505 5TH AVE S (3).PDFiiiiii 11111111
16033
505 5TH AVE S
5-1-11 ALE
Startzman, Jeanne
November 14, 2013
ATTN: Geoff, Alpha Graphics
Reproduction Order from:
Reproduction specifics (hard copy, CID, etc.) to be arranged with Alicia Pierce, Foster Pepper,
206-447-5941.
Originals and copies/disks to be returned to City of Edmonds.
Please call with any questions.
Thanks,
?.,atiiie Stair-tzmatn
Public Disclosure & Records Management Specialist
City Clerk's Office - 425-775-2525
505 � 5 th Avenue South
Gregory Condos
Public Records Request by Alicia Pierce
(Jeanne's request)
a
Received: 10-15-2013 Closed: 11-25-13
Please keep documents together for
Building to re -file.
FOSTER- PEPPER,.,
Direct Phone (206) 447-5941
Direct Facsin-dle (206) 749-216q
E-Mail Pierk@foster.com
November 8, 2013
Via E-Mail (jeanne.startzman�ci.edmonds.wa.us)
Jeanne Startzman
Public Disclosure & Records Management Specialist
City Clerk's Office
City of Edmonds
121 5`h Avenue North
Edmonds, WA 98020
Re: Public Records Act Request: 505 5th Ave., S., Edmonds, WA "The Gregory Condos"
Dear Ms. Startzman:
'Pursuant to the WA Public Records Act, RCW 42.56) et seq.,,we are requesting a copy of all
documents/records regarding The Gregory Condos at 505 5 1h Avenue, South, Edmonds, WA.
This request includes but is not limited to: all building permits; drawings; plans; records;
inspection reports; and fire related records, from all departments at the City of Edmonds, such as
the Building Department, Planning & Engineering Department, etc.
If there is a. charge for copying these records, please let me know so that we can remit payment
promptly. Additionally, I realize that we are requesting a large volume of documents. Please let
me know if we could review/receive copies of these documents on a rolling basis as we. would
like to receive these records as soon as possible.
Thank you for your assistance. If you have any questions or concerns, please'do not hesitate' to
contact me at (206) 447-5941 or via email, piera@foster.com.
Best regards,
Alicia B. Pierce
Paralegal
F-.1 --M M.,
A, "
TEL: 206.447.4400 FAx: 206.447.9700 1111 THIRD AVENUE, SUITE 3400 SEATTLE, WASHINGTON 98101-3299 WWW.FOSTER.com
51334061.1 SEATTLEWASHINGTON SPOKANE WASHINGTON
CITY CLERK"S OFFICE
Public Records Request
Response'-Tirne Tracker
As a member of the City's Clerk's response team —and to keep track of the total time spent
responding to this specific public records request that originated in the City Clerk's Office —
please enter your name and time spent on the request described below.
Request Made By: Alicia Pierce
Request Received: November 8", 2013
Request (Summary): 505 51h Ave S / The Gregory / Everything
N a V. 7F,�;
our me
ime� pen
Linda Thornquist
4 hours
TOTAL
Please email the Response -Time Tracker to the Clerk's Office when you have completed a request, or
return it with your responsive documents. In addition, to your name, please list other staff in.your
division who spent time on this request.
Thank You!
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BLD20040390
FINAL
5/21/2004
23 - Demolition
505
5TH AVE
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BLD20040513
FINAL
6/29/2004
70 - Tanks/Fuel
505
5TH AVE
BLD20040721
FINAL
8/27/2004
28 - Fill/Grade/Excavate
*2
505
5TH AVE
-S
S
BLD20041001
FINAL
12/6/2004
32 - Foundation
42�
505
5TH AVE
S
'BLD20050047
FINAL
1//Ib/2005
47 - Plumbing/Water Service Line/Fountain
q 2-
505
5TH AVE
S
BLD20050258
I
FINAL
3/30/2006
6 - Apartment/Condo New
44�71
505
5TH AVE
S
BLD20050384
FINAL
5/10/2005
56 - Fire Connection
.,4 2_
1505
5TH AVE
S
,9'-BLD20050433
FINAL
5/26/2005
30 - Fire Sprinkler
�505
5TH AVE
S
X'BLIJ20050697
FINAL
8/15/2005
40 - Mechanical/Solar
505
5TH AVE
S
BLD20051134
FINAL
12/12/2005
40 - Mechanical/Solar
4- '32
505
5TH AVE
S
BLD20061136
FINAL
10/10/2006
70 - Tanks/Fuel
505
5TH AVE
S
BLD20061258
FINAL
11/14/2006
22 - Deck/Porch/Patio Cover
505
5TH AVE
S
PLD20070014
FINAL
1/4/2007
179 - Fire Alarm
4 `�7
505
5TH AVE
S
BLD20070786
FINAL
7/26/2007
1 63 - Sign
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5045
5TH AVE
5
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B-103
BLD20070790
FINAL
7/27/2007171
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505
505
5TH AVE
5
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A-103
lie.BLD20070836
FINAL
8/13/2007
71 - Tenant Improvement
5TH AVE
S
B-103
BLD20070876
-FINAL
8/23/2007
63 - Sign
-e4
505
5TH AVE
S
A-103
BLD20070940
FINAL
9/14/2007
40 - Mechanical/Solar
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505
5TH AVE
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A-103
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BLD20070941
FINAL
9/14/2007
40 - Mechanical/Solar
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505
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B-103
X.BLD20070973
FINAL
9/27/2007
79 - Fire Alarm
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BLD20070974
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79 - Fire -Alarm
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BLD20071009
FINAL
10/5/2007
30 - Fire Sprinkler
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30 - Fire Sprinkler
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11/19/2007
71 - Tenant Improvement
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11/26/2007
63 - Sign
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FINAL
1/24/2008
79 - Fire Alarm
505
5TH AVE
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104
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BLD20110958
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BLD20110993
FINAL
11/30/2011
47 - Plumbing
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STH AVE
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BLD20111035
FINAL
12/13/2011
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505
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5TH AVE
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PERMIT
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JOB
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THIS PERMIT AUTMORIZES ONLY THE WORK NOTED. TH13 PERMIT COVERS WORK TO Mechanical
L BE DONE ON PRIV TE P OPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS. SIDEWALKS, DRIVErA IS. MARQUEES, ETC.) WILL REQUIRE Grading
SEPARATE PERMISSIOH.
Engr. Review
PERMITAPPLICATION: SEE ECDC 19.00,005(A)(5)
PERMIT LIMIT. SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFOR.ATXN Engr. Inspection
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESSORS Fite Review Plan Chk. Deposit
Re Re
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD ARMLESn THE CITY OF ve
fiv
EDMONDS, WASHINGTON. ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection
Inspection Receipt III
A�LC IMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIREGTLYOR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. 13SUANCE OF THIS PERMIT SHALL NOT BE
Le sc- pe osp
DEEMED TO MObIFY.WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE LandSC3peinsp.. Total Amt. Due
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
R.comong Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GWEN 15 CORRECT: AND THAT I AM THE OWNER, OR THE DVLY AUT14ORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUe' TN3 appl- a M a 4 unil ,qr.0 I, U,,
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOY CALL Bodding Off�al a N�- DePoty: ano Foe, - Pool, Iox!
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATI FOR INSPECTION
SURANCE AND RCW 16:27.
OFF[ S AT DATE
SIGMA 11,00YINER OLIN !
(425)
DATE SIGNED
zt- f-,
V 771-0220
�SE. BY,
Ly CA
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUI I LDING OR STRUCTURE UNTIL EXT. 1333
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI.
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / ISC110 / IRCIIG.
'KING 4 COPIES PINK - OWNI`R COLD - ASSESSOR
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DATE: 7
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
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-FIRE DEPARTMENT DATE 60
ENGINEERING DIVISION DATE
A_T
PLANNING DIVISION DATE
PROJECT cl�,.
Y,
SITE ADDRESS ---
PERMIT ADB# DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection. was conducted to determine compliance with -,approved plans. Filial approval
denotes' that there are no objections from.:the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
GRANTYINAL PROJE, CT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector.,
FAILED FINA L INSPECT'ION - OUTSTANDING ISSUES
Copy of CORRECFION NOTICE given to owner/con tractor by inpector
2.
3.
RE-INSPE&ED OUTSTANDING ISSUES - GRANT FINAL P I ROJECT APPROVAL
Date Signature
1:tcmp:b1dg:fbmis:ocaprv1 3/25/04
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FEE
Description
FEE
/,4w7' 7- 4 MAW
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HEAT SOURCE
Check
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Building Permit
City Surcharge
16-
PLAN CHECK 12) 15�4
Plumbing
Base
F
THII PERMIT AUTHORIZEI ONLY 1.1 WORK NOTOD. THIS PERMIT COVERS WORK TO
Mechanical
V E DONE ON PRIVATE PROPERI , �NLY. ANY CONSTRUCTION ON THE PUBIC
GONMAIN (CURB S, SIDEWALKS, OR14WAYS. MARQUEES, ETC.) WILL REOUIRE
SEPARATE PERMIS SION.
Grading
PERMIT APPLICATION: SEE ECCii 19.00.0 II(AIM
Engr. Review
PERMITLIMIT. SEEECDC 12.00.D05(AIM
SEE BACK OF PINK PERMIT FOR PjORE_ORMATON
Engr. Inspection
'APPLICANT, ON,BENALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESSORS
Fire Review
Plan
Ch.�. Deposit
IN INTEREST, A REES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVEn MATURE. ARISING DIRECTLY OR IND RECTLY
Fire Inspection
Receipt
#
FROM THEISSUANCE OF THIS PERMIT ISSUANCE OF TAIS PERMIT SHALL NOT BE
DEEMED TO MODIFY. WAIVE OR Rr.DUCE ANY REQUIREMENT OF ANY CITY URD INANCc
Landscapelnsp.
Total
Amt. Dun
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROV SION.-
Recording Fee
Receipt
#
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN 13 CORRECT' AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPL111 ATION APPROVAL
THE OWNER. I AGREE TO COMPLY WTH CITY AND STATE LAWS REGULATING CONStRUC'
CALL
TN. Pob.— . � II W 1 VNK, . IN.
TION: AND IN DOING TH 0 K AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF H a R CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
8�.WIV Offimli a NIvNv DoWly. aW F 0,d� 3N
QW-Mc. P—t.
WORKMEN 3 COMPE ION IN UFLANCC AND RCW 18:27.
OFFICIALS SIGNATURE p
NA. R� C R AGENW�Y)�.: SIGNED
(425)
�,T/E,25
=ATE
771-0220
111
OATE
A17ENTION
F.XT. 1333
IT %.UNLAWFUL T6 USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
�(:T.R
A FIRhL INSPECTION HAS BSF
.N MADE AND APPROVAL OR A CFRTI-
�114101
FICATE OF OCCUPANCY HAS BEEN GRANITED.UBC109 I IBC11LI I IF 11 10.
ORIGINAL FILE INS
PINK - OWNER - COLD -ASSESSOR
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PLUMBIN6:' 13
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PEFUJITTAPPLICATION: IEDDAYS
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DEPARTMENT OF BUILDINGS
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PER International Building Code Section 110
A,
At: 1505 5" Ave S, Edmonds, A 98026 Building Permit #: 2005-0258
4 �N7
Dwelling Units: **2
Occupancy established by,this dertificatei 7— No. Stories: 3
R2/M/S2
Basement: Yes
14't- Type Construction: VA Sprink
Maximum Occupant Load (Per IBC 1004)
Room capacity, signs, when required, must remain posted a! all times.
THE The Gregory HAS BEEN IWSPECTED AND APPROVED AS COMPLYING WITH THE REQUIREMENTS OF%THE
Owner of Building: Fifth Ave Developi�ent, LLC Addressrrenant Space: 51 West Dayton St, #304
.2003 EDITION OF THE INTERNATIONAL BUILDING CODE AS ADOPTED BY THF CITY FOR THE GROUP AND DIVISION OF OCCUPANCY AND�
THE
USE FOR WHICH THE PROPOSED OCCUPANCY IS CLASSIFIED.
Issued this 3M day of August, 2007
H
C [EF BUILDING OFFICIAL
BY:
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1 HEREBY ACKNOWLED09 THAT 1 HAVE R EAO THIS APP LICATION: THAT
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
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Grading
PERMIT APPUCATIO N! SEE ECDC I9.W.00S(A)(5j
Engr. Review
T PERMIT Lunt. SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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f
OUSE.
'"PLICANT. ON BEHALF OF HIS OR HER SP HEIRS. ASSIGNS AND SUCCESSORS'
F, --I Review
Plan
Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND LJ HARMLESS THE CITY OF
No
EOM NOS, WASHINGTON. ITS OFFICIALS. EMPLOYEES. AND AD INS FROM. ANY
RE AND
ALL CL,UMS. FOR DAMAGES OF WHATEVER NATURE. ARISING DIR OR INOI CTLY
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F OM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PEERCMn' SMALL NOT BE
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IN VIOLAT!O. OF HE LABOR CODE OF THE STATE OF WASHINGTON RE�.ATING TO
C
WORKMEN S OMPENSATION INSURANCE �;O RCW 18:27.
FOR INSPRICTION 1-01 -1
c('11C DATE
(425�
W'hlft�
771-0220
41
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ATTENhOW
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IT IS UNLAWFUL TO USE OR OCCII17yBU.ING OR STRUCTURE UNTIL
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FICATE OF OCCUPANCY HAS BEEN GRANTED. UBCi09 IBCIIO f IRCI10.
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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MAIN (CURDS, SIDEWALKS. DRIVEWAYS MAROU ES. ETC.) WILI. REQUIRE
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ALL CLAIMS,FOR DAMAGES OF WHATEVER MATURE. ARISING DIRECTLY OR INDIRECTLY
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DEEMED TO MODIFY. WAIVE OR REDUCE ANY REOUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Arrit. Due q11 1
NOR LIMIT WAY TmE crrYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Receipt III
I I HERESY ACK A HAVE READ THIS APPLICATION: THAT THE INFOR . MATION - Recoiding Fee
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7.
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EqUIpment .................
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FIRST FLOOR FRAMING
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RALPH Al.1.1--.N IIII.FORI: USA CROUP INC.
3 W DAYTON SI sTE 304
73 10 1 STI I A VI: NW 3826 WOODLAND PARK AM: N
E'DMONDS, WA 98020
ShA I I Lh, WA 98103
206-39�—I�0
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206-632-0800
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LICENSE 0: IIDLFOU(199011) EX11:12/14r006
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Add 30sq. ft. ofdcckarea to Unit 201, SW conicrol'building.
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WORKMEN'S COMPENSATION INSURANCE AND RCW 19:27.
THISAPPLICATION ISNOT A PERMIT UNTIL'SIGNFD BY THE BUILDING OFFTCIAL OR IIISIIER KPIITY AND ALL_Fr.HSARE PAID m
Signature Prht Narne Date Release d By A)ate
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rris UNLAWFUL TO UNr OR OCCUM A 1101 ov�G OR mucrupr uwnt. A F WAI N'1'1.01U� I IAS 111:1 N �FADLANO API'HOVAL ORA 0:1(111 IcAlli OF
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STATUS: ISSUED BLD200'
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-licck thejob card for all required City inspect; ns including final project approval and linal
thcbuildingorstructurc.0 .0
occupancy inspections. li
Any request for alternate cicsign,'modification, variance or other administrative deviation (licrcinaficr "variance") front
ad�pted codes, ordiAances or policies must be specifically requested in %witing and be called opt and identified. Processing
�;;J �!.fccs for such reques Imll'becs blishedbyCotiticiinridsli.iilbcF,.iidtipoiistibn�tt:il.tn(l:ircnon.rt!ftind;ible..
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noise lintits oraw�lcr5.30, unless a variance has been granted purstiant to ECC5 30.120.
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When,calling for an inspection pf"e leave (he follo�iing informiticn: Permit Number, JobSitc AAlress, i,)Tx.or ins pection tving
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rcritiestcd, Contact Name and Phone.NtnnIxr, Date Preferce(l. am I %ilielher you prerer morning or an rno0q.
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FINAL PROJECT APPROVAL FORK
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MEMO TO: PERMIT COOR-DINATOR, BUILDING DIVJSION.
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R-E-INSPECTED OUTSTANDING ISSUES - GRANT FINAL, PROJECT APPROVAL
Date Signature.
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FIFTH AVENUE DEVr-...OPMENT LLC
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I XGREE TO Y WITH CIT,Y AND STATE LAWS REMLATING CONSTRUCTION AND IN DOING,THE WORK AUTHOKIZED
THERFBY.NOPERSO WILL BE EMPLOYED IN VIOLATION OF THELABOR CODE OF Till- STATE OF WASHINGrON RELATINGTO
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WORKMrN'S COMPENSAT:ON INSURANCEAND RCW 18:27.
Till
API;.ICA'rI(jtf IS j;:
(ITY AND ALI, PAID.
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Signature 'j— Print-Niirnc Date RUA-ced By loate I
ATT3.1
"NTION
1*1 INUNLAWI-Ul. IOUSI:ORO('(1.1l'N',\ IlUILDINGOK INSI'I:C'il()N AND,\I'l'HO\'Al Olt A (1:10111CA11: 01'
0(*(..I)I'AN('N'IIA.','.Ill;.I:N(',ItANII;I.I
ARCHIN/14 PPIACANT k's I.-s s 0
STATUS: ISSUED BLD20070014
Any reques! for aftenn ate design, m2;fiealion, variance or ot her ad min i�tmtiyc deviation (Ii ere inafter' variance rom
adopted codes, ordinances cir'policies niust be spccTic,1ly ,_iqucstlid in Afaing and be called out and identified. Pioccssing
.
kes for such request shall be es I tablishe d by Council wie, �,iiall be paid upolAubmittal and are non-refundable.
Approvalofany platorphn conlaining'provi.s ions which Jo notcomply with city code and for%vilich aviriance.has notbeen
specifically identified, requested and coisidered by the appropriate city official in accordance with the appropriate provision
a r city code or.,ital c law d ocs not ;Ippro VC any it elly; licit to code g pecific.,16oll,
Somid/Nol.le originitting fircitnialliparary coll.41ruelloo Oe.q a.4 11 result orcoo4truction moviiy site evirilti Irroritilic ttobe, IlItI119
r/0-44" Omplur I'M only 11JI&L" Ow 11011ro 1)[TWO111 fli'(e..Wpin oil wi0illiyo mul 101)(fifin InIff 6.01pin 1?11
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THIS PERMITAUTHORIZES ONLY THE WORK,NOTED, 1711S PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPER.Y ONLY. ANY CONS TRUCTION ON niE
PUBLIC DOMAIN (CURBS, SIDPWALKS. DRIVEWAYS, MARQUEES, ETC.) WLL REQUIRE SEPARATE PERMISSION.
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PERMIT TIM LIMIT: SEE ECDC 19.00.005(A)(6).
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77.1-022 EX7. 1333. (47S - --- ---- FIRF(425)771-0215
PUBLICWORKS (425)771-0235 REATMENT (425) 67 RECYCUNG(425)2 54801 .
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F IN A L PR Qj CT APPROVAL FORM
TO:
DATE:_O,�
MEMO TO: PERMIT COORD INATOR, BUrLDfNG DIVISION
FROK FIRE DEPARTMENT DATE
PLEASE SUA
ENGMERfNG bms [ON DATE
FLE�a sIGN
PLANNING DlVfSfON DATT
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q JECT:
PRO Z�
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SITE ADDRESS
PERMIT 9 A_DB# DATE INSPECTED
DES CRIPtION OF,WORK.tO BE INSPECTED
Afield in sp'ection was co'nducted. to determine compliance with -approved plans. Final approval
denotes that the're are� 'no . objections from the above signed Department to the release of
OERPO"IANCE BONDS, and the granting of:
GRAINT FINAt PROJECT- APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - QUTSTANDrNG ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by- inpector
2.
3.
--TNSPEcTED OUTSTANDING ISSU ES - Gl\'.ANT FINAL PPOJECT APPROVAL
RE
Dafe Signature
1:tcmp:b1dgA6rms:ocaprv1 3/25/04
CITY OF EDMONDS,
121 sTII AVENUE NORTH - EDMONDS.WA 98020
P[ IONE: (425) 771-0220 - FAX: (415) 771-0221
STATUS: ISSUED 10/11/2006
pp�
P a rcel No: 00434212400100
'rm,,(;Ri�cw)j4Y. i
AMID410AS IiiROPAN11, 1,1' AMIN(WAS PROPANE, 1.11
51 W 3f)4
Ip .14 H VAI! ;Y Ijwy�' 19244 It VAI.i.I;YlIWY
EDMONDS,WA 98020-
KENT, WA 98032 KENT, WA 98032
253495-3001 253-395-3001
LICENSE N: AlArRIP1,055LIL FIX11:7/31/2007
INSTALL I - 5(X)(A I, 1.1'(ASTANK
. . 1
VALUATION $0
`1 rmrED
PERM;T TYPE:
PEittorr CROUP: 70 -7 a0
-Commercial
GRA D; NG: N CYDS: 0
'rem; OFCONSI'RUCTION:
RETAININGWALLROCKERY: N
OCC(IPANT GROUP:
uCCUPANT LOAD:
FENCE: N 1 0 X 0 FT.)
CODE:
OTHER: N ------- OTHER Df:.SC: -
NUMBER,QFsToRjEs: o
Vl:%1'1'1) DATE:
NUMBER OF DWELLING UNITS: 0
BASEMENT: 0. 1 IST FLOOR:,O 7.2ND FLOOR: 0
7-
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
,3RDFLOOR:0 '-GARAGE:0 DECK:O �� OTI7[FR:.O
3 1 ROFLOOR:0 - GARAGE , :0 DrCK: 0 OTiIEK: 0
I AGREE TO COMPLY WITH CITY AND -STATE L;',ws REGULATING CONSTRUCTION AND IN DOING TIIE WORK AUT14ORIZED
THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF TIIE LABOR CODE.Or I HE STATE OF WASHINGTON RELATINGTO
WORKMEN'S comvi7UsATION INSURANCE AND RCW 18:27.
T)liSAPPI.ICATioI,i IS NOT A PERMIT UNT [I. SIGNED bY Tm-.,q.uiLDiNc, OFFICI,%L,OAJJIYlll:.R Rg'UTY AND ALI, I:Fl-.S ARE PAID.
Signature Print Narne Date Released BV D3)6
I
IVI-l"ENTION
j,risUNI.A%kTIJL WILISLOROCCUPY A
0CCIjI'ANCN'lI%�jwi:,4r;j,
%RCITIVE AITIACAN'r ASISF."IS0111 0,11,11111.1t
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STATUS,: ISSUED BLD2006.1.136
MW IMP
Fire Marsh af must be prc�cnt for tank work (rill. remova I, or cup.)
Any request forth e modification, varian cc orother ad minis[ rative deviatiun (lie Nina It er "v a rian cc") must be specifically called
Out and idcntilkd. A ppruval ol'any plat orplun cc. ntain in g prov is ions which d(h.not comply with City code and lbrwhich a
variance. has not been specifically idCntifiCcl. recIvest and considered by the appropriate City official in accordance with the
appropriate provision ofCity code orStatc !aw does notupprove an), items not io code specification.
Sound/Noise originating from temporary coristructioo sites as a result of -construction activity are evnipt from the noise limits
ofECC Chapter 5.30 only during the hours of7:00am to 6:00pmon weekdays and 10:0(Yam and 6:00pm an Saturdays, c.,rludi . ng
Sundays and Federal Holidays. At all othertirws the noise originating fromconstruction sites!activitcs must,comply with the
a, pur's
noireliffiits of�Chaptft3.30, unlet;s a vanance I s been granted -CC 5.30.120.
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THIS PERMT AUTHORIZES ONLYMAE WORi(Nb*D. THIS P MT COVERS WORK TO BE DONE ON PRIVATE PRorERTY ONLY. ANY CONSTRUCT10N ON THE
PUBLIC DOMAIN (CURBS, IDEWALKS IJRIVEWAY�. �ARQUEES, ETC.) WILL REQUIRE SEPARATE PERM SSION.
PERMIT TIME LIMT: SEE ECOC 19.00.005(A)(6)
BUILMING (42 .771-0220 I=. 1333 F_ ENCTNEERM (425)771-07')OEXT. 1326 FTRE (425) 771 - 115
'CLING I
PUBLIC WORKS (425) 771 0235 PRE-TIRFATNIENT (425) 672-5755 REM 425) 27,54301
F-Fire Final
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Permit: BLD20061136
P E RM 17'
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CITY OF EDMONDS
12 1 .01-1 AVENUE NORTH - HDMONDS.WA 93020
- 2
PHON13: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 96
9/10120071
Expiration'Date: 3/10/200
U,� dd' 5
Parcel-NwO04342.124001
00
COUNTY WIDE HOMES PLUMB SIGNS INC
PLUMB SIGNS INC
9WS28TH!ST.: 909 S 28TH sr
51 W DAYTON ST STE 304,
EDMONDS. WA.. 98020 TACOMA. WA 98409 TACOMA. WA 98409
qt 2 5 3."4 7 3.3 3 '1 3 253-473-33.3
LICENSE #: PLUMBS107 7QS EXP: 12/17/2007
WALLSIGIN Am �csl
$0
L: U
"LETEVALUATION:
PERMIT TYPE: Commercial
PERMIT GROUP: 63 - Sign
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N 0 X 0 FTj
CODE: 06
OTHER:.N ------- OTHER DESC:
ZONE: PD2
NUMBER OFSTORJES: 0
VESTED DATE:
NUMBER OF DWELL:NGUNITS: 0
BASEMENT: 0' IST FLOOR: 0 2ND FLOOR� 0
BASEMENT: 0 -1 S`1' FLOOR: 0 2NDFLOOR:O
3RDFI.00R:O,-;GAP,AGE:O DECK: 0 ar FIER: 0
13RD FLOOR. 0 . GARAGE: 0-
DECK: 0 OTHER� 0
R.FQUIR.ED: PROPOSED: 1, �JPLEQUIRED:,
11133 511 Mai
PROPOSED: IREQUIRED: PROPOSEQ�
HEIGHTALLOWED14 PROPOSED:13
IREQUIRED: PROPOSED I
SETBACK NOTES: WALL SIGN -WHITE LETTERS FOR'COUNTRYWIDE HOME LOANSAND SMALL MULT [-COLOR LOGO, BOTH
INTERNALLY ILLUMINATED
I AGREETO COMPLY WIT H CITY AND:SrATE LAWS REGULATIN.G CONSTRUCTION AND IN DOINGTHE WORK AUT11OPIZE-D
THEREBYj NO PERSON.WILL BE 'EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATINGTO
WORKMEN'S COMPENSATION INSURANCE AND.RCW 18:27.
THIS APPLICATION IS NOT A PERM 1j, UNTIL SIGNED BY T14E BUILDING OFFICIAL OR 141SIFIER Dlfi�UTY AND ALL FEES ARE PAID.
Signature Print Name Date Released By 4 1 /Date
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR S'TRUC-lUkr UNTIL A FINAL INSPEc-n6N HAS tmrN IQAD;7 AND APPROVAL ORA CER11FICATE OF
OCCUPANCY HAS BEEN GRANTT-.D.UBC]09! 113CI 10/ IRCI 10,
ARCHIVE APPLICANT ASS03solk OT111-31
f
STATUS: ISSUED
BLD20070786
. All, new, extended, re-buflt or relocated electrical utility and/or service shall Be placed'underground. D
. Sound[Noiseodgin'atingfror.hteniporary construction sites as a result of construction activity are exen.ipt &omthenois'elirnits
of ECC Chapter 5.30 only d . uring the hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excludii . ig
Sundays and Fed6ral Holida�.s.' At all other times the noise'originating from construction sites/activites must comply with the
noise limits of Chal�ter 5.30, unless a'vanance has been granted pu rsuant to ECC 530. 120.
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED; THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCT10N ON THE
PUBLIC DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) VALL REQUIRE SEPARATE PERIASSION.
PERMIT TINE LIMIT. SEE ECDC 19.00.005(A)(6)
i) 771-0220 EXT. 1333 IENGINMUNG (425) 771-0 0 EXT. 1326. FIRE(425) 1-0215
PUBLICWORKS(4 )771-0235 PRE-TREATMENT (425) 672-5755 1 RECYCLING (425) 2754801
When calling for an inspection please leave the folloAing information: Permit Number, Job Site Address, Type or Inspection being 4"
'requestert, Contact Name and Phone Number. Date Prerereed, �nd wbether you prefer morning or afternoon.
B-Building Final,
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City of Edmonds
Per' ,, *7
mit Application Form.
Form A
A
Permit Application for: New'Single Family N
dw Com/Apt Addition
Interior Remodel Garage/Carport Repair Sign
El Fence Ej Grading . c
0 t _... . . _______yds Ej Storage/Shed
enantImprovement/Change of Use
Rockery/Retaining Wal . I El Fire System (Specify)
Other
Brief Description: _,I.,144 Z,
Site', AddtLiss:
Suit
Sno County Tax Account Parcel #:
Business/Tenant Name (if a�pplicablc): ,0
S
PROPERTYOWNER:
MailingAddress: -50�T
City:)
State:. e�;t),,? -zip: V�2,Do
Phone: FAX: E-Mail:
'TOR:
CONTRAG C]Same as Property Owner
ther (Name)
Mailing Address: 5;��
City:-- State:
__�Zip:
Phone: 6_z>_'3 FAX: (02'�3 7�7 R-7/0 E-Mail:
Sta . te Licen I se Exp:, Date;/ City Business License NO: 11,5 ;74::�l
APPLICANTMONTACT: / Y7�?7-
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OSame as Property Owner C� ntmctor
Fill out the following information if "Other"_, 0
Name & Mailing Address:.21�—)—V�/ 4 6ZI 61/71k:�5
—State: Z ip: !2,p k-61_51
Phone: (ALL) Z �1_3
"7r.:3— FAX: E-Mail:
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L:�TEMP�3UILDING%WEBchecklists\SFR,COMM.APP.docg/21/2006
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HE-DOCUMEN N 'HI
IT IS DUE i-O THE QUALITY OF TH-- DOCUMENT.
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EDMONDS
oftekQI
5'Ill AVI'NUF . NORTI I - EDIAONDS.WA 9SO20
PHONE: (�'
25) 771-022() 17AX: (425) 771-0221
STATUS: ISSUED
8/23/2007 'Perniit'#: BLD20
Expiration Dec: 8/23/2008
Z '.�rc-je' Ss
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arcelNo-.60434212400'10
J.. NKIN.JEWLLERS
51 W DA Y'r ON sr sr E 3 04 .
Aug
FLANKIN JEWEL!3R.S BrLFOR USA GROUP INC.
AVE #1501
.:�14114'1'11
3826. WOODLAND PARK XVE N
cbmoND.S, WA 980;
��'�FATTLU, WA 98 10 1 SEATTLE, WA 98103
206.331-1230 206-63 2.0800
IL,NANI IiM PROVEMr:NT FOR JEWE"
LICENSEP: B[:i.FOUG99oBj EXP:12/14/26
Y 6 1 (JKIL IN SHEIJJCORE
SPA CE, INCLUDING 2,0FFlCES-A'ND SHOWRoom.;4I
SPACEIS 1030sr-. PLUMBING FOR ONE SINX.
