20041070.pdfI
DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEiNAME OF RUEiINESS
MAILING ADDRESS
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NAME
ADDRESS
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STAT ICEN,5,E NUMBER
PERMIT 1xZ "
NUMBER - J,
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ADDRESS Z3?05
PLAT NAME/SUBDIVISION NO
PERMIT EXPIRES
SUITE/APT# 1Cp
IILOT NO, LID NO
LID FEE
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING PROPOSED
REQUIRED DEDICATION-- FT
METER SIZE I LINE SIZE I NO. OF FIXTURES
I ESCP Approved
RW Permit Required
Street Use Permit Requited
Inspection Required
Sidewalk Requited
Underground
Mine reouired
PRV REQUIRED
YES E3 NO 13
REMARKS
OWNER�CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDIRAINAGE
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ENGINEERING REVIEWED BY DATE
FIRE REVIEWED BY DATE
ORE CHECKED By
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NEW RESIDENTIAL ZV"UMBING /i( ECH
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ADDITION COMPLIANCE
MIXED USE 1:1 CHANGE OF USE
REMODEL MULTIFAMILY F� SIGN
GRADING FENCE
REPAIR CYDS 1:1 ( x
DEMOLISH TANK E:i OTHER
GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY 1:3 FIRE ALARM
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VARIANCE OR CU SHORELINE OR ADB# I INSREEO�ION SEPA
D COMPLETED I EXEMPT
13YES 13NOI
CAH ZONE SIGN AREA HEIGHT
WAIVER[3 ALLOWED I PROPOSED ALLOWED , PROPOSED
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STUDY I
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR
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PARKING LOTAREA PLANNING REVIEWED BY DATE
REO'D . PROVIDED I I IL
FT.) I REMARKS
(TYPE OF USE, BUSINESS ORACTIVIT EXPkAIN:
TYPU N
!�.C� N Sj U Ci: TE CODE OCCUPANT
GROUP
NUMBER NUMB OF
CONSULTANT OCCU PANT
STORIES UNIT ER FLOAD
OF DWELLING SPECIAL INSPECTION
I I /VP REQUIRED 13YES
DESCRIBE WORK TO BE DONE
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11 11, IA, GEOTECH REPORT
V/T� BY:
u"T STRUCTURAL DESIGN
BY:
VALUATION
$
Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE LOT SLOPE% VESTED DATE Building Permit City Surcharge
PLAN CHECK NO: Plumbing Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSION.
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5) Engr. Review
PERMIT LIMIT: SEE ECDC 119.00.005(A)(6) Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
*APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt 0
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
RDINANCE Landscapelnsp. Total Amt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY 0
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee Receipt #
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 This application is not a perinit until signed by the
THE OWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building Official or his1her Deputy and Fees are paid, and
TION; AND I� DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED receipt isacknowledgod in space provided
�A ON 0 F T HE L A
T� SC ;" �S
IN VIOLATION OF THE LAD -CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
WORKMEN'ScOMPENSA;Ib INSLh�ANCEXNDRCWI8;2r.
OFFICIALS AIGN7AURE PATE
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SIG ATURV WNER ENT): DATE SIGNED
SIGN (OWNER 0 A j -L) - ?
771- y IF 7'
0220 If DATe
EXT. 1333
ATTONTION
IT -IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL. INS-PECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL -FILE - YELLOW -INSPECTOR
FicATE OF OCCUPANCY HAS BEEN GRANTED. UBC1091 IBC110 I IRC110. PINK -OWNER - GOLD - ASSESSOR
j0j04 PRESS HARD - YOU ARE MAKING 4 COPIES
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CITY OF EDMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5tli Avenue North, Edmonds, WA 98020
(425) 771-0220
Location of Violation (Address and Tax Account Parcel No): Manna Teriyaki (@, 23805 Highwa
Suite 104 or Suite E, Unionds, WA 98026 Tax Account Parcel No. 4519-002-005-00
Issued To: Kim Investment Inc., Business Owners
Address Of Person This Order Is Issued To: 15863 SE 59"'Place, Bellevue 98006
Code Section Violated:. Unifonn Mechanical Code Sections 112 & 115 & 116 & 117.
Description of Violation: Failure to contact City Building Inspector for required inspection on
Mechanical Permit #2004-0392. As of November 25, 2004 the mechanical pen -nit has expired.
Corrective Action Required: On 2/6/04 Evergreen Refrigeration Submitted a pen -nit application o
belialf of Manna Teriyaki to change out a faulty HVAQ unit. The l2ermit was valid until November 24,
2004 and has since expired. The corrective action required is to make application for a new mechanical
p.��r_init, remit fees to the City in the arnount of $65.00, obtain the permit and call for the requi
inspection on the HVAQ unit.
Correction is Required no later than: 5:00pm (time) December 27, 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:
Issuing Party
Signature
Date Mailed: December 9, 2004 Date Served
Title Building Official
CC: Everpyeen Refrigeration Oc, 727 South Kenyon Street, Seattle, WA 98108
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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 .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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