The URL can be used to link to this page

20030655.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION P4"VNAME OF BUSINESS CITY ,a"w e NAMV f\V ADDRESS CITY NAME CITY I- � )Lwk�hu STATE LICENSE NUMBER ZIP ZIP ITELEPHONE ZIP I TELEPHONE 64-1 1-1 � j I, L-.LL— I - -" K 4 PROPERTY TAX- ACCOUNT PARCEL,NO. ft-% n --a- el -'a i — - - NEW ESIDENTIAL ADDITION rouc OMMERCLAL REMODEL '[:] MUI.TIFAMILY 0 REPAIR 0 GRADING CYDS 9 DEMOLISH [] TANK ciGARAGE CARPORT o REIAJNINGWALL ROCKERY UWE OF USE. BUSINESS OR ACT EXPLAIN: �ir —_ - NUMBER NUMBffOF OF DWELLING I STORIES UNITS DESCRIBE WORK TO BE DONE 'PERMIT EXPIRES C/I USE PERMIT Z ' E ON r,.5'9 NUMBER ja)�3 JOB UITE/APT# ADDRESS 1(0 frta PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. LID FEE S PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP IESCP APIWO RW ,., R4V Street Use Permit Req'd EXISTING — PROPOSED Inspection Required Sid&wa!k Required REQUIRED DEDICATION— FT undwWMW Wiring required 13 METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED YES C3 NO 13 REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROWDRAINAGE N � DA� ( ep - ENGINEERING IIEJEWED BY I IF DATE V FIRE REVIEWED BY DATE Lu cc I M VARIANCE OR CV. I SHORELINE OR ADBI r INSPECTION I 1�0 N DMAT E MC 40 WRIET TO BE CLE" NyN f 5 SE EVI BIN COMPLETE E -A] I L EXP LOT CME PLUMBINGIMECH ALLOWED p COMPLIANCE OR 91116 Aww"%A"Re� CHANGE OF USE W" PARKING ,JLOT AREA I PLANNIW5 EWE6 8 B I PRI I ENOLM N INSpECnON SIGN REO D 0 o FENCE PACK OF40" X_ FT) REMARKS FOR INSPE=ON REQUIUMEM OTHER oFIRE SPRINKLER FIRE ALARM C CHECKED BY ITYPE OF LPN HE CK CRITICAL SPE IAL INSPECTION AREA AREAS C NUMBER CH REQUIRED [[:] YES I tREMARKS (i PROGRES INSPECTIONS PER UBC I HEAT SOURCE GLAZING % LOT SLOPE % PLAN CHECK NO: VESTED DATE THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PnIVATIE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURDS, SIDEWALKS, DRIVEWAYS, MMQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT APPLICATION: ISO DAYS PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WffHIN 180 DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS IN INTEREST, 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 OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' I I HERE13Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT.AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; 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. SIGNATURE (OWNER OR AGEND _ _,_, ), DATE SIGNED I ;TBACKS (Fr.) SIDE REAR OCCUPANT LOAD I INSPECTION REO'D VALUATION $ Description FEE Description FEE Plan Check State Surcharge Building Permit City Surcharge K Plumbing Mechanical Grading Engr. Review Engr. Inspection Fire Review Plan Chk. Deposit Fire Inspection Receipt # Landscapeinsp. Total Amt. Due Recording Fee ReceiDt # CALL FOR INSPECTION ifA13 1425) 771-0220 APPLICATION APPROVAL I'Ais application is not a permit until signed by the 811171111cittl or Mather Deputy: arld Fees are paid, and r celpt Is acknowtoped in Waco pr3lided. S NATURE DATE ;ESED BY DATE' ATTENTION hA I I U IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLON-INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING A-T ASBESTO-TEST9 INC. ASBESTOS SURVEY 8516 Main St, Edmonds, WA 98020 Page I of 5 J70231007 Odober 10, 2003 Sundquist Homes P.O. Box 958 Lynamod, WA 98036 Attn: h1ansou Kerner Ph: 425-775-8663 xi 15 Fax: 425-778-0822 LWRODUC77ON On October 6,2003, Asbesto-Test personnel conducted an Asbestos survey (per U.S.E.P.AJARE.