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CITY OF EDMONDS
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METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
13E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
Engr. Review
SEPARATE PERMISSION.
to 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
Fire Review
Plan Clik. Deposit
'APPLICANT, ON BEHAt F OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Inspection
Receipt
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT 13E
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Recording Fee
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT: AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF I his application is not a pertnil until signed by the
T T LAWS REGULATING CONSTRUC-
HE OWNER. I AGREE TO COMPLY WITH CITY AND STATE CALL Building Official or his/her Deputy: and Fees are paid, and
T T HORIZED THEREBY, NO PERSON WILL BE EMPLOYED
ION; AND IN DOING THE WORK ALIT receipt is acknowledged in space provided.
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
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WORKMEN'S COM PEN SATgNrTqN RANCE AND RCW 18.27. OFF�ICIAL SIGNATU DAI E
SIGNATURE (OWNER AGEN DATE GNED (425)
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EXT 1333
ATTENTION )_�
ITIS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVALORA CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/16CI10/iRC110. PINK OWN�H'
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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GARY HAAKENSON
CITY OF EDMONDS MAYOR
Atka 121 5TH AVENUE NORTH - EDMONDS. WA 98020 - (425) 771-0220 FAX (425) 771-0221
Website: wwwxi.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
January l4th,2005
Attn: Scott Huang
20415 79th Ave W
Edmonds, WA 98026
Building Pen -nit: 2004-0958
Site Address: 20415 79th Ave W
Expiration Date: 11/15/05
Dear Scott Huang:
The purpose of this letter is to inform you that the last remaining inspection on your
project is a final inspection(s). The final inspection(s) determines 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 on 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, any
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 pen -nits expire one year from
tile date of issuance. If you will need more time to complete the work, permits call be
renewedprio)- to expiration for one half fees. If tile permit expires without a final
approval granted by the Building Inspector, full fees are required ill order to renew tile
pen -nit. This call be very costly to you and we strongly encourage you to check your
perillit 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 on Your Job Card.
Please feel free to contact me at 425-771-0220 if you have any questions.
Sincerely,
Pennit Coordinator
Incorporated August 11, 1890
Sister CitV - Hekinan, Japan
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
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Wall ..........................
Pier/Porch .................
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USE PERMIT
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NUMBER
CONSTRUCTION PERMIT APPLICATION
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HEAT SOURCE GLAZING % LOT SLOPE %
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PLAN CHECK NO: VESTED DATE
Plumbing
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED PERMIT COVERS WORK TO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
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III PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
to 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
!I IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
M EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
Oc ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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Total Amt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
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Recording Fee
Receipt P
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
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-
CALL
This application is not a permit until signed by the
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Official or his/her Deputy: and Foes are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
OFFICIALS SIGNA:rURE DATE
SIGNATURE (OWNER OR AGENT) DATE SIGNED
(425)
771-0220
I
RELEASED BY DATE
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 - 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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02/16/2004 15:e3 425-827-1444 AAA TANK SVC INC PAGE 02
A A TANK SERVICE, INC.
A 729 KIrkland Avenue, Kirkland, Washington 98033-6319
February 18,2004
City of Edmonds RECEIVED
Construction Permits
Ms. Jeannine Graf FEB t'T 2004
121 FifthAvenue North BUILDING DEPT.
Edmonds, WA 98020
Dear Ms. Graf -
The scope of this letter is to request refund of the permit fee paid for a cancelled
of
underground fuel storage decommissioning. The permit is regarding the property
ssner at 21623 79th Avenue West, Edmonds, Washington. Ms.
Gregory and Alva Li then
contracted our services to perform the work on February 6, 2004, but
Lissner
orning because her husband had contracted with a
cancelled the work on site that m
different firm to perform the project. It is not known who the other firm was or whether
or not they had procured a permit for this address. Perhaps a second permit for the same
s. The property is listed for sale and the
activity at this property will be in your record
house is now vacant. We have no way of contacting the current property owner.
Enclosed is a copy of permit 42004-0106 issued on February 5, 2004, and a copY of our
payment receipt #23560.
Any consideration that you can give t1iis matter is greatly appreciated. Please call me if
you have any questions or need additional information.
Regards,
Ben F, Daniels
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MEMORANDUM
Date: 2/23/04
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To: Debbie Karber, Accounting Assistant
From: Marie Harrison
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Debbie, please prepare a refund check in the amount of $55.00. Please mail the check to AAA
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Tank Service, Inc., 729 Kirkland Avenue, Kirkland, WA 98033-6319. This permit was a
duplicate permit. I have enclosed a copy of our receipt #23560 for your records. Thank you.
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Development Services Division Signature
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