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k- 2 PERMIT EXPIRES - �A/P7-
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CITY OF EDMONDS '�.NE IER I
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CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
FOW-NE,R NAME/NAME OF BUSINESS ADDRESS :
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PLAT NAMEISUBDIVISION NO I LOT NO, LID No -
MA_ LID FEE S
mig��F Isac' At,
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CITY ZIP ITELEPHONE EXISTING — PROPOSED— onad
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REQUIRED DEDICATION— FT La.—d
NAME PAV REQUIRED
YES 0 NO C3
—ADDRESS REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
CITY ZIP ITELEPHONE - — - IL_ —
ENGINEERING
REVIEWEDIDATE
ADDRESS
GIN
FIRE REVIEWED BY
DATE
ZIP TELEPHONE
STATE LICENSE NUM13ER EXPIRATION
VARIANCE OR CU
SHORELINE OR ADD# INSPECTI N BOND
RE 'D POSTE
[3 YES 13 NO
TAX ACCO NT PARCEL NO.
SERA RIDflEW
EXEMPT
SIGN AREA HEIGHT
ALLOWED PROPOSED ALLOWED PROPOSED
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ECOMPLETE
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0 NEW [3' RESIDENTIAL
0
LOT COVERAGE
REQUIRED SETBACKS (FT.) PROPOSED SETBACKS iFr.)
PLUMBING I MECH
ALLOWED PROPOSED
FRONT SIDE HEAR FRONT URSIDE BEAR
[3 ADDITION [3 COMMERCIAL
[i COMPLI NCE 08
CHANGE OF USE
• REMODEL 0 APARTMENT
0 SIGN
ANNING REVIEWED By DATE
• REPAIR GRADING
[I F NO
CYR a
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REMARKS
0 DEMOLISH E3 TANK
0::dTNPR:' f 1
[3 GARAGE RETAINING WALL
CARPORT 0 ROOKERY
0 RENEWAL
(TYPE OF LAIN:
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CHECKED BY Peep GO STRUCTION 0 E CCUPANT
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100
� e GROUP
NUMBER N;UiM 0 E F
CRITICAL,
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SPECIAL INSPECTOR JAREA
REQUIRED [] YES
[REMARKS
OCCUPANT
LOAD
DESCRIBE WORK TO BE DONE
BID -BESS INSPECTIONS PER UBC 108/1FINAL INSPECTION REO'D
Plan Check
11-T SOU�C`
!uilding
Plumbing
Mechanical
THIS PERMIT AUTHORIZER ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUS LIC
Grading
Recording Fee
Is OIIJAdN (CURBS. SIDEWALKS, DRIVEWAYS MARQU 11, ETC.) WILL REQUIRE
SEPARATEPERMiSSION. E
Engr. Review
R ITAPPLICATION: INDAYS
City Surcharge
PERMIT Latim I YEPRE- PROVIDED WORK IS STARTED WITHIN IRS DAYS
Engr. Inspection
State Surcharge
See BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS Oil HER SPOUSE. IIIIRI. ASSIGNS AND SUCC11011
Traffic Mitigation
Plan Chk Deposit
IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLE S THE CITY OF
EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Review
Receipt III
FROM THE ISSUANCE 01 THIS PERMIT. ISS ANCE OF THIS PERMIT SHALL NOT HE
DEEMED TO MODJF�X UCE ANY REQUIREMENT OF ANY GIN ORDINANCE
Fire Inspection
Total Amount Due
W�WAWEORRE
NOR LIMIT IN ANY Y THE GINS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
Landscapeinsp.,
Receipt #
1 HEREBY ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT AM THE OW ER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE To COMPLY WIT" CITY AND STATE LAW REGULATING CONSTRUC-
CALL
This appi cnion is not a ptanatonfil,ioned by did
TION; AND IN DOING THE WORK ALT ORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND ROW ISZ7.
FOR INSPECTION
8,11 dina Oft�al or Inalho, Dop.ty� and Foa% one paid. and
_.ird Is a,k—odged Inapt- pmkliol,
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(4,25)
OFFICIALS DATE
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QAANTIO'N
771 -0220 '
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,
-
p'&, Y DATE
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING
Off 1333
OR STRUCTURE UNTIL
INSPECTION MADE
771-0221
A FINAL HAS BEEN AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
ORIGINAL -FILE Y
PINK - OWNER GOLD - ASSESSOB
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SCALE: 1 20'
Jul Isgs
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IKFERVIOUS SURFAa
PRONSED BUILDING P�
EXISTING BUILDING P�
EXISTING GARAGE:
EX ST NG GRAVEL ORD
TOTAL
�IEIGHT CALM
A=-97.00
B=-95.B7
C--+97.96
Oz-95.92
AVE GRADE=96.S9'
ACTUAL= 120.93'
MAXIMUIAm 121.69*
LOT COVERAGE
3920 SO FT P61r
T
LOT AREA
11,340 SO FT
TAX ACCOUT PARM
LNA PT -100'
S. S. COVER
GARY HAAKENSON
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CITY OF EDMONDS MAYOR
5TH AVENUS NORTH EDMONDS, WA 98020 (425) 771�= FAX (425) 771-Mi
Website: ~dedmondsmams
DEVELOPMENT SERVICES DEPARTMENT
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Planning Building Engineering
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January 17,2003
Heidi Medina
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Associate Broker
Inc.
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Windermere Real Estate/HKW,
19031 33d Avenue W, Suite 200
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Lynnwood, WA 98036
Re: Promissory Note
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Dear Ms. Medina:
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I am writing you regarding a promissory note retained by the City of Edmonds in the
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amount of $4,000.00. This note was offered as security for completion of driveway
improvements to die property at 8821 Main Street in Edmonds, WA.