VALUATION: $69,948
PERMITTYPE; Comincrcial
G VRA
DING: N CY s:'o
RETAININGI (,\Lt. ROCKrRY' -N
j!LLRMIT GROUP: 71 Tenant linprcvcmcnt
�r�yf'rOFM�NSIRUcr�joNvA�
Signature
F�rinl Narne Date >
ReleaSe Date
ATTENTION
I '['ISU\'LAWI-Lil.T'OUSCOROCCUI'� A BUILDING ORSTRUMUIRE UN-111. A FINAL 1,�.SPECJION HAS BRENSIADl- AND AITROVAL ORA CERWICA71: OF
ARCHIVE APPLICANT tSSL'3SoIz 0111ER
796
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STATUS: ISSUED
Olson BLD20070790
Seperatc Pcrmit Required For:
1) MECHANICA UHVAC:
2) FIRE SPRINKLER ALTERATIONS
3) STATE ELE&PICAL
Final . ruval on a project or filial occupancy approval inust be gran led by the Building 01ficial prior to use or occupancy of
the building or structure. Check thejob card for all required City inspections including final project approval and Final
occupanc�insp�ctions. : ' I
Any request for aitt.-nate clesi'kil. mnJiiication,varianci: or other achilinistrative deviation (liereinaRer "variance") from
adopted codes, ordinances or'policics must be spccifi�ally requesicclin ATiting and be called nut and identified. Processing
�fces,forsuch request shall belstablishcd by Coui cil �nd shall be
13-K upon su nuttal and are non-refundabic.
Approval-o�any plot or plan cointaining provi�ions which do not comply with city code and tor which a variance has nii been
specifica!ly idclltirlcd, rcquest�d and considered by the appropriate city official in accordance with tile appropriate provision
cfcity code orsti.te law does hot nporov'� any itcrns not to code spcciricition..
Sound/Noise ori ginating from-fimpornryi6nitruction sites as a result OrConstruction activity are cxmpt rrom the noise limits
ofECC Chapter 5.30 only durin'9 the hourii of 7:00ani to 6:00pm on weekdays and 10:00am and 60pm on Saturdays, . excluding
Sundays and Federal Holidays. At alfothcr times the noise 0;igilinting from construction sites/activites must comply with the
noise limits ofChaptcr 5.30, unless a variance has been granted pursuant to ECC 5.30. f20.
Final Locations orillunlinated c,,dt signs & emergency lighting subject to field inspection by the Fire Marshal.
is
THIS PER I MITAU7HORIZES ONLY THE WORK NOTE'D. TH'IS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION 0 1 N THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT. SEE ECDC 10.00.005(A)(6)
P UB LIC W0.1119 a25) -77 1 -G235 PR&TRIFATMENT �425) 672-5755 RECYCLIN (425) 275-4801
leaw tile following Information: Pernntit Number, Job Site Address, TyT)e or Inspection . &�i-n7g
id Phone Number, Date Prefereedand whether vou z�fer ft!o fic-riloon.
B-Plumb Ground Work
B-Plumb Rough In
B-Ceiling Grid
B-Frarning
B-Sheetrock Nail
B-Plumbing Final
B-Building Final
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City of Edmonds
PermIt Applicklon Form
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UT EmPTUILDI NGv&ww�,vsFRcomuAPP.e=wirnw
AECEIVED
.3 Rankin Jewlers
�c 13 2007
EWILDING
Dec. 13th, 2007
am writing on behalf Of Belfor and 3. Rankin jewlers
-regardlbg', th6� 1-
Jew 'ery sto.re at 505,5th Ave S. Edmonds Wa.
The T y certificate of bccupancy is'set to expire on
em orar
the. 4N of Dec. Thef-kithchenette and plumbing have been
completed but the A6A ca�'h'wrap has not yet been altered to
accomodate the'A'DA.' �-I hdve-been in contact withRalph Allen
the Architect
on this matter and we are working out a
resolution. I am asking to be,granted a
n extended 30 days
in part �ecausethe holiday season is an enormous part of
the stores yearly gross. :)upled with their grand
sales, c(
opening and.I would deem it a burden on them
to have any
construction going on during this time. I would proceed with
the correct -ion immediately following the holiday season.
Thankyou for your consideration in this
matter.
sincerely
'k, V_
-P�
P.S. The permit Vis 2007-0790
C,;� /477/3-107
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CITY -OF EDMOND
S
121 STH AVENUE NORTH EDMONDS, WA 98020 - (425) 771-0220 FAX (425) 771-0221
Wcbsiile: w�i ci.edmorldSma.us
DEVELOPMENT SERVICES DEPA
Planning - B d RTMENT
ing - Engineering
March 18; 2008
GARY HAAKENSON
. MAYOR
Belfor USA Group, Inc.
3826 Wo6diand Park Avenue �Iortli
Seattle, Washington 98103,
RE: Ra . nk in Jewelers @ 505 5"' Avchuc SOUth, Sditc A- 103 Edmonds
Notice of Civil Violation
FT
To Whom It May,Con6crri:
p
The purpose of this letter is to officially inform your ot ice that you have failed to comply
'on
with. the corrective action requireld the Notice of Civil Violation (issued on February
251- 1.008)'and failed - to, file� an appeal in the timeline provided. Therefore, your
administrative remedies are exIlAsted and as of toda civil pqnalty fines pursuant to the
y
No!ice of.Civil Violation total $2,300.00 ant! are immediately due and Payable to th
City.. Remit fines immediately to ayoid this matteii . I -being referred to the City's
collection agency.
Be advised fines of $ 100.00 per day shall C0116111.11C to a.ccruc for each and every day tile
violation exists and until this matter is resolved to the satisfaction of the City. We
strongly urge you. to correct the vrolations immediately and contact the Building
Inspector by callin�_ 425-771-0220 extension 1333 for the required, inspection.
If you have any questions regarding the civil penalty process or,fines -,.!ease feel free to.
contact me during City business hours of 8:00am to 5:00pm, at 425-77.1-0220.
Sincerely,
Jeannine L. Graf
Building Official
Incorporated August 11, 189b
Citv - Hekinan. Jiman
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CITY OF EDMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5th Avenue Norf�i, Edmonds, WA 98020
(425) 771 0220
CIVIL NIOLATId'N'
NOTI
CEO-r
Location of Violation (Address): Rankin Jewelers 505 3th Avenue South, A-1 03, Edmonds, WA
98020
Issued To: -13611 for USA Grod��, I�c:. dontractor
Address Of Person This Order Is Issued To: 3826 Woodland Park Avenue No I , Seattle, WA 9 03
rt 1 81
Code Section Violated% International
Buildinp
-Code Smtion H 09.11
Description of Violati
on: P6rti0fLQf —Sales counter is reguire to be accessible and the tempora[y
certiftate of occupancy expieed
Corrective Action Required: Submit d f code compliantaccessibie counter,
etails o
once approved install
per appro�gd vlan and recall for inspeciion.
Be advised, the perso�(s) to whom this Notice is issu
ed'is being aisessed $100-00 per day, or portion
of a day, during which the violation. continues. The ; -It— -
imposed monetary penalties are immediatel
y
due and payable to the City.of Edmonds at 121 5th Avenue
North, Edmonds, WA 98020 during
normal City business hours. Fines shall continue to 'accrue at the rate of $100.00 per day until this
matter is resolved to the satisfaction of the City.
Further, if correction is not made by-A:0�0rk.(time) March 10. 2008 .(date) an abatement notice may
be issued warning of impending City abatement of the violation. -Any and all costs, including incidentai
Costs" will be added te the monetary penalties assessed against the person(s) to whom the Notice is issued.
Note, this decision is'appeaLble to the City of Edmonds Hearing Ex
aminer by riling a complete
�?ppeal application including Written notice of appeal with the Developm'!nt Services Director n o
later than March 10. 2008at 4:00 p.m. The appeal filing fee is $'605.00.
Date Posted:
Date Mailed: February 25, 20U
'issuing Party:_ Jeapnine L. Graf_ —Title: Building Official
Signature:
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CITY -OF EDMONDS
DEVELOPMENT SERVICES DEPARTMENT
121 5th Avenue North, EdmoR.ds, WA 98020
.1 (425) 77.1-0220
ORDER TO CORRECT VIOLATION
Location of Violation (Address): Rankin Jewelers (a) 505 5"' Avenue So . uth, A-103, Edmonds. WA
98020
Iss-d-e—dT16! Belf6r.USA tio�p, rk, , Contra`ctor
Address Of Person Thisbrder Is lssucdTo:_2820 Wood�a Se
__nd Park Avenue N6rtl),__qtf1c.WA 91101
4�'
Code. Section Violated:. Interriational Buildinp: Code.Section 1109.11
Description of Violation: Portion of sales counter is required to be accessible and the ternporary
certificate of occupancy expired on January 14, 2008,
Corrective Action Required: Providc code compliant accessible counter and recall for inspection.
Correction is Required no later than: 5:00pm
—(time)— February 17, 2008 .(date)
If correction is� not made t - by the date and time specified in the Order, a Notice of
Civil. Viol2t.ion'sh.all 1�e issued. -The Notice of C - wil ViolaVon shall(as3l'e ss fines of
$100.00 Per day, or.p6rtion'of*a, day, during w1itch the violation continues.
Date Posted: Date Mailed: J nuary 16, 2008 Date Served
a
Issuing Party-L—leannine L. Graf Title Building Official
Signature
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CITY COPY
ELEV T7.
L
Lu
ERGENCY
P HWAY DISPLAY�.��
'CASE
DISPLAY
TOWER
A-8" SHOWR
MIN CLR
101
r SHO ROOr
DISP SY
�;A�S
(C%ASH W
T'r(PARTOF
FIXTURE
PACKAGE) EXSTING
COLUMN
RELITE
103 10,
DIAMOND
CASH WRAP
RELITE, ITA
104
OFFICE FFICE
104
OFFICE ALIGN
106
OFFICE
105
coiftft'
' jn��
GEP) H-,Wfiv,"?
-17Y -)r
7
MWA ZII-c ev lie d�
30 61e4lLA
(01
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CONSTRUCT ACCESSIBLE FXTE:.'SjO
WORKSURFACE ALONG FOLLOWING
GUIDELINES:
30'OEEP ACCESSIBLE COUNTER
FOR FRONTAPPROASH / TOP
CONSTRUCT OF 2 LAYERS 314'
PLY WITH FINISH VENEER TO
MATCH E)USTING COUNTRRTOP.
EDGE FINISH TO MATCH ASWELL
SUPPORT WITH FULL I
ANCHORAGE ALONG COSTING
rACE OF CASEWORK, AND
WITH PIPE COL BASE AT FREE
EDGE. CLEAR KNEE SPACE
BETWEEN PIPE COL BASE AND
NEAREST EDGE OF E)OSTING
DESKTOBE36*MIN. HTSHALL
MATCH EXISTING, BUT SHALL NOT
EXCEED36* -
CL EARANCE BELOW SHALL BE A
MINIMUM OF 2r CLEAR UNDER
THE ENTIRE CO=ERSUPFAC
ACCESSIBLE CASH
WRAP PLAN /
REVISED DRAWING
A2.1 ASI 1 2 22 08
ARCHITECT'S SUPPLEMENTAL INSTRUCTIONS FOR:
1927 Post Alley
Seattle, WA 98101
206-9'U7-9800 T 4435 REGISTERED
206-682-3159 F ARCHITECT
+
ALPH W. ALLEN
STATE OF
WASHINGTON
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DEPARTMENTOFBUILD11,106
AA+ d&6AkA
PER International Building Coda Section 110
505 5'—h Ave
�L#A-103
4#: T
Occ-upancy established1by this cerifficate: Dwelling Units: N/A No. Stories: I
M!
4N os Stories.
Ba t.
Type Constructio.-I: -VA
Basement: N/A
Maximum Occupant Load 34 (Per IBC 1004)
Room capacity signs, when required, must remain posted at all times.
Owner -of Bullcllng� GPA Inc J —Address[Tonant Space:
THE J. Rankin J elers. 505 5"' Ave S. # A-103
HAS,BEE INSPECTED AND APPROVED AS COMPLYING WITH THE REQUIREMENTS�OF THE
2006 EDITION OF THE INTERN I N L BUILDING C06E AS ADOPTED BY THE CITY FOR THE GROUP A . ND DIVISI
USE FGR WHICH THE PROPO CCUPANCY IS CLASSIFIED. ON OF OCCUPANCY AND THE
Issued this day of April, 2008
CHIEF BUILDING OFFICIAL
TNS Ceitfi-e S: aR be posled in a consp.cuOu, public .,be
and WW n14 be, emved. "u"'ated W ebs�ed and tritil be inaintaind in
r-em"U16 Of OCCupancy issued by Me Otj of Edinonds On �. ad Z. Aly 0hange of �Pancy V use
a Buildin, otfiOaj_ requires 8 WwOlng Ptml &W a ne�
3H.L zlokinvm 3HJ. 01 3na si -Li
-331ION SIHI NVH I blw—lo L—
I Z)1 :JYMA SfH1 NI IN3yvnooa 31-11 =Ii :3ol.LON
IPlermit Inspection Details
PF-IRMITTP-Ax.. Permit: BLD20070790
112'!
6�12712007 6ull,S 30
Tota I Time: 30
09127/2007-
c 0, M" P
Buii,s 30' Correction notice issu ed
10,'03/2007 Bullisi 30 Wall framing approved
N
10/15/2007-= Bullis 261�'Framing df
N
drop ceiling breaat north end o(tenant space approved.
Y
Total Time: so
10/03/2007 Bums 30i Wall sheeirock approved
1.1/14/2007 Graf. 51", E.xlsting no change.
IN
bi .-N
Total Time: 35
11/1412007 Graf.
Com
15'
Y
Total Time: is
11/1412007 Graf 0 emporary. Occupancy Granted expires 12/14/07.
OMP ete?_ Y
04110/2008 steinike 20
N
Y
Total Time: 20
!re,Final
�1 �lk(50i WESTFALL 60 Fire approved TI.
--.Z061
Total Time: 60
Total Inspections:
10 Total Time: 240
I
10
Page 1 of 1-
0 1)11
c�
NDS
CITY OF EDMO
121 5TI 1 A NOR I I I
EDMONDS WA 9-0
VIIONF: (.12;)771-0220-1�AX.(425)771-0-'21
STATUS: ISSUED
:PeM4#:-13L
OJ93'6'
3/29.!'!067
Expiration Date: 8/29/2008.'� *r"'
k V. F
Parcel NO: 00434212400 100 11
COVWRYV�IDE HOME LOANS
-,RACE �RCMTEcrs
51 %V DAYTON ST STE 304' , ; iwur—oit USA
.1927 POSr ALLEY 3826 WOODLAND PARK AVE N
I MARVIN �'AMAGUCIII
EDMCNDS. WA 9S020 srA-rTI]H WA 93101 SEATTLE. WA 94103
'2C -'9800
6.95i" 206-63 2-0800
LICrNT.. H. ;'n 1'7.\
NNIVIV208
'rENAN'i I T
M RE - RONTILN*J'J�y
..VALUATJON: 63,715
PER.Mj'r'ryPI-,: Commercial
PLRMIT
GROUP: 71
N"
GRADING: N CYDS: 0 T VmA SVRINK
1R.ETAINING WALL ROCKERY: N OCCUPAN'r GiOUP: B
(.)CII III A NT LOAD: 23
FENCE: N ( OXO FT.) Cu
DI': 06
--- ------- OTHER DJ;SC: 1,-12
'NI..
[NU M711 E R 6F ST 0 —RI
FES r 1: ATP:
LNUMBER OF DWELLING UNITS: 0
BASEMENT, o IS]* FLOOR: 1507 2ND FLUOR: 0 BASEMENT: o IS[' FLOOR 0 2ND 1:1 OOKO
13 RD FLOOR: 0 GA RA G F.: 0 Dl-.CK: 0 ciT H F. R: 0 —1 - -D—rCK --EjjIcR —o
3RD FLOOR: 0 GA RA GF: 0 1.11_0
REQUIREM. OPOSED:
PR REQUIRED: PROPOSED:
i - IRrQUIUD. P R--O P 0 SEE D:
HEIGHT ALLOWrD-u-PKOPOSrD-0 jkEQUIRrD: PROPOSE j:
[SETBACK NOTES: NO CHANGE -
I AGREr'I'O
"GU' COMPLY wITH CITY AND F!'A'I'F, LAWS REGULATING CON'�I'RUCTIOI`q AND IN DOINGTHE WORX AU THORIZED
j
')'q 'W 'U'
THEREBY, NO PERSON WILL 13E EN TEO
HE 1:
G T')
NG"ON RrLAI'IN
r F WAS 0
IOLATION OF THE LABOR CODE Or THE SrATE OF WASHING-l' NRELAIrINGTO
WORKMEN'SCOMPENSATION INSIJ.RANCE AND RCIWI 18:27.
T[�IISAP71��LIC,ATIONISNOTAPERNilT UNTIL SIGNI-,D'riY-j-jIr 0 111 1) "UT Y
L :rS L
BUH-DINGOFFICIAI. OR IIISIIFR DEPUTYAND ALL FEESARL AID
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ATTENTION
ITISUNLAWFULTO , VSr.OkO.CCUV)'Ai]L;ILDINGORS'll(t,(-[L;P.+.ti.NllL,%F:INA1.1'4S['['C'nONIIASIll:L�NNIAI)rANL)AI't'ROVAI.OliACI.'RIIFI(�ATr..OF
OCCLPANCYFIASi3f-.LN(;ILXNIT-.D.LB(.'10�.liBCIIOIIRC'ilO
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STATUS: ISSUED
BLD20070836
ENNIS"
Scperate Permits Required For:
1. State Electrical Perinit
2. Mechanical Permit
3. Fire SprinkIcrAlter-ation (if ncc�`ssiry)
4. Sign
. Obtain Becthcal Permit fi-c �$epartmc of'Iabor&Indust
lmStalc n
. Sound/Noise oHginatingfronit,-rr�i'poraryconstrtictioiishesas a result of construct ion activity rj(;M,.:ld noise I its
Of ECC Cliapter 5.30 only during the F.ours o itni
7:00ani to 6:0,opm
on weckdays and 10:00ain and 6:00pni on Saturdays, exrluding
Sundays and Federal Holid3ys. Xt all otheriirrics the
noise ori,
ginitinl; rromconsiniction sites,'Ictivitcs must comply with tile
IlOiSc-.1inlits Of Chaptcr-5.30, un1c4- -io ECC 5.30.120.
a variandt his been granted pursuini
Provide 2A:IOB:Cpoilable firteg'M'guishers at locations as noted on approved plans.
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Request final Fire Department Inspection (425)775-0215.
New. and, c.Nds t ing build ihgs s 11111 have approved addres s numbers, build ing numbers or approved bu ild iog ident ifical ion
placed in ai positionthit is pliinly:�Iiiblc froih the
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street crioad frOnling tile Property. Address numbers shall be Ambic
numera s oi alphabet letters. Nuni,
1' '63 shall ;c legible from.,dic public way, at least 4 inches high %vith inch
5i
%vidth oi a min, stroke
-incontrasting'backgrouriV
M
IT,
T41C PERIAT AUTHORIZES ONLY THE WORK NOTED. THIS PERMI r COVERS WORK TO BE DONE ON PPIVATE PROPERTY ONLY. ANY CONSTR UCTION ON THE
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Pueuc bOMAJN (C.URBS. SIDEWALKS. DRIVEWAYS. MARQUEES; ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE.Ecbc 19-00.0i)S(A)(G)
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33. 10
25) 771-0220 Dff. 13 ]ENGINDRING, (425) 771-02 2 Lxr. 1326 - FIRE (425) 771-0215
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PUBLIC WORKS (425) 771-0235 PR&TREATNUNT (425) —6-
72-5755 �RECYC�LINC(425�)2754801�
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NI'llen calling for an inspectini, pic:Lje 1 C:Ivv tile 1`0119%ing inforrmiliow Pernill Nurnbi I)SIle A41,11re.v.4.1),ile orillipertion being
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City of Edmonds-:.
Permit Application Form REOUIVED oi
Form A
AUG 13 200Y
.1110. IS90
BUILOING
04: Ec)MONDS
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POIn 'A " I
wi. .11fibil, Aim-411ty.
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Prief Descriptlen: Non-structural tenant �mprovernents of a "Office in an existing mixed -use
ottice building
Site Address: 505 5th Ave, S
— Suite
Snb County,Tlx Account Parcel 252703-2-076-�0002; 004342-124-001- . 00; 252703-2-170-0007
.113usinoseninak'Narne (if appll.�Oblo), untrywldo Homo Lo�nz
0
-6'A\� n�rO.:04V014prnerit LLC�
:��PRDP5F�� .0 Ntjti�! F i
Mailing Address: 51 West Dy6ton, Suite #304
City: Edrnoi,is State: WA p: 9M&U
Z,
Phone: 425) 673-4218 FAX:.
E-Mail:
COINT'RA_ CTO'
R. 0. B e Ifo r
E
06th6r (Name)
3826 Woodland Park Ave N
Mailing Address..
City: Seattle State: WA Zip: 98103
Phone: LLIL 632-0800
FA�: E-Mail:-
"State License Number
Exp: Date- ------ City Business License No:
APPLl.CAH.TVb�.tArT, .0Sa*6iP',afit�*Pid .';Q*v�npr. Osninie`as ContraFctor..-
Fill out the 1�11 OAring inforinnation if "Other",
Name & Mailing Address: Grace Architects 1927 Post Alley
Seaftle
WA
C AT. State: zip: 98101
Phone: 206 632-0800 FAX: 206 682-3159 E-Mail:
daphne@gracearchVectsplIC.00nI
Ed 15
P2L:kTEMr-iiU.ILDINGWVEBcheck.lisfsVSF71 '21/2006
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PLUMBING. FIXTURE COUNT
Number Rcture I
Water C16 set (toilet)
Sink (kitchen, laundr�, b�rl etj)
Lavatory,,;;'
Tub/Sh
ower
Dishwasliet
Hose Bib!
Water He'ater Point -of -use w'ater hc -Aer
E�panslo�6"Tqnk��or Witer'He ater
7-
Floor Driln
Pressure Reduction Valve
Water Service Line
Drinking Fountain.
Bide.ttUrinal
Clothes 'Washer
Backflow Protection Device
Hydronic Heat In Floor Wall
Other
GAS OUTLETS
AC Unit BTUs Location
Furnace BTUs Location.
Water Heater. BTUs Location
01 U§
Dryer
Stove/Range/Oven'
Firepla6efinsert BTUs_ Location
Outdoor BBQ
DETAILEDSCOPE OF WORK
Please provide a complete,* detailed 'written scope of work fo I r. the
proposed project.
Additions (additional square footage)'.: Specify room use, floor level and s
quare footage and
direction if applicable (i.e. 545 square. foot master bedroom/bath room addition or) the s6con'd floor
.,with 140 square foot deck and 245 square foot kitchen addition on the maln.floor. South sidg of
house).
-�-Remodels (interior ren6V-ations):-:S'pech��y.room"6ses and flio"'br levels (i.e. combine bedrooms 1 and
.2 on the main floor to create new master bedroom/bath room; replace dinin ' room sliding glass door
9
With new French doors, reconfigure -kitch�.h with new island prep counter and install new gas fireplace
in the living roo
tenant irnprovements on level 1:
One (1) 145 square foot reception area for retail business office.
f7hree (3) 124 square foot private offices.
One (1) 190 square foot private office.
Approximately 365 square foot open office for freestanding office furniture (desks).
52 square foot Workroom for photocopier/printer.
'Approximately 100 square foot break area �(staff 6nly*coffee area).
Approximately 12 square foc-'t WAN/teldcom closet for tenant's server/t e*lephone equipment and low -
voltage cabling.
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CITY'OFEDMONDS
12 1 s r�l AVENU NORTH ED MONDS.
WA 98020 (425) 771-0220 FAX (425) 7? 1-0221
Website: ww.ci.edM0nds.wa.us
DEVELOPMEhT SERVICES DEPARTMENT
P16nning
I? C. I 8bilding - Engineering
March 6. 2008
GARY HAAKENSON
MAYOR
Belfor USA
3826 Woodland Park Avenue North
Seattle, Washington 98 103
RE: Countrv,6vid'e Homes 505 5'h Avenue South, Suite B 103, BLD20070836
Notice of Civil violation Fines,
To Whom It May Concern:
The purpcse of this letter to officially inform you th�ft7j�o—tice of Civil Violation Fires in
this matter stopped on March 5, 2007 �ecause you obtained Final Building inspecti
-al on the referenced tenant improvement wor I k. on and
mcupancy appro,.
Unfortunately, as y
on ar�! awar Civil Penalty fines were assessed in this matter; them,
el
assessment of fines is considered to be the last resort in gaining code compliance. Fines
accumulated from February 25, 2008 to March 5, 2008 at the rate Of $100.00 per day;
thus total fines owed to the City is S 1,000.00. pI
1h ease remit full payment to the City of
Edmonds, c/o Building Dt:? . artm ;ent at 1215 Avenue North, Edmonds, WA 98020.
Failure to pay by March 21, 2008 shall result in the matter being referred to the City's .
collection company f6r the recouping Tffill fines. Be advised, once fines are turned over
or
to collections fines are collected at a iate of 150% of the fine amount owed in addition to
administrative costs the collecti . on agency is permitted to assess.
If.you have any -questions regarding the civil penalty fines' please�fccl fre . c to con tact me
during City business hours of 8:00am to 4:'30pni, Monday thr'ough Frid . ay, at 425-771-
0220. extension 1226.
Sincerely,
Building 0tficial
Inrorp , oratedAugust 1.', 1890
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...CITY. OF EDMONDS
DEVELOPMENTS VICES DEPARTMENT
121 5th Avenue Noz1h, Edmonds, WA 98020
(Q�) 77102;.0
Vj-
ICE Om C1
2L 'T L V1 0 TION
Location of Violation (Address): Coukrywide
Homes 0) 505 5'h Avenue South, Q- 103, Edmonds, WA
98020
Addrbss Of Person T i
his Orde Is Iss
�d To: 3826 Woodland Park Avenue North, Seattle, WA 98103
Code Section Violated'. International Building Code Section 1109.11
.Description of Violation.:. Rear exit door swing not accessibic and the tern orary rqrt;F1q-tq �F�
expired.
Corrective Action Required: Revqse door swing at rear exit door, cornnictc, installation of electrical
connection to o%i6n outlet and obtain final Electrical Inspector al2r)roval and recall City for
inspection on
the door.
Be advised, the person(s) to whom this Notice is i
ssued is being assessed $106.00 per daL or portion
of a day,'ddring which the vio'lat'jon c"ontinues. The . imposed monetar . penalties are immediately
due and payable to tfi-' .1 . y
e City of Edmonds at 121 5th Avenue North, Edmonds, WA 980ZQ during
I
normal City business hours. - Flines'shall continue to accrue at the rate of S 100.00 per day u ttil this
ma . tter is.resolved to the satisfaction of the City.
Further, if correction is not made by--4:00pm (time) March 10, 2008 (date) anabatement n,otice.may
be issued warning of impending,City abatement of the violation. Any and all costs, including incidental
costs,.Will be added to the monetary penafties assessed against the person(s) to whom theNotice is issued.
Note, this decision is.appealable to (be City of Ed.monds. Hea . ring Examine.- by Ming a complete
appeal iipplication including written notice of ap�peal with the Development Services Director no
late.�- *han IV larch 10, 2008 at 4:00 p.m. The appeal filing fee is $605.00.1
Date Posted -
Date Mailed: Februa[y 2*5,- 2008
I ssuihg Party:. kanninc L. Graf' 'ritic:— Building official
Signature:-
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CITY OF ED '0
M NDS
DEVELOPMENT SERVICES DEPARTMENT
I! l 5th Avenue North, Edmonds, WA 98020
(475), 771-0220
0y)"
ix"ER TO CORRECT V
JOLATION
Location of Violation (Address):. Countrywide I lomes (2� 505 5'h
WA 98020
Issued To: Belfor USA Group, Inc., Contractor
-----------
Address Of Pei -son This Order Is Issued To: 3826 Woodland Park Avenue North. Seattle, WA 98103
Code Section. V, led: -Se
wlat. . International Building Code ction 1109. 1
Description of Violation:- Rear exit door swing not accessible and 'the temporary certificate of
occupang anuary 14, 2068.
Cvrrective.'Action Required: Reverse
docr swing at,rear exit goor, complete installation of electrical
connection to oven outlet and obta;n ffnal Electtical In
sl2octor approval and recall City for insPection An
J. the door.
Correction is Required
no later than: (thne.) February, 17. 2008 Jdate)
If -correction iSnot made by the date and time specified in t . he Order, a Notice of
Civil Violation shall be 'issued. The Notice o . f Civil Viol'tion shall assess fine's of
$100-00 a
-PfLda', or portion of a day, during wh.-ch the violation continues.
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Date Posted: Date Mailed: january 23, 2008 'Date Served
Tssuing Party- Jeannine L. Graf _Title Building . Official
Signature
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DEPAPTMENT OF BUILDINGS
ANEW 11 F
L V
t. am".t-'
P ER Internatiorial Building Code Section 1 0'
505 51h Ave S;.#B-103�-- ding Permit#: 2 00f�Q 83 6
Bull
Occup3ricy established by this certificate: Dwelling Units: NIA'
No. Stories: I
B
Type Construction: VA SPRINK Ba . sement: N/A
Maximum Occupant L . oad 23 (Per IBC 1004)
Room capacity signs, when—r-e—qu-ir' d"'
e tmust remain posted at all times.
Owner of Building: Gremci Prodqq4lp Associates, I . nc., 1____Ad I dressfTenart', Space: 505 5" Ave S #B103
THE I 'Cowntrywide Home Loans * HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH THE REQUIREMENTS
OF THE 2006 EDITION OF THE INTERNATIONAL BUIED—ING CODE-: AS ADOPTED BY THE CITY FOR THE GROUP AND DIVISION OF OCCUPANCY
AND THE USE FOR WHICH THE PROPOSED OCCUPANCY IS CLASSIFIED,
Issued thi , s— 8 th day of-----N!Y.2008
CHIEF BUILD
AUG-QF-FICIAL
BY:. /� )
TA.szeltfic3leshBubeP.1i.d,nawnspiwwsp,ublicarwanC
V-.11 not be lemo�.O. mulillledorobs—d.nd snall be maintained in legible �*('w -1 811tilnel. Anj 0ange Of ��Oancy v use rectutres a ougo.ng permd and anew
Cerl,ricale of OccupanCy iss.ed by the Ci:y of Ed,nonds B.'Jd;
Offioai.
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:331-LON
Perm it.inspection Details
Permit: BLD20070836
PE:RMITTRA-,&
-N
09/27/ 2007
C omplote?"",...
Bullis 3 0
Y
Z'7
Total Time: 30
B61fis
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.0 Correction notice issued. Wall framin 9 approved.
10/03/2007 Builis 30 Framing app ' N
roved. Do not cover framed drop ceiling
over north
sp.inkler permit issued and system alterations made.
display area until fire N
11/01/2007 Bunis 30 Drop ceiling grid approved
Y
Total Time: 60
10/03/2007 Bull,s
Y,
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30 Wall shee rock* approved e; c-!e"p'-t-at no'rthfurred wall and framed
". -
drop
display.
ceiling above north Y
Total Time: 30
60—m—p'*1ete?-.-',
12/17ii6'07 Bullis 20
Y
I n1caLFIAN.", Total Time: 20
a
_Ec y_
12117/2007 Bullis ...
30
... ..
Y
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Total Time: 30
11/14/2007 Graf
ompleto?,,*�T,-'�;71�--
0 T PmPo�ary Occupancy Granted -80-Days. Expir%js 12/14/n7.
12/17/2007 Bullis 30* Correction notice . issued. TCO extendej for 10 days.
N
01/16/2008 Sullis 20 Correction notice for do' N
or still outstanding. Called contractor door is on order.
03/05/2008 TFMP- 20
N
NATOLA
Y
S
Total TI-ne: 70
C, M
o plete?-.-,. -Y�
11/13t2OO7 WESTFALL 0 IFife approved.
.
Y
... ... ...
Total Time: 0
C. e
11/13/2007 WESTFALL 60 FirL approved Ti.
—om
Y
Total Time: 60
Total Inspections: 13
Total Time: 300
8/17/2010 10:09:32 AM
9
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CITY OF EDMONDS
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12 1 51 It AVI.Nur NORTH - EDMONDS, -0
WA 980
-PHONE: 025071
0120 17AX: (425) 771-0221
STATUS: ISSUED
f 7 :.1
mut
10/11/2007
Expiration Date: 4/11/2008 . A ; , I
iq2l .reSS..,,
Paicei No: 00434212400100-.
