20040340.pdfI
DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
MAILING �ADRFSS
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CITY ZIP TELEPHONE
NAME
ADDRESS
PERMIT EXPIRES
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USF PERMIT
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JOB .I— SUITE/APT#
ADDRESS .Z()L/_ & J'r/ 6�1111c"
PLAT NAMEISUBDIVISION NO. I LOT NO. I LID NO.
LID FEE $
IESCP Approved
RW Pornet Requited
Street tise Permit Raq'd
inspric6an Required
Sidewalk Required
Underground
Winng required
CITY ZIP TELEPHONE
NAME
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ADDRPGI-
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CITY ZIP TELEPHONV
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&ATE LICENSE NUMBER EXPIRATION DATE CHECKED B1
PROPERTY TAX ACCOUNT PARCEL NO.
NEW
RESIDENTIAL
ADDITION
COMMERCIAL
REMODEL
MULTIFAMILY
REPAIR
GRADING CYDS
DEMOLISH
TANK
GARAGE
RETAINING WALL
CARPORT
ROCKERY
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER
NUMBER OF
OF
DWELLING
STORIES
UNITS
DESCRIBE WORK TO BE DONE
Kit-!
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O/PLUMBING/MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
EFENCE
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OTHER
FIRE SPRINKLER
FIRE ALARM
CRITICAL
AREAS
NUMBER
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED
REQUIRED DEDICATION— FT
MEIER SIZE I LINE SIZE I NO. OF FIXTURES
REMARKS
OWNERICONTHACTOR RESPONSIBLE FOR EROSION CONTI
Ile
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FIRE REVIEWED BY
VARIANCE OR CU
SEPA REVIEW
COMPLETE EXEMPT
EXP I
LOT COVERAGE
ALLOWED PROPOSED
PARKING
REO'D I PROVIDED
REMARKS
CH�CKED BY ITYPE
PRV REQUIRED
YES El NO 1:1
DATT
DATE
SHORELINE OR ADB11 I INSPECTION I BOND
REO'D POSTED
OYES []NO Is
HEIGHT
T )SED I ALLOWED , PROPOSED
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REQUIRED SETBACKS (FT.) PROPOSED SETBACKISEA(V) I
FRONT SIDE REAR FRONT UR SIDE I
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L8T AREA I PLANNING REVIEWED BY DATE 1 15
SPECIAL INSPECTION JAREA
REQUIRED [] YES
REMARKS
PROGRESS INSPECTIONS PER UBC 1
VALUATION
$
HEAT SOURCE
GLAZING %
LOT SLOPE %
PLAN CHECK NO:
VESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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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
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PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS
ISEE BACK OF PINK PERMIT FOR MORE INFORMATION
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'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
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IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
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NOR LIMIT IN ANY WAY THE CITY'S 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 CONSTRLIC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE L-ABOR CDPE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION'ro&u2 CE AND RCW 18.27.
SIGNATURE-(O�w 0 E
DATE S�IG7D,,/.
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Description I FEE
Olan Check
Building Permit
Plumbing
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OCCUPANT
GROUP /
OCCUPANT
LOAD
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INSPECTION REO'D 5
Description FEE
State Surcharge
City Surcharge
Base Fee 0
Plan Chk. Deposit'
Receipt #
Total Amt. Due
Receipt N
APPLICATION APPROVAL
This application is riot a permit until signed by the
Building Official or his/her Deputy: and Fees ate paid, and
receipt is acknowledged in space provided.
F rF))C I ?AL S S AIG Al U R E DATE
E --D Y/; DATE
ATTENTION:..." UCTURE UNTIL 5 AV-. 2 Ze
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STR
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - 1APEAR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER - GOLD - ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscaoelnsp.
Recording Fee
CALL
FOR INSPECTION
(425)
771-0220
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1711
GARY HAAKENSON
CITY OF EDMO NDS MAYOR
121 5TH AVENUE NORTH EDMONDS, WA 98020 (425) 771-0220 FAX (425) 771-0221
Website: vmw.dedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
it? C. Planning - Building Engineering
April 30, 2004
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Co us Christi Chapel
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Post Office Box 636
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Edmonds, Washington 98020
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RE: Ex osed plumbing piping at north side of building @ 204 6"' Avenue North
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To Whom It May Concern:
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As a f011OW-LIP to my letter dated April 14, 2004 the City has received a formal citizen's complaint
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about exposed plumbing piping on, t iorth side of e building at venue North owned by
Corpus Christi Chapel.- The Building Inspector was able to view1froin the City,alleyway, the exposed
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'piping which, appears to be connected to a groundwater surnp pump.. The piping discharges from the,
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SUMP pump onto a splasliblock in the City alleyway' . A plu mbing permit is,required for this work and .
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un fortunately,, a'search of our records did not show a permit issued to this, address.
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-pose of applying for, and obtaining, the required plumbing permit by;
Please contact the City for the pui I'D
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M lian e fe since.work was performed
May 7, 2004. Be advised, the City shall charge*a,violation co ip c c
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in advance of permit issuance.
