20030200.pdfr
DATE RECEIVED
I
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
MAILING ADDRESS -n4
16�5 i �1 _�z "D 5 � p�
CITY ZIP ITELEPHONE
A?n I
2
NAME
ADDRESS
40-2- A
CITY TELEPHONE
r
Z 4�� �)
ip
NAME CBL#
A
AD
.QRESS
111eWzJ1�1h1V_,15.
CITY 1 11 ZIP TI?LEPHONE
STATE LICENSE NUMBER EXPIRATION
IQ I PROPERTY TAX ACCOUNT PARCEL 110.
[PERMITEXPIRES
USE PERMIT
ZONE 2
NUMBER Z,
JOB
ADDRESS
PLAT NAME/SU 13DIVI SION NO. LOT NO. LID NO.
LID FEE S
TESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP AW Permit Required
Surral Use Pomit Raq 'd
EXISTING --�-e� PROPOSED— Inspection Roquired
Sidewalk Required
REQUIRED DEDICATION FT Underground
wiring required C
METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
I I 1�� YES13 NO 13
NEW
RESIDENTIAL
PLUMBING / MECH
ADDITION
COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
REMODEL
MULTIFAMILY
SIGN
REPAIR
CYDS
FENCE
X FT)
DEMOLISH
TANK
OTHER
GARAGE
RETAININGWALL
FIRE SPRINKLER
CA22QW
ROCKERY
FIRE ALARM
(ME OF USE, BUS)NESS OR ACTIVITY) EXPLAIN:
U.:
5-> I Kq [e,
Faon
t
NUMBER NUMBER OF
OF DWELLING
STORIES UNITS I
DESCRIBE WORK TO BE DONE
Aet
AREAS
NUMBER03 13
HEAT SOURCE GLAZING % LOT SLOPE %
PLAN CHECK NO: VESTED DATE
L
THIS PERMIT AUTHORIZES 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.
PERMIT APPILICATION: 180 DAYS
PERMIT LIMIT 1 YEAR - PROVIDED WORK is STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, 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 C11YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
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-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION Of,^E LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S Q�QPENSATIQN INSURANCE AND RCW 18.27.
DATE SIGNED
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
ENGINEERING REVIEWED BY
FIRE REVIEWED BY
VARIANCE OR CU
SEPA REVIEW
COMPLETE EXEMPT
EXP
LOT COVERAGE
ALLOWED PROPOSED
35 % 7,3 vi,
PARKING
REO'D I PROVIDED
4 2 11
REMARKS �
DATE
DATE
SHORELINE OR ADBI I INSPECTION I BOND
REO'D POSTED
OYES 636 S
SIGN AREA HEIGHT
ALLOWED , PROPOSED I ALLOWED , PROPOSED
0 7�5 - P'to,
REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
FRONT SIDE REAR FRONT URSIDE REAR
7- 5 75 1 S71 70 e. P4, 1 t.
LOT AREA I PLANNING REVIEWED BY DATE
.3
CHECKED BY ITYPE (IF ONSTRUCTION C OCCUPANT
GROUP
SPECIAL INSPECTION A
OCCUPANT
REQUIRED [] YES LOAD
z
z
a
T1,
W
W
rL
REMARKS a
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE01D I ;
15
VALUATION
$ 1 adc.
Description
FEE
Description
F
Plan Check
k%y —
State Surcharge
Building Permit
City Surcharge
6�
Plumbing
Mechanical
-7-a
Grading
IVLO�
Engr. Review
'6e7
Engr. Inspection
r_J&4) 7
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
Landscapelnsp.
Total Amt. Due
Recording Fee
Receipt It
CALL
FOR INSPECTION
(425)
771-04220
APPLICATION APPROVAL
This application is not a permit until signed by the
Building official or his/her Deputy: and Foes are paid, and
receipt Is acknowledged In space provided.
OFFICIALS SIGNATURE DATE
f
L�AELEAT"j I I DAf E
ATTENTION - / t:x I I Jj;j
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
RIGINZ' FILE YELLOW - INSPECTC
PINK -OWNER GOLD -ASSESSOR
GREEN - ACCOUNTING
V,
t
z
0
0
M
X
C ITI
M 0
0
10
0 C
-j K
3: M
M Z
z
X
0)
0 -n
n
--I
x
M M
a
0
0 M
CJ)
M 0
Z
7-1
X
z
--I
x
ra
z
0
i
0
M
77
a
La
CNJ
c::)
rr
L4
:�:,NOTICE: IF THE.DOCUMENT IN THIS FRAME,IS LESS. CLEARTHAN THISNOTICE
E DOCUMENT,
IT IS DUE TO THE QUALITY OF TH
ED tA
G
V
N E
U,
GL
LN V
OL
�3
in
in
CL
Height Calculation Worksheet
-7
Address:
Date:
hweetor(s):
1. DatumPoint:
2. Datum Point Elevation:
3. AverageGrade: I
4. Maximum Elevation Allowed: (averagdgiade)' '25
5. Reference Point Elevation Shot to House:
c4i.d.6�?
