0636_001.pdfAI
OY rCITY OF EDMONDS
121 5TH AVENUE NORTH -EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
C. I89
STATUS: ISSUED 03/29/2019 Pc „nit;+: D2,01' 342
Expiration Date: 09/29/2019 �'i'ii�t ii .iiiiii'i t . �1 1 Z I,) L1 x-r 14 t — 111 1, v rv%'1 f v (a1CS
Parcel No: 00843300110300
LINDA BELZ ANNEX REMODELING DURNIN PLUMBING
404 3RD AVE S UNIT A-103 C/O JON SVEINSSON C/O JAMES DURNIN
EDMONDS, WA 98020 6830 NE BOTHELL WAY SUITE C-234 23701 102ND PL W
KENMORE, WA 98028 EDMONDS, WA 98020
(425)776-5939 (425)219-0820 (206)546-4940
LICENSE #: DURNIPI901DZ EXP:03/09/2020
MOVE SHOWER DRAIN AND FAUCET, MOVE TUB FAUCET
VALUATION: $0
PERMIT TYPE: Residential
PERMIT GROUP: 47 - Plumbing
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: ( 0 X 0 FT)
CODE:
OTHER: ------- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS: 0
LOT #
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
BEDROOMS:0 BATHROOMS:0
BEDROOMS:0 BATHROOMS:0
REQUIRED: PROPOSED: 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.
'�afHIS ICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL Oje%/HER DEQ jj ANa jLL FEES ARE PAID.
Dv► SJ�v�SScs
nature
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. UBC109/ IBC110/ IRC110.
a FIRE = APPLICANT = ASSESSOR = CITY
�f
STATUS: ISSUED BLD20190342
• 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. Checkthe 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 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 fi-ont the noise limits
ofECC 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
hartriless 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 ordumance 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)
TO SCHEDI ILE INS PECTIONS
BUILDING I I ENGINEERING (4251 771-0220 EXT. 1326 1
Go to: www.edmondswa.gov
2. Then: Services
3. Then: Permits/Development
4. Then: Online Permit Info
5: If you don't have one already, create a
login (upper right hand corner)
6: Schedule your inspection
Building Department Inspections
are now scheduled online. If you
have difficulties, please call the
Building Department front desk for
assistance during office hours.
(425) 771-0220
FIRE (425) 775-7720
PUBLIC WORKS (425) 771-0235
RECYCLING (425) 275-4801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection
being requested, Contact Name and Phone Number, Date Preferred, and whether you prefer morning or afternoon.
• B-Plumb Rough In
• B-Plumbing Final
BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 5th Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, permit status and inspection
scheduling information go to: http://www.edmondswa.gov/
JOB SITE INFORMATIO//N��/LO(� ACCATION: (Where the work is taking place)
Job Site Address: 7- 7 �yc 6
Parcel: ��{{
Lot /Unit/Suite #: A 103 Subdivision:
PROPERTY OWNER:
r
Name: / H CL Se /Z7
Mailing Address: Y/Ord 74-1%CCS• A�03
City/State/Zip:c�y170�?Gts GU,4 / 8cob
Phone #: Y.ZS • a�-6 55 ? 3 %
Email:
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? ❑ Yes . No
I own, reside in, or will reside in the completed structure.
This installation is being made on property that I own which is
not intended for sale, lease, rent, or exchange according to
RCW 18.27.090.
Owner Signature:
APPLICANT / CONTACT INFORMATION:
Name of Applicant: J 0 h 6J e4 vus a `i
Mailing Address: 6830 14F SaYA&�f
City/State/Zip: Keel twao Ir- WA- 'j 8a 26
Phone #: y' ��`1 a 820
E-mail:
�
GENERAL CON RACTOR (If kdijfferent from pa plic nt) f V /
General Contractor: Aom c.yc LI.s
Mailing Address: 68,70 ZVX ghO 46 / h/d c5 G'23j�
City/State/Zip: Ky�-weD tx - WA 9(foL6,
Phone #: /�VZ5 ' Au�I ' �5�6 J_
E-mail: 09/-Ce �LZ/1�1CC %�DKO(�etisG.(d(A(
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
AIJI✓f xA4 9Y�Lof
CITY OF EDMONDS BUSINESS LICENSE #:
7Permit #:
TYPE OF
❑ Accessory Structure/
Detached Garage
..-
❑ Addition
❑ Demolition
❑ New Single Family / Duplex
❑ Mechanical
V151umbing
❑ Remodel
❑ Fire Sprinkler
❑ New Commercial/ Mixed Use
❑ Re -Roof
❑ Signs
❑ Tank
❑ Tenant Improvement ❑ Other
Remodel Permit fees are based on:
The value of the work performed. Indicate the value (rounded to
the nearest dollar) of all equipment, materials, labor, overhead,
and the profit for the work indicated on this application.
Valuation:
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
Basement sq ft: Finished ❑ Unfinished ❑
1st Floor, sq ft:
2nd Floor, sq ft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
Othersq ft:
PROJECT•
C.
vh o ✓t` 74-uh 1 u ,c (2.,�
I certify that the information I have provided on this form/application 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: �J
Signature: Date
GENERAL COMMERCIAL DATA
Occupancy Group(s): Occupant Load(s):
Type(s) of Construction:
Fire Sprinklers: Yes ❑ No ❑
WA STATE ENERGY CODE: If your project affects the building envelope,
mechanical systems, and/or lighting, you must complete the
appropriate WSEC forms.
DEFERRED SUBMITTALS: All commercial building permits that will require
associated plumbing, mechanical, fire sprinkler, and/or fire alarm
permits are applied for separately.
TI / CHANGE OF USE / NEW BLDG: Include TRAFFIC IMPACT worksheet
COUNTSMECHANICAL EOUIPMENT
BTUs Gas / Elec / Other City
A/C Unit /Compressor
Air Handler /VAV
Boiler
Dryer Duct
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
Other:
PLUMBING FIXTURE COUNTS (New, Relocated or re -piped)
Qty Qty
Clothes Washer
Tub/ Showers
Dishwasher
Backflow Device (RPBA, DCDA, AVB)
Drinking Fountain
Pressure Reduction/ Regulator Valve
Floor Drain/Sink
Refrigerator Water Supply
Hose Bibs
Water Heater - Tankless? Y or N
Hydronic Heat
Water Service Line
Sinks
Other:
Toilets
Other:
GAS/FUEL CONNECTION COUNTS (New, Relocated or re -pipe
BTUs Qty BTUs Qty
A/C Unit
Outdoor BBQ/ Fire pit
Boiler
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
Other:
Furnace Other:
MEDICAL•
(New, Relocated or re -piped)
Qty
Qty
Carbon Dioxide
Nitrous Oxide
Helium
Oxygen
Medical Air
Other
Medical - Surgical Vacuum Other:
DEMOLITION
Type of structure to be demolished:
Square footage of structure to be demolished
AHERA Survey done? Y / N PSCAA Case #:
1
—
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
,
Fill in Place ❑ Fill Material:
Removal ❑ Size of Tank (Gallons)
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
,D
Grading: Cut cubic yards
Fill cubic yards
Cut / Fill in Critical Area: Yes ❑ No ❑
GENERALPROVISIONS
APPLICATIONS: Applications are valid for a maximum of 1 year.
ESLHA Applications, 2 years.
LICENSING: All contractors and subcontractors are required -to be licensed
with Washington State Department of Labor & Industries and have a
current City of Edmonds Business License.