Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
old application.pdf
0 L,r�,t�r, BUILDING PERMIT V "�o APPLICATION Development Services Building Division 121 5th Ave N / Edmonds, WA 98020 ✓✓ c . t 8 `� 425.771.0220 For handouts, submittal requirements, permit status and inspection scheduling information go to: httn://www.e(inionciswa.gov/ JOB SITE INFORMATION/LOCATION: (Where the work is taking pplace) Job Site Address: y)2tPLA O)Vlmpi tyi w �)y L' Parcel: Lot /Unit/Suite #: 71� Subdivision: PROPERTY OWNER: V Name: &ADV ,yIr(__ Mailing Address: Pei DC lwl1 City/State/Zip(:: E41-well1 Phone #: -1 --1 ` I Email .J r t,2 I l J VS� C�WI I� �g7lM OWNER INSTALLATION: *If yes, read and sign* Will work be performed by the property owner? ❑ Yes ❑ No I own, reside in, or will reside in the completed structure. This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange according to RCW 18.27.090. Owner Signature: APPLICANT / CONTACT INFORMATION: 771� __ Name ofApplicant: > V e�� lM'�- Mailing Address: [ r� -0 ,/'1 ©o City/State/Zippy TZ/� V" V Phone #: -I E-mail: ✓'I'_]/Gll1 �,y 5�1L1 '(�%�"L GENERAL CONTRACTOR: (If different from applicant) General Contractor: 6C LC'h T-V(_'h,yVA Mailing Address:,-!) ,, City/State/Zip: ^�ltiL, S w� / n02_0 Phone #: E-mail: C�'t✓1 Gbh► L� ��e - WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE: ',LV-CG(( NN4.4 //&- A iy— CITY OF EDMONDS BUSINESS LICENSE M _ VO LKI 1 EXPIRED APPLICATION# BLD2018-1030 (NEW) PERMIT# BLD2019-1025 TYPE OF PERMIT (Provide ❑ Accessory Structure/ Detached Garage Details on Page 2) ❑ Addition ❑ Demolition ❑ Mechanical New Single Family / Duplex ❑ Plumbing ❑ Fire Sprinkler ❑ Remodel ❑ New Commercial/ Mixed Use ❑ Re -Roof ❑ Signs ❑ Tank ❑ Tenant Improvement ❑ Other Remodel Permit fees are based on: The value of the work performed. Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the work indicated on this application. Valuation: _ PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION Basement sq ft: Finished ❑ Unfinished ❑ 1st Floor, sq ft: 2nd Floor, sqft: I l Garage/Carport:, sq ft: Deck/Covered Porch/Patio: Other sq ft: PROJECT• 5 f ,2 Z s I I certify 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: r/ 1,41/u Signature: Date 7� 7 /� COMMERCIALGENERAL Occupancy Group(s): Occupant Load(s): Type(s) of Construction: Fire Sprinklers: Yes ❑ No ❑ WA STATE ENERGY CODE: If your project affects the building envelope, mechanical systems, and/or lighting, you must complete the appropriate WSEC forms. DEFERRED SUBMITTALS: All commercial building permits that will require associated plumbing, mechanical, fire sprinkler, and/or fire alarm permits are applied for separately. TI / CHANGE OF USE / NEW BLDG: Include TRAFFIC IMPACT worksheet EQUIPMENTMECHANICAL • BTUs Gas / Elec / Other Qty A/C Unit /Compressor Air Handler /VAV Boiler Dryer Duct I�C Exhaust Fans Fireplace k,cl Furnace 67C4S I Heat Pump Unit Hydronic Heating Roof Top Unit (Provide eleva- tions if a Commercial Bldg) Other: COUNTSPLUMBING FIXTURE Qty Qty Clothes Washer ` Tub/ Showers Dishwasher Backflow Device (RPBA, DCDA, AVB) Drinking Fountain Pressure Reduction/ Regulator Valve �I Floor Drain/Sink Refrigerator Water Supply Hose Bibs 2 Water Heater - Tankless?(5r N Hydronic Heat Water Service Line I Sinks Other: Toilets Other: GAS/FUEL CONNECTION COUNTS (New, Relocated or re -piped) BTUs Qty BTUs Qty A/C Unit Outdoor BBQ / Fire pit I Boiler Stove/Range/Oven l Dryer Water Heater I Fireplace/ Insert I Other: Furnace 1 Other: MEDICAL1COUNTS Relocated . Qty Qty Carbon Dioxide Nitrous Oxide Helium Oxygen Medical Air Other: Medical - Surgical Vacuum Other: DEMOLITION Type of structure to be demolished: Square footage of structure to be demolished: AHERA Survey done? Y / N PSCAA Case #: Critical Areas Determination: Study Required ❑ Conditional Waiver ❑ Waiver ❑ Fill in Place ❑ Fill Material: Removal ❑ Size of Tank (Gallons) Critical Areas Determination: Study Required ❑ Conditional Waiver ❑ Waiver ❑ Grading: Cut (70 cubic yards Fill 10 © cubic yards Cut / Fill in Critical Area: Yes ❑ No GENERAL PROVISIONS APPLICATIONS: Applications are valid for a maximum of 1 year. ESLHA Applications, 2 years. LICENSING: All contractors and subcontractors are required to be licensed with Washington State Department of Labor & Industries and have a current City of Edmonds Business License. A °r [bMo Y �N CITY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 me g90 PHONE: (425) 771-0220 - FAX: (425) 771-0221 BUILDING APPLICATION ACCEPTANCE Thursday, August 02, 2018 This Application has been accepted by the City of Edmonds for review. More information and changes may be required during this process. The review target date is: Your City Contact is CHRISTINA WAYLAND Application Number: BLD20181030 Project Address: 8364 OLYMPIC VIEW DR, EDMONDS PROPERTA'OWNER APPLICANT VECTOR ONE LLC VECTOR ONE LLC PO BOX 13377 PO BOX 13377 EVERETT, WA 98206 EVERETT, WA 98206 (425)791-3253 Work Description: New SFR Outstanding Items at Time of Submittal: It is anticipated that the following departments will be reviewing your application: ❑ Building ❑ P lanning ❑ Engineering ❑ Fire Please wait to re -submit corrections until after you have received comments from all reviewing departments. I HEREBY ACKNOWLEDGE THAT IHAVEREAD THIS APPLICATION THAT THE INFORMATION GIVEN IS CORRECT AND THAT AM THE PROPERTY OWNER, OR THE DULY AUTHORIZED AGENT 0 FTHE PRO PERTY OWNER TO SUBMITA BUILDING PERMIT APPLICATION TO THECITY. SIGNAT1! E(OWNt3 G OR PRINT NAME DATE S To view up to date information about your application please visit the City of Edmonds Development Services website at http://www.edmondswa.gov. c; y e`• t MU�N CITY OF EDMONDS 121 5TH A VENUE NORTH - EDMONDS, WA 98020 �n� i gQo PHONE: (425) 771-0220 - FAX: (425) 771-0221 Thursday, August 02, 2018 Your Application has been accepted by the City of Edmonds and we will start the application process with the information you provided. More information and changes may be required during this process. The decision target date is . Application Number: CRA20180142 Project Address: 8364 OLYMPIC VIEW DR, EDMONDS P RO PERTV OWN ER APPLICANT Vector One CC CONSTRUCTION PO BOX 13377 8415 192ND ST SW EVERETT, WA 98206 EDMONDS, WA 98026 (206) 714-9429 To view up to date information about yourpermit please visit the City of Edmonds Development Services website at http://Www.cLedmonds.wa.us.