BLD20110261.pdfSTATUS: ISSUED -5/3/2011
Expiration Date: 5/3/2012
Parcel No: 00434209400500
DARRELL D FORD
17998 STATE 1-IWY•20
WINTHROP. WA 98862-
(509) 906-20-14 1'.xt
CITY OF EDMONDS
1215TH AVENUENORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
Permit #: BLD20'11
Project Address: 618 ALDER ST, EDM
DARRELL D FORD HOME OWNER EXE'•MPTION TAKEN
17998 STATE MY 20
WINTHROP, WA 98862-
(501) `)`gib -2040 Ext ( ) - Fxt.
LICENSI- #: EXP
ADDINGNEW BATHROOM & FINISHING EXISTING ROOM IN HOUSE.
VALUATION: $6,200.00
PERMIT TYPE: Residential
PERMIT GROUP: 04 - Alteration/Remodel Interior
GRADING: N CYDS: 0
TYPE OF CONSI'Rt1CrION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD
FENCE: N ( 0 X 0 FT.)
CODE: 09
OTHER: N ------- OTHER DESC
ZONE:
NUMBER OF -5 -TORIES: 0
VE91'ED DATE:
NUMBER OI' DWELLING UNITS: 0
LOT #:
EXISTING ARE4,
BASEMENT: 0 ISI' FLOUR:0 2ND FLOOR: ti
PROPOSED ARE4
1.5ASEMENf U ISI FLOOR:0 2ND I•L.00R:0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FRONTSETBACK
SIDE SEYBACK;
REQUIRED: PROPUSLU I(EQUIRI U: PROPUSED: ICEQUIRIiD PROPOSED
HEIGITT ALLOWED:O PROPOSED:O REQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TU COMPLY WI 111 CITY AND STATE• LAWS REGULA I INGCONSfRUCI ION AND IN DUING THE WORK AU I'HORIZ.ED
THEREBY, NO PEKSON W ILL BE EMPLOYED IN VIOLATION OF THE LABOR CUUE OF f HE STATE 01• WASHINGTON RE'LATINGTO
WORKMEN'SCOMPE'NSATION INSURANCI: AND RCW 18:27.
THISAITLICATION ISNOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR 1-IIS/I-IEKDEPUTY AND ALL FI-ESARE PAID. _
• Date Releali& �.
AT'I'ENTION
ITIS UNLAWFULTO USE OR UCCUI'Y A bU ILUING URS I R141URI: UN IIL A I,INA L INSI'L-('IION Ii AS bL•LN MAUI' ANU AI'PRU\Ai. UR A C- -FR IIHCA "IF, OF
OCCUPANCY IIAS BEEN GRAN 111:1). UBCI OW 1110 10/ IRCI 10.
ONLINE APPLICANT ASSESSOR x V -
OTHER
STATUS: ISSUED
BLD20110261
• 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 froniteniporary construction sites as a result of construction activity are exempt fronithe noise limits
of ECC Chapter 5.30 only during the hours of 7:00ani to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all other tinics 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 indenuiify 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 5-onithe issuance for this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce ally requirenicnts of:my City ordinance nor Iii -nit in any way the City's ability to enforce any ordinance
provision.
INSPECTIONS
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)
OXAL 1']INSPECTIONS
BUILDING (425)771-0220F=7533 1•iNGINEERING (425) 771-0220 EXf. 1326 FIRE (425) 775-7720
PUBLIC N1'ORKS 425) 771-0235 1 I'll Fr UPWIA1HTT(425) 672-5755 1 RECYCLING (425) 2754801
When calling for an inspection Blease leave the follming 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.
13 -Plumb Rough In
• 13 -Framing
•
13 -Wall Insulation/Caulk
13-I11sulation/Energy
• 13-Sheetrock Nail
• 13 -Building Final
Inspection
Comments
BLD20110261
04 - Alteration/Remodel Interior
PERMiTTraax
Applied: 04/14/2011
Issued: 05/03/2011
Expires:
05/03/2012
Address: 618 ALDER ST, EDMONDS
jINSPECTION
DATE
INSPECTOR
ACTION
1126 - B-Plumb Rough In
05/16/2011
STEINIKE
CMP
Comment: .
1142 - B-Framing
06/17/2011
STEINIKE
CMP
Comment: Ok but advised that sliding door does meet egress.
1144 - B-Wall Insulation/Caulk
06/28/2011
BJORBACK
CMP
Comment: Walls only. Check R38 ceiling at final.
1158 - B-Building Final
08/09/2011
STEINIKE
CMP
Comment:
8/10/2011 7:52:53 AM
Page 1 of 1
j 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
less than twelve months. RCW 18.27.090(11).
l 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 IMMEDIATELY REVOKED AND ALL FEES PAID FORFEITED.
DATED this day of20 /l.
PROPERTY OWNEWAUTHORIZED
PERSON
C
Aignature�
Print Name
WITNESS
i
�►/iii _...`%
L:\TEMP\BUILDING\HANDOUTS REVISED IN 2009\PREVIOUS HANDOUTS\FORMS\CONTRACTOR EXEMPTION FORM
D.DOCREVISED 7/07