20020404.pdfPERMIT EXPIRES
I 'US' PERMIT
CITY OF EDMONDS ZONE N U M B E R
CONSTRUCTION PERMIT APPUCATION ADDRESS Wrti UITFJAPT#
LOT4 L NO
7; 717TO" 8,USI"S,Vq A�e, 'Ile
L�D FE $
MAILING ADDRESS DFE
.... I OF —II g
clt PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Imms N.1usse
I
ITELEPHONE EXIST114G — PROPOSED
U_nO=usOd
tests III—
M TER SIZE LIKE SIZE 110. 01 FIXTU111 11 BEGIN"' ds
it YE �A No 13
-ADDRESS REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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CITY, IP 4VN #I ght(i6rWiLlIa, -. Mklil.WN
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ENGINEERING,
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If, Ave M11 102-
FIRE REABEWED BY DATE
BIT, TELS1.ONE
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VARIANCE OR OU SHORELINE OR ADIMP INSPECTION PSOND
STATE LICENSE NUMBER EXPIRATION DATE Y," Oa�'D
I6VLLrVAVk00G�,JL0
I � � E3yRE
ES
q/zo/x"03 SEPA REVIEW SIGN AREA
EL NO. COMPLETE EXEMPT ALLOW ALLOW,, PROPOSED
"7
00 0 1 XP ;1, 5 � -f5-'
I
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS I".
<Nw'
IIMIIIII. MECH ALLOWED PROPOSED OUT UR SIDE AM
P FR
C MPLIANCE OR
ADDITION COMMERCIAL c3 C14ANGE OF USE PARKING LOT lb
0 REMODEL APARTMENT SIGN REGS PROVIDED AREA P LAMMING REVIEWED BY
CYOS 0 F NCE
REPAIR I _x— Fri REP KS
0 DEMOLISH 0 TANK E3 OTHER
10
'tBAR BE [3 RETAINING WALL
h CARFORT ROCKERY [3 RENEWAL
ID2721 0 'PA
CHECKED By TYPE 0 GROUP
NUMBER ICAL
DA ks SPECIAL INSPECTOR AREA fy)� IL41 kC I OCCUPANT
NUUN
OF LOAD
Is
0
STORIES REQUIRED 0 YES ta k _L,Z)
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DESCRIBE WORK10 BE DONE REMARKS
PROGRESS INSPECTIONS PER USC 1081FINAL INSPECTION Ii
IBUL14AL
_WA,t�g� J��gc&�
VA
VALUATION $
$
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S iptlon
FEE
Description
FEE
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rUAl.ON
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in
Building
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TED DATE!
__
'PumlIm.
Plumbing
210. —_
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Mechanical
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THIS PERMIT AUTHIORIZIES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
`;Zwding
t BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE ]PUBLIC
Grading
Fee
'S'ETC'
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS E )WILLREQUIRE
SEPARATEPERMIS=ION""
—_
Engr. Review
Cit Surcharg
PERMIT APPLICATION: IN DAYS
PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN IN DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
State Surcharge
*
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
At
Traffic Mitigation
Plan Chk Deposit
T F
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
I N ry
'Y AND
EDMONDS, WASHING1 ON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
G
Fire
Fire Review I
p
Receipt #
"CTLY
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
AL
E
FROM THE ISEGANC OF THIS PERMIT ISSUANCE .1 THIS PERMIT SMALL NOT BE
'0
I
Total Amount Due
I
T
DEZMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
F "a IT
'INA
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINA CE PROVISION.-
N,
Landscapelnsp.1
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS C 0 RRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
CONSTRUC-
IETRU.
This application Is not a permit unlit signed
by the
THE OWNER. I AGREE TO COMPLY WITH AND STATE LAWS REGULATING
Buy
Le
TION; AND IN DOING THE WORK AUTHOnIZED THEREBY. No PERSON WILL BE EMPLOYED
CALL
Building Offiel.1 .1 hi.dhm Deputy: it Fee. me Pere, Add
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
ecelpt Is asimmdodged 11 sPICO
prmided.
