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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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REMARKS ar
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL,.—
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THIS PETIMIT AUTHORIZES ONLY THE WO K NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
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Grading
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:3 OMAIN (CURBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERM;SSION.
Review
Engr. Review
RE MITAPPLICATION: ISO DAYS
PERMIT LIMM I YEAR -PROVIDE WORK IS STARTED WITHIN 180DAYS
Inspection
Engr. Inspection
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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'APPLIC NT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
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Fire Review
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Plan Clik, Deposit
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IN INT2REST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
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EDMONDS. WASHINGTON. S OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
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Fire Inspection
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Receipt #
ALL CLAIMS FO DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE I SUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT HE
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REOUMEMENT OF ANY CITY ORDINANCE
Landscapoinsp.
Total Amt. Due
NOR LIMIT IN ANY WAY THE CITYB ABILITY TO ENFORCE ANY ORDINANCE PROVISION
Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT � HAY READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION
APPROVAL
GIVEN IS COHRECr. AND THAT AM THE OWNER, OR THE DULY AUTHORIZE AGENT OF
THE OWNER. I AGREE TO MPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
CALL
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TION; AND IN DOING THE ORK AUTHORIZED 1HEREITY. NO PERSON WILL BE EMPLOYED
IN LAT 01 THE LA508 CODE 01 Till STATE OF WASHINGTON HILATM. To
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FOR INSPECTION
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ding Offielal 011,1111,11 apasy: and fees are paid, and
Alp. 8 COMPENSATION, INS RANCE AND RCW 18 27�
DATE
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771-0220
DAVE
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EXT 1333
OR OCCUPY A Bill' DING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
'OR GV(AL - F�E - YELl,& - INS4CTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
P� -Son
04/02 PRESS HARD -YOU ARE
MAKING 5 COPIES GREEN - ACCOUNTING
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GARY HAAKENSON
CITY OF EDMONDS MAYOR
1215THAVENUE NORTH - EDMONDS,WA9502D - (425) 771-0220 FAX (425) 771-OM
Website: �.ci.edrnondSm..U$
DEVELOPMENT SERVICES DEPARTMENT
Planning Building Engineering
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February 5, 2004
Seattle Baytist Church
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7620 242- St SW
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Edmonds, WA 98026
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RE: Permit #2003-0263 & #2003-0857 - 76:20 242 lagineffig�
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The City of Edmonds, Engineering Division, has not yet given final project approval for
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the installation of the backflow preventor and vault or the barrier free parking at 7620
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242 nd ST SW. The following items need to be completed prior to final Engineering
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approval.
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1. A remote read meter is required to be installed at the vault.
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2. Parking stall striping must be installed per City of Edmonds standards. (Inspection has
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not been done to verify compliance)
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Please ensure the items noted above are complete and then call to reque st an Engineering
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final inspection at 425-771-0220, ext 1326. An inspection request sha 11 be made prior to
�nfbrcement action. Please feel ft. ee to contact me with
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February 20, 2004 to prevent code
any questions you may have regarding the parking stall striping at 771-0220, ext 1338. For
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to the remote read meter you may contact Scott Highland, Water Lead
questions related
Worker, at 425-771-0235.
Sincerely,
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Jeanie McConnell
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Engineering Technician
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c: Permit file #2003-0263
Permit file #2003-0857
Scott Highland
Er?- "AL PROJECT APPROVAI �17 OR M
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FROM: FIRE DEPARTMENT DATE-- 2 -5.Lo 3
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE—
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DESCRIPTION OF WORK TO BE INSPECTED—Ctt��Crr�-L-4i
A field Inspection was conducted to determine final compliance with approved plans. Fbal approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE B and the granting of
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL VMH CONDITIONS NOTED
o Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
&3 Copy of CORRECTION NOTICE given to owner/contractorby inspector
2.
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RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date. Sign_
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a Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
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RE-INSpECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
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Date Signature
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