20170803082751.pdfCITY OF EDMONDS
121 5TH A NENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
C. I
STATUS: ISSUED 08/03/2017 Pennit#: 13LD20171061
Expiration Date: 02/05/2018 Project Address: 10421 228TH ST SW, EDMONDS
Parcel No: 27032500311300
TERRY & ANN BARTON
NW BLUE SKY REMODELING LLC
NW BLUE SKY REMODELING LLC
10421 228TH ST SW
C/O GRACIELA RODRIGUEZ
C/O GRACIELA RODRIGUEZ
EDMONDS, WA 98020-5104
13031 123RDLNNED-101
13031 123RDLNNED-101
KIRKLAND, WA 98034
KIRKLAND, WA 98034
(206) 226-3420
(206) 290-0662
(206) 290-0662
LICENSE #: NWBLUBS843K7 EXP:05/27/2018
RB-ROOF; SHEATHING INCLUDED
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:
OTHER: ------- OTHER DESC:
ZONE:
INUMBER OF STORIES 0
VESTED DATE:
NUMBER OF DWELLING UNIT S: 0
LOT 4
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
BEDROOMS: 0 BATHROOMS: 0
BEDROOMS: 0 BATHROOMS: 0
FRONTSETBA('111. SIDESFFBACK REAR S L-1'11 ACK
MQUIRED: PROPOSED: REQUIRED: PROPOSED: IREQUIRED: PROPOSED:
]EIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED-
ETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHE WORK AUTHORIZED
THEREBY, N1161ERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATINGTO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
T 1 US fwvl/,ION IS NOT A PERMIT UNT�11. SIGNED BY THE BUILDING OFFICIAL OR HISMER DEPUTY AND ALL FEES ARE PAID.
ILA IZ
0--311-7- kklkl� 70hJIS 09131,2D17
Zw�ggture Wi6flNaryi6 Date / / ' 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 I O/IRCI 10.
ONLINE APPLICANT = ASSESSOR 521 OTIIER
STATUS: ISSUED BLD20171061
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. Cbeck 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.
• 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 7:00arnto 6:00prn on weekdays and 10:00arn 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
harntless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly froth the issuance for this pen -nit. 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.
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)
CALL FOR INSPECTIONS
BUILDING (425) 771-0220 EXT. 1333 ENGINEERING (425) 771-0220 EX1,. 1326 FIRE(425) 775-7720
I PUBLIC WORKS (425) 771-0235 1 PIR&TREATMENT (425) 672-5755 1 RECYCLING (425) 275-4801 1
When calling for an inspection please leave the folloming information: Permit Number, Job Site Address, Type of Inspection being
reques ted, Contact Name and Phone Number, Date Prefereed, and vibether you prefer mornin2 or afternoon.
• B-Roof Sheathing
• B-Building Final
DEVELOPMENT SERVICES
RESIDENTIAL BUILDING PERMIT
APPLICATION
1215 Lh Avenue N, Edmonds, WA 98020
Phone 425.771.0220 2 Fax 425.771.0221
City of Edmonds
PLEASEREFER TO THERESIDENTIAL BUILDING CHECKLISTFOR SUBM17TAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, Cit St te, Zin):
Q T -
.97-5 W PY27--twe'.11 WA72.�c,?z
Parcel #:
Subdivision/Lot #:
Project Valuation: $
APPACANT:
Cq C'A dwvyc�,
Phone:
Fax:
I
Address (Streeft -City, State, Zip):
I k 4 ko M t` I 7-WEE sr -11
E-Mail Address:
ry we,.� f,6 6 r Wee, eo;"
PROPERTY OWNER:
Phone:
Fax:
Address (Street, City, Stv, Zip):
JC1 ,;7 -7-5 Ed
*0,20
'13-Mail Address:
�L(76A 53 9-VO k,4e9. Cel^_
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTIRACTOR; *
, on:
6
Fax:
Address (Street, City, State, Zip):
1L) (C7 J01�7 - 7- 41 V Y-; dq(fnal
UA-_
M,
-E- -ail Address:
AbIA1UPS-�-bS
4�t
*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 #[E-xp. Date:
z h
City Business License #/Exp. Date:
DETAIL THE SCOPE OF WORK: M N P rA S A // YL,
- 'T&-� -, r O'n 0 C bA
( 30 ys� S CotrAZS Z �Z-r) el. r
-
PROPOSED NEW SQUARE F
OTAGE FOR THIS PROJECT:
Basement: sq. ft.
Select Basement Type: Finished LJ Unfinished LJ
I s' Floor: sq. ft.
Garage/Carport: —sq. ft.
2 d Floor: sq. ft.
Deck/Cvrd Porch/Patio: sq. ft.
Bedrooms # Full-3/4 Bath # Half -Bath #
Other: sq. ft.
Fire Sprinklers: Tes [_] No El
I Retaining Wall: Yes L]
=0
Eq
Grading: Cut —cu. yds. Fill --cu.yds.
I Cut/Fill in Critical Area: Yes U No
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.
_�;r5f,Vj, Aqg_-2
Print Name: Owner E]Agent/Other (specify): WV Y-"
Signature: Date:
FORM A LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Form A2014.docx Updated: 1/17/2014