20040665.pdf. TDATE -RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNE"A NAMF/NAME OF BUSINESS
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NAME
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ADDRESS
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STATE LICENSE NUMBER EXPIRATION DANE CHECKED BY
PROPERTY TAX ACCOUNT PARCEL NO.
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RESIDENTIAL
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COMMERCIAL
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MULTIFAMILY
REPAIR
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GARAGE
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(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
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DES RIBE WORK TO BE DONE A e tA o
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HEAT SOURCE I GLAZING %
PLUMBING / MECH
COMPLIANCE OR
CHANGE OF USE
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FIRE SPRINKLER
FIRE ALARM
CRITICAL
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NUMBER(
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PLAN CHECK NO: VFSTFD DAT
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED THIS PERMIT COVERS WOFIKTO
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN JCURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. LTC) WILL REQUIRE
SEPARATE PERMISSION
CC PERMIT APPLICATION: tOO DAYS
W
PERMIT LIMIT., 1 YEAR - PROVIDED WORK IS STARTED WITHIN 100 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. III IHS. ASSIGNti AND SLJLcF.'_,OI1S
ILL) IN INTEREST. AGREES TO INDEMNIFY, DEFFND AND 11011) HARMtESS Ilif CITY OF
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2 EDMONDS, WASHINGTON. ITS OFFICIA1 S, FMPtOYFFS. AND AGFN I'S FHOM ANY AND
Ir
ALL CLAIMS FOR DAMAGES OFWIiATFVFR NAT LAW. ARISING Dliff: C I I Y Oil INDIIIFC I iY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCIF Of THIS I'F'IIMII SHAH N01 III
DEEMED TO MODIFY, WAIVE OR REDUCE ANY HFOU111117MENI OF ANY GIIY ORDINANGF
01 NOR LIMIT IN ANY WAY THE CITYs Atilt IIY to FNFO1ICF ANY ORDINANCf PHOVISION *
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS A11114.1CATION, THAT I HE 11,11701011ATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR IIIIF DLILY AUTIIORlZIlD AGENI OF:
THEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS 1IFGUtAIlNG CONSTRUC
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PUIISON Wit I fill 171-11"LOY17D
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RFLAIING TO
WORKMEN'S ��.�NSATION INSURANCE AND RCW I H 27
USE
ZONE
JOB
ADDRESS <
PLAT NAME/SUBDIVISION)
PERMIT EXPIRES
PERMIT
NUMBER
SUITE/APT#
,//'i S/—
LOT NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING - PROPOSED
REQUIRED DEDICATION- FT
METER SIZE I LINE SIZE I NO. OF FIXTURES
LID NO.
LID FEE $
7ESCP Approved
E3
RW Permit Required
13
Street use permit Roq'd
(3
Inspection Required
13
Sidewalk Required
E3
Underground
Wiring required
PRV REQUIRED
YES 13 NO 13
REMARKS
OWNER/CONTRAcroR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
ENGINEERING REVIEWED BY DATE
FIRE REVIEWED BY DATE
VARIANCE OF�
SHORELINE OR ADBI
INSPECTION
BOND
REO'D
I
OSTED
L P�l
OYES 'ONO
S
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
EXP ,
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT L/R SIDE REAR
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PARKING
LOT AREA
PLANNING REVIEWED BY
D A41E
REO'D I PROVIDED
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C.,
REMARKS
CHECKED BY I TYPE OF CONSTRUCTION COD OCCUPANT,
C11 GROUP
SPECIAL INSPECT[ OCCUPANT
REQUIREDF1 YE LOAD
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PROGRESS INSPECTIONS PER UBC 1 08/FINAL INSPECTION REO'D 1 3
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VALUATION
$ ,Af7 /.
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
101
CALL
FOR INSPECTION
FEE
Description
FEE
qState
Surcharge
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City Surcharge
$k
Base Fee
5�6
Plan Chk. Deposit
Receipt #
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Total Amt. Due
Receipt # I.QY 71711.
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,
OFFICIALS SIGNATURE DATE
�IGNATURE NE Oil AGENT)
DATE SIGNED 1! 1
1.-
771-0220 EASED BY
EXT 1333
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ORI ! AL - FILE
GIN
PIINK�- OWNER
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MAKING 4 COP ES
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ATTENTION /
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCIURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL Oil A CERT11-1
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
09/03 PRESS HARD -YOU ARE
YELLOW - INSPECTOR
COLD - ASSESSOR
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SPRUCE ST.
LEGAL DESCRIPTION Plot Plcn
LOT 1-0" NTS
THAT PORTION Of THE NORTHWEST QUATER Or THE NORIMgMTER OF NORTH
SEC71ON 25. TOVINSHIP 27 NORIH, RANGE 3 EAST. Wit, AS FOLLOINOWS: LOT COVERAGE CALCULATION EXISTING
BECINNING308 FEET SOUTH OF 1W NORTHYAMT CORNER OF SAID NORTHyjEST
QUARTER OF NORTHEAST QUARTER OF SECTION 25. TOMSHIP 27 NORTH. Z�T WAXJ��— —18-1,3 SOL Fr.
RANGE 3 EAST WJA.: P*NM SOUTH 88 OEOL 05' Olf EASITOR tO&87 FEET; LOT AREA IZO28 SO. Fr.
THENCE SOUTH a Om 30' 36' *EsT roll lie nrT; TNcNm mvTH as oEc.
05' O(r VAEST FOR IO&%gF&=6N.CRTH 0 DEC. 30' 36- EAST FOR LOT COVERAGE PERCENTAGE 14.35 X
lid FEET TO THE IRUE
SITUATE IN THE COUNTY OF SNCHOmISH. STATE OF WASHNOTON.
PARCEL NWI)ER 27 0325 001 004 00 PARCEL up l000sm
NEW DECK FOR:
CHRIS & SUSAN BREVIK
910 SPRUCE ST. EDMONDS, WA 98202
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LOT COVERAGE CALCULATION NEW Rg(:EIVED
LOT COVERAGE 2.M9 SQ. FT.
LOT AREA lZ828 SQ. Fr.
LOT COM1AGE PERMTAGE 17.09 X MAR 2 4 2004
PERMIT COUNTER
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c n n r)F INSPE TIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall.......................... -----------
Pier/Porch .................
-----------
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground ............. ------------
-----------
Rough-In ...................
----------
commercial Final ......
HEATING:
Gas Test ....................
Gas Piping .................
Equipment ................. ----------
Commercial Final .......
EXTERIOR SHEATHING
NAILING..........................
FRAMING ........................
FIRST FLOOR FRAMING...
-----------
INSULATION ...................
Floor insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETRoCK NAILING ...
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
The Initials Warc Milton
ThOl"Pson, a te'llporary contract
"IsPectol, 1,01, thc city.
200vo, 01,45
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