20050142.pdfDATE RECEIVED r PERMIT EXPIRES
PERMIT
CITY OF EDMONDS NUMBER Y,
JOB SUITE/APTl$
CONSTRUCTION PERMIT APPLICATION ADDRESS
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ER.NAMEINAME OF BUSINESS .51
MAILPADDRESS
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CITY
Mfton ds
NAME
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PROPERTY
AL
NEW
ADDITION
REMODEL
REPAIR
DEMOLISH
inGARAGE
CARPORT
NUMBER
OF
STORIES
PLAT NAMEISUBDIVISION NO, LOT NO. LID NO,
45A —1 1 LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCPApprova(i
RVV Permit Required
Street Use Permit Requeed'
ZIP TELEPHONE EXISTING PROPOSED inspection Reqwred
Sidewalk Required
REQUIRED DEDICATION '1� FT Underground
. ........ .
METER SIZE LINE SIZE NO. 05-FIXTURES PRV REQUIRED
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YESE3 NO 13 z
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REMARKS ru
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLJDRAINAGE z
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ZIP
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ENGINEERING REVITED BY DATE
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FIRE REVIEWED BY DATE w
TELEPHONE of
RESIDENTIAL
COMMERCIAL
MIXED USE
MULTIFAMILY
GR QJNG_ CYDS
TA14K
RETAINING WALL
ROCKERY
SS OR ACTIVITY) EXPLAIN:
0
VARIANCE OR CU
SHORELINE OR ADB#
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INSPECTION
REO'D
OYES 1rNO1
SEPA
COMPLETED EXEMPT
I W"t
FION DATE
CHECKED BY
CAP
ZONE
SIGN AREA
HEIGHT
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WAIVER a
STUDY 13
Y6 i ,�
ALLOWED I PROPOSED
&ft
ALLOWED I PROPOSED
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PLUMBING / MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
X FT.)
LOT COVERAGE
ALLOWED PROPOSED
35 �.r 5-
REQUIRED SETBACKS (FT.)
FRONT SIDE REAR
I :Z57 10 7-1-5
PROPOSED SETBACKS (FT.)
FRONT URSIDE REAR
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PARKING
REQ'D 1 PROVIDED
LOT AREA I
PLANNING REVIEWED BY DATE
REMARKS L/
T7
0 HER
FIRE SPRINKLER]
FIRE ALARM
I
TYPE OF CONSTRUCTION
NUMBER OF N, I I
DWELLING SPECIAL. INSPECTION
UNITS REQUIRED 13YES
TO BE DONE REMARKS
I \J ZAA,/ tz�
GEOTECH REPORT
BY:
4L�_ �7
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STR�C lT51GI
BY:
VALUATION
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Description
plir)vc- (III
Plan Check
HEAISOURCE
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LOT SLdPEO
I I e, A�,,-
VESTED DATE
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Building Permit
—
PLANCHECKN01__ I
LL
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Grading
Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
PERMIT LIMIT. SEE ECDC 119.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
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
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 CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT., AND TH� M H OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TgROYIPILAY WTITIHECITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN 1: CALL
oil N ZGT W K AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
W
F
IN VIOLATIO F E IL OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
-L
N S#
WORKMEN'S I NS,:VION INSURANCEffi$b RCW 18:27.
SIGNED
(425)
771-0220
OCCUPANT
GROUP
OCCUPANT
LOAD
FEE Description FEE
State Surcharge 4/'64-/
City Surcharge
7 Base Fee
Plan Chk. Deposit Y,_-5L_t4
Receipt #
Total Amt. Due D
Receipt # 1�67[ q,-5
APPLICATION APPROVAL
This application is not a pOrMit until signed by the
Building official or his/her Deputy: and Foos are paid, and
receipt is acknowledged in space provided
I'll S SIGNIARE DATE
S
flk� lqll),
ATTENTION tzA L I JJJ
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC1091 IBC1110 / IRC110. PINK
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
YELLOW -NNSPECTC
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SCALE 1"=30' >
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ol 30, 45' 60' 0 -n
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HEIGHT CALCULATION
0 1� Lit cn
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A = 196.50 (1.8 FT. OF FILL)
0 M
8 = 194.60 coll
C = 197.26 K co
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C\j m
D = 198.58 (1.3 FT OF.FILL) SNI 0
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786.94/4 196.73 AVE.
