BLD20130279.PDFV � OF F� OWN
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
Inc. 1 R90
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 03/20/2013 j Permit #: BLD20130279
Expiration Date: 09/20/2013
Parcel No: 00434600007401
Project Address: 18823 OLYMPIC VIEW DR,
EDMONDS
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NEIL J BROUDY •
MOUNTAIN GOAT ROOFING
MOUNTAIN GOAT ROOFING
ADAMS WANDA LEE
AZA CLINE
AZA CLINE
18823 OLYMPIC VIEW DR
1804 LOCUST WAY
1804 LOCUST WAY
EDMONDS, WA 98020
LYNNWOOD, WA 98036
LYNNWOOD, WA 98036
(425)670-0761
(206)841-1675
(206)841-1675
LICENSE #: MOUNTGRO25D7 EXP:06/25/2014
REMOVE EXISTING ROOF COVERING - INSTALL PLYWOOD SHEATHING - INSTALL ASPHALT COMPOSITION
SHINGLES
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 54 - Re-Roof/Roof Alter/Repair
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION: VB
RETAINING WALL ROCKERY: N
OCCUPANT GROUP: R-3/U
OCCUPANT LOAD:
r' -�`�
FENCE N 0 X 0 FT-)
CODE:
F_ ;,..
OTHER: N ------ OTHER DESC:
ZONE:
U Nli
I
NUMBER OF STORIES: 0
VESTED DATE:
Er:.
NUMBER OF DWELLING UNITS: 0
LOT #:
BASEMENT: 0 IST FLOOR: 0 2ND FLOOR: 0
BASEMENT: 0 IST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
3RD FLOOR: 0 GARAGE: 0
DECK: 0 OTHER: 0
SETBACKFRONTSETBACK SIDE SETBACK REAR
REQUIRED: PROPOSED: I REQUIRED: PROPOSED: REQUIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O I REQUIRED: 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 EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S
COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY A D ALL FEES 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 APPLICANT ASSESSOR OTHER
STATUS: ISSUED BLD20130279
CONDITIONS
• 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.
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)
BUILDING (425) 771-0220 EXT. 1333 I ENGINEERING (425) 771-0220 EXT. 1326 I 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 requested, Contact Name and Phone Number, Date Prefereed, and whether you prefer morning or afternoon.
• B-Roof Tear Off
• B-Roof Sheathing
• B-Building Final
,i
OF EDP
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DEVELOPMENT SERVICES
RESIDENTIAL BUILDING PERMIT
APPLICATION
I't 1 oz 121 5h Avenue N, Edmonds, WA 98020
City of Edmonds Phone 425.771.0220 2 Fax 425.771.0221
PLEASE REFER TO THE RESIDENTLML BUILDING CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Stre t, Suite #, City tate, Zip :
ah
Parcel #:
Subdivision/Lot #:
Project Valuation: $
APPLICANT:
L
Phone:
2� VZ11 1,�771Qx11J<5
Fax:
Addres�Street,Ci tate, Zip):
Dl LOGI/
E-Mail Address:
.%lJliC./�i
PROPE TY OWNER:
J
Phone:
'�;'7 5e'7d 07'l
Fax:
Address (Street, City, Stat , ip): y�
44N,02, !i
E-Mail Address:
LENDING.AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:*
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
*Contractor must have.a valid City of Edmonds business license prior to
doing work in the City. Contact the City Clerk's Office at 425.775.2525
WA State License #/Exp. Date:
dv 2 7
City Business License #/Exp. Date:
DETAIL SCOPE OF WORK: e o tte' &�'
/L-' • � J G P f 1
PROPOSED NEW SQUARE FOOTAGE
FOR THIS PROJECT:
Basement: sq. ft.
Select Basement Type: ❑ Finished ❑ Unfinished
I" Floor: sq. ft.
Garage/Carport: sq .ft.
2° Floor: sq. ft.
Deck/Patio: sq. ft.
Retaining Wall: ❑ Yes ❑ No
Other: sq.ft
I declare under penalty of perjury laws that the information I have provided on this form/application is true, correct and
complete, and that I am the property owner or duly authorized agent of the property owner to submit.a permit application to
the City of Edmonds.
Print Name: '4�z- ���� ❑ Owner l�gent/Other (specify): 6y
Signature: Date:
FORM A LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Foim A.doc
Updated: 10/2011