20050871.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF allSINESS
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PERMIT
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PLAT NAMEISUBDIVISION NO.
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
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EXISTING PROPOSED
Street Use Permit Required
Inspoclion Required
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METER SIZE
LINE SIZE
NO. OF FIXTURES
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REMARKS
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OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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STATE LICENSE NUMBER EXPIRATION DATE CE VARIANCE OR CU SHORELINE ORAD111 INSPECTION SEPA
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PROPERTY TAX ACCOUNT PARCEL NO. ZONE SIGN AREA HEIGHT
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ESIDENTIAL PLUMBING if MECH LOT COVERAG REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
NEW F4� 1:1 ALLOWED PROPOSED FRONT SIDE REAR FRONT LJRSIDE REAR
COMMERCIAL
ADDITION COMPLIANCE OR -b Y'I* 45 llo/ z
1:1 CHANGE OF USE (0 8 2
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(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
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TYPE %ONSTRUCTION C099 OCCUPANT
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OF CONSULTANT OCCUPANT
UNITS _TLOAD
DWELLING SPECIAL INSPECTION
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DESCRIBE WORK TO BE DONE
REMARKS
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Description FEE Description FEE
HEAT S RCE LOT SLOPE% TED DATE Plan. Check /t 36 State Surcharge /V
7'. 1 _41151- Building Permit 6C7 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
:_E DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
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t SEPARATE PERMISSION.
Lu PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5) Engr. Review T
n PERMIT LIMIT. SEE ECDC i9.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection
U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
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_j IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
a 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
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
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
Fire Review
Plan Chk. Deposit
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Fire Inspection
Receipt #
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Total AITIL Due
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Recording Fee
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
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-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
APPLICATION APPROVAL
This application is not it pefrint until signed by the
Building Off icial or hisilbor Deputy and Fees wo paid.
and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
recoilit is arknowledgied in space provided
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
(425) r117
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OFF ALS SIGNAT J)E D TF
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SIGNATURE OWNER OR&
DATE SIGNED
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771 -0220 --RTD BY 1-1 E
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- Z
IGINAI FILE YELLOWANSPE TC
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 1 IRC110. PINK -OWNER GOLD - ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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........... GARY HAAKENSON
CITY OF EDMONDS MAYOR
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. . . . . . . 121 5TH AVENUE NORTH EDMONDS, WA 98020 (425) 771-0220 FAX (425) 7.71-0221
Websile: wwad.edmondsma.us
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building Engineering
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December 7, 2006
Barb Janacek
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19228,92" Ave W
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Edmonds, WA 98020
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RE: Bui Iding Permit # 2005-0871
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Site Address 1922892 Ave W
Ex iration Date 09/29/06
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Dear Barb Janacek:
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According to the City of Edmonds Building Division records and the. Edmonds
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community Development Code Chapter 19.00.005 A 6.c Section 105.5, the above.
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0 6. Our records indicate that
referenced building permit expired n September 29, 200
work has not begun on this project and we ar e closing the permit.
65
if you have abandoned the project please not ify us in writin g as soon as possible. We
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may be able. to refund a portion of your permit costs.if W e receive a written response
you in the next 10 days.
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'If you would like your plans returned to you they will be available for pick up , until
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Januar 25 2006.
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if you wish to pursue this project in the future a new application, new plans under the
current code, and new permit fees will be required.
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If you have any questions please don't hesitate to contac t me at 425-771-0220.
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Sincerely;
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Pennit C ordinato
Development Services Department
(425) 771-0220 x1336
Incorporated August 11, 1890
Sister City - Hekinan, Japan
RECORD OF INSPECTIONS