BLD20110907.pdfIlil��lll
1117O� E� Oil
r _ ° CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
�c. I R90
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 10/31/2011 Permit #: BLD2011,090 1
Expiration Date: 4/30/2012 - Project'Address: �212,14 SHELL-NALLCY,R]
—_- — - --- - — ,EDMOND
Parcel No: 00649900002700
PROPER'n, OWNER APPLICANT C*N?AACT0R
LARRY D & GERDA A FISCHER JANUSZ MYDLARCZYK IVAN REMODELING COMPANY
21214 SHELL VALLEY RD 104 NE 50TH 16605 Ne 30Th St
EDMONDS, WA 98026 SEATTLE, WA 98105 BELLEVUE, WA 98008
(206)715-4583 (206)856-1272
LICENSE#: IVANSRC91 I QR EXP: 11/19/2011
JOB DESCRIPTION
REMOVE EXISTING ROOF COATING, SHEETING AND INSULATION AND REPLACE WITH NEW I/2" SHEETING,
INSULATION AND ASPHALT SHINGLES.
VALUATION: $8,000.00 Also inAffin.1 2 1131 -/vll?J A0 e-k5�vl-
PERMIT TYPE: Residential
PERMIT GROUP: 54 - Re-Roof/Roof Alter/Repair
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: on
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS: 0
LOT #:
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
BASEMENT: 0 1 ST FLOOR- 0 2ND FLOOR- 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13RD FLOOR. 0 GARAGE: 0 DECK: 0 OTHER: 0
1 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 APPLICA 'd NOT A PERMfr UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY ND ALL FEES ARE PAID.
>Ousz. ti or o oa'� ( a) uf 16,E I l
SigPrint Name Date IReleased K Date
�t / Q
DLA<Ziw- ATTENTION
IT IS UNI LTO 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/ IBC110/ IRCI 10.
ONLINE APPLICANT ='ASSESSOR
OTHER
STATUS: ISSUED
BLD20110907
• 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.
• SoundMoise 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
beinz requested, Contact Name and Phone Number, Date Prefereed, and whether you prefer morning or afternoon.
B -Roof Sheathing
B-Insulation/Energy
• B -Building Final
of ED41 Inspection
Comments
Sp
- BLD20110907
54 - Re-Roof/Roof Alter/Repair
Applied: 10/31/2011
Issued: 10/31/2011
Expires:
05/02/2012
/7c. I R90
Address: 21214 SHELL
VALLEY RD, EDMONDS
INSPECTION
DATE
INSPECTOR
ACTION
1133 - B-Roof Sheathing
12/09/2011
LAWLER
CMP
Comment:
1146 - B-Insulation/Energy
12/07/2011
LAWLER
CMP
Comment:
1158 - B-Building Final
05/01/2012
LAWLER
CMP
Comment:
0
5/1/2012 12:12:34 PM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 1 of 1