20040453.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
MAILING ADDRESS
0 14 A A, I f.: T 5p=
CITY T)t 1(f NO ZIP ,, TELEPH?NE
_T '2C C - 2- 1 <7
NAME
E ADDRESS
0
Cr 76 `6�
CITY �l P TELEPHONE
_TT
� -7e�k-?
NAME CBL $s
mi ADDRESS
CITY ZIP I TELEPHONE
STATE LICENSE NUMBER EXPIRATION DATE
PROPERTY TAX ACCOUNT PARCEL NO.
et c7f3r
71 _`4 � 0C)3 -- c
NEW
5Z RESIDENTIAL
ADDITION
E] COMMERCIAL
REMODEL
MULTIFAMILY
REPAIR
GRADIN
CYDS
DEMOLISH
TANK
GARAGE
RETAINING WALL
(CARPORT)
ROCKERY
(TYPE OF USE, BUSINESS 411V ACTIV�TY)jXPLAIN:
Ri NUMBER NUMBER OF
OF DWELLING
ci STORIES UNITS
DESCRIBE WORK TO BE DONE
L7A
-714
HEAt �PURCE GLAZING %
c�A- AC —
PLAN CHECK NO:
)L j
CHECKED BY
PLUMBING / MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
I X FT)
OTHER
FIRE SPRINKLER
FIRE ALARM
CRITICAL..,,
AREAS
NUMB, n
-Z=4�1
cy--O. All,
LOT
VESTED DATE
09
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
W PERMIT APPLICATION: ISO DAYS
PERMIT LIMIT 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
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. N01 BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
01 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
x
I HEREBY ACKNOWLEDGE 111AT 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 LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 10.27.
SIGVTIJREt(OVNERrf 7GENT1 DATE SIGNED
USE
ZONE
PERMIT EXPIRES (,1141 LJI
PERMIT
11)(1— OL15�
NUMBER 1-71t
JOB -/APT#
SUITE
ADDRESS
IIL�L I I C PA
PLAT NAME/SUBDIVISION NO.
LOT NO
LID NO.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved 13
AW Permit Requtred 13
1OWNER/CONTRACIOR
Street Use Permit Roq'd E3
EXISII..G __ PROPOSED
inspection Required 13
Sidewalk Required E3
REQUIRED DEDICAIION- FT
I Underground
ving inquired
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES 13 NO
cc
REMARKS
RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
/9-- Z,; /_11 f -
z
ILI
FIRE
I I &r �jl . f f , f-- "if f , -,: I f ,
REVIEWED BY
D BY
DATE
-7
DATE
W
M
lz
VARIANCE OR CU
HORELINE OR ADB#
INSPECTION
I BOND
REO'D
I
I POSTED
OYES 51�10
IS
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
, X
EXP
F
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT)
ALLOWED PROPOSED
FR9NT S I IDE R - EAR
FROPIT Lip SIDE REAR
�x
z
2
z
PARK G
'F%VIDED
LOT AREA
RIF:%,/;1;EW DATE
REQ'D I
w .1P
MNING WDY
REMARKS
'HECKED BY ITYPE V�PTRUCTION OCCUPANT
I GROUP
SPECIAL INSPECTION JAREA OCCUPANT
REQUIRED [] YES LOAD
REMARKS
PROGRESS INSPECTIONS PER UEIC 108/FINAL INSPECTION REQ'D
VALUATION
$ 0 -,� 1 -3 9
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
4
FEE Description FEE
State Surcharge
City Surcharge
3 0 f-xvw,
cc)
CALL
FOR INSPECTION
(425)
771-0220
PlanChk.Deposit
Receipt 0
Total Amt. Due 57 2.
Receipt . # W/9
APPLICATION APPROVAL
This application is not a perinit until signed by the
Building 011icial or his/tier Deputy: and Fees are paid, and
receipt is acknowledged in space provided.
OFFICIALS SIGNATURE DATE
AT,TENTION / EXT 1333 IF I I A
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 1-41
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
0-1102 PRESS HARD -YOU ARE MAKING 5 COPIES
ORIGINAL - FILE YELLOW - 14SPECTd
PINK - OWNER GOLD - ASSESSOR
GREEN - ACCOUNTING
V/
z
0
i
0
M
M
M
0
10
0 C
M
M Z
jo
X
cf)
0 T1
n ;a
--I >
3:9
M M
0 C-1)
0 r-
0 IT!
C cf)
K U)
M 0
Z
7-1
z
--I
X
Cl)
z
0
1
0
M
14-TCA,
A\k;6vA,,0
-A -- +(o
5-46-
C 7--
to
. VOczr A�Opajn-INE
L. 0
0.5 RIVEYVAY
I -mvrpr iv5
f5r- rcl4sr I 9P
CIO --%a
-Nawj72fve- FAVIN"'.
