20040500.pdfI
DATE RECEIVED
CITY OF EDMONDS
PERMIT EXPIRES
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LjUOSE PERMIT
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CONSTRUCTION PERMIT APPLICATION ADDRESS �7
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NAME CBL #
ADDRESS
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CITY ZIP I TELEPHONE
STATE LICENSE NUMBER EXPIRATION DATE —F-FFC—KED BY
PROPERTY TAX ACCOUNT PARCEL NO.
15,59 1 60 �2 oc)rpoo
NEW
RESIDENTIAL
PLUMBING / MECH
ADDITION
El
COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
MULTIFAMILY
SIGN
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REPAIR
1:1
GRADING
CYDS
FENCE
( X FT)
DEMOLISH
1:1
TANK
OTHER
GARAGE
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RETAINING WALL
ROCKERY
FIRE SPRINKLER
FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN�,, /)
NUMBER NUMBER OF CRITICAL
OF I I DWELLING AREAS
STORIES UNITS NUMBER
DESCRIBE WORK TO BE DONE
HEAT.SOURCE LOT SLOPE %
PLAN CHECK NO' VESTED DATE
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180DAYS
Lu
It. PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) OAPPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
13 IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
M 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 MODIF'� WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.4
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 CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLfTION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WnRiflultN'S COMPENSATION INSURAaE,.AND RCW 18.27.
DATE SlfNED I
ION /�&v
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SUITE/APT#
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PLAT NAMEISUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
TESCP APPo�ed
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
RW Formil Required
Street Use Permit Roq'd
EXISTING - PROPOSED
inspection Required
Sidewalk Required
REQUIRED DEDICATION- FT
Underground
Wiring required
METER SIZE
I LINE SIZE
I NO. OF FIXTURES
PRV REQUIRED
YES [3 NO 1:1
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
ENGINEERING REVIEWED BY DATE
FIRE REVIEWED BY DATE
VARIANCE OR CU
SEPA REVIEW
COMPLETE , EXEMPT
EXP
LOT COVERAGE
ALLOWED PROPOSED
SHORELINE OR ADBI I INSPECTION 1, BOND
REO'D POSTED
OYES ONO
SIGN AREA I HEIGHT
WED - PROPOSED I ALLOWED , PROPOSED
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REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
FRONT SIDE REAR FRONT L/RSIDE REAR
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REMARKS
CHECKP BY Ty�pS4W�CONSTRUCTION CQQE OUL;UVANY-7)
GROUP
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SPECIAL INSPECTION JAREA OCCUPANT
REQUIRED [] YES LOAD
REMARKS z
1PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RE01D 15
VALUATION
$ h /I �,4,
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection_
Landscapeinsp.
Recording Fee
CALL
FOR INSPECTION
(425)
771-0220
FEE Description FEE
State Surcharge
�77 City Surcharge
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Plan Chk. Deposit
Receipt # -7j 70)
Total Amt. Due
Receipt #
APPLICATION APPROVAL
This application is not a perinit until signed by the
Building 011icial or his/her Deputy: and Fees are paid, and
receipt is acknowledged in space provided.
OFFICIALS SIGNATURE DATE
V, �-
ATTENTION Will, 1 100110
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
D BY DATE
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ORIGINAL -FILE YELLOW- IN41PECTOR"
PINK -OWNER GOLD -ASSESSOR
GREEN - ACCOUNTING
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CITY OF EDMONDS
121 STH AVENUE NORTH EDMONDS, WA 98020 (425) 771-0220 FAX (425) 771-0221
Website: www.d.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
C ()'�3 Planning - Building - Engineering
GARY HAAKENSON
MAYOR
September 8, 2004
Lucille Rochester
21725 98'11 Ave W.
Edmonds, WA 98020
Re: Building Permit: 2004-0500
Site Address: 21725 98"' Ave. W.
Expiration Date: June 24, 2005
The purpose of this letter is to inform You that the last remaining inspection oil your
project is a final inspection(s). The final inspection(s) deten-nines that there are no
outstanding life -safety issues and approval allows the City to close your pen -nit file.