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Lastly, because the piping discharges onto the City alleyway review by Our City Pub i.
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Engineering Division will be perforined (at'an additional charge) although it is highly uIllikely'that this
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configuration will be approved.
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if there are, circumstances beyond your control that will prevent you or your instadler from meeting this
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deadline please contact my office in, writing. If you have any other questions pleas e feet free to contact
me during normal City business hours at 425-771-0220 extension 1226. Failure to respond by the
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noted deadline shall result in the initiation of the City's Civil Penalties process whereby fines may be
assessed Lintil this matter is resolved to the satisfaction of the City. It is not the City's intent to cause
You Undue hardship however compliance to the codes is mandatory for the fair and equal treatment of
all citizens.
Sincerely,
Jeannine L . G rk"
Building Official
Incorporated AUgLISt 11, 189.0
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Sister City - Hekinan, Japan
GARY HAAKENSON
MAYOR
CITY OF EDMONDS
121 5TH AVENUE NORTH EDMONDS, WA 98020 - (425) 771-0220 FAX (425) 771-0221
Website: wwwdedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning Building Engineering
April 14,2004
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Corpus Christi Chapel
post Office Box 636 M
Edmonds, Washington 98020
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RE: Exposed plumbing piping at north side of building 204 6 Avenue North cn
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To Whom It May Concem: 0
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itizen's complaint about
The purpose of this letter is to inform you that the City has received a formal c
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exposed plumbing piping on the north side of the building at 204 6th Avenue North owned by Corpus rn z
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ipt of the complaint I dispatched our City Building Inspector to the site to C
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Christi Chapel. Upon rece >
perform an inspection. Although no one answered at the door, he was able to view from the City
nnected to a groundwater sump pump. The piping Zn
alleyway, the exposed piping which appears to be co
a splashblock in the City alleyway. A plumbing permit is o -n
discharges from the sump pump onto M �
s did not show a pen -nit issued to this
required for this work and unfortunately, a search of our record
have relied on your installer to obtain such permit, our State laws hold the rn rn
address. Although you may 0 6
(s) responsible in such matters. 0 r-
property owner 0 M
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r, and obtaining, the required plumbing permit by 9 cn
Please contact the City for the purpose of applying fo M 0
tion compliance fee since work was Z
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April 29' , 2004. Be advised, the City shall charge a viola
performed in advance of permit issuance. On a sidenote it is highly likely that an electrical permit
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fy that such permit was
uld also be required for this work and I strongly suggest that you veri
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obtained. z
Lastly, because the piping discharges onto the City alleyway review by our City Public Works and
(at an additional charge) although it is highly unlikely that this 5i
Engineering Division will be performed z
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configuration will be approved.
If there are circumstances beyond your control that will prevent you or your installer from meeting this M
deadline please contact my office in writing. If you have any other questions please feel free to contact
me during normal City business hours at 425-771-0220 extension 1226.
Sincerely,
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Jeannine L. Graf
Building Official
Incorporated August 11, 1890
Sister City - Hekinan, Japan
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GARY HAAKENSON
CITY OF EDMONDS MAYOR
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121 5TH AVENUE NORTH EDMONDS, WA 98020 (425) 771-0220 FAX (425) 771
Website: wwwxi.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
June 17, 2004
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Corpus Christi Chapel
Post Office Box 636 7n,
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Edmonds, Washington 98020
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RE: Exposed plumbing piping at north side of building 204 6 Avenue North __10
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To Whom It May Concern: --i
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As a follow-up to my reminder postcard sent on June 4th, the revised plumbing work performed under
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plumbing permit #2004-0340 must still be inspected and approve
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Please contact the City Building Inspector by June 25, 2004 to schedule for the required inspection. If
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there are circumstances beyond your control that will prevent you or your installer from meeting this
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deadline please contact my office immediately. 0 F_
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If you have any other questions please feel free to contact me during normal City business hours at
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425-771-0220 extension 1226.
Sincerely,
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Jeannine L. Graf 0
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Building Official
FINAL PROJECT APPROVAL FORM
TO:_W�_
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: -FIRE DEPARTMENT DATE
PLEASE SIGN
ENGINEERING DIVISION DATE_��C'/- z
PLEASESIGN 0
PLANNING DIVISION DATE M
PLEASESIGN
PROJECT QWD
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SITE ADDRESS Q04 ow 0
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PERMIT ADB#_ DATEINSPECTED —4 K
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DESCRIPTION OF WORK TO BE INSPECTED 2
A field inspection was conducted to determine compliance with -approved plans. Final approval cn
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denotes that there are no objections from the above signed Department to the release of n ;d
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PERFORMANCE BONDS and the granting of 3: K
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GRANT FINAL PROJECT APPROVAL C Cl)
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED z
0 Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES M
D Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
Hemp:bldg: forms: ocaprvl 3/25/04
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ......
HEATING:
GasTest ....................
Gas Piping .................
Equipment.................
Commercial Final .......
EXTERIOR SHEATHING
NAILING..........................
FRAMING ........................
FIRST FLOOR FRAMING ...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FQff�
QQC.U;*My .................. 16,t
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