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161205 MAD (Permit Application Form E).pdfDEVELOPMENT SERVICES '.,;...:: COMMERCIAL M ERCIAL & MULTI -FAMILY BUILDING PERMIT APPLICATION Est 1 ago 121 5" AvenueN, Edmonds, WA 98020 City of Edmonds Phone 425.771.0220 A Fax 425.771.0221 PLEASE REFER TO THE COMMERCIAL & MULTI-FAMILYBUILDING CHECKLIST FOR SUBMITTAL REQUIREMENTS PROJECT ADDRESS (Street, Suite #, City State, Zip): Parcel #: 9300 236th Street SW; Edmonds, WA98020 27033600404600 Subdiv sioiVLot #: Project Valuation: 6 7,000,000 APPLICANT: Phone: Fax: Mahlum (Corrie Rosen) 206.441.4151 206.441.0478 Address (Street;City, State, Zip): E-Mail Address: 71 Columbia Street, Floor 4, Seattle, WA 98104 crosen@mahlum.com PROPERTY OWNER: Phone: Fax: Edmonds School District (Taine Wilton) 425.431.7172 425.431.7171 Address (Street, City; State; Zip): E-Mail Address: 20420 68th StreetW, Lynnwood, WA 98036 wiltont@edmonds,wednet.edu LENDING AGENCY: Phone: Fax: Address (Street, City, State, Zip): E-Mail Address: CONTRACTOR:* Phone: Fax: FORMA Construction Company (Derek Boysen) 360.754.5788 360 943,5868 Address (Street, City, State, Zip): E-Mail Address 2823 29th Avenue SW, Tumwater, WA 98512 derekb@formacc.com WA State License #/Exp. Date: *Contractor must have a valid City of Edmonds business license prior to 600 604 496 / December 31, 2016 doing work in the City: Contact the City Clerk's Office at 425.775.2525 City Business License #/Exp. Date:: NR-022460 / December 31, 2016 DETAIL THE SCOPE OF WORK - Prepare site for construction of future Madrona,School. The existing Madrona School will remain in operation during construction and will be demolished upon completion of the new school. Sitework will include parking and loading areas, track, playfields, storm water management, and utilities. A separate building permit will be forthcoming. PROPOSED NEW SQUARE FOOTAGE FOR THIS PROJECT: 1st Floor: N/A so. ft. 2° Floor: N/A sq. ft, 3' Floor: N/A sq. ft. Basement: N/A s . ft. Garage: N/A sq. ft. Decl(/Cvrd Porch: N/A sq. ft. Other: N/A sq. ft. Retaining Wa1L YeSE No U Fire S nnklers: Yes;Fj No Occupancy Grou (s): Occu ant Load(s): Types) of Construction: Grading: Cut 22.222 cu.yds. Fill 0 cu.yds. I Cut/Fill in Critical Area: Yes No *For permit use only, not for bidding. ONSITE SLOPES >40% AND 10 VERT FEET I declare underpenalty of perjury laws 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: Taine Wilton,, Owner MAgent/Other ❑ (specify): Signature: 3 Date: December"1, 2016 FORME L:)Building New Folder 2010\130NE&x-ferred to L-Building-New driveWorm E 2014.doex Updated: 1/17/2014 Equipment Type Appliance/Equipment Information (new and relocated) Total # Furnace Gas #Elec #_Other: # BTUs: <100k >100k Location(s) Air Handler / VAV (circle selected) Gas # Elec #_Other: # CFM: <10k >10k Location(s) AC / Compressor / Boiler / Heat Pump / Roof Top Unit (circle selected) Gas # HP: Elec #_Other: <3, 3-1.5, # BTUs: <100k, 100k-500k, 500k-1Mil 15-30 Location(s) Hydronic Heating Gas # Elec #_In -Floor _Wall Radiant_ Boiler BTUs: Location Exhaust Fans (single duct) Bath # Kitchen # Laundry # Other: -# - Fireplace Gas # Elec #_Other: # Location(s) Dryer Duct Appliance Type FUEL GAS Appliance/Equipment Information (new and relocated) Total # AC Unit BTUs: Location(s): Furnace BTUs: Location(s): Water Heater BTUs: Location(s): Boiler BTUs: Location(s): Other: BTUs: Location(s): Fireplace/Insert BTUs: Location(s): Stove/Range/Oven Dryer Outdoor BBQ TOTAL OUTLETS PLUMBING Fixture Type (new and relocated) Total # FIXTURE COUNT Fixture Type (new and relocated) Total # Water Closet (Toilet) Pressure Reduction Valve/Pressure Regulator Sink (kitchen, laundry, lavatory, bar, eye wash, etc.) Water Service Line Tub/Shower Drinking Fountain Dishwasher Clothes Washer Hose Bib Backflow Prevention Device (e.g. xBPA, nCnA, AVB) Water Heater Tankless? Yes ❑ No ❑ Hydronic Heat in: Floor ❑ Wall Floor Drain/Floor Sink Other: Refrigerator water supply (for water/ice dispenser) Other: FORM E L:\Building New Folder 2010\DONE & x-ferred to L-Building-New drive\Form E 2014.docx Updated: 1/17/2014 DEVELOPMENT SERVICES COMMERCIAL & MULTI -FAMILY BUILDING CHECKLIST 121 5`h Avenue N, Edmonds, WA 98020 Phone 425.771.0220 A Fax 425.771.0221 City of Edmonds PROJECT ADDRESS: 9300 236th Street SW, Edmonds, WA 98020 PRE -APPLICATION MEETING? YES © NO If YES, Pre -application Number: PRE2016-0002 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. n �� SUBMITTAL REQUIREMENTS The number indicates the number of copies for submittal (if applicable). Check marks indicate additional submittal requirements that may apply to your project. QoIle n a `� z —y o n c. o �n mot n p Application Form E 1 1 1 1 1 1 Site Plan 3 3 3 3 3 3 F/C Pr,,/ A Reduced Site Plan (11 X 14 or 8 r/2 x 11) 1 1 1 1 1 1 F/C Construction Drawings 3 3 3 3 3 3 N/A Structural Drawing and Calculations 3 3 3 3 ✓ N/A WA State Energy Code NREC Calcs & Lighting ✓ ✓ ✓ ✓ Site Classification Worksheet "E72-SWM" ** 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 2** 1 1 ✓ Geotechnical Report 3 3 N"N/A Health District Approval Letter ✓ ✓ ✓ N/A Manufacturer's Specifications/Cut Sheets ✓ ✓ ✓ ✓ 3 ✓ Contractor's City of Edmonds Business License ✓ ✓ ✓ ✓ ✓ ✓ Washington State Contractors License ✓ ✓ ✓ ✓ ✓ ✓ Plan Check Fee (due upon submittal) ✓ ✓ ✓ ✓ ✓ ✓ �/ Traffic Impact Analysis 3 3 3 3 V/ Survey 3 3 N.°A Special Inspection and Testing Agreement ✓ ✓ ✓ ✓ N1A Envelope Plans and Documents/Condos 2 2 IWA Bonds 1 1 ✓ ✓ v/ Architectural Design Approval 1 1 ✓ ✓ N`S/'-a Peer Review Fees ✓ ✓ N/A Deferred Submittals ✓ ✓ N/A Shop Drawings ✓ ✓ N/A Street Use ✓ ** Clarified by Kristin Johns, 11/30/2016 • Handouts and Standard Details may be found on the City's website www.edmondswa. ov 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. FORM E L:\Building New Folder 2010\DONE & x-ferred to L-Building-New drive\Form E 2014.docx Updated: 1/17/2014