20041051.pdfFDATE �AECEIVED
C1W OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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STATE LICEOSE NUMBER EXPIRITION DATE -"GE
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NEW
RESIDENTIAL
ADDITION
COMMERCIAL
REMODEL
MULTIFAMILY
REPAIR
G ZN7 CYDS
DEMOLISH
TANK
oGARAGE
CARPORT
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RETAINING WALL
ROCKERY
(TYPE OF USE, BUSINE5�5� ACTIVITY) EXPLAIN:
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w NUMBE NUMBER OF
DWELLING
UNITS
OF
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DESCRIBE WORK TO BE DOWE
PERMIT EXPIRES
442
USE
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PERMIT
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ADDRESS
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PLAT NAMEISUBDIVISION NO.
LOT NO.
LID NO.
LID FEE
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
IESCP Approved
RW Permit Requited
EXISTING PROPOSED--——
street Use Permit Req'd
inspection Required
K_j
Slaawalk Required
REQUIRED DEDICATION
Fr
Underground
Wifing required
METER SIZE
LINE SIZE
NO� OF FTURES
PRV REQUIRED
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YES X NO 13
PLUMBING / MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
( X Fr)
OTHER
FIRE SPRINKLER
FIRE ALARM
CRITICALftV,jVt'
AREAS
NUMBER
REMARKS
OWNER/CONIRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND
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COMPLETE EXEN4PT ALLOWED PROPOSED .7 'lv OPO
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LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT)
ALLOWED PROPOSED FRONT., SIDE REAR FRONT
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SPECIAL INSPECTION JAREA OCCUPANT
REQUIRED YES LOAD
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REMARKS
PROGRESS INSPECTIONS PER UBC 108 / IBC109 if IRC109 FINAL INSPECTION REQ'D z
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CHECKED -BY ITYPE
VALUATION
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Description
FEE
Description
FEE
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Plan Check
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State Surcharge
HEAT SOURC9
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Building Permit
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PLAN CHEQk-AO-.
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Plumbing
Base Fee
Mechanical
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THIS PERMIT AUTHORIZES ONLY THE WORK i )PERM rnVliRSWORKTO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Grading
Engr. Review
PERMIT APPLICATION: 180DAYS
PERMIT LIMIT: 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
,APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES 10 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
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MO DIFY WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
L
Landscapelnsp.
Total Am I. Due
Recording Fee
Receipt III
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 LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
CALL
FOR INSPECTION
(4251
APPLICATION APPROVAL
This application is not a porinit until signed by the
Building 011icial or his/her Deputy: and Fees are paid, and
receipt is acknowledged in space provided.
OFF C T DATE
SjGNAjUfRjP,(0WN1i!j OR AGENT)
DATE SIGNED
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ATTENTION E)ff 1333 Q
IT IS UNLAWFULTO USE OR OCCUPYA BUILDING OR STRUCTURE UNTILA FINAL
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110.
09!03 PRESS HARD -YOU ARE MAKING 4 COPIES
0131C��-f/FILE"-i, YELLOW -/NSPr_
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PINK -OWNER - GOLD.ASSESSOR
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TIM AND SHELLY CROSBY
152110TH PLACE NORTH
EDMONDSs WASHINGTON 98020
APPROVED AS NOTED
BY ENOINEERING
Date:-.,
APPROV
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BY PLANNING
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3J 2004
DEVELOPMENI SERVICES CTR.
CITY OF EDMONDS
An,
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Height Calculation Worksheet
Address: P I V -J
Date: 0
hispector(s): Vf%
1. Datum Point: Q��4,-ez=
2. Datum Point Elevation:
3. Average Grade:
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Maximum Elevation Allowed: C�71- vera&- giude): 3
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5. Reference Point Elevation Shot to House:
55 -4
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c, (datum elevation) + (grade to transit level line 'shot to house)
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.6. Measurements from line shot onto house to i -6of ridge:*
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7. Actual Elevation: (reference point elevation) +?q'c?�',(measdrements
-4
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from #6)
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(actual) is greater/ ess th (allowed); therefore the house W
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is not over the height requireme�n ECDC 16.20.30 requirements
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ACCEPTABI
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SDR 35
SCV1 40
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SHADED AREA INDICATES IMPERVIOUS SHADING INDICATES AREA
SURFACE AREA OF 676.20 S.F. OF IMPERVIOUS SURFACE
A IS 692.00'
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BUILT
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EKISTi G GARAGE B�FORE 11 W=7=7 U
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W4Y � EWTIjjp �IVEWAYPUILT BVFORE lVj.
1601-01
IMPERVIOUS SURFACE CALCULATIONt GUTTI�A&DOWNSPOUTS RECEIVED
T6 GONNtOT To EXIST. SYST.
AREA 1 AND 2 - 676.20' S.F. JUN 30 2004
AREA 3 - 692.00' S.F.
TOTAL AREA = 1368.20' S.F. ADD GUTTERWOWNSPOUTS DEVELOPMENT SERVICt., - i ��k NORTH
AND SPLASHKOCKs, CITY OF E DN',Oi iDS
DRAINAGE PLAN
A pW&E 1 1
tb As
TIM AND SHELLY CROSBY BY ENGINEERING
y
1521 10th PLACE NORTH C v r
TAX ACCOUNT PARCEL # 27031300408900 "7110
FINAL PROJECT APPROVA' FORM
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TO:
DATE:
mi".1mo,ro: PEIZMIT COORDINATM, BUILDING DIVISION
FROM: FIRE DEPARTmEN'r DATE
1PLEASE SIGN
_ENGINEERING DIVISION DATE z
PIXASE SIGN 0
PLANNING DIVISION DATE
FLUASE SIGN
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PR0fECT_ J3,*,/ r
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PERMIT ADBY- DATE INSPECTED/,Z/ Z± X M
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DESCRIPTION OF WORK TO BE INSPECTED (E)/'7ri P- _/,7 aj, (= -2
C_14 >
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
PER17ORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WIT14 CONDITIONS NOTED
El Copy of CONDITIONS given to owner/contractor by inspcctor
FAILED FINAL INSPECTION - OUTSTANDIN-G ISSUES
Copy of CORRECTION NOTICE , given to owncr/contnictor by inpector
2.
3.
REMNSPECTED OUTSTANDING ISSUES - GRANT FINAL PRO]FICTAPPROVAL
Date SigilatUre
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
XT
5
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
?22 Z_
17
z
Slab Insulation ..........
0
PLUMBING:
Underground .............
Rough -In ...................
MS
0 M
C
Commercial Final ......
M
0
0
0
HEATING:
Gas Test ....................
—0S
C
—4 C
X M
M Z
Gas Piping .................
C
> z
Equipment .................
Commercial Final .......
0 -n
n
--I
EXTERIOR SHEATHING
NAILING ..........................
VO�
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M M
0 5
FRAMING ........................
0 r-
0 ITI
FIRST FLOOR FRAMING...
C0
Cn
M 0
INSULATION ...................
Z r-
Floor Insulation .........
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Wall Insulation ...........
Ceiling Insulation .......
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SHEETROCK NAILING ...
CD
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SPECIAL INSPECTION
0
0
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
2Aq, lo5l w000,
The filitials NIT are WWI'
Thompson, a temporary colitract
illspector for tile City.