WORKMIATS COMPENIATI IRANCE AND RCW 18,27,
Off I�LS SIGNATURE
DATE
DATE SIGNED
(425)
kt—Va 4A,441VA
J
771-0220
BED By
DATE
ATTENTION
W 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
ORIGINAL, FILE YELLOW' INSPE6TOR
—PINK - OWNER GOLD - ASSESSOR
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p
'o HEIGLff —=7- r
M- Sa,
S 89- 45' AD' E -j
Gl.:- Ca
r3IO.2 D DRIVE WAY
HOT TAP
310.0' A EX. 6" DI WATERLINE
6;6p
15' 40
89*
RESIDENCE FOOTING I
)RAI�
310
FINISHED FLOOR 0 TO BE TIED INTO
;Mac
RIVE WAY 4 L-x
JERRY 1%
WA 7ER
MATER UVER
S
R 35
GARAGE
S H 40
N - 12 PLANNING
APPROVED BY
Fsl HANC R ssco
3100 8
.0
JE 6* C.O. 3
Ao"U z cs
98.86' A 310.0
B 31
11.0
C 3 0.0
D 310.2
OWNER/CONTRACTOR IS RESPONSIBL TOTAL 1241.2 X 4 -3 '3
SITO L.AN _0
VFlmOSlON CONTROL AND DAMAGE 3
LOT 4 4943, �R �UST RED
al-AKE!Ncr�l! JAN0 COFFMI-T
ECT
SHOM*r PLAT
I-L-AT NUM150K #9 APPROVED AS OTED
ooljV'60� oo(,
BY ENGINEER NG
07- STATE 0 SHINGTON BUILDINC. OpT
2 2 Date:
Height Calculation Worksheet
Address:
Date:
Inspector(s):
1. Datum Point:
N
2. Datum Point Elevation: 5 08 105
O�
ff
3. Average Grade:
4. Maximum Elevation Allowed: 3(avera egrade)+25'=
(a
In
4i
C
M
5, Reference Point Elevation Shot to House:
C:
�OJdatum elevation) (grade to transit.level line shot to house)
M m
6. Measurements from line shot onto house to roof ridge:
Z,
0
�Mtn-
0
0
c:
3: c4i
M 0
Z,
Total 2
0
M
7. Actual Elevation: 'Slddig(reference point elevation) +d AO(measurements
from #6) I'S
Conclusion:
(actual) is gr klegs han (allowed); therefore the house is/
eater
is not over the height requirement-im,1W13C 1.6.20.30 requirements
LATEMPSUMI)INGMSCWeight Calculation Worksheet.doc
FINAL PROJECT APPROVAL FORM
TO: -
DATE:
mmom PERmrr COORDINATOR, BUILDING DIVISION
FROM� FIRE DEPARTNMNT DATE —
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE—
PROJECT__��
SITE ADDRESS_aaqaL__W� alk
PERbM#,rimP_- o+04- _ADB#______pATEINSPECTID
DESCRIPTION OF WORK TO BE INSPFCTED_E_(0_&_—
A field 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:
,�GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
c3 Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
c) Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date— Sign_
ocaprvl.doc.l:tenip:bldg:forn'910/01
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
po)
b (0
Footing ....................
z
wait .....................
0
Pier/Porch ..............
Retaining Wall
Stab Insulation ..........
C:
PLUMBING:
M
Underground .............
0
C
Rough -In .............
:z M
M
Commercial Final
HEATING:
Gas Test ....................
0
Gas Piping
3:
M M
Equipment .................
0 V;
Commercial Final
0
C
EXTERIOR SHEATHING
NAILING ..........................
C Co
z
FRAMING
..................
FIRST FLOOR FRAMING
yy)
z
INSULATION ...............
-4
Floor. Insulation
co
Wall Insulation ...........
z
Ceiling Insulation
vn�s
ITI
SHEETROCK NAILING
SPECIAL INSPECTION
q -, -S . 7—
MISCELLANEOUS ..........
FINAL APPROVAL FOR
03
OCCUPANCY
cm
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49/2_/
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AMOUnt Pa!d_z� L�_��RCCC!Pt f1_C;99-24L"4
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Amount Paid $—RCCeiPt fi—