20030263.pdfDATE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
r-�W771_ Ag: el5V71 /J7 0111111(f,
MAILING ADDRESS
V
CITY ZIP TELEPHONE
9 ez)d (of
NAME
ADDRESS
CITY ZIP ITELEPHONE
NAME CEIL 11
jAZ
�J) leote_
CC ADDRESS
CITY ZIP TE EPHONE
0
STATE LICENSE NUMBER EXPIRATION DATE CHECKED
;�f PROPERTY TAX ACCOUNT PARCEL NO!
'rADDITION
0 RESIDENTIAL
MERCIAL
rron
1:1 REMODEL
:DMLTIFAMILY
13 REPAIR
1:1 GRADING CYDS
C] DEMOLISH
0 TANK
oGARAGE
[3 RETAINING WALL
CARPORT
ROCKERY
(TYPE OF USE. BUSINESS
NUMBER
OF
NUMBER OF
DWELLING
STORIES
UNITS
DESCRIBE WORK TO BE DONE
41L�
L1
PLUMBING / MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
X_FT)
� Tru
FI14E SPRINKLER
F
FIRE ALARM
PERMIT EXPIRES
USE PERMIT
ZONE N U M B E R
JOB SUITE/A%PT#
ADDRESS /A,*(
71j z10
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
RW Permit Required
Street Use Permit Rsq'd
EXISTING - PROPOSED
Inspection Required [3
Sidevralk Required [3
REQUIRED DEDICATION- FT
Underground
Wiring required E3
METER SIZE
LINE SIZE
OF FIXTURES
PRV REQUIRED
P&
YESM NO 13
REMARKS z
PSN /CON IBLE FOR EROSION CONTROL/DRAINAGE
IQJ$:�eR RESPONS
_kFL
yhW_M,` F)e IN cfr,4
te�. _MMA �40 �7f
k:�002�n ()jf,�
IfNGINIEERING REVIEWED BY E
IT/
CC
FIRE '7), DATE us
XID�
4 M.
IANCE OR Cy
SHFLINE OR ADS#
INSPECTION
BOND
REO'D
POSTED
I
OYES 13NO
S
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE
EXEMPT
ALLOWED
PROPOSED
ALLOWED
PROPOSED
EXP
,
,
LOT COVERAGE
REQUIRED SETBACKS (Fr.)
PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UR SIDE REAR
PARKING
LOT AREA
PLANNING REVIEWED BY DATE
REO'D
I PROVIDED
REMARKS
PURSUANT TO UPC 605.2
CHECKED BY 1=0
1j117I4)II1j9!2E IMU6111y"'INJ
CRITICAL GROUP
AREAS SPECIAL INSPE&ION
N JUM S JAREA OCCUPANT
UMBER REQUIRED [] YE LOAD
REMARKS
z
PROGRESS INSPECTIONS PER UBC I 08/FINAL INSPECTION REO'D
VALVE (MV)
VALUATION ___ — __ _� A`Q�FLL%
T
Description FEE Description FEE
Plan Check I State Surcharge
HEAT SOURCE
GLAZING %
LOT SLOPE %
Building Permit
City Surcharge
PLAN CHECK NO:
VESTED DATE
Plumbing
QL
Mechanical
THIS PERMrr AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC
Grading
23 DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMITAPPUCATION: ISODAYS
IL PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
'EDMONDS,
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapelnsp.
Total Amt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
L
X1
Recording Fee
Receipt #
I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
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 CONSTRLIC-
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 Foos are paid. and
IN VIOLATION OF THE LAAOR-GQDE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt Is acknowledged In space provided.
WORKMEN;P<O"N ,9N-tN.SUyNCE AND RCW 18.27.
0 A SIG AT�RE DATE
SIGN��"NEWENT
00
DATE S
(425)
7,- t/
�z L
771-0220
T5(
g
FNTTION
Off 1333
IS LIN WFUL TO USE OR OCCUPY 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
0
z
0
4
0
171
=i ii
rn
C
M
0
-40
0 C:
� C
. ITI
M
z
-4
x
0)
0 -n
n
ITI ITI
0 C-0)
0 r-
0 ITI
C CO)
C CO)
Q 0
Z
.A�
X
z
z
0
4
0
M
Elm
DEPARTME14T OF BUILDINGS
.-PER UNIFORM BUILDING CODE SECTION 109
At: 7620242 nd St SW. Edmondt WA 98026 :_66ildIng Permit #;_._2002 57
Occupancy established by this certificate: Dwelling Units: **NA** No. Stories: 2
El Typ!,.Constructlon: V-1 Hr-Sprink Basement: NA
Maximum Occupant L6ad �,._(Per U.B.C. 1002)
Room,capacify signs, w"!7!0qy"�',Mqst remain posted at a# times.
