20040388.pdfI
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DATE RECEIVED.;..
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
9�IDWR NAME/NAME OF NER
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MJALING ADDRES
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ADDRESS
CITY ZIP T2ELEPHONE
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TATE LICENSE NUMBER EXPIRITION DATE CN9KED,BY
r-460
"OK I o 4 (D 1 lo t;�F A&k
PROPERTY TAX ACCOUNT PARCEL NO.
42 0 0_1D c;t o — a-0
NEW RESIDENTIAL PLUMBING / MECH
fiq COMPLIANCE OR
r-1 ADDITION COMMERCIAL CHANGE OF USE
REMODEL MULTIFAMILY F-1 SIGN
GRADING FENCE
REPAIR CYDS ( x FP,
DEMOLISH TANK OTHER
GARAGE RETAININGWALL FIRE SPRINKLER
CARPORT ROCKERY E] FIRE ALARM
(rYPE OFAE, BUSINESS
f: jL IZACTIVIM EXPLAIN:
NUMBER NUMBER OF CRITICAID,_
OF DWELLING AREAS �! I
STORIES 79,- UNITS NUMBER 14 I'll
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PERMITEXPIRES
P-____
USE
ZONE
PERMIT
NUMBER
JOB
SUITE/APT#
ADDRESS
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PLAT NAME/SUBDIVISION NO. LID NO.
LID FEE S
7ESCP Approved 13
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pernlit Required 0
Streru Use Parnul Heq'd 13
EXISTING — PROPOSED Inspeclion Required E3
Sidewalk Required C3
REQUIRED DEDICATION— ITT Underground
Wiring required E3
METER SIZO 1) HNE SIZE N
9. ?Ej RES PRV REQUIRED
Ic !VI 1 1% ED YES 13 NO 13
REMARKS
FIRE
PROPERTY LINE
0 WATER METER
�M-_
VAMANCE 08 CU
EROSION CONIROL/DRAINAGE
INSTALLED
DUMP SWONLY
"�KLIST ON BACK OF JOB tTARD
INSPECTION REQUIREMENTS
SHORELINE OR ADBI I INSPECTION PBOND
REQ'D OSTED
OYES ONO s
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED , PROPOSED I ALLOWED . PROPOSED
EXP I
LOT COVERAGE
ALLOWED PROPOSED
PARKING
REQ'D I PROVIDED
REMARKS
CHECKED BY
SPECIAL INSPECTION
REQUIRED [] YES
REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.)
FRONT SIDE REAR I FRONT LIR SIDE REAR
LOT AREA I PLANNING REVIEWED BY DATE
OF CONSTRUCTION CODE OCCUPANT
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IABEA OCCUPANT
LOAD
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I PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION REQ'D] a
VALUATION
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C:--nt JZCW- 'R 'jNE]r"
Description
FEE
Description
FEE
Plan Check
State Surcharge
H At SOURCE G �;LOT SL OP r�_�
7A %
Building Permit
City Surcharge k5
A- k Lo llr�
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
Grading
DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
_j SEPARATE PERMISSION.
IP-
Engr. Review
Ir
III PERMIT APPLICATION: 180 DAYS
IL PERMIT LIMIT., I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
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< ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE.OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapeinsp.
Total Amt. Due
DEEMED TO MODIFY, PAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY W THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
x
Recording Fee
Receipt#
I HEREBY/ CkNOWLED6 THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
I
'5 THAT I
APPLICATION APPROVAL
GIVEN IS FIRE T. AN THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
T 4 THAT I
THE OVfN . �l AG EE f, COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
i T CO Mpt
TION; No IN,DO G THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN C 1 0 RK
CALL
This application is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
IN Vlo� HE ' BOB CODE OF THE STATE OF WASHINGTON RELATING TO
7130 R C
FOR INSPECTION receipt is acknowledged in space provided.
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WORK�E�J�jr,CqP4, N�A N INSURANCE AND RCW 18.27.
IALS SIGNATURE DATE
SIGN UR 0 DATE SIGNED
!10
(42,15)
IkI12� VL /�_ 1)v I
771-0220
- - .-
RELEA ED BY
'19
ATT!i�N 11
EXT 1333
IT IS UNLAWFUL T USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
T
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
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
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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: wwwxi.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
�t.,? C. 1 sc)�3 Planning - Building * Engineering
Mr. Colin Winters June 30, 2004
Hammerworks, Inc.
