BLD20100700.pdfOF ED4f
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STATUS: ISSUED 9/7/2011
Expiration Date:2
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Parcel No: 00547600000200
PROPERTYOWNER
ACACIA SENIOR HOME II ( AFH)
PHYLLIS MUTALI
21818 93RD PL W
EDMONDS, WA 98020-
(206) 498-6744 Ext.
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
F. F. BROWN DESIGN
185 2ND AVE SE
ISSAQUAH, WA 98027-
(206) 792-7177 Ext.
CONTRACTOR EXEMPTION
( ) - Ext.
LICENSE #: EXP:
INTERIOR REMODEL FOR ADULT FAMILY HOME. GARAGE CONVERTING TO LIVING SPACE. NEW OUTDOOR
PATIO AND 43 SQ FT RAMP /q ��j Hy� O�%� NE V
I P�- T E
VALUATION: $101,760.00
PERMIT TYPE: Residential
PERMIT GROUP: 82 - Adult Family Home
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N ( 0 X 0 FT.)
CODE: 09
OTHER: N ----- OTHER DESC:
ZONE: RS -8
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS: 0
LOT #:
BASEMENT: 0 IST FLOOR: 0 2ND FLOOR: 0
BASEMENT: 0 1ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FRONTi
.EQU[RED:25 PROPOSED: 26 REQUIRED: 7.5 PROPOSED: 10.5 1 REQUIRED: 15 PROPOSED: 29.5
[EIGHT ALLOWED:O PROPOSED:O REQUIRED: 7.5 PROPOSED: 11.5
ETBACK NOTES: Project converts existing garage to living space. Still room for two parking spaces in existing driveway.
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO
PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S
COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLI TI N IS NOT A PERMITTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AW ALL-EftES ARE PAID.
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ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC109/ IBCI 10/ IRCI 10.
= ONLINE 0• APPLICANT
ASSESSOR ® OTHER
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STATUS: ISSUED
BLD20100700
• Installer shall provide the manufacturer's installation, operating instructions, and a whole house ventilation system operation
description. A label shall be affixed to the whole house timer control that reads "Whole House Ventilation" (see operating
instructions).
• Obtain Electrical Permit from State Department of Labor & Industries. 425-290-1309
• Gas pipe test must be observed by City Building Inspector, affidavits shall not be accepted.
• 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 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 775-7720
PUBLIC WORKS 425) 771-0235 1 PRE-TREATMENT 425) 672-5755 1 RECYCLING 425) 275-4801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection
being reauested. Contact Name and Phone Number. Date Prefereed, and whether you prefer morning or afternoon.
• B -epoxy holdowns
• B -Plumb Ground Work
• B -Plumb Rough In
• B -Gas Test/Pipe
• B -Mechanical Rough In
• B -Exterior Sheathing
• B -Framing
• B-Insulation/Energy
• B-Sheetrock Nail
• B -Building Final
• F -Fire Final
OV EI)k Inspection Comments
N
BLD20100700 82 - Adult Family Home
Applied: 09/30/2010 Issued: 09/07/2011
Address: 21818 93RD PL W, EDMONDS
Expires: 12/06/2012
INSPECTION
DATE
INSPECTOR
1108 - B -epoxy holdowns
11/30/2012
LAWLER
Comment:
1114 - 13 -Isolated Footings/Piers
12/12/2011
LAWLER
Comment: Porch footings
1122 - B -First Floor Framing
11/14/2011
LAWLER
Comment: see correction notice
1122 - B -First Floor Framing
11/28/2011
LAWLER
Comment:
1126 - B -Plumb Rough In
11/29/2011
LAWLER
Comment: hydronic test approved
1126 - B -Plumb Rough In
12/06/2011
LAWLER
Comment: DWV to crawl space approved
1126 - B -Plumb Rough In
04/03/2012
LAWLER
Comment: except second shower installation
1126 - B -Plumb Rough In
07/18/2012
LAWLER
Comment: second shower
1128 - B -Gas Test/Pipe
04/03/2012
LAWLER
Comment: Bonding of gas piping required
1128 - B -Gas Test/Pipe
04/18/2012
LAWLER
Comment:
1130 - 13 -Mechanical Rough In
04/18/2012
LAWLER
Comment:
1132 - 13 -Exterior Sheathing
11/28/2011
LAWLER
Comment:
1142 - B -Framing
12/12/2011
LAWLER
Comment: Two front porch posts okayed as ground contact
1142 - B -Framing
12/21/2011
LAWLER
Comment: garage conversion space only.
