20170608163218.pdfov. Foko
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 06/08/2017 Pail* ft, B LD121 171769
Expiration Date: 12/08/2017 I'mico Addrv%s: 1 137 6TH AVE S, EDNIONDS
Parcel No: 00619400700702
SELECT HOMES
SELECT HOMES INC.
SELECT HOMES INC.
CIO KAYLA CLARK
CIO RANDY & JUDY CLARK
CIO RANDY & JUDY CLARK
16531 13TH AVE W STE A107
16531 13TH AVE W SUITE A] 07
16531 13TH AVE W SUITE A107
LYNNWOOD, WA 98037
LYNNWOOD, WA 98036-
LYNNWOOD, WA 98036-
(425) 742-6044
(206) 963-3787
(206) 963-3787
LICENSE #: SELECHI I I OKN EXP:12/31/2018
RE -ROOF OF ACCESSORY STRUCTURE
VALUATION: $0.00
PERMIT TYPE: Commercial
PERMIT GROUP: 54 - Re-Roof/RoofAlter/Repair
GRADING. N CYDS: 0
TYPE OF CONSTRUCTION
RETAINING WALL ROCKERY
OCCUPANT GROUP
OCCUPANT LOAD:
FENCE: 0 X 0 FT.)
CODE: 2015
OTHER: ------- OTHER DESC:
IZONE:
INUMBER OF STORIES: 0
IVESTEDDATE
NUMBER OF DWELLINGUNITS: 0
1 - O'l" 11
BASEMENT: 0 151* FLOOR: 0 2ND FLOOR: 0
BASI.-.MENT. 0 1 ST FLOOR: 0 2ND FLOOR 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
BEDROOMS: 0 BATHROOMS: 0
BEDROOMS: 0 BATHROOMS: 0
FRONTSFTBACK SlDESFrBA('K REARS "-'BA('k
REQUIRED: PROPOSED: IREQUIRED: PROPOSED: IREQUIRED: PROPOSED:
HEIGHT ALLOWED-0 PROPOSED 0 IREQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULAT ING 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.
TI IIS APPLICATION ISNOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS(HER DEPUTY AND ALL FEES ARE PAID.
lx�'Zll"Llzv e'-wialk"'((- V Wlv� <�, i(Ah-7
Print Name/ Date ( I Released By L--1 Date
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTTFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBCI 09/ IBC1 10/ IRCI 10.
ONLINE APPLICANT ASSESSOR 10 OTHM
-STATUS: ISSUED BLD20170769
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 7:00arnto 6:00pm on weekdays and 10:00am and 6:00prn 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.
INSPILCTIONS
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCT10N ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6)
CALL FOR INSPECTIONS
BUILDING (425) 771-0220 EXT. 133' , ENGINEERING (425) 771-0220 EXT. 1326 FIRE (425) 775-7720
PUBLIC WORKS (425) 771-0235 PR&TREATMENT (425) 672-5755 RECYCLING (425) 2754801
When calling for an inspection please leave the follovving information: Permit Number, Job Site Address, Type of Inspection being
reques te(L Contact Name and Phone Number, Date Prefereed, and Mbether you I)refer mornine or afternoon.
• B-Roof Tear Off
• B-Building Final
'City of Edmonds
eli�Do��
'�LOPMENT SERVICES
PLUMBING,_MECRANICAL, TANK, & DEMOLITION
PERZAIT ATION
th Edmond �V
nu Edmonds, WA 98020
0 x
Phone 425.771.022 x 4�25.771.0221
PLEASE REFER TO THE PLUMBING & MECHANICAL CHECKLIST FOR SUBMJTTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
Pa reel #:
�A 0k 0
Associated Permit #:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes F-1 No E]
APPLICANT:
Phone:
Fax:
Se-12,C—L ikQMXS,
Address (Street City, State, Zip):
E-Mail Address:
S':�k hJf-- UJ- Sk A104- Ul"I'LA00d, 1AJ4 W1
a (11 CICArV QV Oak—
PROPERTY OWNER:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
IUS!11 t3rtu *Je-- &J - 4101- 1-4111.16'"410144 WH %03 1-
LENDING AGENCY:
Phone:
Fax:
A)
Address (Street, City, State, Zift.
E-Mail Address:
CONTRACTOR:*
Phone:
Fax:
sf_[�_Cjk konAi-c" ty1c.
q-t,; . �N &,u _jq
"Z. - 50&
Aodress (Street, City, State, Zip):
E-Mail Address:
KO-S4 (a -
WA StateLicense #/Exp. Date:
*Contractor must have a valid City ofEdmonds business license prior to doing work
in the City. Contact the City Clerk's Office at 425.775.2525
City Business License #/Exp. Date:
PERMITAPPLICATION FOR
PLUMBING MECHANICAL TANK I
DEMOLITION
DETAIL THE SCOPE OF WORK: KICLA-) Voo� P-n� M_Cessone::� bW la�ne
I declare underpenalty ofperjury laws that the information Ihaveprovided on thisforneapplication is true, correct and complete,
and that I am theproperty owner or duly authorized agent of theproperty owner to submit apermit application to the City of
Edmonds.
Print Name: K&' Owner wAgent/OtherE] (specify):
Signature: Date:
101
FORMC L:\Building New Folder 2010\DONE & x-ferred to L-Building-New drive\Form C 2014.docx Updated: 1/17/2014