6545 1h Avenue South, Suite 300
Edmonds, Washington 98020
RE: Demolition work at 505, 511 & 515 5"' Avenue South
Dear Mr. Winters:
The purpose of this letter is to inform you that the City is levying fines against Hammerworks, Inc. in
the amount of $200.00 for demolition work performed at the subject project without first obtaining
City required inspection approval(s).
After speaking with you on the phone last week about the demolition work at the Hong Kong Garden
restaurant (Hammerworks failed to contact the City in advance for the proper building and engineering
inspections) demolition work resumed on Monday June 29"' on the adjacent auto repair shop building
and single family residence --again without all required inspections.
As clearly stated on the job card there are several required inspections to be performed by the building
and engineering inspectors that are needed in advance of start of demolition work. Since only the
engineering inspections were called for and performed, fines are instituted at the rate of $100 per
building and are immediately due and payable to the City of Edmonds.
The levying of fines is considered a method to encourage compliance to the code however, a second
method exists as permitted by the Uniform Building Code that allows the Building Official to "Stop
Work" until code compliance is obtained. Failure to remit fines in 10 working days shall result in the
issuance of a 'Stop Work' order and all construction shall cease until this matter is resolved to the
satisfaction of the, City. We understand that your subcontractor may be the negligent party in this
matter however, Hammerworks, Inc. is the noted contractor on the job card and therefore is the
responsible party in this matter.
If you have any questions regarding this matter, the inspection process, the fines, etc. please feel free
to contact my office during normal City business hours of Monday through Friday, from 9:00am to
noon and 1:00pm to 4:00pm.
Sincerely,
Jeannine L. Graf
Building Official
Incorporated August 11, 1890
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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.d.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
11, C. Planning - Building - Engineering
Mr. Colin Winters June 30, 2004
Harnmerworks, Inc.
6545 1h Avenue South, Suite 300
Edmonds, Washington 98020
RE: Demolition work at 505, 511 & 515 5"' Avenue South
Dear Mr. Winters:
The purpose of this letter is to inform you that the City is levying fines against Hammerworks, Inc. in
the amount of $200.00 for demolition work performed at the subject project without first obtaining
City required inspection approval(s).
After speaking with you on the phone last week about the demolition work at the Hong Kong Garden
restaurant (Harnmerworks failed to contact the City in advance for the proper building and engineering
inspections) demolition work resumed on Monday June 291h on the adjacent auto repair shop building
and single family residence --again without all required inspections.
As clearly stated on the job card there are several required inspections to be performed by the building
and engineering inspectors that are needed in advance of start of demolition work. Since only the
engineering inspections were called for and performed, fines are instituted at the rate of $100 per
building and are immediately due and payable to the City of Edmonds.
The levying of fines is considered a method to encourage compliance to the code however, a second
method exists as pennitted by the Uniform Building Code that allows the Building Official to "Stop
Work" until code compliance is obtained. Failure to remit fines in 10 working days shall result in the
issuance of a 'Stop Work' order and all construction shall cease until this matter is resolved to th e
satisfaction of the City. We understand that your subcontractor may be the negligent party in this
matter however, Hammerworks, Inc. is the noted contractor on the job card and therefore is the
responsible party in this matter.
If you have any questions regarding this matter, the inspection process, the fines, etc. please feel free
to contact my office during normal City business hours of Monday through Friday, from 9:00am to
noon and 1:00pni to 4:00pm.
Sincerely,
Jeanninc L. Graf
Building Official
Incorporated August 11, 1890
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CITY OF EDMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5th Avenue North, Edmonds, WA 98020
(425) 771-0220
ORDER TO CORRECT VIOLATION
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Location of Violation (Address and Tax Account Parcel No): Hong Kong Garden Restaurant at 505
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5 1h Avenue South, Edmonds, WA Tax Account Parcel No. 004342-127-001 -00
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Issued To: Bob Greag, Fifth Avenue Development LLQ, owner & Harnmerworks Inc., contractor.
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Address Of Persons This Order Is Issued To: 51 W Da3qon, Suite 304, Edmonds, WA & 654 51
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Avenue South, Edmonds, WA
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Code Section Violated:. Edmonds Community Development Code Chapter 18.30 & 19.00.
