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20040903.pdfDATE RECEIVED PERMIT EXPIRES CITY OF EDMONDS USE PERMIT ZONE NUMBE _5'�K CONSTRUCTION PERMIT APPLICATION JOB SUITE/A # ADDRESS xz��OWNER NAMEMAME OF BUSINESS iiiiiA tet - IiA— PLAT NAME/SUBDIVISION Nor LOT'NO. LID NO. LID FEE S MAILING ADDRESS TESCP Approved z 3: VJ PUBLIC RIGIIT OF WAY PER OFFICIAL STREET MAP RW Permit Required 13 Street Use Permit Roq'd 0 EXISTING — PROPOSED inspection Required E3 Sidewalk Required E3 CITY ZIP 1 TELEPHONE F-A, .20 U, --,cA U, 10 b 0 REQUIRED DEDICATION— FT underground Winno required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED NAME we-u I YES 13 No 13 z R W z ul t= ADDRESS REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE z 5 Le 5(p L; 1 6 F z W CITY zip TELEPHONE 221,;L T/I M I I — NAME CBL4 L uv!g Pjrrii &�,t( H-IA(A ENGINEERING REVIEWED By DATE cc 0 ADDRESS 1-1) 1 1 P-Av- -E/(- FIRE REVIEWED BY DATE W cc t CITY ZIP TELEPHONE .i 0 S;V-� 3;HD VARIANCE OR CU SHORELINE ORAD1111 1 INSPECTION REO'D OND POSTED §TAYE LICENSE NUMBER )IRATION DATE CRE KED BY 71 '� j 17�) q la;lb AYR, - - OYES ONO S HEIGHT SEPA REVIEW COMPLETE EXE MPT SIGN AREA ALLOWED PROPOSED ALLOWED POSED PRO -j PROPERTY TAX ACCOUNT PARCEL NO. La 0 C) 1 C) C) EXP I WNEW RESIDENTIAL PLUMBING / MECH 19 LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (Fr.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIRSIDE REAR z COMPLIANCE OR ADDITION COMMERCIAL 13 CHANGE OF USE z z PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL MULTIFAMILY SIGN REO'D I PROVIDED GRADING FENCE REPAIR CYDS ( X Fr) REMARKS DEMOLISH TANK OTHER ,in GARAGE RETAININGWALL FIRE SPRINKLER FIRE ALARM z A-ji CARPORT ROCKERY (TYPE OF USE, BUSINESS OR ACTIV" EXPLAIN: CHECKED BY TYP7E0FiCONSTRUC�.1_0N 7_6 OCCUPANT GROUPe Lu a NUMBER OF NUMBER OF DWELLING CRITICAL AREAS SPECIAL INSPECTION AREA OCCUPANT M 0 STORIES UNITS NUMBER REQUIRED [:] YES LOAD DESCRIBE WORK TO BE DONE REMARKS 111PROGRESS INSPECTIONS PER UBC 108/iBC109/IRC109 FINAL INSPECTION RECI'D z M HEAT SOURCE GLAZING % LOT SLOPE % n r) Y� r\AE:) PLAN CHECK NO: VESTED DATE L/ 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 APPLICATION: IBODAYS 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 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANYAND ALL CLAIMS FOR DAMAGES CF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECI LY 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 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 CO .4�ENSATION INSURANCE AND RCW 18,27. SIGNATUR�E16WNER OR AGENT) DATE SIGNED IC L -A �1 �0 VALUATION Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing Base Fee Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due /X�l Recording Fee Receipt # APPLICATION APPROVAL I his application is not a permit until signed by the CALL Building official or his/her Deputy: and Fees are paid. and FOR INSPECTIONI .--j Treccipt is. acknowledged in space provided. FI SIG ATURE DATE (425) Jo 771-0220 RELEIA *ED Y ATTENTION IZA 1 1 ITIS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL INSPECTIONHAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU- ORIGINAL - FILE YELLOW - INSPECTOR PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110. PINK - OWNER GOLD - ASSESSOR 09103 PRESS HARD -YOU ARE MAKING 4 COPIES z 0 A 0 M --i -n 0 M C M 0 0 40 0 M M Z 10--i C Cn o -n n M M 0 6) 0 r- 0 M cl) Cn M 0 Z z 0) z 0 M - M M! GARY HAAKENSON CITY OF EDMONDS MAYOR 121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 0 Website: www.d.edmondsma.us DEVELOPMENT SERVICES DEPARTMENT I C. Planning - Building Engineering October 27, 2004 Mr. Baldock 23619 104"' Ave W Edmonds, WA 98020 SUBJECT: Water Service Lino Repair — 23619 104"' Ave W Mr. Baldock, An inspection was performed for the water service line repair at your property on September 3, 2004. The inspection results were good and the repair was approved. Our records indicate however that a water service line repair permit was never obtained. Please visit the City of Edmonds, Development Services Department, and obtain the required water service line repair permit. Our offices are open from 9am-12pm and 1pm- iit prior to receiving 4pm, Monday thru Friday. You will be required to obtain this pein final approval of your building permit for the detached garage (permit # 2004-0704). Please feel free to contact me should You have, any questions at 425-771-0220, ext. 1338. -nit Coordinator at 425-771- For questions regarding permit fees, please contact a Pen 0220. Thank you, Jeanie McConnell Engineering Technician c: street file 92004-0704 Incorporated August 11, 1890 Sister City - Hekinan, Japan z 0 4 � ' 0 M =i =fl FINAL PROJECT APPROVAL FORM TO: DATE: MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE PLEASESIGN MEW aelt ENGINEERING DIVISION DATE— hzee PIXASF SIM PLANNING DIVISION DATE' PLLASH SIGN PROJECT & 'Ud SITEADDRESS LJ PERMIT, uokvO ADB# DATE INSPECTED DESCRIPTION OF WORK TO BE INSPECTED A field inspection was conducted to determine final 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 u Copy of CONDITIONS given to owner/contractor by inspector FAILED FINAL INSPECTION - OUTSTANDING ISSUES u Copy of CORRECTION NOTICE given to owner/contractor by inspector 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocaprv1.doc.1:temp:b1dg:fonns 10/0 1 z 0 M --i -n Fn --i r M M 0 C) 0 C: --i K M rn M Z C) -1 C 0 -n n ;u > M M 0 U5 0 r- 0 M C: U) K U) Q 0 Z z z 0 1 0 M I RECORD OF INSPECTIONS INSPECTOR DATE APPROVED SETBACKS ..................... FOUNDATION: Footing ...................... Wall.......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Under -ground ............. -In ................... Rough 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 NAIL[ NG ... SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. ow z 0 0 ITI