I RANKIN JEWELLERS— 41TRUSSELL '-SIGN
51 W DAYTON ST 91-E 304 RUSSELL SIGN
5121 2 o 8T I I ST SW .51* 1' 5'
5121 208711 Sl-,SW Sl'iz, 5
EDMONDS, WA 9.3020 WA q8O36
LYNNWOOD,
WA 9SO36
425-775.7,0 425-775-7010
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LicrNSE #: RUSS.SC000DE CX11:4117/2009
MARQUE SIGN
VALUATION:.$o
PERMIT TYPE: Commcrcial PERM IT
GRADING- i� CYD& 0 TYPE OF
RETAINING WALL ROCKrRY� N FN
OCCUP NT GROUP: M
FENCE: N 1. 0 X 0 FT.) OCCUP NT LOAD:
CODE: 0
OTHCR� N ------- OTI MR DESC:
ZONE.
NUMBER OF Si'ORIES: 2 VESI'ED DA*I'-E:it'-
NUMBER OF DWELLING UNITS. —0.
SEMEN'r: o .1 ST FLOOR: 0 :21,IDFLOOR:�
_[BASEMENT: 0
j3RDFLOOR:0... UAKAGE:0 DECK:O OTHER-0 I ST FLOOR: 0 2NC FLOOR: 0
DECK: 0 OTHER: 0
MIT
REQUIRED:— -.;PROPOSED: _"REQV6R—rD' PROPO SED: -QUIP
U IRE
'r
HEIGHT ALLO _Q PROPOSED:
13D�0 PROPOSFD-0 1�' REOUIRED: PROPOSED�
7S'll;'11 11JA�LKNOT E&
To COMPLY 5
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHE WORK AUTHORIZED
THERE BY. NO PERSON WILL BE EMPLOYED IN VIOLATION OFTHE LABOR CODE or THE STATE OF WASHINGTON RrLATINGTO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY'rHE BUILDING OFFICIAL OILLIS" DEPUTY AND At.[. FEESARr PAID. .
z/vSignature Print
Narne Date Released By
Dile
ITISUNLAW ATTENTION
FUI.'t'O(JSI:OROCCUPN'A BUILDING ORS'rRUCIURE UNIT . LAFINALIN
SPECTION IIAS BECNMADE AND APPROVAI. ORA 0XIII.-ICAII: OF
OCCUPA4CYIIASBEr;NGR,\NlrD.UBC1091IB(:IIO/IRCIIO.
ARCIIIVE Api"LICANT 'kssf�ssofl 0TIIFR
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STATUS: ISSUED
BLD20070876
All new, "ended, re -built or cc located electrical utility and/orscry ice shall be placed tin demround.
Sound[No is c originating from temporary coils truction sites as a result of construct ion activity are e.xcnpt from the noise !irnits
of ECCCh a pter5.30 only during the hours 7:00am
of to 6:00pnion weekdays and 10:00arnand 6:00pni on Saturdays, e>xfud in g
Sundays and Fed eral Ho lid ays. At all other times the is in
IVI
no e o rig ating from cons I ruct ions it es/activites must co nip ly with the
no is e linlits of Chapter 5.30, unless a variance has been granted rnrsuant to ECC5.30.120.
ME
I .
THIS PERMIT AUTHORIZES ONLY THEWORKNOTED. THIS PERMIT COVERS
WORK TO BE DONE ON PRIVATE PROPER TY ONL Y. ANY CONSTRUCTION ON THE
'PUBLIC 0001AIN 1CURo. SIDEWALKS . DRIVEWAY�.MAR*&EES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT TINE LIMIT., SEE ECDC 19.00.005(A)(6
-:BUILDING (425) 771-022b D(T. 13D, 'ENGINEMING (425) 771-0220 Da. 1.326 FIRE(425) 771-0215
P jRIC W011KS (425) 771-02-35 PR9:nzFATMRVT (425) 672-5755 RECYCLING (425) 275-4801
len ca I rig for an inspection please lea"! the follmiing inforntation. Perm;'Numirr-lob, Site Address, Type of Inspection being
Cox'
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renuestetl, tact Nan . )c and Phone Number, Date Prcrer.!�tL��jd Wict'jer you prefer morning or afternoon.
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City of Edmonds
Permit AppIkation Form
Post-110 Fax Note 7671
TO 0614,�,O
COIDW.
C40.
Ph" �_Is 774 ozZo
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P rmlit Application for,'
Inter Remodbt Use
!or OIL
T
Onqe"..
Sign,_
Rorker'y g VVbll
in
IRetai ir
OtherjApp
cify
-,Brlef Descrl�tio�`.A� txe
Site Address: U-6 Sulta
No_�
Sno County Tax Account Parcel
Buslnessrrenant Name ap
.(If pllcable):_7 t 0-� UEF,N C7 W_- C-7 P-5
PROPERTY-.OWNEk:..
Mailing Address: e
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City: state; \.,r
—zip: -A
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Phone: L AX:
E-Mail:
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:CONTR,�CTOR: er.
Mailing Address: SQ 4
city.
State
Zip: -
Phone: (42-9 -7 7 7010 Q fm
FAX: (W-f- 6 7 3 - �,5-os E-Mail:Dl� -,_5 ds _$6;
- -----------
Sta.te License Nurnber:.9_qJ3_EiLP_a2,Q_,� Exj�. Date: IZ&? /0 1 City Business LI . cense No:N P,-O Ill".
APPUCAN,T/CONTACT:
Fill out the following informationIf "biher".
Mailing Address
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Permit Inspection Details
RE Nrmit: BLD20070876
1.58;--,B:B611dihb Fin' 1" .0-
6/-O�
6/2008 TEMP. 201APPROVED
. . ........
NATOLA
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Total Time: 20
Total Inspections:
Total Time: 20
V
8/17/2010 10:09:50 AM
Page 1 of i
OV F DA,
T'1% s
CITY 0 F EDMON"
121 5T 14 AVENUE N ORTH - rDMONDS,WA 98020
PHONE: (425) 771w0220 FAX: (425) 771-0221
S TATUS: IS SUED
.-Peirmit #i. LD20070
9/20/2007
WI . . . . . .
Expirationbate: 3/20/2608
ji-'505;- 5THAVE
_,Tx4;1t.Addmss:1'_ A, g,
Parcel N6:004_3342124=00
J RANKIN JEW ELLERS
X.!�
'�565tHAVE§A'103
NOR PARK HEATING INC. NORTHPARK NE-ATING INC.
19204 BALLINGER WAY NE 19204 BALLINGER WAY NE
EDMONDS, WA 98020
SEATTLE, WA 981'55 SEATTLr,WA 98155
206-365-14 14
LICENSE #: N6R,ri4PH348LF EXP:4!30/2009—_
PROVIDE DUCT -WORKTHROUGHOUT EXISTrNG S11 RE TENAI�FF SPACE FROM ExisTINGMSCHA�NC�AtAiVAC UNIT
VA M",
FORTENANT IM PROVEM ENT. INSTALL FIRE bAMP (ji'_
_,,t;'17E�ISTING I -HOUR WA U_
VALUATION: $0
' PERMIT TYPE� Commerciai
I: RM' T T Y I E C"'nnerL""
FILRi�IT GROUP TO - Mcch)(nical/Solar
GRADING: N CYD& 0
�7
ERETAINING
ITYPE OF CONSTRUCTION: VA
_ W K
I " WALL ROCKERY: N
JOCCUPANT GROUP: M
OCCUPANT IOADI�__
FENCE: N ( 0 X 0 Fr.)
CODE: 2006
0 T H H. R! N ....... OTHER DESC:
ZONE:
NUMBER OF 57 ORIES:0
VES7'ED DATE:
EE���
[N�BER OF DWELLING UNITS: 0 4
[PASEMENT:0,. , I ST FLOOR: 0 � I 2ND FLOOR: 0
BAS14MENT: 0— IST FLOOR: - 0 - 2ND FLOOR: 0
13RD FLOOR: 0 GARAGE:O DECK:0,, bTIAER:0 13
RD FLOOR: 0 CA RA GE: 0 DECK: 0 J7 7 F R0____j
REQUIRED: PROPOSED: -__fREQUIRED: PROPOSED: IRrOUIPED: PROpoqu)-
IIEIG14T ALLOWED:O PROPOSED:O REQUIRED� PROPOSED:
SETBACK NOTES:
%
I AGREE TO COMPLY WITHETYAND STATE LAWSREGULATINGCONSTRUCTION AND IN DOINGTHE WORX
AUTHORIZED
G T'j
THEREBY, NO PERSO . N WIL . L BE EMPLOYED IN VIOLATION OFTHE LAhORCODEOFTHE STATE OFWASHINGTON tIELATINGTO
WORKMEN'SCOMPENSATION INSURANCEAND RCW 18:27.
IT HIS AP P LICAT ION IS NOT A P ERNIIT UTNT II.. SIGNED BY THE BUILDING OFFICIA1 0
R-HIS/111311 DLIWIY AND ALI. FEES ARE PAID.
Signature Print Name
Relpased By
ATTENTION
I rl� UNLAWFUL 10 US17 OR,OCCUPY A BUILDING ORSTRUCIVRE UN'J1L A FINAL INSPEC7nON 11AS BEEN MADE AND APPROVAL OR A CERTIFICAIIE 01:
06CIJPNNC)'IIA.313r.-LNGP,\NlrD.UBC]09/113CI I 0/1RC11('.
ARCHIVE APPLICANT ASS,ESSOR
TIIFR
1"Ko
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STATUS: ISSUED BLD20070940
Sound/Noise originating fro ' mterrpomry cons truction sites as a result of construction activity are excMt from the no is e limjl!s
of ECCChaptei-5-30 only during the h6urs of7:00amto 6:00pmon v�eekdays and 10:00amand 6:00pnion Saturdays, . e.xcluding
Sundays and Federal Holidays. At all Ither times thenoise originating from construction si
0 tes/activites "lust comply with the
noise Emits of aptcr 5.30, unless a vari�aqe hijbeen granted'Pursuant to ECC5.30.120.
I PENN
THIS. PERMITAUTHO�JZESIjNLY THEWORkN6TEr,. TAiSPERMIT'
COVERS WORK TO BE 60NE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CORBS. SIDEWI.LKS. DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION.
�%EiOMITTIW%'UMIT., SEE EC Or 19-00. 005(A)(6)'
Jim-
0 EXT. 1333 bNGINMUNG (425)-771-0220 EXT. 1326 FIRE(425)771 215
P (425) 771-0235
PRE-I'REATIML-q'i'(425) 672-5755-�, RECYCLING( 25)-77-54-30-1--�
When cillLig for an inspection please leive the follo%ing inforrnatik: Permit Number, Job Site Address, T of Inspection beinq
ype
reauested.ContnetN2 . —11 Phone Number, Date Prefereedand,%hether'You 1 efer mo;-ning oi, afternoon.
13-Equipmcrit-Mech
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City of Edmonds
OV E
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Permit Applica-tion Form
Form A
-7 C. IS9,3
-Per mit.Application for.-' El. New; Single, Family
ft"odeV
New Com/Apt
F Addition
Fen
cY-d—s,.
'f'U
Repair
[I-storage/Shed -
EI.Sign
.6n�Aht--'Imp�ovemL-6i/iiha:'n""7*"
gplo,; se%,
oc ei�y�ReMining_ifi:.
-W,
0 Fire System
Othe
DATE:.
Brief Description- L- T_- 4 7
iOa,,,l In
Site Add ress:_;5�� f�IFT�J 4vt- S:
Suite # 2,2 3
Sno County Tax Account Parc�i C?O Y.3
-Busiriess/Tenant Name (:If applicablo:j PL,,, ^j k�_ I
PROPERTY OWNER:
Mailing
State:
--Zip:_
Phone: FAX: E-Mail:
CONTRACTOR': ElSa4`e as Pir6perty Owner r3d, -�J to L. -JC- 4q),
e) /JOn7 A 12, L
-10
Mailing Address: 12, RA Ql 4 912-
City: SC_-7t_,_L
State: LIJ A �Izip:_S&m�
Phone: (1)0(;' -.FAX: (d06 Y_ J:!�) E-Mail: A_Uff_7�J6o4,4-/-/Pv,4,�L- Cor-i
State License Number: L20K;r1-1P1J S Y110 �:F Exp: Date: City Business Licen . se No:
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APPLICANTICONTACT: 0same'a I/ontractor 00thiv
s Propertv�omer. 12�amq as t
Fill out the following information if "Other".
Name & Mailing Address:
City:
State: —Zip:
Phone: FAX:
E-Mail:
L:\TEMPkBUILDINGNWE13ch.ecklists\SFR.COMM.APP.doc5/24/�007
Permit ln�pection Detairs
Permit: BLD20070940
PCRMI-�T,-Ax.
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Total Time: 15
c0i �wp �V�RU=
11/14/20()7 Graf .15
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Tota I Time:
Total I nspoctions:
2 Total Time: 30
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Page 1 of 1
O�� 1 13,11
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CITY., OF EDMONDS
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121 5TH AVENUE NORTH - E DMONDS.WA 98020
PHONE: (425) 771-0220 FAX: (425) 771i,0221
STATUS: ISSUED
enmt I
9/10 007 p 4:.jiLD260 69 4
/2
Z ,
ExpiFiiiiin, Ofif6. 3/20/2008;
Parcel No: 00434212400100
Mum
COUNTR YWiDE HOME LOANS
505 STH AVE S
11 OR
NORTHPARK HEATING INC. �:,IORTHPARK HEATING INC.
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19204 BALLINGER WAY NE 19204 BALLINGER WAY NE .
EDMONDS� WA qi(); 20
SEAtTLE, WA 98155'i
.: It
. I I SEATT 1_17, WA 98 1 5j
�06-31�- 1414 206-365-1414
LICENSE NOTPJIPH3,IkLr EXPA/30/2009
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VALUATION: $0
M
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PERMI r TYPE: Commeicial
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PERMIT GROUP: 40 - McManicbl/Solar.
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION'.�
RETAINING WALL ROCKER ` N
OCCUPANT GROUP:
OCCUPANT i.nAr)-
CO E; 06
OTHER* N ------- OTHER DESC:
ZONE:
OF STORIES: 0
'STC
VL -DDATE:
OF DWELLING UNITS: 0
T, 0-� 0 2N.D FLOOR: 0
IBASEMENT: 0 ISr FLOOR: 0 2ND FLOOR: 0
3RD FLOOR7 0 GARAGE�:*O oTHER, 0
3 RD FLOOR: 0 GARAG_
E: 0 DFCK: 0 OTHER: 0
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I AGRE MPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED- z
RE
E ,Y TION OrTlil' LA13OR COUI-. Oi, -mr STATE OF WASHINGTON RELATINGTO —i
THEREBY; NO PERSON WILL 13C EMPLOYED IN VIOLA
P, WORKMEN'S COMPENSATION INSURANCE AND HCW IN 27,
THIS APPLICAT;ON IS NOTA PERMIT UNTIL S16NED 13Y,mr; BUILDING OFFICIAL OR IIIIVIII:R WLPUTY AND ALLI'MARE PAID.
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Signature pr
Released By D e
IT
ATTENTION
ITIS UNLAWFULIO US[::)ROCCUPYA BUILDING OR S'I�RUCIURE UN-rIL A FINAL MSPECIION HAS BEENNIADE AND APPROVAL ORA CERIIHCA'11�01
OCCUPANCY IIA� ur.,j ORAWMD UBC1091 IBCI 101 IRC'l to,
ARCHIVE APPLICA . NT A.S.S.TESSOR
STATUS: ISSUED,
BLD20071OQ41
Sound/Noise originating fromtenT orary construction sites as a result orconstructioll Z'Cfivity are cwnVt fromthc noise lirnits
of LCC,Chapter 5.30 onl� duriiig the hours
of7:00amto 6:00pmun weekdays an(i :1:00arnand 6:00jamon Saturdays, exhicling
Sund,-iys and Federal Holidays. At all othertinIcs !he noise originating fromcons.i.-uction
sites/ac tivites must comply with the
noise lirnits ofChaptr �30, unless a.variance has been granted pursuant to ECC 5.30.120.
THIS FERMIT AUTHORIZES O�Ly THE WORK NOTED. THIS PERMIT COVERS
WORK TO BE DONE ON PRIVATE PRC!'.'�RTY ONLY. ANY CONSTRUCTION ON THE
�7; PUBLIC DOMAIN�JCURBS, SI`bEWALXS, DRI�VEWAYS. MARQUEES, ETC.)
VOLL ReQUIRE SEP Ai0TE PERMISSION.
PERMIT TIME LIMIT: SEE iCDC 19'00.005(A)(6)
z
BUILDING (425� 771-0220 EXT. 1333 ENGINEERING (425) 771-0220 EXT. —
1326 FIREL425) 771-0215=
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p 7)RKS (425) 771-0235 rR&—TREATMFNTf425) 672-5755 RE)CYCUNG (425) 275-48 1
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Permit Application Form
Form A
Pe�TitAppl'ica , tign for: Ej New-Sin9l.e.Famil
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�l EI.Addition.
e arage'/Ca-
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State License Number: tJOYI-714,0�4 3q8LF
Exp: Date:
_V0 City Business License No:
APPLICANT/CONTACT: CiSame as PrOPertV Owner
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Name & Mailing Address:
Phone:'
FAX:
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Permit Inspecti on Details.
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RE: F�,.,7TR"AX Permit:. 13LD20070941
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CITY OF EDMONDS
121 5TII AVENUE NOR'm - i--i)mot,,Ds,V.'A 98020
IIIIONI:�.(4 25 1771-0220 FAX: (425) 771-0221
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STATUS: -ISSUE D
10/2/2007,: 2.007097 3
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Expiration Date: 10/2/2008
c i;` 5.0 51 VPS, EDM
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Pa o:00434212400100�'
COUNTRYWi DE HOMES
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PROTi-'cTION & COMMUNICATIONS PROTI'C'I'ION & COMMUNICATIONS. INC.
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51 W DAYTON ST STE 304
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EDMOND . S. WA.98020
LYNNWOOD, WA 98036 LYNNWOOD, WA 98036
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LICENSE #: PROTrCII65L8 EXP:5/31r009
FIREALARM ALTERATION.
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PERMIT GROUv: 79 - Firc Alarm
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FENCE. N ( 0 X 0 FT.)
CODE: 06
OTHER: N ------- OTHERDESC:
ZONE:
NUMBER OF STORIES:-)
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STED DATE-
NUMBE UNI S: 01
2ND FLOOR: 0 JBASEIMENT:
FLOOR� 0.
0 1 ST—FLOO R: 0 2ND FLOOR: 0
13RD GARAGE: 0 . DECK: 0 OT IER' 0 13
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REQUIRED� PROPOSED: REQUIRED: PROPOSED: C) i
HEIGHT ALLOWED:O PKUPOSED:0 IREQUIRED: PROPOSED: ;n i
ACK NOTES: IREOUIRED: PROPOSI., . D: >
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CONSTRUCTION AND IN DOINGTHE WORK ALITHORIZI
I AGREE'ro coMPLY WITH CITY AND STATE LAWSREGULATING im
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OFTHE LABOR CODE &THE STATE OF WASHINGTON RELATi :D
NGTO
WORKMrN'SCOMPrNSATION INSOPANCE AND RCW 18:2i.
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THIS APPLICATION IS NOT A PERMIT U TIL SIGNED BY THE BUILDING OFFICIA 2Lt[l���AND,�LL171-:I.SARrl'AID,
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Signature Flint Name Date
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ITISU . NLAWFULTO USE OROCCUPY A BUILDIN ATTENTION
GORTIRUCIURrUN11LA 11NALINSPrC-11ONIIASUM;
MADE AND APPROVAL ORA CER'nI:ICA1T-.0F
OCCUPANCY IIASI.11-.r.,�-'GRANII-D.(Jt3C[09/[BCIIU/IRCIIO.
ARCHIVE APPLICANT THEIR
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STATUS: ISSUED
BLD20070973
S
ound/No is e originating fro in temporary con's truction sites as a result of construction activity are exempt from the noise limits
of bZCChaipter*5.30.only during the hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding
Sundays and Fcdera I Holidays. At all othertimes.the no is e orig in at in g from cons truction sit cs/activ it es Inus I comply with the
no is c Uinits 6fChapter5.30, unless a variance his been g ran fed pursuant to ECC5.30.120.
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THI.S PERM T A tYTHORIZES'ONLY THEWORK NOTED. THIS PERMT 6OVERS WORK TO 13E DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIk4j(CURBS. SIDEWALKS. DRIVEWAYS, MARQUEES,' ETC.) WILL REQUIRE SEPARATE PERM
SSION.
PERMIT ME LIMIT: SEE ECDC 19.00.005(A)(6)
BUILDLNG (425).7.71-0220F,3(7 MINFERING (425) 771-0220 D(T. 1326 IFIRE (425) 771-01�15 1
Rl9C_Y___G__1 2-75.-48-01---
�672-5755 CUN 1,4.%L____]
=ng for an ins pcction 19 ms e leave. the fol lowing information: Permit Numberi Job Site Address, 'I�Tie Of Ills pectic—
i;Ti -
�!!Pjested, ContactName wid Phone Number, Dite Prefereed. andwhether vou Eefer morning or afternoon.
F-Fire Alanii System Acceptan
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.City of Edmonds
Permit Application Form
Form A
Permit Application for: Ej New Single Family . El New Com/Apt [] Additio n
ElInte'rior. kemodel
0 Gira6e/Oarl)Ort Repair El Sign.
E] F6 Hc'e * , 6
El bra -din cvds El. Storage/Shed
El-Ten"aint'lFnOr6Vemi*nt/Cha�n-"
ge o Use 'Q
D kockery/RetainingWall P2_ire System
Other
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DATE
Brief Descriotion: ";C,�_e T�L
Site 1. Address: 5/4-1 4,f S.
Suite # /3—/�,3
Sno County Tax Account Parcel #:
SusinessfTenant Name' (if applicable):
PROPERTY OWNER:
Maili�g'Address:
City: /,d '7,fe) 2
State: jv�j
Phone: V2_5 �Z/ FAX:
E-Mail:
CONTRACTOR. 0,Same as Property Owner
jt2LJNamej
Mailing Address� A�
City:
--State: —Zip: 76(�O� 6
Phone:
FAX: E-Mail-.
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State License Number:. S31
Exp: Date./ C)7 city Business License No:
APPLIC ANTICONTACT:
OSarne as Property owner 0.r1rn, as Contractor 00ther
Fill out the following information if "Other".
Narne & Mailing Add,ess:
City:�_ State:
Zip:
Phone:, FAX:(
E-Mail:
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direction if applicable (i.e. 545 square foot mast& bedroom/bathroom addition on the ser—
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with 1,4u square foot'deck and 24
squa.re foot i6tchen addition cn the main floor at south side of
house).,
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2 on the main fl-' :j
oor to create new master bedroom/bath room; replaup.dining room sliding glass door- 0
with new French doors, reconfigure kitchen with new island prep counter and ins,all new gas f; rn
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Permit lw3pection Details
Permit: BLD20070973
RkRMITTRAX'.
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11/13/2007 WESTFALL 60, Alarm mods iipproved.
Total Time: 60
7.1al Inspections:
Total Time: 6
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CTTY OF EDMONDS
121 5TH AVENUF WORTH -'EDMONDS.'.VA 98020
PHONE: (425) 771-0220 FAX: (425) 771-0221
STATUS: ISSUED
10/2/2007
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Expiraiion Date: 10/2/2008
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..,.i�-,--...-.,—P3rceiNo:.00434212400100'
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nurECTION COMMUNICAT IONS, PROTECTION COMMUNICATIONS. INC.
INC..
51 W DAYT ON ST STE 304
19630`�o'rll AVE W 19 630 401*11 AVE W
EDMONDS� WA 98020
LYNNWOOD, WA' 93036 LYNNWOOD, WA 93036
42 5.774-9099 425-774-*90�9
LICENSE #: PROTECI1651.8 EXP:5/31/2009
FIREALAIRM ALTERATION.
VALUATION: $0
PER,mll" TYPE Commercial
-
'ERMI 1 GROUP: 79 - Fre Alarm
GRADING; N CYD S: 0
crION:
RETAIN
OCCUPANT GROUP:
OCC 1) T LOAD:
FENCE: N ( 0 X 0 FT,)
Conr: or,
OTHER: N --�---- OTHER DESC:
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NUMBER,OF STORIES: 0
VEST ED OAT H:
NUMBER OF DWELLING UNIT S: 0
BASEMENT: U— I ST FLOOR: 0 2ND FLOOR: 0 JBASEMENT:0
I ST FLOOR: 0 2ND FLOOR: 0
13 RD FLOOR: 0.,, GARAGE: Oi,, - DECK.�',O OTHER: 0 _t
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o �GARAGE: 0 : DECK-0 �:OTwviz-n I
JR[QUiRED: PROPObl,-,D:'
, IRrQUIRED: PROPOSED: JRFQUIRED: PROPOSED:
ALLOWED:O PRDPOSED:0 I IREQUIRLD: PROPOSED:
!�CTILAC NOTES:
-'E TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WOR;� AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OFTHE LABOR CODE Or THE STATE Or WASHINGTON RELATING TO
THIS APPLICATION WORKMEN'SCOMPENSATION INSURANCE AND RCW,18;27.
ISNOl'APERMIT-UNTILSiGNrDI3�rTl4C'BtjlLL)I,'�GOFFICIAI.ORIII.CI ,R -P
ER DEPUTY AND ALL FEES ARr PAID.
Signature Narne 11.1.
ATTE, NTION
I . TIS UNLAWVUL 10 USL dR OCCUPY A 13UILDING OR si Rucrum UNTI'- A RNA L INSP L-'c-r.'N HAS BEEN MADE AND APPROVAL OR A C17RTIFICAII: OF
OCCUPANCY I IAS 13CEN GRLANIED. U[IC109, JL'Cj 1 0/ IRCI 10.
ARCII.IVE APPLICANT ASSESSOR
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BLD20070974
Sound/Noise originating f�omte omry cons'
MP tnictior, ites -�
s as a res uh of cons truction-activity are emirpt fTom!he no*
OfECC Ise liars
Chapter 5.30 ' only during.the hours of7:00am to 6:00pm on -�eekdays and 10:00am
and 6:00pm on Saturdays, e>rluding
Sunday5 and Federal Holidays. At all other times the noise originating ftom constniction sites/activiles must comply vMh the
noise.firnits ofChapter 5.30, uniess'a'variance
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has been granted pursuant to ECC 5.30,120.
THIS PERNIITAUTHORIZE'
S ONLI�. THE WORK NOTED. THIS PERMIT COVERS WORKTQgr-,DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLICOOMAIN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES.
ETC.) WILL REQUIRE SEPARATE PERMISSION.
PEFZ�TIT�k� LiMIT: SEE ECOC 19-00.005(A)(6)
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B )ILDIM 1� 425 771:,! �:210 EXT., 1333 ENGINEFRING 421; 771-0220 EXT
TIRE (425) 771-0215
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PR&TR EATMLNT (425) 672- -LING(425 2754801
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en calling ror an inspection please leave the follo-Aing infor nuition: Permit Number, Job Site s s, Type if I-n-s-j-x-c-fi--on--bei-n7g
reduested, Contact
Name and Phone Numbe�, D te PrerereecL indMether loll pre rnOon
F-Fire Alann System Acceptance
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City of Edmonds
Permit Application Form
Form A,
Of ");tf
A
Permit Ap 'lication for:"; 0 New*Single Family El New com/Apt
E] Addition
[11n,wriorpR6model
El (jarag'elcarp6rt
0 ' [I Repair El Sign
El Fe - n*, 6 e; -Grading_____ cyds El §Jorag'e'/Shed
El Tdnant1 t/ ha " "
mprovemen C nge*of'Use- i
�q System (Specify) 7.7.
R661<6��/ke�j�fihihng4W all
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DATE: A;, /,j 7
Brief Description: 7-Z—
Site Address: 5os 's Y:�,
Suite#
S.no County Tax Account Parcel #:
Business/Tenant Name (if applicable): J
-PkOPEkTY OWNER: 5 )�z
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Mailing Address:. 5", li), /0- /c
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City:.
State: Aur
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FAX:
Phone:
E-Mail:
1: coNTRACTOR:' OSam'e as Pr�o'pertv owner 0!;j1:hjer (Narne)' AZAle"
Mailing Address: /7,& 3ci Zz�j Ab--!
City:. State:
Phone: 7c) FAX: 5
E-Mail:44 Aae V�,� 0
State License NumberfK07--c-l-le.,51,P - Exp: Date:
City Business License No:
APPLICANTICONTACT: OSame as Prope!ly wner 2S-a-rne as Contractor 00the I r
Fill out the following information.if "Other"�
Name & Mailing Address:
City: State: Zin-
Phone:,(_)
FAX: (_)
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project.
Additions (additional square footage): Specify room, use; floor le vel and square footage and
'applicable
direction if (i.e. 545 square foot master bed roorn/bath room addition on the second flc:)r
with 140 square foot deck and 245 square foot kit'
chen addition on the main floor at south side of
house).
Remodels' (interior renovations): Sl5ecify room' uses and, floor levels . (i.e. combine bedrooms 1 and
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3
Permit Inspection Details
Permit K020070974
E:RmIrTRAX�
OT?�§Y�tb.IT;:A -pep ance,�,,:.,., I.
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11/13/2007 WESTFALL ';'
60 A6rm mods approved.
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Total Inspections:
Total Time: 60
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C1.117rOF EDMONDS
121 5 r I I AVENUE NORT H - rDMONDS,WA 98020
PHONE: (425) 771*�70 - FAX: (425) 771 .0221
STATUS: ISSUED -B
% P I:- LD20071*00
10/15/2007-
E�piratio n Date: 10/15/2008
5 5,5THAVE-S'-1 10'-3"-T1).1q0NDS!
0-,�rc-c—lNo:00434212400100
[12 tul w 51 IV
RANKIN JI:WLLLI:I6
WWII
WI:YITI(N VATES FIRE-PROTI..'C'NON W I:Sl* M(N SI'ATIIS 1:1 RE 11 ROTECTiON
51 W DAY ]'ON Si' ';I'E 304
7102 1 SOTH AVE N H 7102 180TH AVE Nr
GENE VOLOSHENKO GENE VOLOSTIENKO
EDMONDS, WA 93026
REDM6ND, WA 98652 REDMOND, WA 98052
425-8.3.1-0100 425-881-0100
LICE.NSI: u: wi-,,sTESF136QF LXP:1/18/2009
FIRE SPRINKLER ALTERATION TO ACCOMODATETENANTIMPROVEMENT
VALOATiON: $2,650
gh
JPERMI T TYPE: Commerciii
PERMIT GROUP: 30 - Fire Sprinkler
IG14LADiNG: N CYDS: 0 -
TYPE OF CONSTRUCTION
!RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N 0 X 0 FT.)
CODE: 2006
OTHER: N ------- OTHER DESC:
N �,
xO ;..
NUMBER OFSTORIES: 0
VESI'ED DATE
NUMBER OF DWELLING UNITS: 0
0 1 ST 1:1.00R: 0 2ND FLOOR, 01 r,
0 1 Sl' FLOOR: 0 2ND FLOOR: 0
13 RD FLOOR- 0 GARAGE 0 DECK; 0 OTHER: 0_ 13RD
FLOOR: 0 GA RAGE. 0 DFCK: 0 OTHER: 0
i TEREQUIRED: PROPOSED, IREQUIRED: PR )]RED: PROPOSED:
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QIG I I —TA L L 1:0 PROPOSED.0 IREQUIRED: PR
SETBACK NO
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-1-10N AND IN DOING THE WORK AUTHORIZED
THERE -BY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR -CODE OF THE STATE OF WASHINGTON RELATINGTO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION IS NOT A PrRMIT UNTIL SIGNED BY -THE BUILDING OFFICIAL OR HISIHERPOPUTY AKD ALL FrESARn PAID.