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Description of Violation: Failure to contact City Engineering Inspector for the following inspections:
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TECP site erosion control, water service and side sewer cap inspection, proper abandonment of fats, oils
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and grease (FOG) fixture, pedestrian safety measures in place, and 2) Failure to contact City Buildin
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Inspector for pre-dernolition inspection for proper abandonment of power, gas, phone, cable, and
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verification of PSCAA asbestos pennit.
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Corrective Action Required: 1) Contact City Engineering Inspector for inspection of TECP, side
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sewer and water service cap at property line, proper abandonment of FOG fixtures, and t)edestrian safety
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measures, and 2) Provide to the Building Division, a copy of the Asbestos Permit issued by PSAPCA
and submit letter signed by demolition contractor that proper abandonment of power, gas, nhone. and
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cable has been perfon-ned on site.
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Correction is Required no later than: 5:00pm (time) June 28, 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: June 24, 2004 Date Mailed: June 24, 2004 Date Served
Issuing Part Jeannine L. Graf Title Building Official
y
Signature 7�4/W) ---
CITY OF EDMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5th Avenue North, Edmonds, WA 98020
(425) 771-0220
ORDER TO CORRECT VIOLATION
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Location of Violation (Address and Tax Account Parcel No): Ho nt at 505
5 1h Avenue South, Edmonds, WA Tax Account Parcel No. 004342-127-001-00
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Issued To: Bob Gregg, Fifth Avenue Development..LLC, owner & jarnmerworks Inc., contractor.
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Address Of Persons This Order Is Issued To: 51 V D ton, S ite 304, Edmonds, WA � 654 5
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Avenue South, Edmonds, WA
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Code Section Violated:. Edmonds Community Development Code ChApter 18.30 & 19-00.
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ntact City -ist)ections:
Description of Violation: Failure to co gineering Insp
TECP site erosion control, water service and side sew er cap inspe,,tion, proper abandonment of fatsoils
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and please (FOG) fixture, pedestrian safety measures in place, and 1) Fail ure to contact City Buildin
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Inspector for pre-dernolition inspection for proper ab as, phone, cable, and
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verification of PSCAA asbestos permit.
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Corrective Action Required: 1) Contact City Engineering Inspector for inspection of TEQP, side
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at andonment of trian safely
sewer and water service caD line, proper ab
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measures. and 2) Provide to the Building Division, a col)y of the Asbestos Pen -nit issued by PSAPCA
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bandormu-nent of po as hone and
and submit letter signed by demolition contractor th A pro)er aban q ii ii
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cable has bee
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Correction is Required no later than: 5:00pm -(time) 3une 28, 2004 (date)
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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
$100.00 per day, or portion of a day, during which the violation continues.
Date Posted: June 24, _2004 Date Mailed: June 24, 2004 Date Served
Issuing Party Jeannine L. Graf Title Building Official
Signature
Ma�j 18 04 04:08p Insurance Services Group 425 640 9225 P.02/04 p.4
MAY-10-2004 15:48
noud Nu
GARY HAAKENSON
MAYOR
CITY OF EDMONDS
12, �T�j WENVE NOAYH - EDMONO%, WAI GeM - (&M) 771-0220 - FAX (420 771
WCVD'AW WWW.61.&dftVMC.W3.U$
c)EVELOPMENT SEFMCES DEPARTMENT
Planning - Svikiing o Engineering
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,M0Lj,nON jaONDISONDING COMPANY
Edmonds Building Permit
Project Address
0wn.ra*VCl4e—WCO
herei=fter refwed to as 'Ihc
WHEREA in conformanoc: with the pwvisiOlu Of
primi;W19, has securod B ng 0. or otim improvements on a sitc located at
the Uniform Building Code to d=olish a s=t=
505 Fifth Avenue within the City of EdMonds� and,
WHEREAS, M Order to provide: secUnlY for the OWP60W of ft Princ'Pal under the UMf0rTn
BuildiAe Code in the course Of Wd demolition Within -La— calendar days (not to cxcc'cd 18()
calendar days) from ffic issuance of sad BuildixIg permit by dw City of Edmonds, hereinafter referred
to as .,the CiV- 9nd to enable the City to See= C.Ompiction of said obligations, including site
restoration. clean-up and find site grading.
