21718 97TH AVE W.PDFiiiiii iiiiii
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21718 97TH AVE W
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
Website: www.d.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
loc. 18,9 "1 Planning Building Engineering
May 16,2003
WESCO
Attn: Candace
2800 Thorndyke Ave W
Seattle, WA 98199
Re: Refund for duplicate permit
Dear Candace;
GARY HAAKENSON
MAYOR
STREET FILE
I am writing to let you know that we received a refund request from WESCO on 5-15-03
for permit #2003-0287 a 21718 97th Ave W in Edmonds in the amount of $95. The owners
name is Olsen and it was for the installation of a gas furnace and water heater. The City
realized we issued two permits and were in the process of refunding you for #2003-0248
when we got your request. I just wanted to clarify for your records that the City has
voided #2003-0248 and finaled #2003-0287. The check is on it's way to you, you should
receive it within two weeks. If you have any questions, please feel free to contact me.
Sincerely,
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Lara Palmatier
City of Edmonds
425.771.0220 p
425.771.0"1 f
Pahnatier,@ci.edmonds.wa.us
Incorporated August 11, 1890
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CANCELLATION AND REFUND REQUEST FORM
L-'y• DATE:
• MUNICIPALITY: �A-m oa
• PERMIT NO: 02
AW• SITE ADDRESS:,,-:
Please make payable to the address listed below.
If there are any questions, please call Candice at (206) 378-6922 or 1-800-398-4663)
ex. 6922. Thank you.
APPLICATION
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.Description FEE Description FEE
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Plan Check
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FPLAN CHECK NO: VESTED DATE Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
2 Engr. Review
Lu PERMIT APPLICATION: 180 DAYS
CL PERMIT LIMIT 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
IAND
2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
0 FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp.
.j DEEMED TO MODIFY; WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Total Amt. Due
0 NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee Receipt #
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 APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRLIC- This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official or his/her Deputy: and Fees are paid, and
IN VIOLAT!ON OF THE LAB�O�QODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN S qbMPEN 041INSU�ANCE AND RCW 18.27.
OFFICIALS SIGNATURE DATE
SIG4AfURe,(bw1K14 0 �GENT) DATE SIGNED f - , ;P
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L' - 1 771-0220
RELEASED BY' DATE
ATTENTION EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL-FILE - YELLOW- INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER - GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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ADDITIONAL CITY REQUIREMENTS
ANY WORKJN*ITIATED WITHIN AN APPEAL PERIOD
]SATAPPLICANT'S RISK
Any request for modification, variance or other administrative devia-
tion (hereinaft�r ".v`ariance") must be specifically called out and iden-
tified. Ap:pr ' oval of any plat or plan containing provisions which do
not comply with city code and for which a variance has not been
specifically identitied, requested and considered by the appropriate
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city offib M' aecu'rdance with the appropriate provision of city code
or 9tAte]aws:,d96$..r16t approve any items not to code specification.
PERMIT EXPIRATION:
Every peftnit issued by the Building Official shall expire one year
from the date of issuance except for the following permits which shall
expire 180 days from the date of permit issuance: Demolition, Relo-
cated of Moved Buildings, Plumbing, Mechanical, Water Service Line,
Tank, Sign, Fence, Deck, Dock, Fill, Grade, Excavate, Swimming
Pool, Hot Tub, Spa, Re -Roof, Rockery, and Retaining Wall.
If work is not complete within the permit issue time limit the applicant
may, prior to the expiration of the original permit, apply for a permit
extension for an additional year. The fee for extension shall be one
half thdiotidirial'; permit fee provided the plans are the -same as origi-
na.1 Iyaliproved "otherwise, full fees shall be required. If the applicant
allows the, perrhit-to expire, full permit fees shall be paid until work
may , r;sur-he.-. If -the work is not completed during the second year,
the permit may be extended a third year at a fee rate established in
ECDC 19.00.17, provided the applicant renews the permit prior to
expiration. Any action on an expired permit shall result in full fees
paid to the City.
OCCUPANCY:
Final approval on a project or final occupancy approval must be
grantedbythe Building Official prior to use or occupancy of the building
or structure. Check the job card for all required city inspections in-
cluding final project approval and final occupancy inspections.