Signa ture
Print Name Date Released By Date/
ATTE NTION
lll-SUNL,%WFULIOUSI:OROCCLIPYABUII.DINGORS'rRUC-,URriUN-TILAFINAI.[Nsl'l--.CilONII�%Sl3LI:Nt,[ADr.AND.%['PROVALORACr--.I,IIFICAILOF
OCCUPANCY IIAS[31:ENCRA.'411:D.UBCIO')/IBCIIO/Il�CI 10.
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STATUS: ISSUED
BLD20071009
Sound/Noise*od&a'ti'ng frorntemp o*mry construction sites as a result ofconstruction activity arc e)Q:mpt fromthic noise Units
of ECC Chapter 5.30 only during the hours of7:00am to 6:00pmon weekdays and 10:0 . Oam and 6:00pm oil Saturdays, excluding
'Ile noise originating from cons truct ion sitcs/activites must comply %ith tile
Sundays'and Federal Holidays. At all other times ,
noise firnits ofChaptcr 5.30, unless'a wflance his been granted pursuant to ECC5,30.120.
THIS'PER MiALITH.
ORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUC71ON ON THE 11
PUBLIC OOMAN (CURBS, SIDEVALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMSSION.
TTINE LINT: SEE ECDC 19.00.005(A)(6)
PERM
BUILDING (425) 771-021.0 EXT. 1333 ENGINFIRING (425) 771-0220 EXT. 1326 7��FIRE (4252 771-0215
PJ-1JiJCW0—RKS(425)77l-0235 I'R&TREkD1SVT, (425) 672-575 5 RlEr)'CLING (425) 2754301
When cal li ng f0r an ins pection 19cas e leive tile fol lowi ng information: Perm! t Number,.Job S ite Address, T)pC of Ins pection be
requesteA COntict Name in to PrefereeWand whether you prerer morning or afterno . on. in] V; C:
d Phone Number, Da
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Permit Application Form
Form A
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Permit Application for: New single Family E] New Com/Apt El Addition
El Interior Remodel E] Garagelcarport. El Repair
T1 G'radin
Elfence - . ;.ri El sign
Li Storage/Shed
EffTenani—ImproTeme'rit/Change of Use M Fire Wern Ispocilly)
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PROPERTY OWNER AVLP P6 I 10 11 M 1AA A 1A I
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CONTRACTOR: OSarne as Property' Owner
Mailing Address� -710-2— t8o-��
City: j I
State: —zip: 119 0 S—Z
Phone: I
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Sta te License Number: WF!iM S(*�36 a F
Exp: Date,— City Business License No: 1JR 0
APPLICANT/CONTACT: lisame as Property owner _0Sarne 3s Cont racfor
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Name & Mailing tAciclress:_(!�" V16 11 k1D -7101
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Phone: (±12-E) IS,?/ - D z
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ermit Inspection details
PER;.,11TT' - Permit: BLD20071009
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11/13 /20"'
07 WESTFALL 60 F.re approved spiinkler mocls.
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11/13/2007 WESTFALL 0 Fire accepts modifiied system.
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CITY OF Ell)
""MONDS
121 5TI I AVENUE NORTH EDNIONDSMA 93020
P I ION F: (425) 771-0220. FAX: 025) 771-0221
STAITS: ISSUED
10/15/2007
'a,
X�iration batc:� 10/15/2,008
sdt.Addii -A-V '101,M]MONDS1
T"S"
Nrcel NG: 00434212400100
COUNTR T w I uL HOME LOANS
51 W DAYTON ST sT . r, 304
wrSTI - 'RN SI-A-1- FIRE P I� oTrCTION wiisraRN STATES FIRE.PRoTEFT
7102 1 90TI I A Vr N C 7102 IEDTH AVE NE
EDMONDS. WA 9SO20
GENE VOLOSHENKO GENI: �OLOSJIENKO
REDMOND, WA 98052 REDMOND, WA` 980521
425-881-0100 415-381-0100
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LICENSE #: WI'S`I*I3SFI36QF rxp:.'/[ 812009
FIRESPRINKLE RALTERATION ACCOMODATE
TO
TENAw IMPROVEM ENT
YALUAT�ON: $3,958
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ercial
CYDS: 0
PERMrr ROUP.30.Firr;-��,
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OCC'JPANT'G OLIP:
FENCE: N 0 X 0 FT.)
OCCUPANT LOAD:
U I [ILK: N - OTHER DESC:
CODE: 2006
NUMHLR OF STORIES: 0
ZONE:
MBER OF D —
WELLING UNITS 0
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0 _L_2sr i-Loow a
ND FLOOR! (I
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PROPOSED:
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EBY 0 WSRV',;ULA-,'INGCONsrRUCI-IONANDIN DOING THE WORK AUTHORIZED
THEREBY.NO PERSONWILL BEEMPLOYED IN VIOLATION OPT141: LA13ORcobEOPTIlESrATEOFWAS]IINGrON RELAT*INGTO
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P'L, . C . TIO", OT A P, WORKMEN'S COMPENSAT ION INSURANCE AND RCW 13:27.
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I -HIS APPLICATION IS NbT A PERMIT UN-ru, SIGNED BYTHE BUILDING . OFFICIAL OR IIWI`I�R DEPUTY I AND ALL FEESARE PAID
otgnature Print Name
ATTLNTION
ITIS UNI.,%W FUC To U5 E OR OCCUPYA BUILDING OR S-IRUC-1URr. MIL A FINAL INS11 L(-
J7UN I 1AS BLUNMADI'AND APPROVAL OR A CERITFICAM: 01'
OCCUPA NCY I IAS BEEN GRAN-M). U13CI 091 ISC I 101 IRCI 10
ARCHIVE APPLICANT ASSUSSOR
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BLD20071010
So undlNo is e�orig in at ing from temporary cc nstruction sites as a rest, It of construct ion activity a, e exempt from the no is e* limits
of ECCLliapter5.30 only during the hours of 7:00am to 6:00pmon
weekdays'and 10:00am aft d 6:00pmon Sat drdays, excluding
Sundays and Federal Hol;days. At ail othertinIes the noise o rig in ating lromcon'struction sitcs/aciivites must comply vAth the
V
nois e lirnits.of Chapter 5.30, uhles s a variance has been granted pursuant to.ECC 5.30.126.
.
'HIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERmircQvERs WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION
ON T HE
PUBLIC DOMALIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC WILL REQUIRE SEOARATE PERMISSION.
I
PERMIT ME LIMIT. S EE kDC 1�1-00.()Ci�A)(6)
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B UILUNG (425) 771-0220 OCT. inj I ENGIN19-RING (425)771-0220EXT, 1326 1
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F1U[JLlCW0R1Q;(425)-77l�)23T7 ]IOCYCLING (425) 275�-80-0-7
When CMIling for,in inspection p1me leaw the 1`0110%ing informahon: Permit Number, Job Site Atkiress, T)I)c of In spection i�fF'g
requeited, Con!act Name
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ind Phone Number, Dai;! 9 cfcrce(
-���r�efer morning or nflernoom-
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Permit Application Form
Form A
Permit Application for: El New Single Family
E] Interior Remodel
Ej New Com/Apt Q Addition
E] Gara66�Qarport
D Repair Sign
.[DF Gra i%_��cds
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Brief Description: F�re 32c,'kier <.
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'3tate License Number U"F-STE r s6 cl Exp: Date: City Business License No:
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APPLICANT/CONTACT: LISarne as Property O�L'Per 10s-me as cotr,,t,, oOther
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11/13/2007 WESTFALL 60 Fire accepts sprinkler mods.
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Total Time: 60
11/13/2007 WESTFALL 0 Fire accepts mods to sprinkler system.
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Total Time: 0
Total Inspections: 2
Total Time: 60
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CITY OF EDMONDS
121 STII AVENUE NORTH - LDMONDSWA 98020
PHONE- (425) 771-0220 - FAX: (425) 7� 1-0221
STATUS: ISSUED
Expiration Date: 7/22/2008
Parcel No: 00434212400 100 1
PROPHUNOWNER APPLICANT CONTICACTOR
SNAP FITNESS SNAP FITNESS PXCIFIC SIGN ERECTORS
51 W DAYTON ST STE 304 10620 229th PI SW 9792 EDMONDS WA # 172
BRYAN JONES (TENANT)
EDMONDS, WA 98020 EDMONDS, WA 98020 EDMONDS, WA 98020
206-930-2005 206-498-3919
LICENSE N: PACIFSE965CK EXP.211212010
WALL SIGN, SEPARATE I-ErFERS
VALUATION: $0
PERMIT TYPE: Commercial
PERMIT GKO '6 -Sign
GRADING: N CYDS. 0
TYPE OF ONST21ICTION7 SIGN
RETAININGWALL ROCKERY: N
OCCUPANT 696UP:
OCCUPANT LOAD
FENCE: N ( OXO FT)
CODE 2006
OTHER: N OTHER DESC.
ZONE: BD2
INUMBER OF STORIES! 0
VESTED DATE:
INUMBER. OF DWELLING UNITS. 0
IBASFMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR- 0
13RD FLOORi 0 GARAGE: o DECK: 0 ' OTHER, 0
13RD FLOOR: 0 GA RAGE: 0 DECK: 0 OTHER: 0
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHE WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27
HISAPPLICATION IS NOT A PERMIT UNTIL SIGNLD BY T14E BUILDING OFFICIAL OR IIISIHER DEPUTY AND Al.l. FEFS ARE PAID
Narne
ATTENTION
JTIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR MUC-FUREUNMI. A FINAL INSPE(:IION HAS BEEN MADE AND APPROVAL ORA CERIIFICAIE OF
OCCUPANCY HAS BLLNGRANTFD.IJBC109/IB('I I0/IRCi 10,
F--] ARCHIVE APPUCANT ASSESSOR OTIIER
STATUS: ISSUED BID20071140
Installation ofraceway and c6n"nents shall be per manuf4cturer's specifications and instructions.
A 0 new, extended, re-buift or relocated ek&riral utility and/or service shall be placed unde%round.
Obtain Sectrical Permit from State Department ofLabor & Industries. 425-29D-M
Sound/koise originating fromtemporary construction skes as a result ofconstruction activity are exempt fr6mthe noise firnits
ofEOC Chapter 530ohly-,during the.hours of7100ajn to-6-.00pmon iwcMays and 10.Wam and 6-OOpmon Saturdays, excluding
Sundays and Federal Holidays, Ai all other times the a . oise originating fiomeonstruction'siteslactivbes must comply with the
noise.5mits of Chapter 5-30, unless a variance has been granted. pursuant to EOC 5.30.120.
THIS PERMT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK 70 BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOWN (CURBS, SIDEWAM, DRIVEWAYS. UNROUEES. ETC.) WILL REOUIRE SEPARATE PERPASSION.
PERWTnME UWr SEE ECDC 19.00.0MMM
BUffJMGjM77l-0220EXrA3j3-- -'ENGVffXMG(425)77i4)22owrj326- I FME(Q* 771-0215
FURUC WORKS (425) 771-=5 F7 PR&IRFATNW�'T07* 5 RWVCtJNG(425)275-M1
VVben calling for an inspection please lexw the 15011WADg lAfOrMIX000: Perxdt Number, Job Site Address, Type of Inspection being
reques te!& Contact Name and Phone Number, Date Prekr" and vibether you prefer morning or afternoom
• E-Fhgineering Final - Pic for SU Me
• B-Building Fi
of E04f Inspection Comments
BLD20071140 63 - Sign
Applied: 11/09=07 Issued: 01/2211008
Address: 505 5TH AVE S #104, EDMONDS
INSPECTION DATE
1077 - E-Engineering Final - Pic for SU file 02/08/2008
Comment: Signed Off
1158 - "uIlding Final 02108/2008
Comment':
Expires: 07/22/2008
INSPECTOR
Iambertj
Bullis
12/5/20114:10:25 PM 121 5ih Ave, Edmonds Washington - Phone: (425) 771-mo
ACTION
CMP
CMP
Page 1 of I
0FEVk0
46--
.1s90
PERMIT#: Q00-7 - 06qo
STREET USE PERMIT
PROPERTY OWNER NAME: 1, '4r-'W'Agi Phone &Z,40 4*7 qZZ9
BUSINESS NAME: S-r
BUSINESS OWNER NAME: Pbondl-ar) 23�2 Z'W-c
ADDRESS OF PUBLIC USE: si2c -r,:A A"-= .c Al!z
APPLICANT MAILING ADDRESS: la(Zo ZM-9 j#Z- SAo- ZF,4��,e
.:;:c, it. -A
Placement of any temporary or movable objects in any portion of public space or City right-of-way shall
meet all Code Requirements as set forth in the following chapters of the Edmonds Community
Development Code.
18.70 STREET USE AND ENCROACHMENT PERMITS
17.65 LIMITED OUTDOOR DISPLAY OF MERCHANDISE
17.70.040 TEMPORARY USES; Bistro and outdoor dining
PERMIT ISSUANCE
A Street Use.Permit may be issued, at the discretion of the Development Services Director, City Engineer
or their respective designee, for temporary objects located within any public space, right-of-way, roadway,
parking strip and/or sidewalk, including the air space above them, if they are placed in compliance with the
above referenced Code Sections and the following criteria are met:
> It has been concluded that the proposal will not adversely impact public space open to vehicular or
pedestrian travel;
> Architectural Design Board approval has been granted or the process has been administratively,
approved;
> The proposal will not unreasonably interfere with the rights of the public;
> Items shall be placed adjacent to the building and may encroach onto a maximum of two feet of the
public sidewalk; or in accordance with Bistro and outdoor dining code; or per an approved building
permit;
> Safe pedestrian travel area, or clear zone, of 44 inches minimum width shall -be maintained on City
sidewalks; (see definition of clear zone below)
> Exterior light fixtures, banners, signs and flags must be a minimum of 7 feet above City right-of-way;
> Clear landings of 44 inches or no less than the width of the door (whichever is greater), measured
toward the street, shall be maintained on the exterior side of all required exit do'ors;
Illumination fi-om City light fixtures shall'not be blocked;
> No objects shall be hung from City light standards; and
SAEngrTorffis\Street Use Pernit.doc � Rnised )215/D5
> Three feet of clearance around fire hydrants, standpipes, manholes, water meters, blowoffs, cleanouts
and valves shall be maintained.
Clear Zone Definition: Clear Zone refers to an area 7 feet in height and 44 inches in width R12�jding a
level, safe walking surface along the public sidewalk (e-g. measuring 44 inches from edge of street tree.
grates or newEpaper stands toward Rlace of business and from the plound UR to a beiglit of 7 feet) -
DESCRIPTION OF PROPOSED STREET USE:
"PLICANT TO READ AND SIGN
NOTE: The issuance of this permit is understood by the applicant to be ofa temporary nature, shall vest no
permanent right and shall be issued and may in any case be revoked at the sole discretion ofthe Cityper
ECDC 18. 70.040. By signing this application, the applicant accepts responsibilityfor all existing andlor
future street uses. Applicant is responsible to provide a copy of the insurance certificate to the City at the
beginning of each calendar year, no later than the 21't day ofJanuary.
INDEMNITY. The applicant understands and by hislher signature to this application, agrees to hold the
City of Edmonds harmlessfroin any injuries� damages or claims of any kind or description whatsoever,
foreseen or unforeseen, that may be made against the applicant or Ike City ofEdmonds, or any of its
departments or employees, including but not limited to the defense of any legalproceedings including
defense costs, court costs, and aitorneyfees by reason ofgranting this permit. In addition, the applicant
understands that helshe shallprovide and continually maintain during the term of thepermit a certificate
of insurance naming the city as an additional insured, with respect to liability, andproviding that it shall
be primary as to any otherpolicy ofinsurance-
CODE APPLICATION. By signing the application below the applicant warrants that. s1he has read or had
the opporiunity to read Ch6pler 18.70,17.65, and 17 70.040 ofthe Edmonds Community Development
Code and s1he understands that all terms, of the adopted ordinance are incorporated herein as ifsetforth in
full and this application andpermits therefore are subject to the terms of those Chapters.
SIGNATURE
Ommer
DATE /I /
L,f A? 7
OR- CITY USE ONLY
Approved by: Insurance Verified by:
Building Permit A. &o-7, 11 L-16 Street Use Fee: C.N 1-1 too
Receipt No:
Issued by:, Date: t/':Z/6VCopy to Applicant: Pick-up E] Mail
di I
SAEngrWor=\Strw Use Peru�tdoc Reviscd 12/5105
Ar&QRQ CERTIFICATE OF UABILITY INSURANCE
awmaummNym
01/09/2008
mum 631)469-3933 FAX (651)469-3930
- ri T
Spanjers Insurance Agency
Arthur 3 Gallagher RKS
]L2S0 Northland Drive #120
Mendota Reights, MN SS120
THS CERTFICATE 19 ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGKTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEM, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLX;IES BELOW
DISURERS AFFORDING COVERAGE
Mw#
wwww First Source Fitness, LLC
WA: SnV Fitness
10620 22M Place SW
Edmonds, WA 98020
mmu A: PennStar
INSURER&
INSURERC:'
Dr.
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THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N0T`WffHSTANDING
ANY RECAJREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCUISMS AND CONDITIONS OF SUCH
POLICIES. AIWREGATE LOWS SHOWN MAY HAVE BEEN REDUCED BY PAFD CLANS.
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POLICY NUMIDER
POUCYEFFECTIVE
POLICY EXPIRATION
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01/16/2009
01/16/2009
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DESCRIP11ION OF OPERATUM I LOCATION15 IVEHICLES I EXCLUSIONS ADDED BY EIMMENIENT1 SPECIAL PRaVISWW
It is understood and agreed that the City of Edmonds is named as an additional insured. Permit for Snap
-itness located in City right-of-way.
05 Sth Ave. S Edmonds, VA 99020
City of Edmonds
Engineering Division
121 Sth Avenue North
Edmonds, VA 99020
SHOULD ANY OF Uff AIMOVE DESCRIBED POLICIES W, CANCELLED NEFORE THE
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CITY OF EDMONDS
121 sri I A VLNIJI- NORT H - EDMONDSW A 98020
I'l-IONE 4425) 771-0220 - I AX (425) 771-0221
STATUS: ISSUED 1/10/2008
Parcel No: 00434212400100
SNAP FITNESS GRACE ARCHITECTS, PI-I.0 BELFOR USA
51 W DAYTON ST STE 304 1927 POST AI.I.FY 3926 WOODI. AND PARK AVL
RALPH ALLEN
EDMONDS. WA 9 8020 SEAVI LE. WA 98101 WAVILE-WA 98103
206-399-9467 20f�632-0800
LICENSL 4- BELFOUG99013.1 EXP 12/14/2008
JOB DESCRIPTION'
OCO�7
'i"tNANT IMPROVDAuwr FOR FITNF-SS(17,N'T'I-F- INCU DING MAIN WORKOUT ROOM- OFFICE TWO DRESSING R.
A ND TA NNINO ROOM. FLOOR A RLA 2752 SF.
VALUATION: $102.919
i'l-RMI'l *1 YPI CommerciaL
PERMIT GROUP 71 -Teriam Iniproicnir1w
GRADING N CYDS 0
TYPI- OF CONSTRUCIAON VA
RETAINING WALL ROCKERY N
OCCUPANT GROUP! Al
OCCUPANT LOAD- 55
FENCL N 0 X 0 IT
CODE 2006
OTIIER N ------- OT)IER DESC
ZONE.
INUMBER OF SrORIES 0
1 Vr--Sl'l:)) DATE
INUMBER OF DWELLING UNITS 0
1
EXI s-, TI NG k R F %
JBASEMENT 0 1 ST FLOOR 0 2ND FLOOR. 0 71BASEMENT-
PRO PO S ED A REA
0 IST FLOOR.0 2ND FLOOR 0
13RDFLOOR 0, GARAGE () DLCK 0 Ol HER- 0
13 RD 1-1 OOR 1) C.AkAGI-, 0 DECK 0 OTHER 0
FRONT S ETR.ACK SIDESEI-BACK RF--XRSLTBACK
REQUIRED PROPOSFI) REQUIRED PROPO,91) �RTQUIRED PROPOV-D
HEICAIT ALLOWED 0 PROPOSED 0 [REQUIRED PROPOSED
W T BACK NOT I:S--
IAGREF TOCOMPLY WITH CITY ANDSTATE LAWS REGULAT ING CONST RtJn'ION ANDIN DOINGTHE WORK AUTHORIZED
IIIEREBY- NO PERSON WILL BE EMPLOYLDIN %1OLATION or I m. I ABORCODE OVI HE SrATE OF WASHINGTON RTI ATINGTO
WORKMF N'S COMPENSAT ION INSlIRAN('L AND RC%k' 18 27
1-1 1-11SAPPLICATION ISNOI A PERMIT UNTILSIGNED BY 11IF BIJILDINGOFFIC-Je4,,0R IV5()W-R DEPIA Y ANDAIJ I-EE-SARE PAID
EgZav4�i L�h( V
Rini Name 'Date baie
AT-MNTION
1-1 IS ON I AlAT111. TO USI ORO( nri,y k nt:ll I)) NG OR% nwunrRr I N]H A VINAI INSPEC11ON HAS tiff NNIA DFAN DAPPROV %I. Oft A (TRTIFICATT Of
(A (VIIA"WN HAS III IN URANIT-J) UBC109 IliCi 10 IRCIII)
ARCHIVE APPLICANU ASSESSOR lFW
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STATUSASSUED MM 0111
Sepeiate Pemit Required For
I. nRE SPRINI(L.ER
7- MECHAMCALIHVAC
3. STATE ELECTRICAL (fiorn labor and Industries)
Finalapproval on a projector final occupancy approvalmust be granted by the Building Official priDrIo use or occupancy of
the building qrstruclure.'Checkthejob card for all required City inspections including final project approval and final
occupancy inspections.
Any request for alternate design, modification.variance orotberadininistrative deviation (hereinafter -variance) from
adopted codes, ordinances orpolicies nwst be specifically requested in writing and be called out and identified. Processing
&-es for such request shall be established by Council and shall'be paid upon submittal and are non-refundabic.
Approval ofany plat orplan containing provisions which do not coryiply with city code and for which a variance has not been
specifica0v identified. requested and considered by the appmpFiate city official in accordance with the appropriate provision
ofckv co�e or state Ia'w does not approve any items not to code specification.
Sound/Noise originating finivaternporaTy construction sites as a result ofconstiuction activity are excinlit fminthe noise limits
ofECC Chapter 530only during the hours of Marnto 6-,Wpmon weekdays and 101&m ana 6:Mpmon Saturdays, excluding
Sundays and Federal Hofidays. At all other times the noise originating fiom construction sites/activites must comply with the
noise limits of Chapter 5-30, unless a variance has been granted pursuant to ECC 3-30.120.
Appricant. on behalf of'his or her spouse, heirs, assigin, and successors in interests. agrees to indemnil�r defend and hold
hanniess the City ofEdmonds, Washington, its officials, employees. and agents from an.y and all claims for damages of
whatever nature, a . rising directly or indirectly fionithe issuance lb this pcffrk. Issuance ofthis permit shall not be deemed to
mod4. waive or reduce any requirements of any City ordinance not ronii in any vmy the City's ability to enforce any ordinance
provision.
i LNSPECTION'S
7M PERNT AUMORIZES ONLY 7M WORK NOTED. TM PERK97 COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY- ANY CONSTRUCTION ON 1HE
KMUC DOMMN (CURBS, SIDEWALKS. DRIVEWAYS. VARMEES ETC.) WILL REOURE SEPM;A'-M PERLISSION.
PERMT TIME UW. SEE ECDC 19.00.009A)(6)
I ]BUILDING 44251771-MEXT. 1333 —1 1- IENGDAMMG (425)7714)rMEXT. 1326 1 ---- . EIRE(425) 771-0215
PUBLIC WOM (125
� 771405 PRMUFAMM L425) 672-5755 RE)CYCUNG(425) I
When CaUlog for Mn inspmdon pease leaw #be 1WIawAng inrorimbon: iftrinit Nun*er, Job Site Aft s, Type oflospection being I
reamstal. Contact Name md Pbone Number, Date Pirefereed, and whether prefer inoming or afte
B-Fire stopping k7-T/
B-Sheetrock Nag
B4[luikling Foal
J
M�� Permit Inspection Details
Permit BLD20071173
PERMIT-1-
1142 - B-Framing
Complete?
y
01/25=8 BuIlls 30 wam framing approved except at dressing rooms. Correction notice issued
N
021MODS Bullis 30
y
Total Time:
so
1144'- B-Wall Insulation/Caulk
Complete?
y
oi/23woa Temp-Nalola 20 Approved
y
Total Tkne:
20
1150 - B-Sheetrock Nail
Complete?
y
0`1125/2008 Bultis 3o Sheetrocic approved except at dressing rooms. Correction notice issued.
N
02A)612008 Buffis 30
y
Total Time:
60
1158 - B-Building Final
Complete?
y
02/202008 Butlis 20 Correction notice issued
N
02/26/2008 Buflis 15
y
Total Tim:
35
1985 - F-Fire Final
Complete?
y
0212512008 SMITHM 20 APPROVED,
y
Total Time:
20
Total Inspections: 8 Total Tlffw: 195
2127/2008 11:50:02 AM Page I of I
C r
ttp of (eb oubi
Occupancy established by this certificate:
A3
DEPARTMENT OF BUILDINGS
lot . (Ptcw 34n
PER International Building Code Section 110
Dwelling Units: N/A
TY06, Construction: VA
Maximum Occupant Lo . a - d'- .'65' (Per ISC 1004)
Room capacity signs, when-requirod, must remain posted at afl times.
No. Stories: I
Basement: N/A
Owner of Building: GPA Inc. I The dboa�rir �d&696/Tenant Space; 505— 51h Ave S #J04
THE Snap Fitness ___HAS BEEN. -INSPECTED AND APPROVED AS COMPLYING WITH THE REQUIREMENTS OF THE IM
EDITION OF THE INTERNATIONAL BUILDING CODE. AS ADOPTED sy-Tievrff FOR -THE GROUP AND DIVISION OF OCCUPANCY AND THE USE
FOR WHICH THE PROPOSED OCCUPANCY IS CLASSIFIED.
Issued this 27 1h . .-dey-6f; February. 2008
CHIEF BUILDING OFFICIAL
BY:
— 00"
TWscen6eft"bepaNdInam, hploicus pub0c M@And" nN bewm4d, =018ted or eu. 14 Z<M11.181ned In hWbis corddw at an Imes. Any c"ngs of o=upancy w use r*Wres a buRd" pe"I vW a now
CvVftste of OoDipancy Issued by ft Oty of Ednwds &AkOng Oftal.
Of ED&
s
ILn
STATUS: ISSUED
Expiration Date: 12/23/2008
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS.WA 98020
PHONE. (425) 771-0220 - FAX: (42'5) 771-0221
Pemit #: BLD20071189
.)�pjeo Address: 505 STH AVE, S EDMONDS'
Parcel No: 00434212400100
PRoPrwn,ow,,--FR APPLICAN'T
THE GREGORY MESSENGERCORP MESSENGER CORP
51 W DAYTON ST STE 304 37 S HUDSON ST 37�S HUDSON ST
EDMONDS. WA 98020 SEATTLE, WA 99103 SEATTLE.WA 99103
425-673-4218 425-673-42*19
LICENSE 0: MESSES*274MP EXP:10/4=0
MONMENT CABINEr SIGN
VALUATION: $0
&%two
PERMIT TYPE: Commercial
PERMIT
GRADING. N CYDS 0
TYPE OF!%�,�)W
RETAININGWALLROCKERY: N
OCCUPANTIAMP:
OCCUPANT LOAD:
FENCE.- N 0 X 0 FT.)
CODE- 06
JOTHEWN —OTHERDESC:
IZONE: 8132
[NUMBER OF STORIES: 0
IVESTED DATE:
NUMBER OF DW ELLING UNITS: 0
�BASEMENT: 0 1 sT FLOOR: 0 2ND FLOOR: 0
.0
18ASEM .0 1 ST FLOOR- 0 2ND FLOOR: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FRONTS EMAM SIMSEMACK RL-%R S FIBACK
REQUIRED: 0 PROPOSED: >0 — — — L LREQUIRED: 0 PROPOSED: 101=11.0 PROPOSED]
HEIGHT ALLOWED:O PROPOSED:O REQUIRED: 0 PROPOSED: — I
SETBACK NOTES: Landscaping at base of sign is less than IvAce the area of the sign (approx 1:1). Homever, the sign's position on 5th Ave. is pan of
larger entry scheme with a ntimber or other planters and improvements. Nobondrequivd.
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHE WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATINGTO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
HIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HISIHER DRUTY AND ALL FEES ARE PAID.
Print Wrts
A17MT10N
MIS UNLAWFUL TO USE OROCCUPY A BUILDING OR VIRUCTURE UNnL A FINAL INSPECIION HAS BEEN MADE AND APPROVAL ORA CERTIFICA'IE OF
OCCUPANCY HASBEEN GRANTED. UW1091 IDCI 101 MCI 10.
ARCIEW APPUCANT ASSESSOR THEP.
1�10
I&A
STATUS: ISSUED BLD20071189
Soundftise originating fromtemporary construction skes as a result of construction activity are exempt fiom the noise limits
of SOC Chapter 530 only during the hoursof7fflam to 6-00pmon,%wekdays and 100m and 6.00prn on Saturdays, exluding
Sundays and Federal Holidays. At all other times the noise origina I fing from construction skes/activites must comply with the
noise limits of'Chapter 5-30, unless a variance has been granted pursuant to EOC 530.12D.
TMSPERMTAUT14ORIZES ONLY TMWORK NOTED. 7HISPERFAT COVERS WORK M BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOAWN (CURBS. SIDEWALKS. DRIVEWAYS. MAROUEES. ETC.) WILL REWRE SEPARATE PERIASSION.
PSWT TIME LIMM SEE ECDC ".0Q.M*M
F—BlIftDING (425) 771-M EXT. 1333 1 ENIGNEEIMIG (425) 77)4= EXT. 1326 1 FUtE(425)711-0215 I
PUBILKWORES (425) PRI&IREATMT (425) 672-5755 RUCYCILANG (425) 2754MI
When calling for an inspection Ficase [taw the following infornwition: Permit Number, Job Site Address', Type of Inspection being
requ"ted, Contact Name and Phone Number, Date Prefereed, and whether you prefer nwrniuz_or afternoon.
0 P-Planning Final
j
11
Permit Inspection Details
Permit: BLD20071189
PERMITTRAN,
Complete?
2000 - P-Planning Final
ovo2wN dugslon lrw4xx;bw Wonned 711108 - signed off. y
Total Time:
Total Inspections: Total Thm: is
Q
1r2r2M 12:5819 PM
Page 1 of I
OV EO&
CITY OF EDMONDS
121 51*11 AVENUE ' NORT-H - EDMONDS,WA 98020
P HONE: (425) 771-0220 - FAX: (425) 771-022t
STATUS: ISSUED 1/31/2008
Expiration Date: 1/31/2009
Parcel No: 00434212400100
SNAP FITNESS PROTEc*rION ANT) COMMUNICATIONS PROTECTION AND COMMUNICATIONS INC
INC
51 W DAYTON ST SI'E 304 19630 40TH AVE W 19630 40TIl AVE W
LYLE WELLS LYLE WFLLS
EDMONDS, WA 98020 LYNNWOOD, WA 98036 LYNNWOOD, WA 98036
425-774-9099 425-774-9099
LICENSE #: PROTEC1165L8 EXP:5131/2009
FIREALARM
VALUATION: $0
PERMIT TYPE Commercial
PERMIT (WOUP: 79 - Fire A
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION: FIKE AtARM
RETAINING WALL ROCKERY. N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N ( 0 X 0 FT.)
