20170629135200.pdf4 All
Al
1P CITY OF ED14
121 5TH AVENUE NORTH -EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 06/29/2017 Pertmitif: BLD20170881
Expiration Date: 12/29/2017 Project v1dwss: 19205 80TH ANT W, EDINIONDS
Parcel No: 00573000000200
AVIN B SIMPSON
CR MASTER ROOFING
CRMASTERROOFING
19205 80TH AVE W
23229 97TH AVE W
CIO ODILIO MATA CAMBRONERO
EDMONDS, WA 98026
EDMONDS, WA 98020
23229 97TH AVE W
EDMONDS, WA 98020
(425) 314-1050
(206) 446-9297
(206) 446-9297
LICENSF #: crroor19361<5 EXP:06/29/2019
TEAR OFF 3 LAYERS OF TORCH DOWN, FIX DRYROT AND INSTALL 60 MILPVCMEMBRANE
VALUATION: $0.00
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: 2015
OTHER: ------- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
N ( I M BF IZ OF DWELLING UNIT S: 0
LOT #.
Mllkqmm��
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
BASF-MENT. 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FLOOk 0, GARAGE: 0 DECK: 0 OTHER: 0
—13RD
BEDROOMS: 0 BATHROOMS: 0
JBEDROOM& 0 BATHROOMS: 0
FRONTSFIrBA('K SII)FSFI'BA(_K REA 11 S ETR A('k
REQUIRED: PROPOSED: — ��REQUIRED: PROPOSED: 77RE—QUIRED: PROPOSED
HEIGHT ALLOWED.0 PROPOSED:O IREQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE 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
1 [IS APPLICATION IS NOT A PERMIT UNTIL SIGNED 13Y THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID
>
tig-nafuee b/ f5riht Name Date f Released BY 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.
ONUNE APPUCANT ASSESSOR =OTHER
STATUS: ISSUED BLD20170881
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. 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 firnits
of ECC Cbapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00arn and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all othertimes 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
harinless 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 pennit. Issuance of this pen -nit 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 CA LL FOR INS PIX'TIONS
I BUILDING (425) 771-0*_2>0 EXT. 1333 FNGINITRING (425) 771-02-)01.7XT. 1326 FIRE(425) 775-77 0
PUBLIC WORKS (425) 771-0235 PRE-TREATMENT 1425) 672-5755 RFJCYCUNG (425) 275-480�1
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 Drefer mornine or afternoon.
• B-Roof Tear Off
• B-Building Final
_�� 1- �1,/ go / -7 -0 HE /
OV,
UA DEVELOPMENT SERVICES
RESIDENTIAL BUILDING PERMIT
APPLICATION
121 5h Avenue N, Edmonds, WA 98020
City of Edmonds Phone 425.771.0220 A Fax 425.771.0221
PLEASE REFER TO THE RESIDENTIAL BUILDING CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDREIS (Street Suite # City State, Zip
Parcel #:
1Q22qS
Subdivision/Lot #:
Project Valuation: $
AP Ic A
Fax:
IVY
A-dd-ress (Street qity, State, J
E Mail Address:
JACIx, 44�k
PVrERTY 6WNER-
lione: Fax:
- I
&- M 2,
Address (Street, CIt , State, Zip)':
9 nZ�l il" 4 � �,-z
E-Mail Address:
-4
LENDING AGENCY: 9MX
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CON T
2honc-
Fax:
Address (Street, City,
E-Mail Address:
�Z 2,1 JZJW_-9&&
Tn
/�Mi4c-
WA State License #/Exp. Date:
*Contractor must have a valid City of Edmonds business license prior to
C_ C?l Qnn T2_ L—A 6 r- 6
City Business License #/Exp. Date:
doing work in the City. Contact the City Clerk's Office at 425.775.2525
DETAIL THE SCOPE OF WORK: 5 r) C-�o
Ct nn:4-2
L) v-rk AQ ev.
PROPOSED NEW SQUARE F
OTAGE FOR THIS PROJECT:
Basement: sq. ft.
Select Basement Type: Finished L] Unfinished Li
V Floor: sq. ft.
Garage/Carport: —sq. ft.
Deck/Cvrd Porch/Patio: sq. ft.
-7 Floor: sq. ft.
Bedrooms # Full-3/4 Bath # Half -Bath #
Other: SQ. ft.
Fire Sprinklers: Yes
1
7 No
7
Retaining Wall: Yes[—]
Nol
I
Grading: Cut —cu. yds. Fill cu.ydS.
Cut/Fill in Critical Area: Yes L_] NoE]
I declare under penalty ofperjury laws that the information I have provided on this formlapplication is true, correctand
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::::: e LL h (711 M_ ' OwnerEl Agent/OtherEl (specify):
Signature: Date:
FORM A LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Form A2014.doex Updated: 1/17/2014