20050169.pdfr DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
MAILINGADDRESS
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CITY
TELEPHONE
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NAME P,4 t)
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ADDRESS
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TELEPHONE
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NAME
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PERMIT EXPIRES
PERMIT
NUMBER
JOB SUITEIAPTo
ADDRESS
AME/SUBDIVISION NO.
LOT NO,
LID NO.
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LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCPApproved E3
E3
RW Permit Required
Street use Permit Requited 13
EXISTING PROPOSED
Inspection Required 13
Sidewalk Required E3
REQUIRED DEDICATION FT
Underground 13
Wiring required
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES13 NOM z
REMARKS W
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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ENGINEERING REVIEWED BY DATE
ADDRESS
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FIRE REVIEWED 13Y
DATE
CITY
ZIP
TELEPHONE
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VARIANCE OR CU
SHORELINE OR ADB#
INSPECTION
REO'D
113YEs
SEPA
COMPLETED EXEMPT
EXPIRAT
STATE LICENSE NU MBER ION DATE
ECKED 13Y
13NOI
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CAN
ZONE
SIGN AREA
HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO.
WAIVER13
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ALLOWED PROPOSED
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ALLOWED PROPOSED
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STUDY 13
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NEW
RESIDENTIAL
1:1
PLUMBING I MECH
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (FT.)
FRONT SIDE REAR
PROPOSED SETBACKS (FT.)
FRONT L/RSIDE REAR
E] ADDITION
COMMERCIAL
13
COMPLIANCE OR
MIXED USE
CHANGE OF USE
021 <EMODEL
1:1
SIGN
PARKING
REO'D PROVIDED
LOT AREA
PLANNING REVIEWED BY DATE
MULTIFAMILY
REPAIR
GRADING
CYDS
o
FENCE
( x FT.)
REMARKS
DEMOLISH
TANK
1:1
OTHER
EGARAGE
RETAINING WALL
FIRE SPRINKLER
ALARM
CARPORT
ROCKERY
FIRE
(TYPE OF USE, BU ESS 2!1 ACTIVITY) EXPLAIN:
ales
TYPE OF CqrNSTRUCTION
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OCCUPANT
GROUP
NUMBER
OF
NUMBER OF
DWELLING
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SPECIAL INSPECTION
ONSULTANf
OCCUPANT
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STORIES
UNI�TS
REQUIRED' DYES
LOAD
DESCRIBE WORK TO BE DONE
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REMARKS
GEOTE CH REPORT
BY:
STRUCTURAL DESIGN
BY:
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VALUATION
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Description
Plan Check
HEAT SOURCE
LOTSLOPE%
VESTED DATE
Building Permit
PLAN CHECK NO:
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Grading
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
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'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 ORPINAN CE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
CALL
FOR INSPECTION
(425)
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 C Y WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE Wo P�A)UTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE L,01 CODE OF THE STATE OF WASHIN
#F4 GTON RELATING TO
,�VORKME,N'S C ft'INSURANCE AND RCW 18:27.
(OWNE"'�GENT):
DATE
7S1 iED
e
771-0220
ATTENTION hA L 1;5;3;J
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC1110.
FEE Description FEE
State Surcharge
City Surcharge
-Base Fee
Plan Chk. Deposit
Receipt #
Total Amt. Due
Receipt #
APPLICATION APPROVAL
This application is not a permit until signed by the
Building Official or hisih6t Deputy: and Fees are paid. and
receipt is acknowledged in space provided
IGNATURU DATE
FICI�lf
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
ORIGINAL - FILE YELLOW - INSPECTOR
PINK -OWNER GOLD - ASSESSOR
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CITY, OF EDMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5th Avenue North, Edmonds, WA 98020
(425) 771-0220
O-O"ER TO CORRECT VIOLATION
Location of Violation (Address and Tax Account Parcel No): 22608 95'1' Place West, Edmonds, WA
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98026 Tax Ac count Parc
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Issued To: Martha Meeks, Property
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Address Of Pe rson This Order Is Issued TO: 22608 95"' Place West, Edmonds, WA 98026
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Code Section Violated:-Sections 106 108 and 109.
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Description of Violation: Failure to contact QijXjK-EMW red final inspection on building permit
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#200 463 i for decks.
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Corrective Action Required: On er obtained a buildin"ermit toremodel
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f the home a t 22608 95"' Place West in E imonds. Dggk_permits are valid for
decks at the front and rear, o
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I LO days and the permit ext)ired on Febru.M 2, 2005. The City Building Insp ector jUanted the owner an
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additional 7 days to finish the work anAd call for a final in ner failed to contacLffie City
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and no further extensions shall be vxant,,d. The corrective action require is tor the propert -v owner
to remit a new application a nd required City inspection fees of $117.00. The City will process the
call for a final inspection within
permit and o nce a new Permit is issued the Property owner shall
60 days date.
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Correction is Required no later than:— 5:00pm (time) March 11, 2005 (date)
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If correction is not.m ade by the date and time specified in the Order, a Noti e of
civil Violation shall be issued. The Notice of Civ il Violation shall assess fines of
0.00 per rtion of a day, during which the violation continues.
$10 day, or po
Date Posted: Da te Mailed: Februa!y 25, 200_5 Date Served.
Issuing Party. Jeannine L. Graf Title Building Official
Signature
RECORD OF INSPECTIONS
INS PECTOR DATE APPROVED
SETBACKS ......................
FOUNDATION:
Footing......................
Wall................. ........
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Pier/Porch .................
Retaining Wall .....
Slab Insulation .....
PLUMBING:
Underground ..............
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Rough -in .................... .
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Commercial Final ......
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HEATING:
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Gas Test ...............
Gas Piping .................
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Equipment ..............
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Commercial Final .......
EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ....... ................
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FIRST FLO OR FRAMING...
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INSULATION ...................
Floor insulation .........
Wall Insulation ...........
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Ceiling Insulation .......
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SHEETROCK NAILING ...
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SPECIAL INSPECTION ...
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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