20040911.pdf0
DATE RECEIVED ok
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F_� ERMIT EXPIRES
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PERMIT
NUMBER
JOB
ADDRESS
40
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kJ11
SUITE/APT#
OWNER NAMEMAME OF BUSINESS
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LAT NAMEISUBDIVISION NO.
()C,)
LOT NO.
LID NO.
LID FEE S
�13
MAILING ADDRESS
-7 q VV
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED
REQUIRED DEDICATION FT
TESGP Approved
MW Permit Requited
Street Use Primit Roq'd
Inspection Required
Sidewalk Required
Undergrowd
Winng required
0
13
EL
0
0
CITY ZIP
C2 -J-0
TELEPHONE
-2 �T- 7 7LO)
METER SIZE
LINE S�
NO. OF FIXTURES
PRV REQUIRED
YES 13 NO
W
NAME
AD T) a
tN/
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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ADDRESS
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CITY ZIP
TELEPHONE
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NAME
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ENGTEERING REVIEWED By
DATE
/1/0
ADDRESS
AE REVIEWED 13Y
DATE
CITY ZIP
TELEPHONE
STATE LICENSE NUMBER
CHECKED BY
J9 PROPERTY TAX ACCOUNT PARCEL NO.
5
L2 10; 0 0 00 000 0
0
NEW
RESIDENTIAL
PLUMBING / MECH
ADDITION
COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
El REMODEL
MULTIFAMILY
SIGN
REPAIR
G DING CYDS
FENCE
I X
E] DEMOLISH
TANK
OTHER
GARAGE
RETAINING WALL
FIRE SPRINKLER
CARPORT
ROCKERY
FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTIV" EXPLAIN:
U)
NUMBER
NUMBER OF
CR ITICAL
OF
DWELLING
FAIREAS
0 jSTORIES
UNITS
N
MBER
3
ESCRIBE WORK TO BE DONE
D DE�CR,.E
0Nf ARC`VC
FT)
VARIANCE OR CU HORELINE OR AD1111 I INSPECTION I BOND
REQ'D - POSTED
OYES �<No S
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE , EXEMPT ALLOWE DPRO POSED ALLOWP I PROPOSED
1 ,
EXP K g_
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED FRO SIDE/- REAR ., FR9NT PR SIDE /" REARr
3 Ile i 6 'Ib ?-0 15 eq 1. q �4 6
PARKING LOT ARE� PIAIJNING REVIEWEID FLY DATE
REI DIED
PRQVJ
115aiy6
REMARKS, - 0 K -.,
I recv, �el
6000
CHECKED BY I TYPE
OCCUR
GROUP
SPECIAL INSPECTION JAREA UtiLaUFAN I
REQUIRED [:] YES LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC108/IBC109/IRCID9 FINAL INSPECTION RECI'D
TO 8-E L-;Es < A77,. A t-j D VALUATION
0 - $
MO,�,k A,p j- 44VT AT- A I 6446—�-r
09 /1A 66 OA7.Ln L=N I Description FEE Description FEE
Plan Check State Surcharge
I-& g /)j sryLc /+rib r, tj u."
HEATSO RCE GLAZING % LOT SLOPE % Building Permit City Surcharge
A( t 0�r6 -4PjA,1toX �Iet �2
PLAN CHECK NO:
c
VESTED DATE Plumbing Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: ISO DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF fn
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANYAND Fire Inspection Receipt #
5—
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY -
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp. Total Amt. Due
DEEMED TO MODIF'� WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee___r� Receipt #
�HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
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- CALL 1 his application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or his1her Deputy: and Fees are paid, and
IN VIOLATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided
WORKMEN'S COMPENSATION INSURANCE AND RCW 111.27. QfFICIA", TUFtF DATE
SIGNATMUIIOW�N DATE SIGNED (42,15)
0�
0"11OR AGEN�Q
- - C_� t Liu
Z 7
771-0220 D BY li/DATE
ATTENTION E)ff 1333
IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVALOR A CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110.
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
ORIGINAL - FILE YELLOW - INSPEJCTC
PINK - OWNER GOLD - ASSESSOR
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Zone Corner A"' Flag_�L
Actual
Left Elevation �jetbacks E29LIr—el.l.
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Sides
AS NOYE-O 6"
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APPROVE: 11Y PLANNING
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"IT Or""OPY
site Plan
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CO
Tax File # 00
Legal Description
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Lot Area WE
,Site co�erage 1 :-143
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PEHMIT 4, ��
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Height Calculation Worksheet
Address:
Date:
hLspector(s): Va
1. Datum Point: it-- UL.A z
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2. Datum Point Elevation: r�Q c) 6 0
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3. Average Grade: 10 n
V5
.4. Maximum Elevation Allowed: 10 0, 1 q (average &ade)41' 35 M
C
MO
0
5. Reference Point Elevation Shot to House: -40
0 C
M
106. (datum elevation) +LAq (grade to transit level Une'shotto house)= loo, 44 Mz,
C
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6. Measurements from line shot onto house to roof ridge:*
Cn
0 -n
n
3:9
M M
0
0 M
C CD
K cn,
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Total..
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7. Actual Elevation: 10 2,,14 (reference point elevation) + I (measurements
from #6) �LA -1 19
conclusion:
4 -1 qK (actual) is greater/ less than k -15 (allowed); therefore the house is/
is not over the height requirement per ECDC 16.20-30 requirements
MEMO TO:
FROM:
PERMIT COORDINATOR., BUILDING DIVISION
FIRE DEPARTMENT DATE
MEASS SWN
__Azal ENGINEERING DIVISION DATEZZ/9j(-�
:>
MEASE S14N_
PLANNING DIVISION DATE
rLEASE SIGN
PROJECT
SITE ADDRESS-710 - la 3 7
PERMIT # ADB# *DATE INSPECTEDz_-
DESCRIPTION OF WORK TO BE INSPECTED 14 f
V17
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
'o Copy of CONDITIONS given to owner/contractor by inspector
I .
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
1.
PJ
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign,
ocaprv1.doc.1Aenip:b1dg:fonns 10/0 1
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing
MV
......................
_�^A K�4
Wall J�: A
LlfA)W. r
Pier/Porch .................
Retaining Wall ...........
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0
Slab Insulation ..........
M
PLUMBING:
Underground .............
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:E
Rough -In ...................
M
M
Commercial Final ......
0
-1 0
0
C
HEATING:
K
rn
M Z
Gas Test ....................
Gas Piping .................
C z
>
Equipment .................
W
Commercial Final .......
0
-n
EXTERIOR SHEATHING
A
M M
NAILING ..........................
0 Fn
2-1- e) 6
0 r-
FRAMING ........................
M
C Cn
FIRST FLOOR FRAMING...
9 (n
Q 0
INSULATION ...................
Z
Floor Insulation .........
Wall Insulation ...........
z
Ceiling Insulation .......
Cn
SHEETROCK NAILING ...
z
0
SPECIAL INSPECTION ...
__4
0
C.
DA
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1711
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
The Initials TAT arc Milton
Thompson, a Wiliporary contract
i�,Ilspector for the City.
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