1427_001.pdfCITY OF EDMONIDS
12I 5THAVENUENORTH - EDMONDS, V/A 98020
PHONE: (425) 77 l-0220 - FAX: (42s) 77 1 -022r
STATUS: ISSIIED 0611412019
Expiration Date : l2lll 12019
Parcel No: 00450700700001
ì i1.r i,r irlil #ti: I lìl I .l t!)40) j
BTIILDTN(; PERMIT
PROPERI-Y OWNER ,tPl,l,t( tAN'l-C]ONTIìA('TOIì
DANIELLE & LUCASSMITH PH FINNEY
22606 98TH AVE W
EDMONDS, WA 98020-5908
(42s) 672-3431
ADDICOTT ROOFING
C/O RODNEY ADDICOTT
18926 S3RDAVEW
EDMONDS, WA 98026
(425') 774-0806
ADDICOTT ROOFING
C/O RODNEY ADDICOTT
18926 83RD AVE W
EDMONDS" WA 98026
(42s) 77 4-0806
LICENSE #: ADDICI*21 9JT EXP:05/l 0/2020
,totì t)l1s(.Rn,TloN
REROOF
VALUATION: $0
PERMIT TYPE: Residential PERMIT GROUP: 54 - Re-Roof/Roof Alter/Repair
GRADING: N CYDS: O TYPE OF CONSTRUCTION:
RETAININGWALL ROCKERY OCCUPANT GROUP:
OCCUPANT LOAD
FENCE: ( 0X0 FT.)CODE:
OTHER: ----- OTHERDESC:ZONE:
NUMBER OF STORIES: O VESTED DATE:
2ND FLOOR: 0
NUMBER OF DWELLINGUNITS: O
BASEMENT:O 1ST FLOOR:0 IST FLOOR:0 2ND FLOOR: 0
LOT #
BASEMENT:O
3RD FLOOR: 0 GARAGE:0 DECK:0 OTHER: 0 3RDFLOOR:0 GARAGE:0 DECK:0 OTHER:0
BEDROOMS:0 BATHROOMS:0 BEDROOMS:0 BATHROOMS:0
r,:\ts llN(, .\t{t,t\I)llO l'O S l'll) r\l{l'"Â
REQUIRED: PROPOSED lnrqulneo: PRoPoSED REQUIRED: PROPOSED
HEIGHT ALLOWED:O PROPOSED:0 lR¡eurRrn: PRoPoSED:
SETBACK NOTES:
FIÌONTSETIìAI K stDE,sEt'BACt(REAII SE]-BA(-K
I AGREE TO COMPLY WÍTH CIÏY AND STATE LAWS REGULAÏNG CONSTRUCTON AND IN DOING THE WORK AUTHORZED THEREBY, NO
PERSON WLL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RE-ATING TO WORKMEN'S COMPENSATION
INSURANCE AND RCW 1 8:27.
THIS APPLICATION IS NOTA PERMII UNTIL SIGNED BY THE BUILDING OFFICIAL ALL AREPAID.
PERMIT APPROVAL
IPrint Narne Date By
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICA'IE OF
OCCUPANCY HASBEEN GRANTED. UBCI09/ IBCI IO/IRCI IO.
FIRE APPLICA¡TT ASSESSOR CITY
(]ONDIT¡ONS
STATUS: ISSUED 8LD20190720
Final approval on a project or final occupancy approval must be granted by the Building Offìcial prior to use or occupancy of
the building or strueture. Checkthe job card for all required City inspections including final project approval and final
occupancy inspections.
Any request for altemate design, modification, variance or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specificalþ requested in witing 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
specificalþ identified, requested and considered by the appropriate city ofücial in accordance with the appropriate provision
ofcity code orstate lawdoes not approve any items not to code specification.
SoundÀtroise originating fromtemporary construction sites as a result ofconstruction activity are e)cmpt fromthe 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, elaluding
Sundays and FederalHolidays. At all othertimes the noise originating fromconstruction sites/activities must compþ 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 indemniff defend and hold
harmless the Cþ of Edmonds,'Washington, its ofücials, employees, and agents from any and all claims for damages of
whatever nature, arising directþ or indirectly from the issuance for this permit. Issuance ofthis permit shall not be deemed to
motlify, waivE or rcduce any requfemenís of any City ordinance nor limii in any way the City's ability io enforce any orciinance
provision.
THIS PERMIT AUTHORZES ONLY THEWORK NOTED. THIS FERM]T COVERS WORK TO BE DONE ON PRMATE FROPERTY ONLY. ANY
CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDËWALKS, DRMEWAYS, MARQUEES, ETC.) WLL REQUIRE SEPARATE PERMISSION. PERM]T
TIME LlMl-l-: SEE ECDC r9.00.005(A)(6)
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INSPE(]TIONS
.I'O S( ]HFI)I JI,E, INS PÈI'TIONS
BUILDING ENGTNEERTNG (425) 7714220 Ð(T. 1326
L Go to: www.edmondswa.gov
2. Then: Services
3. Then: Permits/Delelopment
4. Then: Online Permit lnfo
5: lf you don't hare one already, create a
login (upper right hand comer)
6: Schedule vour inspection
Building Depañment lnspections
are now scheduled online. lf you
have dificulties, please call the
Building Department font desk for
assistance during offce hours.
(425) 771-0220
FIRE (425) 775-7720
PUBLTC WORKS (4251 771 4235
RECYCLT NG 14251 27 54801
When calling for an inspection please leale the following information: Permit Number, Job Site Address, Type of lnspection
beinq reouested, Contact Name and Phone Number. Date Prefened. and whether vou prefer momino or afremoon.
