Building PermitADULT FAMILY HOME Permit
J
City of Edmonds
www.edmondswa.gov• •
Type: ADULT FAMILY
Subtype: NEW AFH COMPLIANCE
Status: ISSUED
HOME
Parcel No: 00434207103800 Site Address: 415 9TH AVE S EDMONDS,WA 98020-3308
Applied: 4/12/2022
Subdivision: BLA AFN 200009185001, 004342 Lot: 0
Issued: 4/25/2022
Fire Sprinklers: Lot Area: Zoning:
Final:
Valuation: $0.00 Occupancy Type: Construction Type:
Expiration Date: 4/20/2023
Code Edition: 0 No. Stories: 0 # of Dwelling Units: 0
Issued by: JOK
Scope of Work: BETTER LIVING RETREAT- AFH COMPLIANCE INSPECTION - NEW OWNER
WA State Contractor L & I #:
NAME TYPE
NAME
ADDRESS
PHONE
EMAIL
APPLICANT
ZBIGNIEW BARNAS
415 9TH AVE S, EDMONDS WA
(425)297-3703
DKOPER@YAHOO.COM
98020
CONTACT
BETTER LIVING RETREAT
LLC
415 9TH AVE S, EDMONDS WA
(425)297-3703
dkoper@yahoo.com
98020
CONTRACTOR
CONTRACTOR UNKNOWN
OWNER
TOMICI CORNELIA BRUIBAN
415 9TH AVE S, EDMONDS WA
(206)550-4785
98020-3308
FEE
INFORMATION
DESCRIPTION
ACCOUNT
AMOUNT
PAID
PAID DATE
RECEIPT #
ADULT FAMILY COMPLIANCE - SUB
001.000.322.10.000.00
$175.00
$175.00
4/13/22
R19370
BLDG PERMIT FEE
ADULT FAMILY COMPLIANCE - SUB
001.000.345.83.000.00
$175.00
$175.00
4/13/22
R1 3370
BLDG PLAN REVIEW FEE
ADULT FAMILY COMPLIANCE - SUB
001.000.342.40.000.00
$100.00
$100.00
4/13/22
R19370
FIRE INSP FEE
ADULT FAMILY COMPLIANCE - SUB
001.000.345.83.100.00
$100.00
$100.00
4/13/22
R19370
FIRE PLAN REVIEW FEE
CITY TECHNOLOGY FEE CHARGED
001.000.321.99.100.00
$40.00
$40.00
4/13/22
R19370
PER PERMIT
RESIDENTIAL STATE SURCHARGE
001.000.237.150
$6.50
$6.50
4/13/22
R19370
TOTALS: $596.50
$596.50
CONDITIONS
• •NS
- Schedule •nline
at: htti)s://Inspection.MvBuildingPermit.co
COMPLETED
SEQID INSPECTION TYPE
INSPECTOR
NOTES
DATE
X-1 FIRE FINAL
X-3 BUILDING FINAL"
Printed: Monday, April 25, 2022 9:08:32 AM 1 of 1