20030260.pdfI
DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
MAILING ADDRESS
21121 77 P1 W #2
CITY ZIP ELEPHONE
Edmonds 98026 M-918-1341
NAME
ADDRESS
CITY
ZIP ITELEPHONE
LERMIT EXPIRES MIZ
P
USE PERMIT
ZONE NUMBER
JOB SUITE/APT#
ADDRESS 21121 77 P1 W 2
LOT NO. LID NO.
PLAT NAME/SUBDIVISION N6�_t LID FEE$
- - I 16.11=01=-Recl-d
FLOPF"tt— Sid.21k J(Zmd
e .9"00. RIREQUIRED 3
08T" YEPS I NO 13 z
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
NAME CB
Fas:L Water Heater
ENGINEER] WEV El B
fe;s.
the water:W::Atem
CC
0
ADDRESS
.6
of whether
MR20SIOD
12601 132 Ave NE
open 0; 4WAdFwa
ed on all hot water tanks p&TE
CITY ZIP TELEPHONE
0
Kirkland 98034 1425-814-3124
a
ECDC 19-3 .020 (c)
VARIANC15i 7CU No
STATE LICENSE NUMBER EXPIRATION DATE REO'D POSTED
13YEs ONO IS
FASTWHC052DF 2-16-05
SEPA REVIEW
t1dual 101m EA V HEIGHT
9
PROPERTY TAX ACCOUNT PARCEL NO.
COMPLETE EXEMPTA
9wn PROPOSED
I
00835874700200
E XP S
I
BE ;rs NT
EW :UMBlNGCE ECH
N RESIDENTIAL rX] (!L
LOT COVERAGA-UNk AW
ALLOWED PROPOSED
10 BACKS (FT)
FRONT SIDE REA IDE REAR
C A
ADDITION COMMERCIAL C ANCE OR
CHANGE OF USE
z
0
PARKING LOT AREA PLANNING REVIEWED BY DATE
REO'D PROVIDED
REMODEL MULTIFAMILY siGN
I I
GRADING [:] FENCE
REPAIR 13 CYDS ( X FT)
REMARKS
DEMOLISH 0 TANK [:] OTHER
0 GARAGE RETAINING WALL 0 FIRE SPRINKLER
FIREALARM
CARPORT ROCKERY
(TYPE OF USE, BUSINESS OR A EXP IN:
i2
CHECKED By Typfgf
OCCUPAIS17Z�
I
JCPV�)
r GRO Up
NUMBER NUMBER OF CRITICAL
OF DWELLING AREAS
�2_ 1 Kfk—
0j;r _U
SPECIAL INSPECTION OCCUPANT
LOAD
STORIES UNITS NUMBER
JAREA
REQUIRED 13 YES
DESCRIBE WORK TO BE DONE
T?LMMONTPIreplace gas, W;;j-P_r hP-,qi-Pr
REMARK
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REG'D.
9
ciagage on stand 40.000 btu's
VALUATION
$
Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE —F—GLAZING % LOT SLOPE %
Building Permit
City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
*1 dr%
Mechanical
THIS PERMIT AUTHORLIES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I= BE DONE ON PRIVATE PROPERTV ONLY. ANY CONSTRUCTION ON THE PUBUC
Grading
2 DOMAIN (CURRS, SIDEWAILKS. DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
3
SEPARATE PERMISSION.
t:
Engr. Review
PERMITAPPIUICATION: ISO DAYS
PERMIT UMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICAK 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
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapelnsp.
Total Amt. Due
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITY$ ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
I
Recording Fee
Receipt
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This application is not a permit until signed by the
TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
Building 01ficial or his/her Deputy: and Foos are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
receipt Is acknowledged In space provided.
WORKMEN'S COMPENSAT19M:t4
,,kURANCE AND RCW 18.27.
OFFICIALS SIGN E 4ATE
SIGNATURE (OW DATE SI
(425)
01
'd 04 13
A
771-0220
DATE
d�JNED
RELEASED BY
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
z
0
d
0
M
Ar
CITY OF EDMONDS
121 5TH AVENUE NORTH 9 EDMONDS, WA 98= e (425) 771-02M e FAX (425) 771-Ml
WeWe-. www.d.edmondsma-us
DEVELOPMENT SERVICES DEPARTMENT
C. r1anning * Building 0 r-nginee"ng
November 6, 2003
Attn: Jackie Mabry
21121 77th PL W #2
Edmonds, WA 98036
Re: Building Permit: 2003-0260
Site Address: 21121 77th PL W
Expiration Date: 10/10/03
A
Dear Jackie Mabry:
According to City of Edmonds Building Division records, the above referenced building
final inspections. Final
permit expired on 10/10/03 without obtaining the required
inspections are required pursuant to Uniform Building Code Sectio n 108. Since the
permit has expired you must call for and pass a final inspection by November 20, 2003.
If City records are incorrect and the job card indicates final inspection approval, please
provide a copy of the job card for City Records. N your records concur that no final
inspections have been granted, you must call for final inspection within 10 business
days from the date of this letter. Failure to respond shall result in this matter being
turned over to Code Enforcement for resolution and possible legal action.
N you have any questions please feel fi-ee to call our offices at 425 -771-0220.
Sincerely,
or,
Peffrinhit oo or
L\T=P\DsT,sV&sw Leum\Expred Pumtdoc 7/01
0 Incorporated August 11, 1890
I;iqtpr r3h# - HpkinAn Janan
CITY OF EDMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5th Avenue North, Edmonds, WA 98020
(425) 771-0220
Location of Violation (Address and Tax Account Parcel N
Issued To: Jacki
Address Of Person This Order Is Issued To: 21121 77th Place West, Edmonds, WA 98026
Code Section
Description of Violation: Installation of a gas water heater without inspection gpDroval.
Corrective Action Required:,
Correction is Required no later
If correction is not made by the date and time specifled 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: Date Mailed: November 25, 2003 — Date Served
Issuing Party_ Jeannine L. Graf Title Building Official
Signature
-ff'1 -E-%
CITY OF rijiMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5th Avenue North, Ednionds, WA 98020
(425) 771-0220
SECOND NOTICE
tiRRECT VIOLATIO'N
ORDE"' To' C'
Location of Violation (Address and Tax Account Parcel N - -st. Unit 2
Edmonds, WA 98026 Tax Account P ircel No. 00835874700200
Issued To: Jackie MabM Prop dy 0 vner
Address Of Person This Order Is Issued To: init #2. Edmonds, WA 98026
Code Section Violated:. Uniform Plumbing Code Sections 103.5.
Description of Violation: Inst illation of a gas water eater without ingRection V
gr—oyal.
Corrective Action Required: Q itact the Cily Building ftartment inapection hotline at 425-771-
0220 extension 1333 and schedule for the Muired insve on for the gas water heater installation.
Failure to LeMnd shall result in additional enforcement tion.
Co . rrection is Required no later than: 5:00RM (time) December 31s 2003 (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
$10L.00-Rer day, or portion of a day, during which the violation continues.
Date Mailed: December 15, 2003 SECOND AND FI NOTICE
Issuing Party—jeannine L. Graf Title - Building Official
or
Signature