&A. guidelines as designated and specified by Puget Sound aeon Air Agency and Washington State) o e house& out structures (a), 8516 Main St. Edmonds. Snohomish Countg Washington 98020. This survey purpose is to identify any Asbestos Containing Materials that may be present and will require professional remvalprior to demolition. NARR,4 THT OF WISIC CONSTRUCTION: The house is two story wood frame. The exterior siding is wood. The roofing is composition. The wood siding vapor barrier and composition roofing materials were sampled. The flat rolled composition roofing was also sampled from the back flat area of the house. INTERIOR CONSTRUCTION9 FINISHES, AND FLOORINGS: The interior is drywall and wood. The drywall/taping materials were sampled. Vinyl and tile flooring materials with relating backings and mastics were sampled per each located homogenous area. The mastic was sampled from beneath the parquet wood floor tile 2d layer in the dinette. ELECTRICAL SYSTEM: The electrical wiring insulation is not of the kind to be ACM and was not sampled. Any additional suspect electrical wiring insulation or any suspect TS1 (nermal System Insulation) found in, around, or behind any localedfuse or breaker boxes should be considered to be A CM (Asbestos Containing Material), unless determined otherwise by laboratory analysis. CONTINUE TO PAGE 2 1429 Ave. D.PMB#187, Soobomish, WA 98290 pb:206-914-SSCO fnx:360-563-2469 page: 206-540-2401 n V n T T n nn Page 2 of 5 October 10, 2003 N9231007 Asbesto-Test, Inc. (206) 914-5500 8516 Main St.,Xdmonds. Shohondsh County Washingion 98020 ATTIC/WALL ENSULATION: There was no visible suspect ACM located. HEATING AND VENTILATION SYSTEM: There is gas wall heat and electric wall beat in the house, There was no visible suspect ACM located associated with the heating units, except the flue mortar packing material that was sampled from the gas heating unit. Note: It was not possible to dismantle the heating units to locate andlor evaluate any additional suspect A CM which may be concealed, inside the units, or associated in -hidden areas. It is our opinion anyfurther handling of the heating units should be coordinated by the project manager andlor abatement contractor. If any additional relating suspect materials are locatedprior to andlor during any demolition or renovation, any and all additional related suspect materials should be considered to be ACV (Asbestos Containing Material). unless determined to be otherwise by laboratory analysis. Misc.: The window glazing was sampled. ADDITIONAL STRUCTURES ON SITE INCLUDED IN SURVEY: There are three sheds behind the house. Twd of the sheds are metal with composition roofing that was sampled. The back shed is all wood. The window glazing was sampled from that aructure. one house & three sheds ofstructum included in survev. 11 F Odober 10, 2003 Asbesto-Test, Ine- (206) 914-5500 8516 Main St., Edmonds, Shohondsh Countp Waslsinrton 98020 Any and all -materials identified as ACM or PACM In this report (and/or additional materials associated with the structure that may be discovered and later identified as ACM or PACM), must be professionally abated prior to demolition. ASSESSMENT AND QUANTD7CATION OF ACM FOR ABATEMENT PURPOSES AND/Olt PRICING FOR REMOVAL SHOULD BE DE TERMINED BY ON SITE RVALUATION9 AS LISTED QUANrffZS ARE NOT GUARANTEED AND AM AN APPROMUTION ONLY. -AMPLE 0 ISANRE"M CONTAINING MATEWL ANALYSIS ED ASBEST0SMTVnUANTffV OTHERMATERIAL 1-0) FLUE MORTAR PACIMG yes fl chrysotile # 5-10% non -fibrous materials NON-FRUBLE-LESS, n1AN I SQ. Fr. ACM Circle of paeldng material around gas heater flue exhaust entry into brick chimney NOTE: Any additional colors or Idads of floor tile and/or insistics backings that were