20060267.pdf1/1
DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OW VER NAME NAME OF BUSINESS/
MAILING ADDRESS
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ZIP
IONE
PERMIT EXPIRES
PERMIT
NUMBER
J�9LI
ADDRESS
CF-W 07
PLAT NAME SUBDIVISION NO.
LOT NO�
LID 10
LID FEE S
-1
PUBLIC RIGHT OF WAY PER OFF:CIAL STREET MAP
I LSC P Appfo,eo
Fl%'V 1,01MA RI)COINI
street USE, Pelm-1 Reqirel
EXISTING PROPOSED
inspect,on Req,,,recl
sloe hai� Reqjlred
FILQUIRED DEDICAI ION
FT
undergrowi-ci
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MEIER SIZE --[LINE
SIZE
NO OF FIXTURES
PRV REQUIRED
YESO NOO
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ADDRESS REMARKS z
OWNERiCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE EE
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CITY ZIP TELEPHONE a
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CBL4 I ENGINEERING REVIEW
IN+e RECYCLE REVIEWED BY DATE
ADDHESS R I
.CITY qV TEI.EPH1ONE el PUBLIC WORKS REVIEWED BY DATE
ZIP FIRE REVIEWED BY DATE W
�T�TE LICENSE NUMBER EXP RATION DATE BY
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PA
VARIANCE OR CU. SHORL:LlNt:ORADB# INSPECTION 5
PROPERTY TAX A,��;(07T PANEL NO REO'D ICOtAPLETED EXE?/T1
E3YES KNO
HEIGHT
CA# ZONE SIGN AREA
ALLOWED PROPOSED ALLOWED PROPOSED
NEW RESIDENTIAL PLUMBING I MECH 4<EAIVER A�
OMMERCIAL COMPLIANCE OR DSTUDY
ADDITION CHANGE OF USE LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.)
MIXED USE ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR Lo
REMODEL MULTIFAMILY SIGN ------ z
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13 z
GRADING FENCE <
El REPAIR 1:3 CYDS 1:1 LOT AREA PLANNING REVIEWED BY DATE _1
X FT.) PARKING It.
REO'D PROVIDED
OTHER
1:1 DEMOLISH El TANK 3L 04-1
EGARAGE RETAINING WALL FIRE SPRINKLER f-j,'OV\ REMARKS
CARPORT ROCKERY ftRE-Ab%R&4,
(TYPE OF USE. BUSINES� OR ACTI Y EXP N:
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.0 NUMBER NUMBER OF
3 OF DWELLING T NSTRUCTION D OCCUPAN
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STORIES
DESCRIBE WORK TO BE DONE
SPECIAL INSPECTION CONSULTANT OCCUPANT
I REQUIRED 13, 1 1 LOAD
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Description
HEAT SOURCE LOT SLOPEO 0 VESTED DATE Plan Check
/�C:._ ( cd jL/±/-
PLAN CHECK NO: Building Permit
Plumbing
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS , DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5) Engr. Review
PERMIT LIMIT: SEE ECDC 19.00.005(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 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
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.' Landscapelnsp.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
1E AINFA N
ORM TIO
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF CALL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
I
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED FOR INSPECTION
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSA`FqRINS�ANCE AND RCW 18:27.
(425)
SIG TURE (OWNER Oq-`AG� DATE SIGNED
771-0220
P
FEE Description FEIE
State Surcharge
City Surcharge
Base Fee
Recording Fee
Plan Chk. Deposit
Receipt ft
Total Amt. Due
I
Receipt # I
APPLICATION APPROVAL
This awicaimn in nal it perfT111 unti, siqned ny the
Building Officiai or hj�,Iher Deputy and Fees we paid and
rLiceirit is acknowledried in space. provideo
DAT E
14".
V ;,
RELEASED BY
E T. 1333
AT EEN_Rk�N Lj�
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. UBC1 09 / IBC1 10 / IRC1 10.
6/05 PRESS HARD - YOU ARE MAKING 4 COPIES
DAT
14
ORIGINAL I-ILE YELLOW - INSPLCTOR
PINK - OWNER GOLD - ASSESSOR
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMOTO: PME1 Oror--R,-BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
IMANES VN
ENGINEERING DIVISION DATE
PIF-%SL S11,N
-PLANNING DIVISION DATE
PROJECT
SITE ADDR-ESS. 9� S_
P E R-M IT tt-06 - "z 6 -7 ADB# DATE INSPECTED
DESCR.I.PTION OF WDRK TO BE INSPECTED F, 'L-6� J—j4,�—
A field inspection was conducted to determine compliance with approved plans. Finil ipproval
denotes that there are no objections from the above signed Department to flie release of
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PERFORIN1,ANCE BONDS and (fie granting of:
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GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/con tractor by inpector
I .
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3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
lAemp:bldg:fomis:ocaprvl 3!25/04
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch ................. z
0
Retaining Wall ...........
0
M
Slab Insulation ..........
PLUMBING:
Underground ............. 0 M
C
M 0
Rough -In ................... 0
0
0 C:
Commercial Final ...... —i K I .
3: M
HEATING: M Z
Gas Test .................... C
>
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Gas Piping ................. 3:
Cn
0 -n
Equipment ................. n
Commercial Final ....... x
M M
EXTERIOR SHEATHING
0
NAILING .......................... 0 M
C: Cn
FRAMING ........................ ?. Cn
Q 0
Z
FIRST FLOOR FRAMING...
INSULATION ................... ;U
Floor Insulation ......... >
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Wall Insulation ........... --I
Ceiling Insulation ....... C/)
z
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SHEETROCK NAILING ... I
SPECIAL INSPECTION ... M
MISCELLANEOUS ..........
FINAL APPROVAL FOR —z, (e
OCCUPANCY .................. on -Is
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