addid
Owner of Building: Seattle Baptist Chuvi;L�� AMM— 5 Nth tiwkdmonds, WA 98026
THE SeaftleBaDtistSchOol HAS BEEN INSPEdTEO AND A P?R0V_RP AS"COMPUING WITH'THE REQUIREMENTS OF THE J!9_7 EDITION OF
THE UNIFORM BUILDING CODE AS ADOPTED BY THt,CITY;FOk THE'OROUP ANDbIVISWON OF OCCUPANCY AND THE USE FOR WHICH THE
PROPOSED OCCUPANCY IS CLASSIFIED.
Issued this `_25th da- Jof July,. 2003
X
CHIEF BUILDING OFFICIAL
BY: 25�
This certificate shall be posted In a conspicuous public area and shall not be removed, mufflated or obscured and shall be maintained In legible condrdon at all times. Any change of oocupency or use requires a bullding permit and a now
Certificate of Occupancy Issued by the City of Edmonds Building Official.
�'�n C. i S 19 '13
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 1 FAX (425) 771-0221
Website: www.dedrnondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
February 5, 2004
Seattle Baptist Church
7620 242n' St SW
Edmonds, WA 98026
GARY HAAKENSON
MAYOR
I
RE: Permit #2003-0263 & #2003-0857 - 7620 242 nd St SW, Engineering Final
Inspection Reguired
The City of Edmonds, Engineering Division, has not yet given final project approval for
the installation of the backflow preventor and vault or the barrier free parking at 7620
242nd ST SW. The following items need to be completed prior to final Engineering
approval. I
1. A remote read meter is required to be installed at the vault.
2. Parking stall striping must be installed per City of Edmonds standards. (Inspection has
not been done to verify compliance)
Please ensure the items noted above are complete and then call to request an Engineering
final inspection at 425-771-0220, ext 1326. An inspection request shall be made prior to
February 20, 2004 to prevent code �nfbrcement action. Please feel free to contact me with
any questions you may have regarding the parking stall striping at 771-0220, ext 1338. For
questions related to the remote read* meter you may contact Scott Highland, Water Lead
Worker, at 425-771-0235.
Sincerely,
Jeanie McConnell
Engineering Technician
jm
c: Permit file #2003-0263
Permit file #2003-0857
Scott Highland
S:\ENCIRUcwie\lnspeVions'Scattle Baptist 7620 242nd-ac lnco�porated August 11, 1890
FINAL PROJECT AIPPROVAL FORM I
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DAT
FL91= aturl
ENGINEERING DIVISION DATE
nEASZSIGN
PLANNING DIVISION DATE'
PROJECT
SITE ADDRESS S
PERMIT —ADB#___--_-_-PATE INSPECTED. �7— 2—S�— '0-?
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
PERFQRMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRAM PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
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:fonnsIO/OI
z
9
0
M
"4 9
C M
M0
0
-40
0 C
-49
= M
Mz
10-1
C
cl)
0 -n
n
M M
a
0
0 M
C C/)
?. CO)
Q 0
Z
z
-4
Cn
z
0
M
FINALPROjEC APPROVAL FORM
MEMO TO: PERMIT COORDINATOR, WELDING DIVISION
FROM:
TO:--------
DATE:------
FME DEPARTMENT DATE --------- —
nimsm C
.71 11
ENGINEERINGDwisioNDATE— iwk—
PLANNING DIVISION DATE�--.--------�
SITE ADDRES5 I LF "' " — 'V �� ,
I 21iL
— ADB#__________pATE.INSPECTED— 04—�
PERMIT a I
DESCREmoN OF WORK TO BE IN
ance with approved plans. Final approval
A field inspection was conducted to determine final compli
denotes that, there an no objections from the above . signed Department to the release of
and the granting of
GRANT FINAL PROJECT APPROVAL
GRAM PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDMONS given to owner/contraCtOr by inspector
F,,jkjj.M-FjN.A,L INSPECTION - OUTSTANDING ISSUES
Q Copy of CORRECTION NOTICE given to owner/contractor by inspector
I .
4
3.
GRANT FINAL PROJECT APPROVAL
RE_]NSPECTED OUTSTANDING ISSUES
Si
ocaprvl.doc.l:temp:bldg:formsIO/OI
z
0
M
:; 9
M
C
M
0
--10
0 C
--I K
X M
M Z
C) —1
C —Z
Cn
0 -n
n
M M
0
0
0 M
C cl)
K C/)
Q 0
Z r-
z
z
0
1
0
M
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING,
Underground .............
