20170627132923.pdf0 4.1
PHONE: (425) 771-0220 - FAX: (425) 771-0221
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
STATUS: ISSUED 06/27/2017 Pemitift: BLD201"08-63
BUILDING PERMIT
Expiration Date: 12/27/2017 ProjettAddruss: 1130 5TI-LAVE S #300, EDNIONDS
Parcel No: 00691200130000
BEVERELY ROSS BOYCE PYRAMID CONST & RPR LLC PYRAMID CONST & RPR LLC
1130 5TH AVE S UNIT 300 CIO GARY ROSS CIO GARY ROSS
EDMONDS, WA 98020-4668 4913 PORTALIS WAY 4913 PORTALIS WAY
ANACORTES, WA 98221 ANACORTES, WA 98221
(425) 330-8180 (425) 471-1238 (425) 471-123 8
LICENSE #: ovramcr990im EXP:09/10/2017
REMOVE WINDOWS FROM DECK APPROXIMATLY2 LARGE AND 2 SMALL WINDOWS ON INSIDE OF DECK 1/2 WALL
INSTALLING HARDIE BORAD. REN40VE 4 OUTLETS AND ONE HEATER -
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 23 - Demolition
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY:
OCCUPANT GROUP
OCCUPANT LOAD:
FENCE: 0 X 0 FT.)
CODE: 2015
OTHER: ------- OTHER DESC:
ZONE,
NUMBER OF STORIES: 0
VESTED DATE:
I NUMBER OF DWELLING UNIT & 0
ILOT
ENISTING kl4l"A
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
1114011(),SE ' 1) Alt EA
ASEMENT� 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
BEDROOMS- 0 BATHROOMS: 0
BEDROOMS: 0 BATHROOMS: 0
FRONTSE-FBACK SIDESEMACK REA 11 S FTB ACK
REQUIRED: PROPOSED: ��REQUIRED: PROPOSED: 7RE—QUIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O ]REQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHE 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.
'I'l-IIS APPMVITION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID.
j -771 z— X�-4za&a, g�� 0�12-712-017
SigWature Print Name Date( Released Bv 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. UBC1091 IBCI 10/ IRCI 10.
ONLINE APPLICANT ASSESSOR Lz] OTBm
STATUS: ISSUED BLD20170863
-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 aftemate 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 7:00amto 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
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.
PERMIT TIME LIMIT. SEE ECDC 19.00.005(A)(6)
I PUBLIC WORKS (425) 771-0235 1 PRFTREATMENT (425) 672-5755 1 RECYCUNG (425) 275-4801 1
When calling for an inspection please leave the follovving information: Permit Number, Job Site Address, Type of Inspection being
requested, Contact Name and Phone Number, Date Prefereed, and mbether vou m-cfer mornine or afternoon.
• B-Window Tear Off Inspection
• B-Budding Final
!V
Un DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
121 5h Avenue N, Edmonds, WA 98020
Phone 425.771.0220 It Fax 425.771.0221
City of Edmonds
PLEASE REFER TO THE PLUMBING & MECHANICAL CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
Parcel #:
//,-3 6
Associated Permit #:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? YesE] No [jj`
APPLICANT: 57J ( p '4�,t4l'a e,
'Yoe
Phpne:
-
117 q71
Fax�.�
Add S (Street, City, State, ZT-):
E-Mail Address:
0, /_::3bA( q Z_
J'Y 0
PROPEjC WNER:
Phone:
- 36_?I;
3 01
Fax:
Address (Street, City, State, Zip): t4lVi7-300
E-Mail Address:
g:;o
0 5_.�W 4V L_ C41A,
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:* 42-PC
12&PA1#2
Phone:
44�-;;7J
Fax:
Ap,ress (Street, City, State, Zip):
0, 130,< X2_57�Vf
E-Mail Address:
61*#. C041
WA State License #/Exp. Date:
*Contractor must have a valid City of Edmonds business license prior to doing work
f:'Y1Z,4A4C_1Z'7963-^� I
City Business License #/Exp. Date:
in the City. Contact the City Clerk's Office at 425.775.2525
PLUMBING MECHANICAL TANKI
I DEMOLITION
DETAIL THE SCOPE OF WORK: J// A3&
e-
-7 Z AA
:5 jae
/2 S ID f2 Y W64-
3CO
I declare under penalty 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: Owner D Agent/Other [�(specify):
Signature: A
f /1-0 LI
FORMC LABuilding New Folder 201000NE & x-ferred to L-Building-New drive\Form C 2014.docx Updated: 1/17/2014
MEDICAL GAS, AIR, VACUUM
Type of Gas/AirNacuum System (new and relocated)
Total#
Oxygen
Nitrous Oxide
Medical Air
Carbon Dioxide
Helium
Medical - Surgical Vacuum
Other:
I TOTAL OUTLETS
TANK #1
TANK #2
Method of Abandonment
Method of Abandonment
Fill in Place D Fill Material
Fill in Place
Fill Material
Removal F-1
Removal
Number of Gallons:
Number of Gallons:
Critical Areas Determination: Study Required
Conditional Waiver E
WaiverEl
Type of structure to be demolished (e.g. house, shed, garage, etc.): - s'v0o,,, 5 -#. _4L-.,vvl L5- T-RLl
Floor area of structure to be demolished: / Z— )e' / 2- sq.
Critical Areas Determination: Study Required Conditional Waiver E Waiver El
PSCAA Cas No.
AHERA Survey done? (required)
Additional comments:
FORM C LABuilding New Folder 2010\DONE & x-ferred to LBuilding-New drive\Form C 2014.docx Updated: 1/17/2014