COD
MAXIMUM HEIGHT = 221.73
3:
TO DETERMINE THE AMOUNT OF FILL AT ENVELOPE >
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06'
CORNERS "A" AND "D" TEST PITS WERE EXCAVATED
DETERMINE THE DEPTH OF THE FILL.
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ELEVATIONS FOR ENVELOPE CORNERS "A" AND "D" z
'ARE 1.8 FT. AND.1.3 FT. BELOW THE ACTUAL GROUND BUILDING HEIGHT STUD .0
ELEVATION TO COMPENSATE FOR THE FILL.MATERIAL FOR
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JAN HELLEREN
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IN NE1/4, NE1/4, SEC. 13, T.27N., R. 3E., W.M.
If Wft ON CITY OF EDMONDS
SNOHOMISH COUNTY, WASHINGTON
22969
EXPIRES 10-15-05
Height Calcul, 0
Mi n WorLsh eet
Address:
Date:
Inspecto�* M,
1. Datum Point:
2. Datum Point Elevation: -7
z,
I Average Grade: i q (a
.4.. Maximum Elevatimi Allowed: jftk�-�(average grade)'+ 25" 9 -V, 73*
CI) 4
3:
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5. Reference Point Elevation Shot to House:
M a
(datum elevati!)n) + LA-] (grade to transit level line 'shot to house)
C,
C
rn M
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6. Measurements from line shot onto house to roof ridge:'
LI
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m m
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Totid I k
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meastiremen
7. Actual Elevation: aocj,q'7 (reference point elevation") + I I s:-, ts
from #6)
Conclusion:
ater
2"Xi .5k (actual) is gire (eDsshan 0-2.1.-13 .(allowed); therefore the house b/
is:not over the height -requirement per ECDC 16.20.30 requirements
FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
PLEASESIGN
14 K/_.I�NGTNEERING DIVISION DATE
- 'FLAISPSIGN-
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PLANNING DIVISION DATE
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PLEASE SIGN
PROJECT,
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SITE ADDRESS
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PERMIT #20(A-5- — ADB# DATEINSPECTED
MM
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DESCRIPTION OF WORK TO BE INSPE CTED/e,,�
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Final ap ioval
A field inspection was conducted. to determine compliance with approved plans. p
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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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1:1 Copy of CONDITIONS given to owner/contractor by inspector
CD
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FAI LED FINAL INSPECTION - OUTSTANDING ISSUES
0.
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0 Copy of CORRECTION NOTICE given to owner/contractor by inpcct.or
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date.. Signature
I:tcinp:bldg:fonns:ocaprvl,3/23�/04
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
M5
Footing ......................
Wall ..........................
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Pier/Porch .................
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Retaining Wall ...........
Slab Insulation ..........
_40E
7-05
-
0
M
PLUMBING:
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Cl)
x
Underground .............
OM
C
Rough -in ...................
M
Commercial. Final ......
0
C.
HEATING-
M
M Z
JC) —4
Gas Test ....................
Gas Piping .................
os
CO)
Equipment .................
0 -n
-n
Commercial Final ...
EXTERIOR SHEATHING
M M
0
NAILING..........................
0
CM
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FRAMING ........................
K Cn
Q 0
FIRST FLOOR FRAMING...
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INSULATION ...................
;U
Floor Insulation .........
:C
Wall Insulation ...........
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Ceiling Insulation .......
CD
SHEETROCK NAILING ...
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SPECIAL INSPECTION ...
Dom
0
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
&05 0 1 44 za
A. I= 0 Z: I- P
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.
12,t[05
62(0 0 1 t�
OcIf
The Initials MT are Milton
Thompson, a temporary contract
�3(xc_?
-or the City.
inspector f