U WNE E m) DATE
(425)SIG
1 771-0220 _51�
R DAYS
Y,
EM* 1333
JILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORKINAL-FILE YELLOW - INSACTC&R
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK - OWNER GOLD - ASSESSOR
10/01
PECEIVED
HEIGHT CALCULATIONS pF US SURFACE C 0 ROME
Leo. Lot 3 olyinple View Crest ad 911111 ng Ped 1480 SF
APR`05 20d'
A&Uvm / S02-+ ohipw Original Pmp*Nd propow earage
pmpoW pg90 & deft 120 SF:
T A 367.00 368.0( SF
Assomes Tex Pom #:
DEVELOPMCN Ui ICU CT
CITY OF 11NMONDS prepow walloways IS
a 363.00 3811.0c ftposod D" 1200 SF
ndl
C 370.00 3wo(
3
D 375.00 30.0( Impemous Surfoos 34" SF
I Average Grodo We.25 3M.00
'712.4s, Sr
Scale: 1"-20'0" size
Ldt Shm 2160 SF
ibalwopment 0. Re Datum - MH 06 367.31 Lot Covers
16927 80 Ave, NE %oo
KouloofewA9108 Haight of Stnx*u 25;W 25.00
' 0 1 1 . WATER & SEWER
ENGINEERING Mwdmum Allowe 391,96 7'1391.OD
AM4M7P
INSIpEe-,,,joNS REOrD.
-o220 EXT. 1326
71
L 425-7
All
Date:
f'"'2
4,� 55
//0 '2'
cAtjt4o
tx"A
A".
70 C4.1"LlAlce
0
D4>
!CUT 16D CY
FILL 6D CY
BALANCE 0 CY
TOTAL 210
4-'ILOT SLOPE 10 %
ACCEPIABLE TIGHTLINE
MATERIAL
Sp E T MPOZY"C CTION SDR 35
SCH 40
FOR EROSION CONTROL AND DAMAGE ENTRANCE REQUIRED N - 12
F810 HANCOR
Lot 3 olymple View Crest
98GHTMOULATIONS
A"IM / SvO24- &,?Va�Pg) Rrc-"IVED
Original
Proposw
AMMYl TAX PArcill
occG 4)CtD(��, AFR 0 2002
A
357.00
36e.00
0EV[L0PkIENTR,-RVICES CTFI.
8
c
363.00
370.00
3e&00
3e5.00
CITY CF
D
375.00
360.00
I Avenme G a 306.25
rad
368.00
Owner. Westar Dmlopment co.� Inc Sale: 1"=2010"
&A& A—. Will,
Datum - MH 06
367.31
outifill
WA "028 HalghtolStructu 25.00 26.00
L 7 EdmumAllowe P, OV D k L
-2757 391.26 91.00 .0 ZrN.I�ING
425497
tQ
367 51
c4l
La. 131
L
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A/0 —7 61
IN'
D467.
NG ULATIONS
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OUT 160 cy
FILL so cy
�Fs
"o,/ BALANIX 0 cy
I je— Y, TOTAL 210
LOT SLOPE 10%
12
MAXIMUM DRIV SLO E
ALLOWED 1141/o
K
FINAL PROJECT APPROVAL FORM
TO
DATE:
mEmom: PERmrr cooRDiNAToR, BUMDING DIVISION
FROM: FM DEPARTMENT DATE
1) Co I L42;,Gy—,r ---.ANGM DIVISIONDATE-11,11elos
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P GDIVISIONDATE�_
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PERMIT 5�09Z `03 2 ADBY DATEINSPE TED
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DESCRIPTION OF wORK TO BE INSPECTED�-
A field inspection was conducted to determine final compliance with approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
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FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL Wrffl CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
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FARM FINAL INSPECTION - OUTSTANDING ISSUES
13 Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Datc_ Si
ocaprvl.doc.l:temp.bidg:fonmIO/OI
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ....................
FOUNDATION:
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Footing ......................
wall ..1_1 ....................
Pie,/Poch .................
Retaning Wall ...........
Stab Insulation
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final
HEATING:
Gas Test ..................
Gas Piping ..............
A
.72 L L
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
0
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall insulation ...........
Coiling Insulation
SHEETROCK NAILING
SPTjjINSPECTION
v"�
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
AmoatPa!d!�
Date bsued ��f xplires
IMterAleter -c
Si-
AmountPea '�LA Receipt
DctePumiasCd__
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Amount POd $_Recelpt
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