20030474.pdfI
DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
WNER NAME/NAME OF BUSINESS
MAILING ADDRESS
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NAME
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TELEPHONE
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ADDRESS
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ZIP
TELEPHONE
LICENSE NUMBER
PROPERTY TAX ACCOUNT PARCEL NO.
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NEW
MOeESIDENTIAL
M-195ITION
1:3 COMMERCIAL
a-RE"MODEL
11 MULTIFAMILY
REPAIR
0 G2kDING
150 cyos
0 DEMOLISH
0 TANK
oGARAGE
CARPORT
[3 RETAINING WALL
ROCKERY
I[TYPE OF USE, BUSINESS OR ACTIVIM EXP
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NUMBER
NUMBER OF
OF
DWELLING
STORIES
UNITS
DESC81BE WORK TO
BE DONEh
xEi� MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
( X FT)
OTHER
0 F RE SPRINKLER
FIRE ALARM
PERMITEXPIRES
USE PERMIT
"' Ni NUMBER
JOB SUITE/APT#
ADDRESS ,atge)� (71 l-," A L(0).
PLAT NAME/SUBDIVISION NO. LOT NO. LID NO.
LID FEE S
TESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP AW Pefrnh Required
Street Use Permit Req'd
EXISTING - PROPOSED Inspection Required
Sidewalk Required
UnddrarOund
REQUIRED DEDICATION- FT Wiring required 13
METER SIZE LINE SIZE NO. F XTURES P EQ I D
__L�ES NO 13
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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:NGINEERING REVIEWED BY DATE
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SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED / PROPOSED
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LOT COVERAGE
REQUIRED SETBACKS (FT)
PROPOSED SETBACKS (4
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UR SIDE
PARKING
LOT AREA
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PLANNING REVIEWED BY bATE of
REO'D I PROVIDED
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SPECIAL INSPECTION
JAREA OCCUPANT
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NUMBER
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REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INS PECTION REG'
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Description
Plan Check
LOT SLOPF ft� Building Permit
PLM CHECK NO: VEg Plumbing
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COVE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THISP RMIT RS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CURBS, SIDEWALXS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION. Engr. Review
PERMiTAPPILICATION: ISODAYS
PERMIT UMM I YEAR . PROVIDED WORK IS STARTED WITHIN Iso DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
FEE Description FEE
State Surcharge
City Surcharge
PY-0 11 15— -
�2^ YL __-1
'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 #
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
Landscapelnsp.
Total Amt. Due
0 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
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 application Is not a permit until signed by the
Building Official or his/her Deputy: and Foos 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.
WORKME��SATION INSURANCE AND RCW 18.27.
OFWFICIAIGNIAMfhx DATJ
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DATES NED
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771-0220
RELE BY
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ATTENTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE - YEIICw-IN-JECfOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER - GOLD . ASSESSOR
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MW OATE
APRIL 30,
2003,'
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MAYESTESTING ENGINEERSy INC.
Evereff Office
917-134th Street SW
Suite A-1
Everett, WA 982D4
ph 425.742.9360
fax 425.745.1737
IVITE No.:
E3200
Tacoma Office
Project:
NICHOLS RESIDENCE
1o029 S. Tacoma Way
Address:
nd
22204 92 Avenue West, Edmonds, WA 98020
Suite E-2
Tacoma, WA 98499
Permit M
2003047 4 (City of Edmonds)
ph 253.584.3720
fax 253.584.3707
Owner:
Nichols Residence
Pordand Ofte
7911 NE 33rd Drive
Architect:
Suite 190
Engineer:
Perbix Bykonen
Portland, OR 97211
Contractor:
Edmisten Construction
ph 503.281.7515
fa 503.281.7579
A
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Verification Worksheet
Permit #: ZrV
Height Calculation/Grading
Address:
Date:
A. Datum Point: JL I NX
B. Datum Point Elevation: L)j
C. Average Grade: U,�-Su
3. Maximum ElerOation Allowed: iO�>-A average grade)+ 25'= idS�.ao
4.. Refempe Point Elevation Shot to Housi:
(datum elevatlon).4-�L,.�.
(grade to transit level Hue shot to hous�)
6. Measurements from line shot onto house to.roof ridge:
Total:
7. Actual Elevation: 164,,2- (reference point elevation)
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Conclusion:
(Actual) 4 gitaker 3 wowed).,e therefore the-ho4se.b/
Is not over the height requiremiZenpper EICDC 16.20.30 requirements
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FINAL PROJECT APPROVAL FORM
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign.
