20020466.pdf0
DATE RECEIVED
PERMIT EXPIRES
CITY OF EDMONDS
USE
'C.E EIRMIT
NUM'ER2 Y-2 - (,) (L (f 2
CONSTRUCTION PERMIT APPLICATION
JOB SUITEIAFIT#
OWNER NAMUNAME OF BUSINESS
ADDRESS
SUL 7 A iPjhj
PLAT NAME/SUBDIVISION No' LID No
LOT No.
MAILING ADDRESS
611
'�1/ L1D FEE S
"au, 4.
PUBUG RIGHT OF WAY PER OFFICIAL STREET MAP R. P.I. K-1. I
tics., U.. 1 r".
CITY
EXISTING — PROPOSED— l'up—ri.quassi
REQUIRED DEDICATION— FT uss
NAME
METER SIZE
LINE SIZE
NO� OF FIXTURES
PRV REOUIA90 us
I
I
YES 13 NO ;3 25
ADDRESS
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTRC..-,.-.
CITY ZIP
lmspo'TION r-7)T---tbctot\)
ITELEPHONE
NAME t�ew 199
4EVIVAIEDIDATE
0 12
ENGINEERING
ADDRESS
611-ger,-F 6,2-1,07
CITY
FIRE REVIEWED By DATE
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ZIP TELEPHONE
It
0
d
STATE LICENSE NUMBER EXPIRATION �KED BY
VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND
POSTED
0
R1
ES
'3yRE0f0-
PROPERTY TAX ACCOUNT PARCEL NO.
SERA REVIEW SIGN AREA HEIGHT
COMPLETE Ey:�� ALLOWED PROPOSED ALLOWED PIOPO
17,
3:
NEW RESIDENTIAL PLUMBING I MECH
R
0 G SQUIRED SETBACKS (FT) PROPOSED SETBACKS IFT)
M
M 0
b�ADWTHDN COMPLIANCE OR
WIG PH OPOSED FRONT SIDE 4W.Aft- 'FRONT L/R . E AR
A11A
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0
0
0 COMMERCIAL
CHANGE OF USE
, , ;�*" 1,5'
ARDKI LOT ARRA�LANNINII REVIEWED By ATE
0 REMODEL 0 APARTMENT SIGN
I ROVIDED
X M
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[3 F NCE
[3 REPAIR 0 = CYOS I — X FT)
Md,
HE ARKS
DEMOLISH [3 TANK [3 OTHER
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[3 GARAGE [3 RJECAINING WALL [3 RENEWAL
CARPORT ROOKERY
0 "n
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
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CHECKED BY OF COjffON -JOCCUFA "Ta
" � � - 6�� !�;i ;
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ITYPE
GROUP
NUMBER kr NUMBER OF
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OF D ELLING AREAS AL bLWeZ
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�QCLAL INSPECTOR CUPA14T
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0 STORIES UNITS NUMSER;o),(�O�a -00ZP
R UIRED 0 YES JAREJ NO
0
DESCRIBE WORK TO BE DONE
6 Fn
REMARKS es
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PROGRESS INSPECTIONS PER USC 1108/FINAL INSPECTION REaD
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7U
VALUATION $
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Description FEE Description FEE
:�02 -
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/-H ATSOURCE -, �G%� LOT SLOPE%
IND,,
Building , - mw
0
PLAN CHECK NO:
Plumbing
Mechanical
In
THIS PFAMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: HE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE P= TO
Grading Recording Fee_
DOMAIN (CUASS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC) WILL REQUIRE
SEPARATEPERMISSIM
Engr. Review City Surcharge
PER ITAPPIUCATION: ISODAYS
PERMIT UMM. I YEAR -PROVIDED WORK IS STARTED WITHIN INDAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection State Surcharge 14,0
'APPLICANT ON BE-11 01 HIS R HER SIOUSE. 1-1EMS. A.M.N. AN. HU.CE.O..
Traffic Mitigation Plan Chk Deposit :.20
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review Receipt #
ALL CLAIMS 1OII=G1S OF WHATEVER a., ARIS NO DIRECTLY a INDIRECTLY
1
FROM T.�.SSU 0, THIS PERMIT ISSUANCE 01 THIS PERMIT SHALL NOT BE
'9 DEEMED TO MODIF16 WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection Total Amount Due
0 NOR LUJUTINANYWAYTHE CITY ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
.1
Landscapainsp. Receipt # 12PI) 9
[HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN I% CORRECT; AND THAT I AM THE OWNER, OR THE Duty AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNE . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
a unin. Fares, arlll.ignad by
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STAT OF WASHINGTON RELATING TO
quiThisappicaflo
diett Offial.1 � �Isjher Deputy; and Fees are paid. and
FOR INSPECTION rac,ipt 10 ackne,eledged In space prankled.
WORKMEN'S COMPENSATION INSURANCE AND NOW 10.27�
Hill NATURE (?W It A DATE SIGNED
(425) OPPLI SIGNATURE DATE
he�
771-0220 1 BIJ DATE
ATTENTION
IT IS UNLAWFUL
EXT 1333 21 /.11
TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - Ffij YELLOW - 14SPECT'OR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK � OW1,19 GOLD - ASSESSOR
10101
DfPERVIOUS SURFACE CALM
EXiSt Bld Pad: 1899 sf. (constructed prior to 1977)
Proposed Garage: 624 sf.
Proposed Bedroan: 288 sf.
Proposed Driveway: 892 sf. IOOT4 AVIF,vl
-west
If to 10,0" slope
GARAGE HEIGHT CALCS
1 = +99'
2 = +99' TEMPORARY CONSTRUCTION APPROVED BY P1 ANNING
3 = +102'
ENTRANCE REQUIRED
4 = +101.75'
AVE GRADE = +100.31
ACTUAL 0WINEMI001TWTOR IS REWONSIBLE FOR
#16WIC"OL AND DRAINAGE
o"BEDROOM HEIGHT CALCS
A &6RS/DOWNSPOU'TS
A +101.25'
51
B +102 AND SPLASHBLOCKS
C +101:51
D +101 . 251
7'
AVE GRADE = +101.6'
ACTUAL = 4.114.1'
PROPOS ea
nucrxm = +126.61
eX,
IOr COVERAGE 11
3703 SQ.FT. (34.7%)
Lor AREA
10,647 SQ.FT.
APPROVEU AS NOTED
OY ENGINEERING j 2501,
Tax account parcel F;65-0 N �1
00555000002400 'Res i 1� C N
2,1 k
IJOr MOPE: PIUSPINP:ff&Mi-��
CITY COPY
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CITY OF LwiciDs
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RECORD OF iNSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .............
FOUNDATION:
Fooling ...............
Wall _ .................
r Pier/Porch ...........
z
Retaining Wall
9
Slab Insulation ..........
0
PLUMBING:
Underground .............
0 M
Rough -in ...................
IT 0
Commercial Final
C
HEATING:
Gas Test .................
Gas Piping . ................
Equipment .............
On
Commercial Final
x
rn M
EXTERIOR SHEATHING
MIS
0
NAILING ............
FRAMING
S—,-
0
0 Fn
.............
FIRST FLOOR FRAMING..,
-7 fdl;-
TO
ri
INSULATION ...................
X!
Floor Insulation ..........
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
z
0
SPECIAL INSPECTION
0
ITI
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY
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SideSewerg—_
AMOUU&*,'��
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Date ls=�__
Amet:
Detepu j
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AmountP=W$ 75— Ilecelpto—V6
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