20050104.pdfDATE RECEIV
P
/A PERMIT EXPIRES
F
PERMIT
CITY OF EDMONDS N U M BE R
CONSTRUCTION PERMIT APPLICATION JOB
ADDRES SUITEIAPT#
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OWNER NAMEINAME OF BUSINESS
PLAT NAMEISUBDIVISION NO. LOT NO LID NO
MAILING ADDRESS LID FEE $
u
7ESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required 13
0 ex 77 Street use Permit Required 13
CITY ZIP TELEPHONE EXISTING PROPOSED Ins;oCtion Required C3
Sidewalk Required [3
REQUIRED DEDICATION FT riderground [3
2� 7 7t? 7-5 0
NAME METER SIZE LINE SIZE NO OF FIXTURES PRV REQUIRED
YES 13 NOM
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ADDRESS REMARKS
2 OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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CITY ZIP I TELEPHONE rz--,,�wnenuL,4i r
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ENGINEERING REVIEWED BY DATE
x ADDRESS
FIRE REVIEWED BY DATE
CITY ZIP TELEPHONE
0
VARIANCE OR Cu SHORELINE OR ADB# INSPECTION EPA
EXPIRATION DATE CHECKED BY RED D S
STATE LICENSE NUMBER COMPLETED EXEMPT
113YES 13N)l
CA# ZONE SIGN AREA HEIGHT
j PROPERTY1 ACCOUNTPARCUNO.
< WAIVER13 ALLOWED , PROPOSED ALLOWED PROPOSED
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_j STUDY [3
NEW RESIDENTIAL LOT COVERAGE REQUIRED SETBACKS FT I PROPOSED SETBACKS (FT.)
PLUMBING MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR 0
E] I ADDITION COMMERCIAL. COMPLIANCE OR z
CHANGE OF USE
0 MIXED USE z
- PARKING LOTAREA PLANNING REVIEWED BY DATE 5
REMODEL _ie REQ*D PROVIDED 0.
MULTIFAMILY SIGN
Z GRADING FENCE
XREPAIR El CYDS 1:1 ( — X FT.) REMARKS - x,
OTHER
DEMOLISH TANK
GARAGE RETAINING WALL FIRE SPRINKLER
z CARPORT ROCKERY FIREALARM
(TYPE OF USE, BUSIES OR ACTIVITY) EXPLAIN:
TYPE OF 9ON CTION CODE OCCUPANT
GROUP
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NUMBER NUMBER OF K
OF DWELLING SPECIAL INSPECTION CONSULTANT OCCUPANT
STORIES UNITS LOAD
0 REQUIRED YES
DESCRIBE WORK TO BE DONE
REMARK
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BY: 674 LWIVA My
5� ev /dr, P.~ 'z "'j'.'P/X STRUCTURAL DESIGN
BY:
C" C.;' /.A- VALUATION
V)) Description FEE Description FEE
Plan. Check State Surcharge �z
HEAT SOURCE,/ LOTSLOPE% ESTED DATE Building Permit City Surcharge i,,,tc
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
t= SEPARATE PERMISSION.
2 Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6) Eng I r. 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
W IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
i
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
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 MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due
01 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee Receipt # 5;�5 Z�501
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION �ZPPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application is not a permit until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building Official or hisihor Deputy: and Fees are paid, and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED receipt is acknowledged in space provided.
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
WORKMEN*S COMPENSATION INSURANCE AND RCW 18:27. DATE SIGNED 0!; RANAT -7 DATE
-Ty
SIGNATURE (OWNER 0 GE iTY' (425)
N J�
771 -0220
RE AS. D BY
TENTION EXT. 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI ORIGINAL -FILE YELLOW INSPATOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 i IRC110. PINK -OWNER GOLD - ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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Feb 15 05 01 :01p CHRIS LINDn I -L P.1
3GO 6 GO -1007
lace,
DESIGN & CONSTRUCYION & SERVICE
tdcal Contractots
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(425)4&55118 1 (42.5)78"118 P.O. Box 1003
Paget
Botheo, WA 9W41
(Of 1) Foy'(42.5) 485-3734
February 15.,2005
To: Salamonsen ConstraCtiOn (425)798 -7549 .771.3878 (fax)
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Ike: Skandi Apaytinents (425)775 -57617 (office and fa.
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23809 84h -Ave. W.
Apartrmnt 4 101
Edmonds, WA. 98026
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Attn: Michelle Grigsby (Mankper)
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To ,vhom it may concern.
'101 'It the above addr -ess::
Tn regards to the vchicle damage that was sustained by Apt, 114-
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1) The existing Y/iring linder the vyindow was undai -naged and does not need to be
eplaced.
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The existing electrical, panel was alSO Undamaged and can be lefl is"
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3) Upon completion of insulation and sheetrock instaLlation, the outlets and -BB
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heater can be F,eplaced without any repairs to the wiring.
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Note P-1: If the building inspector requires an el ectrical inspection, we can arrang e this for
$150.00 fr & Industries (Everett. Office)t
om the Department of Labor
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Please. .1'eel frce to call if YOU have any ques
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Sincerely,
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RECEIVED
Chris M Hill
President and Adi-ninistrator
FEB 16 2004
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
MICRORLM
Licensed, Bonded & InSUred
POPEL 044DF