20041043.pdfDATE RECEIVED
PERMIT EXPIRES
USE PERMIT
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CITY OF EDMONDS NUMBER
CONSTRUCTION PERMIT APPLICATION JOB SUIlEl""'
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REMARKS
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THI 'FIF YCoV_hqWA_
t= BE DONI� ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 Grading
:3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE '7/9
SEPARATE PERMISSION.
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W PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT., 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTERES r, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMi ESS I I IE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHAT EVER NAT URE, ARISING DIREC HY Oil INDIREC TLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT 13E
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.,
Fire Review
PlanChk.Deposit
Fire Inspection
Receipt #
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LandscapeInsp.
Total Amt. Due
A.'906. .
Recording Fee
Receipt #
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 �O COMPLY Willi CITY AND STATE LAWS REGULATING CONSTRUC
TION; AND IN DOING *THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATIgNOF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEr COM,!�ENSATION INSURANCE AND RCW 18 27. 1
CALL
FOR INSPECTION
(425)
771-0220
EXT 13,33
APPLICATION APPR�
I his application is riot a pennit until signed by the
Huilding Official or hisihof Deputy and Fees are paid, and
recLipt is acknowledged in space Provided
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SIGNATPR (OW E 111 AGENT)
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DATE SIGNED
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING Oil STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI- ORIGINAL - FILE YELLOW - I SpCC-TC
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD ASSESSOR
0903 PRESS HARD -YOU ARE MAKING 4 COPIES
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PHONE : 425-670-2711 SkP 2
PLOT PLAN �,? 20
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BENCH MARK FOR
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THE PROJECT BENCH MARK IS THE CONCRETE q)0 L: ;-jj
MONUMENT IN CASE LOCATED AT THE L 0 T 3, VIKING HEIGHTS
CENTERLINE OF 238TH STREET S.W. AT
APPROXIMATELY THE MIDPOINT OF THE IN SE1/4, SECTION 31, T.27N., R.4E., W.M.
PROPERTY. CITY OF EDMONDS
ELEVATION : 200.00 SNOHOMISH COUNTY, WASHINGTON
DATUM : ASSUMED
WATER & SEWER
INSPECTIONS REQ'D.
CALL 425-771-0220 EXT. 1326
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OWNER/CONTR Q L�6 -
VIKING PROPERTIES, INC.
P.O. BOX 1034 4
LYNNWOOD, WASHINGTON 98046
NOTEL
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Date:
�Nm% Lovell -Sauerland & Associates, Inc.
Engine-s/Surveyors/Plmners/DevelopmenL Comultants
—e-mafl: info@Lsaea&eering.com - web: Isaengineenng.com
19400 33rd Avenue I., Suite 2W - LYnnwood, IFA MW - (425)775-1591 - (425)672-7998 fax
DRAWN —r4656-0-2�:
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
PLEASESIGN
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DESCRIPTION OF WORK TO E INSPE TED
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
0 Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owncr/contractor by inpector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:tenip:b1dg:1'onns:ocaprv1 3/25/04
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
K"T
FOUNDATION:
Footing......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ......
HEATING:
Gas Test ....................
"'f
Gas Piping .................
g4T
Equipment .................
!A - "S
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING ...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
MT
-AS;
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
Luc, �, *
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MISCELLANEOUS ..........
FINAL APPROVAL FOR e— 16--dr"
OCCUPANCY .................. ry,,Ll�
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