20180611131705.pdfCTTY OF EDMOT.{DS
ilillllll
I2I 5TH AVENUENORTH. EDMONDS, WA 98020
PHONE: (425)771-0220 - FAX: (a25) 77r-0221
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STATUS: ISSITED 06ltll20l8 Pennit #: 8LD20180793
BIIILDING PERMIT
Expiration Date: l2lt[ /2018
Parcel No: 007248001 I 0300
ProjectAddress: 520 PINE ST #103' EDMONDS
PROPTRTYOWNM,APPLICANT CONTRACTOR
CLIFFORD D & MARY ANN CAMERON
8912 l92ND ST SW
EDMONDS, WA 98026
(42s) 776-0370
CLIFFORD CAMERON
520 PINE ST # I03
EDMONDS, WA 98020
(42s)'776-03'70
WALLNER PLUMBING INC
PO BOX 477
BOTHELL, WA 9804 I
(42s) 28 1 -3468
LICENSE, # : WALLNPC08 8LH qXP.0412812019
JOB DESCRIPTION
PERMIT TYPE,: Cornmelcial PERMIT GROUP: 47 - Plurnbing
GRADING: N CYDS: O TYPE OF CONSTRUCTION
RETAININGWALL ROCKERY OCCUPANT GROUP
OCCUPANT LOAD:
FENCE I OXO FT)CODE:2015
OTHER. ------- OTHER DESC:ZONE:
NUMBER OF STORIES: O VESTED DATE
NI]MBER OF DWELLINGUNITS: O
BASF,MENT:O I ST FLOOR: 0 2ND FLOOR: 0
LOT #
BASEMENT:O 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR:0 GARAGE:0 DECK:0 OTHER:0 3RD FLOOIì: 0 GARAGE: 0 DE,CK: 0 OTHER: 0
BEDROOMS:0 BATHROOMS:0 BEDROOMS:0 BATHROOMS:0
REPLACEV/ATERHEATER
VALUATION: $0
(Ðanisø Nalson Junø ll, 20l8
Signature frint Narne Released By Date
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDINC OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBCI09/ IBCI IO/ IRCI IO.
REQUIRED: PROPOSED:REQUIRED PROPOSED:REQUIRED: PROI,OSED:
REQUIRED PROPOSED:HF,lcHT ALLOWED:0 PROPOSED:0
SETBACK NOTES:
RF,ARSETBACKSIDESUTBACKFRONTSETBACK
I AGREE TO COMH.Y WTH CtrY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK
PERSON WLL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RB-ATING TO WORKIVEN'S COMPENSATION
INSURANCE AND RCW 1 8:27.
BY THE BULDNG OFFICIAL OR HIS/HER DER,lry AND ALL FEES ARE PAID,
AUTHORZEDTHEREBY, NO
THIS AFPLICATION IS NOT A FERMI-I- UNTIL SIGNED
lt
PERMIT APPROVAL
FIRE APPLICANT ASSESSOR CITY
CONDITIONS
STATUS: ISSUED 8LD20180793
Installation, use and maintenance of equipment and components shall be per manufacturer's specifications, installation
instructions, and applicable state codes. Plovide manufacture's installation instructions on site forBuilding Inspector.
In addition to the required pressure/relief valve, an approved listed e>pansion tank shall be installed on all hot watertanks. Per
UPC 608.
Final approval on a project or fural occupancy approval must be granted by the Building Offìcial prior to use or occupancy of
the building or structure. Check the job card for all required Cify inspections including final project approval and final
occupancy inspections.
Any request for altemate design, modification, variance or other administrative deviation (hereinafter "variance") fi'om
adopted codes, ordinances or policies must be specifìcalþ 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 provis ions which do not comply with city code and for which a variance has not been
specificalþ identified, requested and considered by the appropriate city offìcial in accordance with the appropriate provision
ofcþ code or state law does not approve any items not to code specifìcation.
Sound/Noise originating fromtemporary construction sites as a result of construction activity are exempt fi'omthe noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all othertimes the noise originating fromconstruction sites/activities must compþ 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 indemniff defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, aris ing directly or indirectty fl'om the issuance for this permit. Issuance ofthis permit shall not be deemed to
modifi, waive or reduce any requirements of any Cify ordinance nor limit in any way the Cþ's abilþ to enforce any ordinance
provision.
THIS PERMITAUTHORIZ ES ONLY THEWORK NOTED. THIS FERMTT COVERS WORK TO BE DONE ON FRIVATE FROPERTY ONLY. ANY
CONSTRUCTION ON THE RJBLIC DOMAIN (CURBS, SIDB/\/ALKS, DRMEWAYS, MARQUEES, ETC.) WLL REQUIRE SEPARATE PERMISSION. PERMIT
TIME LIMIr: SEE ECDC 19.00.005(A)(6)
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INSPECTIONS
TO SCIIEDULE INS P FCTIONS
BUILDING ENGTNEERTNG (425) 771-0220 EXT. 1326
1. Go to: \^Mrv.edmondswa.gov
2. Then: Senices
3. Then: Permits/Derclopment
4. Then: Online Permit lnfo
5: lf you don't hale one already, create a
login (upper right hand corner)
6: Schedule your inspection
Building Department lnspections
are now scheduled online. lf you
haw dificulties, please call the
Building Department front desk for
assistance during ofice hours.
(425) 771-0220
FIRE (425) 775-7720
PUBL| C WORKS (42s1771-0235
RECYCLT NG (4251 27 s4801
When calling for an inspection please leaw the following information: Permit Number, Job Site Address,Type of lnspection
Contact Name and Phone Num Date and whether or afternoon.