Rough -in ...................
Commercial Final ......
HEATING:
...........
ping Op.
Equipment .................
Comm" ercial Final .......
EXTERIOR SHEATHING
NAILING..........................
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ...................
�Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
7dT':-J �b
FINAL APPROVAL FOR
OCCUPANCY ..................
02woo
01.
'DATE RECEI
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
MAILING ADDRESS
2
CITY ZIP
"K", 9 el9d TELEPHONE
NAME
ADDRESS
CITY ZIP I TELEPHONE
NAME CBL#
J-6/400- le" i
ADDRESS
� �z z
CITY ZIP TELEPHONE
b.0-7hW_2Z_ 76-0-2 / 41� r Vff.�- SX_�
STATE LICENSE NUMBER EXPIRATION DATE I CHECKED
"551tAr el,4 2-me) it
NO.
rM
[:] RESIDENTIAL
ADDITION
OMMERCIAL
rr-1
REMODEL
.
1:1 MULTIFAMILY
REPAIR
GRADING CYDS
DEMOLISH
TANK
GARAGE
CARPORT
RETAINING WALL
ROCKERY
(TYPE OF USE, BUSINESS grAOTV
M E*PLAIN:
0.�) I
1:1 PLUMBING / MECH
COMPLIANCE OR
1:1 CHANGE OF USE
0 SIGN
1:3 FENCE X FT)
NUMBER NUMBER OF CRITICAL I
OF DWELLING AREAS
STORIES UNITS NUMBER
DESCRIBE WORK TO BE DONE
7.Als 7Z 211eK*1,,z.-.,eeAj 1�ekar
PERMIT EXPIRES
1-r-rinfill 1
NUMBER
ZONE
JOB SUITE/APT#
ADDRESS 5-f—sn-j
PLAT NAME/SUBDIVISION NO. LOT NO. L D NO.
LID FEE $
TESCP APProVed
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit 1`16clulf"t
street use Permit 11'd
EXISTING — PROPOSED Inspection Requ f
Sidewalk Required [3
REQUIRED DEDICATION— FT Underground
Wiring required 13
METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED
13 z
YESO NO
REMARKS z
PtMFILCON
.W,TPR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
<
tNGINIEERING REVIEWED BY
FIRM
JDATE
6 /0-Y
IANCE OR C SH ..ELINE OR ADBN INSPECTION I BOND
; ; REQ'D POSTED
]�SH OYES ONO $
SEPA REVIEW IGN AREA HEIGHT
COMPLETE . EXEMPT ALLOWE PROPOSED I ALLOWED . PROPOSED
LOT COVERAGE' REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT LJR SIDE REAR
I
z
PARKING LOT AREA PLANNING REVIEWED BY DATE
j
REO'D PROVIDED
eM
rRAPR K S PURIUANT To UPC 605.2
LINg AS 1T9NT_B__U__
CHECKED BY JYMOrRUT,107 OCCUPANT
GROUP
COW
SPECIAL INSPE&IEN AREA OCCUPANT
REQUIRED C] YES LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
Pn
HEAT SOURCE GLAZING % LOT SLOPE %
PLAN CHECK NO: VESTED DATE
THIS PERmrr 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 APPUCATION: 180 DAYS
PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WrrHIN 180 DAYS
I SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICAUt 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 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 THE LA130"QDE OF THE STATE OF WASHINGTON RELATING TO
WORKME4�NWUrCE AND RCW 18.27.
SIGNATU*-tQWNER'OA AQEPMdJ . I DATE SIGNub
APRESSUREREGULATORVALVE (PRV)
...
VALUATION
$ F_
I !a, BE R48 117M= NE A-K
THE WATER SHIMOM
Description
FEE
Description
FEE
Plan Check
State Surcharge
Building Permit
City Surcharge
:2
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
Landscapelnsp.
Total Amt. Due
Recording Fee
Receipt #
CALL
FOR INSPECTION
(425)
771-0220
EXT 1333
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.
OF,r�51ALS SIGNAT RE DATE
7x� /"//,
n-ELEA ED by DATV
fif IS UNLAWFUL TO USE OR OCCUPY 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 COLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
I
z
0
1
0
M
i -n
M
M
0
-10
0 C
M
M
10
z
o -n
n
ITIM
a Vi
0
0 Fn
Co
M ca
M 0
Z
z
0
4
0
M