20170627162650.pdf6
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 06/27/2017 Pennit#: BLD20170831
Expiration Date: 12/19/2017
Parcel No: 00610600300501
AMATA THAI LLC
22804 1 OOTH AVE W
EDMONDS, WA 98020
Project Address: 22804 1 OOTH AVE W, E DMON DS
BUDGET ROOFING LLC
C/O JEFFERY MORGAN
1709 N 160TH ST
SEATTLE, WA 98133
(206) 588-2073
BUDGET ROOFING LLC
C/O JEFFERY MORGAN
1709 N 160TH ST
SEATTLE, WA 98133
(206) 588-2073
LICENSE #: BUDGERL847LW EXP:06/16/2018
INTERIOR MINOR DEN40 OF PONYWALLS, CARPEr, MNERAL CLEANING FOR FUTURE TI.
VALUATION: $0.00
PERMIT TYPE: Commercial
PERMIT GROUP: 23 - Demolition
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: OXO FT)
CODE
IOTHER: ------- OTHER DESC:
IZONE
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
FRONTSEI'BACK SIDESETRACK 14 FA 11 S FTR ACK
REQUIRED: PROPOSED: REQUIRED: PROPOSED: REQUIRED: PROPOSED:
FIEIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED:
3ETBACK 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 RELATINGTO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27
TI IISAIRLIC&T ION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR I 11S/I 1I:R DEPUTY AND ALL FEES ARE PAID
e 1^,/ / "No
Signature Print Narre Datej --7/ 1-7 Relbased By Did
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/ IBC1 101 IRCI 10.
ONLINE APPLICANT ASSESSOR FX1 OTHER vils
STATUS: ISSUED BLD20170831
• 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 thejob 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 con ' struction activity are exempt fromthe 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 inderrinify 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 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.
• DEMO - Scope of work is limited to derno of non -loading bearing pony walls, removal of old furnishing, paint, clean. No
further work is to start until TI is issued. This permit does not guarantee the timeline or issuance of TI permit.
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
PERMITTIME LIMIT: SEE ECDC 19.00.005(A)(6)
I CALL FOR INSPECTIONS *7-71RE(42�) 77�-77_10
I BUILI)ING (425)771-02201XV, 133, ENGINEERING (425) 771-0220 EXT. 1326
PUBLIC WORKS (425) 771-0235 PRE-TREATNIENT (425) 672-5755 RECYCLING (425) 27�54801
When calling for an inspection please leave the folloMng information: Permit Number, Job Site Address, Type of Inspection being
requested, Contact Name and Phone Number, Date Prefereed. and vðer vou i)refer mornine or afternoon.
. B-Final Demolition
OV ED410
Al
DEVELOPMENT SERVICES
-FAMILY BUILDING
COMMERCIAL & MULTI
PERMIT APPLICATION
.6, 121 5h Avenue N, Edmonds, WA 98020
City of Edmonds Phone 425.771.0220 2 Fax 425.771.0221
PLEASE REFER TO THE COMMERCL4L & MULTI-FAMILYBUILDING CRECKLISTFOR SUBAffTTAL REQUIREMENTS
PTOXECT ADDRESS Street, Suite #, City State, Zi ).
Parcel #:
Subdivision/Lot
Project Valuation:
APPLICANT:
Ar
Phone-
1206 -.* 9�_(_2- k'I'l?
Fax:
Address (Street ity, Statwip) PlIv/
192- C77 It
E-Mail Odr�� r
if?T -�'t- �&? lond e�MOJJ'16
PROPERTY OWNER- I-
'P M,;/"- .74q" L 4 c
�J Wg(?
4hTf , ws-'
Fax:
Address (Street, Cit��Stte ZF*)*
W I/ (e/
E-Mail Address:
rj'�� 47 pe e)7� i_;1oy 14
�j�rG AGENCY:
Phone:
Fax:
�111%� (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:*
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address
*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
WA State License #/Exp. Date:
City Business License #/Exp. Date:
1?N -
DETAIL THE SCOPE OF WORK: )0-e ��o ncg n /C 40"^/ 1.*7& Pon 6067 //1
1 '-7
n -49 tv /h a �- F
PROPOSED NEW SQUARE FOOTAGE FOR TMS
PROJECT:
1 st Floor: sq. ft.
2'd Floor: sq. ft.
3' Floor: sq. ft.
Basement: sq. ft.
Garage: sq. ft.
Deck/Cvrd Porch: sq. fftt
Other: sq. ft.
Retaining Wall: YesM
No
Fire Sprinklers: Yes No
Occupancy Group(s):
Occupant Load(s):
Type(s) of Construction:
Grading: Cut cu.yds. Fill —cu.yds.
I Cut/Fill in Critical Area: Yes L-1 No [_J
Ideclare underpenalty ofperjury laws that the information Ihaveprovided on thisformlapplication is true, correct and
complete, andthatIam theproperty owner or duly authorized agent of the property ownerto submit a permit application to
the City of Edmonds.
e- —, 1) 0
Print Name: J le OwnerElAgent/Othe (Specify):
Signature: L1_ Date:
V
coiz,
FORME LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Forin E 2014.docx Updated: 1/17/2014