NOW 2,ffEREFORE, the under!liped PrincipW and Tj]dPZnity cam;wnx of Califgrnia
a corporation authorized to transad surety business in the StM of wasbington. herein� referred to
as -%b0:Snrety,,, agree and birid themftiveq� their heirs, executors, admini5tmtors and assigns, unto the
city in the sum Of Two Thousand ------------ S 2, 0 0 0 - 0 0 lawful money of the United
States. according to the following terms and conditions:
1) If the PrinCipal and Surety agree that in thr, event that aM demolition permitted under the
above-referenccd Buildint Pennit. is lot cOmPleted '" accOrdance with the provisions of the Unifbrm
Building Code and the Ordinances of the City of Edmonds within a period of I BQ - — calendar
days from the doe of the issuance of the Buildift Permit for the demolition therein permitted, the
Surety shall, upon the demand of the City and the failure to cure the noted defmts within a reasonable
time ar, deterrained and specified by the City, remit to the City within teu (10) days of reCeiPt of
demand for remittmcc. ft amount of this bond or smh les= mnmmt as may bc specified in the
demand.
2) If the Principal fails to cure any dofcct within the time period specified by the City, the
City's employees wd agents am hereby authorized to enter into said propeltY and perform said work,
This provision shall not be construed 2s creating an obligation on the part of the City Or its
representatives,
L:omp.-blds.forws d=,6bd.j197J99
Incorporated Augu3t 11, 1890
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lla�j IS 04 04:08p Insurance Services Group 425 640 9225 P.5
MA Y-18-2004 15:49 P. 03/04
City of Edmonds Demolition Bond Bonding Company
page Two
lawsuit is instituted by the City of Eftonds, the Principal or ihe Surcty to
3) In the event Any aty hereunder, the prevailing party in
enforce the tenns of this bond or to determine the rights of any P?
such liti24on shall be entitled to recover from the losing PAY its costs, including reasonable
attorneys' fees, incurred as a result of 6uch lawguit.
DATED this __Lqzb,_ day of 2004
Indemnity Compan of �c
y� Developer/Owner
ending Company
Bouc
f ff ........ Title
le -in-fact
ficer/TitIc Attorney
9750 Third Ave NE, Suite 305_.,_.__
Seattle, Wa 98115 Address/PbOne
AddMsMhOne 25-8201
573053S / 20 6-5
cs Technician U(ate
Bond A�jjptcd by Development SO(Vic
Wj%'DGF.MZNT
STAT.E OF WASMNGTON)
ss.
COUNTY OF
)2004 before me, the undersigned, a
on this19th day of __M_a_y______—
Notary Pablic in and for the State of WasWngton, duly commissioned and swom Po"on.,idly appeared
Dan Bouc to me knoVM to be the Attorney -in -fact
the cojpmation that oxmuted the foregoing instrinnent,
act and dccd of said corporation, for
and acknowledgcd the said instrtunent to be the fToe and volul .
the uses and purposcs therein mentioned, and on oath stated that Dan 'Rour was
d instnuncnt and the seal affmcd. is the corporate scal of said :
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authorized to execute SM .......
affixed the day and year first
WITNESS my �and and official seal horeto
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teo 100
NOTARY pU)Dj,(C in and for the S U I
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Washir0on, f0sidiniz at (1 ill
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City of Edmonds Demolition Bond Bonding COMPADY
page Thrcc
.tcjnp.,bjdg:fom)s dembdJ192/99
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DISCLOSURE RIDER
Terrorism Risk Insurance Act of 2002
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The Terrorism Risk Insurance Act of 2002 created a three-year program under which the
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Federal Government will share in the payment of covered losses caused by certain events of
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international terrorism. The Act requires that we notify you of certain components of the Act, and
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the effect, if any, the Act will have on the premium charged for this bond.
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Under this program, the Federal Government will cover 90% of the amount of covered
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losses caused by certified acts of terrorism, as defined by the Act. The coverage is available only
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when aggregate losses resulting from a certified act of terrorism exceed $5,000,000.00. Insurance
carriers must also meet a variable deductible established by the Act. The Act also establishes a
cap of $ 100 billion for which the Federal Government or an insurer can be responsible.
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Participation in the program is mandatory for specified lines of property and casualty
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insurance, including surety insurance. The Act does not, however, create coverage in excess of
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the amount of the bond, nor does it provide coverage for any losses that are othe rwise excluded
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by the terms of the bond, or by operation of law.
