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PERMIT EXPIRES 14&4�2
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CITY OF EDMONDS
PERMIT
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ARKS
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ENGINEERING
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STATE UCENSE NUMBER EXPI9
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RE"D POSTED
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LOT COVERAGE REQUIRED SETBACKS (Fr) PROPOSED SETBACKS (FT)
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VESTED DATE
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PLAN CHECK NO,
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DOME ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIJ C
Grading
Recording Foe
n TC.) WILL REQUIRE
OMAIN (CURBS. SIDEWAIJUI, DRIVEWAYS, MARQUEES, F
SEPARATE PERMISSION,
Engr, Review
City Surcharge
PCFMITAPPUCATI M: 180DAYS
PERMIT MMIr. I YEAR - PROVIDED WORK IS STARTED WITHIN IN DAYS
EngL Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-PLICANT, ON BEHALF OF HIS 01 HEN SPOUSE. 11111S, ASSIGNI AND IUCCESOAS
Traffic Mitigation
post
IN INTEIIEST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS 7111 CITY OF
AND AGENTS FROM ANY AND
Fire Review
I Receipt#
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOtEES,
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
_rT.1.1A..Lint
F OM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT 8'
Fire Inspection
9 D GVED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
N LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
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IHEREDY ACKNOWLEDGE THAT I HAVE R. THIS APPIIGATJON� THAT THE INFORMATION
-
APPLICATION
— ROVAL
APPF
GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I ACRE TO COMPU WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
Tib-ppi c.b.. 1. p.,.j,I NUArd by III.
TION; AND IN DOING C E WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
ft, 1,10.1 O.ply. and p.10. �rd
,ipj is a,I,m.I,dg,d h spac. P-1d.d.
WORKMENS COMPENSA)TON INSURANCE �ktlt) RCW 18,9,
DATE
R AGE
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E SIGNED
(425)
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13, V
77 1-0220
RELEASED BY DAIS
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EXT 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL � FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNER - GOLD . ASSESSOR
10101
SITE PLAN
FENCE
Tax Account Parcel #:
00491100000902
85'
+45
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LOT COVERAGE:
1,188 SQ. FT,
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+35
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LOT AREA:
11,475SQ.FT.
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MY
RECEIVED
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STREET
DEPT.
CITY OF EDMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5th Avenue North, Edmonds, WA 98020
(425)771 -0220
�:."`RDERTO CORRECT VIOLATION,
24130
A.."of Violation (Address and Tax Account Parcel No). 76"' Avenue West, Edmon&,
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WA 98 1 026 Tax AccomtParcel No. 00-4911-00-009-02
Issued To: Genuadly Kuinhvili, Prol2erty Owner.
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Add ess Of Person This Order Is'lssued To: 9107 9" Avenue.SE, Everett, WA 98208
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Code Section Violated-.; Tjnif�rin Mldiu� Code Sections iO6 and 108, Edmonds Communit
Develo�rnefti Q66:26.1 I O�' �T�
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i'iDescript , ion of Violation: Demolition permit #2002-0361 was issued for dernolition of q house zin
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The.wo is not satis torily courolefe, utilities and debris remain which constitute a public:
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nuisaneg.
Corrective Action Required: 1) Expose the side sewer cap at the ijropg�fty line and contact the Ci
J Engirteefirig Inspector for inspection (425-171-0220 extension.1326). and 2) Rem ve all debris, K4rbage
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and appliances from site and. diWose at an apRroved dump site, and 3) All utilities mu be pKqpLerly
dikonne6ted (water may remain provided an AVI3 is installed at the spigot).
Correction is Required no later than: 5:oopm (time)__L November 7 2002 (date)
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If is not, made by the date and time specified in the Order, a Notice of
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correction
Civil Violation shall be issued. The Notice of Civil Violation shall assess fines 6. f
$100.00 ver dav, or portion of a day, during which the violation continues.
Date Posted: ----- Date Mailed: October 24, 2002 Date Served
Is I suing Party Jeannine L Graf Title Building Official
Sigfiature 4*M2��
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CITY OF EDMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5th Avenue North, Edmonds, WA 98020
(425) 771-0220
ORDER TO CORRECT VIOLATION
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Location of Violation (Address and/or description of locatio 24130 76h Avenue West, Edmonds,
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WA 98026 jax Account Parcel No. 004911-000-009-02
Issued To: Gennadly Kutashvili, Pro erjy Owner.
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Address Of Person This Order Is Issued To: 9107 9th Avenue SE, Everett, WA 98208
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Code Section Violated:. Uniform Bui ding Code Section 108
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Description of Vielatipw Final inspection required on demolition of sttuctures.
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Corrective Action Required: The pmerty owner obtained a demolition permit to demolish a single
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family residence and cuport. Upon final.inspection by the City Building inspector it.was noted that the
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pnReE!y owner failed to obtain a Puget Sound Air Quality (PSAQ) Asbestos.PerTnit. Therefore, the Ci
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is unable to., grant final project WXLoval. The.. corrective action. reg d is to obtain the require
Asbestos Pemfit and submit documentation from PSAO that no violations exist on site.
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Correction is Required no later than: 5:00om _(ti-e)__ October 18, 2002 (date)
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If correction is not made by the date and time specified in the Order, a Notice of
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Civil Violation shall be issued. The Notice of Civil Violation shall assess fines of
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E100.00 per day� or portion of a day, during which the violation continues.