B-Plumbing Final
c' l8
BUITDING PERMIT
APPTICATION
Developmenl Services
Building Division
l21 sth Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, perm¡t status and inspection
scheduling information go to: http:/lwww.edmondswa.sovl
JOB S|TE INFORMATION/IOCATION:the work is taking place)
Job site Address: SLe +
Parcel
I a 3 subdivision:Lot /Unit/Suite #:
PROPERTY OWNER:
Name:Cli,ÇÆcÅ C-a.r¡¿sen
Mailing Address:l?e s++-ob
City/State/Zip:vtt"oy1,ÅS VJa 1borc
Phone #:7-3 - 11 -o ô
Email: lívv'e'nele>n Q'h
OWNER INSTAIIATION: *lf yes, read and sign*
Will work be performed by the property owner? ! Yes
I own, reside in, or will reside in the completed structure.
This installation is being made on property that I own which is
not intended for sale, lease, rent, or exchange according to
RCW 18.27.090.
Owner Signature:
APPLICANT / CONTACT INFORMATION:
Name of Applicant:Sanve- A-S OWlr\?-,î
Mailing Address:
City/State/Zip;
Phone #:
E-mail:
GENERAT CONTRACTOR: (lf different from applicant)
K"
G e n e ra I co ntracto r : \*l o I I tt¿'r Ø' vw L'rrra I t ¿-
Mailing OOOr"rn ?
City/State/Zip:Ø"+{',t-l t, U,l 4bo$l
phone#: 4Z*' 4tl - 34cob
E_mait: w â-l her @ w &lL ^p,f eb nb unain¿ ."<otfl
wASTATE CONTRACTOR t & r # (CCB) & EXPIRATION DATE:
Øt-¡;.ao\za-7qvPermii #
lfJ¡cc tlsù Orìl\
E Accessory Structure/
Detached Garage
tr Addition
! Demolition ! Mechanical
þumbing! New Single Family / Duplex
! Fire Sprinkler D Remodel
! Re-Roof! New Commercial/ Mixed Use
n Signs ! Tank
E Tenant lmprovement ! Other
Remodel Permll fees ore bqsed on:
The volue of lhe work performed. lndicole the volue (rounded to
the neorest dollor) of oll equipment, moleriols, lobor, overheod,
ond the profit for the work indicoted on this opplicoiion.
Voluolion:
Finished E Unfinished !Basement sq ft:
1st Floor, sq ft:
2nd Floor, sqft
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
I certify that the information I have prov¡ded on this form/application is true,
correct and complete, and that I am the property owner or duly authorized
agent of the property owner to subm¡t a permit appl¡cation to the City of
Edmonds.
C / ,' fî*l lS. C,-^^ €,tv-'-,t
Other sq ft:
w é2r
o^rc ó I t/rs_-
Print Name:
Signature:
TYPE OF PERMIT (Provide Deloils on Poge 2)
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
PROJECT DESCRIPTION
CITY OF EDMONDS BUSINESS LICENSE S:
?
Occupancy Group{s):Occupant Load(s):
Type(s) of Construction:Fire Sprinklers: Yes E No !
WA STATE ENERGY CODE: lf your project affects the building envelope,
mechanical systems, and/or lighting you must complete the
appropriate WSEC forms.
DEFERRED SUBMITTALS: All commercial building permits that will require
associated plumbing, mechanical, fire sprinkler, and/or fire alarm
permits are applied for separately.
Tl / CHANGE OF USE / NEW BLDG: lnclude TRAFFIC IMPACT worksheet
BTUS Gas / Elec / Other Qty
A/C Unit /Compressor
Air Handler /VAV
Boiler
Dryer Duct
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
Other:
Qtv Qtv
Clothes Washer Tub/ Showers
Dishwasher Backflow Device (RPBA, DCDA, AVB)
Drinking Fountain Pressure Reduction/ Regulator Valve
Floor Drain/Sink Refrigerator Water Supply
Hose Bibs Water Heater - Tankless? Y o@ I
Hydronic Heat Water Service Line
Sinks Other:
Toilets Other:
GENERAL COMMERCIAL DATA
MECHANICAL EQUIPMENT COUNTS (New and Relocated)
PLUMBING FIXTURE COUNTS (New, Relocated or re-piped)
BTUS Qty BTUS Qty
A/C Unit Outdoor BBQ / Fire pit
Boiler Stove/Range/Oven
Dryer Water Heater
Fireplace/ lnsert Other:
Furnace Other:
qtv Qtv
Carbon Dioxide Nitrous Oxide
Helium Oxygen
MedicalAir Other:
Medical - Surgical Vacuum Other:
Type of structure to be demolished:
Square footage of structure to be demolished:
AHERA Surveydone? Y/N PSCAA Case #:
Critical Areas Determination:
Study Required I Conditional Waiver E Waiver E
Fill in Place ! Fill Material
Removal E Size of Tank (Gallons)
Study Required E Conditional Waiver E Waiver E
Grading: Cut cubic yards
Critical Areas Determination:
cubic yardsF¡II
Cut / Fill in Critical Area: Yes E No E
APPLICATIONS: Applications are valid for a maximum of l year
ESLHA Applications, 2 years.
LICENSING: All contractors and subcontractors are required to be licensed
with Washington State Department of Labor & lndustries and have a
current City of Edmonds Business License.
GAS/FUEL CONNECTTON COUNTS (New, Relocated or re-piped)
MEDICAL GAS, AIR VACUUM COUNTS
(New, Relocated or re-piped)
DEMOLITION
TANK
GRADE/FrLL/EXCAVATE
GENERAL PROVISIONS