20040580.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
6 _ /
MAILING ADDRESS
?- 1 -11 k;� 9 bil^
CITY ZIP TELEPHONE
201A — q If) � 0110) 2
::�v7 A_ke�
kel
NAME
vi%) I A
CITY
NAME
ADDRESS
CITY
STATE LICENSE NUMBER
ZIP TELEPHONE
CBL 0
lze�—x
ZIP I TELEPHONE
PROPERTY TAX ACCOUNT PARCEL NO.
0
0 C�F,59
o C) �;% t:)o g
13
NEW
A RESIDENTIAL
El
ADDITION
COMMERCIAL
rV
REMODEL
MULTIFAMILY
REPAIR
GRADING CYDS
F]
DEMOLISH
TANK
EiGARAGE
CARPORT
RETAINING WALL
ROCKERY
(TYPE OF USE, BUS)NESS OR ACTIVITY) EXPLAIN:
6.1 t-7
L,C- Y�U)
NUMBER
NUMBER OF
OF
DWELLING
STORIES
UNITS
DESCRIBE WORK TO BE DONE
0
V-9
HEAT SOURCE I GLAZING %
1k_-
DATE I CHECKED BY
PLUMBING / MECH
COMPLIANCE 08
CHANGE OF USE
SIGN
FENCE
( — X_
OTHER
FIRE SPRINKLER
FIRE ALARM
CRITICAL
AREAS
NUMBER
LOT SLOPE %
VESTED DATE
PERMIT EXPIRES
USE PERMIT
ZONE
NUMBER
JOB
ADDRESS
PLAT NAME/SUBDIVISION NO, LOT NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED
REQUIRED DEDICArION. FT
METER SIZE LINE SIZE NO. OF FIXTURES
�_�) IKO
SUITE/APT#
LID NO.
LID FEE $
TESCP Approved
E3
RW Permit Required
Ej
Street Use Permit Raq'd E3
Inspection Required
E3
Sidewalk Required
E3
Underground
Wiring required
PRV REQUIRED
YES 1:1 NO
REMARKS
OWN E R/CON TRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
ENGINEERING REVIEWED BY . DATE
FIRE REVIEWED BY DATE
ui
z
z
a
z
W
W
a:
a:
VARIANCE OR CU
HORELINE OR AD1111
INSPECTION
BOND
REQ'D
I
POSTED
I
OYES ONO
S
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE EXEMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
EXP I
I
,
LOT COVERAGE
REQUIRED SETBACKS (F7)
PROPOSED SETBACKS (FT)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT LiR SIDE REAR
z
z
PARKING
LOT AREA
I
PLANNING REVIEWED BY DATE
I
REO'D I PROVIDED
FT) I REMARKS
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
1= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
M
uj PERMIT APPLICATION: ISO DAYS
a. PERMIT LIMIT' I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) '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
A Lt. CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
�ROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT 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. -
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 LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
S;1;GNATUR OWNE lOR AGENT) DATE SIGNED
�N - 2 4CL C,
1�7 - Lj
CHECKED BY
OCCUR
GROUP
SPECIAL INSPECTIO11- AREA OCCUPAWT_
REQUIRED [:] YE LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 108/IBC109/IRC109 FINAL INSPEC11ON REQ'D z
9
VALUATION
7110
��j S
Description FEE Description FEE
Plan Check State Surcharge CD C
Building Permit City Surcharge L's
Plumbing Base Fee
Mechanical
Grading
Engr. Review
Engr, Inspection
Fire Review Plan Chk. Deposit
Fire Inspection Receipt #
Landscapelnsp. Total Amt. Due
Recording Fee Receipt It
APPLICATION APPROVAL
This application is not a permit until signed by the
CALL Building Official or his/her Deputy: and Fees are Paid, and
FOR INSPECTION receipt is acknowledged in space Provided.
OF PIAL IGNA 'RE ---------
DATE
(425)
771-0220 RE[ E' SED 8 Y A v
ATTENTION E)ff 1333 1
IT IS UNLAWFULTO USE OR OC STRUCTURE UNTILA FINAL v
CU YABUILDINGOR
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110. ORIGINAL
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES PINK - 0
LL IN C 0
GOLD ASS SSOR
V
z
0
11
0
M
—i -Ti
0 M
C
M 0
0
C-)
0 C:
4 K
:E M
M Z
_z
W
0 Tl
n
M M
0
0
0 M
C: Cl)
r, (n
M 0
Z
7-1
z
--A
x
W
z
0
i
0
M
W.,
ppi
,a
W**�?Rope?-Ty IANIE
po �t i 1�-4 El
GIAZA6115. 7114"
N64 SF-
'!�Q- FT.
A A,
totAr-AeTe
r J, -0
L.oT Aft -A = lola-95 S4 F-r
eocalt I I'l = 2.0 k
Iz
WR 0
1.5 F-
WOO
CA4hv4i�E iN
d5Q- FT.
C&W 9ftle OF LVr
a
Zone Corner Flag_
Setbacks Required Actual
oe
Front
PL
�TL
Sides
Rear
PLp1v4TF1?-
- I- -%- -q
Other t, I'l
H�igljt
RECEIVED
rbLe JUL - 2 2M
qsTw
v/
ACcESS PERMIT COUNTER
ME7 �N E;PMM�rS WA CITY COPY
IPMCF,7L-*V- C)o 551j-too Z00500
z
0
4
0
m
C.
CITY OF EDMONDS
121 5TH AVENUE NORTH -EDMONDS. WA98020 - (425) 771-0220 *FAX (425) 771-0221
Website: wwwd-edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
January 4th, 2005
GARY HAAKENSON
MAYOR
Attn: Kari & Andrew Emery
21715 98th Ave W
Edmonds, WA 98020
Building Permit: 2004-0580
Site Address: 21715 98th Ave W
Expiration Date: 7/16/05
Dear Kari & Andrew Emery:
The purpose of this letter is to inforra you that the last remaining inspection on your
project is a final inspection(s). The final inspection(s) determines that there are no
-n
outstanding life -safety issues and approval allows the City to close your pen it 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 foll!Dwing must be complete:
smoke detectors, house numbers, guardrails, handrails, self -,close doors between garage
and residence, egress frorn sleeping rooms, safety glazing, weathei -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
pern-iit 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,
Permit Coordin
Incorporated August 11, 1890
Sister Citv - Hekinan, Japan
Z
0
M
--i -n
0)
M
C
M
0
-1
0
0 C
M
M Z
C _Z
co
0 -n
n
M M
C—/)
0
0 M
C C()
9 Cf)
M 0,
Z
Z
3:
CD
Z
0
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:
Gas Test ....................
Gas Piping .................
btl
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
cnq —
NAILING ..........................
/a
FRAMING ........................
FIRST FLOOR FRAMING ...
INSULATION ...................
Floor Insulation .........
Wall insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
V/
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
_9 2 -05
.3
OCCUPANCY ..................
The Initials MT are Milton
Thompson, a temporary contract
inspector for the City.
z
0
1
0
M
—11 -n
C/)
M
0
0
0
rn
M z
,C)
C0
o -n
n
IT! M
0
0
0 M
C C/)
9 Cn
ITI 0
Z
z
C/)
z
0
0
ITI