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~� , PERMIT EXPIRES r
PERMIT
CITY OF EDMONDS NUMBER
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CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT#
ADDRESS
OWNER NAMEINAME OF BUSINESS \ L
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C� PLAT NAMEISUBDIVISION NO. LOT NO. LID NO
tY ULING�iADDRESS 1 111 LID FEE 5
roved E3�� �,l \ Y\ �� PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP AppRW Permit Required
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Street Use Permit Required E3.
CITY ZIP TELEPHONE EXISTING PROPOSED Inspechon Regm
Sidewalk Required
Undergro+od
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��y`,�,^ f - i•• '' 7` / und E3REQUIRED DED
�, s < i.`� f [ �L,• ) y,'� r' ICATION / FT Vann required E3
NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
r�� �� YES O NO O z
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ADDRESS REMARKS Z
= OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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rnTY ZIP TFLFPHt)NE lJl ,•�i!.��iii� �tC��i�� 1"C�IX �A.�`1`"'riLJ.
CULa
ENGINEERING
WA
ADDRESS
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FI RE IE1)4E Y, DjTE K
CITY ZIP 7ELEPNO EAL
STATE LICENSE NUMBER EXPIRATION DATE CIIFCKED BY VARIANCE CUY060000�
SHORELINE OR DB# NSPECTION SEPA
READ O COMPLETED E%E�IPT
e[�,L,G^�, ONO 'L`
CA# ZONE SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO.
�% ,WAIVEr ALLOWED PROPOSED ALLOWED PROPOS
E� J /q STUDY O 44
EW
RESIDENTIAL ❑ PLUMBING I MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
l ❑ ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR
COMMERCIAL COMPLIANCE OR �•�•�"�'- �'! _
❑ ADDITION ❑ CHANGE OF USE _
MIXED USE
❑REMODEL ❑ PARKING LOTAREA NNING REVIEWED BY DATE g
MULTIFAMILY 1:1 SIGN REO'D PROVIDED If
GRA FENCE
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❑ REPAIR ❑ CYDS ❑ ( X FTJ REMARKS
❑ DEMOLISH ❑ TANK 1:1OTHER
❑GARAGE RETAINING FIRE
CARPORT ❑ ROCKERY WALL ❑ FIRE ALARM SPRINKLER
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
G TYPE OF CO RUCTION C E OCCUPANT
I/.'.AJC GROUP
NUMBER NUMBER OF
OF DWELLING SPECIAL INS ECTION CONSULTANT OCCUPANT ,
STORIES ' UNITS LOAD %'_
DESCRIBE WORK TO BE ONE 11 REQUIRED YES �a�}7
REMARKS z
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GEOTECH REPQQn7 /
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TRUCTURAL DESIGt�,.1
TION [.%
ription FEE Description FEE
heck State Surcharge
HEAT SOURCE LOTSLOPE%VESTED DATE g Permit % City Surcharge
PLAN CHECK NO: Plumbing Base Fee r
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED.. THIS PERMIT COVERS WORK TO Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION, Engr. ROVIOW
LU PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
a PERMIT LIMIT: SEE ECDC 19.00,005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION. Engr. Ir)SpeChOn
U) "APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit ,
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IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
? EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # (
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due i(( ''
O NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,*
Recording Fee Receipt a
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT i AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application is not a permit until signed by the
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Ehnlding 01110111 Or his/her Deputy and Foos are paid, and
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 INSPECTION rOC11Erl +s acknowledged et space provided
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27. r R l TELE DATE
SIGNATURE (OWNER O AGENT): DATE IGNED `425> `71e
% Lam'
10
-A/ /
y.Ji0 Ely 1 -0220 RE / S r f DAT'/
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ATTENTION EXT. 1333 - , : �a f' 4
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL • FILE • YELLOW • INSPECT R
FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC109 I IBC110 1 IRC110, PINK • OWNER • GOLD ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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BAKER ENGINEERS, INC.P.S.