CX) (grade to transit level fine shot to house)
(datum elevation)+
6. Measurements from line shot onto house to roof ridge:
Total
7. Actual Elevation: I o4-d"? (reference point elevation) + IS-IIJ (measurements
from #6)
Conclusion:
(actual) Is greater t�n (allowed); therefore the house is/
is not over the height requirement per ECDC 16.20.30 requirements
y
0
M:
OMI
r
M
4�
0 C,
R
M
ID
C
0.
M M!
C) Fm
Ir
M
M
I
Inc. 1 89�3
CITY OF EDMONDS
121 5TH AVENUE NORTH * EDMONDS. WA 98020 - (425) 771-0220 - FAX (425) 771-0221
Website: wwadedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
May 28,2003
Attn: Keith& Tammy Miller
10517 235th PL SW
Edmonds, WA 98020
Building permit: 2003-0200
Site Address: 10517 235th PL SW
Expiration Date: 3/14/04
Dear Keith & Tammy Miller:
GARY HAAKENSON
MAYOR
The purpose of this letter is to infonn you that the last remaining inspection on your
project is a final inspection(s). The final 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 project, this is noted on your Job Card.
Please feel free to contact me at 425-771-0220 if you have any questions.
Sincerely,
erm. oordinato
Incorporated.August 11, 1890
Sister city - Hekinan, Japan
Z
FINAL PROJECT APPROVAL
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE-
MXASE MON
ENGINEERING DIVISION DATE /q-
?LLASE SIGN
PLANNING DIVISION DATE
PROJECT� e-a n
SITE ADDRESS I b G t -1 a-61E�� P
PERMIT B#________PATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
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
PERFOR-MANCE BONDS, and the granting of :
V GRANT FINAL PROJECT APPROVAL
GRAM PROJECT . APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
I .
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
I .
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Dat Si
ocaprvl.doc.l:tenip:bldg:fomisIO/OI
z
9
0
M
=i =5
6-1
OM
C
MO
0
-1 0
0 C
--I K
X M
M Z
g) --I
C
0 -n
n
I
x
M M
055
0 r-
0 M
C cl)
90)
Q 0
Z r-
z
z
9
0
M
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
nZASE SIGN
1fi 1 �10_ —ENGINEERING DIVISION DATE
PLANNING DIVISION DATE
MASE SIGN
PROJECT� I I
SITE ADDRESS
PERMIT# 1AA-2)-6U0 ADB#---------PATE INSPECTED
W__ I
DESCRIPTION OF WORK TO BE INSPEC
A field inspection was conducted to determine flnal compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRAW PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
1 .
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
I .
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Dat Si
ocaprvi.doc.l:temp:bldg:formsIO/OI
z
0
1
0
Ri
=i 9
U5 -1
0 M
C
MO
0
--1 0
0 C
: -1 r.
P A
M Z
10-1
Cn
0
n
i
3:9
M M
0
0
0 M
a CD
9 CD
M 0
Z
z
Cn
z
9
0
M
I
RECORD OF INSPECTIONS
INSPECTOR, DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING: ':x,
Underground .............
Rough -in ...................
Commercial Final ......
HEATING:
Gas Test ................... I
Gas Piping .................
Equipment ...........
Commercial 11 1,77
Final .......
EXTERIOR SHEATHING C�3
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING ...
INSULATION ...................
Floor Insulation .........
Wall Insulation ........... 1"�:'
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR 03
OCCUPANCY ..................
ilde Sewer 1,
*a t e r 1%, C. t r
Ainount P.,.,
how K.,
AmcuntP_
d'a! e
DATE RECEIVEJ Pi'RMITEXPIRES 4q),
�CJTYOFEDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
M + T-AIM 1_111'1�_
MAILING ADDRESS T0
)o� I --I - V-L __" VQ
CITY ZIP ITELEPHONE
12- -5,,1-
a:mn,-'o__j i �4 -
NAME
ADDRESS
CITY ZIP ITELEPHONE
4
NAME 1CBL#
S E
USE PERMIT
N E
ZONE
0
I &03 - 0 2-Off
NUMBER
0 B
JOB SUITEIAW
D D R E S S
ADDRESS Z ��S_tt' P L
A ME
PLAT NAME/SUBDIVISION NO.
