890150.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
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ADDRESS
ADDRESS
CITY
STATE LICENSE NI
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Legal Descripti
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ZONEvUSE PERMIT 8 901so
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JOB
ADDRESS / �l n /Ae
LEGAL DESCRIPTION CHECKI SUBDIVISION NO.
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TELEPHONE NUMBER PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. APPROVED BY
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r Y+ YvENS PROPOSE OUIRED DEDICATION _Q _
�J RIGHT OF WAVY `CONSTRUCTION PERMIT REQUIRED
STREET USE PERMIT REQUIRED
SEE ENGINEERING MEMO DATED �y REE E
TELEPHONE NUMBER�/ _ _ .
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NUMBER
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NEW 129 RESIDENTIAL PLUMBING
AODIALTER COMMERCIAL� MECHANICAL
n
REPAIR RETAINING WALL LJ SIGN
EXCAVATE FENCE
DEMOLISH OR FILL
❑x—FT)
REMODEL El
PRE•MOVE INSP.I a SWIM
COMPLIANCE INSP. POOL
WOO INSERT APT.
APT. BLDG RENEWAL
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NUMBE OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK O BE DONE (ATTACH PLOT PLAN)
lies
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
"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
i 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 ordinance
nor limit in any way the City's ability to enforce any ordinance
provision."
1 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 construction; and in doing the work authoriz-
ed thereby, no pbrson will be employed In violation of the Labor
Code of the State of Washington relating to Workmen's Compensa-
tion Insurance.
.-30
ALLOWED
OR CU
r&V
PROPOSED I COMPLETE i EXEMPT
YARDS '^
FRONT ZS I SIDE �0 '
NI G REVIEW DATE
WV6 �11.
HEIGHT LOT COVERAGE Z
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1'"A 40rTy,4/•rE Ta
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SPECIAL INSPECTOR AREA OCCUPAN OCCUPANT
REQUIRED GROUP LOAD
❑ YES C NO I ,
PROGRESS INSPECTIONS PER UBC 305
6& u,o,4wcy . ffsNe"owv
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
GRADINGIFILL
STATE SURCHARGE �.To
ENERGY CODE
Afmo
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED, UBC
CHAPTER 3,
102-87
•
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ATTENTION APPLICATION APPROVAL
THIS PERMIT This application is not a permit until
AUTHORIZES pp
ONLY THE signed by the Building Official or his
WORK NOTED Deputy; and fees are paid, and receipt is
INSPECTION acknowledged In space provided.
DEPARTMENT
CITY OF OFFICIAL'S SIG TURE DATE
EDMON
REL D B TE
771=32DS 3/m
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
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SYSTEM CROSS SECTION
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CoWrIk0L CATCH
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`SEE PAGE 3 FOR OUTLET CONTROL DETAIL
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FOUTLET.
CONTROL
WASHED GRAVEL
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FROM
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OUTLET
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2' s 2� a W'VU.P. 4=6" SP^UPS
r V ■ 2' r 3" DEEP. I�- CRUSHED ROCK
RIPRAP OUTLET
OUTFLOW TRENCNp MIN 10' LONG.
TOP 4 4" PERF PIPE TD OE 6mvIEL
4" PERF P%PE WITH CAPS
RUNOFF SPREADER OUTLET'
STANDARD DRAINAGE PLAN
DETENTION SYSTEM
PAGE I OF 2
for
location
plan by SIT'
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date_^:= R4
DESIGN DATA
System Imperm Pipe Pipe Orifice
Wonhor Area Diam Length Diameter
NOTES
1* 7714202)
for�prebDivision
ackfillgandfinal inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Material
accumulated in the storage pipe must
be flushed out and removed from Catch
basins to allow proper operation. The
outlet control orifice must be kept
open at all times. ,
owl
REClt 1VF=D
FEB 2 2 RICO!
PERMIT COUNTER
CITY OF EOMONDS
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Date Sent to Engineering
MEMO TOO
FROM:
ENGINEERING APPROVAL FOR OCCUPANCY
Permit Coordinator
Building Division
Dan Smith
Engineering
DATE: /, ! OF fe)
Inspector
SUBJECT ADDRESS: 7//0 of yj
SUBJECT NAME: sF KL ji'T�'t
I. PERMIT APPROVED FOR FINAL
II. PERMIT NOT APPROVED FOR FINAL
Requirements:
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RECORD OF INSPECTIONS
Date Passed
FOUNDATI0N
House
Porches, piers
Retaining walls
Garage, carport
PLUMBING
Underground
Rough•in
Water service
Ay o� Cf HEATING SYSTEM
FRAMING
WALLBOARD
FINAL
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