20170316161931.pdf01: EDAf
CITY OF EDMONDS
121 5TH AVENUE NORTH -EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
Expiration Date:
Parcel No: 00555400000900
REBECCA R & BRENDAN KELLY
GUARDIAN ROOFING
GUARDIAN ROOFING
8524 215TH ST SW
CIO LORI SWANSON
C/O LORI SWANSON
EDMONDS, WA 98026-7319
1400 W MAIN ST SUITE B
1400 W MAIN ST SUITE B
AUBURN, WA 99001
AUBURN, WA 98001
(206) 227-7780
(253) 926-9966
(253) 926-9966
LICENSE #. GUARDR'1847RO EXP:12/20/2018
RE,ROOF; SHEATHING INCLUDED.
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP 54 - Re-Roof/Roof Alter/Repair
GRADING. N CYDS: 0
TYPE OF CONSTRUCTION
RETAINING WALL ROCKERY:
OCCUPAN GROUP:
OCCUPANT LOAD -
FENCE: OXO FT)
CODE: 2015
OTHER: ------- OTHERDESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS: 0
LOT
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR 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
IBEDROOMS: 0 BATHROOMS: 0
BEDROOMS: 0 BATHROOMS: 0
FRONTSF7BACK Sl[)LSFrBA('K RLAR SFI'RACK
REQUIRED: PROPOSED IREQUIRED: PROPOSED: 771—REQUIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED:10 IRFQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWSREGULATING CONSTRUCTION AND IN DOINGTHE WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATINGTO
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.
7v�—k R g&6z� 0311(ol-7-017
Signature Print Name Date
Released
Date
ATTENTION
ITIS 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. UBC109/ IBCI 10/ IRCI 10.
ONLINE APPLICANT ASSESSOR E�IOTEIER
STATUS: ISSUED BLD20170362
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 thejob card for all required City inspections including final project approval and final
occupancy inspections.
• Any request for altemate 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 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 fi-om any and all claims for damages of
whatever nature, arising directly or indirectly from the 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)
77 1 -0220 EXT. 1333 1 IISGINEERING (425) 771-0220 Ex-r. 1326 1 FIRE (425) 775-
PUBLIC WORKS (425) 771-0235 PR&TREATMENT (425) 672-5755 T RECYCLING (425) 2754
When calling for an inspection please leaw the folloAng information: Permit Number, Job Site Address, Type of Inspection being
reques ted, Contact Name and Phone Number, Date Preferced, and mbether you prefer morning or afternoon.
• B-Roof Sheathing
• B-Building Final
DEVELOPMENT SERVICES
RESIDENTIAL BUILDING PERMIT
APPLICATION
121 5h Avenue N, Edmonds, WA 98020
st, 1 Phone 425.771.0220 ft Fax 425.771.0221
City of Edmonds
PLEASE REFER TO THE RESIDENTIAL BUILDING CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
F52-q 2,1'skh ST- 3W Mmpyka--y L'"I C1602-6
Parcel #:
Subdivision/Lot #:
Project Valuation: $
APPLICANT:
C-lurAICAlavi 0 My0AW03
Phone:
cizc C19661
Fax:
Address (Street, City, State, Zip): 16001
1400 L-fe-s+ lAwil %-rc- 1?5 AU�00,11, Q"I
E-Mail Address:
PROPERTY OWNER:
[< 'BfAF_TX&t1 — &.)De_C_CC,\
Phone:
zo �, Z,?-:l iq
FFax:
Address (Street, City, State, Zip):
R,5?_J4 ?_ 1:S+ \A :5,-, C A mon CA3 VA 9 6OZ4,
E-Mail Address:
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR: *011n
(_-7ucLyckto,t\ 0�?eyckA100,Y
Phone:
Zz.2 9 2, 2 16 ( d
Fax:
Address (Street, City, State, Zip): I 160C) I
1q(!)C) u/eA Ram s-r zaa S Au)oufa wA
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 License #/Exp. Date:
G Li A \,Lt> 9- * &1 -1 fLo
City Business License #/Exp. Date:
DETAIL THE SCOPE OF WORK: 5N-\k ake.-C and (lad
S
_W,�CA rNk -s Ni ml e -Y �,ftd q(iwnnd
\3
PROPOSED NEW SQUARE F
OTAGE FOR THIS PROJECT:
Basement: sq. ft.
Select Basement Type: Finished L] Unfinished 1-1
I" Floor: sq. ft.
Garage/Carport: —sq. ft.
2 d Floor: sq. ft.
Deck/Cvrd Porch/Patio: sq. ft.
Bedrooms # Full-3/4 Bath # Half -Bath #
Other: scl.
Fire Sprinklers: Yes
D
No
El
1 Retaining Wall: Yes
L]
No
Grading: Cut —cu. yds. Fill cu.yds.
I Cut/Fill in Critical Area: Yes [_] No L]
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: T;f-d Owner 0 Agent/Other (specify):
Signature: ol-, Date:
FORM A LABuilding New Folder 2010\130NE & x-ferred to L-Building-New drive\Form A2014.doex Updated: 1/17/2014