20180625142111.pdfCITY OF EDMO}{DS
I2I 5TH AVENUENORTH - EDMONDS, WA 98020
PHONE: (425)771-0220 - FAX: (425)771-0221
STATUS: ISSUED 0612512018
Expimtion Date: t2 /25 12018
Parcel No: 004342041 00500
BTIILDING PERMIT
APPLICANTPROPFRTYOWNF:,R (]ONTRAC'TOR
JONATHAN S & CLAUDIA M PAYNE
1O2O EDMONDS ST
EDMONDS, WA 98020-2905
(413) s3s-9293
NGB Roofing
19215 80TH PL W
EDMONDS, wa 98026
(206) 883-6232
NGB Roofing
19215 80TH PL W
EDMONDS" wa 98026
(206) 883-6232
LICENSE #: n 889M7 EXP:07/30/2018
JOB DESCRIPTION
reroof, metal root no sheathing
VALUATION: S0
PERMIT GROUP: 54 - Re-Roof/Roof Alter/RepairPERMIT TYPE: Residential
TYPE OF CONSTRUCTIONGRADING: N CYDS: O
OCCUPANT GROUPRETAINING WALL ROCKERY:
OCCUPANT LOAD:
FENCE- I OXO FTì CODE:2015
OTHER: ------ OTHER DESC:ZONE
NiJMBER OF STORIES: O VESTED DATE:
I ST FLOOR: 0 2ND FLOOR: 0
LOT #
BASEMENT: O2ND FLOOR: 0
NUMBER OF DWELLINGUNITS: O
RASEMENT:O 1ST FI,OOR: O
3RDFLOOR:0 GARAGE:0 DECK:0 OTHER:03RDFLOOR:0 GARAGE:0 DECK:0 OTHER:0
BEDROOMS:0 BATHROOMS:0 BEDROOMS:0 BATHROOMS:0
Plìot,()sEl) Alì8,\[xlsllN(; \lì.Iì{
PROPOSED:REOUIRED:REOUIRED: PROPOSED:REQUIRED: PROPOSED:
HEIGHT ALLOWED:0 PROPOSED:0 REQUIRED: PROPOSED:
SETBACK NOTES:
RFÂR SETRA(]KFRONT SETBACI(SIDESETBACK
I AGREE TO COMPLY WTH CrfY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORZED THEREBY, NO
FERSON WLL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RE-ATING TO WORKMEN'S COMFENSATION
INSURANCE AND RCW I 8:27.
THIS AFP-ICATION IS NOT A FERMI UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID.
PERMIT APPROVAL
{Denise Nelson June 25, 2018
Signature Print Released By Date
ATTENTION
1T IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCruRE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBCI09/ IBCI IO/ IRCI I O.
FIRE APPLICANT ASSESSOR CITY
CONDIT'IONS
STATUS: ISSUED 8LD20180869
Final approval on a project or final occupancy apptoval must be granted by the Building Offìcial prior to use or occupancy of
the building or structure. Check the job card for all required City inspections including fìnal project approval and final
occupancy inspections.
Any request for altemate design, modification, variance or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specificalþ r'equested 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 compþ with city code and for which a variance has not been
specificalty identified, requested and considered by the appropriate cþ official in accordance with the appropriate provision
ofcity code or state law does not approve any items not to code specification.
SoundÀtroise originating fromtemporary construction sites as a result of construction activity are exempt fiomthe 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 othertimes the noise originating fromconstruction 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
hannless the Gty of Edmonds, 'Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directþ or indirectþ from the issuance for this permit. Issuance ofthis permit shall not be deemed to
nrodi$, waive or reduce any requirements of any Cþ ordinance nor limit in any way the Cify's abilþ to enforce any ordinance
provision.