The City considers the final inspection to be one of the most important inspections
conducted oil a project. In order to grant final approval the following must be complete:
smoke detectors, house numbers, guardrails, handrails, self -close doors between garage
and residence, egress from sleeping rooms, safety glazing, weather-stripping, ally
Engineering department requirements etc. Of course not all of these things may
specifically apply to Your project but it does give you all idea about the kinds of things
that must be complete as well as some items that do not need to be installed such as:
paint, carpet, moldings, wallpaper, etc. Please be advised pennits expire one year from
the date of issuance. If You will need more time to complete the work, permits can be
renewedprior to expiration for one half fees. If the permit expires without a final
approval granted by the Building Inspector, full fees are required in order to renew the
permit. This call be very costly to you and we strongly encourage you to check your
permit expiration date and call for the required final inspection(s). Note: If more than
one department is required to Final Your project, this is noted oil your J'ob Card,
Please feel free to contact me at 425-771-0220 if You have any questions.
J I I?Mely,
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JifnyeReadwin
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Permit Coordinator
Uremp\DST'Master Le(tcrs\,SRwanml_trSFIZ
Incorporated August 11, 1890
Sister Citv - Hekinan. JaDan
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CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS. WA 98020 - (425) 771-0220 - FAX (425) 771-0221
Website: wwadedmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
February 23, 2004
Attn: Lucille Rochester
21725 98th Ave W
Edmonds, WA 98020
Application: 03-436 / Interior Remodel
Expiration Date: March 12th, 2004
Dear Lucille Rochester:
GARY HAAKENSON
MAYOR
The above referenced permit application is ready to be issued and will expire on March
12th, 2004. According to Edmonds Community Development Code 19.00.010, approved
applications are only valid for a period of 90 days unless a written request for an
extension is submitted to the Building Official showing that circumstances i beyond the
control of the applicant have prevented action from taking place. If an application
extension is granted it may only be extended 180 days for a total period of one year from,
the received date of the application. If you need and are eligible for an extension you
must submit a request in writing to the Building Official prior to March 12th, 2004.
In order to pick up your permit the remaining items due are: 1. New Contractor with
current State and City Business License (M. Rose Const. is out of business), and 2. a
written bid from your contractor so we may determine the remaining permit fees.
Please be advised, once the permit application expires, the application materials and plans
will be destroyed within ten working days. Also, if the project is pursued in the future a
new permit application and new fees will be required.
if you have any questions please don't hesitate to contact our offices at 425-771-0220.
Sincerely:
Theresa Umbaugh
Permit Coordinator
Incorporated August 11, 1890
Sister City - Hekinan, Japan
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CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 * (425) 771-0220 - FAX (425) 771-0221
Website: www.cl.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
February 23, 2004
Attn: Lucille Rochester
21725 98th Ave W
Edmonds, WA 98020
Application: 03-436 / interior Remodel
Expiration Date: March l2th, 2004
. Dear Lucille Rochester:
GARY HAAKENSON
MAYOR
ady to be issued and will expire on March
The above referenced permit application is re. ty Development Code 19.00.010, approved
12th, 2004. According to Edmonds Commum
applications are only valid for a period of 90 days unless a written request for an
extension is submitted to the Building Official showing that circumstances beyond the
control of the applicant have prevented action from taking place. If an application
180 days for a total period of one year from
extension is granted it may only be extended
the received date of the application. if you need and are eligible for an extension you
must submit a request in writing to the Building official prior to March 12th, 2004.
e remaining items due are: 1. New Contractor with
In order to pick UP your permit th
ity Business License (M. Rose Const. is out of business), and 2. a
current State and C
written bid from your contractor so we may determine the remaining permit fees.
nce the permit application expires, the application materials and plans
Please be advised, o
will be destroyed within ten working days. Also, if the project is pursued in the future a
new permit application and new fees will be required.
if you have any questions please don't hesitate to contact our offices at 425-771-0220.
Sincerely:
There ugh
Permit Coordinator
Incorporated August 11, 1890
Sister Citv - Hekinan, Japan
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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 .......
C1 - I
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
15 0 1
OCCUPANCY ..................
The Initials MT are Milton
Thompson, a temporary contract
inspector for the City.
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