20170302152026.pdf0%:
CITY OF EDMONDS
121 5TH AVENUE NORTH -EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 03/02/2017 Pttmk* RJAW 7=4
B LJILD M G PER M IT
Expiration Date: 09/04/2017 Prt�jcct.kddress: 1813.� 86TH PL W, E-DNIONDS
Parcel No: 00612400000500
WILLIAM JR & ELIZABETH TR
WILLIAM JR & ELIZABETH TR
OWNEREXEMPTION
BARNSDALE
BARNSDALE
CIO WILLIAM JR & ELIZABETH TR BARNSDALE
18133 86TH PL W
18133 86TH PL W
18133 86TH PL W
EDMONDS, WA 98026
EDMONDS, WA 98026
EDMONDS, WA 98026
(425) 743-9951
(425) 743-9951
(425) 743-9951
LICENSE #. EXP:
SEE ATTACHED LETTER FOR SCOPE OF WORK.
TIES PERMIT FOR FINAL INSPECTION
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 43 - Miscellaneous
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: OXO FT)
CODE: 2015
OTHER: ------- OTHERDESC:
ZONE:
.NUMBER OF STORIES: 0
VESTED DATE:
NUMBER �OF DWELLING UNITS: 0
LOT
I
ASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
# 0
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 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
FRONTSFTRACK SII)ESFfBA(_K [ILA 11 S FTB ACk
REQUIRED: PROPOSED: IREQUIRED: PROPOSED: =REQUIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING 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.
[IS APPLICATION IS NOT A PERMIT UbrrJY SIGNED BY THE BUILDING OFFICIAL OR HISA IE'R DEPUTY AND ALL FEES ARE PAID.
111&4 _e) o3lol/�017
J. 2
Releas
Date
ATTENTION
ITTS UNLAWFUL TO USE OR OCCUPY A BUILDrNG OR STRUCTURE UNTIL A FrNAL rNSPECTION HAS BEEN MADE AND APPROVAL ORA CERTTFICATE OF
OCCUPANCY HAS BEEN GRANTED-UBC109/ IBC1 10/ IRCI 10.
F-1 ONLINE APPLICANT = ASSESSOR 1z) OTHM
STATUS: ISSUED BLD20170310
CONDITIONS
• 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 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.
SoundNoise originating fromtemporary construction sites as a result of construction activity are exempt from the noise fin-rits
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 fronithe issuance for this permit. Issuance ofthis 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.
PERMIT TIME LIMIT. SEE ECDC 19.00.005(A)(6)
I PUBLIC WORKS (425) 771-0235 _F PR&TREATMENT (425) 672-5755 1 RECYCLING (425) 2754801 -1
When calling for an inspection please leave the follo-Aing information: Permit Number, Job Site Address, Type of Inspection being
reques ted, Contact Name and Phone Number, Date Prefereed, and whether vou vrefer morninp- or afternoon.
. B-Building Final
DEVELOPMENT SERVICES
RESIDENTIAL BUILDING PERMIT
APPLICATION
1215 th Avenue N, Edmonds, WA 98020
Phone 425.771.0220 9 Fax 425.771.0221
City of Edmonds
PLEASE REFER TO THE RESIDENTIAL BUILDING CHECKLISTFOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
g 1.13 2 6'04 P1 aep W r= 0 tO MAS, WA- 19026
Parcel #:
Subdivision/Lot #:
Project Valuation: $ LJ/_4_
APPLICANT� .
gill jt�
Phone:
Fax:
Address (Streci, City,�,%ate, Zip):
E-Mail Address:
bWUM&&g W @-44,41� -
PROPERTY OWNER: _5'Amrr-
As IPA-Fea(�&vr
Phone:
r ax:
Address (Street, City, State, Zip):
E-Mail Address:
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:*
Phone:
Ad��t, City, State, Zip):
E-Mail Address:
*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
WA State��hsc #/Exp. Date:
�Ousiness License #/Exp. Date:
DETAIL THE SCOPE OF WORK:
315is-
0,TT;kC4e,0 i_0TTC-R
.3
A4.,,,&n alp 2-01s - 0
C)"w
PROPOSED NEW SQUARE FOOTAGE
FOR THIS PROJECT:
Basement:
Select Basement Type: Firjshad�_] Unfinished LJ
1" Floor:
sq. ft."-�
Garage/Carport:- Z —sq. ftJ
2"d Floor:
—sq. ft. ��
Deck/Cvrd PorchoKtio: so. A.
Bedrooms # FuJ14_ A Bath #
Half -Bath
,,Other- I--,' sq/ft.
Fire Sprinklers: )A
"
No
L]
Nainiag'Wall: Yes L] :: �O
\11/
Grading: Cut cu. yds.
Fill cu.yds.
I Cut/Fill in Critical Area: Yes L_J No LJ
I declare underpenalty ofperjury laws that the information I have provided on this formlapplication 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: -.4vlt U1, OA&
-1 o�, TV, Owner [� �Agent/OtherE] (specify):
Signature: Date: a,"
FORM A LABuilding New Folder 2010\130NE & x-ferred to LBuilding-New drive\Form A2014.docx Updated: 1/17/2014
DEVELOPMENT SERVICES
RESIDENTIAL BUILDING PERMIT
APPLICATION FORM A
121 5h Avenue N, Edmonds, WA 98020
City of Edmonds
Phone 425.771.0220 t Fax 425.771.0221
Equipment Type
AppliancelEquipment Information (new and relocated)
Total #
Furnace
Gas #YElec #—Other:
# — BTUs: <100k— >100k-- Location(s) Artf_�C-
Air Handler / VAV
Gas #_!:�`Elec #_Other:—
#—CFM: <10k. >10k_ Location(s) Aid c-
(circle selected)
AC / Compressor
Boiler / Heat Pump
Gas #—Elec #—Other:—
# BTUs: <100k, 100k-500k, —500k-IMil
Roof Top Unit
HP: <3,3-15,15-30
Location(s)
(circle selected)
Hydronic Heating
Gas #—Elec #—In-Floor
—Wall Radiant Boiler BTUs: Location
Exhaust Fans (single
Bath # 3 Kitchen #_LLaundry # #
duct)
—LOther:
Fireplace
Gas #—Elec #—Other:—
# Location(s)
Dryer Duct
/Vo WDAK WA-5 061\/C- T-D
Appliance Type
Appliance/Equipment Information (new and relocated)
Total #
AC Unit
BTUs:
Location(s):_
Furnace
BTU's:
Location(s):
Water Heater
BTUs:
Location(s):
Boiler
BTUs:
Location(s):
Other:
BTU's:
Location(s):_
Fireplace/Insert
BTUs:
Location(s):
Stove/Range/Oven
Dryer
Outdoor BBQ
TOTAL OUTLETS
Pl-tJN111ING
Fixture Type (new and relocated)
FlX'lJJl?F COUNT
Total # Fixture Type (new and relocated)
Total #
Water Closet (Toilet)
I
Pressure Reduction Valve/Pressure Regulator
WA
Sink(kitche). laundry, lavatory, bar, eye wash, etc.)
Water Service Line
Tub/ghwlo'wer
Drinking Fountain
Dishwasher
Clothes Washer
Hose Bib
Backflow Prevention Device (e.g. RBPA, DCDA, AVB)
(,J/ft
oem�
�Vater Ilea r Tankless? Yes 9 NoE]
t4 f, itJ
Hydronic Heat in: FloorE] WallE]
Floor -Drain/Floor Sink
Other:
Refrigerator water supply (for water/ice dispenser)
Other:
FORM A LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Form A2014.docx Updated: 1/17/2014