20020773.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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ADDRESS
PLAT NAMEISUBDIVISION NO�__[_7071_
LID NO,
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11. FEE. S
PUBLIC IGHT OF WAY PER OFFICIAL STREET MAP
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REQUIRED DEDICATION— FT —
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LINE SIZE
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YES NO 0
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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FIRE REVIEWED BY
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DATE
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NUMBER NUMBER OF
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ARE S
SPECIAL OCCUPANT
LOAD
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STORIES UNITS
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REQUIRE
DESCRIBE WORK TO BE DONE
REMARKS ER U8C 1108/171NAL INSPECTION FlEi
PROGRESS INSPECTIONS P
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VAI IIATION
FEE
Description
FEE
Plan Check
State Surcharge
LIT 5111
Building Permit
21qy-1 city surcharge
PLAN CHE X NO TED DATE
Plumbing
31/0-
Mechanical
CIO
THIS PERIJITTAUTHORIZES ONLYTKEWORKNOTED. THIS PERMIT COVERS WONKTOW
BEDONEONPRIVATEP PERGY ONLY. ANY CONSTNUCTIONONTIHE PUSLIC
MARQUEES, WILL REQUIRE
Grading
lqo
0 OMAN (CURBS. SIDEWALKS, DRIVEWAYS, ETC.)
SEPARATE PERMISSION.
Engi Revi—
PERMITAPPUCATI N; INDAYS
PERMIT UMm I YEAR - PROVIDED WORK is STAITTED WITHIN IN DAYS
SEE BACK OF PINK PERMIT FOR MORE INFOBMATION
Engr. Inspection
-APPLICANT ON BEHAR. OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Revim
Plan Chk, Deposit Wf
IN INTEREST AGREES TO INDIIINIFY, DEFEND AND HOIO HARMLESS IRS CITY 01
FROM ANY AND
Fire Inspection
Receipt go �1'7 0
SOMONG S, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS
R. G, , T
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, An SING DIRECTLY OR INDIRECTLY
ISSUAND "IT S. S
OF THIS PERMIT. E O;F` THIS PER T ALL NOT
19
FROM THE ISSUANCE E
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF AN"Y'CAR ORDINANCE
Landscapoinsp.
Total Amt. Due
NOR LIMIT IN ANY WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
Recording Fee
�ipt U
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPUrATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. ANDTKAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER, I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This AN11-1c, . X,.jj ursil.ip d by th
TH)i AND DING THE WORK AUTHORIZED THEREBY, NO PERSON WILL HE EMPLOYED
IN 0
RLI1dfngOftcIaInhi:rsID1 ty:dnd -05—Puld,ald
P2 ... Ided.
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IN VIOLATIOME ODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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WORKMEWS SATION
, INSURANCE AND RCW 1027� - —1
DATE
SIGNATUR ENT) IGNED
T
(425)
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UVIL
771-0220 A.�TE
N ji� �ENTION
M 1333 ri 0-2-
1 T` IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
OR GINAL - FILE YELLOW�INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
P;NK - OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING
5 COPIES GREEN - ACCOUNTING
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WATER & SEWER
ic�y!. ea %g�Q- o o r L ANr, INSPECTIONS REQ'D.
CALL 425471*20- EXT. 1326
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Inv, 36
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51J4
FOOTING DRAINS NOT
TO BE TIED INTO
DETENTION SYSTEM
ACCEPTABLE TIGHTLINE
MATERIAL
c- N L� 1'�, 20! 0 -SDR� 35
SCH 40
N - 12
Cj Cu j0j,01110 INCIR
APPROVED AS NOTED
ENGINEERI cu'o, 0%
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Date: L3
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OWNE j NTRACTOR IS RESPONSIBLE
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Height Calculation/Grading Verification Worksheet
Address: Permit #: Cpa,� 0-7 -7
Date: 9 -63
A. Datum Point:
B. Datum Point Elevation:
Z,
01
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C. Average Grade:
0
M
m 0
A
0-4
N
C
0 n
3. Maximum Elevation Allowed: 3 ?Z' average grade) + 25'=
m m
4. Reference Point Elevation Shot to House: 055
51P (datum elevation) + -7-5L (grade to transit level line shot to house)
K co
M C)
Z
6. Measurements from line shot onto house to Toof ridge:
M
Z
z
In
Total
7. ActualElevgtion:9721 (reference point elevation) +�R-L(measurerneuts- from
#6)
Conclusjon:
'3 IS-S (actual) is greater A (allowed); therefore the house is/
nt-p--e— irements
is not over the height requireme r ECDC 16.20.30 requ
LATEWBUILDINGWISCHeight CalculationGrading Verification Worksheet.doc
FINAL PROJECT APPROVAL FORM
TO: --
DATE:
MEMO TO: pERWT COORDINATOR, BUILDING DIVISION
FROM: ____;,...FIRE DEPARTMENT DATE-
6 ca'r ENGINEERING DIVISION DATE
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PERM[1T#__,/Ja5 0223- ... ADB# DATE INSPECTED
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DESCRIPTION OF WORK TO BE INS PEcTED rtOAL—
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A field inspection was conducted to determine final compliance with approved plans. Final approval
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.denotes that there are no objections from the above signed Department to the release of
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PE ANCE BONDS and the granting of:
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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,
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Sign_
ocaprvl.doc.l:tcn)p:bldg:forrnsIO/OI
—mount Paid
RECORD OF INSPECTIO�&,__,
INSPECTOR DATE APPROVED
ZQ/1 S:�- -2—
SETBACKS ..................... d
FOUNDATION:
Footing ......................
wall ...............
Pier/Porch .................
Retaining Wall ...........
Stab Insulation
PLUMBING:
Underground
Sough -In ...................
Commercial Final
HEATING:
Gas Test .................
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
MIS
FRAMING .......... .............
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ........... ...
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Side Sewer 0 20DZ-073v"'
Amout Paid $
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LOW
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