-tember25,2002 DateServed—
Date Posted: Not Avylicable Date Mailed:. Sep
Is-suing Party-Jearmine L. Graf Title: Building Official
Signatu'. 44W
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Agency %,as5 INU. MiEl'SIJUND CLEAN AIR AGENCY Date Received
110 Union Streak Suite 500
.... Searle, WA 98101-2038 RECEIVED
2002012 www.pscleanair.org OCT 0 8 200z
79 N OF INTENT euG
A. Project Type: 11. ( .3 Asbestos 2. 0 Asbestos Rem 3. (3 Demelliticul. No Asbestos Recatlytill
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PropertyOwner: &"Adad'v— [Phone: ZI.R.37 R949-
lLfE ciz lr-;-Iw& I State ivw Zi :Wwa'?
C. Asbestos
Contractor: 16),//
Owne EO: f4#&oW"14E dAeleovq;
Maiiiing Address: .3 73Z Ave .6!,6
Phone:Q.1S--.30.3—,T`Q!7t[�J.
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on
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S-17q,9_1
CiLr Eve at
Zip: '94? 491
Fax:
D. Site
--A:ddr.. 4#eO
Sile
Manage. Local Phone:
E. 0 Asbestos Survey or No. of Date Asbestos Su5Ley led?
I _ _ _ _ I Was Friable Asbestos identill yes 7WO
C) Mat I Presumed
Structures: was Conducted:
Was Noriffiable Asbestos Identified? Wes UNo
Attach a copy ofthe survey, iflaoriftiable asbestos is
identified or ifno asbestos is identified on survey.
is requir-aTeTpre all dam # n P eca
AHERA Building Inspector:
Certification No.:
Dar:
Start
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"Str-uctures.:
I U Training Fire (List Fire Dept)
2: C1 Ordered Demolition (attach co of dj-
Demolition insert dentmittion contractor's mailing address a back I Will nonfriable asbestos be left in place during demo? U tYes fNo
Contractor: i5ma-zaa&I 11yes, list type and city.
G. Asbestos Project
Informadom-
Work Do T W Th F-Sa Su—
Start Date: Completion Date: MXA�
Hours
WMall a —yes
Total Qty. to be Rcmvcd,. Linear Ft. So materials be removed? No
=Ins.
Thermal System Insulation: I U BoilerTumace Due
0111cr.
SurfactsMat'l: I UF6proofing U Paints,, U plst"
Othm,. J*,Vg�
ntpiPe UPda-b—leFlooi
H. AsbestosilDemnatiflon Project Categories.
1. Single -Family Residence:
A. Asbestos Removal Project Only
B. M Demolition Project (with or without asbestos removal project)
*(Asbestos removal can begin upon notification; demolition -must wait l0daWmA
A. Prior Notice
B. 10 Days*
0
Asbestos Demolition
Pro!. Fee SurchaMe
A. $25
B. $50
2. U All Other Demolitimas With No Asbestos Removal Praiect 11 ilt�
sl�ays
S200
3. W a 10 - 259 linear feet or a 48 - 159 square feet ofasbestos (see back 1 -7::�wW
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$150 $50
4. U 260 - 999 linear feet or 160 - 4.999 square iect ofasbestos t-5131" r-
10 DIE
$300 $100
5. U 1.000 - 9.999 linear feet or 5,000 - 49,999 square feet of asbestoll-""j-'�W4
$750 S250 1
6. U > 10,000 linear feet or > 50,000 square feet of asbestos � - - --r P13 -I
S2,00 . 0 -9-1 M00-0-1
7. U —E—rgewy Asbestos Project or U Emergency Demolition Projec;W -
(Single-family Residences are exemot from emergency lacz h—er. property O"m must movide a
Prior Notice
written ernartincynguest)
Twice Project �Fee
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is, to the best army tanowledge, accurate &complete.
luget Sound Clan Air Agency Form No.: 66-160 (Rc�lsed 9102) TS
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CITY OF EDMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5th Avenue North, Edmonds, WA 9800
(425) 771-0220
ORDER TO CORRECT VIOLATION
Location of Violation (Address and/or description of location 24130 76'h Avenue West, Edmonds,
WA 98026 Tax Account Parcel No. 004911-000-009-02
Issued To: Gennadly Kutashvili, Property Owner
Address Of Person This Order Is Issued To: 9107 9", Avenue SE, Everett, WA 98208
Code Section Violated:. Uniforin Building Code Section 108
Description of Violation: Final inspection required on demolition of structures.
Corrective Action Required: Theproverty owner obtained a demolition permit to demolish a sinjzle
family residence and cgMort, Upon final. inspection by the City Building Inspector it was noted that the
pmertv owner failed to obtain a Puget Sound Air Quality (PSAQ) Asbestos Permit. Therefore, the Cit
is unable to grant final project gporoval. The corrective action reguired is to obtain the required
n from PSAO that no violations exist on site.
Correction is Required no later than: 5:00mn _(time) October 18.2002 date)
If correction is not made by the date and time specified in the Order, a Notice of
Civil Violation shall be issued. The Notice of Civil Violation shall assess fines of
$100.00 Per day, or portion of a day, during which the violation continues.
Date Posted: Not Applicable Date Mailed: September 25, 2002 Date Served
Issuing Party: Jeannine L. Graf Title: Building Official
Signature_ 64L#q
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FINAL PROJECT APPROVAL FORM
TO:
DATE: -
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: -FIRE DEPARTMENT DATE-
W ENGINEERING DIVISION DATE_LL"e� 02-
PLANNING DIVISION DATE -
'PROJECT
tL fe
SITEADDRESS 0, Lo . ...... . ........ .
PERMIT #_ADB# DATE INSPECTED . ..... .. . . td2.
DESCRIPTION OF WORK TO BE INSPECTED---C)g" _Q
Afield inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANgE BONDS and the granting of:
__X__�GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
1.
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.,
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date- Sign_
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