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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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TESCP Approved
RW Permit Required
CITY ZIP TELEPHONE
EXISTING PROPOSED
Street Use Permit Required
inspection Required
REQUIRED DEDICATION
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Sidewalk Required
Underground
Wiring required
NAME
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Plan Check
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HEAT SOURCE LOTSL PE%
P�A�� , 1 14
VESTED DATE
Building Permit
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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
Engr. Review
SEPARATE PERMISSION.
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
Fire Review
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
LandscapeInsp.
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. -
Recording Fee
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-
CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTIO
WORKMEN'S COMPENSATIO"URANCE AND RCW 18:27.
no%
771-0220
SIGNJT�RE (2WNER
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DATE SIGNED
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1-0
FEE Description
state surcharge
City Surcharge
4,x 1
;12 — Base Fee
F,h.�
FEE
Plan Chk. Deposit
Receipt #
Total Amt. Due
,
Receipt # a67
APPLICATION APPROVAL
This application is not a permit until signed by the
Building Official or hisiher Deputy: and Fees are paid. and
receipt is acknowledged in space provided.
III EXT. 1333
ATTENTION
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 I IBC110 / IRC110.
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PROJEC
LOT SIZE: 8,276 SQ. Fr. 62' x 134.5'
558 41tl AVE SOUTH tp EN"iNEERING
EDMONDS 98020 LOT COVERAGE:
EXISTING RESIDENCE/ GARAGE: 1,414 T�T.
OWNE C EXISTING DETACHED GARA(
SANDRA & BOB H
'A 396 SO. FT.
AM
8316 OLYMPIC VIEW DR ADDITION
TOTAL: 2290 SQ. FT. 27.6%
EDMONDS 98026
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IMPERVIOUS SINCE 1977: 396 SQ. ff. ADD GUTTERS/DOWNSPOUTS
425-776-9378
AND SPLASHBLOCKS
TAX No 00409600101200 %FIGHT CALCULATIONS: AR4
ONDS DATUM: BASE OF, TELEPHONE . POLE @ SE CORNER.: 100.0'
LEGAL: CITYPARK ADD TO N
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BLK 001 D-00 BLK 1 LOT 12.
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SCOPE 0 OJECT:
PR
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ADDITION OF 396 SQ. FT. LIVING TO
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402 4 100.5' +25ft =12
EXISTING RESIDENCE. MAINFLOOR
117.25PROPOSED RIDGE
OF SINGLE LEVEL.
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
I'LLASESIGN
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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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FAILED FINAL INSPECTION - OUTSTANDINGISSUES
El. Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
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RE- I INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fonns:ocaprv1 3/25/04
RECORD OF INSPECTIONS
INSPECTOR DATE, APPROVED
SETBACKS .....................
FOUNDATION:
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Footing ......................
Wall..........................
OR
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Pier/Porch ................
Retaining Wall ...........
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Slab Insulation ..........
PLUMBING:
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Underground .............
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Roubh-In ...................
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HEATING:
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Gas Test ....................
Gas Piping ..............
Equipment .................
Commercial Final .......
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EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ........................
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FIRST FLOOR FRAMING...
INSULATION ........ ..........
Floor Insulation ..........
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Wall Insulation .....
Ceiling insulation .......
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SHEETROCK NAILING ...
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SPECIAL INSPECTION. —
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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