BLD20151130.PDFof EDL
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED
Expiration Date: 03/02/2016
Parcel No: 00865300000100
� -,------°--_--------~--- ~.-Permit#: BLD20151130
Project11,ddress: 1233 OLYMPIC VIEW DR,;
EDMONDS
PROPERTY OWNER APPLICArIT C*11VWACTOA
BLOOM EARLY EDUCATION BLOOM EARLY EDUCATION MCDONALD HOME CONSTRUCTION
C/O DAVID B LIVING TRUST PAGE C/O DAVID B LIVING TRUST PAGE 19815 Yew Way
1233 OLYMPIC VIEW DR UNIT 2 1233 OLYMPIC VIEW DR UNIT 2 Snohomish, WA 98296
EDMONDS, WA 98020-2658 EDMONDS, WA 98020-2658
(425) 361-7992 (425) 361-7992 (206) 920-9599
LICENSE #: MCDONHC855LK EXP:06/12/2017
t DESCRIPTION
INTERIOR DEMO ONLY OF GRID CEILING AND NON LOAD BAIRING WALLS FOR PREP OF NEW FIRE BARRIER
VALUATION: $0.00 CO'ImAmPLETED
PERMIT TYPE: Commercial
PERMIT GROUP: 23 - Demolition
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY:
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: ( 0 X 0 FT.)
CODE:
OTHER: ------- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
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
BEDROOMS:0 BATHROOMS:O
BEDROOMS:0 BATHROOMS:0
FRONT S E1rBACK SIDESErBACKi
REQUIRED: PROPOSED: REQUIRED: PROPOSED: REQUIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O REQUIRED: PROPOSED:
SETBACK NOTES:
1 AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHE 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.
11�S APPLICA 1 NNQTJA PERMIT UNTIL SIGNED BY THE BUILDING QFFICIAL OR HISIHER DEPUTY AND ALL FEES ARE PAID.
Print Name Date IReleased By
Date
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. UBCI09/ IBCI 10/ IRCI 10.
ONLINE APPLICANT = ASSESSOR OTHER
STATUS: ISSUED
BLD20151130
• 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.
PERMITTIME LIMIT: SEE ECDC 19.00.005(A)(6)
771-0220 EXT. 1326 1 FIRE (425) 775-7720
PUBLIC WORKS 425 771-0235 1 PRETREATMENT 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.
• B-Final Demolition
N
DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
Est, l
121 5 h Avenue N, Edmonds, WA 98020
Phone 425.771.0220 A Fax 425.771.0221
City of Edmonds
PLEASE REFER TO THE PLUMBING & MECHANICAL CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
1233 01ym iLUieZv iv-c�G4M6y,AS,Lkyr g80w
Parcel #:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes � No ❑
Associated Permit #:
APPLICANT: Bloom Eav (kc 6Y)
Phone:
l �l
Address (Street, City, State, Zip): 1� D' IL I/i
y V �r.
E-Mail Ad s : ,
1-av� vl ��06
PROPERTY OWNER
Phone:
Fax:
Address (Street, City, State, Zip�jf
�o? ! r. (;4ynm,4s R O zU
E-Mail Address:
LENDING AGEN Y:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:*T�
h t, 0
�C
Phone:
Fax:
Address (Street, City, State, 2'p):
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 6
WA State License #/Exp. Date:
City Business License #/Exp. Date:
NR-021__�_1
PLUMBING MECHANICAL L I TANKI
I DEMOLITION
DETAIL THE SCOPE OF WORK: Te-gxDye_ qyi J Ce-1 I) nci 46 `dye p ,(/e `FoY-
ct,� cs� CIF rbowy'fc_r - --1hAed Or on LU
0
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. ( OU)
Print Name: 1 ` Owner❑ A ent/Ot erx] (specify): ruly-
01LLg s- &Ovn
Signature: Date: 8 1
�ll_CCt_T1
FORM C LABuilding New Folder 2010\DONE & x-ferred to LrBuilding-New drive\Form C 2014.docx Updated: 1/17/2014
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