0001101
o-o,oo,o
STRUCTURAL DESIGN
0001001
123 4TH AVE. N. Phone: (425) 771-6666 SINCE 1977
EDMONDS, WA 98020 Fax, (425) 771-6558 www,bakerengineers.com
Email mailbox@bakerengineers.com ti
DA'L'E, January 28, 2006 r
City of Edmonds O
Building Division n
1215" Ave. North
MICROFILMr"
Edmonds WA. 98020 ,
f -=1 �1Co
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ATTENTION: Ann Bullis v,
Co ;.
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SUBJECT: Plan check # OS - 182 n
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Building permit No. 2005.0721 },
j Project: Rotary Bandstand m Z
Small
Project address: 540 3`d Ave. S. A
Edmonds, WA. 98020
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Dear Ann Bullis: p Son
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On January 13, 2006 and January 20, 2006 James A. Crim, P.E. and Edwin'F. Baker, P.E., S.E.,
Mm j.
made site visits to the referenced project for the purpose of observing construction progress. vo �n
C vCn, :.
r On January 13, 2006, Crim and Baker found the grade beam footings and caisson reinforcin steel v
g icco
in place and the site ready for the delivery of concrete that afternoon. January 20, 2006 site visit t, MO
confirmed floor slab reinforcing to be in place and properly "chaired", grade beam reinforing and
slab dowels in place. Concrete construction was in accordance with building permit approved
plans and details. ,
Please call if you have any questions. �� ►
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Somali T.
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Sincerely, �� F $��, zz
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BAKER ENGINEERS, INC:, P.S.- 113:e - ►c`�t�' �
Edwin F. Baker, P.E., S.E. -
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R 2 / 10 1 2007 i
c.EXPIES _..__._._.. __.. _.._......�...._.....i
RECEIVED i
.DEVELOPMEN'r SERVICES CTR.
P. CITY OF EDMONDS
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BAKER ENGINEERS, INC.P.S.
0001101
o-o,oo,o
STRUCTURAL DESIGN
0001001
123 4TH AVE. N. Phone: (425) 771-6666 SINCE 1977
EDMONDS, WA 98020 Fax, (425) 771-6558 www,bakerengineers.com
Email mailbox@bakerengineers.com ti
DA'L'E, January 28, 2006 r
City of Edmonds O
Building Division n
1215" Ave. North
MICROFILMr"
Edmonds WA. 98020 ,
f -=1 �1Co
.
ATTENTION: Ann Bullis v,
Co ;.
p ,; :•
SUBJECT: Plan check # OS - 182 n
O
Building permit No. 2005.0721 },
j Project: Rotary Bandstand m Z
Small
Project address: 540 3`d Ave. S. A
Edmonds, WA. 98020
C z;.
Seem!
Dear Ann Bullis: p Son
� !'
On January 13, 2006 and January 20, 2006 James A. Crim, P.E. and Edwin'F. Baker, P.E., S.E.,
Mm j.
made site visits to the referenced project for the purpose of observing construction progress. vo �n
C vCn, :.
r On January 13, 2006, Crim and Baker found the grade beam footings and caisson reinforcin steel v
g icco
in place and the site ready for the delivery of concrete that afternoon. January 20, 2006 site visit t, MO
confirmed floor slab reinforcing to be in place and properly "chaired", grade beam reinforing and
slab dowels in place. Concrete construction was in accordance with building permit approved
plans and details. ,
Please call if you have any questions. �� ►
z
Somali T.
co
Sincerely, �� F $��, zz
�� wa�N�
BAKER ENGINEERS, INC:, P.S.- 113:e - ►c`�t�' �
Edwin F. Baker, P.E., S.E. -
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al
p
Princi <R!c►s,►R<°-1��'
R 2 / 10 1 2007 i
c.EXPIES _..__._._.. __.. _.._......�...._.....i
RECEIVED i
.DEVELOPMEN'r SERVICES CTR.
P. CITY OF EDMONDS
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