4573_001.pdf01; Fr)p
CITY OF EDMONDS
PHONE: (425) 771-0220 - FAX: (425) 771-0221
121 5TH AVENUE NORTH - EDMONDS, WA 98020
90
STATUS: ISSUED 11/27/2018 it Pemiit#: BLD20181518
Expiration Date - 05 1-17112 0 19
Parcel No: 00434400700800
II.—Mj t Ad (11-re s -: 2 10 1 M 14. 1 N 'ST' E D M 0 N D S
APPLICAPIT CONTRACTOR
2020 LLC EDMONDS 2020 LLC EDMONDS EDMONDS 2020 LLC
PO BOX 1773 PO BOX 1773 C/O 2020 LLC EDMONDS
EDMONDS, WA 98020 EDMONDS, WA 98020 PO BOX 1773
EDMONDS, WA 98020
(425) 640-8000 (425) 640-8000 (425) 640-8000
LICENSE 4: EDMON2L864B3 EXP:01/29/2020
JOB DESCRIPTION
1) DUCT WORK FOR DRYERS AND BATH/RANGE FANS USING4" AND 6" ROUND PIPE. (TOTAL OF 70 VENTS)
2) FIREPLACES AT 20 APARTMENTS.
3)161NWALLA/Cs
4) 4 MINI SPLIT HEAT PUMPS (DUCTLESS)
VALUATION: $0
PERMIT TYPE Commeicial
PERMIT GROUP- 40 - Mechanical
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION
RETAINING WALL ROCKERY.
OCCUPANT GROUP,
OCCUPANT LOAD
FENCE: 0 X 0 FT
CODE
IOTHER: ------- OT HER DE SC:
IZONE�
INUMBER OF S ORIES 0
IVESTED DATE:
INUMBER OF DWELLINGUNITS 0
ILOT #:
EXISTING ARLA
BASEMENT: 0 1 ST FLOOR 0 2ND FLOOR: 0
PRO I'0 S ED A R LA
ASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR 0 GARAGE 0 DECK: 0 OTHER: 0
FLOOR 0 GARAGE 0 DECK: OTHER 0
BEDROOMS: 0 BATHROOMS: 0 IBEDROOMS:
0 BATHROOMS: 0
FRONTSETBACK SIDESErBACK REARSETBACK
REQUIRED: PROPOSED: ]REQUIRED: PROPOSED: -::�REQUIRED: PROPOSED
HEIGHT ALLOWED:O 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 EIMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION
INSURANCE AND RCW 18:27.
A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID -
Print
Released By
Date
ATTENTION
IT IS 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. UBC] 09/ IBCI 10/ IRCI 10.
= FIRE = APPLICANT = ASSESSOR = CITY
STATUS: ISSUED
BLD20181518
• Final approval on a projector fin a] occupancy approval must be granted by the Building Official prior to use or occupancy of
the building or structure. Check 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 subinittal 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.
• Sound/Noise 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 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must comply with the
noise lirnits 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
hanTdess 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 pen -nit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requii-ements of any City ordinance nor limit in any way the City's ability to enforce any ordinance
provision.
I INSPUCTIONS
THIS PERMIT AUTHORIZ_ES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY
CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRK/E\/VAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT
TIME LIMIT: SEE ECDC 19.00.005(A)(6)
I BUILDING I I ENGINEERING (425) 771-0220 EXT. 1326 1
Go to: www.edmondswa.gov
2. Then: Services
3. Then: Perm its/Development
4. Then: Online Permit Info
5: If you don't have one already, create a
login (upper right hand corner)
6: Schedule vour inspection
Building Department Inspections
are now scheduled online. If you
have difficulties, please call the
Building Department front desk for
assistance during ofice hours.
(425) 771-0220
FIRE (425) 775-7720
PUBLIC WORKS (426) 771-0235
RECYCLING (426) 275-4801
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 Preferred, and whether you prefer morning or afternoon.
