20020765.pdfDATL ,UCEIVED
I LPERMITEXPIRES
CITY OF EDMONDS
S
ZONE
ERMIT
NUMBER _�q
CONSTRUCTION PERMIT APPLICATION
JOB
ADDRESS
S ITE/APT#
__
2�5/9
o,7
OWNER NAM
PLAT NAMEISUBDIVISION
NO. LID 0
qAL O)Caddel�g�
—ILING
ADDRESS F_
MA 73127 e;?--44:_M vi
—
PUBLIC RIGHT OF
WAY PER OFFICIAL STREET MAP
CITY 17EUEPH HE
S 7
EX STING
PROPOSED 13
U-19-
REQUIRED DEDICATION—
FT — 1.3-
NAME
METER 1111
LINE 5111 NO, OF FDrTURE1 PAY REQUIRED ar
1
YES C3 NO 13
1
ADDRESS
REMARKS
OWNERICONTRACTOR
RESPONSIBLE FOR EROSION CONTROUDRAINAGE
�1 —
I—
or
I
CITY
,P]m
Alitl-L 0,64. 'd-
zip TELEPHONE
Ob -2�
NEW RESIDENTIAL PLUMBINGIMECH
C MPLINNCE OR
ADDITION COMMERCIAL CHANGE OF USE
rl REMODEL 1%—Mu".." SIGN
REPAIR GRADING CYDG X (I FT)
DEMOLISH rl TANK OTHER
GARAGE FIRE SPRINKLER
C RETAININGWALL FIRE ALARM
ARPORT ROCKERY
fTYPE OF
1 dRIT]b
'A
AREAS
-NUMBEh
DKIWOLRIK T
FIRE EVIEW5D By
DATE
VARIANCEORCU
1
HORELINE 08 AOS9
I INSSPEEOTION
0
BOND
11 10 STE.
)�ES ONO
___d'EPA RVIEW
SIGN AREA
HEIGHT
E11MPT
ALLOWED
ALL7D
_00MILETE ,
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT)
AW1;1 jT7;1D
FRONT 81DI BEAR
jrf
FRONT 1IRSJDE BEAR
- I
- N 0,
]'� ,
PAR
LOT AREA
i�
�'Z;Tj
A
Are �IQNJ�G
ROD OVIDED I
�J,; /,D
M vsT eF—::: LE�5'10^N (2, P-r 140611-r
7—ECKED BY 1]�ON Cq2 GCCUPA.TA?;;;,
GROUP
SPECIAL INSPECTION OCCU NT
REQUIRED [] JAIIEA LOADPA
YES
or
REMA KS M
PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REaD 5
5
or
$
F
i"9It-1T(44j2"`.—d,,s -A4*
FEE
Description
FEE
J-P',-Description
4' "� ! V"
P, an Check
P,
State Surcharge
HEW�SOURCE GLANN& % '0 _.p
Building Permit
City Surcharge
PLAN CHECK NOC,12 FISTED D
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
D ED NEON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
0
Grading
E D C, )WILLREQUIRE
OMAIN (CURBS, SIDEWALKS,GFIRTIEWAYS
PEAM, OAR DIES, LTC.
SEPARATE SSION.
Engp. Review
PERMIT APPUCATION: UBDAYS
PERMITLIMIT I YEAR -PROVIDED WORK IS STARTED WITHIN 180DAVS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
LInspection
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
FIT. HAE
Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY Of
a EDMONDS' WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire
Receipt 4
1 ALL CLAIMS FOR DAMAGES OF WHATEVER, NATURE ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT SSUANCi OF THIS PERMIT SHALL NOT BE
Landscapeinsp.
Total Arm Du9j,
9 DEEMED TO MODIFY, WAIVE OR REDUCE A Y REQUIREMENT OFANY CITY ORDINANCE
H PROVISI
0 NORLimirINANYWAYT E CITYS ABILITY TO ENFORCE ANY ORDINANCE ON.-
,
&
Recording Fee
"p t, /,
Race p A,
=
I HEREBY ACKNOWLEDGE THAT I HAVE AM THIS APPLICATION; THAT THE INFORMATION
0
APPLICATION APPR VAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
rSPECTION
jel case, 1, not a pannift,not signed bY the
TION; AND IN DOIN THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMP LOYED
G HE STATE OF WASHINGTON RELATING TO
T
For"ThIeN,
ceng Offi,�al,c hisforK OOPIIY! and Fees arc paid, and
FOR IN eadinfl—knoModgedinap,c, pfAded4
0 IN
A VIOLAT THE LABOR CODE OF
ION OF
WORKMEN'S COMPENSA��BANCE AND FIC)N 18.27.__
So "AT'
SIGN A!64� R E DATE IGNED
(425)
,�IAL �GATUBI
G�F
771 -02.40
RE1EA___ AYE
ATT I 'ION
EXT 1333
ITISUNLNVFULTOUS OR nrrII/Y A BUrILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK - OWNED GOLD - ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN ACCOUNTING
z
0 M
co
M 0
-40
0 C
IT1
z
-4
V)
0 -TT
ITT M
0
0,
0
C
ITT 0
>
z
—i
x
0)
z
3)
IT!
T-;F I Y ur-
�T�W�E�]N
DEPA
----------
-,o AJ Of . ....
Y-k 4f
0 Pa
Uf-
E L-��
BF-R
BUILDING DEPT.
a
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE -
ENGINEERING DIVISION DATE-
PLANNING DIVISION DATE-
PROJECTI&��A S6Y�"2yo�,
z
0
:_j
:4 �n
0 M
C
MO
SITEADDRESS
PERMIT #,2�- �.ADB#__DATE INSPECTED-
0
0
7: M
DESCRIPTION OF WORK TO BE INSPECTED_t��,�....
M Z
0-4
z
-4
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
0 -n
PERFORMANCE BONDS and the granting of:
"n
m M
"L-GRANT FINAL PROJECT APPROVAL
0
C
9 C/)
M 0
Z r-
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
>
z
a Copy of CONDITIONS given to owner/contractor by inspector
co
1.
z
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
1.
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Si
ocaprvl.doc.l:temp:bldg:fomlslOIOI
Oak
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ..............
FOUNDATION:
Footing ......................
Wall ........... .
Pier/Porch .................
Retaining Wall ...........
0
Slab Insulation ..........
PLUMBING:
—n
-4
Underground ............
3:
Tn
C
M
Rough -in ...........
0
C
Commercial Final
M
HEATING:
Gas Test ....................
to
C Z
>
Gas Piping ................
Cft
Equipment
0,n
It 23
Commercial Final
-4
M M
EXTERIOR SHEATHING
a 65
0,—
NAILING .........................
ITI
FRAMING ........................
M 0
FIRST FLOOR FRAMING
INSULATION ...................
Insulation
Floor
z
Wall Insulation ...........
Ceiling Insulation
z
SHEETROCK NAILING
0
SPECIAL INSPECTION
M
MISCELLANEOUS
FINAL APPROVAL FOR
G3
OCCUPANCY ..................