BLD20170176.pdfr�
'41T
1215TH AVENUE NORTH- EDMONDS, WA 98020
�
PHONE: (425) 771-0220'- FAX: (425) 771-0221
C '
STATUS: ISSUED 02/06/2017111!UYI
Expiration Date: 08/06/2018 �, ���JJ������ ����r ,, 1, ,ai�',e,
Parcel No: 27041900104400
VICTOR ILYUKEVICH VICTOR ILYUKEVICH VICTOR ILYUKEVICH
1961581STPLW 1961581 STPLW 1961581 STPLW
EDMONDS, WA '98026 EDMONDS, WA 98026 EDMONDS, WA 98026
(206)375-6429 (206)375-6429 (206)375-6429
LICENSE #: EXP:
Frame,insulate walls, new drywall in family room and garage, install sound panels in garage. Relocate gas p
future fireplace in family room
*ALL WORK SUBJECT TO FIELD INSPECTION, WORK BEGAN PRIOR TO PERMIT*
VALUATION: $5,000.00
N
gas
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. AND ALL FEES ARE PAID,
)Elv V;,L-(Qr 28 "14,6 2_041
gm tee v
Signature Pqht Name Date Released By Nate
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED, UBC109/ IBC110/ IRC110
ONLINE APPLICANT ASSESSOR 0THFlt �.
STATUS: ISSUED
BLD2017017
• 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 fromtemporary construction sites as a result of construction activity are exempt fromthe noise limits
of ECC Chapter 5.30 only during the hours, of7:00amto 6:00pmon weekdays and 10;00amand 6:00pmon Saturdays, excluding
Sundays and Federal Holidays. At all othertimes the noise originating from construction sites/activities most 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 pen -nit 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);
PUBLIC WORKS 425" 771-0235
When calling for an inspection please leave the 11
requested) Contact Name and Phone D
• B -Cas Test/Pipe
•r B -Framing
., B-Insulation/Energy
• B-SheetrockNail
• B -Building Final
&TREATMENT ( 672-5755 1 RECYCLING 425 2754801
ig information: Permit Number, Job Site Address, Type of Inspection being
r, Date Prefereed, and whether you Kefermornin or afternoon.
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).
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 of „ 2011
PROPERTY OWNER/AUTHORIZED WITNESS_
PERSON
Signature Signature
Print Name Print Name
LATEMP\BUILDING\HANDOUTS REVISED IN 2009\PREVIOUS HANDOUTS\FORMS\CONTRACTOR EXEMPTION FORM
D.DOCREVISED 7/07