P LA T N
LOT NO.
LID NO.
LID FEE S
to R
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
U B L I C IG H
TESCP Approved 13
RW Permit Required
EXISTING
E XISTI NG _ PROPOSED—
Street Use Permit Roq'd
Inspection Required
REQUIRED DEDICATION Fr
Sidewalk Required
Underground
Wiringroquired
METER SIZE
LINE SIZE
NO. OF FIXTURES
PAV REQUIRED
YEs13 NO 13 E
S z
REMARKS z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
K�7'1
M wri I A IV- ZZTr-Ti;; kit, tvJ (4_�
-r, I t4 A U
C �IT dY ZIP j TEfLEP"O1E
&2
7
STATE LICENSE NUMBER EXPIRATION DATE CflECfMl�B
AIRT,1111(110ff,�*U Woy
PROPE TAX ACCOUNT PARCELPO,.-
NEW
19 RESIDENTIAL
PLUM13ING I MECH
ADDITION
OMMERCIAL
0
COMPLIANCE OR
CHANGE OF USE
REMODEL
0 MULTIFAMILY
SIGN
REPAIR
V-4
9q CYDS
FENCE
( _ X _ FT)
DEMOLISH
0 TANK
OTHER
GARAGE
RETAINING WALL
F RE SPRINKLER
OARPW
ROCKERY
FIRE ALARM
(TYPE OF USE , 'US1 NESS OR ACTIVITY) EXPLAIN:
'!!�' t � I t�t
e- �-- o m (L�-1
I A -
NUMBER
OF
NUMBER OF
DWELLING
CRITICALWOArt
AREAS %03-13
STORIES
UNITS
NUMBER
DESCRIBE WORK TO BE DONE
HEAT SOURCE GLAZING % LOT SLOPE'%
PLAN CHECK NO: VESTED DATE
0 2, L
THIS PERMIT AU',rHOR'ZE OmLfAWORK�,O". THIS PERMIT CO7V S W N70
I U
PRIV H2"
I Bt
BEDONEON AT I I ONLY. NY COOSTRUCTION ON H US
S11
E DI
DOMAIN (CURBS, 61 1 , DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
PERMIT UMM I YEAR " PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. 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 C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
I HEREBY ��K'NOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECP, 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-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION Of,4HE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S rgAPENSATIQN INSYRANCE AND RCW 18.27.
ENGINEERING REVIEWED BY ATE
FIRE REVIEWED BY DATE
VARIANCE OR CU
SHORELINEORADB#
I INSPECTION
BOND
RECko
POSTED
OYES
$
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
,
,
I
EXP
LOT COVERAGE
REQUIRED SETBACKS (FT)
PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT LIR SIDE REAR
352 7-1
1 Z5 75' /5L_f&
IT. V,
'i I L.
PARKING
LOT AREA
PLANNING REVIEWED BY DATE
REO'D
PROVID*
I
I
Ht:MAKII-0
b,/;K 4W
CHECKED BY I TYPE OF CONSTRUCTION OCCUPANT
V—/I/ GROUP T_\
SPECIAL INSPECTION JARkA OCCUPANT
REQUIRED [] YES LOAD
.0 1
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
0
1/1/"i L "/' .4 J_ J1.4" A I 1� 1. Im
VALUATION
$ 175 +-V
uIvir-1 r 1 r_
- mwm - I cu-
Description
FEE
Description
FEE
Plan Check
State Surcharge
Building Permit
-City
Surcharge
Plumbing
Mechanical
7!9
Grading
Engr. Review
Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
L-w L
Landscapelnsp.
Total Amt. Due
5�
Recording Fee
Receipt #
CALL
FOR INSPECTION
APPLICATION APPROVAL
This application is not a permit until signed by the
Building official or his/her Deputy: and Fees are paid, and
receipt Is acknowledged in space provided.
OFFICIALS SIGNATURE DATE
SlGr i/I WN 9 XGE DATE SIGNED ffiu-'00)
DATE
71 771-02,20 '-fiELEfift
mi / )p 2-.
ATTENtION Off 1333
IT IS UNLAWFUL TO U�SSEVORV&PY =VGt)OPSTRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 0RIGINAr-'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
z
9
0
ITI
--I -n
M
C
M
0
80
C
M
M z
g) -4
C
0 -n
M M
0
0
0 M
C 0)
K V)
ITI 0
Z
X
z
z
0
ITI