20030634.pdfI DATE
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
MAILING ADDRESS
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CITY q0 IZ12_ I ITELEPHONE
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NAME
ADDRESS
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CITY ZIP I TELEPHONE
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NAME
L�J - C OLE
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CITY
ZIP
TELEPHONE
T&O
S70 A -74"71
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STATE LICENSE NUMBER EXPIR ION DATE C E
LIRr-LCA
Q22-2,&F.
PROPERTY TAX ACCOUNT PARCEL NO.
D22 —
NEW
RESIDENTIAL
PLUMBING / MECH
ADDITION
COMMERCIAL
01
COMPLIANCE OR
CHANGE OF USE
REMODEL
13 MULTIFAMILY
SIGN
REPAIR
GRADING
1:1 CYDS
FENCE X FT)
(
DEMOLISH
TANK
OTHER
oGARAGE
CARPORT
RETAINING WALL
ROCKERY
0 FIRE SPRINKLER
FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTWITY) EXPLAIN:
M C-E�
NUM13ER
CRITICAL
OF
STORIES '5
*56"U
NMFW -V
AREAS
I NUMBER
DESCRIBE WORK TO BE DONE
HEAT SOURCE GLAZING % LOT SLOPE %
PLAN CHECK NO: �7 VESTED DATE
Lz:i�: , L22
THIS PERMIT AUTHORUES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: ISO DAYS
PERMIT UMM I YEAR - PROVIDED WORK 15 STARTED WITHIN 160 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT; ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
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-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
SIGNATURE (OWNER OqkGxNA DATE SIGNED
I I Min A N-b^ I (b - 1-1 - 0 :;,>
5 L-1 .4( /
PERMIT EXPIRES
USE PERMIT
ZONE /zv 0 2,-)
NUMBER
JOB IS20— '2 SUITE/APT#
ADDRESS Le
L2 KA __A 9:)Q 2 L o
PLAT NAME/SUBDIVISION NO.
A LOT NO. LID NO.
LID FEE S
TESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required
Street Use Permit Req'd
EXISTING - PROPOSED inspection Required
Sidewalk Required
REQUIRED DEDICATION- FT I Underoround
no required
METER SIZE LINE SIZE NO.OF PRV REQUIRED
f!T ES C3 NO 13
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
REVIEWED BY DATE
FIRE REVIEWED BY DATE
VARIANCE On CU RELINE OR ADB# I INSPECTION I BOND
REO'D POSTED
13YEs 13NO S
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE . EXEMPT I ALLOWED . PROPOSED I At I OWED - PROPOSED
LOT COVERAGE REQUIRED SETBACKS (FT1 PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR
PARKING LOT AREA I P NNING REVIEWED BY DATE
REQ`D I PROVIDED
REMARKS
CHECKED BY I TYPE OF CONSTRUCTION CODE OCCUPANT
GROUP
--;PPPN9, Q7
SPECIAL INSPECTION JARE . A OCCUPANT
REQUIRED 13 LOAD
PER UBC 1013/FINAL INSPECTION REO'D
$ - --- - - -1
Description
FEE
DescriptIon
FEE
Plan Check
/00—
state surcharge
Building Permit
City Surcharge
/57—
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
Landscapelnsp.
Total Amt. Due
Recording Fee
Receipt #
CALL
FOR INSPECTION
IA'35)
'k-W96
771-0220
EXT 1333
APPLICATION APPROVAL
This application Is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid. and
receipt Is acknowledged In space provided.
IGNAT 1. DATE
-Ai
ELEASED BY DrE/
)JAA 4�
IT IS UNLAWFUL TO USE oKOCCUPY A BUILDING OR STRUCTURE UNTIL 44,`-1!?-= )- \---- c-'41 '4:
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIG AL - LE YELLOW /INSP16TC
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 P]Nft�NIEFI GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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CITY OF EDMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5th Avenue North, Edmonds, WA 98020
(425) 771-0220
T" CORRECT VIOLATIOIN
Location of Violation (Address and Tax Account Parcel NO): Stevens Medical Office Building at
7320 216'h-Street South*est. Edmonds, WA 98026 Tax Account Parcel No. 0058007-000-029-0100
Issued To: Mr. John Walker, Teutsch Partners, LLC
Address Of Person This Order Is Issued To: 2001 Western Ave, Suite 330, Seattle, WA 98121
Code Section Violated: 1997 edition of the Uniform Building Code, Section 1003.3.3.10 Special
Egress control devices.
2003-0634) to
Description of Violation: On 8/19/03 the building owner obtained building Remlit
install §pecial eUess ontrol-devices on the second floor atrium door #204A. On October 22, 2003 the
ired corrections on this door and
Cfty Building hWector Berformed an ingpection andfound three Mgu:
also noted that the atrium pharmacy door was held open by a door block. The building owner was gLyen
until October 31, 2003 to correct door 204A. re ove the pharmacy door block and recall for iWection.
As of this date the Cily has not been Lquested to re-iWect.
Corrective Action Required: 1) Make all Mguired corrections as noted in the attached c9Z of -the
correction notice dated 10/22/03 to door 204A. and 2) Remove the pharmga door block and ensure that
ui ed
this door is no longer illegally held=gpen, and 3) Call the Cily Building !Mector for the Mg r
-771-0220 x1333) for these corrections.
ingpection (425
Correction is Required no later than:' 5:00nm me) November 18, 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
continues.
$100.00 per day, or portion of a day, during which the violation
Date Posted: Date Mailed: November 4. 2003 Date Served
Issuing Party — JeannineL. G—raf Title Building Official
Signature
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