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PERMIT EXPIRES
PERMIT
CITY OF EDMONDS NUMBER
CONSTRUCTION PERMIT APPLICATION ooREss SUITE/APTP
OWNER NAME/NAME OF BUSINESS
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Street Use Permd Required
CITY ZIP TELEP ONE EXISTING PROPOSED _ Inspection Required 0
! Sidewalk Required E3
/3�7 REQUIRED DEDICATION FT Underground
Wdm required 17
'N'�AMMEEYr f� ( r j p� METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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STATE LICENSE NUMBER EXPIRATION GATE CK Y V RIANCE OR COSH RELINE OR ADB# INSPECTION SEPA
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PROPERTY TAX ACCOUNT PARCEL NO.
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❑ NEW ❑. RESIDENTIAL PLUMBING MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR
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❑ ADDITION MIXED USE ❑ CHANGE OF USE �_ •�
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❑ REPAIR ❑ GRADING CYDS ❑
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❑ DEMOLISH ❑ TANK ❑
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❑GARAGE RETAINING WALL , ` ~
CARPORT ❑ ROCKERY ❑ FIREA ARM LER
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: U 1
//r/�• �' I O TYPE OF CONSTRUCTION CODE OCCUPANT
N C iC/ GROUP
NUMBER NUMBER OF
OF DWELLING SPECIAL INSPECTION CONSULTANT OCCUPANT
STORIES UNITS ���� LOAD
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GEOTECH REPORT
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VALUATION t�-i�.'Yl �T S�LL%'�✓'
Description FEE Description FEE
Plan Check State Surcharge ~0
HEAT SOURCE LOT SLOPE% VESTED DATE }
Building Permit City Surcharge /J
PLAN CHECK NO: �, �' I r „ 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 Gradin
J DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE g
f SEPARATE PERMISSION,
2 Engr. Review
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PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
CL PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection
H 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit i
Lu IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
I EDMONDS, WASHINGTON, ITS OFFICIALSt EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
a ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
o DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due
i NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
Recording Fee Receipt #
1 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. CALL Budding Official or his/her Deputy: and Fee s.are paid. and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF .THE LAB ODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged to space provided
WORKMEN'S COMPENSAT)Oli INS ANCE AND RCW 16:27.
OF - IGN�� E DAT
SIGNATURE (OWNER OR GENT DATE SIGNED (42.5)
771 '0220 RELEASE BY IDATP
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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 -INS ECTOR
— FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC109 / IBC110 if IRC110, PINK -OWNER • GOLD - ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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Y 4.F . ,��, ��„<<w• GARY HAAKENSON
CITY OF EDMONDS
r MAYOR
- 121 STH AVENUE NORTH • EDMONDS, WA 98020 • (425) 771-0220 • FAX (425) 771.0221
:� • Website: www.d.edmonds.wa.us
DEVELOPMENT SERVICES DEPARTMENT
5
j� c 189Q Planning • Building • Engineering
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June 2, 2005
Maurine &Mary. Burris
Post Office Box 843 m'
Edmonds, Washington 98020
RE: 9681 Firdale Avenue, Olympic Dancesport, LLC m w.
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I Dear Mr. & Mrs. Burris:i
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The purpose of this letter is to follow-up on a Stop Work order issued -by the City Fire e Z %.
Department to your business in Firdale on May 19, 2005. The Order required you to obtain a D-
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remodeling permit but as of today no building permit application has been filed. NL
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Please respond to this letter by either:
Submitting a complete application at City Hall (121 5`)' Avenue -North) for remodeling M m is
(see enclosed Tenant Improvement permit submittal handout for what constitutes a
complete application) by June. 20, 2005 OR, ` c
• If you believe that the work performed does not require a building permit (please refer to rn r
the enclosed Commercial permit exemption handout) provide a letter to my office n;
explaining what work was done. Please submit such letter by June 20, 20050
If you. want to meet in person to discuss this matter please call in advance for a mutually
agreeable day and time as I am frequently assisting other citizens and not always available. I can } z
be reached at 425-771-0220 extension 1226 during City business hours of Monday through
Friday from 9:00am to noon and 1:00pm to 4:00pm. z
On a sidenote your City business license is not yet approved because the City needs to know the n
age range of .your students and maximum class size. m
Sincerely,
Jeannine L. Gr
Building Official
• Incorporated August 11, 1890 • .
Sister Citv - Hekinan. Japan