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20030699.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS - C 0 (L N �_ 1, 1 1 fi- a R V MAILING ADDRESS yglo -2, 3 c ( T/? T V_ CITY ZIP I TELEPHONE C 1'zC6 5_s� 0,?, t6 NAME ADDRESS [PERMIT EXPIRES USE PERMIT ZONE NUMBER JOB /7 SUITEIAPT# ADDRESS CPI-) f-, PLAT NAME/SUBDIVISION N07 LOT NO. LID NO. LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved RW Permit Required EXISTING - PROPOSED Street Use Permit Req'd InspectJon Required El REQUIRED DEDICATIOIJ.=--- FT Sidewalk Required Underground Wiringroquirod METER SIZE LINE SIZE NO. OF FIXTURES V EQUIRED P V R 43 I YE; NO 13 3; REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE F3 15 CITY ZIP TELEPHONE U tJ �rt KJ I MtY�-Nl I U %A�> 7"&�3 1 16 -Vl jj�� NAME CBL N 6,9 p- fif 9V 7 84 N ENIGINEERING REVIEWED BY DATq ADDRESS 5' 9— n,o (I l"z' 1 0LjAf'r FIRE REVIEWED BY DATE U, CITY ZIP I TeLEPHONE I VARIANCE OR CU SHORELINE OR ADBI I INSPECTION PBOND STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY REO'D OSTED I []YES ONO $ SEPA REVIEW SIGN AREA HEIGHT PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED AM— Fr,— Lf 00 1(96) .2 , , I EXP NEW RESIDENTIAL P PLUMBING / MECH XI LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT UR SIDE REAR ADDITION COMMERCIAL COMPLIANCE OR 0 CHANGEOFUSE PARKING LOT AREA PLANNING REVIEWED BY DATE REMODEL REPAIR DEMOLISH _0 GARAGE CARPORT Lj MULTIFAMILY Lj SIGN GRADING FENCE CYDS ( X FT) TANK OTHER RETAINING WALL F RE SPRINKLER ROCKERY FIRE ALARM REO'D I PROVIDED 1 1 REMARKS _TeV*1 I CA- Q/n 1) cle '446 (TYPE OF USE, BUSINESS OR N: CHECKED BY I TYPE OF V:T.RU 4� OCCUPANT GROUP NUMBER OF STORIES NUMBER'OF DWELLING U CRITICAL AREAS NUMBER M SPECIAL INSPECTION REQUIRED [] YES .. JAREA OCCUPANT LOAD DESCRIBE W093K TO BE DONE I REMARKS 0 PROGRESS INSPECTIONS PER UBC 1 08/171NAL INSPECTION REFQ'�D P-14 (6 67 C,9 rif Vrt. k 7-E D. $10, Description FEE Description FEE Plan Check State Surchargel HaSOURCE 04-5 GLAZING % LOT §LOPE % IVA Building Permit 07n Lk_j city Surcharge �L? .- PLAN CHECK NO: 0 71-11) Lg'7 L/ VESTED DATE Plumbing Ae-'^ Mechanical Du THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC Grading a 3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE 1: SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: ISO DAYS PERMIT UM[r 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 PlanChk.Deposft IN INTEREST, AGREES TO INDEMNIFY� DEFEND AND HOLD HARMLESS THE CITY OF J" 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 CITY ORDINANCE Landscapelnsp. Total Amt. Due DEEMED TO MODIP� WAIVE OR REDUCE ANY REQUIREMENT OF ANY 0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* I x I - Recording Fee Receipt # 7 I HEREBY ACKNOWLEDGE THATI HAVE READ Tija-APKICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS ECT, AND THAT I AM THE rER, OR THE DULY AUTHORIZED AGENT OF THE OWNE�ROPIRAGREE TO COMPU ITY AND STATE LAWS REGULATING CONSTRUC- rCl Y W�HDRaIZED CALL This application is not a permit until signed by the TION; AND 0 DOING THE WOR THEREBY. NO PERSON WILL BE EMPLOYED TH 506`8-qF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION Building official or his/her Deputy: and Fees are paid, and receipt is acknowledged In space provided. �14 OOFP S C M EN!SAP09 ^IN RANCI AND RCW IV7. 'I — OFFIS��NATURE DgE 9/?,( SIGNATOIE (OWNER 01 GE I DATE S19NED, 1425) %7K- �dx - I 771-0220 REL A*AYBY: DATE ATTENTION Off 1333 3- IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIG`iNAJ- FILE YELLO� -/INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK�6WNER GOLD - ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING 0000 z 0 1 0 M I . =P9 rn C rn 0 --to 0 C 4 r, X In M Z 0 -n n ITIM 0 Vi 0 0 Fn C CA M 0 rn 0 Z z z 0 M CORNELIA BRUJBAN ............................. ........ ............. ................................................................................................. ............................................................................. 9810 234th ST SW Edmonds, WA. 98020 Ph #206/533-0316 E-mail address: cbrujban@yahoo.com WCROFI�M TO: CITY OF EDMONDS ATTN: LARA PALMATIER T� I would like to clarify that I am only asking the City of Edmonds for a remodeling -building permit at the above location. In the future I might consider having an Adult Family Home If I will ever decide to go in that direction I will apply for an Adult Family Home permit at that time. If you have any other questions or concerns regarding this matter please contact me at 206/533-0316. Thank you for your consideration. Sincerely, Cornelia Brujban 0 jM, 74 V1. K- C, 0 P: MW ck M: ;k Fill 00 fF propel lu 60� 1A 1001_0 it -STREET FILE Vi P �c FW� �Mmc_ DOW G 19 P, iq 61=- — -ri-o N-c. 'FORM 1A 1oT-_r,-i=z 13ovv': I A L V= A �,_c L LP 49 0 5s- 'is 0 0 0 peep.", pokcvt /A. q8 10 mlo 2-3 Lf,&T--s Ly LVNIF�Z 1vol kJJ $A/ I A dw 10 APPROVED AS NOTED BY ENGINEERING Date: TH V30 taw I M ?5 : I, m . i M c M C.) C', M. m C m Sc F8n' 01 co Z -04 M I Inc. 1891, CITY OF EDMONDS 121 STH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 e FAX (425) 771-0221 Websfte: www.dedmondsma.us DEVELOPMENT SERVICES DEPARTMENT Planning- Building* Engineering October 10, 2003 Attn: Cornelia Brujban 9810 234th St SW Edmonds, WA 98020 -0699 Building Permit: 2003 Site Address: 9810 234th St SW Expiration Date: 9/9/04 Dear Cornelia Bmjban: GARY HAAKENSON MAYOR The purpose of this letter is to inform you that the last remaining inspection on your project is a final inspection(s). The'final inspection(s) determines that there are no outstanding life -safety issues and approval allows the City to close your permit file. The City considers the final inspection to be one of the most important inspections conducted on a project. In order to grant final approval the following must be complete: smoke detectors, house numbers, guardrails, handrails, self -close doors between garage and residence, egress from sleeping rooms, safety glazing, weather-stripping, any Engi;aeering department requirements etc. of course -not all of these things may specifically apply to your project but it does give you an idea about the kinds of things that must be complete as well as some items that do not need to be installed such as: paint, carpet, moldings, wallpaper, etc. Please be advised permits expire one year from the date of issuance. If you will need more time to complete the work, permits can be renewedprior to expiration for one half fees. if the permit expires without a final approval granted by the Building inspector, full fees are required in order to renew the permit. This can be very costly to you and we strongly encourage you to check your permit expiration date and call for the required final inspection(s). Note: If more than one department is required to final your project, this is noted on your Job Card. Please feel free to contact me at 425-771-0220 if you have any questions. Sincerely, Permit Coordinator Incorporated August 11, 1890 Sister Citv - Hekinan. Japan M1 Z; 0, I RECORD OF INSPECTIONS (00) INSPECTOR DATE APPROVED "<_., q - I r-'. 63 SETBACKS ..................... FOUNDAT ION: Footing ...................... Wall.......................... Pier/Porch ................. Retaining Wall ........... Slab Insulation .......... PLUMBING: Underground ............. Rough -in ................... Commercial Final ...... HEATING: GasTest .................... Gas Piping .................. Equipment ................. Commerclal.Flnal EXTERIOR SHEATHING NAILING.......................... FRAMING........................ FIRST FLOOR FRAMING ... INSULATION ................... Floor insulation ...... Wall Insulation ........... Ceiling Insulation SHEETROCK NAILING ... SPECIAL INSPECTION MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. ql.? DATE RECEIVED 0 1dz_1 V PERMIT EXPIRIES USE PERMIT CITY OF EDMONDS ZONE NUMBER JOB UITEM CONSTRUCTION PERMIT APPLICATION ADDRESS cl� /0 ,23v OWNER NAMEINAME OF BUSINESS Q 0 n f'?_' 11 Aj PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. L, K_ f1 t-_ (_ I I"" I/ MAILING ADDRESS 7� T// T S CITY ZIP TELEPHONE j4 6 5- -� I 1E11T'F= ADDRESS CITY ZIP ITELEPHONE LID FEE $ PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TEsup Approved RW Permit Requ!red Street Use P.- t Req'd EXISTING — PROPOSED ..W.. Required 13 REQUIRED DEDICATioA,_--' FT Sidewalk Required 13 Undergrawd wiring required 0 LINE SIZE NO. OF FIXTURES P,,XV REQUIRED 1 ,505 YE NO 13 z REMARKS z z OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I I & in - i) qlv_*Ar-t�� VH2:r-_A. I I VkWMD-20 fAA%tA1Pc\W 2- 0: NAME CBL if 0 /Z 1qf_ L_ 1 614 Al. I N fATY—)iNi6ft 5ffK;P_9 - ENGINEERING REVIEWED BY / DATI� T Mire-LL. q1q'1iW3 ADDRESS k-e /77 Q0j 147c e- g6an FIRE REVIEWED BY DATE Us cc M CITY ZIP TE1EPHONE OR Cu SHORELINE OR ADBI INSPECTIOIN I D STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE I REO'D OYES 13NO PBOOSNTED $ I SEPA REVIEW COMPLETE , EXEMPT EXP SIGN AREA ALLOWED PROPOSED HEIGHT ALLOWED I PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. Lf � CC /06 2 0 L NEW RESIDENTIAL ADDITION COMMERCIAL PLUMBING / M�CH X COMPLIANCE OR CHANGE OF USE LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT LIR SIDE REAR z PARKING REQ`D I PROVIDED LOT AREA I PLANNING REVIEWED BY DATE 06 REMODEL MULTIFAMILY El SIGN REPAIR GRADING CYDS FENCE X FT) REMARKS 1:1 DEMOLISH 0 TANK OTHER X**A 144- /40011) de rc GARAGE 1 RETAINING WALL CARPORT 0 ROCKERY (TYPE OF USE, BUSINESS OR N: 37r F RE SPRINKLER FIREALARM CHECKED BY ITYPE OF VTRUCTI ce/7-- OCCUPANT /7 GROUP a NUMBER OF STORIES mr9UNITS NUMBER bF DWELLING CRITICAL AREAS NUMBER SPECIAL INSPECTION IAFiEA REQUIRED [:] YES OCCUPANT LOAD DESCRIBE WORK TO BE DONE f 8 V E 12- 77i D REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D § i H ;UCE GLAZING % LOT §LpPE % a MA PLAN CHECK NO: 0 VESTED DATE THIS PERMIT AUTHORIZES 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: 180DAYS PERMIT UMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 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 MODIFY, 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 TWSAPPLICATION; THAT THE INFORMATION GIVEN IS COPRECT; AND THAT I AM THE 0 _R OR THE DULY AUTHORIZED AGENT OF _Y M THE OWNERf I AGREE TO COMPI ITY A 6 STATE LAWS REGULATING CONSTRUC- TIC I IN. AND DOIN HE WORK��ORIZED THEREBY, NO PERSON WILL BE EMPLOYED GT L IN VIOLATON OF THE A D SU�q THE STATE OF WASHINGTON RELATING TO )_INS C WORKMEVS COMPEN'W(� �_, C AND RCW 1 V7. SIGNAT JE (OWNER(�O �GE DATE S19NED 114 A 1197( Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge Plumbing rx-.01 Mechanical ic ^ :)u Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due 5v Recording Fee Receipt # CALL FOR INSPECTION (425) 771-0220 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or hisfher Deputy; and Fees are paid, and receipt Is acknowledged In space provided. OFFIPI&L" rURE DRE . . QNA1 f I& Ir4 ) LZ—,) RELrA-SWBY- DATE ATTEN ION `!fW 1 __21 EXT 1333 , T e__?1 IT IS UNLAWFUL TO U9E URP ik&oy Ab60WbA STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- OR ASPECTO P�C ILE . ELLON '��N�)- F - Y' CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 _'�NER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING I k z 9 0 M -11 -n 55 � a M C M 0 0 C: � C M M 10 �i z cn 0 _n n M M 0_0 0 0 Fn Co cm MO X z 0 z 0 4 0 1711