• BCONDENSATELfNE
• B-Mechanical Final
• B-Building Final
• B-Other
OV. E 1,),Il BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 5th Ave IN / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, permit status and inspection
scheduling information go to: http://www.edmondswa.gov
JOB SITE INFORMATION/LOCATION: (Where,the work is taking place)
I
Job Site Address: PqA I K (j f-
Parcel: 3 0 0 7 on 0
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER
Name:
Mailing Address:
City/State/Zip:
Phone#:
Email:
OWNER INSTALLATION: *If yes, read and sign*(J
Will work be performed by the property owner? E]Yes E]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:
MailingAddress: pe,
City/State/Zip: 4�5—'d 'A'U
Phone #: /6�0 - --&t.)YO
E-mail:
GENERAL CONTRACTOR: (if different from apqpicant)
General Contractor: C—d,44,6 �, d 1
MailingAddress: P&' lgep X / -7 7
City/State/Zip: 9�6&b Aj-r)
Phone #: 6vo ?Jp
E-mail: 'e-A(wo P4-f -Z4)1V
WA STATE CONTRACTOR L & I # (CCB) & EX7ATION DATE:
— e 6� 4557 7) /U�o IL) 11-17,L, 106 13 3
CITY OF EDMONDS BUSINESS LICENSEM 0(_—
=umit #: '�)(s I
RD" - V
TYPE OF PERMIT (Provide
Details on Page 2)
[I Accessory Structure/
El Addition
Detached Garage
14Mechanical
El Demolition
El New Single Family / Duplex
El Plumbing
� !-- r inkler
L_jHit!apr1 K
0 Rernodel
El New Commercial/ Mixed Use
El Re -Roof
• Signs
0 Tank
• Tenant Improvement
0 Other
Remodel Permit fees are based on:
The value of the work performed. Indicate the value (rounded to
the nearest dollar) of all equipment, materials, labor, overhead,
and the profit for the work indicated on this application.
Valuation: yO 4 Cd, 1 0 ej 0 1
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
Basement sq ft: Finished El Unfinished El
1st Floor, sq ft:
2nd Floor, sq ft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
Other sq ft:
PROJECT DESCRIPTION
4 iiie
'I'01 �"�V'Aowk
Z14,
ph', C
I certify that the information I have provided on this form/application is true,
correct and complete, and that I am the propert owner or duly authorized
plete, and that, a m the proper'
agent of the prope W o submit a per application to the City of
Edmonds.
?
Print Name:
Signature: Y Date
GENERAL COMMERCIAL DATA
Occupancy Group(s): Occupant Load(s):
Type(s) of Construction:
Fire Sprinklers: Yes El No El
WA STATE ENERGY CODE: If 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.
TI / CHANGE OF USE / NEW BLDG: Include I RAFFIC IMPAC I worksheet
MECHANICAL EQUIPMENT COUNTS (New and Relocated)
BTUs Gas / Elec / other Qty
A/C Unit /Compressor
c-
Air Handler /VAV
Boiler
Dryer Duct
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
fib
jL
Hydronic Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
Other:
PLUMBING FIXTURE COUNTS (New, Relocated or re -piped)
Qty Qty
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:
GAS/FlUEL CONNECTION COUNTS (New, Relocated or re -piped
BTUs Qty BTUs Qt y
A/C Unit
Outdoor BBQ / Fire pit
Boiler
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
ZA
Other:
Furnace
Othier.
MEDICAL
GAS, AIR VACUUM COUNTS
A
(New,
Relocated or re -piped)
Qty Qty
Carbon Dioxide
Nitrous Oxide
Helium
Oxygen
Medical Air
Other:
Medical - Surgical Vacuum
Other:
DEMOLITION
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 El Conditional Waiver 0 Waiver
Fill in Place 11 Fill Material:
Removal 11
1 Size of Tank (Gallons)
Critical Areas Determination:
Study Required 0 Conditional Waiver 0 Waiver
GRADE/FILL/EXCAVATE
Grading: Cut cubic yards
Fill cubic yards
Cut / Fill in Critical Area: Yes El No El
GENERAL PROVISIONS
APPLICATIONS: Applications are valid for a maximum of 1 year.
ESLHA Applications, 2 years.
LICENSING: All contractors and subcontractors are required to be licensed
with Washington State Department of Labor & Industries and have a
current City of Edmonds Business License.