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No additional premium has been charged for the terrorism coverage required by the Act.
Developers Surety and Indemnity Company
Indemnity Company of California
17780 Fitch, Suite 200
Irvine, CA 92614
(949) 263 3300
www.InscoDico.com
ID-1498 (Rev. 5/03)
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P0 NNI E 110 FIATI 0 11 N EY 1, 0 11
V,
D E VE' LO 1) E RS S U R ETY A N D I N 1) E N1 N ITY CO N1 PA NY
I N D E N I N ITY CO IN I PA N Y 0 F C A 1, 1 FO R N I A
PO BOX 19725. IRVINE. CA 926231 (949) 263-3300
EVELOPERS SUIZETY AND INDEMNITY CONIPANIN' and INDENINITY
KNOW ALL ME-Ni BYTI [FISE- PRESEN'I S, III,
'it except its expressly limited. 1) -
CONIPANY 01: CALIFORNIA. (Io each. hereby illak conslitille M Oi
nie M. Finniss, jointly or severally***
***Jak
e W. Murphree, Karen L. Staffanson, Dan Bouc, Mela
or.1tiolls. !Is Sill-Clics. bonds. undertikings
lis Illeil, trocand lawl'tol Allorney(s)-in-Fact. to make. exectole. (lei if,,erand acknowledge. 1111-alld oil bellillf'ol'stlitl c0rP Z,
propel�
IWcI* 1111dauthority ill (ill and to Perform every act necess 0
YW-ill-Fact 11111 lit illy. requisite of
Mid Com racts of, surelvsh ill
corpora I i oils Full POWer (It' substitution arld revocation. and _11.
said corporations could do. bill reservillo., to cach ol'said
to be done ill connection therewith as e0ch Of
-e herelly ratified and Coll Ill rilled.
all ol'the acts ofsaid Atiorney(s)-in-Fael. Pursuant to these presents. ill M
resolotionsadopted by the respective Board ol'Dircclors of'
of rig
This Power ot'Attorney is granted luld is signed by I'llesitililc lfoderif"(I by ill"llor"y ol' tile " low'
FORNIA. effe6yeas ol'Noverilber 1. 2000: -n
ITY COMPANY and INDEMNITY COMPANY OF CALI
DLVELOIII--RS SURETN"AND INDLIVIN
It elcII ol'them hereby is. authorized to
sident and arly Vice President ol*IlIe corporation be.and Ill,
'llizill Ol'the Board. tile Pre M�
R1 SOLVED. that tile Chaii
of ill tile Powers ot'Allorney to execute, oil behal 1* of, tile col.1101-aliolls. horlds. underlakiligsand contracts C
I 1v exectite Powers ol*Attorney. qualil'ying, tile tillOrtleY(s) 1 -11 c M
be. and cach oil theill hereby is. 111thorized loatlest the execution (11' ally stiell 0
Seel-clary ol'the corporations 0
P, (11, sorclysbip: tbII file Seereljry of lily Assistill 1 0
Power of* Attorney: 0 P
-til"cille rel -clo fly
*UR, e sh-ollillores (11, such officers Inn be alfixed to arly such III wer (it' Allorricy (W to Illy cel � Illel
RESOLVED. F I'llER. that Ill poralioll whell So ili'llixed "Irldlill
ile bearilli, such ShAl Ile Villithind binding upon [lie Cot M
ofAilorney oi. eertific, z
1*.Icsilllile. ;IIILI illy such Powci
ill-clyshill to which it isallached.
illy bollill; olidertaking, fit' contract (it's
the 1,11tore with respect to 1
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INITY CON/IPANY OF CALIFORNIA have sevei
SURETY AND INDI_-,,mNrrN, COMPANY and INDE'N
-lI_`RE'OF. DEVELOPERS
IN WITNESS WI -cl;lry Illis I sl (lily oI* October. 2003.
(I by their respective Seel X�
respectiVe I_:NCCIlIi\V \'ice PreSidCot 1111(i 111teSle
tilese Presents to be signed by theii 0).
