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121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
Expiration Date:
Parcel No: 00488800600901
P. *. 1.
KEN TERUYA & JULIE SHOKO BETTER BUILD INC BETTER BUILD INC
HIRATSUKA C/O ROBIN ST JOHN C/O ROBIN ST JOHN
24005 76TH AVE W Po Box 6142 Po Box 6142
EDMONDS, WA 98026-9101 Edmonds, WA 98026 Edmonds, WA 98026
(425)343-2202 (425)343-2202
LICENSE #: BETTEBI904JN EXP:04/15/2018
RE -ROOF; NO SHEATHING
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 54 - Re-Roof/Roof Alter/Repair
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY:
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: ( 0 X 0 FT.)
CODE: 2012
OTHER: ------- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNIT S: 0
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
LOT #:.
BASEMENT: 0 1ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
_BEDROOMS: 0 BATHROOMS:O
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
BEDROOMS:0 BATHROOMS:O
REQUIRED: PROPOSED: REQUIRED: PROPOSED; REQUIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O 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 RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27
THIS APPLICATION ISNOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID,.
peb 'sTd#A 5-24 7p
Sfunature Print 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 ORA CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED,UBC] 09/ IBC110/ IRC110,
ONLINE A:4'f�IQ.AN"C' ASSESSOR.,
7w IHiI !2.
STATUS: ISSUED BLD20160684
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, 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 7:00amto 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
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
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PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6)
FIRE I4251775-7720
PUBLIC WORKS (425) 771-0235 PR&TREATNIENT (425) 672-5755 RECYCLING (425) 2754801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection being
rested, Contact Name and Phone Number, Date Prefcreed, and whether Von trefer pc ornina or afternoon.
• None
'a DEVELOPMENT SERVICES
RESIDENTIAL BUILDING PERMIT
APPLICATION
121 5`h Avenue N, Edmonds, WA 98020
City of Edmonds Phone 425.771.0220 ft Fax 425.771.0221
PLEASE REFER TO THE RESIDENTIAL BUILDING CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite City State, Zip):
R
Parcel #:
Subdivision/Lot #:
Project Valuation: $
APP AN
Phone: Fax:
N)-5 -3Y -�?n
Add;e(" rw, C'ily S, 1, ,t���, lifrlr
E -Mail Address;
PR RT OWNER:
_l�
Phone: :1X:
Address S reet, City, State Zi
( y
E -Mail Address
3
D 6 .9 i v✓ �r ,110
LENDING AGENCY:
Phone.:. Fax:
Address (Street, City, State, Zip):
E -Mail Address:
CONTRACTOR:*
Phone: Fax:
Address (Street, City, State, Zip):
E -Mail Address:
WA State License #/Exp. Date:
*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 City Bta.'la °,1"IMIsr„ 01/11.x ).:Daher
DETAIL THE SCOPE OF WORK:....._....
-_ —-w...................�
PROPOSED NEW S LIAIM FOOTAGE FOR THIS PROJECT:
Basement: .. ww.._. s . ft.
Select Basement Type: Finished Unfinished
lst Floor: ,..-m��_–.....__�__.......�- s . ft.
Gara e/Car ort: .._..... _.f , ft.
2° Floor:......., _ _. s . ft.
Deck/Cvrd Porch/Patio: ....... _.-........ – __sq. ft.
Bedrooms # Full -3/4 Bath # Half -Bath #
Other: s. ft,
Fire S rinklers Yes 17No
Retaining Wall: Yes No
Grading: Cut ......... cu. ds. Fill cu.yds.
I Cut/Fill in Critical Area: Yes LJ No
I declare under penalty 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.
A
�
❑ Agent/Other
Print Name: _ ._ ..! _.... —..
Owner (specify):
_
Signature:. ::.
,r
Date: 7
_ ......— ....... ..,....
FORM A LABuilding New Folder 2010\DONE & x-ferred to L -Building -New drive\Form A2014.doex Updated: 1/17/2014