-CODE. 2006
[OTHER- N ------OTHER DESC:
ZONE.
INUMBER. OF sroRlES: 0
VESTED DATE.-
INUMBER OF DWELL ING UNITS: 0
BASEMENT: 0 1 ST FLOOR. 0 2ND FLOOR: 0
BASEMENT: 0 1 ST FLOOR: 0
2ND FLOOR: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
3 RD FLOOR: 0 GARAGF: 0 DECK: 0
OT I JER- 0
REQUIRED: PROPOSED: IREQUIRED: PROPOSED� REQUIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSEDO JREQUIRFD: PROPOSED�
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATjNGTO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION IS NOT APERMIT UNTIL SIGNED BY THE BUILDING OFFICIALGqk HIS(HER DEPUTY AND ALI. FyESAPF PAID.
S.gnature /Print Narne Date
ATTENTION
rrISUNLAWI-'TJL'rO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC1091 IBCI 10/ IRCI 10.
ARCIRVE APPUCAN-r MSESSOR MER
STATUS: ISSUED BLD20080046
SoundfNoise originating from temporary construction sites as a result of construction activity are exempt from the noise. lirnits
of ECC Chapter 5.30onl�y during the hours of 7:00am to 6,00pm on weekdays and 10:00arn and 6:00pm on Saturdays, ex!Iluding
Sundays and Federal Holidays. At all other times the noise originating from construction s ites/activites must comply with the
noise limits of Chapter 5.30, unless a variance has been granted pursuant to BOC 5.30.120.
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC 19.00.WS(AX6)
BUILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (4251771-0215
PUBUC WORKS (425) 771-0235 PR&TREAimiRr (425) 672-5755 RE)CYCMG (425) 275,4 1
When calling for an inspection please leave the folloving information: Permit Number, Job Site Address, T�ype of his pection being
reouested. Contact Name and Phone Number. Date Prefereed. and %fiether von nrefer mornine or afternoon.,
F-Fire Alarm System Acceptance
F-Fire Final N
0
1p
V t
Permit Inspection Details
Permit: BLD20080046
PERMIT'
,1935 - F-Fire Alarm System Acceptance
Complete?
Y
0WjiRD08 SMITHM 15 APPROVED
Y
Total Thw:
Is
1985 w F-Fire Final
Complete?
Y
0212S2DD8 SMITI-IM 10 APPROVED
Y
Total Time:
10
Total Inspections: 2 Total Tkne: 25
2/27120M 11:49:44 AM Page I of 1
0 4f
STATUS: ISSUED 2/12/2008
Expimtion Date: 8/12/2008
Parcel No: 00434212400100
CITY OF EDMONDS 111IL1111
121 5TH AVENUE NORTH - EDMONDS,WA 98020
� P I IONF- (425) 771-0220 -FAX: (425) 771-0221
SNAP FITNESS WESTERN FIRE PROTECTION W EST ERN FIRE P ROT ECT ION
51 W DAYTON ST STE 304 7102 1 SOT H AVE NE #A- 105 7102 180TH AVE NE#A-105
CHRIS ISAAC CHRISISAAC
EDMONDS, WA 98020 R.LDMOND, WA 98052 REDMOND, WA 98052
425-8 81-0100 425-881-0100
LICENSE #: WEST ESFI 36QF EXP:1/18/20
FIRE SPRINKLER ALTERATION FOR TI
VALUATION: $3,325
PERMIT TYPE: Commercial
PERMITGROUP 30- Fire Sprinkler
(MADING: N CYDS: 0
TYPE OF CONSTRUCTION VA
RETAINING WALL ROCKERY: N
OCCUPANT GROUP- A3
OCCUPANT LOAD. 55
FENCE: N ( 0 X 0 FT.)
CODE 2006
IOTHER:N -----OTHER DESC:
IZONF:
NUMBER OF STORIES: 0
VESTED DATE -
NUMBER OF DWELLING UNITS: 0
I9101111aluts
�BASEMENT � 0 1 ST FLOOR: 0 2ND FLOOR: 0
JBASLMENT: 0 1 ST FLOOR-- 0 2ND FLOO
13RD FLOOR: 0 GARAGE� 0 DECK: 0 OTHER 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHE
FRO N'T S 1:1-BACK SIDLSEI BACK IUAR SLTBACK
?,EQUIRED: PROPOSED: IREQUfRrD: PROPOSED: IREQUIRED: PROPOSED:
3EIGHT ALLOWED:6 PROPOSFD:O IREQUIRED: PROPOSED:
3ETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCT ION AND IN DOINGTHE WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OFTHE LABOR CODE OF THE STATE OF WASHINGTON RELATINGTO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
rHISAPPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS(HER DEPUTY AND ALL FEESARE PAID.
Print Name
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR MUCTUREUNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERMFICAII� OF
OCCUPANCY HAS BEEN GRANIED.UBC109/IBCI 101 IRCIIO.
ARCHIVE =APPLICANT ASSESSOR MP OTMM
STATUS: ISSUED BLD20080093
• Sound/Noise originating fTomterriporary construction shes as a result of construction activity Are exempt from the noise lirrits
of 130C Chapter 5.30 only during the hours of 7-00am to 6:00pm on weekdays and 10-00am and 6:00pm on -Saturdays, dxcluding
Sundays and Federal Holidays. At all other times the noise originating from construction shes/activites must comply with the
,noise limits of Chapter 5.30, unless a. variance has been granted pursuant to ECC 5.30.120.
• Request final Fire Department Inspection (425) 775-0215.
INSPR:TIONS
THIS PERI�IT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS. SIDEWALKS. DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERFATTIME LIMT, SEE ECDC 19.00.005(A)(6)
BULDING (425) 771-0220 EXT. 1333 1 ENGINEMING (425) 771-0220 EXT. 1326 1 . FIRE (425) 711-0215
PUBUC WORKS (425) 771 -M5 PRFTREATMENT(425)672-5755 REr-VCLJNG (425) 27374iO�l
When calling for an inspection please leave the follomAing information: Permit Number, Job Site Address, 7)jx of Wpection being
reauestecL Contact Name and Phone Number. Date PrtfereedL and %bether vou.nrefer n'iornine or afternoon. -
F-Fire Sprinkler Acceptance
F-Fire Final
Permit Inspection Details
Permit: BLD20080093
PERMIT:
1930 - F-Fire Sprinkler Acceptance Complete? y
02125/2008 SMITHM 20 APPROVED y
Total Time: 20
1985 - F-Fire Final Completa? y
02/25/2008 SMITHM 20 APPROVED y
Total Thne: 20
Total Inspectlom: 2 Total Time: 40
2r=2008 11:50:34 AM Pop I Of I
BELFOR WORK AGREEMENT N2 15--004768
This agreement made this SW day Of '_F&hELA_0*'j AD. 20 b and between Belfor USA
Group Inc. hereinaftr called. t.he mContractorm and Wgl,�A QJiA 6014-, herefrafter
caged. the aSubcontracW. For consideration, Subcontractor covenants and agrees with C"*actor
as foams:
FIRST., The Subcontractor agrees to fUmish all labor, and equipment to perform an
09
work necessary to complete the Arz LA ILL) 2;4.f for Me Wmaof
$ -Sss 00 Dollars at P="m 01"Wak)
accorcling to the plans and speff=a=
as detailed but not ffrnited lo the attached Exhibit or Proposal to the full satisfaction of contractor.
SECOND: The Subcontractor Is to begJn work on And will complete work by
W. . Subcontractor ftirew agrees to reduce contract arnourd by
$ #J/A- for each. and every day beyond the completion day C( IJIA- poe).
THIRD: The General Terms and Conditiorts of this uWark Agreement! and any attachment to
this -Work Agreemenr will covenant to those term an Beffor's Master Subcontractor Agreernent.
FOURTH: At the discretion of the Contractor. a -ten Percent ffitAinage win be withheld from all
paymentq. Conkptpr agrees that he will pay to Subcontrackc, In draw Paymenft the sum of
!A 9��944"-, Dollars ($,--I &-& I'--- ) for material and worK
amounfto be paid as follows: completed per'cent to be pald on 6r about the 30th, following the month
in which the work Is approved except the final payment, which ft Contractor shall pay to the
Subcontractor within 30 days after to Subcontractor sWI have con leted his work to Me full
satisfaction of the Contractor, but payment shall not precede the Conbactor's final payment.
In witness whereof. they have completed this agreement the day and date written above.
CONTRACTOR
Beffbr USA G19
By
Date
SUBCONTRACTOR Pra -0ol W,
ff_e.'9= "W4,05 Rre-
By
Date— 2-It-104
Attach Subcontractor Proposal, Speclflcadons or Work Scope as Part of this Conb
Vendor Code
Subcontractor copy (White)/Invoke Copy (Yellow)/ job File Copy (pink)
4t
A%
STATUS: ISSUED 5/9/2008
Expination Date: 5/9/2009
Parcel No: 01070900000200
CITY OF EDMONDS
121 5TH AW,N1JE NORTH - EDMONDS.WA 98020
PHONE (425) 77 1-0220 - VAX (425) 771-0221
0114
-'�;Pli*''Add"'s'--;"505-S'ST AVEf .2-� :..k MONDS
et re s.,
PACIPEKI-i'ONNINEA
Al't'LICANT OFNT&AUTOR
DOLCF LA BELLE
DOLCE LA BELLE. PROPERTY OWNER EXEMPTION TAKEN
51 W DAYTON sT STE 304
30 GRANT sr
JOY
EDMONDS, WA 98020
POR'r'I'0WNSEND, WA 98368
425-67 3-4 21 X
360-301-1027
LICENSE N. EXP.
DBSCRIPTION
JOB
TINA NT I M PROVENiENT, LICIMNQ A C M.SIBLE DRESSfNG ROOM W/BENCI 1. TENANT SPACE IS 937 SF.
VALUAnON: $11,760
PERMFI TYPE Commercial
PERMITGROUP 71 -Tenant )jnpr0vCme% I
GRADING N CYDS 0
FYPI--,01:(:ONSI*RUCI'ION VA 7,
RETAININ(iNVAILROCKERY N
OCCUPANT GROUP M
OCCUPANT LOAD. 31
FENCE. N 0 X 0 FF
CODE 2006
OTHER N ------ : OTHER DESC
ZONE
NUMBER OF STORIES 0
VFI�T ED DATE
NUMBER OF DWELLING UNITS: 0
lIASF.MENT- 0 191' FLOOR. 0 2ND FLOOR 0
-BASEMENT 0 IS`r FLOOR- 0 2ND FLOOR- 0
3KI) FLOOR 0 GARAGE 0 DECK 0 , OTHER 0
13RD FLOOR- 0 GARAGE 0 ___ DECK 0 OT I IER 0
FRONT S EYBACK SIDESEUBACK REARSEYBACK
REQUIKED. PROPOSED ��RTQOIRFD. PROPOSLD iREQUF-RFD: PROPOSED:
HEIGH f ALLOWED-0 PROPOSED 0 IREQUIRED PROPOSE'D.
SE-T-BACK NOT ES
I AGRLEE TO COMPLY WIT 11 CITY AND S7ATE LAWS REGULATING CONSTRUCT ION AND IN DOING THE WORK AUTHORIZED
T HEREBY, NO P FRSON W I LL BE EMPLOYED IN VIOLATION OF T] IE LABOR CODE OF T HE STAT E OF WASHING-]- ON RELATING T 0
WOR KMEN'SCOMPUNSATION INSURANCE AND RCW 18-27.
THIS AP P 1.1 CATION IS NOT A PERmj-r UNTI 1. NI GN E'D B Y T I IE BUI LDI NO OFFICIAL OR ill SAIERDE PUT Y AND ALI. FEES AKE P41 f)
1��,&A'f "malm
ATTENTION
111SVNIAWFUl T01ISFOROCCUPN AL)L;11[)IN(iORS*IRII(-11.'Rt:tl��'nI AFINAI INSI'l-CilONIIASIII,.I,NMAIII-.ANI)AIIPRO\,AI.ORA('FKIIFIC'ATEOF
ARCHIVE APPIJ(.ANI' MSSINSOR THER
NO C_
4�1
TUS: ISSUED
BLD20080114
Seperate Permit Required For
1) MECHAMCAL DUC`TWORK ALTERATION
2) FIRE SPRINKLER HEAD ALTERATION
3) STATE ELECTRICAL PERMIT
4) SIGN
PARTITION WALLS NOT TO EXCEED 5V IN H EIGHT
Obtain Electrical Pennit from State Department of Labor & Industries. 425-290-1309
Any request for alternate des ign, modification, variance or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Process Ing
fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable.
Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not,been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any items not to code sperification.
• Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6.00pm on weekdays and 101)Oam and 6:00pm on Saturdays, excluding
Sundays and Federall-Iolidays. At all other times the noise originating from construction sites/activites must compty with the
noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC! 5.30,120.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors In interests, agrees to indemnify defend and hold
harmless the City of Edrnon�s, Washington, its officials, employees, and agents fromany and all claims for damages of
whatever nature, arising directly or indirectly from the issuance fo this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance not Unit in any way the City's ability to enforce any ordinance
provision.
Provide 2A: IOB:C portable fire em inguishers at locations as noted on approved plans.
Final Locations of illurninated Odt signs & emergency lighting subject to field inspection by the Fire Marshal.
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS V40RK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES. ETC,) WILL REOUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT, SEE ECDC 19.00,005(AX6)
PuBuc WORKS (425) 771-0235 1 PR&TRFATMENr (425) 672-5755 1 RWYCILING (425) 275480�1
When calling for an inspection please leave the following information: Penrdt Number. Job Site Addliress, Type of.Inspection being
reques ted, Contact Name and Phone Number, Date Prefereed, and whether you prefer morning or afternoon.
ACCESSIBLE CHANCE STALL/BR4CH.
B-Building Final
F-B&guishers
F-Fire Final
gws---, 6 11 V-,�
Permit Inspection Details
Permit BLD20080114
PERMIT
1134 - ACCESS'IBLE CHANGE STALUBENCH
Complete?
y
06/05=08 steinike 20
y
Total Time'
20
1158 - B-Building Final
Complete?
y
06/OkOO8 steinike 20
y
Total'nffw:
20
1955 - F-Extinguishem
Complete?
y
o6/0=008 SMITHM 0 APPROVED
y
Total Tkne:
0
1985 - F-Fire Final
Complete?
y
o6jo2r"B SMITHM 10 APPROVED
y
Total Tinw
10
Total Inspections: 4
Total Time:
so
6IW2008 4:19:57 PM Page 1 of I
11
-- -------------
9MIPPA
DEPARTMENT OF BUILDINGS
r IF
PER Into t one lot C (0 110" itit
rnati I Building ode Section
Occupancy established by this certificate: I Dwelling Units: N/A
M
No. Stories: i
Construction: VA I Basement: N/A
Maximum Octupant Load 31 _ (Per IBC 1004)
Room capacity signs, when required, must remain posted at all times.
Owner of Building: GPA, Inc. _jkddress/Tenant Space: 505-eAve3#102 '
THE Dolce La Belle HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH THE REQUIREMENTS OF THE IM
EDITION OF THE INTERNATIONAL BUI NG CODE AS ADOPTED BY THE CITY FOR THE GROUP AND DIVISION OF OCCUPANCY AND THE USE -
FOR WHICH THE PROPOSED OCCUPANCY IS CLASSIFIED.
Issued this 12th day of June.2008
CHIEF BUILDING OFFICIAL
BY:
This rartificate shall be posted In a conspicuous public area and shall not be removed, mutilated or obscured and shall be maintained in legible Condition at all times. Any change of occupancy or use reWres. a bLmlOng permit and a now
Certificate of Occupancy issued by the City of Edmonds Building Official.
of E04
0.. CITY OF EDMONDS
PHONE: (425) 771-0220 - FAX: (425) 771-0221
121 5'I*H AVENUE NORTH - EDMONDS,WA 98020
STATUS: ISSUED 2/21/2008.
Expiration Date: 8/21/2008
Parcel No: 00434212400100
SNAP FITNESS MATRIX ENERGY MATRIX ENERGY
5 1 W DAYTON ST SI'E 304 11 Of 0 GOODWIN WAY NE I 10 10 GOODWIN WAY NE
J TOM DATES TOM DATES
EDMONDS, WA 98020 SEATTLE, WA 98125 SEATTLE, WA 98125
206-234-6233 206-234-6233
LICENSE #: MATRIES934MC EXP:713/2009
MECHANICAL DUCTWORK FROM E)GSTINGHVAC UNITS FORTENANT IMPROVEMENT, INCLUDING 13 SUPPLYAIR
DIFFUSMS AND 2 RETURN AIR DIFFUSERS. I EXHAUST FAN.
VALUATION: $0
PERMIT'TYPE. Commercial
PFKMITGROUP- 40 - Mechawcal/Sohfk
GRADING N CYDS: 0
TYPE OF CONSTRUCT ION: VA
RETAINING WALL ROCKERY: N
OCCUPANT GROUP: A3
OCCUPANT LOAD: 55
PENCE. N ( OXO Fr.)
CODE 2006
OTHER- N ----- OTHER DESC:
IZONE.
INUMBE R OF ST DRIES. 0
JVESTFD DATE:
OF DWELLING UNITS: 0
�NUMBER
BASEM �FNT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
IBASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR; 0
13RD FLOOR: 0 GA RAGE: 0 DECK 0 OTHER: 0
13RD FLOOR: 0 ' GARAGE: 0 DECK: 0 OTHER: 0
FRONT -S EFRACK SWESF1,11ACK RE%RSIABACK
tFQUIRED: PROPOSED: [IMQUIRED: IREQUIRED: PROPOSED:
-IFIGIIT ALLOWED.0 PROPOSED�O IREQUIRED: PROPOSED:
;FT BACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED
THEREBY, NO PERSON WI LL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27
TIIISA?PIACATION IS NOT A PERMIT UNTIL SIGNED BY,rHi-. BUILDING OFFIC An OR HIS/HER DI-1PUTY-AND ALL FFES.ARE PiVD
Jo 5 L U
nature Print tbm
ATTENTION
ITIS UNLAWFUL 11D USE OR OC(`UPY A BUILDING OR S'rRU('IIIKF UNTIL A FINAL INSPEC'nON HAS BEEN MADE AND APPROVAL ORA CERTIFICA'11'. OF
OCCUPANCY HAS BEEN GRANTED. UBC109/ IBCI 10/ IRCI 10.
if\
F--] ARCIUVE APPLICANT ASSESSOR OTIIER
T
STATUS: ISSUED BID20080119
Any request for alternate design, modification, variance or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies umst be specific* requested in writing and be called out and identified. Processing
fees for such request shag be established by Ouncil and shag be paid upon submittal and are non-refundable.
Approval ofany plat or p . Ian containing provisions which do not comply with citycodc and for which a variance has Dot been
specifically identified, requested iind considered by the appropriate city official in accordance with the appropriate provision
ofeity code or state law does not approve any it= not to code specification.
Sound/Noise originating from temporary constructiDn"skes as a result ofconstruction acti4ity are ei=pt from the noise firnits
of Ex Chapter 530 only during the hours ofMarn to 6.00pm on weelufays and I0.W= and 6.00pinon Saturdays, extuding
Sundays and FederalHolidays. At all other times the noise originating from construction sites/activites must comply with the
noise likso"J'Chapter5.30, unkss avariaice has been gmted putsuant to B005jO.M'
Applicarit, on behalfol'bis or her spouse, heirs, -assigns, and successors in interests, agrees to indeimify defend and hold
hanniess the City offidniondi, Washington, iti.officials, employees, and agents from any and all claim for damages of
whatever nature, arising directly or indirectly #am the issuance 1b this permit. Issuance of this permit shag not be deemed to
modify, waive or reduce any requireine, ts of�ny City ordinance not link in any way the City's ability to enforce any ordinance
provision.
INS PER14TALM40RIZES ONLY THE WORK NOTED. WS PEIVAT COVERS WORK M BE DONE ON PFUVATE PROPERTY ONLY. ANY CONSTRUCMON ON THE
KIBLIC DOURM (CURBS. SIDEWALKS. DRIVEWAYS, MRQUEES. ETC.) WILL REQUIRE SEPARATE PERLISSIOR
POW TIME LIMr SEE ECDC 1100.WS(AXS)
PVl3IJCW0PJG(425) IIF2�35� __ PR&T1WATM6VT(425)672-3755 i��G(425)275-Ml
When calling for im inspecom please leaw the follovAng Information: Permit NumberJobSite Address,Type of Inspection being
reques!A Cwtact Nam and Phone NumbeE2 Date Prefereed, and %bether you prefer moming or afternoon.
B42quipmcnt-Mech
B-Mechanical Final
Pennit Inspection Details
Permit BLD20080119
PERMIT--
1130 - B-Equipment-Mech Complete? y
02/2512008 Buflis 20 Ductwork extensions approved y
Total Tirne: 20
1 156 - B-Mechanical Final Complete? y
02/25/2008 Buffis 20 y
Total Time: 20
Total Inspections: 2 Total Tinw: 40
2/2712008 11:51:48 AM Page I of I-
I- Dy
CITY OF EDMONDS
121 5TH AVENUE NORT 1-1 - EDMONDS,WA 98020
PHONE (425) 771-0220 - FAX (425) 771-0221
I sqQ1
STATUS: ISSUED 5/9/2008
0
Expiration Date- 11/9/2008 01-5-101 -
4�-
Parcel No: 0 1070900000200
PROPERTYOWNER APPLICANT CONTR.A.CTOR
DOLCE LA BELLE DOLCE LA BELLE PROPERTY OWNER EXEMPTION TAKEN
51 W. DAYTON ST 0304 1 10 HAKRISON Sl'
S-WAIDELICH& If FREUND
EDMONDS, WA 99020 PORT,rOWNSLND,WA 99368
4 25-67 3 -4 2 18 360-3145-2969
LICENSE # EXP.
I NSTA LL SIGNS (2)
VALUATION: $0
PERMITTYPE. ComniCTC131
PERMIT GROUP. 63 - Sip U 71 T e A, t0i
GRADING. N CYDS 0
TYPE OF CONST[ RUC-710N
Rl:*rAININ(; WALL ROCKERY N
OCCUPANT GROUP.
OCCUPANT LOAD
Ft.'.NC[: N ( 0 X 0 F1'
OTHER N ------- OT I IER DhSC
ZONE BD2
NUMBER OF S7 ORIES 0
VESTED DATE -
NUMBER OF DWELLING UNIT S: 0
1BASEMENT 0 1 S7 FLOOR. 0 2ND FLOOR 0
BASEMENT. 0 1 ST FLOOR: 0 2ND FLOOR: 0
13RD [:LOOK 0 GARAGE: 0 DECK 0 - o'rHER 0
13RD FLOOR: 0 GARAGE 0 . DECK:O OTHER- 0
FRONT S ElFBACK SIDESEl'BACK RLARSE-FBACK
I'QUIRFD- PROPOSED. IREQUIRED: PROPOSED: 'IRE�UIRED: PROPOSED:
IFIGHT ALLOWED.0 PROPOSED:O IREQUIRED- PROPO,%D:
FTBACKNOTES Unit has approximately 30' frontage on 5th Avenue.
. I AGREE TO COMPLY WITH CITY AND sTAT h LAWS RE GULAT ING CONSTRUCIAON AND IN DOINGTHE WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OFTHEsrATE OFWASHINGTON RELATINGTO
WOKKMEN'S COMPENSATION INSURANCE AND RCW 18 27.
IIISAW),14AI'SONISNOTAPERMIT UNTIL SI'GNhD BYTHE BIJII.DkNG.0FFICIAL Og Hlsllfl"'� PFPLJTY AND ALL FEES AVE P4D
TSignatlke Print Name Date I Releised By It te
ATTENTION
ITISUNLAWFULTO USI� OKOCCUPY A BUILDIN6 OR SIRU(-IUFE UN*nL A FINAL INSFEC110N I IAS BEEN MADE AND APPRoVALoR A CLI(ImCKIE 01�
0C('UPANCYilASBEFNGRANlVD VBC109/JBCll0ilRCll0.
El ARCHFVE APIPMANT ASSFNSOR -MER
�(o
STATMISSUED BLD20080169
--
All new, e)dended, re -built or relocated electrical utility and/or service shall be placed underground.
Sound/No is e originating from temporary construct ion sites as a result of construction activity are emmpt from the noise limits
of ECCChapter 530only during the hours of 7.00amto 6:00pmon weekdays and 10:00amand 6:00pmon Saturdays, excluding
Sundays and Federal Holidays. At all othertimcs the noise originating from construction shes/activites must comply with the
noise lirnits ofChapter5.30, unless a variance has been granted pursuant to ECC5.30.120.
THIS PERM AUTHORIZES ONLY THE WORK NOTED. THIS PERMT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
I
PUBLIC DOMAIN (CURBS. SIDEWALKS, DRIVEWAYS, UAROUEES. ETC.) WILL REQUIRE SEPARATEE PERMSSION.
PERFAT 71WE UIAT: SEE ECDC 19.00.005(AX6)
.I . B UILDING (425) 771-0220 Exr. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FI]RE(425) 771-0215
I PUB11C WORKS (425) 771-0235 1 PRI&TREATMENT (425) 6n-5755 — I RECYCLING (425) 275-4801 -1
'When calling for'an inspection itease leave the follo%ing information: Permit Number, Job Site Address, T�Irpe of Ins pection being
requested. Contact Name and Phone Number, Date Pretereed, and %bether vou Prerer mornina or afternoon.
B-Building Final
Permit Inspection Details'
.Permit: BLD20080169
PERMIT""
I 158 - B-Building Final Complete? y
06/09/2008 steinike 20 Also gave correction to have ADA counter to match plans. y
Total Time: 20
I 1114pections: I Total Tlme: 20
6/9/2008 4:22:47 PM Page I of 1
26 .23
sr:c*noN cofeeR
vit-VLE IN LEAD 20.5 24
PUJ& IN 20 I.P.
DOM 6-q IN CASIN&.
JU
ir
27-66 W-06
TptEE �
PLANTER L
O)o
4� 5TREET
W
_M06--:7
oo�
BIKE
FP.L 1M.61
oe
4fr
--err,
1/19/
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS,WA 98020
1101, PHONE- (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 5/2Ot2OO8 Permit#: BLD20080357
BUILDING PERMIT
Expiration Date: I . 1/20/2008 Project Address: 505 5THAVE S 306, EDMONDS
Parcel No: 01070900000200
PROPMn'011
OZ71E PA)YLE GREENWOOD HET ING& AIR GREENWOOD HETING & AIR CONDITIONING
CONDFrIONING
505 5TH AVE ssurrl- 306 825 SOUTH STACYST 925 SOUTH YrACY ST
EDMOND'k WA 9NO20 StATTLE. WA 98134 SEATTLE. WA 98134
425-697-3100 206-784-1918 206-794-1918
LICENSE #� GREENHA922U7 EXP:2/3/2009
30B DESCRIPTION
mm-spur sys'n:-A A/C UNIT (9K BTU) ON EXISTING DECK (WEIGI IT OF UNIT 68 LB
VALUATION: $0
u�.
PERMITTYPE. Commercial
PERMIT GROUP: 40 - Mechanical/Solar
GRADING N CY us: n
l'YPF-.OFCONSJ'RUC-TION:VA
RE-TAININ0 WALL ROCKERY: N
OCCUPANT GROUP: R2
OCCUPANT LOAD:
FENCE N ( 0 X 0 F-I
CODE: 2006
OTHER: N -- OTIW.R DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWFLLING UNITS: 0
- -"CUSIING ARE%
BASEMENT: 0 IS[ FLOOR: 0 2ND FLOOR: 0
PROPOSED AREX
�BA%LMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD, FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13 RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FRONTSErBACK:,. SIDESETBACK RM S MACK
RFQUIRI-'.D: PROPOSI-13. IREQUIRIA) PROPOSED. IREQUIKED: PROPOSED-
HIFIGH-1 AILOWFDO PROPOSED-.0 JRFQUIRI, PROPO%1-1)
SETBACK NOTE.S
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED
THEREBY. NO PLR�A)N WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RFLATINGTO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
ITHIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HISW DEPUTY AND ALI. FEES ARE PAID.
Ow 3; 1,44,11,ae
Signature kint Narre Date
Releasid By - -
ATf ENTION
IT IS 1INLAWFUL rO (!SI; OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE. AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY IIASBE.F.V4 GP-AN-n-D.UBC109 IbCII0 IRCII0
ARCHWE APP1,1CANT ASSESSOR OTHER
-PC IlIq le4La 1/4
. 1b,
9TATUS: ISSUED BLD20080357
CONDITIONS
• Pursuant to FCDC 20.11.030.A.3, if the unit is visible fromstreet levelonce it is installed, it must be painted to nriatch the main
colorof the building.
• Installation. use and nuintcriance of equipment and components shall be pern-anufacturer's specifications, installation
instructions, and applicable state codes. Provide manufacture's installation instructions on site for Building Inspector.
Obtain Electrical Peffnit from State Department of Labor & Industries. 425-290-1309
Any request for alternate des ign. modification. variance or other administrative deviation,(hereinafter "variance") from
adopted codes, ordinances orpolicics must be specifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable.
Approval of any plat orplan containing provisions which do not comply with city code and for which a variance has not been
specifically identified, requested and considered by the appropriate city official in accordance with t he appropriate provision
of city code or state law does not approve any items not to code specification.
Sound/Noise originating frorntemporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:0(Mmto 6-OOpm on weekdays and 10:00am and 6:00prn on Saturdays, excluding
Sundays and Federal Holidays. At all other times the noise originating from construction s ites/activites must comply with the
noise limits of Chapter 5.30. unless a variance has been granted pursuant to ECC 5.30.120.
Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests. agrees to indemnify defend and hold
harmless the City of Edmonds, Washington. its officials, employees. and agents fi-orn any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance fo this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance not limit in any way the City's ability to enforce any ordinance
provision.
Applicant shall repair/replace all damage to utilities or frontage improvements in City fight -of -way per City standards that is
caused by or occurs during the permitted project.
INSPECTIONS
THIS PERFAT AUTHORIZES ONLY THE WORK NOTED. THIS PERMT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY.ANY CONSTRUC11ON ON THE
PUBLIC DOMOUN (CURBS. SIDEWALKS, DRIVEWAYS. MARQUEES. ETC.) WILL REQUIRE SEPARATE PERMSSION.
PERIAT 71ME MIT SEE ECDC 19.00.005(A)(6)
BLILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 77)400 EXT. 1326 1 FIRE (425) 771-0215
I PUBUC WORKS (425) 771-M5 I PR&T-REATMENT (425) 672-5755 1 RECYCLING (425) 801 1
When calling for an inspection please lea%e the follo-Aing information: Permil Number, Job Site Address, Type of Ins pection, being
requested, Contact Name and Phone Number, Date Prefereed, and whether you prefer morning or afternoon.
• 13-Equipment-Mech
• BFire Stopping
• B-Mechanical Final
• P-Planninge Final(�Lreening Inspection')
Permit Inspection Details
Permit BLD20080357
PERMITT;=AX
1130 - B-Equipment-Mech
Complete?
y
05r27r2M steinike 25
y
Total Thm:
25
1141 - B-Fire Stopping
Complete?
y
06130=09 steirdke 15
y
Total Thm:
15
1156 - B-Mechanical Final
Complete?
y
06rio/2009 steirike 20
y
Total Time:
20
Total Inspections: ' 3 Total Thm: Go
711/2009 2:38:29 PM Page 1 of i
Of ED4f
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 10/20/2011
Expiration Date: 10/20/2012 MaRr" ' - ___ A ' A - 0
.Lgo
,jMeflF�L&d=res4, 50
Parcel No: 01070900000200
PROPERTYOWNER APPLICANT CONTRACTOR
JACK HOOVER - PARAGEN PROPERTIES H, TGB ARCHITECTS BRUNNER CONSTRUCTION COMPANY
LLC STEVE BUTTERFIELD 19109 36Th W Ste 103
19426 35TH AVE W, SUITE 210 21911 76TH AVE W Lynnwood, WA 98036
LYNNWOOD, WA 98036 EDMONDS, WA 98026
(425) 248-2255 (425) 778-1530 (425) 771-5148
LICENSE #: BRUNNCC93 I DT EXP:6/1/2012
JOB DESCRIPTION
7,056 SQ. FT. TENANT IMPROVEMENT FOR OFFICES.