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OPANYO —4
AND
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By: ......... PO
David 11. IZ -xcctlli\,e Vice-president
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bodes. 1 9-9 0 R4 -�S,
OCT
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1936
By: *6 44tilzo�A
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Willer A. Crowell. Seeretill-V ......... V z 0
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STATE 01: CALIFORNIA
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COUNTYOF ORANGE'
i well. personfilly known to file (01' Proved 10 X.
oil October 1. 2003. beflore file. Dkinc.l. Kawata. persolillily ifilicared David 11. Rhodesand Walter A. Cro
lie 111,11 tiley exectited the
ill i list I-lirriew and acknowledged to I
ole oll t1lo bilsis ill'satist"Ictory evidence) Ill be the Persons Whose 11-11 es !Ire sobscl"bef" to tile w'll -sollsacte(l. execole(I tile instrument.
[lie clilily upon belialfot,which tile Pet
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s1lille ill tileirlotilorized capacities. and that by their signatures oil [lie instrument
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WITNESS lily liarldlod 011"Icilli seill- DIANE IKAWATA 0
COMM. a 1334746 M
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-California
Notary Public
ORANGE COUNTY
L My Comm. Expires JAN. 8, 2006
CER'I`lFlCV1'E
-President. U liderwriting ot'DEV E- LOP 1: RS SURETYAND INDENINi'l-N, COMPANY
The 1111dersiuncti.as Senior vice
revok-ed.arld 1111-therillore. that tile Provisions
01: CALIFORNIA. does hereby certify [lilt tile tore'Villir' Power ol'Atiorney re'lllills ill I"Ill torce,111(l b-Is I'(" "eel' I' this certifielle.
rIs set I'llrill ill tile Power ol*Altorrimare it, lorce i's ill
of' tile resolutions of' tile respective Bonds of' Directors ol'said corporatio
4�kly oI'
lie City of, 11-ville. California. Ill
This Cellificille is executed ill I
By
7W�cs e \V, Cowlill,.. .,clliol. Vice-president, Underwri 11 g,
ID- 1380 (Rev. 10103)
GARY HAAKENSON
CITY OF EDMONDS MAYOR
n, FAX (425) 771-0221
121 5TH AVENUE NORTH EDMONDS, WA 98020 (425) 771-0220
website: www.d.edmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
111 Planning Building Engineering
November 10, 2004
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Indemnity Company of California
Dan Bouc, Attorney -in -fact
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9750 Third Avenue NE, Suite 305
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.71
Seattle, WA 98115
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Re: Demolition Bond #573058s
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Fifth Avenue Development 505 Fifth Avenue S, Edmonds WA
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Dear Sir or Madam:
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The City of Edmonds hereby authorizes the release $2,000.00 from the above referenced
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Demolition Bond. All interested City departments have approved the release of the
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Demolition Bond.
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Sincerely,
CD
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Marie Harrison
Pen -nit Coordinator
Cc: Applicant
File
111'eiiii)/DS'l"s/MasterLetters/itele-,�sel)crforiiiaiiceO2/01
0 Incorporated August 11, 1890
Sister ON - Hekinan, Japan
FtNAL PR03ECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
PLEASE SIGN
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7- ENGINEERING DIVISION DATE 1
Pi.r.ASESIGN'
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PLANNING DIVISION DATE
PIXASPSIGN
PROJECT 515-
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SITE ADDRESS
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4-05 C�l ADB# DATE INSPECTED_Y/_,Q�/Z;V��
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PERMIT 9
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DESCRIPTION OF WORK TO BE INSPECTED
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A field inspection was conducted to determine compliance with -approved plans. Final approval
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denotes that there are no objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
El Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date SignatUre
1:tenip:b1dg:forms:ocaprv1 3/25/04
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
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Pier/Porch .................
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Retaining Wall ...........
Slab Insulation ..........
PLUMBING: --j
Underground ............. M
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Rough -In ................... 0
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vv�� Commercial Final ......
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HEATING:
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Gas Test .................... > Z
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Gas Piping ................. CO)
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Equipment ................. -n
Final .......
Commercial ITI M
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EXTERIOR SHEATHING 0
NAILING .......................... 0 ITI
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FRAMING ........................ Q 0
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FIRST FLOOR FRAMING ... 71
INSULATION ...................
Floor Insulation ......... >
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Wall Insulation ...........
Ceiling Insulation ....... z
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SHEETROCK NAILING ... --i
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SPECIAL INSPECTION ... M
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................