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The driveway improvements have been inspected and approved by the City of Edmonds
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Engineering Department. We no longer require the promissory note. Please find the
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promi ssory note in the amount of$4,000.00 enclosed. Thankyou.
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Please call me at 425-771-0220 ifyou have any questions.
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Sincerely,
Jeannine Graf
Building Official
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Enclosure
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Cc: File
incorporated August 11, 1890
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CITY OF EDMONDS GARY HAAKENSON
MAYOR
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning Building Engineering
November 6, 2002
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Heidi Medina
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Associate Broker
Windermere Real Estate/HKW, Inc.
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19031 33d Avenue W, Suite 200
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Lynnwood, WA 98036
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RE: Promissory Note
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Dear Ms. Medina:
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I am writing you regarding a promissory note retained by the City ofEdmonds in the
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amount of$4,000.00. T'his note was offered as security for completion of driveway
improvements
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to the property at 8821 Main Street in Edmonds, WA.
The driveway improvements have been inspected and approved by the City of Edmonds
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n eenng epartment. a would like to surrender this promissory note to you.
Please visit the Department of Community Development at 121 5th Avenue N. Edmond S.
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We are on the second floor of City Hall.
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We would like to personally surrender the promissory note to you. Thank you. Please
call me if you have any questions 425-771-0220.
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Sincerely,
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Jeannine Graf
Building Official
Cc: File
Chron
Incorporated August 11, 1890
Sister City - Hekinan, Japan
GARY HAAKENSON
CITY OF EDMONDS MAYOR
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F 1 1-0221
121 STH AVENUE NORTH EDMONDS, WA 96020 (425) 771-0220 AX (425 77
Website: —Ledmonds,wa.us
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DEVELOPMENT SERVICES DEPARTMENT
C)'Z' Planning Building - Engineering
September 27, 2002
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Heidi Medina
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Associate Broker
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Windermere Real Estate/HKW, Inc.
19031 33d Avenue W, Suite 200
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Lynnwood, WA 98036
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RE: Promissory Note
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Dear Ms. Medina:
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I am writing you regarding a promissory note retained by the City ofEdmonds in the
$4,000.00. This was offered as security for completion of driveway
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amount of note
improvernents to the property at 8821 Main Street in Edmonds, WA.
The driveway improvernents have been inspected and approved by the City of Edmonds
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Engineering Department. We would like to surrender this promissory note to YOU.
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Please visit the Department of Community Develo pment at 121 5"' Avenue N, Edmonds.
We are on the second floor of City Hall.
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We would like to personally surrender the promissory note to you. Thank you.
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Sincerely,
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Jeannine Graf
Buildin- Official
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Cc: File
Chron
Incorporated August 11, 1890
Sister City - Hekinan, Japan
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Nick and Beth Brett
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7916 196 PL SW
Edmonds, WA 98026
May 6, 2002 3 U 1 0 1 N 6
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MAY 6 2002
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Ms. Jeannine L. Graf
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Building Official C.B.O.
City of Edmonds
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Development Services Department
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Building Division
121 5�' Avenue North
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Edmonds, WA 98020
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Dear Ms. Graf:
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I would like to thank you for working with us to resolve the seemingly many
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issues surrounding our desire to purchase the house at 8821 Main Street.
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As I understand it, when all of the work and inspections that are currently being
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completed are in fact finalized, there will still be left as unresolved the recent
correction notice regarding the width of the driveway.
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Reworking the driveway is a great concern to us, and will certainly be one of the
first things we do as new homeowners. We would like to have the opportunity to.
actually develop a comprehensive plan for the driveway and area in front of the
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house and would hope to take advantage of some better summer weather before
contracting that work.
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We would request that the City of Edmonds grant us until September 30, 2002 to
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have the driveway worked completed and re -inspected.
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Please know that we sincerely appreciate all of your efforts on our behalf. We
will do our part to get this matter resolved as well.
Sin gerely,
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Beth Braft
Exhibit a To Promissory Note
This Note is offered as security for completion of driveway improvements to the property at
N.
8821 Main Street in Edmonds WA. These improvements consist of construction or modifica-
tion to the existing driveway to bring it to Code requirement of 12 feet in Width for 20 feet in
length of concrete, asphalt or other City approved surface.
Work and City re -inspection must be completed prior to Sept 30th 2002 Upon completion
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and approval by the city of Edmonds Engineering Dept this Note shall be voided in full. In the
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event this work is not completed and approved by City of Edmonds Enginee ngthisnote
shall be due and payable in full.
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERN1177 COORDINATOR, BUILDING DIVISION
FROM: ME DEPARTMENT DATE —
ENGINEERING DIVISION DATE
WOW
PLANNING DIVISION DATE —
SITE ADDRES
PERMIT# AD]3#___----PATE INSPECTED —1-1J1
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine fWal compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFOBMMCE B2NDS and the granting of:
---�-GRANT FINAL PROJECT APPROVAL
GRAM PROJECT APPROVAL WITH CONDITIONS N01M
a Copy of CONDITIONS given to owner/contractorby inspector
FAILED FINAL INSPECTION OUTSTANDING ISSUES
ti Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date_ Si
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ............
FOUNDATION:
Footing ......................
Wall ....... . .................
Pier/Porch .................
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Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
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Rough�ln ..........
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Commerclat Final
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HEATING:
GasTest ................
10
Gas Piping
Equipment
Commercial Final
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EXTERIOR SHEATHING
NAILING .................
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FRAMING ..............
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FIRST FLOOR FRAMING
INSULATION ...................
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Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
hill
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ...........