not discovered in this survey and may later be located in this structure are also presumed to contain asbestos unless tested otherwise by laboratory analysis J"_ THERE WAS NO ASBESTOS DETECTED IN ANY OF THE REWA11411NG SAWLES 2.0) drywall NAD non -fibrous materials cellulose, fiberglass, paint, (gypsum) 2.1) drywall taping compounds NAD non -fibrous materieds, �j SAMPLED PER AHERA PROTOCOL cellulose, fiberglass 2.2) surface paint (homogenous throughout) NAD paint cellulose 3.0) tile flooring NAD non ibrous materials NAD NAD adhesive, cellulose adhesive, cellulose NAD non -fibrous materials, ccllulose, tar NAD adhesive, cellulose, tar A-7 continue to page 4 Page 4 of 5 October 10, 2003 VV#231007 Asbest6-Tesl, Ina (206) 914-5500 8516 St., Edntonds, Snohomish County Wash&ton 98 ANALYSIS ID ASBESTOSUTYPEM/01JANTITY OTHER MATERUL 4.0) sheet vinyl flooring NAD kitchen & bath surface -color: off white/tan squares 4.1) mastic NAD 4.2) linoleum flooring NAD kitchen & both bottom layer-colnir: green 43) mastidbacking NAD 5.0) linoleum flooring NAD living room -color: red fern pat(em 5.1) mastic/backing NAD 6.0) linoleum flooring NAD south bedroom -color. painted tan 6.1) mastietbacidog NAD 7.0) sheet vinyl flooring NAD laundry room stirface-cobr: tan rectangle 7.1) mastic NAD 7.2) linoleum flooring NAD laundry room bottom layer -color: green 7.3) mastic/backing NAD 8.0) window glazing NAD house 9.0) window glazing NAD shed In back 10.0) composition roofing NAD & underlying materials -house 10.1) composition roofing NAD & underlying materials -over back flat area of house 11.0) wood siding vapor barrier NAD materW beneath wood siding exterior 12.0) composition roofing NAD & underlying materials -metal shed next to house 12.1) compo3ition roofing NAD & underlying usterials-middle metalshed non -fibrous materials cellulose, fiberglass adhesive non -fibrous materials, cellulose, tar adhesive, cellulose, tar non -fibrous materials, cellulose, tar adhesive, cellulose, tar non -fibrous materials, cellulose, tar adhesive, cellulose, tar non -fibrous materials cellulose, fiberglass adhesive non -fibrous materials, cellulose, tar adhesive, cellulose, tar non -fibrous materials, cellulose non -fibrous materials, cellulose cellulose, tar, fiberglass, non -fibrous materials cellulose, tar, fiberglass, non -fibrous materials cellulose, tar cellulose, tar, fiberglass, non -fibrous materials cellulose, tar, fiberglass, non -fibrous materials A-T continue to pag, S j � j e r rj r% n T T *% *Nn ' W, A U-11F] W USEPA 60OM93/116*0 (PLM); WAC 296-62-07753 App. J analytical test method. ACM signifles"AsbesM COnuining Material" PACM 3ignift"PresanwdAsbWmCaftininsM&terW" CAD sisnifies"CAncrete Asbestos Read" -C sipiffes "fen thae T,;j signifies -rhamal System Intulation" HVAC sigMiles "Heating Ventilating Air -Conditioning" NAD sivilfiss"No Asbastos Detected" 010nepov t Is the USEPA regulatory limit fbrm !A bulk sample& coamot be PIM hubecOnown to missasbutosift mail pot tages ofsome amrAcs. which contain asbestos, thus nego6ve PLM results guaranteed. Floor tiles and wipes should be tested with SEM or TEM, to insure analytical accuracy when reported in unall permntages. Asbesto-Tcst� Inc. claims responsiVility for sample content only. END OFRMRT ArLyan Hammond Analytical CURIO, R-SC. A-7 AIHA proficient k, 5M �11 So -I OF-P.