20050604.pdfFOATE RECEIVED
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCPApprovea 13
RW Permit Requited cl
EXISTING PROPOSED Street Use Permit Required 13
Inspection Requited 13
Sidewalk Required 13
PDE-INSPECT�QIN RE.QUIRE-Elundergrouna 13
REQUIRED DEIICATIbl`4� — Wifinq required 0
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Description
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HEAT SOURCE
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Building Permit
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HECK NO:
Plumbing
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
SEPARATE PERMISSION.
Grading
Engr. Review
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PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
OCCUPANT
GROUP
OCCUPANT
LOAD
Description
State Surcharge
City Surcharge
Base Fee
FEE
*APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND S Fire Review Plan Chk. Deposit
UCCESSORS
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IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
I M 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
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
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Olficial or his/her Deputy! and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORJMI�N'S COMPENSATION #4SURANCE AND RCW 18:27. OFF DATE
CIALS Sl N TU E
SIGNA 'F916�0;*NER O� Ar�,ENTj�.' DATE SIGN T A,
ED (425)
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771-0220 _REL1ASIfD13y ADATE
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 I IRC1110. PINK -OWNER - GOLD - ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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'Aug 12.05 08:57a American Environmental Co 20.6 522 4099 P.1
PO Box 81005, Seattle, WA 98108-1005
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Phone: (206) 267-0746 or (860)357 -2760
Fax: (206) 522-4099
WA State Contractor# AMERIEC996MB
August 12, 2005
Sandra Zuanich
Nalund & Associates Inc
9792 Edmonds Way, PMB #266
Edmonds, WA 98020
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Fax: .425.771.7105
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Lette*r of Completion
(AEC Job 5303)
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Re: Asbestos Abatement Services at: 22815 102
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This is to cert that'American Environmental Construction LLC has removed all of the,
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asbestos containing materials from the above referenced address per the Asbestos
Proposal & Contract
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Survey conducted by Asbesto -Test Inc., dated July 21, 2005 and our
dated July 29, 2005.
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Clearance Air Monitoring (Sample Type CL) as reported on the attached Air Sample Data
Sheet indicates that the airborne asbestos level is below th e EPA established standard of
fibers/cubic centimeter for clean air after an abatement project. Accordingly, the work
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area is safe, in regard to asbestos exposure, forre -occupancy and/or demolition.
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Please.call me at 206-523-4441 if you have any questions or comments regarding this
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Letter of Completion.
Respectfully submitted,
Arneric nvironmental Construction, LLC
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RECEIVED
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AUG. 12 2005
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DEVELOPMENT SERVICES. CTR.
CITY OF. EDMONDS
FINAL PROJECT. AFPROVAL FORM
TO:
DATE:
ME-MOTO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
VLEASC SIGN
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DESCRIPTION OF WORK TO BE INSPECTED f;I
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A field inspection was conducted to -determine. compliance with -approved plans. Final appioval
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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. qwner/contracior by inspector.
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FAJILED FINAL INSPECTION - OUTSTANDING ISSUES
.0 Copy of CORRECTION NOTICE.given to owner/contractor by inpector
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RE-INSPE-CTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
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