20040391.pdfCITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS P13A
0. 01'. 0 7M: 10A, Il it, (A -c' C
MAILING ADDRESS
-Ti) v-0 A
CITY ZIP
d 013
_y"c))1ACW q,
TELEPHONE
r _S� '�)
Lj j 6
NrM E
bA
c
U
t:
L)
ADDRESS
L
CITY ZIP
S,
TELEPHONE
NAME
CBLN
3f=,0"f-r
0
ADDRESS
0 6 C)
11
CITY ZIP
TELEPHONE
1
0
0
C1 5 tl Y,
1-2,
STATE LICENSE NUMBER
EXPIRATION DATE
CHECKED BY
PROPERTY TAX ACCOUNT PARCEL NO.
W
00 (0 1 CO- 00:2 00,110)
)Lvlo 10'11004C-080.4
_j
NEW RESIDENTIAL
PLUMBING / MECH
ADDITION *1$,COMMERCIAL
E] COMPLIANCE OR
CHANGE OF USE
REMODEL MULTIFAMILY
SIGN
REPAIR GR �ING
FENCE
CYDS ( x Fr�
I
DEMOLISH TANK
F� OTHER
Z,
Ei GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
01-
1= (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
NUMBER NUMBER OF CRITICAL
OF UNITS AREAS
STORIES DWELLING NUMBER
DESCRIBE WORK TO BE DONE
1,412
i6��
PERMIT EXPIRES
USE PERMIT
ZONE
NUMBER ;�_ �e�X
JOB SUITE/APT#
ADDRESS
PLAT NAM I E/SUBDIVISION NO LOT NO. LID NO. (V[A0y
------ LID FEE $
IIESCP Approved 13
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Perrild Required 13
Street Use Pounit Req'd [3
EXISTING PROPOSED-- Inspection Required
Sidewalk Required
Underground
REQUIRED DEDICATION— FT Wiring coquirod
METER SIZE LINE SIZE NO, OF FIXTURES PRV REQUIRED
I I YES NO 13
REMARKS
fpj P, ON CONTBOL/D�AINAGE
G1
Ata,�,JKW41�
NGINEERING REVIEWED BY
I Wp, M I
I �Ij DATE
0
z
cc
W
z
z
5
z
LU
FIRE REVIEWED BY
DATE
U,
f
VARIANCE OR CU
SHORELINE OR ADB#
INSPECTION
BOND
I
/R 'D
POSTED
v4p I
A��-- 0 I —If 7o
EXYES CNO
s
SEPA REVIEW
SIGN AREA
HEIGHT
COMPLETE ETIMPT
ALLOWED PROPOSED
ALLOWED PROPOSED
044AW
,
1-77
NA
I— s
EXP iu a
So
REQUIRED SETBACKS (FT)
PROPOSED SETBACKS (Fr.)
E:�
t==ROPO
FRONT SIDE REAR
FRONT LIR SIDE REAR
z
21 14. 12-
ZA3
Z2
3p
PARKING
LOT AREA
PLANNING REVIEWED BY D AT E_J)�//
REO'D
+3
PROVIDED
-*1
REMARKS 16-
CHECKED BY ITYPE OF CONSTRUCTION
INSPECTION JAREA
D:F�p YES 12,
CZO P. -
OCCUPANT
-7 GHOIIP M
OCCUPANT
LOAD
4 3 2�
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D
VALUATION
$ /./ Jh
Got t--C) t &21 j Description FEE Description FEE
FEE��
V I]ff]
Plan Check State Surcharge
HEAT SOURCE GLAZING % LOIULOPE 0XL
Building Permit City Surcharge
12L
PLAN CHEC ESTED Nil, Plumbing z 3-A li' �- -7
1 /�� 7) -75��,! , -�;—? 4 d Mechanical
OVE FIS
—M ' j
N THE P i
_'4 L R
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED THIS M1 OVEFIS ORK TO
I= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCT N THE BLIC Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ET LRE UIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 180DAYS
W
0. PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U U) OAPPLICANT, ON BEHALF OF HIS OR HER SPOUSE ND SUCCESORS Fire Review Plan Chk. Deposit
HEIRS, ASSIGNS A
W IN INTEREST AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, I�ASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt III
OR DAMAGES OFwHArEVEH NAIURE, ARISING DIRECrLY OR INDIRECTLY
ALL CLAIMS F
ISSUANCE OF IHIS PERMIT SHALL NOT BE
FROM THE ISSUANCE OF THIS PERMIT Total Amt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp.
_j
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION
x Recording Fee Receipt #
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 APPLICATION APPROVAL
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL I Ills application is not a poinut until signed by the
TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Hudding Olficial or hisilief Deputy. arid Fees are Paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION recLipt is acknowledged in space proviclud
/WORKMEN'S OMPENSATION INSURANCE AND RCW 18,27. - -NAfURF DAIF
0 Fr! LS SIG
7
SIGNATURE DAT E . I r GNED[C�.,�
ER (425)
CrAjENY-L
c,
RE BY DA1'E
C 771-0220
ATTENTION 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- ORIGINAL FILE - YELLOW - INSP/CTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK OViNER - GOLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES CIALLN ACCOUNTING
z
0
M
--i -n
0 M
C
M
0
-i (-)
0 C
I K
X M
M Z
ID —i
c
�m
U)
0 -n
n ;d
>
M M
0 Fn
0 r-
M
U)
Cf)
M
Z
z
Cn
z
0
1711
MEMORANDUM
Date: 5/27/2005
0
To: Nicole Daniels, Accounting Assistant
M
From: Marie Harrison
=n
Subject: REFUND CD
M
C
M
0
0
0
M
Nicole, please prepare a refund check in the amount of $4,29 1.00 payable to Westgate Shopping M z
Center. Westgate Shopping Center building C obtained building permit number 2004-0391 on
C
-mit z
May 21, 2004 but due to loss of future tenant, the applicant has failed to start work. The pei >
expired May 21, 2005. Since no inspections have been performed, they are due a refund of
Co
$4,291.00 including inspection fees and building permit fees for Building, Engineering, Fire and
0 -n
-n
Planning. Please mail the check to WM. C. Nelson III at PO Box 46 1, Redmond WA 98073.