. B-Roof Tear Off. B-Building Final
c. 18
BUITD¡NG PERMIT
APPL¡CATION
Development Services
Building Division
l2l sth Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requ¡rements, permit status and inspectíon
sched uling information go to: www.ed mondswa.gov.
PLEASE NOTE: lntake appointments are required for New Single Family
Residences, lorge Additions, ADU's, New Commercial, and Mojor Tenant
lmprovement application submittals. lf plans are prepared by a profession-
al, electronic files are requested in addition to the hard copies. Please bring
electronic files on a flash drive or coordinate for electron¡c transfer.
Pledse cdll 425-777-0220 to schedule on intdke appointment!
Ø,pzni447nPermil #:
! Accessory Structure/
Detached Garaee
n Addition
E Demolition tl Mechanical
n Plumbingn New Single Family / Duplex
n Fire Sprinkler I Remodel
JOB SITE INFORMATION/LOCATION: {Where the work is taking place}
robsiteAddress: áe&o19 qÔ{rt |¡,vc wJ
n New Commercial/ Mixed Use Re-Roofa
n Signs ! Tank
parcer: OO{5OaOl +O(2OO t n Tenant lmprovement n Other
Lot /Unit/Suite #: _ Subdivision
PROPERTYOWNER:
Remodel Permll fees ore bosed on:
The volue of lhe work performed. lndicote the volue (rounded to
the neqrest dollor) of oll equipment, mcteriols, lobor, overheod,
ond the profit for lhe work indicoted on this opplicotion.
Vqluollon:
a\lauxName:
Mailing
\
Address:âQ to5b c(b{¡úP t^-)
City/State/Zip:ÞÀvn,r^Às t.L)A 4KOJ-D
Phone#: qÂqr.(o-l å . Sqat
ãVr"tn.\.Email Basement sq ft:Finished I Unfinished !
OWNER INSTALLATION: *lf yes, read and sign*
Will work be performed by the property owner? n yes d¡lo
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
1st Floor, sq ft
2nd Floor, sq ft:
Garage/Carport:, sq ft
L8.27.090.
Owner Signatüre:Deck/Covered Porch/Patio:
APPLICANT / CONTACT INFORMATION:Other sq ft:
Name of Applicant:r}¡-ni¿\¿ f'r.nnè\
Mailing Address: 22¡1gt q,Ð+\ .sOc- 'l¡-)Èq 2Õ ê
City/State/Zip:ôô
Phone#: L\a-a- i-o-ì 2-' ãL\ã\€, fr.ov¿ Ò\,\, Iz¡-rtêl'S l",s'hl I
E-mait: À9. nn€:r 'Þ hcknna.i\. ¿ar''-.
GENERAL CONTRACTOR: (lf different from applicant)Ia {\r
General Contractor:lcver f,or¿rn"r.
Mailing Address: \rÒ Auc
City/State/Zip , Ë.òmonÅs . \ÐA qgozb. bO\-+
Phone #: L{ 2-ã.-1'l r'\ . o o
rò I certify that the information I have provided on this form/application is Íue,
correct and complete, and that I am the property owner or duly author¡zed
agent of the property owner to submit a permit application to the City of
Edmonds.
E-mail
srArEUBf *: (a0O 24\q(o+
CITY OF EDMONDS BUSINESS IICE ruse *: BLØ(}L\\ ?-a ()run\e-\\¿ O.'F.,-.,*, e -oPrint Name:
WA STATE CONTRACTOR L & I s: (CCB) & EXPIRATION DATE:
3qb(o ?>laÕa û:zl zo2-o wrtgl¡.4utfr,Sign o"t"L '[3' l9
IYPE OF PERMII (Provide Deloils on Poge 2)
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
PROJECT DESCRIPTION
Occupancy Group(s)Occupant Load(s):
Fire Sprinklers: Yes Ü No IType{s) of Construction:
WA STATE ENERGY CODE: lf 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.
Tl / CHANGE OF USE / NEW BLDG: lnclude TRAFFIC IMPACT worksheet
BTUs Gas / Elec / Other Qty
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 Commerc¡al Bldg)
Other:
Qtv Qtv
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
GENERAL COMMERCIAL DATA
MECHANICAL EQUIPMENT COUNTS (New and Relocated)
PLUMBING FIXTURE COUNTS (New, Relocated or re-piped)
BTUS aty BTUs Qty
A/C Unit Outdoor BBQ/ Fire pit
Boiler Stove/Range/Oven
Dryer Water Heater
Fireplace/ lnsert Other:
Furnace Other:
Qtv Qtv
Nitrous OxideCarbon Dioxide
Helium Oxygen
Medical Air Other:
Medical - Surgical Vacuum Other:
Type of structure to be demolished
Square footage of structure to be demolished
AHERA Surveydone? Y/ N PSCAA Case #:
Critical Areas Determination:
Study Required E Conditional Waiver I Waiver !
Fill in Place Ü Fill Material
Removal tf Size of Tank (Gallons)
Critical Areas Determination:
Study Required n Conditional Waiver I Waiver n
Grading: Cut cubic yards
cubic yardsFilt
Cut / Fill in Critícal Area: Yes il No E
APPLICATIONS: Applications are valid for a maximum of L year
ESLHA Applications, 2 years.
LICENSING: All contractors and subcontractors are required to be licensed
with Washington State Department of Labor & lndustries and have a
current City of Edmonds Business License.
GAS/FUEL CONNECTION COUNTS (New, Relocated or re-piped)
MEDICAL GAS, AIR VACUUM COUNTS
(New, Relocated or re-piped)
DEMOLITION
ÏANK
GRADE/FILL/EXCAVATE
GENERAL PROVISIONS