20170404105910.pdf0 A,, 0
CITY OF EDMONDS
PHONE: (425) 771-0220 - FAX: (425) 771-0221
121 5TH AVENUE NORTH - EDMONDS, WA 98020
STATUS: ISSUED 04/04/2017 Permit #1: B LD201 7 0442i
i
BLJILI)ING'PERMIT
Expiration Date: 10/04/2017 ProjectAddress: 23707 1()-2 ND PL W, EDMONDS
Parcel No: 00405800001300
JAMES C FEGLER
23707 102ND PL W
EDMONDS, WA 98020-5766
(206) 909-3825
RB-ROOF; NO SHEA THING
VALUATION: $0.00
B & B ROOFING
CIO STEVEN BERNDT
1823 QUEEN ANNE AVE N
4 301
SEATTLE, WA 98109
(206) 632-7221
B & B ROOFING
C/O STEVEN BERNDT
1823 QUEEN ANNE AVE N
4 301
SEATTLE, WA 9 8109
(206) 632-7221
LICENSE #: BBROO* * I I I N I
EXP:04/22/2018
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:
OTHER ------- OTHER DESC:
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
BEDROOMS: 0 BATHROOMS: 0
BEDROOMS: 0 BATHROOMS: 0
FRONI SEUBACK SIDESFIFBACK RLAR S FTB ACK
REQUIRED: PROPOSED: REQUIRED: PROPOSED: FR—EQUIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED.0 IREQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHE WORK AUTHORIZED
,LTHEREBY, 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
' .1111S
I'll[SAPPLICATION ISNOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL ORHISIHERDEPUTY AND ALL FEESARE PAID.
4�6ie . '7
L 42
Signature Print Narne Date Released By
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 OTHER
STATUS: ISSUED CONDITIONS BLD20170442
• 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. Cbeckthe 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 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 7:00am to 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 Cbapter 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
hanydess 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.
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.
BUILDING
PERMIT TIME LIMIT. SEE ECDC 19.00.005(A)(6)
771-0220 EXT. 1326
I PUBLIC WORKS (425) 771-0235 1 PR&TREATMENT (425) 672-5755 T -RECYCLING (425) 27�5-4801 �
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection being
requested, Contact Name and Phone Number, Date Prefereed, and whether vou urefer mornine or afternoon.
• B-Roof Tear Off
• B-Building Final
C, I- EDAI 0
DEVELOPMENT SERVICES
RESIDENTIAL BUILDING PERMIT
APPLICATION
121 5h Avenue N, Edmonds, WA 98020
City of Edmonds Phone 425.771.0220 9 Fax 425.771.0221
PLEASE REFER TO THE RESIDENTIAL BUILDING CHECKLIST FOR SUBMITTAL REQUIREMENTS
WS (Street, Suite
PROJECT ADD S City State, Zip):
2, 0 -7 &�2
Parcel #:
Subdivision/Lot #:
Project Valuation: $
APPLICAI�U: 662Vb 7
Phone:,,.,,
I Fax:
Address St t C*t State. ip):
1 '09 A-")-J&A_) 44-301
E-N�ail Ad I
" 5 - f '4 L.,) u'j' L, 'e, V 4 A-� Z.0 IV. ce.
PROPERTY OWNER:
Phone:
-za. q0q -3gz1r
Fax:
I
Address (Street, Cit State, Zip):
-,7?) -�'D -7 - f C) -2- 2 L
E-Mail Address:
LENDING AGENCY:
Ile
Phone:
Fax:
I
Address (Street, City, State, Zip):
E-Mail Address:
C,ONTRAC-'PnR:
Phone:
7 0 b H 7-- -_3 2-2- 1
Fax:
S
Add s (Street, City, tateo�V /U __,4_3( e-4 rX,%111y
- *1 Add
E ail '�\
,e6l T&oOLIAW41 I
1�1 ,
*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 NE xp D e: .
% 8 (zoo -)io i , 11 ti I
City Business License #/Exp. Date:
DETAIL THE SCOPE OF WORK: V,-M W,6q"- , :0057-ALl-
1_�;4kbZM
V-9015
PROPOSED NEW SQUARE F
OTAGE FOR THIS PROJECT:
Basement: sq. ft.
Select Basement Type: Finished LJ Unfinished7
0 Floor: sq. ft.
Garage/Carport: sq. ft.
2 n('Floor: sq. ft.
Deck/Cvrd Porch/Patio: sq. ft.
Bedrooms # Full-3/4 Bath # Half -Bath #
Other: sq. ft.
Fire Sprinklers: Yes
El
No
Retaining Wall: Yes
No
Grading: Cut —cu. yds. Fill __cu.yds.
Cut/Fill in Critical Area: Yes U No
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 C:n?,J Owner 1-1 Agent/Other N (specify): 0_VA1t&C070_
_;5 —
Signature: Date:
FORM A LABuilding New Folder 201000NE & x-ferred to LBuilding-New drive\Form A2014.docx Updated: 1/17/2014