20040885.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY
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PROPERTY TAX ACCOUNT PARCEL NO.
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009 5 21 &Z,613 161
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NEW RESIDENTIAL
ADDITION COMMERCIAL
REMODEL MULTIFAMILY
REPAIR GRADING CYDS
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PLAT NAME/SUBDIVISION NO.
PERMIT EXPIRES
PERMIT
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LOT NO,
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED
REQUIRED DEDICATION— IFT
METER SIZE I LINE SIZE I NO. OF FIXTURES
SUITE/APT#,
LID NO.
LID FEE $
TESCP Approved
RW Permit Rortmiod 13
Street Use Pamir Reit'd [3
Impection Required Q
Sidewalk Required 13
underground
Wiring required E3
PRV REQUIRED
YES 13 NO 13
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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FIRE REV I?D BY DATE
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'11ARIANCE OR CU SHORELINE OR ADBN WSPECTION BOND
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COMPLETE , EXEMPT ALLOWED PROPOSE ALLOWED PROPOSED
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LOT COVERAGE REQUIRED SETbACKS (Fr.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR
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CODE
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OCCUPANT
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SPECIAL INSPECTION
REQUIRED [] YES
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PROGRESS INSPECTIONS PER UBC 108/ IBC109/ IRC109 FINAL INSPECTION REQ'D
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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.
PERMIT APPILICATION; 1180 DAYS
PERMIT LIMIr 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
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
611D., 111, ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
EEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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.
SIGNATURZ��NE OR A 3EN DATE SIGNED
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VALUATION
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FEE Description FEE
State Surcharcie
City Surcharge
d&7.,qrr-,r;- Base Fee
Plan Chk. Deposit 1�j�77
Receipt #
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Total Amt. Due
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APPLICATION APPROVAL
This application is not a permit until signed by the
CALL Building 011icial or his/her Deputy: and FOOS are paid, and
FOR INSPECTION receipt is acknowledged in space provided.
OrFICAL"IGNATI.19E DATE
(42-1
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ATTENTION EXT 1333
ITIS UNLAWFULTO USEOR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/[BC110/IRC110.
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
BY
ORIGINAL - FILE YELLW- INSPdTC
PINK OWNER GOLD -ASSESSOR
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: YfRE DEPARTMENT DATE
PLEASESIGN
ENGINEERING DIVISION DATE
PLEME SIGN
PLANNING DIVISION DATE
PLVIIGN
PROJECT '--FL 6, 29—
SITE ADDRESS 43-2- 6—A,,c,f-
PERMIT # 24n4 0`385- - ADB#___________�DATE INSPECTED 11-71
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine compliance with -approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of
"GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
1:1 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
I
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fornis:ocaprv1 3/25/04
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
PLEASE SIGN
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PLANNING DIVISION DATE
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DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine compliance with -approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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RE —INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:tcii1p:b1dg:r6rn1s:ocaprv1 3/25/04
of (IbmOub5
DEPARTMENT OF BUILDINGS
of (DEC "it" alitp
PER International Building Code Section I 10
At: 437 5 th Avenue Street, Suite 100 Building Permit #: 2004-0885
No. Stories: 3
Occupancy established by this certificate: Dwelling Units: 'N/A** --
Basement: No
B Type Construction: VA
Maximum occupant Load **61** (Per U.B.C. 1002)
Room capacity signs, when required, must remain posted at all times.
1h West Dayton St., Suite 3)4 Edmonds, WA 98020
Owner of Building: 5 Avenue Development Address: 51
THE Edmonds Real Estate Center HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH THE REQUIREMENTS OF THE
—C —ITIOAN OF THE INTERNATIONAL BUILDING CODE AS ADOPTED BY THE CITY FOR THE GROUP AND DIVISION OF OCCUPANCY AND THE
20C13 D
US� FOR WHICH THE PROPOSED OCCUPANCY is CLASSIFIED.
Issued this I Dth — day of-------J—a—nu—`aM, 2005
CHIEF BUILDING OFFICIAL
By.
This certificate shall be posted in a conspicuous public area and shall not be removed. mutilated or obscured and shall be maintained in legible condition at ail times. Any change of occupancy or use requires a building permit and a new
Certificate of Occupancy issued by the City of Edmonds Building Official.
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1b---------------- --- --- — - -----
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 .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING ...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
Jc
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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