20020419.pdfDAI E RECEIVED
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PERMIT EXPIRES
PERMIT
CITY OF EDMONDi NUMBER 041P
77
CONSTRUCTION PERMIT APPLICATION JOB
ER NAMIUNAME OF ED ADDRESS
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REMARKS
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STATE LICENSE NUMBER EXPIRATION DATE VARIANCE OR CU SHORELINE OR ADEX INSPE�TION
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LOT COVERAGE REQUIRED SETBACKS (FT ') PROPOSED SETBACKS JFT)
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DEMOLISH 0 TANK 0 OTHER &
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_. .. CARPORT — ROCKERY RENEWAL
(TYPE OF USE. BUSINESS OR ACTivrry) EXPLAIN:
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DESCRIBE WORK TO BE DONE
REMARKS
PROGRESS INSPECTIONS PER UBC 1081PINAL INSPECTION REQ-
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PLAN CHECK FEE
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BUILDING
PLAN CHECK NO VESTED GAT E
PLUMBING
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
MECHANICAL
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN ICURBS, SIDEWALKS , DRIVEWAYS , MAROUEES, ETC.) WILL REOUIRE
Be PARATIE PERMISSION.
GPADtNG)FILL
STATE SURCHARGE
PERMIT APPLICATI N: loo DAYS
PERMIT LIMIT,� I YEAR PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK O� PINK PERMIT FOR MORE INFORMATION
ENG. REVIEW FEES
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
ENG, INSPECTION FEE
IN I" TEREST AGREES TO INDEMNIFY. DEF END AND HOLD HARMLESS THE CITY OF
2 EDMONDS. WASHINGTON, ITS OFFICIALS. E PLOYEES, AND AGENTS FROM AN" AND
A CLAIMSFORDAMAGES oFWRAT
LL EVER NATURE. ARISING DIRECTLYOR INDIRECTLY
LANDSCAP NO
_L?��CTION FEE
FIR M THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
D EMEDTO MODIFY. WAIVE OR SEDUCE AMY REQUIREMENT OF ANY CITYORDINANCE
PLAN CHECK DEPOSIT
NOR LIMIT INANYWAYTHECITY-SABtLITYTO ENFORCE ANYORDINANCE PROVISION
TOTAL AMOUNT DUE
IHEREB ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; T14AT THE INFORMATION
GIVEN IS CORRECT AND THAT I AM THE OWNER, OR THE DULY AD rHORIZED AGENT OF
THE OWNER� I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUc-
T(ON. AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WI LL BE EMPLOYED
CALL
I IN V 01 THE LABOR CODE 01 THE STATE 01 WASHINGTON RELATING TO
FOR INSIPECTI
COMPENSATION INSURANCE AN�� 18,17
WCR�
DATE SIGNED
(425)
771-0220
EXT 333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING .11 STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
5198
FAX
VALUATION FEE
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REQUIRED SETBACK
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FRONT YARD 20 FEET 9: 1 bi 3 SF
SIDE YARDS 5 FEET lw I EXISTI G a. ;-n
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REAR YARD 15 FEET UTI ASPH NC
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PLOT PLAN
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FINAL PROJECT APPROVAL FORM
TO: X, '//,a
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MMOTO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: DEPARTNIENT DATE —
ENGINEERING DIVISION DATE, --
DIVISION DATE�—
PROJECT—',
SITE ADDRESS —
PERMIT #P
ADD#__ ------PATE INSPECTED —
DESCRIPTION OF WORK TO BE INSPECTED
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
a Copy of CONDITIONS given to owner/contraCtOr by insPect-
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7 F ED FINAL INSPECTION - OUTSTANDING ISSUES
OP3 RRECTIOpq NOTIC given t� ?v�"e contractor by inspector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date— Sign_
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GARY HAAKENSON
CITY OF EDMONDS MAYOR
FAX 771-0221
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ONDS,WA98020 (42�)
EDM (425) 771 �0220
121 5TH AVENUE NORTH Web$1re: �.ci,edmnds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
Planning Building Engineering
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January 20, 2004
Fuji Residence
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1023 Glen Street
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Edmonds, WA 98020
RE: Final Engineerin g inspection of Addition — Permit #2002-0419
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The City of Edmonds, Engineering Division does not have reco rd of a final
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inspection being completed for your addition. In order for your permit file to be
documentation that
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closed, you will need to call for a final inspection or provide
the Engineering Division did in fact grant final approval.
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Please call to request an Engineering final inspection at 425-771-0220, ext 1326.
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An inspection request shall be made prior to Februa ry 4, 2004 to prevent further
code enforcement action. Please feel free to contact me with any questions you
may have at 771-0220, ext 1338.
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Thank you,
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Jeanie McConnell
Technician
Engineering
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Incorporated August 11, 1890
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE —
ENGINEERING DIVISION DATE A
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PLANNING DIVISION DATE,—
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PROJECT'
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SITE ADDRESS
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PERMIT #-. 1,6 0 1 -OA- 0L—.ADB#____-----PATE INSPECTED— 11A to
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DESCRIPTION OF WORK TO BE INSPECTED
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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
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PERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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u Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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a Copy of CORRECTION NOTICE given to owner/contractor by inspector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Sign_
ocaprvl.doc.l:temp:bldg:fomisIO/OI
Wall ..........................
Pier/Porch .................
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Retaining Wall
Slab Insulation
PLUMBING:
Underground .............
Sough -in. ..........
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Commercial Final
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HEATING:
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Gas Test ...............
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Gas Piping .................
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Equipment . .............
Commercial Final
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EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ........................
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FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
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Wall Insulation ...........
Calling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ..................
The initials RSR are Rick S.
Roberts, a ternporary contract
inspector for the City.