20170126120021.pdf��lr 11,11�r�
t,,ITY OF EDMONDS
121 5TH AVENUENORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 01/26/201 7
Expiration Date: 07/26/2017
» rr
Parcel No: 00956300010100
PERTV OWNER APPLICANT CONTRACTOR
TOM TINDALL CROWN -ROOFING INC CROWN ROOFING INC
126 3RD AVE NC/O ROBERT PEREIRA C/O ROBERT PEREIRA'
EDMONDS, WA 98020 18596 - 76TH AVE W 18596 - 76TH AVE W
EDMONDS, WA 98026 EDMONDS, WA 98026
(425) 712-7663 (425) 712-7663
LICENSE #. CROWNRI002K2 EXP.04/14/2019
DESCRIPTIONJOB
REMOVE EXISTING- INSTALL LANDMARK AR, NEW FELT, NEW FLA SHINE
VALUATION: $2,800.00'
PERM11 IT TYPE: Commercial PERMIT GROUP: 54 - Re-Roof/Roof Alter/Repair
GRADING: N CYDS: 0 TYPE OF CONSTRUCTIONe
RETAINING WALL ROCKERY;; OCCUPANT GROUP;
OCCUPANT LOAD:
FENCE. ( 0 X 0 FT, CODE: 2015
JOTHER: ------- OT HER DESC, " Z ON ri.,'
NUMBER OF STORIES: 0 VESTED DATE;,
NUMBER OFiDWELLING UNITS: 0 ILOT
BASEMENT:0 1ST FLOOR:0 2NDFLOOR: 0 BASEMENT:0 1ST FLOOR:0 2NDFLOOR: 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 REQUIRED PROPOSED:'
SETBACK NOTES:
PERNW APPROVAL
I AGREE TO COMPLY WITH CITY AND STATE LAWSREGULATING 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.
THIS APPLICATION' IS NOT'A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAIDd
Signature Print Name Date Released By Date''
ATTENTION
ITIS 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'„
ONLINE APPLICANT ASSESSOR OTHEII
• Final approval on a projector 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 ► quited City inspections including final project approval and final
occupancy inspections.
• Any request for alternate design, modification, variance or other administrative deviation (hereinafter "variance") from
adapted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing
fee'F"orsuch 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 o'licial in accordance with the appropriate provision
of city code or state law does not approve any items not to code specificdt on,
• Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
wtAM%,J aiuw(x,a Lrar, ,JJVJ.aV VJJ 11, eCI.lfa,�; JJVI WIRi'U11C� 011 511,e�i/Act IVIlICS '1'1'11,1SI C01T7p y With the,
noise limits of C'liapter .30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf Ofhis 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 fromthe issuance forthils 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;
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.
PERMITTIME LIMIT: SEE ECDC 19.00.005(A)(6)
• B-Roof Tear Off
• B-Building Final
11 If
C1`1
ii
o
Lin
M
CD
O
f rnm ii M
.*
- N
>= 0
N
If
O
! 00 co 1100
d-
O
I
O
L J
1--
11 Cl) Cl) I i C 3
EEO s.W..
LLl
"
C''3
'iNN
C
N
IIN
4E
If
111
CD
CD
CTif
iE
CC:C ell L O N
1
if
CD
a)L0
C')
CD0"L0
9.f... O L.
C/7 C Z O V
I I
O
L
a)
r-
LC)
r�
'.
""L0
00
Q) CT - -
I I
CC)C-
—
=
—
C'r] Cn
O
j 3 ; I
_
O
C
,:µ..,w .. a) C ..
4)
Zr•� O ]C
If
r-
—
LL-
—
N�
CD
fl Ii
O
..-
W W U r- -X
i a)�LL-
I!
