20010719.pdfDATE RECEIVED
CIV OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
NNER NAMEMAME OF BUSINESS
Teresa Castner, DDS Castner Dental Care
41LING ADDRESS
120 W. Dayton, Suite C-2, Bldg. 2
TY ZIP ITELBIHONE
Edmonds. WA 98020
ADDRESS
CITY
NAME
Crown Fire Protection, Inc.
ADDRESS
4932 W. Interurban Blvd.
CITY "P TELEPHONE
Bothell, WA 98012 425.481.7669
STATE LICENSE NUMBER EXPIRATION DATE I OECKED BY
�W
CROWNFP044LL 4.8.02 At -
PRO EFITY TAX ACCOUNT PARCEL NO.
23270340750100
F1 NEW RESIDENTIAL 0 PLUMBING I MECH
E] ADDITION CHANGE OF USE
COMMERCIAL C MPLIANCE OR
REMODEL APARTMENT SIGN
C] REPAIR GRADING CY�S F NCE
( X FT)
D DEMOLISH [3 TANK
[3 GARAGE 0 RETAININYG WALL Cj RENEWAL
CARPORT
(TYPE OF USE, BUSINESSORA�� EXPLAIN:
commercial, dentist office
NUMBER 11MIE101 CRITICAL
OF DWELL NO AREAS
STORIES UN TS NUMBER
DESCRIBE WORK TO BE DONE
er heads
PERMIT EXPIRESZIV��
us _E_ PERMIT
ZONE NUMBER
IOB SUITE/APT.
ADDRESS 120 W. Dayton, Suite C-2, Bldg 2
PI.AT NAMEISUBDIVISION NO
I LOT NO
LID NO
LID FEE
PUBLIC RIGHT Or WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED—
8
0
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0
METERSIZE
LINE SIZT_f_T��
PAV REQUIRED
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R MARKS
OWNERICONTAACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
FIRE REVIEWED By DATE
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VARIANCE OR CU
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INSPECTION
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SERA REVIEW
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ALLOWED PROPOSED
ALLOWED PROPOSED
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REQUIRED S.TBACKS J� T)
PROPOSIrD SETBACKS (FT)
ALLOWED PROPOSED
FRONT SIDE REAR
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PARKING
LO T AREA
PLANNING REVIEWED By DATE
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ICTIECIEDBY TYPE OF CONSTRUCT I OCCUPINI�3
ff&.d,&4jc I W 7 F.UP I
S ECIAL INSPECTOR' JAREA OCCUPANT
APEOUIRED 0 YES LOAD /15-
VALUATION
FEE
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OPE
HEAT SOURCE GLAzING % LOT SLOPE I
BUILDING
L. G
IVESTED DATE
PLAN CH:227..,,� D DfATE
PLUMBING
PLUMBING
MECHANICAL
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT CDVERS WORK TO
BE DONS ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
GRADINGIFILL
DOMAIN JCURBS, SIDEWALKS, DRIVE S, MARQUEES. ETC.) WILL REQUIRE
WEARMISSION.
SEPARATE
STAIESURCHARGE/,Ij
PE MITAPPL=71 N: IODDAYS
PERMIT LIMIT, 1 YEARR PROVIDED WORK IS STARTED WITHIN 180 DAYS
j;;MFIN FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE. HEIAS. ASSIGNS AND SUCCESORS
JIMIE.1l.N FEE
;APPLICANL,'.
I, I NTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
LANDSCAP NO
2 EDMONDS. WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
INSPECTION FEE
LY
ALL CLAIMS FOR DAMAGESOFWHATEVER NATURE, ARISING DIRECT ORINDIRECTLY
FROM THE ISSUANCE OF THI S PERMIT ISSUANCE OF THIS PERM T SHALL NOT BE
DEEMEDTo MODIFY. WAIVE OR REDUCE ANY REQUIREMENT oFANY CITYORDINANCE
PLAN CHECK DEPOSIT
NOR LIMIT IN ANY WAYTHE CI-S ABILITYTO ENFORCE ANY ORDINANCE PROVISI ON.'
CEIJIS�
-
TOTAL AMOUNT DUE
11
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1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPOCATION APPROVAL
GIVEN [SCoRRECT.ANDTHATIA THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THEOWNER. I AGREE TO COMPLY WIT. CITY AND STATE LAWS REGULATING CONST
DYED'
CALL
— . r—, �� — ,, ".
TION; AN D IN DOING THE WORK AUTHORIZED THERE BY. NO PERSON W1 ILL BE EMPIL
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Dlo.l, Ild F111 11, PILd.
WORKMEN'SCOMPENSATIGN INSURANCE AND ROW 1821,
DATE
IOWIEI OR -1 SIGNED
(425)
o,=
42 W6
J;RE
A 9.19.01
-
771 0220
-
-DATf
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ATTENTION
EXT 1333
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL -0221
771
L 7N
'
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
"�RUGINAL 'ILE - YELL&W INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
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FINAL PROJECT APPR VAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FIRE DEPARTMENT DATF-42=L2----L—
FROM:
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE—
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SITE ADDRES
ADB#__________pATE INSPECTED-&=L2,-a�.
PERMIT
DESCRIPTION OF WORK TO BE INSPECTED-FZ04.�����
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
there are no objections from the above signed Department to the granting of:
><_Final approval ofthe described work
GRANT FINAL PROJECT APPROVAL
PROJECT APPROVAL WITH CONDITIONS NOTED
—FAILED FINAL INSPECTION - OUTSTANDING ISSUES
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-RE-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Fooling ......................
wall..........................
4 Pler/Porch .................
Fatalning Wall ...........
m
Stab Insulation ..........