30-7 C?=�
37 * -sp
707W—
i --r- -
CAgPDXT-
-507
'cOV773
-C*-3
to
i�,V15;rmlo
-4
WAUe
v4F
NEW
ov V!�: A -L,
APPHOVE-li AS NOT6
BY PT017NERING
z, t
9 LOCATM
0
_j
elH
NEW
7,(
SETBA
CKS:
IDA-To-ro
A 4\lpv;�-W FRONT.-.,.-.
A'cD 7- T Al G 14A 1W /e 014CP s
R & 7
S / 7-ff /"::/ A,,V
777-416
a,/ �we,-- wc-,� (//,44EWT
0 05 /0 go
ZD C)
V,
r
ul
6\
�z WE
Vy
0-1
MAY 2 8 20N
PERMIT COUNTER
Ir
Height Calculation Worksheet
Address: loJA�s RA
Date: Q,
Inspector(s):
1. Datum Point:
2. Datum Point Elevation: rz
3. Average Grade: .4/. L-)
.4. Maximum Elevation Allowed: 4,D (averago� &ade): 25""— �Zc
5. Reference Point Elevation Shot to House:
(datum eleva.tion)+S.qL (grade to transit level line'shotto house)
6. Measurements from line shot onto house to k6of ridge:
Total 'S ,S
7. Actual Elevation: j. (reference point elevation) + (measurements
from #6) S6
Conclusion:
(actual) is greater / less than -5tcl , 6 (allowed); therefore the house isl
is not over the height requirement per ECDC 16.20-30 requirements
z
0
4
0
M
GARY HAAKENSON
CITY OF EDMONDS MAYOR
121 5TH AVENUE NORTH EDMONDS, WA 98020 (425) 771-0220 FAX (425) 771-0221
Website: wwaci.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
it, Planning - Building Engineering
February 22nd, 2005
Attn: Francis E. O'Brien
Z
10415 Nottingham Rd 0
Edmonds, WA 98020
0
M
Building Permit: 2004-0453
Site Address: 10415 Nottingham Rd
Expiration Date: 6/10/05 M
C
M
0
Dear Francis E. O'Brien: 0
0
C
The purpose of this letter is to inforni you that the last remaining inspection on your M
M Z
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 V5
0 -n
conducted on a project. In order to grant final approval the following must be complete: n
smoke detectors, house numbers, guardrails, handrails, self -close doors between garage
M M
and residence, egress from sleeping rooms, safety glazing, weather-stripping, any 0 _0
0
Engineering department requirements etc. Of course not all of these things may 0 r-
M
specifically apply to your project but it does give you an idea about the kinds of things C W
9 co
that must be complete as well as some items that do not need to be installed such as: Q 0
Z
paint, carpet, moldings, wallpaper, etc. Please be ' advised pen -nits expire one year from
the date of issuance. If you will need more time to complete the work, permits can be X
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 >
Z
pen -nit. 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 Cn
one department is required to final your project, this is noted on your Job Card. Z
0
Please feel free to contact me at 425-771-0220 if you have any questions. M
Sincerely,
Permit Coor Pinator
0 Incorporated August 11, 1890
Sister Citv - Hekinan. Japan
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM- FIRE- DEPARTMENT DATE
PI.F,\SE IGN
N
1111"� -.41 ENGINEERING DIVISION DATE 6 Zzo, 0
PLANNING DIVISION DATE
PIXAShSIGN
PROJECT
SITE ADDRESS- 11r)zl J A?
PERMIT #,2
OQI=a _115-3 ADB#__ DATEINSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
P-) // t—
A field inspection was conducted to determine compliance with -approved plans. Final approval
nt to the release of
denotes that there are no objections from the above signed Departme
PERFORMANCE BONDS and the granting of
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0, Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES GRANT 17INAL PROJECTAPPROVAL
Date SignatUl'C
I:tciiii,i:I)I(lg:f'oriiis:ocaprvI 3/25/04
z
0
i
0
M
—i -n
M
M
0
C)
0 C::
--i K
X M
M Z
n, --i
C _z
iU=)
0 -n
Ti X
>
M M
0
0
0 M
C/)
Cn
M
Z
z
U)
z
0
1
0
M
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
v
U,
Underground .............
Rough -in ...................
Commercial Final ......
HEATING:
Gas Test ....................
Gas Pinina .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ...................
2Z
FRAMING ........................
FIRST FLOOR FRAMING...
INSULATION ................... 141
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION
4le L4
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
Tile initials NIT are Milton
Ti,onipson, a temporary contract
inspector rol. tile City.
z
0
A
0
ITI
--I -n
M
C 0
M 0
0 C:
3: M
M Z
> z
3:
W
o -n
n
- I
mc I
M ITI
0
0
0 M
C Cn
90)
M 0
Z
z
Cl)
z
0
1
0
ITI