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20030950.pdfDATE CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS GKa" &4 MAILING ADDRESS' 11,20q wznr_116,4� Dr CITY TELI�PHONE c;,\ -2j� T) 4 -?-Z, uj wic� Zip I . q�ow 4 NAME ADDRESS CITY ZIP I TELEPHONE [PERMIT ED(PIRES U S E USE PERMIT -9 Z 0 N E ZONE NUMBER J 0 JOB I A D R E ADDRESS D S C k-C— SUITE/APT# 1) LA T PLAT NAME/SUBDIVISION NO. P 6 LOT NO. LID NO. LID FEE S P UB U C PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved Rw Permit Required Street Use Paffnit Roq*d EXISTIP EXISTING PROPOSED— Inspection Required Sidewalk Required REQUIRED DEDICATION— FT I underground Wiring required METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED T YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE NAME ICBLN W-A-SH T_neaq LA WV 11 -2-7 0 ADDRESS -2z C) CITY ZII;, TELEPHONE STATE LICENSE NUMBER EXPIRATION DATE DJA-S-H J%X=s�-710_13 q �-16!� IC PROPERTY TAX ACCOUNT PARCEL NO. P NEW R." ESIDENTIAL ADDITION COMMERCIAL REMODEL MULTIFAMILY REPAIR GRADING CYDS 0 DEMOLISH 1:1 TANK IGARAGE 3 -1 RETAININGWALL 1:1 PORT ROICKERY (ME OF USE. BUSINESS OR ACTIVITY) EXPLAIN: Rr—P, NUMBER NUMBER OF OF DWELLING STORIES UNITS DESCRIBE WORK TO BE DONE 21FM :_ I reggired (in fuel-boxming applianew is ENGINEE 116fff,&&dr space& UMC 815.1-17IATE FIRE REVIEWED BY DATE cc M VARIANCE OR CU SHORELINE OR ADB# I INSPECTION BOND BY REQ'D POSTED PROPOSED V EXP I ftde Lator & Industries I PLUMBING / MECH COMPLIANCE OR CHANGE OF USE SIGN L&TX.GWSPAQ&— ALLOWED PROPOSED PKIP090 BACKS (FT.) FRONT SIDE REAR FRONT URSIDE REAR z PA KING N DOE DATE REOID I PROVIDQjSOjn1% R' "U54 FENCE x FT) ( _ FT) r%nodnillCo a C0111SPECTOR REMARKS--U------ HOT 0 OTHER S SHALL AF;intag _ F RE SPRINKLER I -RE FIRE ALARM CHECKED BY ITYPE OfjWUqT1 N CQQE - OCCUPANT& CRITICAL I GROUP AREAS SPECIAL INSPECTION JAREA OCCUPANT NUMBER REQUIRED [:] YES LOAD IREMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 46 rhqce� I V A- H& SOUS: I GLAZING % LOT SLOPE % PLAN tHECK NO: VESTED DATE saaaaesas THIS PERMIT AUTHORIZIES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC 2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE 3 SEPARATE PERMISSION. h PERMIT APPLICATION: 1130 DAYS PERMIT LIMM 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 2 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 01 NOR LIMIT IN ANY WAY THE cilys ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - I HERE13Y 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 COMPENSAT29WI"NCE AND RCW 18.27. S�IG�IRE (OW E �A;��/ AV)GNED "W DL AA11 �11 $ Description FEE Plan Check Building Permit Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Fire Inspection Landscapeinsp. Recording Fee This Building 1425) 1 %-We- 1, fj&%j;Vj 'Wo FrI.M. 771-0220 1. . 0: Description State Surcharge City Surcharge Ar--% � - - FEE Plan Chk. Deposit Receipt # Total Amt. Due Receipt # .11CATION APPROVAL ation is not a permit until signed by the it or his/her Deputy: and Fees are paid, and Is acknowledged in space provided. . AVENTION U Off IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- � 7 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 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT 121 5th Avenue North, Edmonds, WA 98020 (425) 771-0220 Location of Violation (Address and Tax Account Parcel No): 21004 Woodlake Drive, Edmonds, WA 98020 Tax Account Parcel No. 00637700000400 Issued To: Washington Energy Services Address Of Person This Order Is Issued To: 2800 Thorndyke Avenue West, Seattle, WA 98199 Code Section Violated:. Unifonn Plumbing Code Section 1204.3.2 Description of Violation: On behalf of the propegy owner Shegy Hamblett, Washington Energy Services obtained a mechanical permit (#2003-0950) to install gas piping and a gas fired furnace. The Cily allowed a gas test affidavit to be submitted in lieu of the reguired gas pressure observation test. As of this date the affidavit has not been submitted. Corrective