20020409.pdfDATE RECEIVE��
PERMIT EXPIRES
CITY OF EDMONDS
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CONSTRUCTION PERMIT APPLI!CATION
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ADDRESS
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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EXISTING - PROPOSED -
REQUIRED DEDICATION- FT
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METER SIZE 1 LINE SIZE NO. .1 1'XTUFeS PRV REQUIRED
I I I _';W YE I No C1
4 A)
REMARKS
OWNER/CONTRACTOR RESPONSIBLE OR EROSION CONTROLIDRAINAGE
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ADDRESS
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FIRE REVIEWED BY
DAT9
ZIP
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STATE LICENSE NUMBS
EXPIRATION DATE CHECKED BY
VIIIANCE a CU SHORELINE OR ADG#
INSPECTION BOND
RE P STEC
1
6-,LAMV�0��C�m'�)
zWohor,
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C:3YES 0
!�K
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PROPERTY TAX ACCOUNT PARCEL NO.
SEPA REVIEW SIGN AREA
EXEMPT ALLOWED PROPOSED
HEIGHT
ALLOWED, PROPOSED
or
C)C)4 �q'W
OC) Cxo9o4
EXP
I
_0'N.W
RESIDENTIAL
'1k LUMBING I MECH
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED FRONT SIDE BEAR FRONT LIRSIDE BEAR
ADDITION
COMMERCIAL
ri COMPLIANCE OR
0 REMODEL
[3 APARTMENT
- CHANGE OF USE
0 SIGN
PARKING 1 LOT AN I P�141,117
REDD I PROVIDED _ �W;� T
95260�
0 REPAIR
PENCE
11
:7-
0 eyes
!JJNA
( X Fr)
REMARKS
DEMOLISH
E] TANK
[:] OTHER
ARAG FIT
CARPO
RETAINING WALL
ROCKERY
E3 RENEWAL
Is
(ME OF USE. BUSIN S OR IV" EXPLAIN:
7
CHECKED BY JTYMU TION
cup
C PA
ORO
NUMBER
OF
N MBER OF
LLING
C'RIMTAC
A , a
ff
S1..IAL INSPECTOR
R;
OCCUPANT
STO B'S.
UIE
NU
JAIEA
REQUIRE YES
LOAD
DESCRIBE WORK TO BE
DONE
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1) Li TH
-RENA KS
IPROGRESS.INSPECTIONS PER USC 1108/FINAL INSPECTION REO'D
FEE
Plan Check
'�Olr 47E %
rT,SZRCE
UUId'Rg
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LGradIng
.......... .
THIS PERMIT AMHORIZE-S ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I M lechanical
achamc.,
11 DONE ON IIIRMTE PROPERTY 011VE ANY CO4aMUC1RON ON THE PUBLIC
MARQUEES, 1,=) WILL REG IRE
DOMADI (CURGS, SIDEWALKS. DRIVEWAYS u
to I
Recording Fee
Z��'
.SPA.'SP�RM; SSION.
--- -
PER IT APPLICATION: 100 DAYS
Engr. Review
City Surcharge
PERMIT LIMIT I Y"A" . PROVID WORK IS STARTED WITHIN 100 DAYS
Engr. Inspection
State Surcharge
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, .11 BEHALF .1 .1. .. HER S1.U.E, HE=. AS.I... AND SUCCE..RS
Traffic Mitigation
Plan Chk Deposit
,.,.REST, AGREES To INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
Receipt #
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FRO" ANY All"
ALLCLAI $FOR DAMAGES OFWRATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Review
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT OF MY CITY ORDINANCE
Fire Inspection
Total Amount Due
NOR LIMIT IN ANYWAY THE CITYs ABILITY TO ENFORCE ANY RMNANCE PROVISION.-
Landscapoinsp,
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ 141S APPLICATION; T7T THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I GRFE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONS
CALL
Is not a ponolt ,In signed by tre
L'OUC.
TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMP D
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGI ON RELATING TO
BoIlThisapplicatio.
ding Offlol.1 hisibin D.p.1y; nd Pon, In. p.1d. no
FOR INSPECTION
WORKMENS COMPENSAR III C1 AND RCW 11,11,
OFF AILS SIGN UBE DATE
__:A
(425)
Q! Aj 4APt
771-0220 ' 14a
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFj-
ORIGINAL -FILE YELLOW � INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER GOLD - ASSESSOR
10/01
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ZONE APPROVED BY ENGINEERINC�10,71FL'l�
S
SETACKS:
�6o FRONT
s!DE 5;
Lto REAR 'PPROVLD BY PLANNING DEPT.
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AANA24LIOENIGHTLINE F-8—F;�(' S (115 -7,
M ERIAL
AT 20'-0" ACCESS AND UTILITY EASEMENT
SDR 35 ce #,I
4943 REGIS E
AR H SCH 40 --SD SO
T N - 12
---------- ---- S 89* 45 30 E
F810 HANCOR -7RFVEqWY TURNAROU
PROPOSED LOT SERVICES FOR �-- J�
ION,
ELECTRICAL, TELEPHONE, TELEVI
I N WATER AND GAS UTILITIES TO 13E
F SHI LOCATED IN THE SOUTH 3' OF
THE EASEMENT.
THE CONTRACTOR SHALL COORDINATE
NTH THE OWNER AND ALL UTILITY
COMPANIES FOR THIS WORK. WA IER
AtElEg
WATER & SEWER
INSPECTION$ REUD.
A 308.0 Gv-
B 307.0 CALL 425-771-0220 EXT. 132F
3
C ":' GARAGE [Olt
3055 2-
306.2 +
TOTAL 1224.8 % 4
k)' s'bj.'2— lq-c-+'—j 'sap .225—
LOT I
sHonT lwl-AT
"L-AT Numsla", RESIDENCE
00
TI-Vo0cocqoL� FOUrING ANS, NOT FINISHED FLOOR 0 305
TO BE AS INTO
SYSTEM
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Fo7vs7iv7,—
jo(OWNER/CONTRACTORIS RES
FOR EROSION CONTROL AND DAMAGE
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Height Calculation Worksheet
Address:
Date:
Inspector(s):
1. Daturn Point:
2. Datum Point Elevation:
Z&
NI
3. Average Grade: 3( AD
m
4. Maximum Elevation Allowed: Sj(� ��(,verage + 25'=
grade)
5. Reference Point Elevation Shot to House:
a M
m 0.
40"
N
—SO:5-5 (datum elevation)+ 5,0 (grade to transit.level line shot to house) 5-
0
MR
'N11:1
6. Measurements from line shot onto house to roof ridge:
(0,00"
ai,
br,
dr
0 Mn
'n
'0'
rum,
0'
0
C
-4;
z
Total:
ZI
M
0� z
7. Actual Elevation: 0, (reference point elevation) +<A� (measurements
from #6)
Conclusion:
3 31 (actual) is greater / k'-�-s- �thn� 3 'T 1 (allowed); therefore the house is/
is not over the height requirement per ECDC 16.20.30 requirements
UTEWBUILDINGWIS011eight Calculation Worksheet.doc
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTNEWT DATE—
SION DATE —
ENGINEERING Diw n-,
PLANNING DIVISION DATE—
PROJECT_9;0�11—��.��
SITE ADDREW.44014 AW � __1M_
PERmrr# �o,56L-OIQ9 ADB# __JDATEINSPECTED,
DESCRIPTION OF WORK TO BE INSPECTED_L1__K)A
A field inspection was conducted to determine fmal compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release, of,
P RFORMANCE BONDS and the granting of:
E
GRANT FMAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WrM CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractorby inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by mispector
2.
3.
RE-INSpECTED OUTSTANDING ISSUES -GRANT FINAL PROJECT APPROVAL
Date_ Si
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SETBACKS ..................... I
FOUNDATION:
Fooling
wall ......... . ......
z
Pier/Porch .................
Retaining Wall
Stab Insulation ..........
PLUMBING:
Underground ..........
Z
0 M
M 0
0
Rough -in ...................
C
Commercial Final
M
IT!
HEATING:
GasTest ....................
4Y)s
Gas Piping
0 "n
Equipment .................
-n
Commercial Final
M M
EXTER:OR SHEATHING
0
NAILING
FRAMING
Q 0
................
FRAMING....
FIRST FLOOR
INSULATION ...................
Floor Insulation
z
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
z
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SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
LO
OCCUPANCY ..........
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