20050735.pdfDATE RECEIVEC5 I ob
PERMIT
CITY OF EDMONDS NUMBER
CONSTRUCTION PERMIT APPLICATION JOB
ADDRESS
OWNER NAMEINAME FF BUSINESS
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STATE LICENSE NUMBER,.,,O- EXPIRATION DATE CHECKED 13Y
PERMIT EXPIRES
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PLAT NAME/St IVISION NO.
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LID NO
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
RW Permit Required
Street Use Permit Requited
EXISTING PROPOSED
inspection Required
Sidewalk Requited
REQUIRED DEDICATION FT
Underground
Wairm required
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
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YES 11 N013
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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(TYPE OF USE. BUS S R ACTIVITYk)XPLAIN
TYPE OF 7�tUCTION CODE
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NUMBER 2 NUMBER OF
OF . ,.A DWELLING SPECIAL INJPECTION CONSULTANT
STORIES I UNITS REQU YES
AS)ElD CRIBE WORK TO BE DONE
-T-Mre-of\bf�L REMARKS
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V,ecl GEOTECH REPORT
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VALUATION
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)4i v1 r ooL b�� -abajh - bm Description FEE
Plan Check
EAT S94RCE LOTSLOPE% VESTED DAI h Building Permit
15c
618' 2-
PIL AN CHECK NO: 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 Grading
SEPARATE PERMISSION.
E � Engr. Review
r PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
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PERMIT LIMIT. SEE ECDC 19.00.005(A)(6) Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
OCCUPANT
GROUP
OCCUPANT
LOAD
Description
State Surcharge
City Surcharge
Base Fee
FEE
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'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESSOR
Fire Review
Plan Chk. Deposit
1)
LI IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
040,3
F EDMONDS, WASHINGTON,
x 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 MOD IFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp.
Total Amt. Due
4
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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Recording Fee
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Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION AP
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.
IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
Building Official or his/her Deputy! and Foes are paid, and
TION; AND
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt is acknowledged in space provided
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
-hFFimALs
SIGNATU
DATE
SIGNAT REIIEW EN DATE SIGNED
.!N 2YEJ G T): (425)
5" 27 -o-;- 771-0220 R ' eEB
ATTENTION EXT. 1333
IT IS UNLAWFULTO 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 IBC110 I IRC110. J PINK -
110/04 PRESS HARD - YOU ARE MAKING 4 COPIES
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BUILDING DEPARTMENT
CI-TY OF EDMONDS
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AUG 15 2005
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EDMONDS
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APPROVED BY PLANNING
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Everett Office
TESTING ENGINEERS
MAYES INC. 917-134th Street SW
Suite A-1
Everett, WA 98204
ph 425.742.9360
fax 425.745.1737
Tacoma Office
MTE No.: E5342
10029 8. Tacoma Way
Project: BLEVINS RESIDENCE Suite E-2
Address: 728 — 6th Avenue S, Edmonds, WA Tacoma, WA 98499
ph 253.584.3720
Permit No.: 2005-0735 (City of Edmonds) fax 253.584.3707
Portland Office
Owner: Blevins Residence 7911 NE 33rd Drive
Architect: Suite 190
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Portland, OR 97211
Engineer: Sitts & Hill Engineers, Inc. ph 503.281.7515
Contractor: Blevins Residence fax 503.281.75�9
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Page 1
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Date: 2/2/06
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Weather: Indoors
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Inspection: Epoxy Grout
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'Sample(s): N/A
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Observed epoxy grouting of 5/8" threaded rod embedded 7" for PHD-2s and PHD-5s located
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around entire perimeter of, house and interior stair wall. All per sheet 2 and 3 of approved
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drawings. All holes were cleaned, and filled with Simpson SET.
To the best of our knowledge, items inspected this date are in accordance with approved plans
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and specifications.
INSPECTOR: Lisa Pyper
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RECEIVED
FEB 1'3 200S
bEVELOPMENT SERVICES CTR.
CrrY OF EDMONDS
REVIEWED BY:
4T4y51G_. �Becl
, T y G. Beckerle, P.E.
cc: Tim Blevins-Blevins Residence; Larry Lindell-Sitts & Hill Engineers, Inc.; Bldg Dept -City of Edmonds
MAYES, TESTING ENGINEERSy INC.
Everett Office
917-134ih Street SVV/
35WM;";'N' MM"W"T-0 0"'!
Suite AM
Everett, WA 98204
ph 425.742.9360
fax 425.745.1737
July 11, 2006
RECEIVED
Tacoma Office
10029 S. Tacoma Way
Suite E-2
Tacoma, WA 98499
Jt IL 4 2006
ph 253�584.3720
fax 253.584.3707
City of Edmonds Building Department
DEVELOPMENT SERVICES CTR.
Portland Office
1121 5th Avenue N CITY OF EDMONDS
7911 NE 33rd Drive
Edmonds, WA 98020�3146
suite 190
Portland, OR 972,11
Attn.: Jeannine Graff
ph 503.281.7515
fax 503.281.7579
Re: Blevins Residence FINAL LETTER
th -0735.
728 6 Avenue South Permit # 2005
Edmonds, WA
MTE Project No. E5342
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Ms..Graf,
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This is to inform you that. registered special ins pections have been completed for this project as
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per our reports, copies of which have b en sent to you
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Specia I inspection was provided for:
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Epoxy Grouted Anchors
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To the best of our knowledge, all work inspected was either performed
in accordance with, or.
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corrected to conform to the city approved drawings, or enginee r approved changes.
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We trust that this provides you with the information,which you require.
Should you have any
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questions give us a. call.
Sincerely,
MAYES TESTING ENGINEERS9 INC.-
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Timothy kerle, P.E.
nothy G.
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�Branch Manager
Cc: Tim Blevins — Blevins Residence.
Larry Lindell — Sitts & Hill Engineers, Inc.
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Height Calculation Worksheet
Date I — Lp
-735
Permit Number 0.
Address
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Inspector VN,-,,, z�,
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Average Grade Ci up
Max Height (25'+Ave.)
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Elevation of transit above Datum (B).
Datum Elevation (A) I ap, c)
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1/tenip/buildiii&fomis/lieigilt worksheet
FINAL PROJECT APPROVAL FORM
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