Action Required: Submit a gas test affidavit for the gas piping work installed at 21004 Woodlake Drive, in Edmonds. Correction is Required no later than: 5:00pm _(time) June 7, 2004 (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 $100.00 per day, or portion of a day, during which the violation continues. Date Posted: Date Mailed: Mgy 25, 2004 Date Served issuing Party Jeannine L. Graf Title Building Official Signature IqP#4-�W 0 fe z W a, r) PECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR OCCUPANCY .................. lift at ltgp&uv% Gw IV are David IoLls D act tellipovary Col"r ity - ilaspectOr for t1le C I nt DPTE R. 0 ff — CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OW ,AER NAME/NANIE OF BUSINESS cskarw 4.Aar"I)M+ MAILING ADDRESS' 2_1C)6q Wbod 16" CITY TEt4PHONE W T) q 7Z Zip !ab NAME ADDRESS CITY ZIP ITELEPHONE -.A— PERMITEXPIR (0 ES seeseee' USE PERMIT ZONE NUMBER JOB ADDRESS SUITEJAPT# DK_ PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. LID FEE III PUBLIC RIGHT OF WAY PER OFFICIAL MEET MAP 7ES RW =08vqeUdired street use ParrrA Room EXISTING — PROPOSED— inspection Fteqtgred Sid&*&* Required REQUIRED DEDICATION— FT u WM9 required METER SIZE LINE F FIXTURES PRV REQUIRED YES 13 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NAME BL# WASH T_ne_�39 sery 11-2-70 ADDRESS -2Z o D �� wy1d � k-a- Ai) e__ 6J CITY ZIP TELEPHONE !��e%44t_ 619 ao(o 2,&2_(-t96C STAM LICENSE NUMBER EXP RATION E I CHECKED BY 3 1 WAS--H lesq--710-13 /6 PROPERTY TAX ACCOUNT PARCEL NO. V I Cob 3-1 -1 0000n Lkyj [3 NEW ESIDENTIAL U M B IN M E PLUMBING I MECH P L G C H 'ADDITION 1:1 COMMERCIAL P L C E 0 COMPLIANCE OR M G E 0 F U SE CHANGE OF USE C REMO DEL TIFAMILY 0 MUL G N SIGN 8 13 REPAIR 0 GRADING CYDS C FE CE F F N E X_F7) E] DEMOLISH 0 TANK E R OTHER [3GARAGE 0 RETAININGWALL 0 FIRE SPRINKLER CARPORT ROCKERY FIRE ALARM (TYPE OF USE, BUSINESS OR ACTIVIM EXPLAIN: NUMBER NUMBER OF CRITICAL OF STORIES DWELLING UNITS AREAS AS NUMBER DESCRIBE WORK TO BE DONE a EN 0 E 0 W, -0 V-"� =24 I WA �Ai m ITSow= GLAZING % LOT SLOPE % a I I - PLAN CHECK NO: I VESTED DATE 7WS PERMIT AUTHORCM8 OMY THE WORK WffED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURSS. SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERmnr APPUCATIOlt 180 DAYS PERMIT UMM I YEAR - PROVIDED WORK 18 STARTED WITHIN 180 DAYS SEF MACK 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 THF-0TWOF EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECT& 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 ANYWAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I HEREBY ACKNOWLEDGE THAT I HAVE READTHIS APPLICATION; THAT THE INFORMATION GIVEN 18 CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CRY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLA)YED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATgWVMMMCE AND RCW 18.27. SIGNFYRE ( �R MNT�l DA3_ 70NED �;� 17L r_-1 '. .7--) 1 -�, / c) onfuel-burning [ spaces. Umt; FIRE REVIEWED BY VARIANCE OR CU DATE us Cr IE BOND POSTED HTGHT ALLOWED PROPOSED LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIRSIDE REAR PARKING*`.' �LGT AREA I PLANNING REVIEWED BY DATE REOD I PROVIDED hAS PA TEST MUST BE CHECKED BY ITYPE Or�N SPECIAL INSPECTION JAREA REQUIRED 0 YE REMARKS PROGRESS INSPECTIONS PER UBC VALUATION $ Description FEE Plan Check Building Permit Plumbing Mechanical aD Grading Engr. Review Engr. Inspection Fire Review Fire Inspectldh' Landscapelnsp. Recording Fee GROUP I OCCUPANT LOAD INSPECTION REqCrD Description State Surcharge City Surcharge 09 A A - Plan Chk. Depo Receipt # Total Amt. Due Receipt # FEE Thlo'boication is not a perrind! until signed by the BWWg OMcW or hK'tw Deputy: and Fees am paid, and rec6lpt is w*nowtodged In space provided. . (Ag t4r�25) 7 -0220 r 71 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES ORIGINAL -FILE YELLOW -'IN!q'PqCTOAk PINK -OWNER GOLD -ASSESSOR' GREEN - ACCOUNTING m! z m M In m M z 0 -n 'n A rm m 0 6, z z 0 0 m