-A Ll 19 log, SCALE 20 40 518 MAIN runi Ann Box.. -DwYKIL, VION ALCUL 7- �OUlg: 730 SF / CgNCRE,TE 4LAB: 1050 SF .S ED: 260 SF FOLLOW PRE -DEMOLITION PROCEDURES PER CITY OF EDMONDS HANDOUT 8516 MAIN STREET lAveU—Sauerland & Associates, Inc. DEMOUTION PERMIT PLOT PLAN Lmm 19" MADRONA COVE PRD 02-171 u m - Wn*A n om - (mYM-lWlA"*0-m ICITY OF EDMONDS WASHINGTON FILENAKi 44"\DVG\DENG UPDATED 00/19/03 LSA JOB NO. 4486 z 0 m am ca m 0 --lo 0 C: -49 X M m Z g) -4 CE co o -n n m M a 0 0 m a (j) c (j) M 0 Z V, z -4 3: Cl) z 0 m RE-INSPISUIZI.) Vu 10 1 lu-4w'"w A"'w" si Date ocaprvl.doc.l:temp:bldg:formsIO/OI QDATE RECEIVE;D; z/z �7) PERMIT EXPI _&/Ov I RES A_ CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION' ��E OF BUSINESS i' "r, nok�� i_4A11Af\,IN1V[kv( �,.) MAILING'ADDRESS �(�) 'V-* " - - 11 CITY A 10�,\WQQ� ( NAMI� ADDRESS CITY NAME CrTY STATE ZIP ITELEPHONE I USE PERMIT ZONE NUMBER JOB UITE/APT# ADDRESS 4� lb fn 12 .- PLAT NAME/SUBDIVISION N OT NO. LID NO. -0-7 LID FEE S YESCP Apprmtd PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Pan* Asquirod Stmt Use Peffnk 11"'d EXISTING PROPOSED fnspecWn Requked Skfewatk R*WkW REQUIRED DEDICATION— FT UndwWound WkIngmquired 13 METER SIZE LINE SIZE I NO. OF FIXTURES PRV REQUIRED REMARKS I YES C3 NO 13 OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE ZIP ITELEPHONE CBL Lr� " � I ENGINEERING FIE\AEWED BY DATE! LIL \j Q — A)C FIRE REVIEWED BY DATE ZIP TELEPHONE m PROPERTY TAX ACCOUNT PARCEL NO. r NEW M -AESIDENTIAL PLUMBING / MECH ADDITION COMMERCIAL COMPLIANCE OR 13 CHANGE OF USE REMODEL 0 mummmiLy SIGN REPAIR, GRADING [:3 CYOS FENCE X—F'T) DEMOLISH TANK o OTHER , n GARAGE CARPORT o REtAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM 4 V I (TYPE OF USE, BUSINESS OR ACT 4N: VARIANCE OR CU SHORELINE OR ADB11 INSPECTION BOND . RECYD I I POSTED 13YEs 13NO S SEPA IEW AIGN AREA HEIGHT COMPLETE EXE T PR OSE OPOSED :xP LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR PARKING REA PLANNING REVIEWED BY DATE RE11D I PRO REMARKS CHECKED BY ITYPE OFT) CRITICAL OF DWELLING AREAS STORIES UNITS NUMBER NUMBER NUMBfflrOF 07A & SPECIAL INSPECTION AREA 010 - RE UIRED [:] rES DESCRIBE WORK TO BE DONE ]REMARKS OCCUPANT LOAD PER UBC 108/FINAL INSPECTION REaD VALUATION L <_ L4 Description FEE Plan Check HEAT SOURCE GLAZING % LOT SLOPE % Building Permit PLAN CHECK NO: VESTED DATE Plumbing al-112 Mechanical THIS PEWiT AUTHORMES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO t: 2 3 BE DOME On PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC Grading DOUNN (CURM, SIDEWALKS, DRMWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMiSSION. Engr. Review PERurrAPPU'CATION: ISODAYS PERMIrr UMM I YEAR -PROVIDED WORK 18 STARTED WTrHIN 180DAYS Engr. Inspection . Description FEE State Surcharge City Surcharge SEE BACK OF PINK PERMr1r FOR MORE INFORMATION Fire, Review Plan Chk. Deposit 'APPLJCANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUdOESOPS I . I IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY . - . I - FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT $HALL NOT BE DEEMED TO MODIFY, WAIVE OR REDUCkAN 4ENT QF ANY CITY ORDINANCE AWPRDIAANCE PROVISION.* \L "n;CapG Insp. I Total nt. Due EN%IREk NOR LIMIT IN ANY WAY THE cmrs ABI�� RCE TYS Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GWEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL a applicallon 13 not a permIt until sIgned by the a app" TION; 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 FOR INSPECTAON B It cW or W/her Deputy: aqd Fees We PaW. and I ' pt Is acknowfooped InjWaco rwAlded. WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. NATURE DATE DE. i SIGN�ATUIJE (OWNER OR AG:L DATE 9GNED 1A9 I A0 771 -0220 E ED BY DATE' S BY ATTENTION EXT 1333 IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW. INSPECTOR�' CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING