20020526.pdfDATE RECEIVED
/o) 6!
PERMIT EXPIRES
CITY OF EDMONDS
YOSIZE
PERMIT
Z<'15� 0
-
"MIER eZ�j
CONSTRUCTION PERMIT APPLICATION
JOB
SUITEIAPT#
ADDRESS
NER "AM ME OF BUSIN 4SS
A, V.
Pt AT NAME/SUBDIVISION NO. IOTNQ LID NO,
_; . _
[LING ADDRESS
Lt. FEE A
D-33 `-'� '�"t
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
Y ZIP
EXISTING —
PROPOSED— "upes" sessed
aid ...... u, an
IIELEIHONE
ctyo)-o 1I 'f o 6 It
U-0=
REQUIRED DEDICATION— FT — Wft.uni."o 0
ME
D VL!;
METER SIZE I LINE SIZE WNO. OF FIXTURES PIg..UIRIED,
YES
DRESS
REMARKS
I �; 2-'�
WNEFVCCNTRACTOR RESPONSIBLE FOR EROS!Ot_CONTR )LIDRAINAGE
Y ZIP
I�SPV-MNL R*n '[):CI)5PLY�fo�J (2)Pi0L
ITIL11HON'
ADDRESS t_' 7-2-02-
FIRE REVIEWED By DATE
CITY ZIP TELEPHONE
I
z
m
STATE LICENSE NUMBER EXPIRATION WED BY VARIANCE OR CU SHORELINE OR ADS# INSPECTION I PBOND
Ra�k.0
YES
SERA REVIEW SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE IX ALLOWED PROPOSED ALLOWEO PROPOSE.
:4 i9n
0CM344L 0 1-- 11 - -Y��
, , 2-�'
E XP 1�11�1
m
LOT COVERAGE REQUIRED SMACKS (Fl) PROPOSED SETBACKS (FT)
0 NEW Eff RESIDENTIAL LUMBING/M H ALLOWED PROPOSED EAR FFION� R
FRONT SIDE A LFBI R
MUSE
C: a
m
a
COMPLIANCE OR
ADDITION 0 COMMERCIAL GH-AMG-IN-0P
de
0
By
PARKING 'I LOT AREA A)ATE
As
C:
--4
0 REMODEL [3 APARTMENT SIGN 1��o OVIDED -VIEWED
)_ I F�,
C
M
ITIZ
'VNNINI1
F NCE _
REPAIR YDS
( _X FT) REMARKS
DEMOLISH 0 TANK 0 OTHER
o GARAGE RETAINING WALL
RENEWAL
V)
CARPORT ROOKERY
0 *n
ITYPE OF USE. BUSINESS OR EXPLAIN:
CH�01111 BY 0 cu`RANW,�
OF CRNySffN
ITYPE
IC GROUP
7-7
N
7UMIEII LIM ER OF
OF DWELL No 4SPECTOR OCCUPANT
LOAD
m M
_a UNITS YEE JAREA
STICIN,
0
O"a
DESCRIBE WORK TO BE DONE
0
REMARKS
PROGRESS INSPECTIONS PER UBC 103/FINAL INSPECTION REDD
C 0i
9 Cry
ifi:!iftGto�701 2"
0
Z
r 144
VALUATION 137,
z
Description FEE Description FEE
1
X
Plan Check MIS—
(a
z
NEXT SCKNICEI LAZIN..
FA iL� 3C A,
LOT SLOPE Is Building
VESTED DATE Plumbing
I Mechanical
0
m
PLAN CHECK NO:
0,2— — Z:Zq
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORKTO
t 11 '*"' ON P"11P"OPEATY O.W..... CTMONTHEPUBLIC
Grading
Recording Fee
DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
t: SEPARAITEPERMISSION.
1 PER ITAPPLICATION: IBODAYS
Engr. Review
b0
City Surcharge
A. PERMIT Uses I YEAR-PROVID 0 WORK 15 STARTED WITHIN I.DAYS
Engr. Inspection
/1x)
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Traffic Mitigation
—
Plan Chk Deposit
'APPLICANT. ON BEHALF F HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO IND MINIFY. DEFEND AND HOLD HARMLESS THE CITY OF
1DMOND1* WASHINGTON, "I OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND
Fire Review
Receipt III
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
P
FROM THE ISSUANC OF THIS PEAMR. ISSUANCE OF THIS ERMIT SHALL NOT HE
F re Inspection
Tot at Amount Due
103
FYI
DIEMEDTOMODI WAIVE OR REDUCE ANY REQUIREMENT OF A NY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE DRYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
.
Landscapeinsp.
I HERESY ACKNOWLEDGE TH I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I Am THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE To COMP WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
allon Is not a panniturtill signed byes.
0
TION; AND IN DOING THE WORK AUTH RIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTIO N
LutuTheyappit
ding Offid.',, Idelher Deputy: and Fees are pad. and
na.ipt I—ka-I.dgedhepetraid.vid.d.
WORKMENS 5OWkNSATION INSURANCE AND RCW 16.27.
11011-URE DATE
Sfl��JRE(I(OVVNIER �R
DATE 1114111D
21 -L
(425)
JOCI41.1
7
�AG
lk—e-
6 _J�� ,:,
771-0220
DATE
;MENTION
M 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-
FILE YELLOW. INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER GOLD-ASSESSOA
10101
Height Calculation Worksheet
Address:
Date:
hwecto�s) IVI E
1. Datum Point:
2. Datum Point Elevation: C�D .0 0
Z,
0
:j:
I AveragcGrade: I W,()C>
0,
M.
4. Maximum Elevation Allowed: LQL-) (average grade)+ 25'= ka'�,,DO
5. Reference Point Elevation Shot to House:
0 M
M 0
80
,o (datum elevation) + S (D (grade to transit.level line shot to house)
C
N,
m
'0
6. Measurements from line shot onto house to roof ridge:
C 2
>
E:
37,
On
In M
0_�
0
rno�
z
Total
Z.
0
M
7. Actual Elevation: -!C,)S (reference point elevation) + (measurements
from #6)
Conclusion:
ia,3�1 k (actual) is greater /jef.��th:.�S, (allowed); therefore the house is/
is not over the height requirement per ECDC 16.20.30 requirements
UTENOBUnDINOWSOHeight Calculation Worksheet.doc
FINAL PROJECT APPROVAL -FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, WELDING DIVISION
FROM: DEPARTWMNT DATE —
ENGINEERING DIVISION DATE
PLANNING DIVISION DATE—
PROJEC
SITE ADDRESS 0 3 S 'if r6(Q [A i
PER
.Nff INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED—EffiLL------------L—
A fleld 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 WIT11 CONDITIONS NOTED
[3 copy of CONDITIONS given to owner/contractor by inspector
I
FAMED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractOrbY insPcct0r
1.
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Datc_ Sign—
ocaprvi.doc.l:wW:bldg:formsIO/OI
z
'A 5i
Vi
M
M 0
0
80
a: M
M Z
0 --1
z
0)
0
3:
M M
6 cn
0
a 'T
C C/)
M 0
Z
.q�
M
--I
>
z
--I
z
F)
M
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ................... .
FOUNDATION:
Footing ................
wall ..................
Pier/Porch .................
Retaining Wall
Slab Insulation
PLUMBING:
Underground .............
IS
Rough -in
Commercial Final
MATING:
Gas Test ............
9,�
Gas Piping .................
Equipment
Commercial Final
EXTERIOR SHEATHING
Oz
NAILING ..........................
0_1 _0Z
FRAMING .................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation
(o /;blo 2-
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................