20040650.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
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MAILING ADDRESS
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NAME
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ZIP TELEPHONE
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ZIP I TELEPHONE
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STATE LICENSE NUMBER
ZIP I TELEPHONE
EXPIRATION BAT
Q PROPERTY TAX ACCOU14T PARCEL NO.
❑ NEW / RESIDENTIAL
ADDITION ❑ `COMMERCIAL
�I REMODEL ❑ MULTIFAMILY
!!!l`"❑���� REPAIR ❑ GRADING CYDS
❑ DEMOLISH ❑ TANK
zz ❑GARAGE RETAINING WALL
CARPORT ❑ ROCKERY
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(TYPE OF USE, BUSINES OR ACTIVITY) EXPLAIN:
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o NUMBER NUMBER OF
OF 2 r DWELLING
OSTORIES T UNITS
DESCRIBE WORK TO BE DONE IV 1
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CHECKED BY
PLUMBING / MECH
COMPLIANCE OR
❑ CHANGE OF USE
❑ SIGN
❑FENCE
( X. FT)
❑ OTHER
❑FIRE SPRINKLER
FIRE ALARM
USE
ZONE
JOB
PERMIT EXPIRES
PERMIT
NUMBER
ADDRESS
PLAT NAME/SUBDIVISION NO.
LOT NO
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED
REQUIRED DEDICATION FT
METER SIZE I LINE SIZE I NO. OF FIXTURES
SUITE/APT#
LID NO.
LID FEE S
I ESOP Approved
❑
RW Permit Ragrered
❑
Strout Use Parrett Roq'd
❑
Inspection Required
❑
Sidewalk Required
❑
Underground
Wrong required
❑
PRV REQUIRED
YES ❑ NO
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REMARKS z
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE t7
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ENGINEERING REVIEWED BY DATE
FIRE REVIEWED BY DATE w
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VARIANCE OR CU SHORELINE OR ADB11 INSPECTION I BOND
�1 RE 'D. POSTED
OYES AO S ��-
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE E E PT ALLOWED PROPOSED ALLO[W`ES PROPOSED
EXP
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED CPR�POSE�ROyy SIDE REAR FRONT Uf±SIDE�REAR z
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PARKING LOT AREA P WE% DATE//� g
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REMARKS
CHECKED BY j=UCTION C $ OCCUP7-�
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CRITICAL �• % ]PROGRESS
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AREAS SPECIAL INSPECTION AREA OCCUPANT
NU MBE REQUIRED ❑ YES LOAD
REMARKS
INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D o
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HEAT SOURCE GIAZINr,• % LOT SLOPE %
PLAN CHECK N %: VESTED DATE
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
H SEPARATE PERMISSION.
w PERMIT APPLICATION: 180 DAYS
a PERMIT LIMIT: 1 YEAR • PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
N •APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
uj IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
i EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
= FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL Nor BE
o 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.•
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-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASIIINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
SIGNATU (OWNER ftFN DATE SIGNED
VALUATION
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Description FEE Description FEE
Plan Check State Surcharge
Building Permit City Surcharge
Plumbing Base Fee
Mechanical '—
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Grading
Engr. Review—
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Engr. Inspection
Fire Review Plan Chk. Deposit
Fire Inspection Receipt N
Landscape Insp. Total Amt. Due t147- j�ljov
Recording Fee Receipt N
APPLICATION APPROVAL
CALL This application is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
FOR INSPECTION receipt is acknowledged in space provided.
OFFICI LS SIGNATURE ATE
(425) �� 3 L
771 VV0220 RELEASED B TE
(A
ATTENTION EXT 1333 ' u
Ill
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL � _ ') � `%L
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI o GINAL-FILE YELLOW -INSP CTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK %YNE GOLD -ASSESSOR
09.03 PRESS HARD -YOU ARE MAKING 4 COPIES
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cl.r.o.w. 7 5 t h Ave. W (Battle Drive)
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100.00' NO3d51'3011E _ _ _ 245,76' NO3d51'30"E _
85.0 f �(n) & (e) roof ob, �Y�
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80.0 (n) Mba. Addition .44 ___ 9
2 story - -1185 sq. ft. (fo tprint)co
above (232 sq, ft.) 1416 ❑ .).�
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(e) Garage w/ ��,, � ,ro - ` —
�+ ti`O , t� (e) ingress easement / �60.a
} peck above _ - e a,c. drive.-- - - -
352 sq. ft. �1 - _ —
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R 115a' PERMIT COUNTER
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Site Plan
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r t s t, . GARY HAAKENSON
MAYOR
,CITY OF EDMONDS -
c x� 121 STH AVENUE NORTH • EOMONDS, WA 98020 • (425) 771-0220 FAX (425) 771.0221
Website: wwwxi.edmonds.wa us
DEVELOPMENT SERVICES DEPARTMENT
Inc 189p Planning • Building • Engineering
July 12, 2005
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Melissa Duane O i
' 23210 75"' PI W.