VALUATION: $161,1 . 59.04 COMPLETE -
PERMIT TYPE: Commercial
PERMIT GROUP: 71 - Tenant Improvement
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION: VA
RETAU41NG WALL ROCKERY: N
OCCUPANT GROUP: B/A3
OCCUPANT LOAD: 132
FENCE: N ( 0 X 0 FT.)
CODE: 09
1 OTHER: N --OTHER DESC:
ZONE:
I NUMBER OF STORIES: 0
STED DATE:
I NUMBER OF DWELLING UNITS: 0
1 LOT #:
EXISTING AREA
I BASEMENT: 0 ISTFLOOR:7056 2ND FLOOR: 0 7BA-SEMENT:
11110POSLI) AREA
0 1 ST FLOOR: 0 2ND FLOOR: 0
13 RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FRONTSETBACK SIDE SETBACK --REAR SETBACK
��_TIRED: PROPOSED: REQUIRED: PROPOSED: I REQUIRED:
I HEIGHT ALLOWED:0 PROPOSED:O I REQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO
PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S
COMPENSATION INSURANCE AND RCW 18:27.
THISAPPLICRATION IS NOT A PERMIT UNTIL SIGNED BY THE- BUILDING OFFICIAL OR HIS/HER DEPUTY -AND ALL FEES ARE PAID.
wzz!�\t)u 29y /P -"-// -
SionatuVe Pdnt Name Date Released By — - ' Date
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC 109/ IBC 110/ IRC 110.
ONLINE APPLICANT ASSESSOR OTHER
STATUS: ISSUE
BLD20110857
• Separate Permit Required For: HVAC, Plumbing, Fire Sprinkler, Fire Alarm,and Smoke Detection, Signs
• WSEC Lighting Summary form must be submitted for review and approval prior to electrical installation.
• Final approval on a project or final occupancy approval must bd granted by the Building Official prior to use or occupancy of
the building or structure. Check the job card for all required City inspections including final project approval and final
occupancy inspections. .1
• Any request for alternate design, modification, variance or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be paid. upon submittal and are non-refundable.
• Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any items not to code specification.
• Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:00prn on weekdays and 10:00am and 6:00prn on Saturdays,
excluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must
comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and. hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance for this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance nor limit in any way the City s ability to enforce any
ordinance provision.
I INSPECTIONS
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6)
BUILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 775-7720
PUBLIC WORKS (425) 771-0235 PRE-TREATMENT (425) 672-5755 RECYCLING (425) 275-4801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection
beinE requested, Contact Name and Phone Number, Date Prefereed, and whether you prefer morning or afternoon.
B-Ceiling Grid
B-Framing
B-Sheetrock Nail
B-Building Final
F-Fire Final
At:
Occupancy established by this ce
B/A3
Kaximu
Building Owner: Paragen Properties-11
THE Jack Hoover. HAS BEEN INSP
INTERNATIONAL BUILDING CODE AS ADI
PROPOSED OCCUPANCY IS CLASSIFIED.
DEPARTMENT OF BUILDINGS
AL
i'PER International Building Code Section 1'11\
Building�perrnit'#: BL 2011
Dwelling Units: N/A %
4T,
,A, ;yppa Construction: VA
!JU ,'4W*32*4,*V-
-7
G.-
main pos e
,tigns W enirequi,�i
ed
No. Stories; 1
Basement: No
IBC4004)
�UIREMENTS OF THE 2009 EDITION OF THE
OCCUPANCY AND THE USE FOR WHICH THE
CHIEF BUILDING OFFICIAL
BY:—
V
This certificate shall be posted In a conspicuous public area and shall not be removed. muti Isled or obscured and shall be maintained in legible condition at all times. Any change of occupancy or use requires a building permit and a new
Certificate of Occupancy issued by the City of Edmonds Building Official.
000000000
61)1, �h (h d) 11h th tb th f�h
Wwwwwwwww
I
0,F E D
Inspection Comments
BLD20110857 71 - Tenant Improvement
Applied: 10/1.2/2011 Issued: 10/20/2011
Expires:
10/20/2012
7C. jgqz
Address: 505 5TH AVE S #102, EDMONDS
"ACTION
1138 - B-Ceiling Grid 01/13/2012
LAWLER
Co�
Comment: Firestop penetrations into rated walls at community room
RemoVe rivets from either north or south perimeter ceiling grid edge track -opposing sides have to
-"float", main area library ceiling
Firestop electrical conduits above electrical panel in office, room 110
Firestop firewall penetrations above ceiling room 115
Complete exhaust duct termination @window in room 103
1138 - B-Ceiling Grid 02/17/2012
LAWLER
CMP
Comment:
1142.- B-Framing 12/20/2011
LAWLER
PAR
Comment: main office area
1142 - B-Framing 01/13/2012
LAWLER
COR
Comment: see correction notice for community room
1142 -8-Framing 02/17/2012
LAWLER
CMP
Comment:
1150 - B-Sheetrock Nail 12129/2011
LAWLER
PAR
Comment: Main office area
1150 - B-Sheetrock Nail 01/18/2012
LAWLER
CMP
Comment:
1158 -. B-Building Final 02/17/2012
LAWLER
CMP
Comment:
1985 - F-Fire Final 02/15/2012
SMITHM
CMP
Comment APPROVED
2/23/2012 7:541:37 AM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 1 of 1
col.�
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t 425.M.IM 21911 � A� W. M, 210
f 425.774.78M Edmo� WA DO=
JACK HOOVER
TENANT
IMPROVEMENTS
5W Sth A.. S
Edmondc WA 98M
SITE PLAN
Permit Set"
10A1.2011
R EECE !UfEiL7:;��
A1.00 OCT 2011
LjEVELOPk',2if,.'SERvjc,,,7ge. c—
CITY OF EDMOP.
CITY copy
JON DETALS
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FLOOR PLAN
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t 4257781530 2191176lbAVOW,S10210
1 425774.7803 Ed...d�WAWD26
777
JACK HOOVER
TENANT
IMPROVEMENTS
505 Sth A.. S
W—.d% WA MM
FLOOR PLAN
Permit Set
10.11.2011
A B =ws
MWE *NEW DECORATIVE COLUMN
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City of Edmonds
DEVELOPMENT SERVICES
COMMERCIAL & MULTI -FAMILY BUILDING
PERMIT APPLICATION
121 5h Avenue N, Edmonds, WA 98020
Phone 425.771.0220 9 Fax 425.771.0221
PLEASE REFER TO THE COMMERCIAL & MULTI -FAMILY BUILDING CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite # City State, Zip):
Parcel #:
Subdivision/Lot #:
Project Valuation: $
APPLICANT-
MF5
Phone:
_1��JFj
ax:
Albmtl-lwy
Address JStreet, City, qtate, Zipl-
4
,Iql -1&i�- A vy. EUMMA4_WA- qO
E- ail Address-
;Aeupt h
41 4W6 qgid;, -tow
PROPERTY OWNER:
Phone:
Fax:
FAF,A6AQ4 FfkoFr=FMeS, =J.L&-
Address (Street, City,, State, Zip):
E-Mail Address-
N41,42 - SS* Aw W. *Ulte, P0 !znn�wk
ig-kooyff,
LEODING AGENCY- V
Pfrone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:*
MANNEF,
Phone: Tll
41S-
Address (Street Ci S ate Zi
ir;:�w
W S L* #
to,
11C
1,4101 V,IZA
WA. q"69
*Contractor must have a valid City of iness license prior to doing work in the
City. Contact City Clerk's 425.775.2525
City Busil§s License ffx�.,Date:
AN A�5; iv,
the QTice at
"gow
A TY QJ-f%1DV 1-% *1 - 0 4r
DET v iiirriniEr- 17-7& 150F -t PAA&tA+ I V%"eA4&J"
Founded in, 1978, the Foun6tion for international Services (rlS) provides language translation services to
Vivate businesses (e.g. marketing materials, HR. manuals, travel documents, etc.), colleges and universities. in the
Northwest as well as around the U.S. and Canada (e.g., transcripts, diplom as), law firms (e.g. marriage certificates, birth.
certificates, patents, etc.), private individuals (e.g. passports, family history documents, miscellaneous correspondence,
etc.). The company also evaluates international educational documents for a broad range of clients including the U.S.
military, certification boards, attorneys, businesses, etc. January through September of 2011 FIS has provided
approximately 12,000 translations and/or reports. More people come to FIS for these services than any provider ofits
kind in the Western United States. IOSED NEW SQUARE F OTAGE FOR THIS PROJECT:
Basement:
sq- ft.
Garage:
sq, ft,
I't Floor:
sq. ft. )<INIA
Deck: ------sq.
ft.
Floor:
sq. ft.
Other:
sq. ft.
Floor:
sq. ft.
Occupancy: Occupancy
Load:
Retaining Wall: 0 Yes
0 No
Grading: ____cyds.
I Type of Construction:
Ideclare underpenalty ofpe)jury laws thatthe information 1haveprovided on this formlapplication is true, correctand
complete, and that I am the property owner or duly authorized agent of the property owner to submit a permit application to
the City of Edmonds.
Print Name: 0 Owner )(Agent/Other (specify):
Signature.N Date: Ah
FORM E CADocuments and Settings%jorback0esktofform E.doc Updated: 10/2010
DEVELOPMENT SERVICES
COMMERCIAL & MULTI -FAMILY BUILDING CHECKLIST
121 5h Avenue N, Edmonds, WA 98020
Phone 425.771.0220 2 Fax 425.771.0221
City of Edmonds
PROJECT ADDRESS:
PRE -APPLICATION MEETING? 0 YES 0 NO If YES, Pre -application Number:
Plans shall be of sufficient cMty to indicate the location, nature, and extent of the work proposed, and conform to the provisions of
the adopted International Codes and City Ordinances.
>
or
SUBMITTAL REQUIREMENTS
The number'indicates the number of copiesfor
submittal( if applicable). Check marks indicate
additional submittal requirement as applicable
20
.4
M
Oil M
a >
0.
0
Application F6zmE
I
1
1
1
1
1
Site Plan
3
3
3
3
3
3
_T�educed Site Plan G I X 14 or 8 1/2 x 11)
Architectural Construction Drawings
3
3
3
3
3
Structural Drawing and Calculations
3
3
3
3
WA State Energy Code N C Calcs & Ligh n
yq/4%
SiteClassification Worksheet
3
3
Site Development Plans
4
4
Lan scape Plan W
3
3
Right —of-Way.Perrrdt Application
I
I
Critical Areas Determination or Checklist
I
I
Geotechnical Report
3
3
Health District Approval Letter
V,
OM
Manufacturer's Specification.s/Cut Sheets
3
N
Contractor's City of Edmonds Business License
V/
11%
Washington State Contractors License
Plan Check Fee (due upon submittal)
Tfaffic Imp�ct Analysis
3
3
3
3
Survey
3
3
Special Inspection and Testing Agreement
V/
I/N
V/
Contractor's Acknowledgement Letter
V,
100'
Enve ope ans and Documents
MA
Bonds
Architectural Design Approval
I
I
V,
V/
Peer Review Fees
V,
eCVW
Deferred Submittals
Shop Drawings
Street Use
0 Handouts and Standard Details may be found on the City's website www.ci.edmonds.wa.us or can be obtained at City Hall
during normal business hours.
0 Plans/calculation/reports prepared by state licensed architects or professional engineers must be stamped and signed by the
design professional.
FORM E CM)ocuinents and Sctfings\bjcrback\Desktop\Form E.doc Updated: 10/2010
a
101020111407584224 (PT -LIVE) - PerinitTrax by Bitco Softwpre Page 1 of I
/L
BUILDING PERMIT PERMIT#: 101020111407684224
CONTACT: STATUS: APPLIED
ADDRESS: BALANCE: $4,337.50
ISSUED: CREATED: 10/10/2011
I
SCREENS: Select Screen... Li4, Q� FUNCTIONS:'Select Permit Function...
71 - TEIAANT IMPROVEMENT
VALUATION ADDNEW SUMMARY
VALUATION TOTAL: $250,000.00
GROUP,' GROUP DESC CONS.. CONST DESC AMOUNT 1 SOF IER TOTA VE
zz Manual Misc $0.00 01 $250,000.00, Remove
http://edmondspmtwebIPermitTraxIModule—Pen-nitsIPermits—Pen-nitIPermit—Valuation.as... 10/10/2011
101020111407584224 (PT -LIVE) - PennitTrax by Bitco Software Page I of I
BUILDING PERMIT
CONTACT:
ADDRESS:
ISSUED:
PERMIT#: 101020111407584224
STATUS: APPLIED
BALANCE: $4,337.50
CREATED: 10/10/2011
SCREENS: 'I Select Screen... FUNCTIONS: Select Permit Function...
71 - TAANT IMPROVEMENT
FEES
CASHIER ADDNEW
SUMMARY
-TOTAL:
$4,337.50 BALANCE DUE: $4,337.50
FEE ID
DATE
FEE TYPE
i FEE DESCRIPTION !FEE AMOUNTI
PAID BALDUE
200
10/10/2011
S
X-Permit Surcharge Fee $15.00
$0.00, $15.00
216
10/10/2011
S
B-Building Permit Fee $2,380.00
$0.60' $2,380.00
220
10/10/2611
s
B-Building Plan Review Fee $1,938.00
$0.00 $1,938.00
430
10/10/2011
S
B-State Building Code Surch... $4.50
$0.60 $4.50
;J�
http,:Hedmondspmtweb/PermitTrax/1\4odule—Permits/Perrnits—Pennit/Permit—Fees.aspx?C... 10/10/2011
DATE: October 18, 2011
TO: Jeanie McConnell, Engineering Program Manager, City of Edmonds Engineering
Division
FROM: Steve Butterfield
RE: Application #: bld20110857
Project: TI — Foundation for International Services (Jack Hoover TI)
Project Address: 505 5th Avenue S, Suite 102
See the following information, corrections, or clarifications as required.
GENERAL
I . Please indicate on the plans where construction materials, equipment, etc. will be staged
on private property.
Construction materials, equipment, etc., per the General Contractor, will be staged
inside the Tenant Improvement space.
2. Will use of the City right-of-way be required for construction purposes? If yes, additional
fees and permits may be required prior to'granting approval for such request.
No: the sidewalks or right-of-way will not be required for construction purposes.
Sincerely,
01
Steve Butterfield
SB/smb
Pli
It 425.778 1530 21911 76th Ave W, Suite 210 Incorporated in the*State ofWashington
f 4 Edmonds WA 98026 www.tgbarchitectscom
49f ED -Af
1P CITY OF EDMOND S
121 5TH AVENUE NORTH,- EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 77.1-0221
Wednesday, October 12, 2011
This Application has been accepted by the City of Edmonds for review. More information and changes may be
required during this process. The review target date is: Wednesday, October 19, 2011
.. Your City Contact is: MARIE HARRISON
Application Number: BLD20110857
Project Address: 505 5TH AVE S #102, EDMONDS
PROPERTYOWNER' APPLICANT
JACK HOOVER - POARAGEN PROPERTIES 11, LLC TGB ARCHITECTS
19426 35TH AVE W, SUITE 2 10 21911 76TH AVE W
LYNNWOOD, WA 98036 EDMONDS, WA 98026
(425) 248-2255 (425) 778-1530
Nork Description:
7,056 SQ. FT. TENANT IMPRO VEMENT FOR OFFICES.
:)utstanding Items at Time of Submittal:
I H REBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THAT THE INFORMATION GIVEN IS CORRECT
AND AT I AM TWIROPER Y 0 ER, R THE DULY AUTHORIZED AGENT OF THE PROPERTY OWNER TO SUBMIT
BUI ING PE IT APPL TIO 0 T ,CI
'yfl PRFNT N ME e 10/1 X ID
To view up to date information about your application please visit the City of Edmonds Development Services
website at http.-1Avww. cL edmonds. wa. us.
VFH Series Vent Free Gas Fireplaces by Majestic Products
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Max BTUIH (Natural Gas)
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Cost to Operate
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Common features for this family
Dimensions
37
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http://majesticproducts.com/fainily/FireplacesNent-FreeNFH-Series/ 10/4/201.1
.. ...... ...
DEPARTMENT OF LABOR AND INDUSTRIES
REQISTERED AS PROVIDED BY LAW AS
CONST CONTR GENERAL
REGIST-#. EXP. DATE
�CCOI BktfNNCC93,ID7. 6/l/2012'.'-:
EFFECTIVE D I A . TE
BRUNNER CONSTRUCTION COMPANY
119109 36TH W STE 103
LYNNWOOD WA 98036
F-62.5-032-ON) (3/97)
Message Page 1 of I
McConnell, Jeanie
From: McConnell, Jeanie
Sent: Tuesday, October 18, 2011 11:26 AM
To: sbutterfield@tgbarchitects.com'
Subject: Hoover TI - bld20110857
Steve,
Please find attached plan review comments from the Engineering Division in review of the TI at 505-5th
Ave S, Suite 102.
Regards,
Jeanie McConnell * Engineering Program Manager
Cit� of Edmonds Public Works Department
121 5th Avenue North, Edmonds WA 98020
'425'771.0220 x1338 I mcconnell@ci.edmonds.wa.us
"Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only
thing that ever has." - Margaret Mea
10/18/2011
ov EIDAfo CITY OF EDMONDS
C"C
PLAN REVIEW COMMENTS
ENGINEERING DIVISION
(425) 771-0220
City Website: www.d.edmondsma.us
DATE: October 19, 2011
TO: Steve Butterfield
sbutterfleld@tgbarchitects.com
FROM: Jeanie McConnell, Engineering Program Manager
RE: Application #: bld20110857
Project: TI — Foundation for International Services (Jack Hoover TI)
Project Address: 505 5'h Ave S, Ste 102
During review of the above noted application; it was found that the following information,
corrections,,or clarifications are needed. Please redline plans or submit three (3) sets of revised
plans/documents with a written response to each of the items below to Marie Harrison.
City of Edmonds handouts, standard. details and development code can be referenced on the City
website.
GENERAL
1. Please indicate on the plans where construction materials, equipment, etc. will be staged on
private property.
2. Will, use of the City right-of-way be required for construction purposes? If yes, additional fees
and permits may be required prior to granting approval for such request.
Please contact me at 425-771-0220 or by e-mail at mcconnell@ci.edmonds.wa.us if you have
specific questions regarding these plan corrections.
W20110857-TI-Hoover-El.doc Page 1 of I
Of'' E D4.f 0
PHONE: (425) 771-0220 - FAX: (425) 771-02'21
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMO14DS, WA 98020
Inc.
As!
Expirati6n Date: 5/28/2012
Parcel No: 01070900000200
PROPERTY OWA ER APPLICA11T C011TAACT41A
JACK HOOVER - MORGAN MECHANICAL MORGAN MECHANICAL
PARAGEN PROPERTIES 7220 212TH ST SW #B� 7220 212TH ST SW #B
19426 35TH AVE W, SUTIE 210 EDMONDS, WA 98026 EDMONDS, WA 98026
LYNNWOOD, WA 98036
(425)-582-0473 (425) 582-0473
LICENSE #: EXP:
INSTALL NEW SUPPLY AND RETURN AIR. INSTALL NEW 2 TON AC.
VALUATION: $0.00
C Agk
ommpL
PERMIT TYPE: Commercial
PERMIT GROUP: 40 - Mechanical/Solar
GRADING: N CYDS: 0 ..TYPE
OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N ( 0 X 0 Fr.)
CODE: 09
1 OTHER: N ----OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS:. 0
LOT #:
EXISTING AREA
BASEMENT: 0 1 ST FLOOR: 0 .2ND FLOOR: 0
PROPOSED AREA
IBASEMENT:'O'- I ST FLOOR: 0 2ND FLOOR: 0
13RD FLOOR: 0 . GARAGE: 0 DECK: 0 OTHER: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FRONTSETBACK SIDE SETBACK REARSETBACK
�EQUIRED: PROPOSED: ��REQUIRED: PROPOSED: ___7REQU1RED:. PROPOSED:
4EIGHT ALLOWED:O PROPOSED:O I REQUIRED: PROPOSED,
3ETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO
PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S
COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AMD AIJ, FEES ARE PAID.
Siqnature 1066t Name Date 4- 4 Released Br Dale
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDIk OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC 109i IBCI 10/ IRCI 10.
ONLINE APPLICANT ASSESSOR 41-WOTHER
F-V--
STATUS: ISSUED BLD20110958
I CONDITIONS
• Final approval on a project or final occupancy approval must be granted by the Building Official prior to use,or occupancy of
the building or structure. Check the job card for all required City inspections including final project approval and final
occupancy inspections.
• Any request for alterriate design, modification, variaff6e or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable.
Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any itierns not to code specification.
Sound/Noise originating from temporary construction sites� as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only duringthe hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays�
excluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must
comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance for this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any'requirements of any City ordinance nor limit in any way the City s ability to enforce any
ordinance provision.
I INSPECTIONS
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6)
I BUILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT". 1326 1 . FIRE
PUBLIC WORKS (425) 771-0235 PRE-TREATMENT (425) 672-5755 RECYCLING'(425) 275-4801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type.of Inspection
being reauested. Contact Name and Phone Number, Date Prefereed, and whether Von prefer morning or afternoon.
• B-Duct Seal
• B-Mechanical Rough In
• B-Mechanical Final
of EID)
Inspection Comments
BLD20110958 40 - Mechanical/Solar
Applied: 11/17/2011 Issued: 11/28/2011 Expires: 05/28/2012
Add ress: 505 5TH AVE S#102, EDMONDS
g�--=77�ef 0—k—
. . . . . . ....
ACTION
1122 - B-Duct Seal 12/28/2011 LAWLER CMP
Comment:
1130 - B-Mechanical Rough In 12/29/2011 LAWLER CMP
Comment:
1156 - B-Mechanical Final 02/17/2012 LAWLER CMP
comment:
10
2/23/262 7:56:06 AM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 1 of 1
V ED
0
CITY OF EDMONDS
21 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
M
BUILDING APPLYCATION ACCEPTANCE
Thursday, November 17, 2011
This Application has been. accepted by the City of Edmonds for review. More information and changes may be
required during this process. The review target date is: Thdrsday, December 0 1, 2011
-Your City Contact is: MARIE HARRISON
,Application Number: BL620110958
Project Address: 505 5TH AVE S, EDMONDS
'PROPERTY OWNER APPLICANT
JACK HOOVER - MORGAN MECHANICAL
PARAGEN PROPERTIES 7220 212TH ST SW #B
19426 35TH AVE W, SUTIE 210 EDMONDS' WA 98026
LYNNWOOD, WA 98036 (425) 582-0�73
Work Description:
'NSTALL NEWSUPPLYAND RETURNAIR. INSTALL NEW2 TONAC
E)utstanding Items at Time of Submittal:
�w
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THAT THE INFORMATION GIVEN IS CORRECT
AND THAT I AM THE PROPERTY OWNER, OR THE DULY AUTHORIZED AGENT OF THE PROPERTY OWNER TO SUBMIT
A BUILDING PERMIT APPLICATION TO THE CJTY.
SIGNAT*fRF-(OWNER OR AGENT) PRINT NAME DA-9
To viety up to date information about your application please visit the City of Edmonds Development Services
website at h1tp.11www. cL edmonds. wa. us.
OV E D Af 0
un DEVELOPMENT SERVICES
qw,
11IFF-9 PLUMBING & MECHANICAL, TANK & DEMOLITION
PERMIT APPLICATION
121 5th Avenue N, Edmonds, WA 98020
St. 1009�j Phor�e
City of Edmonds .1 ,425,771.0220 Fax 425.771.0221
PLEASE REFER TO THE PL UMBING & MECHANICAL CHECKLIST FOR SUBMITTAL REQ UIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
Parcel #:
APPLICANT:
Phone:
-2L6 _5V 73
ax:
6 a (n &
Address_(Street City, State, Zip). 1,D q
7Z2
E-Mail Add
w 44-/J))
PROPERTY OWNER:
Phone:
Fax:
Address (Street City, State, Zip):
E-Mail Address:
LEN DING AGENCY:
Phone:
Address (Street, City, State, Zip):
E-Mail Address:
CONT CTOR:*
Phone:
77
Address (Street, City, State, Zip
E-Mail Address:
*Contractor must have a valid City of Edmonds business license prior to
doing work in the City. Contact the City Clerk's Office at 425.775.2525
WA State License #/Exp. Date:
9
City Business License #/Exp. Datq
PERMIT APPLICATION FOR:
O.PLUMBING 2�.,MECHANICAL 0 TANK 0 DEMOLITION
I declare underpenalty ofperjuty laws that the information I haveprovided on thisform/applicadon is true, correct and
complete, and that I am the property owner or duly authorized agent of the property owner to'subnotit a permit application to
the City of Edmonds.
Print Name: 0 Owner gent/Other (specify):
Signat���
Jc'
FORMC LABuilding New Folder 2010\DONE & x-ferred toL-Building-Newdrive\Form Cdoc Updated: 8/2011
2009 Washinoton State Enerav Code Comr)liance Forms for Nonresidential and Multifamily Residential
2009 Washington State Energy Code Compliance Forms for Nonresidential and Multifamily Residential vised February 2011
Project Address -17D-157 LJA 1
Date A (0/
The followingSinformation is necessary to check a mechanical permit application' for compliance with the mechanical requirements in(the
Washington tate Nonresidential Energy Code.
Applicability I
(yes, no, na)
Code
Section I
_F
Component
Inf:Zt,.n Required
Location
on Plans
Building Department
Notes
HVAC REQUIREMENTS
(Sections 1401-1424)
1411
Equipment Performance
1411.1
Minimum efficiency
Equipment schedule with type, capacity, efficiency
1411.1
Combustion htg.
Indicate intermittent ignition, flueldraft damper & jacket loss
.1411.1
Air-cooled chiller
Provide total air and water chiller capacity
1411.2.1
Water-cooled chiller
Full -load and NPLV values adjusted for any non-standard conditions
1411.4
Pkg. elec. htg. & clg'
List heat pumps on schedule
1411.5
Unenclosed Heat
Indicate radiant heat system and occupancy controls
1412
HVAC Controls
1412.1
Temperature zones
Indicate locations on plans
1
.1412.2
Dea dband control
Indicate 5 degree deadband minimum
1412.3
Humidity control
Indicate humidistat
1412.4
Setback and Shutoff
Indicate thermostat with 7 day program capability & required setback,
1412.4.1
Dampers
Indicate damper location, leakage rate, control type, & max. leakage
1412.4.2
Optimum Start
Indicate optimum start controls
1412.5
Heat pump control
Indicate heat pump thermostant & outdoor lockout on schedule
1412.6
Combustion heating
Indicate modulating or staged control
1412.7
Balancing
Indicate balancing features on plans
1412.8
Ventilation Control
Indicate demand control ventilation for high -occupancy areas
1412.9
Loading Dock &
Garage Ventilation
Indicate enclosed loading dock & parking garage ventilation system
acfivation and control method.
1422
Thermostat interlock
lIndicate thermostat interlock on plans
1432.2.1
Temperature Reset
I indicate temperature reset method
1413
Air / Water Economizers
1412.1
Single zone systems
Indicate multiple cooling stage control capability.
1413.1
Air Econo Operation
Indicate 100% capability on schedule
1413.1
Wtr Econo Operation
Indicate 100% capacity at 45 degF db & 40 deg F wb
1413.2
Wtr Econo Document
Indicate max OSA condition for design cIg load & equipment performance
data.
14
peration
Indicate capability for partial cooling
1413.4
lHumidification
Indicate direct evap or fog atornization wi air economizer
1414
Ducting Systems
1414.1
Duct sealing
Indicate duct design pressures, sealing, and testing requirements
1414.1.2
Low press. duct test
Indicate appTicable low pressure duct systems shall be leak tested
1414.1.3
High press. duct test
nclicate high pressure duct systems shall be leak tested, and identify the
�ocafion of this ductwork on plans
1414 2
Dctinsulation
Indicate R-value of insulation on duct
rit IL
11415
1 Piping Systems
1415.1
1 Piping insulation
I indicate R-value of insulation on piping
1416
Completion Requirements
1416.3.2
System Balancing
Indicate air and water system balancing requirements
1416.3.3
Functional Testing
Provide sequence of operations and test procedures.
1416.3.4
Documentation
Indicate O&M manuals, record drawings, staff training
1416.3.5
JComm. Report
Indicate requirements for final commissioning report
1416.4
1 Compliance Chklist
Pubmit to building official upon substantial completion.
Mechanical Summary Form
Completed and attached. Equipment schedule vvith types, inputtoutput,
lefficiency, cfm, hp, economizer
ITY r%OPY
NOV 1 Lfli
--EF
NICES
infrY OF EUNIONOS
Of ED-4f
CITY OF EDMONDS
STATUS: ISSUED 12/14/2011
Expiration Date: 6/14/2012
Parcel No: 0,1070900000200
'PROPERTV OWNER APPLICANT CONTRACTOR
JACK HOOVER - SERVICE PLUMBING & HEATING INC SERVICE PLUMBING & HEATING INC,
PARAGEN PROPERTIES II, LLC 2100 196Th St Sw 2100 196Th St Sw
19426 35TH AVE W SUITE 2 10 Ste 136 Ste 136
LYNNWOOD, WA 98036 Lynnwood, WA 98036 Lynnwood, WA 98036
(425) 640-2121 (425) 640-2121
LICENSE SERVIPH953QD EXP: I 1/ 11/2013
JOB DESCRIPTION
JNSTALL 2 SINKS, I HWT AND I WATERHEATER TANKLESS. mm Km aft
VALUATION: $0.00
-c%j PL
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE; (425) 771-0220 - FAX: (425) 771-0221
PERMIT TYPE: Commercial
PERMIT GROUP: 47 - Plumbing
GRADING: N, CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N ( 0 X 0 Fr.)
CODE: 09
OTHER: N -----OTHER DESC:
ZONE:
2E STORIES: 0
STED DATE.
N%BE
ER OF DWELLING UNITS! 0
1 LOT #:
EXIS'FING AREA
BASEMENT: 0 1 ST FLOOR: 0, 2ND FLOOR: 0
PRO POS E 1) it REA
1 BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
13RD FLOOR: 0 GARAGE- 0 DECK: 0 OTHER: 0
13RD FLOOR- 0 GARAGE- 0 DECK: 0 1 OTHER- 0
FRONT SETBACK SIDE SETBACK - REAR SETBACK
I REQUIRED: PROPOSED:. REQUIRED: PROPOSED: I REQUIRED: - PROPOSED:
HEIGHT ALLOWED:O PROPOSED:0 I REQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO
PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S
COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION IS NOT A P_ERmrr UNTIL SIGNED BY THE, BUILDING OFFICIAL OR HIS/HER DEPU;FY AND ALL FEES ARE PAID.
'Sig- ure Print Name Date Released By Date
ATTENTION.
IT IS (NLAWFUL TO USE OR OCCIJPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEkTIFICATF OF
OCCUPANCY HAS BEEN GRANTED. UBC]09/ IBCI 10/ IRCI 10.
ONLINE APPLICANT ASSESSOR OTHER
STATUS: ISSUED BLD20110993
CONDITIONS
• Final approval on a project or final occupancy approval must b� granted by the Building Official prior to use or occupancy of
the building or structure. Check the job card for All required City inspections including final project approval and final
occupa . ncy inspections.
