20050432.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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LICENSE NUMBER EXPI�AfIO DATE HECKEq 6
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FIRTY TAX ACCOUNT PARCEL NO
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ROCKERY
;S OR ACTIVITY) EXPLAIN.
PERMIT EXPIRES
PERMIT
NUMBER
JOB SUITE/APT#
ADDRESS.
PLAT NAM EISUB DIVISION NO. LOT NO LID NO
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
RW Permit Required
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EXISTING.-,-_*__p 1tLQjWPECT40N_REQUfREj
Street Use Permit Required
specijon Required
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Required
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REQUIRED DED§ rfh—Cj-M13=L1
underground
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METER SIZE LINE SIZE NO. 06�1 FIXTURES "P OftIRED
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REMARKS
OWNERICONTRACTVJJWI"ZROSION CONTROUDRAINAGE
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HOSE BIB WITHAVB INSTALLED
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DUMP AT APPROVED DUMP SITE ONLY
SEE Dc-MOLInON 1NSPEcnoN
ENGINEERIN EvIf:tflTKLI9T �5NBACK or JOWICARD
FOR INSPECTION REQUIREMENTS
FIRE REVIEWED BY DATE
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VARIANCE OR CU, SHORELINE OR ADBN I INSPECTION I SEPA
REO'D COMPLETED I EXEMPT
YES
ZONE SIGN AREA HEIGHT
CA#&- ALLOWED ROPOSED ALLOWED PROPOSED
WAIVE%tj��
STUDY 13 1 1 1 1
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSEDSEIDAUkk % i I
PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT L/RSIDE REAR a
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PARKING A PLANNING REVIEWED BY DATE
SIGN REQ'D P ROVIDED
FENCE 17
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FIRE SPRINKLER
FIREALARM I
NUMBER NUMBER OF
OF DWELLING
STORIES I I I
DESCRIBE WORK TO BE DONE I
TYPE OF CONSTRUCT
SPECIAL INSPECTION
REQUIRED 1:1 YES
CONSULTANT
OCCUPANT
GROUP
OCCUPANT
LOAD
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GEOTECH REPOtF!;,-
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STRUCTURAL DE,912E��,
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VALUATION
Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE
LOTSLOPE%
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VESTED DATE
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Building Permit
City Surcharge
PLAN CHECK NO: LPlumbing
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
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SEPARATE PERMISSION.
Grading
Engr. Review
u PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
L PERMIT LIMIT: SEE ECDC i9.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION.
Engr. Inspection
*APPLICANT, ON BEHALF OF His OR HER SP . OUSE, HEIRS, ASSIGNS I AND SUCCESSORS
Fire Review
Plan Chk. Deposit
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_1 IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
4 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
Landscapelnspl.
Total Amt. Due
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
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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 permit until signed by the
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
CALL
Building Official or hisihor Deputy and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
receipt is acknowledged in space provided.
FOR INSPECTION
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
C�F IALS SIGNATURE ATE
SIGNAT RE (OWNE R GENT): DPATSIGNED
(425')
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771-0220
'AELEASED BY DAyt
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 CERTI-
ORIGINAL -FILE YELLOW -INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC110.
PINK -OWNER GOLD - ASSESSOR
10104 PRESS. HARD -YOU. ARE MAKING 4
COPIES
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO. PERMIT COORDINATOR, BUILDING DIVISION
FROM: F IRE DEPARTMENT DATE
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ENGIN EERING DIVISION DATE
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PLANNING DIVISION DATE
PLEASE SIGN
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PROJECT 71-o 1_t
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PERMIT ADB# DATE INSPECTED
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DESCRIPTION OF WORK TO BE INSPECTED
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A field inspection was conducted' to determine. compliance with, approved plans. Final approval.
denotes that there are no objections from the above signed Department to the release of
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PERFORMANCE BONDS and the granting of:
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GRANT FINAL PROJECT. APPROVAL
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GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES,
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El Copy of CORRECTION NOTICE given to owner/contractor by.inpectbr
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RE -INSPECTED OUTSTANDING ISSUES - GRANTFINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fbnns:ocaprv1 3M/04
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GARY HAAKENSON
CITY OF EDMONDS
MAYOR.
121 5TH AVENUE NORTH EDMONDS, WA 98020 (425) 771-0220 FAX (425) 771-0221
Websile: www.dedmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
IP C. 1 BC)" Planning Building Engineering
Januar 6,2006
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The Bank of Washington
Christine Sparling
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303.5"' Avenue S #100
Edmonds, WA 98020
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Re: Demolition Frozen Fund Account #110006186, MASTGECH LLC, 21905
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76"' Avenue W, Edmonds WA
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Dear Sir or Madam:
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The. City of Edmonds hereby authorizes the release $2,000 from the above referenced
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Demolition Frozen Fund. All i hterested City departments have approved the release of
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the Demolition Frozen Fund.
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Sincerely,
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Marie Harrison
Senior Permit Coordinator
Cc: Applicant
File
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incorporated August 11, 1890