20030135.pdf4
DATE RECEIVED /j
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PLAT NAME/SUBDIVISION NO. LOT NO. LID NO.
I LID FEE $
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP Rw "'. Required
Stre et Use Permit Rf<d
EXISTING — PROPOSED Inspecoon Required
Sidewalk Required
REQUIRED DEDICATION— FT wiring required
METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES 13 NOX z
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REMARKS z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE I
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PLAN CHECK NO: _77 -7 VESTED DATE
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TH!S PERMIT AUTHORIMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERUrrAPPLICATIOP& 1180DAYS
PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
"APPLICAUL ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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.'
I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRE"' MID THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
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
WORKMEN'S C
,epalit�SATION INSURANCE AND RCW 18.27.
AGENT]I
tIlGNtTURNkj5WjER Q DATE SIGNED
CHECKEDBY I TYPE OF EJATRUCTION I !qE I OCCUPANT
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REMARKS
PROGRESS INSPECTIONS PER USC 11081FINAL INSPECTION RE01D
VALUATION
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DescriptIon
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FEE
Plan Check
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Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
113 0XI
Landscape Insp.
Total Amt. Due
M,175
Recording Fee
Receipt #
1921.4�1
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CALL
FOR INSPECTION
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APPLICATION APPROVAL
This application is not a permit unfil signed by the
Building diricial or Ns/her Deputy: and Fees are paid, and
receipt Is acknowledged In space provided.
OFn�M DATE
�7)e;Zlo!
771-0220 '4121.124 D 0
ATTENTION Off 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 71;Llk 7jo 6� -
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI. 011�6161_ -FILE YELI�W- INSPL(CTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
11
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CITY OF EDMONDS
121.5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 e FAX (425) 771-0221
Webalte: wwwdedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning* Building- Engineering
April 11, 2003
Kim Pierce
17530 Talbot Rd
Edmonds, WA 98026
Building Permit: 2003-0135
Site Address: 17530 Talbot Rd
Expiration Date: 2/25/04
GARY HAAKENSON
MAYOR
Dear Kim Pierce:
The purpose of this letter is to inform you that the last remaining inspection on your
project is a final inspection(s). The finkl inspection(s) determines that there are no
outstanding life -safety issues and approval allows the City to close your permit file.
The City considers the final inspection to be one of the most important inspections
conducted on a project. In order to grant final approval the following must be complete:
smoke detectors, house numbers, guardrails, handrails, self -close doors between garage
and residence, egress from sleeping rooms, safety glazing, weather-stripping, any
Engineering department requirements etc. Of course not all of these things may
specifically apply to your project but it does give you an idea about the kinds of things
that must be complete as well as some items that do not need to be installed such as:
paint, carpet, moldings, wallpaper, etc. Please be advised permits expire one year from
the date of issuance. If you will need more time to complete the work, permits can be
renewed prior to expiration for one half fees. If the permit expires without a final
approval granted by the Building Inspector, full fees are required in order to renew the
permit. This can be very costly to you and we strongly encourage you to check your
permit expiration date and call for the required final inspection(s). Note: If more than
one department is required to final your prcject, this is noted on your Job Card.
Please feel free to contact me at 425-771-0220 if you have any questions.
Sinc ly,
m
Permit Coordinator
Incorporated August 11, 1890
Sister City - Hekinan, Japan
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JDATE RECEIVED f*
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CITY OF EDMONDS ZONE NUMBER
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OWNER NAME/NAME OF BUSINESS LML . —
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STATE LICENSE NUMBER
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ZIP I TELEPHONE
PROPERTY TAX ACC PASCEL NO.
[3 NEW
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ADDITION
COMMERCIAL
REMODEL
0 MULTIFAMILY
REPAIR
GRADING CYDS
0 DEMOLISH
TANK
IGARAGE
[3 RETAINING WALL
CARPORT
ROCKERY
(TYPE OF USE, BUSINESS OR A; EXPLAIN:
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LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TEBW APF__
RW Permit Required
Street Use Permit Req'd
EXISTING — PROPOSED
InspecWn Required
Sldewc,tk RoWired
REQUIRED DEDICATION— FT
Und*WMW
WIringfoquired, 13
METER SIZE
LINE SIZE
OF FIXTURES
PRV REQUIREbA-'
1
7NO,
45
YES 13 Nog
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
DATE
FIRE REVIEWED BY DATE I ?.
a:
— VARIANCE OR cu SHORELINEORADB# INSPECTION BOND
DATE I CHECKED BY REaD POSTED
JOYES 13NO
$EPA REVIEW SIGN AREA HEIGHT
COMPLETE . EXEMPT ALLOWED , PROPOSED I ALLOWED , PROPOSED
pk=�0M ECH
COMPLIANCE OR
0 CHANGE OF USE
[I SIGN
oFENCE
( _ FT)
OTHER
0 F RE SPRINKLER
FIRE ALARM
LOT COVERAGE REQUIRED SETBACKS (Fr) PROPOSED SETBACKS (FT1
ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE R EAR
PARKING LOT AREA I PLANNING REVIEWED BY DATE
AECID I PR VIDED I .
CHECKED 13Y !TYPNE OF N TRUCTION
CRITICAL 7 .. :ja
AREAS SPECIALINSPE 10 AREA
NUMBER AA REQUIRED rl YES
IREMARKS
PROGRESS INSPECTIONS PER UBC
OCCUPANTM
GROUP
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LOAD
INSPECTION REaD
10-0 Lr- WXX
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FEE Descirliption FEE
Plan Check
State Surcharge
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HEAT-SGURCE - GLAZING % LOT SLOPE %
Building Permit
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City Surcharge
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PLAN CHECK. NO: VESTED DATE Plumbing
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I THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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FNE DOME ON PRIVATE PROPERN ONLY. ANY CON37RUCTION ON THE PUBLIC
Grading
2
'OOkWH (CURDS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
3
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SEPARATE PERMISSIONL
Engir. Review
PERMIT APPIUCATION: 1180 DAYS
PERMIT UUM I YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINKIPERMIT FOR MORE INFORMATION
Plan Chk. Deposit
.Vol
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND QUCCESOFtS'-,., FiretReview.
OF
IN INTEREST, AGREES TO INDEMNIFX DEFEND AND HOLD HARMLESS THE'CITY
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, wAra OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp.
Total Amt. Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY OFDINAWE PROVISION.-
Recording Fee
Receipt #
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LEI
'I tLEREBY ACKNOWLEDGE THAT I HAVE REA13 THIS APPLICATION: THAT THE INFORMATION
APPLICATION
I
APPROVAL
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 applicallon Is not a permit until signed by the
A
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
Building Oflicial or his/her Deputy: and Fees are peld, and _.ol
receipt Is acknowledged In space provided.
WORKMEITS,9011`11�JM ON INSURANCE AND RCW 10.27.
OFF11 L DATE
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DATE SIGNED.
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771-0220
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ATMNTION
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EXT 1333;
IT IS UNLAWFUL TO USE OR OCCUPY A 0 UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFi-
04GKNAL- FILE YE INSPeCTOR\j VU1
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK - OWNER GOLD - ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
GREEN - ACCOUNTING 110
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