20030008.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
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MAILING ADDRESS
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NAME
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PERMIT EXPIRES I I I a I
PERMIT /-v-)()S
NUMBER CA-11
SUITE/APT#
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PLAT NAMEISUBDIVISION NO.
LOT NO*
LID NO.
LID FEE S
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WNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLJDRAINAGE
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STATE LICENSE NUMBER
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PROPERTY TAX ACCO PARCEL NO.
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TELEPHONE
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REMARKS
PROGRESS INSPECTIONS PER UBC 1108MINAL INSPECTION REO'D
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PLAN CHECK No*
VE ED DATE
Plumbing
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE 14ORK NOTED. THIS PERMIT COVERS WORK TO
tz BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
32 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
I- SFPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 160 DAYS
06 PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
I
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapeinsp.
Total Amt. Due
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
—
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
APPROVAI
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
This application Is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Official or his/her Deputy: and roes are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt Is acknowledged In space provided.
WORK4ENS
COMPENSATION INSURANCE AND RCW 18.27. -
OF IGN DATE
61
RE (OWNER E
DATE SIGNED
1A
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W I
d314
771 -0220
RE S ATE
ATTENTION
Off 1333
TP 1-5
IT IS UNLAWFUL TO USE�O�DCCUPY A BUILDING 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 - OWNER GOLD - ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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Date:
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Height Calculation Worksheet
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1. Datum Point: M 4
2. Datum Point Elevation: LY)
3. Average Grade: oo .-a4
4. Maximum Elevation Allowed:
t>-at .) (average grade) + 25V
5. Reference Point Elevation Shot to House:
j)o-jjq (datum elevation) + 4) �07 (grade to transit level fine shot to house)*
6. Measurements from fine shot onto house to roof ridge:
k 2- S.*�
7. Actual Elevation: (reference point elevation) + (D 'SO (measurements
from #6) W21 n
Conclusion:
QJ-1( _(actual) Is greaterooelwsoiA�n (allowed); therefore the house Isl
Is not over the height requirenilutIs'er ECDC 16.20.30 requirements
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RE-iNsPEcrED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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DATE RECEIVFD
k1114FPERM IT EXPIRES
CITY 0; EDMONDS
y
USE PERMIT -7 0
ZONE
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NUMBER L,
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT#
ADDRESS
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OWNER NAMEPNAME OF BUSINESS
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PLAT NAME/SUBDIVISION NO, LOT NO. LID NO.
MAILING ADDRESS
LID FEE $
TESCP Appro"d
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP MY Permit Requited
CITY
ZIP TELEPHONE
-+4
Street U5* Permit Aoq'd
EXISTING. Inspection Required
PROPOSED SIdewalkRequirad IT-
Undergrourid
REQUIRED DEDICATION— FT Wifti; required
NAME
mE'rER SIZE LINE SIZE FIXTURES PRY REQUIRED
I N�Of
YES13 NO z
ADDRESS
R 1. RACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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49flf.) 11112 15; 1 <
ZIP _ITELEPHONE
NAME CBL #
—ILA us Ct�) fo_ (];nufl ntj ENGINEERING REVIEWED BY DATE
cc ADDRESS
FIRE REVIEWED BY DATE
CITY ZIP TELEPHONE
-71
a6 VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND
STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY REQ'D POSTED
"e- 14 1 _______r13YES A�O I$ ft-1 -------
SEPA REVIEW SIGN AHEA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. XEMPT
COMPLETE E ILO.WEDPROPOSED ALLOWED PROPOSED
_7
EXP
LOT COVERAGE TBAcid0i
LUMBIN MECH REQUIRED SETBACKS (Fr.) PROPOSED sE
NEW�. RESIDENTIAL ALLOWED, " PROPOSED FRONT SIDE "100 FRONT 01 SID
&1ANCE OR
ADDITION 0 COMMERCIAL CHANGEOFUSE 19 5 " 1 - 5 141A 1 715 1111 "!Ar2rp z
PARKING LOT AREA, �PLANNNG WEWED BY . D E 06
Rfi�O PROVIDED
REMODEL MULTIFAMILY SIGN
NO, ENCE 21L
b REPAIR x
eRKS
f6hia'*1 age Ic =32pes
DEMO�ISH 0 SO
oGARAGE o RETAININ WALL FR
CARPORT ROCKERY FIRE A
WILAIN: BY TYPE C UPANT
UP
NUMBER OF . __j_CRrri CHECKED F LICTION _W7 ro L-1
M NUMBER CAL L AJ
TIOW
OF r DWELLING A A SPECIAL INSPEC E OCCUPANT
S z I I NRUEMW/ Ft.; LOAD
j._STORIE - UNITS Lf) REO UIRED [:] YES a <
DYACRIBE WORK TO BE DONE Kam
itntm. R Ao=mzt� M 0( us:' REMARKS
PROGRESS INSPECTIONS PER LIBC 108/FINAL INSPECTION. REO'D
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VALUAnON
AT Dji=_ t�M 11747t)
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hizz t0 lhkit 2 712 Description FEE De3crilption FEE
Plan Check State Surcharge 6L9
LA4
soLTRrE "'LAZING % I LOT SLQFE % City Surcharge
_�'42"o Building Permit
PLAN CREC20- VESTED U(T—E Plumbing
Mechanical
PERMIT AUTHORIZIES ONLY THE VfORK WTFD. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDE%VALYXh DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
t: Engr. Review
PERMIT APPUCATION: ISO DAY13
PEROT IUMM I YEAR - PROVIDED WORK IS STARTED WnUN 180 DAYS
Engr. Inspection
SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY; DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection Receipt III
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILRY TO ENFORCE ANY ORDINANCE PROVISION."
Recording Fee Receipt N
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION: THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application is not a permit until signed by the
CALL Building Official or h151heir Deputy: and Fees are paid, and
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 FOR INSPECTION - 'receipt Is acknowledged In space provided.
C ENSATION INSURANCE AND RCW 18.27.
OFFI;RGN7ATjft DATE
SIG RE (OWNER E DATE SIGNED IA05)
wAr-
771-0220 _-REL90-0 B DWTE'
M IT
_IJ CCUPY A BUILDING OR STRUCTURE UNTIL
ATTENTION 33
IT IS UNLAWFUL TO USE 0 0 1 b /0
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR�GINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PNK-OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARTAVNGA 9CP'15ES GREEN - ACCOUNTING
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