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DATE RECEIVED
[PERMIT EXPIRES j
USE PERMIT
CITY OF EDMONDS A, ZONE NUMBER
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CONSTRUCTION PERMIT APPLICATION JOB T-,� SUITWAPT#
ADDRESS
OWNER NAME/NAME OF BUSINESS
PLAT NAME/SUBDFVISION NO. LOT NO. LID NO.
Eveyet� KLk0k_-)
M MAILING ADDRESS A All nal I Imer In r% LID FEE S
TESCP AS,
PUBLIC I'll RW P4frN,=.
WX�l I Street use Permit R*qV
CITY ZIP EXISTIN L C1 T
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Sidewalk Required
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REQUIRED DEDICATION— FT Undergrowtd
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METER SIZE LINE SIZE S PRV EQUIRED
NAME
ES
Y_j NO 13
M S
t ADDRESS REMARKS
0 OW VC4
WNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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CITY PHONE
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DATE
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ADPRI
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CITY [-) ) TELEPHONE
ZIP
R1 VARIANCE OR CU SHORELINE.OR ADB# INSPECTIOdN BOND z
STATE LICENSE NUMBER EXPIRATION DATE CH BY R E�'D POSTED
B 0
OYES 0
SEPA REVIEW SIGN AREA HEIGHT 0
4/4 M
PROPERTY TAX ACCOUNT PARCEL NO. f COMPLETE , EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
0 C) — Co L�z �_C) EXP t__01 ;?.5 1 I'l -I!; " :; :f,
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACK13 (FTL
00 MECH i Ui �
j 0 NEW. &WESIDENTIAL ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRS19E REA
NED I a M
COMPLIANCE OR
COMMERCIAL
DITION C
CHANGE OF USE rn
PARKING LOT AREA PLANNING REVIEWED BY 15ATE 06 0
00,
[�<EMODEL SIGN REQ`D I PROVIDED 0
MULTIFAMILY
rM
REPAIR CYDS FENCE FT) S
(—X— e-
r ef-4; 5_' 171
DEMOLISH TANK OTHER 06097'""nfeir
enoll - j-
4 z
GARAGE, REENNING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTWM EV
CHECKED BY ITYPE OF CONSTR ION CIE OCCUPAN
R
G 0
)OIL 0 -n
NUMBER OF CRITICAL (,' VV SPECIAL INSPECTION 19REA OCCUPANT n
OF DWELLING AREAS q
NUMBER
STORIES UNITS N '761 REQUIRED YES I /fj:t 133_= 32 _LOAD
DEACF M M
-DOE WORK TO BE DO
5�un Yoofy-N ~'i UA VQ Q_,Y� Qjcl REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REGID 0
0
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VALUATION
A &6 C /0
$ qe.
Description FEE Descliption FEE
z
Plan Check Z;o
State Surcharge 4
&Maas, C11%4. one 2&1&.
HEAT SOURCE GLAZING % �OT St.
Building Permit City Surcharge z
C:5
L2
PLAN CHECK NO: VESTED Plumbing 1 Set,
Mechanical M
THIS PERMIT AI)THORUMS ONLY THE WORK NOTED- THI FIS wonK TO
I= BE DOI JVATE PROPERTY ONLX AM CONSTRUCTION ON THE PU13UC
__tl�ON PP Grading
DOMAIN (CURN, SIDEWALKS, DRWEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMITAPPILICATION. 180DAYS
PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Inspection
SEE !nKPF PINK PERMIT FOR MORE INFO.RMIATION 2U2
;APIP ON BEHALF OF HIS OR HER SPOA(" HEIRS, ASSIGNS AND SU RS Fire, Review Plan Chk. Deposit
N AGREES TO INDEMNIFY, DEFEf4O_ AND HOLD HARMLESS THE CjjOF
EDMON . WAS
M S HINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM A"D Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OFTHIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due
DEEMED TO MODIFN; WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION." Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; TH;T 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 CRY AND STATE LAWS REGULATING CONSTRUC- CALL This application Is not a permit until signed by the and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid,
4 IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided.
WORKME C RATION INSURANCE AND RCW 15.27. OFFICIA IGN D
(425)G WNER R Ep DATE SIGNED
x 771-0220 -R—ELOW9 BY
ATTENTION EXT 1333-,
y/
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AN ERt.IFI- ORIGINAI -FILE YELLOW-f E R
CATE OF OCCUPANqY HAS BEEN GRANTE PINK-OWISEF! GO -;ldsSOR
PR GAEEN - ACCOU -
04/02 G 5 COPIES