1142 - B -Framing
04/16/2012
LAWLER
Comment: 1.) dryer duct to be smooth wall when permanently
installed
2.) min 1/2" clearance to combustibles at fireplace vent
3.) install nail plates at hydronic piping under shower plywood
4.) provide taller insulation dam
5.) okay to polyseal and insulate
ACTION
CMP
CMP
COR
CMP
PAR
PAR
PAR
CMP
COR
CMP
CMP
CMP
PAR
PAR
COR
12/3/2012 10:36:27 AM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 1 of 2
12/3/2012 10:36:27 AM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 2 of 2
INSPECTION
DATE
INSPECTOR ',;
'ACTION`,:
1142 - B-Framing
04/18/2012
LAWLER
CMP
Comment:
1144 - B-Wall Insulation/Caulk
04/18/2012
LAWLER
CMP
Comment:
1146 - B-Insulation/Energy
11/28/2011
LAWLER
PAR
Comment: floor
1146 - B-Insulation/Energy
12/21/2011
LAWLER
PAR
Comment: Walls approved
1146 - B-Insulation/Energy
10/08/2012
LAWLER
COR
Comment: 1.) Insulate and weatherstrip attic access hatch
2.) install sleeve at B vent in attic
1146 - B-Insulation/Energy
10/11/2012
LAWLER
CMP
Comment:
1150 - B-Sheetrock Nail
04/23/2012
LAWLER
COR
Comment: Maximum spacing for screws is 12 inches
on center, okay to take pictures once completed.
1150 - B-Sheetrock Nail
07/24/2012
LAWLER
CMP
Comment:
1152 - B-shower pan
07/13/2012
LAWLER
COR
Comment: 1.) Fernco not allowed inside building on DWV
2.) install nail plates
1152 - B-shower pan
10/11/2012
LAWLER
CMP
Comment:
1158 - B-Building Final
10/11/2012
LAWLER
COR
Comment: Install grab bars as per approved plans
1158 - B-Building Final
11/29/2012
LAWLER
CMP
Comment:
1985 - F-Fire Final
10/11/2012
SMITHM
CMP
Comment: APPROVED
12/3/2012 10:36:27 AM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 2 of 2
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 are 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. The person employed to do this work has not
advertised nor otherwise put himself/herself forward to the permittee to be a contractor or
qualified to engage in the business of a contract. RCW` 18.27.090(9).
❑ Work performed personally on own property. The undersigned verifies that all work
done under this permit will be done by the permittee personally on his/her own property
and that the improvements constructed on the property are not being undertaken with the
intention and purpose of selling the improved property.
❑ Commercial property exemption. The permittee is the owner of commercial
property and the owner's own employees will perform all maintenance, repair and
alteration work on the property. No work will be done by contract under the permit. 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, licensed electrician
or licensed plumber operating within the scope of his or her license. RCW 18.27.090(14).
Of General Contractor. The owner is the General Contractor for the project and is
required to hire a minimum of two licensed subcontractors (unrelated building trades or
crafts) to work on the permitted project. The general contractor is responsible to verify all
State licenses of all subcontractors on the job. RCW 18.27.010
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 IMMEDIATELY REVOKED AND ALL FEES PAID FORFEITED.
Dated this 0 day of TukwLh, 20) 0
PROPERTY OWNER/AUTHORIZED
PERSON
Signature
Print
Revised 4/07
WITNESS
MR