20020596.pdfCITY OF EDMONDS
USE
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7CONS;T:RUCTION PERMIT APPLICATION
WN NA
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JAORDRESS
"N' Ave
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FLAT NAMEISUDDIVISION NO. LOT 110,
LID NO,
a no _HESS
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LID FEE S
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PUBLIC RIGHT OF WAY PER OFF1 AP
EXISTING PRO
REQUIRED DEDICATIONPRO
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NO. OF FIXTURES
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Print REQUIWED
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REMARKS
OWNEFUCONTRACIOR RESPONSIBLE FOR EROSION CONTROLIDIAINAGE
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COMMERCIAL
ri COMPLIANCE OR
CHANGE OF USE
0 REMODEL
0 APARTMENT
SIGN
REPAIR
o F NCE
( _ X FF)
DEMOLISH
TANK
0 OTHER
0 A' AGE
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RETAIN WALL
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RENEWAL
(TYPE OF USE, BUSINES
NUMBER
OF
NUMBER OF
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DESCRIBE WORK TO BE DONE
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E REVIEWED BY DATE
"�A_�IIANCIOI CU � SHORELINE OR -10 INSPECTION 6�D
POSTED
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$EPA REVIEW
COMPLETE T
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SIGN AREA
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HEIGHT
ose
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LOT COVERAGE
ALLOWED OPOS
REQUIRED SETBPPKS (FTJ
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PROPOSED SETBACKS (FT.)
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AREA P No R E 41Y D E
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REMARKS
CHECKEDRY JTYPEOF`Zj��ON qI
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GROUP
SPECIAL INSPECTOR JAFIEANI�,VAJ� J%OCCUANT
REQUIRED rl YES — r, J� I LOAD i
USC
Plan Check
/1102)_
OT E 'S
Building
PLAN CHECK N22� _I VESTED DATI!
Plumbing
Mechanical
THIS PERMIT AUFTHOPHROES ONLY THE WORK NOTED. THIS PERMIT C."... WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY COMET UCTIONONTHEPUBLIC
Grading
Recording Fee
Do I&AIN (CURES, SIDEWALKS, DRIVEWAYS MAROU -ES,ETC.) WILL REQUIRE
- SEPARATEPERM;SSIOH.
Engr. Review
City Surcharge
P2,1111TAPPLICATION: ISODAYS
PERMIT UMARE PROVIDED WORK
I YEAR - IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
State Surcharge
*APPLICANH. ON SSHAL F OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
E D MONDS, WASHINGTON, ITS OFFICALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Review
Receipt #
FROM THE I SUANCE OFTHIS PERMIT ISSUANCE F THIS PERMIT SHALL NOT BE
0
EMED TO MODIFY, WAIVE OR REDUCE REQUIREMENT CITY
Fire Inspection
Total Amount Due
ANY OF MY ORDINANCE
0 OR LIMIT IN ANY WAY T14E CnYS ABILJWTO ENFORCE ANY ORDINA14CE PROVISION.-
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Landscapainsp.1
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION A OVAL
GIVE" IS COFIFIECT� AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STAT LAWS REGULATING CONSTAUC�
CALL
Th—pplicalloal—we permit until signed try Me
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
Building Off1clal a, �IsRaa Deputy: and Feda a. Fare. and
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FOR INSPECTIO1 A -e 1
WORKMENS COMPENSATION INSURANCE AND RCVV 18,27.
OfflPIALS S!GNATUAP,, DATE
1111 HE HE 01 t2��j) DATE SIGNED
(425)
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771-0220
IIAIE
ATTENTION
EX`r 1333
IT IS UNLAWFUL To USE OR OCCIJ� A BUILDING OR STRUCTURE UNTIL
L tUJ-f4(R'L__
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
771-022
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CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
ORIGINAL - Fit F -JELDOW? - INSPECTOR
PINK � OWNER - GOLD . ASSESSOR
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Height Calculation Worksheet
Address:
Date:
IiWector(s):
N
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1. Datum Point:
2. Datum Point Elevation:
Z
0
0
3 Average Grade:
4. Maximum Elevation Allowed: � �\(average grade) 25'
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5. Reference Point Elevation Shot to House:
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(datum elevation) + Z (grade to transit.level line shot to hous
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6. Measurements from line shot onto house to roof ridge:
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lot
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Total
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7. Actual Elevation: reference point elevation) + 191�-71,t (measurements
from #6)
etual) is grea (allowed); therefore the house Is/
ter t�!sdhan
per ECDC 16.20.30 requirements
is not over the height requiremeir
L.\TFNe\BujLDlNG\NffSCffieight Calculation Worksheetdoc
OWNERICONTRACTOR IS RESPONSIBLE
FOR EROSION CONTROL AND DAMAGE 98.86'
A
61.0
10
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WOER & SEWER
INSPLOTIONS REQ'D.
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RECEIVED
33 JUN 2 6 2002
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MATERIAL
SDR 35 FIREAND ADDRESS SIGN REQUIRED
5CH 40
:810 HANCOR FOOTING DRAINS N Co
TO BE TIED INTO CITY py
DETENTION SYSTEM
Site Plan
APPROVED AS NOTED
B EN INE ING
)��A NIIING
Date: 1 1
5 e
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE—
C, t_gmt ENGINEERING DIVISION DATE--L'_�(1 ---"
PLANNING DIVISION DATE—
PROJEC
SITE ADDRES
PERMIT ADB# —DATEINSPECTED
DESCRIPTION OF WORK TO BE INSPECTED _rIOAG
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 and the granting of
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WrIH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
ri Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date— Sign_
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATIONt
Footing ......................
Wall ......................
Pier/Porch
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground .............
fa> C�_
Rough -in ...................
Commercial Final
HEATING:
Gas Test ....................
C;
Gas Piping
Equipment
Final
Commercial
EXTERIOR SHEATHING
NAILING .........................
FRAMING ........................
FIRST FLOOR FRAMING_
INSULATION ...................
Floor Insulation
Wall Insulation
Gelling Insulation
Ing
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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