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CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS,WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 7/19/2010
Permit #: BLD20100362
Expiration Date: 7/19/2011
Parcel No: 00452000300602
OND`S`
HAROLD W BEST
ROOT STUDIO ARCHITECTS EXEMPTION FROM CONTRACTOR
23709 80TH LANE W
3523 ANTHONY PLACE S WA
EDMONDS, WA 98020-
SEATTLE, WA 98144-
(206) 779-4491 Ext.
(206) 779-4491 Ext. ( ) - Eat.
FENCE: N ( 0 X 0 F -r.)
LICENSE #: EXP:
OTHER: N ------- OTHER DESC:
JOB DESCRIPTION
SINGLE FAMILY ADDITION TO INCLUDE 350 SQ FT GARAGE AND 400 SQ FT ABOVE GARAGE FOR BEDROOM SUITE, WALK
IN CLOSET AND BATHROOM. AN EXISTING BEDROOM WILL BECOME AN EXTENSION OF EXISTING HALLWAY TO ACCESS
ADDITION.
ILOT #:
VALUATION: $54,660
�� O /, • D
PERMIT TYPE: Residential
PERMIT GROUP: 02 - Addition
GRADING: Y CYDS: 57.95
TYPE OF CONSTRUCTION: VB
RETAINING WALL ROCKERY: Y
OCCUPANT GROUP: R3
OCCUPANT LOAD:
FENCE: N ( 0 X 0 F -r.)
CODE: 06
OTHER: N ------- OTHER DESC:
ZONE: RS -8
NUMBER OF STORIES: 2
IVEsTED DATE:
NUMBER OF DWELLING UNITS: I
ILOT #:
EXISTING AIRE-A
BASEMENT: 624 IST FLOOR: 1358 2ND FLOOR: 0
PROPOSED AREA
BASEMENT: 0 1 ST FLOOR: 400 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 702 DECK: 0 OTHER: 0
13RD FLOOR: 0 GARAGE: 350 DECK: 0 OTHER: 0
1
REQUIRED: SE 25 PROPOSED: 25 =REQUIRED: S/E 7.5 PROPOSED: 7.54-/7.5 REQUIRED: W IS PROPOSED: 15+
HEIGHT ALLOWED:25 PROPOSED:16.21 REQUIRED: N 7.5 PROPOSED: 7.66
SETBACK NOTES: Existing house has nonconforming street setback at approx. 23'.
Per ECDC 23.80.050.G, erosion and sediment control per 18.30.
1 AGREE TOZtOMPLY WITH CITY AND STA'T'E LAWS REGULATING CONSTRUCTION AND IN DOINGTHE WORK AUTHORIZED
THEREBY, NQ PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATINGTO
C//J WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
TTMIP 1 ATION IS NOT A PERMIT UNTIL S NED BY THE BUILDING OFFICIAL OR 11 HER DEPUTY AND ALL FEES A PAI Q.
/Aicrfiature Print Name Date elea d By I Date
ATTENTION
ITIS UNLAWFUL. TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPEC11ON HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC 109/ IBC 10/ IRCI 10.
ONLINE APPLICANT ASSESSOR �< f
OTHER
-116 Ojr��J(
STATUS: ISSUED
BLD20100362
• Obtain Electrical Permit from State Department of Labor & Industries. 425-290-1309
• Final approval on a project or final 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 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.
• 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 7:00am to 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 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
harmless 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 permit. Issuance of this 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)
BUILDING (425) 771-0220 EXT. 1333 1 FNGUiFERING (425) 771-0220 EXT. 1326 1 FIRE (425) 771-0215
PUBLIC WORKS 425) 771-0235 1 PRE-TREATMENT(425) 672-5755 1 RECYCLING 425 2754801
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 Prefereed, and whether you prefer morning or afternoon.
• E -Erosion Control/Mobilization
• E•Footing Drain Connection
• E- Engineering Final
• B -Setbacks
• B -Footings
• B -Foundation Wall
• B -Foundation Drainage
• B -Plumb Ground Work
• B -Plumb Rough In
• B -Mechanical Rough in
B -Exterior Sheathing
• B -Framing
• B -Floor Insulation/Caulk
• B -Ceiling Insulation/Caulk
• B-Sheetrock Nail
B -Building Final
Inspection
Comments
.f
BLD20100362
02 - Addition
Applied: 05/27/2010
Issued: 07/19/2010
Expires:
07/19/2011
Address: 23709 80TH LN W, EDMONDS
INSPECTION
DATE
INSPECTOR
ACTION
1001 - E -Erosion Control/Mobilization
07/28/2010
MCCONNELL
INC
Comment: TESC adequate at this time.
Contractor to cover any stockpiles that
may be created.
