20040265.pdfDATE RECEIVED
0
PERMIT EXPIRES
USE PERMIT
ZONE NUMBER
CITY OF EDMONDS
JOB SUITEIAPT#
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OWNER NAMEINAME OF BUSINESS
PLAT NAME/SUBDIVISION NO. LOT NO, LID NO.
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ul) Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge
PLAN CHECK NO: VESTED DATE Plumbing Base Fee
0q_ 0 2 5- Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
tz BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, FTC.) WILL REQUIRE
SEPARATE PERMISSION. Engr. Review
PERMIT APPLICATION: 180 DAYS
W
PERMIT LIMIT' I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Fire Review Plan Chk. Deposit
U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS �2,
W IN INTEHEST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS *THE CITY OF
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2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
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1 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
93 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due
01 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
x 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 PO(Mit Until signed by lite
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LAE30R CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW Ill 27. OFFLCALS SIGN TURE /DATE
7.1 -1/1
I NAT (OwNE R AGENT) DATE SIGNED (425) .1�
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL t
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09103 PRESS HARD -YOU ARE MAKING 4 COPIES
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
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0
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Slab Insulation ..........
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INSULATION ..............
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Ceiling Insulation ....... Cn
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SPECIAL INSPECTION ... M
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DATE RECEIVED
C1W OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER N EINAME OF BUSINESS
DAW'ts: 4 k/1774L-f 7S1Vj1'jz:)-Li=r,
MAILING ADDRESS
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PROPERTY TAX ACCOUNT PARCEL NO. - 1 1
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13 NEW
RESIDENTIAL
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REMODEL
MULTIFAMILY
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GRADING CYDS
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TANK
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OF
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PLAT NAM E/SU 13 DIVISION NO.
�PERMIT EXPIRES
PERMIT
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SUITE/APT#
LOT NO. LID NO
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
rESCP Approved Ej
RW Permit Required 13
EXISTING
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� PROPOSED
inspection Required 13
sidewalk Required 13
REQUIRED DEDICATION� FT
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METER SIZE
LIN�7SIZE
NO. OF FIXTURES
PRV REQUIRED
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YES 13 NO 1:1
REMARKS
OWN ER/CON TRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
ENGINEERING REVIEWED BY
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COMPLETE EXEMPT
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dr1q.5 1 1-2-
PLAN CHECK NO: _1 A— I VESTED DATE
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.
W PERMIT APPLICATION: 160DAYS
PERMIT LIMIT' I YEAR - PROVIDED WORK IS STARTED WITHIN 100 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
2 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
0 NOR LIMIT IN ANY WAY THE CITYS ABIL11Y 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 VI*6LATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18 27
SIGNAIT9FIC
_!(;0WNE5,OR AGENT) DAI SIGNED
VALUATION
$
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
CALL
FOR INSPECTION
(425)
771-0220
El A!
ATTENTION EXT 1333/
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
09,03
PRESS HARD -YOU ARE MAKING 4 COPIES
FEE I Description FEE
7_.P
'Io 4 1 State Surchargel T i7l
City Surcharge _j
Base Fee
Plan Chk. Deposit
Receipt #
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Total Amt. Due
Receipt #
APPLICATION
APPIIOV4�L
This application is not a Permit Until signed by ttle
Building Official or his/her Deputy: and Fees are paid, and
receipt is acknowledged in space
provided.
OFFICIALS SIG�PIURS
/DATE
I PATE
,�4
ORIGINAL FILE YELLOW/INSPECTC
PINK -OWNER GOLD -ASSESSOR
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CASCADE TESTING LABORATORY, INC.
TESTING & INSPECTION / ENGINEERS
1 2919 N.E. 126TH PLACE
"IRKLAND. WASHINGTON 98034 (42b) 823-9800
W=j] EVERETT (425) 259-0817
FIELD REPORT
miff,
pj'\ 2 9 266h
ATTN: Ur Ir.1 PPIA44 �Ir' VICES 01I
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CITY OF EDMON105
(2)
INSPECTION PERFORMED
RESTEELJCONCRETE — RESTEEL ONLY
RESTEELIMASONRY — STR.STfWELDING
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/V OTHER --"'PDX — STR.ST/BOLTING
PREVIOUS
No. 120327
REPORT No.
DATE
04-14-c;4.
TCECR T. NO.