Edmonds; WA'98020 rn
Re: Building Permit: 2004-0650 m x
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Site Address: 23210 75`h P1 W. _ 1'
Expiration Date: 08/03/05 C m
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O C ¢,Dear Ms. Duane, = rn
The purpose of this letter is to inform you that the last remaining inspection on your pz-t ;
project is a final inspection(s). The final inspection(s) determines that there are no
outstanding life -safety issues and approval allows the City to close your permit file.ch
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The City considers the final inspection to be one of the most important inspections
conducted on a project. In order to grant final approval the following must be complete: _
smoke detectors, house numbers, guardrails„handrails, self -close doors between garage m rn
and residence, egress from sleeping rooms, safety glazing,` weather-stripping, anyO'� r '
Engineering department requirements etc. Of course not all of these things may C Cn
specifically apply to our project but it does give you an idea about the kinds of thins �'
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that must be complete as well as some items that do not deed to he installed such as:
paint, carpet, moldings, wallpaper, etc. Please be advised permits expire one year from
the date of issuance. "If you will need more tinge to complete the work, permits can be _
renewed p� for to expiration for one half fees. If the hermit expires without final
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approval granted by the Building Inspector, frill fees are required in order to renew the
permit. This can be very costly to you and we strongly encourage you to check your _
perm lit expiration date and call for the required Final inspection(s). Note: If more than z
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one department is required to final your project, this is noted on your ,lob CarcL
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Please feel free to contact me at 425-771-0220 if you have any questions.
Sincerely
JoAi i n ° u if
Pern ecialist {{
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L\'Temp\US'I"s��4astu• Letters\SR��'aarnl_trSfR
• Incorporated August 11, 1890 •
Sister City Hekinan, Japan
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GARY HAAKENSON
' CITY OF EDMONDS MAYOR
121 57H AVENUE NORTH • EDMONDS, WA 98020 • (425) 771.0220 • FAX (425) 771.0221
Website: wwwb.edmondsma.us
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DEVELOPMENT SERVICES DEPARTMENT'
ps/s Planning • Building • Engineering
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June 16, 2004co
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Melissa Duane rn
23210 75th Ave W C o
Edmonds, WA 98020 m O
hA:C: 206-323-7295 (Sherwood Case) O C,
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RE: Vestingcurrent plan review #04-210 under the current building codes m z
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Dear Melissa Duane: -mi
We are writing to remind you of the City adoption of the International Building Codes effective 00M
on July 1, 2004. m
With the code change -over fast approaching full permit and plaur C.hc,ck fees are required before rn im
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July 1, 2004 to vest your application under current codes. The amount to vest your application is prst
$355,00, C N
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If the noted fees in the amount listed above are not received BEFORE Jul • 1, 2004 your plans zrsssst
ps- must be returned to you and any fees paid to date must be forfeited. �.
If you have any questions please don't hesitate to contact the permit coordinator assigned to your D
project at 425-771-0220. z
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• Incorporated August 11, .1890 •
Sister City - Hekinan, Japan
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS
FOUNDATION:
Footing...................... MM
Wall
Pier/Porch
Retaining Wall
Slab Insulation ..........
PLUMBING:
Underground ............. / [ /�
Rough -in - eK �CcQ1F er i L +�
,rlQ 03 a.d l
Commercial Final ...... M"f' $
HEATING:
Gas Test .................... t�i 1 �-1— f�
Gas Piping ..............:.. Yb1�i j.. 2 mot'!
{ I I M'T' -7�0�
Equipment .................
j! Commercial Final
EXTERIOR SHEATHING ` 14 . 0 �— b
NAILING ..................0.......
FRAMING
FIRST FLOOR FRAMING...
INSULATION 6111.4*64
Floor Insulation .........
Wall Insulation rve17C — w tee% 0$
Ceiling Insulation ....... M G+ " 16 L ` O k
SHEETROCK NAILING ... vv\% �^ J
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR�.—
OCCUPANCY .................. t V u�
The initials MT are Milton
Thompson, a temporary contract
inspector for the City.
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