• Any request for alternate design, modification, varianee or other administrative. deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council And shall be paid upon submittal and are non-refundable.
• Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any items not to code specification.
• Sound/Noise originating from temporary construction sites as a 'result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays,
excluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must
comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance for this permit. Issuance of this permit.shall not be deemed to
modify, waive or reduce any requirements of any City ordinance nor limit in any way the City s ability to enforce any
ordinance provision.
INSPECTIONS
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
I . PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6)
I BUILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 775-7720 1
PUBLIC WORKS (425) 771-0235 PRE-TREATMENT (425) 672-5755 RECYCLIFNG (425) 275-4801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection
being reauested. Contact Name and Phone Number, Date Prefer'eed, and whether you prefer morning or afternoon.
• B-Plumb Rough In
• B-Plumbing Final
OV E io)
Inspection
Comments
BLD20110993
47- Plumbing
Applied: 11/30/2011
Issued: .12/14/2011
Expires: 06/14/2012
Address: 505 5TH AVE S #102, EDMONDS
JNSPECTION-'-'.�
DATE'.-.
INSPECT0R-1�'.1.--,-7'-.1- an
1126 - B-Plumb Rough In
12/16/2011
LAWLER CMP
Comment:
1152 - B-Plumbing Final
02/17/2012
LAWLER CMP-
Comment:
;0,
2/23/2012 7:57:02 AM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 1 of 1
6
OV EDAt
CITY.OF EDMONDS'
121 5TH AVENUE NORTH - EDMONDS, WA 98020
SCO PHONE: (425) 771-0220 - FAX: (4215) 771-0221
BUILDING APPLICATION ACCEPTANCE
Wednesday, November 30, 2011
Th I is Application has been accepted by the City of Edmonds for review. More.information and changes may be
required during this process. The review target date is: Wednesday, December 07" 2011
Your City Contact is:, MARJE HARRISON
Application Number: BLD20110993
Project Address: 505 5TH.AVE S,.EDMONDS
PROPERTY OWNER APPLICANT
JACK HOOVER — SERVICE PLUMBING & HEATING INC
PARAGEN PROPERTIES 11, LLC 2100 196Th St Sw
19426 35TH AVE W SUITE 210 Ste 136
LYNNWOOD, WA 98036 Lynnwood, WA 98036
(425) 640-2121
Vork Description:
YSTALL 2 SINKS, I HWT AND I WA TERHE-4 TER TANKLESS.
)utstanding Items at Time of Submittal:
. IHEREBY
ANDTHAT11
SIGNA'
VLEDGE THAT I HAVE READ THIS APPLICATION THAT THE INFORMATION GIVEN IS CORRECT
PROPERTY OWNER, OR THE DULY AUTHORIZED AGENT OF THE PROPERTY OWNER TO SUBMIT
A BUILDING PE�"T APPLICATION TO THE CITY.
IER OR AGENT) PRINT NAME DATE SIGNED
To vie'w up to date information about your application please visit the,City of Edmonds Development Services
website at http.11www.cLedmonds.wa.us.
-Af
DEVELOPMENT SERVICES
PLUMBING & MECHANICAL, TANK & DEMOLITION
PERMIT APPLICATION
121 5h AvenueN, Edmonds, WA 98020
0091)
City of Edmonds Phone,425.771.0220 It Fax 425.771. 0221
PLEASE REFER TO THE PLUMBING & MECI-MNICAL CHECKLISTFOR SUBMI7-TAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite City State, Zip):
5' C7,--'t1, 4aV-e
05 _S�
Parcel #:
It) q-oci o000C>2_C)C,)
APPLICANT: -
r 1k ri Vic
cz'e�vfu 19 1 Lk4jo �e
Phone:
4 Z40 q a- 24 2_j
Fax:
-L4 35'b
Address (Street Ci "�' State Zi
'p
2-10 0 10 Lo f)-S+ riv 1 -a L L-Lin4wood WA-glos
E-Mail Address: r
� n&P) <ei-V(C'f P Lm i V7 2 dh& �u. 149-+
PROPERTY OWNER:
Phone:
F a-x.
Address (Street, City, State, Zip):
E-Mail Address:
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:*
o--h ki
Phone-
�L, q Q� -2--4 2� 1
Fax:
'�_- -1-;:N
Address (Street City, Stat Zi
I ko�y 5V.S:v'_1 L-�IIAIIVOOcl WA,00-
E-Mail Address:
m-6 C-1 serv"C-e- 14 LkeuL ailk.
*Contractor must have a valid City ofEdmonds business license prior to
doing work in the City. Contact the City Clerk's Office at, 425.775.2525
WA State License #/Exp. Date:
sLav I V +t CC) -5 Q \')
City Business License #/Exp. Date:
PERN/Irr APPLICATION FOR:
PLUM� MECHANICAL TANK DEMOLITION
I declare under penalty ofperjury laws that the information Ihaveprovidedon thisfornilapplication is true, correctand
complete, andthatIam theproperty owner or duly authorized agent of the property owner to subinit apermit application to
the City of Edmonds.
Print Name: Owner (specify): Aaje r0_&w,-
Signature: Date:
OW -A
FORM C C:\Users\Paul\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\9LS805MQ\Form Cdoc Updated:
8/2011
DEiN,IOLITION
Type of structure to be demolished (e.g. house, shed, garage, etc.):
Floor area of structure to be demolished: sq.
Critical Areas Determination: Study Required Conditional Waiver Waiver
Additional Comments:
TANK #1
TANK#2
Number of Gallons
Number of Gallons
Method of Abandonment
Method of Abandonment
Fill in Place Fill Material
Fill in Place Fill Material
0'Removal
0 Removal
Critical Areas Determination: . StudyRequired Conditional Waiver Waiver
Equipment Type
Appliance/Equipment Information (new and relocated)
Total #
Furnace
#
Gas 4—Elec
#—Other:
BTUs:<100k >100k—
Location
Air Handler/ACIVAV
#
Gas #—Elec
#—Other:
CFM:<100k—>100k—
Location
Boiler/Com pressor/
Heat Pump/Roof Top
Unit
#
HP:
Gas #—Elec
<3,_3-16,_15-30
#—Other: BTUs: <100k,_100k-500k,
Location
_500k-IMII
Hydronic Heating
k_Gas
#—Elec
—in-Floor,
—Wall Radiant, Boiler BTUs:
Location
Exhaust Fans (single
duct)
Location: #—Bath
#—Kitchen
#—Laundry- # Other:
Fireplace
#
Gas #
. Elec #—Other:
Location
Other
Number of Outlets
Fixture/Appliance Type
AC Unit -------- — ----
BTUs:
Location:
Furnace --- — ----- ---
BTUs:
Location:
Water Heater ------BTUs:—
Location:
Boiler ---- — ---- — -----
BTUs:
Location:
Fireplace/Insert.
BTUs:
Location:
Stove/Range/Oven:
Dryer
Outdoor BBQ:
Other:
TOTAL OUTLETS
FORM C C:\Users\Paul\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\9LS805MQ\Form Cdoe Updated:
8/12011
Number
Fixture Type
Number
Fixture Type
Water Closet (Toilet).
Refrigerator water supply (for watedice dispenser)
Sink (kitchen, laundry, lavatory, bar, eye wash, e tc.)
Water Service Line
Tub/Shower
Drinking Fountain
Dishwasher
Bidet/Urinal
Hose Bib
Pressure Reduction Valve/Pressure. Regulator
Water He;ter. Tankiess? Yes— No-)e'
Backflow Prevention Device (eg. RBP;k, DCDA, AVB)
..Expansion Tank for Water Heater
Hydronic Heat in: Floor Wall
Floor Drain/Floor Sink
Other: VVa-+-c4- he TA�ouGLc-"
Clothes Washer
Other:
NIEDICAL GAS,
AIR, NIACLJLJiN,l
Number of Outlets
Type of Gas/AirNacuum System
Oxygen
Nitrous oxide
Medical Air
Carbon Dioxide
Helium
Medical — Surgical Vacuum
Other:
Other:
TOTAL OUTLETS
:0
FORM C C:\Users\Paul\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook�9LS805MQ\Form C.doc Updated:
8/2011
(),F ED 4
DEVELOPMENT SERVICES
PLUMBING & MECHANICAL, TANK & DEMOLITION
PERMIT CHECKLIST
121 5hAvenue N, Edmonds, WA 98020
'Pst. 1�qQj Phone 425.771.0220 It Fax 425.771.0221
City of Edmonds
PROJECT ADDRESS:
Plans $hall be of sufficient clarity to indicate the locatio n, nature, and extent of the work proposed, and conform to the provisions of
the adopted International Codes and City Ordinances.
r) >
-4,
SUBMITTAL REQUIREMENTS
0
s
The number indicates the number ofcopie for submittal(if
applicable). Check marks indicate additional subndital
requirement
Application Form C
Site Plan
3
!,1'
Mechanical Plans
2
-2.
Manufacturer's Specifications/Cut Sheets
0
2
2,,-
Elevation View for Roof Mounted Equipment.
0
07
2
-2'..,
Structural Calculations
Plumbing Plans
Listed and Tested Fire Stopping Assemblies
Washington State Contractors License
Contractor's City of Edmonds Business License
Critical Areas Determination or Checklist
State Non -Residential Energy Code compliance forms
2
17,`
Handouts and Standard Details may be found on the City's website www.ci.edmonds.wa.us or can be obtained at City Hall
during normal business hours.
Plan s/cal cul ation/reports prepared by state licensed architects or professional engineers must be stamped and signed by the
design professional.
FORM C C:\Users\Paul\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\9LS805MQ\FonTi C.doc
8/2011
Updated:
Of E04f 0
CITY OF EDMONDS
PHONE: (425) 771-0220 - FAX: (425) 771-0221
121 5TH AVENUE NORTH - EDMONDS, WA 98020
C. I
STATUS: ISSUED 12/27/2011
Expiration Date: 12/27/2012
Parcel No: 0 1070900000200
PROPERTYOWNER APPLICANT C*r1-I-RA(-I'*lA
JACK HOOVER - PARAGEN PROPERTIES 11, AMERICAN SPRINKLER CORPORATION' AMERICAN SPRINKLER CORPORATION
LLC 2311 153Rd Ave Se 2311 153Rd Ave Se
19426 35TH AVE W sUITE 210 Snohomish, WA 98290 Snohomish, WA 98290
LYNNWOOD, WA 98036
(425) 248-2255 (425) 335-4645 (425) 335-4645
LICENSE #: AMERISCO87NC EXP:2/15/2012
INSTALL NEW DROPS FO
VALUATION: $7,000.00
PERMIT TYPE: Commercial
PERMIT GROUP: 30 - Fire Sprinkler
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N ( 0 X 0 Fr.)
CODE: 09
OTHER: N -- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
1 VESTED DATE:
INUMBEROFD LLINGUNITSA
I LOT #:
I-I'XISTUNG AREA
I BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
PROPOSED AREA
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13RD FLOOR: 0 GARAGE- 0 DECK- 0 OTHER: 0
FRONTSETBACK SIDE SETBACK REAR SETBACK
I REQUIRED: PROPOSED: I REQUIRED: PROPOSED: I REQUIRED: - PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O I REQUIRED: PROPOSED:
ISETBACKNOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO
SON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S
AP7 COMPENSATION INSURANCE AND RCW 18:27.
THIS CAT100fS NOT A PERMAr UNTIL S THE
,WNED BY BUILDING OFFICIAL OR HIS/RER DEPUTY AND ALL.,FEES ARE PAID.
innahwo rTrint K13ma niitp Released Bv Date
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC 109/ IBC 110/ IRC 110.
ONLINE APPLICANT ASSESSOR OTHER
STATUS: ISSUED BLD20111035
CONDITIONS
• Final approval on a project or final occupancy approval must be granted by the Building Official prior to use or occupancy of
the building or structure. Check the job card for all required City inspections including final project approval and final
occupancy inspections.
• Any request for alternate design, modification, variarte or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable.
Approval of any plat, or* plan containing provisions which do not comply with city code and for which a variance has not been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any items not to code specification.
Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:00prn on weekdays and 10:00arn and 6:00prn on Saturdays,
excluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must
comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30 .120.
Applicant, on behalf of his or her spouse, heirs, assigns, and successors in inteiests, agrees to indemnify defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance for this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance nor limit in any way the City s ability to enforce any
ordinance provision.
INSPECTIONS
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6)
BUILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 775-'
PUBLIC WORKS (425) 771-0235 PRE-TREATMENT (425) 672-5755 RECYCLING (425) 275-4 01
When calling for an inspection please leave the following information: Permit Number, Job. Site Address, Type.of Inspection
beine reauested. Contact Name and Phone Number, Date Prefereed, and whether Von prefer morning or afternoon.
F-Fire Sprinkler Acceptance
of. EDAf
Inspection Comments
1P
BLD20111035 30 Fire Sprinkler.
Applied: 12/13/2011 Issued: 12/27/2011 Expires: 12/27/2012
Address: 505 5TH AVE S #102, EDMONDS
-T
IN§.'�.��COR',' A"C
D
NSPECTION:�
1930 - F-Fire Sprinkler Acceptance 01/23/2012 SMITHM CMP
Comment: APPROVED
;V
2/23/2012 7:57:58 AM 121 5th Ave, Edmonds Washington -Phone: (425) 771-0220 Page 1 of 1
-L. L 01
City of Edmonds
DEVELOPMENT SERVICES
COMMERCIAL & MULTI -FAMILY BUILDING
PERMIT APPLICATION
121 5th Avenue N, Edmonds, WA 98020
Phone 425.771.0220 9 Fax 425.77l.U21
ov
PLE.4SE REFER TO THE COAD�ffRCL4.L & MULT7-,FAAffLY B UILDING CHECKLIST FOR SUBkHTTAL REQUIRE1ENTS
PROJECT ADDRESS fStreet, Suite 9, City State, Zip):
Pare #:
Subdivision/Lot
Project Valuation: $
APMICAN
Phone:
-:%0 -3 W1
?F
/1_
Address -(Street City State Zip):
'Ig
E _�Wess:
0ail A
TY WNER:
P=
Phone:
Fax:
Address (Street. City. Sta e, Zip)-
/%�' &5�v_ ;Te- V.
E-Mail Address:
LENDING AGENCY:
Phone-
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CO
,DITRACTOR--
65�
Phone:
01- 133-5
Fax:
Address (Street, City, State, Zip):
*ess
E �Xail A
*Contractor must have a valid City ofEdmonds business license prior to
doing work in the City. Contact the City Clerk's Qffi�e at 425.775.2525
W�� State Licqnse #/Exp. D&e:
4,-f Z-'&9:—Sf
City Business License #/Exp. Date:
DETAIL SCO* PE OF WORK:
PROPOSED NEW SQUARE FOOTAGE
FOR TMS PROJECT:
Basement: sq. ft.
arMe:
sq, ft�
I't Floor: sq. ft.
Deck:
sq. ft.
2 d Floor: —sq. ft.
Other:
sq. ft.
3'd Floor: sq. ft.
Occu.2ancy: Occupancy Load -
Retaining Wall: 0 Yes 0 No
I Grading:
cyds.
Ty2e of Construction:
I declare underpenalty ofperjury laws that the information I haveprovided on thisformlapplication is true, correct and
complete, and that I am theproperty owner or duly authorized agent of theproperty owner to submit apermit application to
the City of Edmznds.
Print Name- 0 Owner Vg_'Agent/Other (specify):
Signature: Date:
4-e4-
FORME LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Form E.d'oc Updated: 10/2010
Equipment Type
Appliance/Equipment Information (new and relocated)
Total #
Furnace
#
Gas #—Elec
#—Other:
BTUs: <100k - >100k—
Location
Air Handler/ACNAV
#
Gas #
Elec #
Other CFM: <100k >100k
Location
Boiler/Compressor/
Heat Pump/Roof top
Unit
#
HP:
Gas # —
<3,
Elec # Other: BTUs:_<100k,
_3-15, _I 5-30 Location
100k-500k, 5OOk-lMil
Hydronic Heating
#—Gas
#—Elec
—in-Floor,
—Wall Radiant, Boiler BTUs:
Location
Exhaust Fans (single
duct)
Location: #
Bath #
Kitchen # Laundry # Other:
Fireplace
Gas #—Elec
#—Other:
Location
Other
R�U
LEI! Q�AS
Number of 0��J
Fixture/Appliance Type
AC Unit - — --- -------- BTUs: Location:
Furnace----------- BTUs: Location:
Water Heater -----BTUs: Location:
Boiler --- — ------------- BTUs:_ Location:
Fireplace/Insert BTUs: Location:
Stove/Range/Oven:
Dryer
Outdoor. BBQ:
Other:
—7FToTAL
OUTLETS
NO 07U) N AM _�Mi
Number
Fi�ture Type
Number
Fixture Type
Water Closet (Toilet)
Refrigerator water supply (for water/ice dispenser)
Sin k (kitchen, laundry, lavatory, bar, eye wasti, etc.)
Water Service Line
Tub/Shower
Drinking Fountain
Dishwasher
Bidet/Urinal
Hose Bib
Pressure Reduction Valve/Pressure Regulator
Water Heater Tankless? Yes— No—
Backflow Prevention Device (eg. RBPA, DCDA, AVB)
Expansion Tank for Water Heater
Hydronic Heat in: Floor. Wall
Floor Drain/Floor Sink
Other:
Clothes Washer
Other:
FOP -ME L:\Building New Folder 2010\DONE & x-ferred to L-Building-New drive\Form E.doc Updated: 10/2010
DEVELOPMENT SERVICES
COMMERCL&L & MULTI-FAMILLY BUILDING CHECKLIST
121 5h Aven . ue N, Edmonds, WA 98020
City of Edmonds Phone 425 .771.0220 2 Fax 425.771.0221
PROJECT ADDRESS:
PRE -APPLICATION MEETING? 0 YES 0 NO If XES, Pre -application Number:
Plans shall be of sufficient clarity to indicate the location, nature, and extent of the work proposed, and conform to the provisions of
the adopted International Codes and City Ordinances.
>
0
SUBAHTTAL REQULREMENTS
The number indicates the number ofcopiesfor
submittal(if applicable). Check marks indicate
additional submittal requirement as applicable
2
cl 5
'A
M M
2
0* 'j
n .
ct
W
,
V
ci
0
Application Form E
1
1
1
1
1
1
Site Plan
3
3
3
3
3
Reduced Site Plan (11 X 14 or 8 1/2 x 11)
1
1
1
1
1
Architectural Construction Drawings
3
3
3
3
3
3
Structural Drawing and Calculations
3
3
3
3
WA State Energy Code NREC Calcs & Lighting
V/
V/
V/
Site Classification Worksheet-
3
3
Site Development Plans/Civils
..4
4
Engineering Report/Drainage Calculations
3
3
Landscape Plan
3
3
Right —of-Way Permit -Application
1
1
1
Critical Areas Determination or Checklist
1
Geotechnical Report
3
3
Health District Approval Letter
V/'
V/
Manufacturer's Specifications/Cut Sheets.
V/
V/
V
V
3
Contractor's City of Edmonds Business License
V/
V/
V/
V/.
V/
V/
Washington State Contractors License
V
V/
V/
V
V/
Plan Check Fee (due upon submittal)
V/
V/
V/
V/
V/
Traffic Impact Analysis
3
3
3
3
Survey
3
3'
Special Inspection and Testing Agreement
i/
V/
Envelope Plans and Documents/Condos
2
2
Bonds
1
1
V/
Architectural Design Approval
1
1
V/
V/
Peer -Review Fees,
Deferred Submittals
V/
V/
Shop Drawings
Street Use
V/
• Handouts and Standard Details may be found on the City's website www.ci.edmonds.wa.us or can be obtained at City Hall
during normal business hours.
• Plans/calculation/reports prepared by state licensed architects or professional engineers must be stamped and signed by the
design professional. I
FORME LABuilding New Foider 2010\DONE & x-ferred to L-Building-New drive\Form.E.doc Updated: 10/2011
OV E04f
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-.0221
, ", 4C, S (9)"� "' �
BUILDIN.G APPLICATION ACCEPTANCE
Tuesday, December 13, 2011
This Application has been accepted by the City of Edmonds for review. More information and changes may be
required during this process. The review target date is: Tuesday, December 27, 2011
Your City Contact is: MARIE HARRISON
Application Number: BLD20111035
Project Address: 505 5TH AVE S, EDMONDS 41/'&
PROPERTY OWNER APPLICANT
JACK HOOVER - PARAGEN PROPERTIES 11, LLC AMERICAN SPRINKLER CORPORATION
19426 35TH AVE W sUITE 210 2311 153Rd Ave Se
LYNNWOOD, WA 98036 Snohomish, WA 98290
(425) 248-2255 (425) 335-4645
Nork Description:
NSTALL NEW DROPS FOR NEW CEILINGS
:)utstanding Items at Time of Submittal:
ZENEW CITY BUSINESS LICENSE
'D
I HER,"V ACKNOVLEDGE THAT I HAVE READ THIS APPLICATION THAT TH&INFORMATION GIVEN IS CORRECT
AND 7 WNER TO SUBMIT
'7 1 A77PROPERTV OWNER, OR THE DULV AUTHORIZED AGENT OF THE PROPERTV 0
A BUILDING PEPAIT APPLWNTION TO THE CITY.
TURE (OWNER OR AGENT)
rk'"M
01-/'-� -// .
DATE SIGNED
To view up to date information about your application please visit the City of Edmonds Development Services
website at http.11www. cL edmonds. wa. us.
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE; (425) 771-0220 - FAX: (425) 771-0221
17
io
STATUS: ISSUED 3/12/2012
Expiration Date: 9/12/2012 ��i5 'IDMQNM
Parcel No: 01070900000200
lougugmMm , ' ' -
FOUNDATION FOR INTER. SERVICES RUSSELL SIGN CO. RUSSELL SIGN CO.
PRODUCTION ASSOCIATES INC GREGG 21104 70TH AVE W 21104 70TH AVE W
51 W DAYTON ST STE 304 EDMONDS, WA 98026 EDMONDS, WA 98026
EDMONDS, WA 98020
(425) 775-7010
LICENSE #: RUSSESCOOODF tXP:7/26/2013
I NEW SIGN TO BE'MOUNTED ON LOWER HALF OF DECK
VALUATION--. $0.00
PERMIT TYPE: Commercial
PERMIT GROUP: 63 - Sign
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N ( 0 X 0 FT.)
CODE: 09
OTHER: N --- OTHER DESC:
IZ NE: BD2
NUMBER OF STORIES: 0
1 VESTED DATE:
NUMBER OF DWELLING UNITS: 0
1 LOT
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
1 BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13 RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
REQUIRED: PROPOSED:
REQUIRED: PROPOSED:
JREQ�IRED:. PROPOSED -
HEIGHT ALLOWED: 14 PROPOSED:12.5..
REQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHE WORK AUTHORIZED THEREBY, NO
PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON R.ELATING TO WORKMEN'S
COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION L,&� A PERMIT-j,�L� SIGNED BY THE BUXDINC/OFFICIAL OR HIS/HER DEPUI�41) ALL FEES ARE PAID,
Print game
By
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC 109/ IBC 110/ IRC 110.
ONLINE APPLICANT ASSESSOR Epa;EKI
999 OTHER
STATUS: ISSUED BLD2.0120119
• All new, extended, re -built or relocated electrical utility and/or service shall be placed underground.
• Final approval on a project or final occupancy approval must be granted by the Building Official prior to use or occupancy of
the building or structure. Check the job card for all required City inspections including final project approval and final
occupancy inspections.
• Any request for alternate design, modification, variance or other, administrative ' deviation,(hereinafter "Variance") from
adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable.
Approval of any plat or plan containing provisions which do not comply with city code an d for which a variance has not been
specifically identified, requested and considered by the appropriate city official in a:ccordance with the appropriate provision
of city code or state law does not approve any items not to code specification.
Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays_
excluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must
comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30,120.
Applicant, on behalf of his or her spouse, heirs, Assigns, and successors in interests, agrees to indemnify defend and hold
harmless the City of Edmonds, Washi . ngton, its officials, employees, and agents from any and all claims for damages of
.whatever nature, arising directly or indirectly from the issuance for this permit. Issuance of this permit shall not be deemed to
.modify, waive or reduce any requirements of any City ordinance nor limit in any way the City'".' s ability to enfo,rce any
ordin ance provision.
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6)
BUILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 775-7720
PUBLIC WORKS (425) 771-0235 PRE-TREATMENT (425) 672-5755 RECYCLING (425) 275-4801
When calling for an inspection please leave the following information: Permit Number,,Job Site Address, Type of Inspection
beinE reauested. Contact Name and Phone Number, Date Prefereedi. and whether you prefer morning or afternoon.
E-Engineering Final
B-Building Final
of ED
Inspection
Comments
BLD2012.0119
63 - Sign
Applied: 02/22/2012
Issued: 03/12/2012 Expires:
69/12/2012
Address: 505 5TH AVE S #101, EDMONDS
a.
P TIONIZ V
ECi wm
1077 - E-Engineering Final
04/06/2012 MCCONNELL
CMP
Comment: Approved
1077 - E-Engineering Final
0410612012 MCCONNELL
CMP
Comment:
1158 - B-Building Final
04/06/2012 LAWLER
CMP
Comment:
0
4/12/2012 12:53:06 PM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 1 of 1
OV ED 0
tA DEVELOPMENT SERVICES
COMMERCIAL & MULTI-FAMIELY BUILDING
PERMIT APPLICATION
121 5th Avenue N, Edmonds, WA 98020
City of Edmonds Phone 42.5.771.0220 9 Fax 425.771.0221
PLEASE REFER TO THE COM?�ffRCLIL & MULTI AWL Y B UILD17VG CHECKLIST FOR SUBMITTAL REQ UIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
Parcel #:
Subdivision/L6t #:
-w Ay e- gwougs
WA
P roject Valuation: $
APPLICANT: Fi6
Phone:
Address (Street, City, State, Zip):
Ao� -c), --5t, 10) et9vvavA_
WA
E-Mail Address�
PROPERTY ONPER:
C'r
Phone:
-;a"+� n) 4,
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
LENDING AGENCY:
Phone:
P
Fax:
Address (Street� City, State, Zip):
E-Mail Address:
Co
Phone:
_)o 0
ITC%
Fax:
4h25_('_)3 - 550�
Address (Street, City, State, Zip
21 loci -70' Egurw0g, W4
903-�
E-Mail Address
d2 L.A_� I CA. !�V CO - COV'h
'�Contractor must have a valid City ofEdmonds business license prior to
doing work in the City. Contact the City Clerk's Office at 425.775.2525
WA State License #/Exp. Date:
City Business License #/Exp. Date:
DETAIEL'SCOPE OF WORK: A4 C, _r (4 1 A (22
.5-
PROPOSED NEW SQUARE FOOTAGE
FOR THIS PROJECT:
Basement: sq. ft.
Garage: sq,.
1". Floor: sq. ft.
Deck: sq.
2'd Floor: sq. ft.
Other: q.
.3'd Floor: sq. ft.
Occupancy: Occupancy Load:
Retaining Wall: 0 Yes 0 No
Grading: cyds.
Type of Construction:
I declare underpenalty ofperjury laws that the information Ihaveprovided on thisfornVapplication is true, correct and
complete., and that I am the property owner or duly authorized agent of the property owner to submit a permit application to
the City of Edmonds.
Print Name: 13-6-CA-D Al�� I I V1 041 )A i 0 Owner VAgent/Other (specify): )0 �Iq
Signature: &::Z0
- _G' - LIA 4 1 Date:
_L-1V_%.'1 V_
FOP,ME LABiiilding New Folder 2010\DONE & x-ferred to L-Building- - New driveTorm E.doc Updated: 16/2011
Equipment type
Appliance/Equipment Information (new and relocated)
Total #
Furnace
#
Gas #_Elec
#—Other:
BTUs: <1 OOk— >1 00k,.—
Location
Air Handler/ACNAV
#
Gas #—Elec
#—Other:
CFM: <100k >100k—
Location
Boiler/Compressor/
Heat Pump/Roof Top
Unit
#
HP:
Gas #—Eled
<3,
#—Other:
—3-15,
BTUs: <100k, _100k-500k,
_151R Location
500k.-'lmil
Hydronic Heating
#
Gas #—Elec
—In-Floori'_Wall
Radiant,. Boiler BTUs:
Location
Exhaust Fans (single
Auct)
Location: #—Bath
#
Kitchen # Laundry # Other:
Fireplace
#
Gas #—Elec
#—Other:
Location —
Other
Number of Outlets
Fixture/App)iance Type
AC Unit --------------- BTUs: Location:
Furnace --------------- BTUs: Location:
Water Heater -------- BTU's: Location:
Boiler ---------- — -- ---- BTUs: Location:
Fireplace/Insert BTUs: Location:
Stove/Range/Oven:
Dryer
Outdoor BBQ:
ther:
TOTAL OUTLETS
"77= 7 _y
WIT -co I ZRO T
M 03M
Number
Fixture Type
Number
Fixture Type
Water Closet (Toilet)
Refrigerator water supply (for water/ice dispenser)
Sink (Icitchen, laundry, lavatory, bar, eye wash, etc.)
Water Service Line
Tub/Shower
Drinking Fountain
Dishwasher
Bidet/Urinal
Hose Bib
Pressure Reduction Valve/Pressure Regulator
Water Heater Tankless? Yes— No
Backfiow Pr evention Device (eg. RJBPA, DCDA, AVB)
Expansion Tank for Water Heater
Hydronic H eatin: Floor Wall
Floor Draim'Floor Sink
Other:
Clothes, Washer
Other:
FORME L:\13ililding New Folder 2010\DONE & x-ferred to LBuilding-New drive\Form E.doc Updated: 10/2011
-11. 0
A.
DEVELOPMENT SERVICES
COMMERCLA-L & MULTI-FAMELY BUILDING CIE[ECKLIST
1215"' Avenue N, Edmonds, WA 98'020
Phone 425.771.0220 It Fax 425.771.0221
City of Edmonds
PROJECT ADDRESS:
PRE -APPLICATION MIEETING? 0 YES 0 t*40 If,YES, Pre -application Number:
Plans shall be.of sufficient clarity to indicate the location, nature, and extent of the work proposed, and conform to the provisions of
the adopted International Code� and City Ordinances.
>
CA
SUBMITTAL REQULFEEMENTS
Yhe number indicates the number ofcopiesfor
submittal(ifapplicable). Check marks indicate
additional submittal requirement as aoplicable
90
5* -1
CD
W
0
Application Form E
1
Site Plan
3
3
3
3
3
3 F/C
Reduced Site Plan (11 X 14 or 8-1/2 x 11)
1
1
1
1
1
1 F/C
Architectural Construction Drawings
3
3
3.
3
3
3
Structural Drawing and Calculations
3
.3
3
3
Vol
WA State Energy Code NREC Calcs & Lighting
V
V"
Vol
Site Classification Worksheet
3
3
Site Development Plans/Civils
4
4
Engineering Report/Drainage Calculations
3
3
Landscape Plan
3
3
Right —of-Way Permit Application
1
1
Critical Areas Determination or Checklist
1
1
Ge6technical Report
3
3
Health District Approval Letter
V11
V/
Manufacturer's Specifications/Cut Sheets.
V/
V"
3
Contractor's City of Edmonds Business License
V11
V11
V/
V11
V/
Washington State Contractors License
V/
V11
V
V/
V/
Plan Check Fee (due upon submittal)
Vol
V
V/
V/
V1,
Traffic Impact Analysis
3
3
3
3
Survey
3
3
Special Inspection. and Testing Agreement
V/
Envelope Plans and Documents/Condos
2
2
Bonds
1
1
V11
Architectural Design Approval
1
Peer Review Fees
Deferred Submittals
Shop Drawings
Street Use
Handouts and Standard Details may be found on the City's web'site www.ci.edmonds.wa.us or can be obtained at City Hall
during normal business hours.