PROJECT
LOCATION
12 1 Z— - 05AVAr Al
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BLDG. PERMIT NO.
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(3)
ITEMS INSPECTED
FOOTINGS
AUGER CAST PILES
DRILLED PIERS
(4) '5 <5�
LOCATION (AREAS)
FOUNDATIONS
SLAB
COLUMNS
WALLS
BEAMS
(5)
CONCRETE1MASONRY MIX NO. DESIGN STRENGTH (f*c)
SUPPLIER TOTAL CU. YD. PLACED
SLUMP (INCHES) SPECIMENS CAST
AIRCONTENT(%) SEE CYLINDER REPORT
X—YES _NO _ITEMS INSPECTEDWERE IN CONFORMANCEWITH BLDG. DEPT.APPROVED PLANS
REMARKS:
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TEST RESULTS APPLY ONLY TO THE ITEMS
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BE REPRODUCED EXCEPT IN FULL. WITH-
OUT THE WRITTEN APPROVAL OF CASCADE
TESTING LABORATORY. INC. INSPECTOR SIGNATURE
REVISED 8/00 SIGNED BY —
COPIES TO:Zgz��7- W-Z-jg
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PERMIT COUNTER
LEGAL DESCRIPTION:
'S SOUND VIEW ADDITTOON
NORTH PARCEL OF LOT 5. HAGGARD
VOLU�E 12 OF
CCORDING TO THE PLATTHEREOF RECORDED IN
al PAGE eg. RECDRM Cf- SNOH�11SH COUNTY, VIASHINGTM-
J7 T,,�X I.D. 4615-000-005-0202
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SEWER MAN HOLE COVER bla SIDE YARD SETBACK- 5'
ASSUMED ELEV: 43,0'
AVERAGE BUILDING HEIGHT,
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45.3
45.4
45-0, 18D.8 EXISTING
180.8 45.20'
4 1 STORY
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ALLOWABLE BUILDING HEIGHT: m
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'ACTUAL BUILDING HEIGHT:
64.25' NEW SECOND
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NORTH SIDE YARD SETBACK: 5'
SITE PLAN
KV SCALE: 1"-20'
SITE NOTES: ZONE
1. BUILDING SITE SLOPES GENTLY FROM EAST TO WEST. SETBACKS:
2. PROJECT IS A SECOND FLOOR ADD17ION TO EXISTING HOUSE.
LESS THAN 1 CU. YD. OF SOIL WILL BE EXCAVATED. FRONL�--
3. HOUSE IS NOT LOCATED NEAR ANY WATER OR WETLANDS.
SIDE ILI
4. DRAINAGE: WATER FROM NEW SECOND STORY ROOF WILL FEED INTO
EXISTING GUTTER/DOWNSPOUT Sl RMT94WLI ) �n
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STORM SEWER AT THE STREET REAR-':
L4 OTHER ...... �*.�,_
HEIGHT
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Height Calculation Worksheet
Address:
Date:
hWector(s):
1. Datum Point: �cb bJ--'Z
2. Datum Point Elevation:
3. AverageGrade:
.4. Maximum Elevation Allowed: 4SdO average. giade):+.--25"----
5. Reference Point Elevation Shot to House:
(datum elevation) +1 -3 'shot to house)
(grade to transit level line
6. Measurements from line shot onto house to roof ridge:
8
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Total �7
7. Actual Elevation: 4-7 Y) (reference point elevatio�) + (measurements
from #6) 123
�onclusion:
3, 5-(P (actual) is greater / l:e:s7s&-'n (allowed); therefore the house b/
is not over the height requirement per E45DC 1-6.20.30 requirements
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
z
0
Retaining Wall ...........
0
IT!
Slab Insulation ..........
PLUMBING:
3:
Underground .............
M
C
0
Rough -In ...................
M
0
-40
0
Commercial Final ......
C
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HEATING:
M z
Gas Test ....................
C z
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F- -4
GasPiping .................
Equipment
Yv\�
3:
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.................
Commercial Final .......
x
M M
EXTERIOR SHEATHING
f
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NAILING ..........................
0 M
C
FRAMING ........................
W
M 0
FIRST FLOOR FRAMING ...
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INSULATION ...................
Floor Insulation .........
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Wall Insulation ...........
Ceiling Insulation .......
co
z
0
SHEETROCK NAILING ...
0
SF!�CIAL INSPECTION ...
M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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