20040204.pdfDATE RECEIVE
[PERMIT EXPIRES
USE PERMIT
CITY OF EDMONDS 111E NUMBER
CONSTRUCTION PERMIT ArPLICATION JOB 12 -7 A SUITE/APT#
ADDRESS ) '— -�-, / /-- �7
OWNER N�ME/NAME OF BUSINESS Z2 11:12
AbC 0 V. CIMPAN PLAT NAME/SUBDIVISION NO. LOT No. LID NO.
MAILING ADDRESS
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7 TESCP Approved
3. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
0 V5 4,'> A RW Permit Required
Street Use Permit Req'd
CITY ZIP 7 _LEPIIONr EXISTING — PROPOSED Inspection Required ARK,
Sidm�alk Required E3
REQUIRED DEDICATION FT Underground
s Wiringroquirod E3
NAME METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROODRAINAGE 5
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NAME CBL a
ENGINEERING REVIEWED BY DATE
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FIRE REVIEWED BY DATE
CITY ZIP TEI EP14ONE
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STATE LICENSE NUMBER EXPIRATION DArE CHECKED BY VARIANCE OR CU SHORELINE OR ADBI INSPECTION BOND
REO POSTED
SEPA REVIEW SIGN AREA EIYES��NO $ HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED PROPOSED
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E] NEW )3�kESIDENTIAL 1:1 PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT)
ALLOWE D PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR
El ADDITION COMMERCIAL E:i COMPLIANCE OR .................. . z
CHANGE OF USE z
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PARKING LOT AREA PLANNING REVIEWED BY DATEr
El REMODEL 11 MULTIFAMILY SIGN REOD ED
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DEMOLISH 13 TANK
GARAGE RETAINING WALL FIRE SPRINKLER ',-D Q 1-4 '-V-(
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(TYPE OF USE, BWINESS OR ACTIVITY) EXPLAIN: r rs C:i4-74 G ax'4 Di -
CHECKEDBY I TYPE OF CONSTRUCTION CODE OCCUPANT
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Lu NUMBER NUMBER OF CRITICAL 4/2 —
a OF DWELLING AREAS P,1 SPECIAL INSPECTION AREA OCCUPANT
M UNITS NUM84"/3 REQUIRED [:]
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DESCRIBE WORK TO BE DONE YES
REMARKS
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PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
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VALUATION
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Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge
PLAN CHECK NO- VESTED DATE Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
Engr. Review
LU PERMIT APPLICATION: 180 DAYS
CL PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
I SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESOHS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND Hot D HARMLESS f I IF Cl IY OF
M EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENrS FROM ANY AND Fire Inspection
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECI 'Y Receipt I
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF 1HIS PERMIr SHALL Not [IF
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp.
Total Amt. Due
0 NOR LIMIT IN ANY WAY I HE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION - — I
X1 Recording Fee Receipt # 00'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMA71ON
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC Ito application isAol a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Build I Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING 10 FOR INSPECTION r#ridgecl in spaef provided,
WORKMEN'S
,�ENSATION INSURANCE AND RCW IB.27.
IN V'OLAT 0'
WORKMEN�S I
TU / ( I OFF71A`Ls SIGNAT I E E
SIGNAT DATE SIGNED If% a-
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a� 771-0220 FASED BY
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A41ON 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-
6RIGINAL-FILE - YELL N-IN—*
0 SPECTO
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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GARY HAAKENSON
CITY OF EDMONDS MAYOR
121 5TH AVENUE NORTH EDMONDS, WA 98020 (425) 771-0220 FAX (425) 771-0221
Website: www.dedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning Building Engineering
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March 15, 2004
Nicu Cimpan
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17915 73 Avenue W
Edmonds, WA 98026
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Re: Building Permit Application: 03-386
Site Address: 17915 73d Avenue W
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Expiration Date: March 3, 2004
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Dear Mr. Cimpan:
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The purpose of this letter is to inform you that the above referenced permit application
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will expire on March 3, 2004. According to Edmonds Co mmunity Development Code
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Chapter 19.00.01 OD, applications are only valid for a period of 180 days unless a written
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request for extension is submitted to the Building Official. If an application extension is
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granted it may only be extended for an additional 180 days for a total period of one year.
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If you need an extension on the subject perm. it application you must submit a request in
writing to the Building Official prior to plan review expiration.
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Please be advised, once the permit application expires, the application materials and plans
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will be destroyed within ten working days. Also, if the project is pursued in the future a
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new pe nnit application and new fees will be required.
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If you have any questions, please feel free to call our offices at 425-771-0220.
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Sincerely,
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Permit Coordinator
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Cc: File
L\Temp\DST's\Mastcr Letters\App Due to expire 10/2 1 /00
Incorporated August 11, 1890
Sister City - Hekinan, Japan
GARY HAAKENSON
CITY OF EDMONDS MAYOR
—1 121 5TH AVENUE NORTH EDMONDS, WA 98020 (425) 771-0220 FAX (425) 771-0221
Website: wwwxLedmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
Planning Building Engineering
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December 29, 2003
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Nicu Cimpan
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17915 73d Avenue W
Edmonds, WA 98026
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RE: Plan Check #03..
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Dear Mr. Cimpan:
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Please respond to the enclosed comments from Kathleen Taylor dated September 15,
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2003 regarding your building application. The City cannot continue to process your
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application until you fully respon d to all of the noted items.
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Sincerely;
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Permit Coord tor
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L\Temp\DST's\M aster Letters0s Respond
Incorporated August 11, 1890
Sister Citv - Hekinan, Javan
AlFence must be located on private property.
?L Or, ou S=a 0 /Q *Property owner responsible for determining
property lines.
ScA-Le Ij 1& 14 B 0 dr-ence shall not enclose or prevent access to any
IP kizc C— L— 4T37- cQCV P—Ty City maintained utilities, 6 imes
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E-ITY COPY
RECEIVED
SEP - 3 2003
DEVELOPMENT Sr-MCSS CTFI,
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FINAL PROJECT APPROVAL FORM
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
TROM: FIRE DEPARTMENT DATE ---
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ENGINEERING DIVISION DATE_4Z_ZZ_L'_-1
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PLANNING DIVISION DATEL_____�
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PROJECT--LL07
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I)EsmmoN OF WORK TO -BE INSPECTED Z_' N
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A fleld inspection was condiieted to determine final comp Hance with approved plans. Final approval
to the release of
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denotes that there are no objections from the above signed Department
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PERM AN. CE BONDS and the granting of
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GRANT FINAL PROJECT APPROVAL
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APP ROVAL WITH CONDITIONS NOTED.
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GRANT PROJECr
Copy of CoNDMONS given to owner/contractor by inspector
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FINAL INSP ECTION - OUTSTANDING ISSUES
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'CORR.ECTION NOTI CE given to owner/contractor by inspector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL.
Date --------------- — Si
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
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Retaining Wall ........... 0
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Slab Insulation .......... M
PLUMBING:
Underground ............. Cn
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Rough -in ................... M 0
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Commercial Final ...... —10
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HEATING: 3: M
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Gas Test .................... r)
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Gas Piping .................
Equ 1pment .................
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Commercial Final .......
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EXTERIOR SHEATHING
NAILING ..........................
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FRAMING ........................ C Cn
FIRST FLOOR FRAMING ... M 0
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INSULATION ...................
Floor Insulation .........
Wall Insulation ........... z
Ceiling Insulation ....... x
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SHEETROCK NAILING ... 0
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SPECIAL INSPECTION ... 0
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .................. Lq -7