Please deduct $3,941.00 frorn the Building Permit Fee fund, $250.00 froni the Engineering 2.2%
M M
Inspection Fee fund and $100.00 from the Fire Inspeciton Fee. rund. lhaveenclosedacopyof,
our receipt #24194 for your records. The permit expired. Thank You. 0
0 M
C Cn
9 CD
Q 0
Sincerely,
>
3:
arie Ha Cn
Development Services Division birector's Signature z
0
M
City of Ednionds CQ COMMUnity Services
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
Websile: wmdedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
417 C ' 1 BC)" Planning # Building - Engineering
March 11, 2005
WM. C. Nelson H I
DBA Westlake Village
PO Box 461
Redmond, WA 98073
GARY HAAKENSON
MAYOR
Re: Building Permit 2004-0391
10022 Ednionds Way
Expiration Date: May 21, 2005
Dear Mr. Nelson:
According to Building Division records, the above referenced pen-nit(s) will expire on May 21,
2005. Edmonds Community Development Code Chapter 19.00.005 A. 6. c. Section 105.5
Permit expiration and extension. Prior to expiration of an active permit the applicant may
requesL in writing an ey'Lehsion for an additional year. If the plans and specifications for the
pen -nit extension application are the same as the plans and specifications submitted for the
original permit application and provided there has been at least one (1) required progress
inspection conducted by the city building inspector prior to the extension, the permit shall be
extended. Permit fees shall be charged at a rate of one half the original building permit fee to
extend the permit.
Note: Building permit fees and time frames are established by the Edmonds Community
Development Code and cannot be waived by the Building Official. If you have decided to
cancel this project, please notify us in writing so that we may close out this file.
**If our records are incorrect, please call a permit coordinator at 425-771-0220 orfwc the
signed of
.f col)y ofyout- perinit to 425- 771-0221 and we ivill itntnediatelj? close out yourfile.
Sincerely,
Ua <n �a,rf i *SO 1/1
Senior Peri-nit Coordinator
Cc: File
CDA Architects, Inc.
JR Abbott Construction
Incorporated August 11, 1890
Sister Citv - Flekinan. Janan
z
0
0
M
—1 -n
M
C
M
0
--10
0 C
M
M Z
0-1
C
X.
Cl)
0 -n
n
M M
...0
0
0 M
C cl)
9 0)
Q 0
Z
7'
z
--I
0)
z
0
4
0
M
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
Planning Building Engineering
May 26, 2005
Z
0
WM. C. Nelson III
DBA Westgate Village
0
M,
PO Box 461
Redmond, WA 98073
M
C
M 0
0
Re: Building Permit: 2004-0391
00
C
Si te Address: 10022 Edmonds Way
M
M z
Expiration Date: May 21, 2005
10-4
C —
> Z
Dear Mr. Nelson:
According to City of Edmonds Building Division records, the above referenced building
0 -n
-n
ith this project. Edmonds
lit ex ired on May 21, 2005 w out work commencing oil
peni P
Community Development Code. (E CDC) Section t05.5.1 a. states "In order to
M M
0 5;
recommence work on an expired permit, a new permit application with full Pernlit fees
"New
i
0
0
shall be submitted to the building official." ECDC Section 105.5.1 b. states permit
M
C Cf)
ning and building codes in effect at the
applications shall be reviewed under Current zo ID
Cn
M 0
time of complete application submittal." Currently we tinder the 2003 International
Z r-
Building Codes.
TECDE Section 19.70.025 Refunds. The building official may authoriz c refunding of not
3:
>
more than 80 percent of the Perm it fee paid when no work has been done tinder a permit
z
issued in accordance with this cod e. We will process a refund in the amount of
Cn
$4,291-00. Please note all plans and documents will be destroyed ten days from the date
z
of this letter.
0
If you have any questions please feel free to call out- offices at 425-771-0220.
0
M
Sincerely,
yi/VR��
r i e a i�
Senior Permit Coordinator
Ure n1ps\D S1- s\M aster Letters\Expired Prinit.cloc 7/01
Incorporated August 11, 1890
Sister Citv - Hekinan. Jar)an
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ., ........................
Pier/Porch .................
Retaining Wall ...........
Slab insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ......
HEATING:
Gas Test ................. .
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 FOR 7-)V
OCCUPANCY .................. h_)4
z
0
0
M
=n-
M
C
M 0
0
0
0 C:
M
M Z
C Z_
C/)
0 -n
n
MITI
0
0
0 M
C W
9 0)
Q 0
Z
;AJ
>
z
C/)
z
0
0
ITI