Plans/calculation/reports prepared by state licensed architec ts or professional engineers must be stamped and signed by the
design professional.
FORM E 'LABuilding New Folder 2010\DONE & x-ferred to L-Building-New driveTorm E.doc Updated: 10/2011
0� EDAI
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
SCO
ft-�fl— NGM CATIONACCEMPT ANCE
,I
Wednesday, February 22, 2012
This Application has been accepted by the City of Edmonds for review. More information and changes may be
required.during this process. The review target date is: Wednesday, February 29, 2012
Your City Contact is: LINDA THORNQUIST
Application Number: BLD20120119
Project Address: 505 5TH AVE S #10 1, EDMONDS
PROPERTYOWN-Ek APPLICANT
JACK HOOVER RUSSELL SIGN CO.
PRODUCTION ASSQCIATES INC GREGG 21104 70TH AVE W
51 W DAYTON ST 9TE 304 EDMONDS, WA 98026
EDMONDS, WA 98020
Work Description:
I NEWSIGN
Outstanding Items at Time of Submittal:
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THAT THE INFORMATION GIV EN IS CORRECT
AND THAT I AM T 1E PROP - RTY OWNER, OR THE DULY AUTHORIZED AGENT OF THE PROPERTY OWNER TO SUBMIT
�kkr-Btf ING PERMIT APPLICATION TO THE CITY.
1U63 lyr;16
k4KNATLY*Lr4O"ER 09 Ai�`ENT) PRINT NAME DATE SIGNED
To view up to date information about your application please visit the City of Edmonds Development Services
website at http://Www.ci.edmonds.wa.us.,
OV ED
CITY OF EDMONDS
WA 98020
121 5TH AVENUE NORTH - EDMONDS,
PHONE: (425) 771-0220 - FAX: (425) 771-0221
01/30/2013 10 11
STATUS: ISSUED i
I y
W
Expiration Date: 06/15/2013
Parcel No: 0 1070900000200- NiEN a T'CORP.
MITIMIMBOM01 a PROPERTIES H 'SNAP FITNESS . NORTH CREST DEVELbPmEN
SNAP FITNESS / PARAGON DEBBIE ROSENFELT RICK KLEMM
LLC S #104 PO BOX 340
23929 W WOODWAY LANE 505 5TH AVENVE EDMONDS, WA 98020
WOODW�ky, WA 98020 EDMONDS, WA 98020 (425)774-3181-
(206) 909-5349 LICENSE#: NORTHCD158T)A EXP:02/01/2014
NNW
E NEW SPACt INTO ONE LARGER
TENANT IMPROVEMENT TO REMOVE 1NTERIOR WALLS AND INCORPORAT
SPACE - ADD SHEAR WALL - NO MECHANICAL OR pLUNMrNG
VALUATION: $40,000-00
PERMIT GROUP: 71 -Tenant improvement
E IT TYPE- Commercial RU TION: VA SP
GRADING: N CYDS: 0 OCCUPANT GROUP: LL -------------
RETAINING WALL ROCKERY: N 0(- ANT LOAD: 80
CODE: 09
FENCE: N ( 0 X 0 FT-) ZONE:BD2
OTHER-. N --OTHER DESC: VESTED DATE:
fF 7
NUM13ER OF STORIES -ILUL.
nr nVJP.I.I.TNG UNITS: 0 Ablsx�
BASEMENT: 0
3RD FLOOR: 0
OR: 0
0
b —FS—TFLOOR: 132 2ND FLuur,:
0 TAYI—AGE. _ODECK� 0 1 HER: 0
ICU_ IcIvi.— El Date eeased Date
Signature Print Name
ATTENTION AS BEEN MADE AND AppROVAL OR A CERTIFICATE OF
IT IS UNLAWFUL TO USE OR OCCUVY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION H
OCCUPANCY HAS BEEN GRANTED.'UBC 109/ IBC 110/ IRC 110.
=. ONLINE
APPLICANT
ASSESSOR OTHER
STATUS: ISSUIED BLD20121173
I I
• Obtain Electrical Permit from State Department of Labor & Industries. 425-290-1309
• Final approval on a project or final occupancy approval must be granted by the Building Official prior to use or occupancy of
the building or structure. Check thejob card for all required City inspections including final project approval and final
occupancy inspections.
0. Any request for alternate design, modification, variance or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable.
0
AD Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any items not to code specification.
o Sound/Noise originat . ing from temporary construction sites as a result of construction activity.are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00arn to 6:00pm on weekdays and 10:00arn and 6:00pm on Saturdays,
excluding Sundays and Federal Hohdays. At all other times the noise originating from construction sites/activities must
comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120. ,
0 Applicant, . on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agen&.from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance for this permit. Issuance of this permit shall riot be deemed to
modify, waive or reduce any requirements of any City ordidancei nor limit in any way the City's ability to enforce any
ordinance provision.
Final Locations of illuminated exit signs & emergency lighting subject to field inspection by the Fire Marshal.
0 Request final Fire Department Inspection (425) 775-0215.
I NOMEN11-11NI-S
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC. 1 9.00.0.05(A)(6)
FB�NG (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 775-7720 1
PUBLIC WORKS (425) 771-0235 PRE-TREATMENT (425) 672-5755 RECYCLING(425)2754�8�01
When calling for an inspection please leave the following information: Permit Number, Job Site i
being requested, Contact Name and Phone Number, Date Prefereed, and whether you prefer
B-Preconstruction meeting
B-Shear Nailing
B-Framing
B-Epoxy Bolt Holes
• B-Shear Nailing
• B-SheetrockNail
• . B-Fire Stopping
• B-Ceiling Grid
• B-Building Final
• F-Fire Final
Type of Inspection
! or afternoon.
ENGINEERING
MEMORANDUM
To: Rick Klemm
From: C. Chevy Chase, PE, SE
cc:
bate: April 9,2013
Re: Snap Fitness T1 — Anchor Bolt Locations
C V-
....... ......
D
ue to interferences fron� the existing post tensioned tendons and the existing plumbing
............. ................ cleanouts, the shear wall anchor bolts into the concrete slab were not able to be installed at
exactly 12" oc. Per.the attached email, the total number of anchors was not changed, only the
spacing. This is structurally acceptable.
WA
237 5 N
L
Field Report Report #: 56368
Cilent: North Crest Development Project Number: 13-185
P.O. Box 340
Permit #: BLD 2012 1173
Edmonds, WA 98020
Project Name: Snap Fitness
Contact. Rick Klemm
Address: 605 Sth Ave. S. Suite 104
In.sprection Performed: Epoxy
Datw. 2/28M1 3 Time. Temperature:
Verified epoxy to be Simpson Set-XP, expires;9/2014, Verified hole cleanliness and minimum
embedment of 6". Observed placement of 3/4". allthread and epoxy to form a fully encapsulated
system�.
All work was completed in conformance with manufacturer's recommendations, ESR #2508 and
approved plans (engineer to furnish letter with approval of moving anchors at banded tendon area
of PT slab. Engineer verbally approved move as long as total amount of anchors was kept the
Pame.) New shear wall at grids H.1 /2.3-3.2 was inspected at this time.
Distribution: Distribute Client 0 Distribute Contractor Inspector: Chandler, Loren
Distribute Engineer Distribute Owner
[Vj— Distribute Municipality Distribute Other Reviewed by: Mike Blackwell
Distribute Architect Distribute Other
Ail reports are considered confidential and are the property of the client and A.A.R. Testing Laboratory, Inc.
Reproduction except Irt full without the written consent of A.A.R. Testing is strictly forbidden
I
Inspection
Comments
BLD20121173
71 - Tenant Improvement
PERMITTRAX
Applied: 12/27/2.012
Issued:. 01/30/2013
Expires: 01/30/2014
Address: 505 5TH AVE S#104, EDMONDS
1136 - B-Sheir Nailing
02/15/2013
LAWLER
PAR
Comment: Inside face.
1136 - B-Shear Nailing
03/05/2013
LAWLER
CMP
Comment: Outside face
1142 - B-Framing
03/05/2013
LAWLER
CMP
1144 - B-Epoxy Bolt Holes
03/05/2013
LAWLER
CMP
Comment:
1150 - B-Sheetrock Nail
03/11/2013
LAWLER
CMP
Comment: K
1152 - B-Fire Stopping
03/11/2013
LAWLER
CMP
Comment:
1156 - B-Ceiling Grid
03/11/2013
LAWLER
COR
Comment: membrane penetrations above office
1156 - B-Ceiling Grid
04/1112013.
LAWLER
CMP
Comment:
158 - B-Building Final
04/05/2013
LAWLER
COR
Comment: 1.) Firestop membran ' e penetrations at fire resistive rated wall and
ceiling, above
ceiling grid at anchors
and at wall above electrical panel
2.) final approval letters from
special inspection firm and EOR,
1158 - B-Building Final
04/10/2013
LAWLER
COR.
Comment: Complete prior correction
1158 -.B-Building Final
04/11/2013
LAWLER
CMP
Comment:
1985. F-Fire Final
06/12/2013
KZWEBER
CMP
Comment: Approved.
1985 - F-Fire Final
06/12/2013
HARRISON
COM
Comment: ALSO SIGNED OFF BY MIKE SMITH IN THE FIELD 4/10/2013.
a
6/12/2bl 3 12:41:57 PM Page 1 of 1
E -D
�7_ 0
3.,
DEVELOPMENT SERVICES
COMAIERCL&L & MULTI -FAMILY BUILDING
PERAUT APPLICATION
1215"' Avenue N, Edmonds, WA 98020
City of Edmonds Phone 425.771.0220. It Faii 425.771.0221
PLEASE REFER TO THE COM�ffRCIAL & MULTI-FAAELY B UILDING CRECIaJST FOR SUBlvff.TTAL REQULREAlENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
Parcel #:
C-505 �0- ��- -S -it 1o3
S-4bdivision/Lot #:
Project Valuation: $
/49tcDo
APPLICANT:
! ��as5 LLC-
R
Phone:M%teP_-
clocl
Y.Gt ,
7-Up S732f
Address (Street, City,, State, Zip): ADE5Pr. Si-UNP 6 br-%<aS
E-'Mail Address:
�IOPERT WNER" k
Phone:
Fax:
ran;�)pe,
Addiess (Street, City, State, Zip)-
2;1�1_
E-Mail Address:
S - Loeb, Ca-r-N
LENDINGAGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):.
dre
Mail Ad ss:
CONTRACTOR:*
Phone:
A�-L5_-7-7tj �319i[20U
C4 1
SS-0 q-24S:-
ess �treet, City, State, Zip):
LJC.- qY010
E-Mail Address
Y, I ;�-u D co, tgt. V-\a
*Contractor
WA State Licewe #/Exp. Date: I Z-o I
d 15
must have a valid City ofEdmonds business* license prior to
J,10Y-L-K0_ q oft
doing work in the City. Contact the City Clerk's Office at 425.775.252.5
City Business Liceusq #/Exp. Date.
. 1z"t
22L=- (2 (2 (P03' 1 041 Q)
DETAIEL SCOPE OF WORK: ltzce' C)nt_-)n
1 Q (,D�,Als
ha OfGc_,Cs� E33
CalabL Ur� Irlire1W 0Q
C.1il-, 1w) �n 0-lass, 6�LN-Y%
�A�r, 1:7n ro
s 0 1 CA
PROPOSED NEW SQUARE FOOTAGE
FOR TMS PROJECT:
Basement: sq. ft.
Garage:
sq; ft,
1" Floor: sq. ft.
Deck:
Sq. ft.
2'd Floor: sq. ft.
Other:
S2. ft.
3=Floor: ft.
Occupancy: Occupancy Load:
Retaining Wall:. 0 Yes 0 No
Grading: �yds.
Tne of Construction':
I declare underpenalty ofperjury laws that the information:I have provided on thisfornVapplication is true, correct and
complete, and that I am the property owner or duly authorized agent of the property owner to submit a permit application to
the City of Edmonds.
(C
Print Name: 0 Owner
VAgent/Other (specify):ao KIMItor
Signature: Date:
17— L 2--
FORMF LABuildin g New Folder 70 1 OMONF. & x-ferred to L-Building-New diive\Form E. doe UDdated: 10/2011
Equipment Type
Appliance/Equipment Information (nwr!Gd relocated),
Total #
Furnace
#_Gas
#_Elec
#_Other: BTUs: >iook_
Location
Air Handler/ACNAV
#—Gas
#_Elec
#_Other: <1 OR— >1 00k_
Location-
Boiler/Compressod
#—Gas
#__Other: BTUs: <1 00k, ____I
OOk-500k, 5OOk-lMil
Heat Pump/Roof Top
HP:
3-15, '�'.focai ion
Unit
.0
Hydronic Heating
#_Gas
----------
Ele -Floor, ___Nall Radiant, Boiler BTUs:_
Location
Exhaust Fans (single
Location: #
>#_c
# itchen # Laundry # Other:
a 7th # :K
duct)
Fireplace
#
s #—Ejec #�__Other: Location
Other
Fixture/Appliance T
Number of Outlets
m
AC BTUs: Location:;=����
ca
Furnace-----------BTUs: Loca
ater Heater -----BTUs:- cation:
W W terH 'r-- ---BTUs'--
Location'
BTUs� cation*
Boiler------- BTUs: Location:
Loc - 0
ert BTU ati n-
Fireplace/Insert BTU Location:
Stove/Range/Oven:
Dryer
Outdoop4Q:
A
TOTAL OUTLETS
Number
Fixture Type
Water Closet (Toilet)
Number
Fixture Type
iser)
efr.igerator water supply (foewater/ice d.ispenser)
e'
Sink (Idtchen, laundry, lavat6ry, bar, eye wasS, et
Water Service Line
Tub/Shower
Drinking Fountain .
-
Dishwasher
Bidet/Urinal
Hose Bib.
tor
Pressure Reduction Valve/Pressure Regullator
Water Heater Tankless9 es No
Backflow Prevention Device. (e.g. RBPA, DCDA, AVB)
Expansion Tank for ater Heater
Hydronic Heat in: Floor Wall
Floor Drain/Kkad""
ii r Sink
Other:
Clothes j'asher
Other:
FORME LABuilding New Folder 2010\DONE &x-ferredto L-Building-New drive\Form E.doc 0 . Updated: 10/2011
DEVELOPMENT SERVICES
COMAMRCLAL & MULTI-FAMIELY BUILDING CHECKLIST
12151 Avenue N, Edmonds, WA 98020
Phone 425.771.0220 It Fax 425.771.0221
I City,of Edmonds
PROJECT ADDRESS:
PRE -APPLICATION MMETING? 0 YES 0 NO if IkES,.Pre-application Number:
orm to the provisions of
Plans shall be of sufficient clarity to indicate the location, nature, and -extent of the work proposed, and conf
the adopted International Codes and City Ordinances.
�r V
0
W
SUBMITTAL REQUMEMENTS
The number indicates the number of copiesfor
submittal( ifapplicable). Check marks indicate
additional submittal requirement as applicable
ci
CrQ
�111 Oil �11
0
Application F orm E
Site Plan 1
3
3%1-
3
3
3 F/C
Reduced Site Plan (11 X 14 or 8 1/2 x 11)
Architectural Construction Drawings
1
3
3
i
3.
1
3
1
.3
1 F/C
3
Structuial Drawing and Calculations
3
3
3
WA State Energy Code NREC Calcs & Lighting
V'
V11 -
Site Classification Worksheet
3
3'.
Site Development Plans/Civils
4
4
Engineering Report/Drainage Calculations
3
3 1
Landscape Plan
3
3
Right —of-Way Permit Application .
1
1
.1
Critical Areas Determination or Checldist
1
1
Geotedhnical Report
3
3
Health District Approval Letter
V/
V/
Manufacturer's Specificstions/Cut Sheets
v
3
Contractor's City of Edmonds Business License
V/
V/
Washington State Contractors License
V11
V/
V/
Plan Check Fee (due upon submittal)
V
V/
Traffic Impact Analysis
3
3
3
3
Survey
3
�3
Special Inspection and Testing Agreement
V
I/
V
Envelope Plans and Documents/Con s
2
2
20
Bonds
1
1
Architectural Design Approval
Peer Review Fees
Deferred Submittals
V/
V/
Shop Drawings
Street Use
• Handouts and Standard Details may be found on the City's website www.ci.edmonds.wa.us or can be obtained at City Hall
during normal business hours.
• Plans/calculation/reports prepared by state licensed architects or professional engineers must b I e stamped and signed by the
design professional.
FORME LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Form E.doc Updated: 10/2011
. of ED4f
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
,7c.
DIU, ILDING APPEFCATtON ACCEPTANCE'
Thursday, December 27, 2012
This Application has been accepted by the City of Edmonds for review. More information and changes may be
required during this process. The review target date is: Friday, January. 18, 2013
Your City Contact is: LINDA THORNQUIST
Application Number- BLD20121173
Project Address: 505 5TH AVE S, EDMONDS
PROPERTY OWNER APPLICANT
SNAP FITNESS PARAGON PROPERTIES 11 LLC SNAP FITNESS
JACK HOOVER DEBBIE ROSENFELT
505 5TH AVE S 9.10 1 5055THAVENUES#104
EDMONDS, WA 98020 . EDMONDS, WA 9.8020
(206) 909-5349
Vork Description:
TNANTIMPRO VEMENT TO REMOVE INTERIOR WALLS AND INCOPIPORATE NEW SPACE INTO ONE
ARGER SPACE
)utstanding Items at Time of Submittal:
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THAT THE INFORMATION GrVEN IS CORRECT
AND THAT I AM THE PROPERTY OWNER, OR fHE DULY AUTHORIZED AGENT OF THE PROPERTY OWNER TO SUBMIT
A BUILDING PERMIT APPLICATION TO THE CITY.
SIGNATURE (OWNER OR
PRINT NAME
Z-1-) -
DATE SIC,
To view up to date information ahout your application please visit the City of Edmonds Development Services
wehsiteathttp.lhvww.cLedmonds.wa.us.
I
tgba. AJ 6 COMA
DATE: January 21, 2013 -1
TO: Jennifer Lambert, Engineering Technician, City of Edmonds, Engineering Division
FROM: Steve Butteffield
RE: Plan Check: BLD20121173
Project: SNAP Fitness — Tenant Improvement
5th
Project Address: 505 Avenue S
See the following information, corrections, or clarifications as required.
1. Plans indicate that there is an interior. demolition to occur.
a. Will you require a dumpster? If so, where do you intend to locate the dumpster? If parking
sidewalk closure is necessary then a separate right-of-way construction permit with a traffic
control plan,for closure will be required.
A dumpster is not required.
b. If the dumpster is proposed to be located Within the right-of-way and to remain longer than a
day, please show proper night barricades.
Not applicable
2. Please provide a plan that shows, the areas of clo . sure with dimensions and the length. of time the
closure will be. You may combine this plan with the Traffic Control Plan. Please. note that if the
parking area / sidewalk will be closed disruption fees will be required.
Not applicable.
Sincerely,
Steve Butterfield
SB/smb
JAN 22 2013
SUILDINio VMSPA M.E.W
Qrf 0it lfbi6ioa
t 425.778.1530 1 21911 76Lh Ave W, Suite 2 10
f 425.774.7803 EdmondsWA 98026
Incorporated in the State of Washington
wwwEgbatchirec-ac orn
Carolvn Jewett
From: Rick Klemm [klemster@comcast.net]
Sent: Tuesday, April 09, 2013 2:11 PM
To, Carolyn Jewett
Subject: RE: Snap
I don't have pictures, but here is how the layout werit from east to west in inches for a total of 20 bolts. 5-1/2; 9, 21, 68-
1/2, 7�, 86-1/2, 98, 110-1/2, 122, 129, 146-1/2, 158, 169-1/2, 182, 194, 20S-1/2, 116, 224-1/2, 229-1/2) 238-1/2. 1 never
got the message.
Rick (206) 550-4245
Frorfi: Carolyn Jewett rmailto:Carolyn](�Dcqengineering.com
Sent: Tuesday, April 09, 2013 1:54 PM
to: Rick Klemm
Subject: RE: Snap
Hi -Rick,
I left you a message Monday — I need the revised anchor bolt locations that were installed on either side the 4ft band
width. And pictures if you have them. We had asked for an extra (2) anchor bolts on each side of the 4ft width.
Thanks,
Carolyn Jewett, PE, SE
C-NGINE-GRING
P: 425.778,8500 1 F: 425.778.5536.
2504 Ih Ave. South, Suite 200
Edmonds, WA 98020
.cgengineering.com
From: Rick Klemm rmailto: klemsterObcomcast. net]
Sent: Tuesday, April 09, 2013 1:50 PM
To: Carolyn Jewett
Subject: Snap
Carolyn:
Willyou have a letter available for me to give tdthe City of Edmonds inspector to get our final on the permit for Snap
Fitness?
Rick Klemm (206) 550-4245
I
of ED-4
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
Inc. PHONE: (425) 771-0220 - FAX: (425) 771-0221
I
STATUS: ISSUED 04/02/2013
Expiration Date:
Parcel No: 01
SNAP UINESS/PARAGON PROPERTIES BFPS LLC BFPS LLC
23929 W WOODWAY LANE Po Box 1116 PoBoxIfi0
WOODWAY, WA 98020 Granite Falls, WA 98252 Granite Falls, WA 98252
(425) 388-0124 (425) 388-0124
LICENSE_#_:_ BFPS LL* 929 MA F-XP:07/01/2014
JOB DESCRIPTION
RAISE 13 EXISTING SPRINKLERS FOR NEW TENANT SPACE (NO CEILING).
VALUATION: $0.00
"m'OMPLETED
PERMIT TYPE: Commercial
PERMIT GROUP: 30 - Fire Sprinkler
GRADING: N - CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N ( 0 X 0 Fr.)
CODE: 09
OTHER: N --- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0 *
I VESTED DATE:
NUMBER OF DWELLING UNITS: 0
EXIST I NG,A REA.
LOIT #:
--- P116posEb AREA
�SEMENT. 0 1 ST FLOOR. 0 2ND FLOOR: 0 �BASEM
0 1 ST FLOOR: 0 -2ND FLOOR: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13RD FLOOR-- 0 GARAGE: 0 DECK: 0 - OTHER: 0
FRONT'.SE.TQA'C�K SIDEJSETBACK REARSETBACK
REQUIRED: PROPOSED: 'I REQUIRED: PROPOSED:. REQUIRED: , PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO
PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S
COMPENSATION INSURANCE AND RCW 18:27.
JHIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HISIHER DEPUTY A�4�L FEES ARE PAD).
w�' "IN13 I YIAT'i 15�e
Slignature Print Name Date Released By LJdLC
ATTENTION.
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC109/ IBC 110/ IRC 110.
= ONLINE = APPLICANT = ASSESSOR = OTHER
STATUS: ISSUED BLD20130335
I I
• Final approval on a project or final occupancy approval must -be granted by the Building Official prior to use or occupancy of
the building or structure. Check thejob card for all required City inspections including final project approval and final
occupancy inspections.
• Any request for alternate design ' modification, varia4e or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be spegifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be. paid upon submittal and are non-refundable.
0
• Approva I I of any plat or plan containing provisions which do not comply with city code and forWhich a variance has not been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any items not to code specification.
• Sound/Noise originating from temporary construction sites as a result,of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00arn to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays,
excluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activiiies must
comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
harmless the Cit� of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance for this permit. Issuance of this permit shall not be deemed to
-modify, waive or reduce any requirements of any City or dinance nor limit in any way the City's ability to enforce any
ordinance provision.
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS. WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6)
1. BUILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 775-7720 1
PUBLIC WORKS (425) 771-0235 PRE-TREATMENT (425) 672-5755 RECYCLING (425) 275-4801
When calling for an inspection please leave the following informatiow Permit Number, Job Site Address, Type of Inspection
beine requested. Contact Name and Phone Number, Date Prefereed, and whether you prefer morning or afternoon.
F-Fire Final
Inspection Comments
PERMITTRAx BILD20130335 30 - Fire Sprinkler
Applied: 04/02/2013 Issued: 04/02/2013 Expires: 04/02/2014
Address: 505 5TH AVE S #104, EDMONDS
I!jj TION INSPECT
1985 - F-Fire Final 04/03/2013 SMITHM CMP
Comment: APPROVED
6/3/2013 9:41:57 AM
Page 1 of 1
City of Edmonds
DEVELOPMENT SERVICES
PLUMBING & MECHANICAL, TANK & DEMOLITION
PERMIT APPLICATION
121 5th Avenue N, Edmonds, WA 98020
Phone 425.771.0220 2 Fax 425.771.0221
PL
PLEASEREFERTO= UABING& �ECHAAt7CALCIEC�nISTFORSUBAfl7tALREQUIPEAeIVTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
0 5-- 5 Ave
Parcel #:
APPLICANT:
�M, LLC
Phone:
qz_5 - 398- 012 4
Fax:
1'.160-ol-Voy
Address (Street, City, State Zip):
-Po BN I U D -.-. �ranife PA 114; k1fi qz52
9-Mail Address:
6q a ROL- 60M
PROPERTY OWNER:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR.*
_SEFS LLC
Phone:
Fax:
A
,�dress (Street, City, State, Zip):
ro -A f))( I lip aIrt7wife FaI15,42A 17_F2_
E-Mail Address:
*Contractor must have a valid City ofEdmonds business license priorto
doing work in the City. Contact the City Clerk's Office at 425. 775.2525
WA State License #/Exp. Date:
OF PS L_L*1ZqMA
City Business License #/Exp. Date:
%7M
0 PLUMMING CHANICAL 0 TANK C1 DEMOLITION
X rum, 1CL hv-.u--
f V
V�
I declare under penalty ofperijury laws that the information I have provided on thisformlapplication is true, correct and
complete, and that I am the property owner or duly authorized agent of the property owner to subm it a permit application to
the City of Edmonds.
PrintName: _T10V SP1'+h 0 Owner /^Agent'/Other (specify): __&vd1rP0jVr
Signatur e: 61, )9?219 Date: qL
FOP,MC LABuilding*New Folder 2010\DONE & x-ferred to L-Building�New driveTorm C.doc Updated: 8/2011
Type of structure to be demolished (e.g. house, shed, ga rage, etc.):
Floor area of structure to be demolished: —sq. ft.
Critical Aims Determination: 0 Study Required 0 Conditional Waiver 0 Waiver
Additional Comments:
TANK #1
TANK #2
Number.of Gallons
Number of Gallons
Method of Abandonment
Method of Abandonment
E] Fill inP'lace Fill Material
E] FillinPlace FillMaterial
Removal
Removal
Critical Areas Determination: OStadyRequired 0 Conditional Waiver 0 Waiver
Equipment Type
Appliance/Equipment Information (new and relocated)
Tota I #
Furnace
V
Gas #—Elec
#—Other:
BTUs: <100k—>100k,
Location
Air Handler/ACNAV
'#__�_Gas
#
Elec #
Other: CFIVI: <100k >100k
Location
oiler/Compressor/
Heat Pump/Roof Too
Unit
#__Gas
HP:
#_Elec
_<3_3-15,_15-30
#—Other:
BTUs: <100k, _100k-500k,
Location
5OOk-IMil
Hydronic Heating
#—Gas
#—Elec
—In-Floor,
—Wall Radiant, Boller BTUs:
Location
Exhaust Fans (single
duct)
Location: #—Bath
#
Kitchen # Laundry # Pther:
Fireplace
#—Gas
#—Elec
#—Other:-
Location
Other.
Number of Outlets
Fixture/Appliance Type
AC Un1t_*_-----.--BTUs,-_ Location:
�urnace -----BTUs: Location:
Water Heater -----BTUs: Location:
Boiler -------BTUs: Location:
Fireplaceflnsert BTUs: Location:
StovefRange/Oven:
Dryer
Outdoor BBQ:
Other:
TOTAL OUTLETS
FORMC L:\Building New Folder 20,10\DONE & x-ferred to LBuilding-New drive\Form C.doc Updated: 8/2011
Number
Fixture Type
Number
Fixture Type
W ater Closet (Toilet)
Refrigerator water supply (for waterlice dispenser)
Sink (kit&n, laundry, lavatory, bar, eye wash, etc.)
Water Service Line
S
Tub/Shower
Trb i
Drinldng Fountain
Dishwasher
BidetfUrinal
Hose Bib
Pressure Reduction Valve/Pressure Regulator
Water Heater Tankless? Yes— No—
Backfiow Prevention Device (e.g. RBPA, DCDA, AVB)
Expansion Tank forWater Heater
Hydronic Heat in: Floor Wall —
Floor Drain/Floor Sink
Other:
Clothes- Washer'
ther:
F-0
I TIRnnialt, -- - --- I- -
Number of Outlets
Type of Gas/Air/Vacuum System.
Oxygen
Nitrous oxide
Medical Air
Carbon Dioxide
Helium
Medical — Surgical Vacuum
Other:
Other:
TOTAL OUTLETS
FORM C LABuilding New Folder 2010\DONE & x-ferred to LBuilding-New drive\Form C.'doc Updated: 8/2011
1- -0 Af
.0
DEVELOPMENT SERVICES
PLUMBING & MEECHANICAL, TANK & DEMOLITION
PERMIT CHECKLIST
th
1215 Avenue N, Edmonds, WA 98020
City of Edmonds Phone 42 . 5.771,0220. 2 Fax 425.771.0221.
PROJECT ADDRESS:
Plans shall be of sufficient clarity to indicate the location',- natf2re, and extent of the work proposed, and conform to the provisions of
the aaopted International Codes and City Ordinances.
>
10
CD 4z
F
SUBMITTAL REQULREMENTS
Yhe number indicates the number ofcopiesfor submittal( if
F.
OQ
applicable). Check marks indicate additional submittal,
cc
requirement
tz
Application Form C
.1
1
1
Site Plan
3
Mechanical Plans
2
Manufacturer's Specifications/Cut Sheets
0
0
.2
2
Elevation View. for Roof Mounted Equipment
0
0
2
.2
Structural Calculations
Plumbing Plans
2
Listed and Tested Fire Stopping Assemblies
2
Washington State Contractors License
V/
V
Con --actor's City of Edmonds Business License
V/.
Critical Areas Determination or Checklist
V/.
k
State -Non-Residential Energy Code compliance forms
1 2
• Handouts and Standard Details may be found on the City's website www.ci.edmbnds.wa.us or can be obtained at City Hall
auring nor mal business hours.
• Plans/calculation/reports prepared by state-liceinsed architects or professional engineers must be stamped and signed by the
design professional.
FOP,MC LAB.ildirig New Folder 2010\DONE & x-ferredto LBuilding-New driveTorm Cdoc Updated; 8/2 - 011
ov ED
CITY -OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
BUILDING APPLICATION ACCEPTANCE
Tuesday, April 02, 2013
This Application has been accepted by the City of Edmonds for review.. More information and changes may be.
required during this process. The review target date is: Tuesday, April 09, 2013
Your City Contact is: MARIE HARRISON
Application Number: BLD20130335
Project Address: 505 5TH AVE S # 104, EDMONDS
SNAP FITNESS/PARAGON PROPERTIES BFPS LLC
23929 W WOODWAY LANE Po Box 1110
WOODWAY, WA 98020 Granite Falls, WA 98252
(425) 188-0124
Work Description:
RAISE 13 EXISTING SPRINKLERS FOR NE W TENANT SPA CE (NO CEILING)
Outstanding Items. at. Time of Submittal:
;e&
11 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THAT THE INFORMATION QrVEN IS CORRECT -
AND THAT I AM THE PROPERTY OWNER, OR THE,DULY AUTHORIZED AGENT OF THE PROPERTY OWNER TO SUBMIT
A BUILDING PERMIT APPLICATION TO THE CITY.
IGNAT—Lqit(OVMA OR AGENT) PRINT NAMIE DA
To view up to date information about your application please visit the City ofEdmonds Development Services
website at http.11www.cLedmonds.wa.us.