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20030311.pdfI .""`�LRECEIV PERMIT EXPIRES USE PERMIT CITY OF EDMONDS ZONE NUMBER JOB CON 7 STRUCTION PERMIT APPLICATION J LADDRESS OWNER ONAME /NAME OF BUSINESS IP I/ CITY ZIP TELEPHONE NAME ADDRESS CITY ZIP TELEPHONE NAME X &Z m ADDRESS _�e '100 Rot CLLY. IZIP TELEPHONE STATE LICENSE NUMBER NO. I I PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TIESCP Approved AW Permit Required Street Use Permit Req'd EXISTING - PROPOSED Inspection Required Sidewalk Required REQUIRED DEDICATION- FT Underground Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES El NO C3 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE REVIEWED/DATE FIRE REVIEWED BY VARIANCE OR CLI I SHORELINE OR ADB# SEPA REVI SfGN'AMAP ff I&- L.Qzm COMPL T EXP UNK F1111 RFdO A' 1 DATE INSPECTION BOND REO'D POSTED [3 YES I I I HEIGHT VLAOWED . PROPOSED a z re w z z a z us C] NEW RESIDENTIAL 0 PLUMBING / MECH LOT COVERAGE ALLOWED REQUIRED SETBACKS IFT.) _PR'0P(J8ED SETBACKS (FT.) FRONT SIDE REAR FRONT UR SIDE REAR PROPOSED I ADDITION COMMERCIAL o COMPLIANCE OR CHANGE OF USE 1.� I— PARKING LOT ;7NING REVIEWED BY DATE 0 REMODEL C3 SIGN C:] APARTMENT REO'D PROVIDED 0 REPAIR 0 GRADING FENCE CYDS 0 X FT) I REMARKS OTHER DEMOLISH TANK ci GARAGE 0 RETAINING WALL 0 RENEWAL Z CARPORT RC CKERY iE (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: Sales CHECKEDBY ION OCCUPANT ITYPEOFCONSTR JCW� GROUP lu NUMBER NUMBER OF CRITICALC OF DWELLING AREAS 2— 1 SPECIAL INSPECTOR JAREA OCCUPANT REQUIRED LOAD 0 UMB R STORIES UNITS NUM3ER YES DESCRIBE WORK TO BE DONE _] REMARKS z PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 5 _j 09 h K &f7/A Alln. .0 .01, 1151-10) If VALUATION FEE PLAN CHECK FEE HEAT SOURCE GLAZING % LOT SLOPE % BUILDING .000 PLAN CHECK NO: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADING/FILL DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: 160 DAYS WATf�S_URCHARGE PERMIT LIMITl YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REVIEW FEES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 04 rrz A;: 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS -@4l4MPE`CTION FEE IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING X EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY THIS PERMIT SHALL NOT BE RECEIPT FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF PLAN CHECK DEPOSIT DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENTOF ANY CITY ORDINANCE 0 NOR LIMIT IN ANY WAYTHE CITY'S ABILITYTO ENFORCE ANYORDINANCE PROVISION.- RECEIPT I TOTAL AMOUNT DUE 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,A NO STATE LAW"REGULATING CONSTRUC. CALL This application is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZEC 0 ERSON WILL BE EMPLOYED .By, No THERE RELATING To FOR INSPECTION Building 01ficial or his/her Deputy: and Foos are paid, and receipt is acknowledged in space provided. IN VIOLATION OF THE LABqaSg)DE OF THE STATE OF fASHINGTON WORKMEN'S COMPEN 9)FJRA)4�yikN� RCW 18.2;f OFFICIALS SIGNffTURE SIGNA:1 T) (425) Y_102MG F ZI 771-0220 R`ELE_XSEDBY DATY ATTENTION 7 EXT 333 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 5196 4 LETTER OF CERTIFICATION ProTa nk-USA, Inc. Job #21015-1 Ap0129,2003 James Isbell 941121 & St. SW Edmonds, WA 98020 To: James Isbell ifli es we decom missioned one underground residential heating PrdTank-USA, Inc. cerf oil tank located at: 94 11 21e St. SW, Edmon ds, WA on April 30th, 2003- The math od of decommissioning was Pumping the contents, rinsing and capping below grade. Unifon'n Fire code of the State Of Decommissioning was in accordance with the the local fire Marshal's guidelines Washington and of the tank were dispo sed of at Emerald Petro leum Services, Inc. The co ntents located at I M Airport Way South, Seattle, WX n ing was conducted by Mark Horsch. The d ecommissio Sincerely, Mark B. Horsch, President - Certified Decommissioner #1131625-26 International Fire Code Inst itute ProTank-USA, Inc. 15 FINAL PROJEj;,j APPROVAL FORM TO: DATE: I�IEMO I TO: PERNUT COORDINATOR, BUILDING DIVISION z 9 0 m =i::n OM c Ma 0 80 a MM Mz 10--1 CE 0 -n m no a 0 0 M C ca c w M 0 Z X z cn z 0 1 0 m 2. 3. RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL Date Si ocaprvl.doc.l:temp:bldg:formsIO/OI DATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS 194111 CITY ZIP TELEPHONE NAME ADDRESS CITY ZIP TELEPHONE NAME ADDRESS ELEPHONE STATE LICENSE NUMBER EXPIRA�qN _,RAT C ,W PROPEPI�a ACCOUNT PARCEL NO. d12 _v_y j '40F 0 NEW 0 RESIDENTIAL 0 PLUMBING / MECH 0 ADDITION 0 COMMERCIAL o COMPLIANCE OR CHANGE OF USE 0 REMODEL 0 APARTMENT 0 SIGN 0 REPAIR 0 GRADING CYDS 0 FENCE X FT) 0 DEMOLISH TANK 0 OTHER �Z 0 GARAGE 0 RETAINING WALL 0 RENEWAL CARPORT RQQKERY (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: _7__.eL_, 904-- _007g, CRITICAL C Ej!AF RITICAL !S NUMBER LNUMBER OF 'OF 2. NUMBER OF DWELLING AREAS I STORIES STORIES UNITS NUMBER NUMBER DESCRIBE WORK TO BE DONE 9 01 Mid 44-19-1 1 M� .4 f I L USE PERma r ZONE NUMB1ER2n/?3' n,3 JOB S ITE/APT# ADDRESS zfv./ PLAT NAM EISUBDIVI SION NO. LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approred 0 RW Penn Required Permit Req, EXISTING - PROPOSED Inspeclion Required 0 Sidewalk Required 0 REQUIRED DEDICATION- FT U=rground Wiring required 0 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES 13 NO 0 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAUr ENGINEERING FIEVIEWED/DATE z 0 FIRE REVIEWED BY DATE 0 M VARIANCE OR CU SHORELINE OR ADB# INSPECTION': BOND, REO'D POSTED k a A I C3 YES 0 NO rn SEPAREWE COMPLETE Ei MW"' A WAN HEIGHT ALLOWED PROPOSED C EXP At%% rn L ETBACKS (FT.) PROPOSED SETBACKS (Fr.) ALLOWUMOMPOSE'D FRONT SIDE REAR FRONT UR SIDE REAR 0 C M REVIEWED BY DATE PARKING REO'D PROVIDED LOT AREA PLANNING IL �A 0 —REMARKS BY TYP E OF CONSTR TION Cop OCCUPANT CHECKED GROUP MITI j SPECIAL INSPECTOR' OCCUPANT JAREA REQUIRED YES 0 LOAD REMA& PROdRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO 'D V VALUATION FEE z 0 I PLAN CHECK FEE _ ?_ I '1 0 HEAT SOURCE GLAZING % LOT SLOPE % BUILDING M PLAN CHE,9K NO: VESTED DATE PLUMBING MECHANICAL THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 13E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADINGIFILL DOMAIN (CURBS, SIDEWALKS, PMVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. I I §W<SURCHARGE PERMIT APPLICATION: � 16o'bin, PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS ENG. REV ES SEE BACK OF PINK PERMIT FOR MORE INFORMATION 04 APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS .0ZISIPECTION FEE N INTEREST, AGREES TO INDEMNIFY� DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE ALLCLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY RECEIPT FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE PLAN CHECK DEPOSIT DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* RECEIPT TOTAL AMOUNT DUE 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 LAWPEGULATING CONSTRUC- CALL This application is not a permit until signed by the Building oificial or his/her Deputy: and Fees are paid. and 0 TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO fRSON WILL BE EMPLOYED OF THE IN VIoLAxION OF THE DE STATE OffASHINGTON RELATING To ';041* FOR INSPECTION receipt is acknowledged in space provided. WORKMEN'S COMPEN_SAT PCYAND RCW 118�7 OFFICIAL SIGN DAIE 11T RE SIGNATU T (425) 771-0220 M4 4�=� RELEASED By DATjf ATTENTION EXT 333 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 OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR CATE OF