1017 - E -Footing Drain Connection
08/25/2010
MCCONNELL
CMP
Comment: Infiltration/drywell installed and drain lines connected.
1077 - E -Engineering Final
07/19/2011
LAMBERTJ
COR
Comment: Need downspouts in place - exposed soils must be stabilized.
1106 - B -Setbacks
08/18/2010
LAWLER
CMP
Comment:
1108 - B -Footings
08/16/2010
LAWLER
CMP
Comment: will need to string property lines for setbacks
1110 - B -Foundation Wall
08/18/2010
LAWLER
CMP
Comment:
1112 - B -Foundation Drainage
08/24/2010
BJORBACK
CMP
Comment:
1126 - B -Plumb Rough In
01/04/2011
STEINIKE
COR
Comment: No plans,permit,no one home, left door tag.
1126 - B -Plumb Rough In
01/14/2011
LAWLER
COR
Comment: correction notice
1126 - B -Plumb Rough In
07/12/2011
STEINIKE
CMP
Comment:
1130 - B -Mechanical Rough in
07/13/2011
STEINIKE
CMP
Comment:
1132 - B -Exterior Sheathing
09/13/2010
LAWLER
CMP
Comment:
1140 - B -Height Verification
01/14/2011
LAWLER
CMP
Comment:
1142 - B -Framing
01/14/2011
LAWLER
COR
Comment: correction notice
1142 - B -Framing
07/12/2011
STEINIKE
CMP
Comment:
1146 - B -Floor Insulation/Caulk
07/13/2011
STEINIKE
CMP
Comment:
1148 - B -Ceiling Insulation/Caulk
07/20/2011
STEINIKE
CMP
Comment:
8/10/2012 1:35:30 PM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220
Page 1 of 2
:INSPECTION ----------- - `—
1150 - B-Sheetrock Nail
Comment:
1158 - B -Building Final
Comment: Not ready!
DATE INSPECTOR ACTION J
07/19/2011 STEINIKE CMP
07/20/2011 STEINIKE COM
8/10/2012 1:35:30 PM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 2 of 2
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EXEMPTION FROM CONTRACTOR
REGISTRATION VERIFICATION
FORM D
The undersigned property owner or authorized person as described below, has applied for a
building permit from the City of Edmonds and claims that he/she/it is exempt from providing
contractor registration in accordance with the provisions of RCW 18.27. The property owner or
authorized person, by their signature below, hereby verifies to the City of Edmonds that:
❑ Value of work under $500.00. The aggregate contract price of labor and materials and all
other items required for the project is less than $500.00 and is not part of a larger operation
to be undertaken on the property. This exemption does not apply to a person who advertises
or puts out any sign or card or other device which might indicate to the public that lie/she is
a contractor, or that he/she is qualified to engage in the business of contractor. RCW
18.27.090(9).
❑ Owner who contracts for a project. A property owner contracting with registered
contractors for the project, and who him/herself is not performing any activity of a
contractor for the purpose of leasing or selling improved property that he/she has owned for
ess than twelve months. RCW 18.27.090(11).
Work performed personally on. own. property. Anyone personally working on property
he/she owns, or at which he/she resides, as long as the property owner, or resident, does not
perform any activity of a contractor on his/her property for the purpose of selling,
demolishing, or leasing the property. RCW 18.27.090(12).
❑ Use of own employees. Property owner using him/herself or his/her own employees to
perform maintenance, repair, and. alteration work in or upon his/her own property. RCW
18.27.090(13).
❑ Licensed Architect, engineer, electrician or plumber. All work performed under this
permit will be performed by an architect, civil or professional engineer, certified electrician
or certified plumber operating within the scope of his/her certification. RCW 18.72.090(14).
❑ Other. Specify which provision of RCW 18.27.090 applies:
THE UNDERSIGNED PROPERTY OWNER OR AUTHORIZED PERSON HEREBY VERIFIES
THAT ALL INFORMATION PROVIDED ON THIS FORM IS TRUE AND ACCURATE TO THE
BEST OF HIS OR HER KNOWLEDGE AND ACKNOWLEDGES THAT IF ANY OF THE
INFORMATION PROVIDED ON THIS FORM IS FALSE HE OR SHE UNDERSTANDS THAT THE
BUILDING PERMIT WILL BE IMMEDIATE REVOKED AND ALL FEES PAID FORFEITED.
DATED thislql
day of —'20/0.
PROPERTY QWNE AUTHORIZED WITNESS
PERSON
mpature
i��--/ ,tL• j��2�7�
Print ame
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L:\TEMP\BUILDING\HANDOUTS REVISED IN 2009\PREVIOUS HANDOUTS\FORMS\CONTRACTOR EXEMPTION FORM
D.DOCREVISED 7/07