THIS FERMIT AUTHORZES ONLY THE WORK NOTED. THIS PERMTT COVERS WORK TO BE DONE ON FRIVATE FROFERTY ONLY. ANY
CoNSTRUCTION ON THE RJBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ErC.) WLL REQUTRE SEPARATE PERMISS|ON. pERMtT
TIME LlMl'I: SEE ECDC 1 9.00.005(A)(6)
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INSPECTIONS
TO SCIIEDT]LE INS PECTIONS
BUILDING ENG| NEERTNG (425) 771-0220 EXT. 1326
1. Go to: www.edmondswa.gov
2. Then: Sen¡ces
3. Then: Permits/Delelopment
4. Then: Online Permit lnfo
5: lf you don't hare one already, create a
login (upper right hand corner)
6: Schedule vour insÞection
Building Depaft ment lnspections
are now scheduled online. lf you
haw diffculties, please call the
Building Department font desk for
assistance during ofice hours.
(425) 771-0220
FrRE (425)775-7720
PUBLIC WORKS (4251 77 14235
RECYCL| NG (42s1 27 54801
When calling for an inspection please learc the following information: Permit Number, Job Site Address, Type of lnspection
bei Contact Name and Phone Number Date and whether or afternoon.
. B-Roof Tear Off. B-Building Final
c. l8
BUITDING PERMIT
APPTICATION
Developmenl Services
Building Division
l21 sth Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requ¡rements, permit status and inspection
scheduling information go to: http:llwww.edmondswa.sov/
JOB SITE INFORMATION/IOCATION: (Where the work is taking place)
robsireAddress: ltA E/¿ro^/f t*
Parcel:
Lot /Unit/Suite #: _ Subdivision:
PROPERTY
Name:
OWNER:(
Mailing Address:
City/State/Zip:
Phone #:L//4- fçr-2-13
Email r
OWNER INSTAILATION: *lf yes, read and sign*
Will work be performed by the property owner? D Yes fi, No
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:
APPTICANT / CONTACT INFORMATION:
Name of Applicant
Mailing Address:/qAf Ífl {rL F¿ t^/
City/State/Zip:
Phone#: Lû6- f 8f-62?7
E-mail:" ætk
GENERAT CONTRACÍOR: (lf different from applicant)
General Contractor:
Mailing Address:
City/State/zip
Phone #:
E-mail:
wA STATE CONTRACTOR t A.l ü (CCB) & EXPTRATTON DATE:
1vê880Å{Kg 7 /4>
Permif #:
! Accessory Structure/
Detached Garage
tr Addition
tr Demolition tr Mechanical
tr New Single Family / Duplex ! Plumbing
tr Fire Sprinkler D Remodel
( ne-nooftr New Commercial/ Mixed Use
! Signs tr Tank
! Tenant lmprovement tr Other
Remodel Permil fees ore bosed on:
The volue of the work performed.lndicote the volue (rounded lo
the neorest dollor) of oll equipment, moteriols, lobor, overheod,
ond the profit for lhe work indicoted on this opplicofion.
Voluolion:
Finished tr Unfinished EBasement sq ft:
1st Floor, sq ft:
2nd Floor, sqft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
I certify that the information I have provided on this form/application ¡s 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
,4/r'rrÅ éq'il,aú'
signarure: ,4 -- o"r" 6/z/lr
Other sq ft:
Ì
Print Name:
Edmonds.
TYPE OF PERMIT (Provide Detoils on Poge 2)
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
PROJECT DESCRIPTION
CITY OF EDMONDS BUSINESS LICENSE fi:
Occupancy Group(s):Occupant Load(s):
Type(s) of Construction:Fire Sprinklers: Yes E No E
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 â 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 or N
Hydronic Heat Water Service Line
Sinks Other:
Toilets Other:
GENERAL COMMERCIAL DATA
MECHANICAL EQUIPMÊNT 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
Medical Air 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 E Conditional Waiver ! Waiver E
Fill in Place n Fill Material
Removal E Size of Tank (Gallons)
Critical Areas Determination:
Study Required E Conditional Waiver E Waiver E
Grading: Cut cubic yards
cubic yardsFill
Cut / Fill in Critical Area: Yes E No fl
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 CONNECTION COUNTS (New, Relocated or re-piped)
MEDICAL GAS, AIR VACUUM COUNTS
(New, Relocated or re-piped)
DEMOLITION
TANK
GRADE/FrLL/EXCAVATE
GENERAL PROVISIONS