2063_001.pdfc. 1il
BUITDING PERMIT
APPTICATION
Developmenl Services
Building Division
121 sth Ave N / Edmonds, WA 98020
425.77"t.0220
EXPIRED APPTICATION# BTD2O18-1030
(N EWI PERM tT# BrD2O19-102s
Remodel Permil fees ore bosed on:
The volue of the work performed. lndicote ihe volue (rounded to
the neorest dollor) of oll equipment, moteriols, lobor, overheod,
ond the profit for the work indicoted on this opplicotion.
Voluolion:
5 L
I certify that the informatiotr 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
Edmonds.
Print Name:
For handouts, submittal requirements, permit status and inspection
scheduling information go to: httpt../l!r'ww.cdmonciswa.gov/
JOB S|TE INFORMATION/LOCATION: (Where the work is tak¡ng place)
Job Site Address:t viw r./
Parcel
Lot /Unit/Suite #:
PROPERTY OWNER:
A Subdivision
Name:V Lu\ø( A^4-,t I c,
Mailing Adclress:Po Bc* l3lll
City/State/Zip
q
Phone #:q>ç aql 3)s3
Email rt1 USQ ¿,'t*t
OWNER INSTALLATION: *lf yes, read and sign*
Will work be performed by the property owner? I Yes [J 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
APPLICANT / CONTACT INFORMATION:
Name of Applicant ìJ-L
Mailing Address Þo Bor l33lì
City/State/Zip Ç,u¿,uert-W1Øwø
v>ç--n(-7>tJPhone #:
E-mail:fìn 0sa
GENERAL CONTRACTOR: (lf different from applicant)
General Contractor:(L Lw,Þù-\
Mailing Address l*+tç l,1Lvrcs S-t SW
City/State/Zip:Þ**e^dç LL4 %O>t¿
?-ou--t IPhone #:
E-mail:(-Qvl u Lq
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
;,Y- r TLLUÑ *{ ltpàF r
I Accessory Structure/
Detached Garage
n Addition
tr Demolition n Mechanical
K"* Single Family / Duplex ! Plumbing
n Fire Sprinkler ! Remodel
ü New Commercial/ Mixed Use ú Re-Roof
tr Signs E Tank
! Tenant lmprovement D Other
Finished E Unfinished trBasement sq ft
1"st Floor, sq ft:lnØ
2nd Floor, sqft:t]fÞ
lo >L+Garage/Carport:, sq ft:
q1Deck/Covered Porch/Patio:
Other sq ft:
TYPE OF P.ERMIT (Provide Deloíls on Poge 2)
PRoPoSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
PROJECT DESCRIPTION
ûV ,,.âlw OF EDMONDS BUSINESS LICENSE f:BL.DD KI2 \Signature:/.
C
Date
occupancy Group(s)Occupant Load(s):
Type(s) of Constru.tlon' Jp[Fire Sprinklers: Yes n No n
WA STATE ENERGY CODE: lf your project affects the building envelope,
mechanical systems, and/or lightíng, you must complete the
appropriate WSEC forms.
DEFERRED SUBMITTALS: All commercial building permlts that will require
associated plumbing, mechanical, fire sprinkler, and/or fire alarm
perm¡ts 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
91tc,tDryer Duct
1Exhaust Fans
Fireplace hq<
Fu rnace hqS
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
Other:
QtvQtv
I Tub/ Showers 4Clothes Washer
\Backflow Device (RPBA, DCDA, AVB)Dishwasher
Pressure Reduction/ Regulator Valve tDrinking Fountain
Refrigerator Water Supply |,Floor Drain/Sink
rNWater Heater -Tankless?@ tHose Bibs 1-
I'hWater Service Line
LHydronic Heat
OtherSinksl!
j OtherToilets
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/Ra nge/Oven
Dryer Water Heater I
Fireplace/ lnsert Other
Fu rnace 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 Survey done? Y / N PSCAA Case #:
Critical Areas Determination :
Study Required I Conditional Waiver ! Waiver !
Fill in Place E Fill Material
Removal n Size of Tank (Gallons)
Critical Areas Determination :
Study Required n Conditional Waiver ! Waiver n
1OO cubicGrading: Cut yards
t00 cubic yardsF¡II
Cut / Fill in Critical Area: Yes n *oÉ
APPLICATIONS: Applications are valid for a maximum of l year
ESLHA ApplicatÍons, 2 years.
LICENSING: All contractors and subcontractors are required to be licensed
with Washington State Department of Labor & lndustries and have a
current C¡ty of Edmonds Business License.
GAS/FUEL CONNECTION COUNTS (New, Relocated or re-piped)
GAS, AIR VACUUM COUNTS
, Relocated or re-piped)
MEDICAL
(New
DEMOLITION
TANK
GRADE/FILt/EXCAVATE
GENERAL PROVISIONS
CITY OF EDMOI{DS
121 5TH A\ENUENORTH - EDMONDS, V/A 98020
PHONE: (425)771-0220 - FAX: (425)771-0221
c. l8
B T]ILDING APPLICATION ACCEPTANCE
Thursday, August 02, 2018
This Application has been accepted by the Cþ of Edmonds for review. More information and changes
may be required during this process. The review target date is:
Your Cþ Contact is CHRISTINA V/AYLAND
Application Number: BLD20 I 8 I 030
Project Address:8364 OLYMPIC VIEV/ DR, EDMONDS
PROPERTY OWNER APPLICANT
VECTOR ONE LLC
PO BOX 13377
EVERETT,TVA 98206
VECTOR ONE LLC
PO BOX 13377
EVERETT, WA 98206
(42s) 7et-32s3
Work Description:
New SFR
Outstanding ltems at Time of Submittal:
It is anticipated that the following depaftments will be reviewing your application
Building
Planning
Engineering
Fire
Please wait to re-submit corrections until after you have received comments from all reviewing
depaftments.
I HM.FßY ACKNOWLEDGETHÀTIHA\/EREAD TTIIS APPLICATION THATTHEINFORMATION GIVU\ IS CORRICT
AND THATI AM T1IEPROPm.TY O\ilNM,, OR THEDULY AUTIIORIZED AGFNTOFTIIEPROPFRTY OWNIR, TO
A BUILDING PM,MITAPPLICATION TO TIIECITY
8 '2ú<
SIGNA (ow OR PRINTNAME TES
To view up to døte information øbouî your application please visit the City of Edmonds Development Services
w eb site at http ://www. e dmnndsw a. g ov.
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CITY OF EDMONDS
I21 5TH AVENUENORTH - EDMONDS, V/A 98020
PHONE: (425)771-0220 - FAX: (425)771-0221t1c, I
CRITICAL AREA APPLICATION ACCEPTANCE
Thursday, August 02, 2018
Your Application has been accepted by the City of klmonds and we will staft the application process with the
information you provided. More information and changes may be required during this process. The decision target
date is .
Application Number: CRA20 I 801 42
ProjectAddress:8364 OLYMPIC VIEW DR, EDMONDS
PROPM.TYOWNER APPLICANT
Vector One
PO BOX 13377
CCCONSTRUCTION
8415 l92ND ST SW
EVERETT,\¡/A 98206 EDMONDS, V/A 98026
(206) 7t+9429
To view up to tlate information øbout your permÌt please visÍt the City of Edmonds Development Servìces website
a t ht t p : //www. c i. e d mo n d s.w a. us.