PLUMBING:
m
Underground .............
m
Rough -in ...................
a
Commercial Final
0
HEATING:
m
Gas Test ....................
Gas Piping .................
Equipment
0
Commerdal Final
A A
C3
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ............ . ..........
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Calling Insulation
SHEETROCK NAILING
C)
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR%
OCCUPANCY ..................
§
F!CEIVE�
PERMIT EXPIR�ES
C1* OF EDMONDS
S'
ZONE
ZONE 420'—
PERMIT nf
NUMBER
JOB
ADDRESS
SUITVAPT.
CONSTRUCTION PERMIT APPLICATION
-
120 W. Dayton,
Suite C-2. Bldg 2
IeR NAMEINAME OF BUSINESS
Iteresa Cattner, DD§ Castner Dental Care
j
PLAT NAMFJSUBDIVISION MO.
LA
LOT NO.
LID NO,
LID FEE $
AILING ADDRESS
120 W. Dayton, Suite C-2, Bldg. 2
PUBLIC RIGHT OF WAY PER OFFICIAL
UE
EXISTING - PROPOSED
STREET MAP
-
;Xp
o'.. 1
--A....
S AII-d! 0
TY ZIP
Edmonds, WA 9802
ITELEPHONE
FIEOUIREDDEDICATION�
FT
MET ER SIZE
LINE SIZE
I NO.OFFIXTURES
PRV EOUIRED
AME
I
YES 0 No E3
ADDRESS
CITY ZIP , ITELEPHONE
NAME
Crown Fire Proteefion, Inc.
A DRESS
-4932 W. Interurban Blvd.
CITY ZIP TE11PHO E
Vothell, WA 98012 425.481.7669
STATE LICENSE NUMBER E-1-1-NDATE
CROWNFP044LL 4.8.02 i
fROPERTY TAX ACCOUNT PARCEL NO�
23270340750100
PLUMBING I MECH
0 NEW R:0.
ADDITION CA 0 COMPLIANCE OR
C :NTIALL CHANGE 0 USE
REMODEL APARTMENT 0 SIGN
I
REPAIR GRADING CYOS [3 F NCE
I X FT)
C] DEMOL18H TANK
ci GARAGE
'T ;ENM
CARPO R�TAINING WALL AL
(TyPgOF USE. BUSINESS ORACT EX N
comnlercial, dentist office
NUMBER
OF
NUIIEROF
DWELLING
CRITTAICAL
ARE S
STO IES
UNITS
NU SER
DESCRIBE WORK TO BE DONE
4 sDrinkler
"A"
FIRE REVIEWED BY DATE
2 a
2 - 'I -
VARIANCE OR CU
SHOREURE 00 &DBN
INSF RON
RED G
01 E. - NO
SERA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
'XP I
,
- -
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SLrSACKS (Fr.)
F N�
PROPOSEDSETEACXS(FT)
ET
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REQUIRE E3 YES LOAD
=RKS
04Q INQPFf1.TInNS PER UBC 10afFINAL INSPECTION REWDI
VALUATION
- FEE
PLAIN CHECK FEE
7_EAT7� GI-AZING I LOT SLOPE %
BUILDING
rESTED DATE
PLAN CH
PLUMBING
MECHANICAL
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERM1.110C.0,V.ERS WORCK 10
BE DONE ON PRIVATE PROPERTY ONLY. AMY CONSTRUCT'O 'U.0
GRADINGIFILL
DOMAIN (CURDS. SIDEWALKS, DRIVEWAYS , MARQUEES, ETC.) WILL REQUIRE
I SEPARATE PERMISSION.
STATE SURCHARGET
PERMIT APPLICATION:, Igo DAYS
V
A. PERMIT LIMIT. I YEAR - PROVIDED WORK S STARTED WITHIN 180 DAYS
IEW FEES
SEE BACK OF PINK PERM T FOR MORE INFORMATION
'APPLICANT, ON BEHALF 01 HIS OR HER SPOUSE, HEIFII, ASSIGNS AID SUCCESORS
a
IN INTEREST, AGREES TO :NDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
NDSCAPING
EDMONDS. WASH1NGTCN. TS OFFICIALS. EMPLOYEES, AND AGENTS FROM A.IAND
CLAIMSFORDACE SOFMATEVER NATURE. ARISING DIRECTLYOR INDIRECTLY
OF T IS PERMIT. ISSUANCE OF THIS PERM T SHALL NOT BE
F OM THEISSUAN 0
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT FANYCITIORDMANCE
PLAN CHECK DEPOSIT
11EC117e
NOR LIMIT IN ANYWAY THE CITY-SABIUTY TO ENFORCE ANYORDINANCE PROVISION.'
R "I
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
A71RLI�ATION APPROVAL
H U
GIVEN IS CORRECT. AND T14AT I AM THE OWNER, OR T E DULY A THORIZED AGENT OF
TII
THEOWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
d,�o OF
B.11 Deply: ald Fall 110 P11d. I'd
TION: AND IN DOING THE WORK AUTHORIZED TH EFEBYN PERSON WILL BE EMPLOYED
OF THE STATEOF0 HINGTON RELATING TO
WAS
III
FOR INSPECTIO N '-p I- a.di-p-0-d-
IN VIOLATION OF THE LABOR CODE
WORKMEN S COMPENSATION INSURANCE AND RCW 18.27.
OFFIC Q F DATE
Slg;��E (OWNER ORP DATE SIGNED
(425)
9.19.01
771-0220
IELEA E
ATTENTION
EXT 1333
IT IS UNLAWFULTO USE OR OCCUPY ABUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
U.0 SECTION 109 FAX
FIGINAL - ILE 'ELL
PINK -OWNER COLD - SESS�R
\--,EATE OF OCCUPANCY HAS BEEN GRANTED.
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