O
L
.---
CD
T
CD
. i if
P
*t
A7CS O O
W o25 I >
it
e
Xis
O
X�
O
X!�
X —
XIS
1f fl
W
O
OJ d
t
r0
GO
— CD
+-+TO
N—O
—O
O
li if
I f O01
= L
LA.i O O��O
U
i
II
[V
Q)
-O
N
U
N
a)
"
a)
N
IZ
I I i t
U
7-� O+-+ OCV
it
O
0
_L
M
a]
O
U
LL-
im
N
LJ_
O
J
fl If
l
T H-F
N
_
- O"
1
U
CO
!✓
m
a)
.J
m
m
3
i ; ;
Ln -1
Ln
O T.i) -N-^
0 LL EO
LL.CD
3
CO
DI
�--�
O
11 f1
(1
O
O
= =] Ci).y..s'Fw^.
C O D Lil.---
l i
a)
L
L
t�
L
•�
U
11 11
Q
U
D co
CD NN f�
li
T
kCf9"'O
CDa
, f
a
U
—M
a)
L[7
11
O
•.-
O
(p
O
O
O
O
E
i t -- I I -O
t•
?, L.
� �1'
it
Z
O
>n
Z
U
Z
CaZ
C7I
:M(O
11 r 1! L
— O iF
CF7'".", �PCR
a
-I to f1 (O
if 4- -.' 1 U
Oco 3C-
CV
O
z ..O
s
it s=
�
4
�
-
�
�
_
i1 ra If
C1
f L
L
(o
L
a)
L
L
L
•r
�
L
a)
�
f° (a
UDLnac
I1 a)
Q)
},
a)
L
Q)
al
a)
O
N
(O
I! -04--� 11 (n
I I O O
NC.O iE
CV
I I IZ
W
C!]
d
U
Cl-
0-
C1
M
IZ
d
if V] E— 117
t t,
DEVELOPMENT SERVICES
COMMERCIAL & MULTI -FAMILY BUILDING
PERMIT APPLICATION
121 5`h Avenue N, Edmonds, WA 98020
City of Edmonds Phone 425.771.0220 0 Fax 425.771.0221
PLEASE REFER TO THE COMMERCIAL & MULTI -FAMILY BUILDING CHECKLIST FOR SUBMITTAL REQUIREMENTS
PRO314; .71" Al)D SS ( ree Suite #, ity State, Zip), Parcel #:
"vim
Suhdivision/Lot # Project Valuation: $ xm
APPLICANT: Phone: � ,Z 'Fax:
f"Ow� t '�'
Address (Street, Cit , State, Zip): E-Mail Address:
6 " 6-k^-,4V la% (p /\ rA) C in
PROPERTY OWNER: -ro-, a Phone: Fax:
Address (Street, City, State, Zip), l 26 E-Mail Address:
LENDING AGENCY: Phone: Fax:
Address (Street, City, State, Zip); E-Mail Address:
CONTRACTOR:* Phone: Fax:
Address (Str et, City„ State, ip): E-Mail Address
? A c01�-r1nv�
WA`Stte iel
*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 Business License #/Exp. Date:
DETAIL THE SC)1'1m OF WORK ........� ...(.."� �t"1� ,�
_ ...................... ......... _... .. __ ._ _..... _.._.._
S
PROPOSED NEWSQUARE FOOTAGE FOR THIS PROJECT:
1st Floor: s . ft. 2° Floor: -Sq. ft. 3' Floor: _ ft.
Basement: s . ft. Garage: s . ft._ Deck/Cvrd Porch: s , ft,
Other: _s2. ft. Retainin Wall: Yesr7 No Fire S rinklers: Yes No
Occu anc Grou (s): Occupant Load(s): T e(s) of Construction
Grading: Cut cu. ds. Fill cu. ds, 11 Cut/Fill in Critical Area: Yes No LJ
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 Edttte nds
Print Name; .. Owner E]Agent/Other ❑ (specify): 6y& c k r
Signature: � Date. ..` "2b 20f r
FORD E L:\Building New Folder 2010\DONE & x-ferred to L Building -New drive\Form E 2014.docx Updated: 1/17/2014