BLD2020-1329+Supplementals+12.4.2020_9.59.08_AMnF
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Jurisdiction: Edmonds
Project Name: Swimming Pool Demo
Application ID: 893183
Supplemental Name: Authorization Statement - Building
All provisions of laws and ordinances governing this type of work will be complied with. I certify under penalty of perjury that the
information provided on this application is true and correct and, further that I am authorized by the owner of the above premises to
perform the work for which the permit application is made. I further agree to hold harmless the City of Edmonds as to any claim
(including costs, expenses, and attorney's fees incurred in investigation and defense of such claim), which may be made by any
person, including the undersigned, and filed against the City of Edmonds, but only where such claim arises out of the reliance of the
City, including its officers and employees, upon the accuracy of the information supplied to the City as part of this application.
I hereby authorize the City representatives to inspect my property Monday -Friday between the hours of 8:00 a.m. and 5:00 p.m.
during this permit application process for verifying site conditions.
Yes
The City of Edmonds makes permit applications available to the public in an effort to make its processes as transparent as possible. By signing or initialing this
document, I acknowledge that any and all information submitted as part of this application, is public information. I further acknowledge and agree that this permit
application, and any and all documents related thereto, may be disclosed by the City of Edmonds to the public without redaction.
Enter your digital signature below.
George Peppin
Supplemental Name: Electronic Submittals - Building
Electronic documents submitted to the City of Edmonds for plan review and permit issuance must be provided in a format that does
not prevent the City from making code comments on the documents during review or from making the documents ready for permit
issuance. Documents submitted in any manner that prevents the City from completing the review and permit issuance process,
including but not limited to submitting documents that are locked, may result in additional review time, permitting delays, and/or
cancelation of the permit application if the problem is not resolved by the applicant in a timely manner.
Please refer to chapter 18.43 RCW, chapter 18.210 RCW, chapter 196-23 WAC and chapter 196-33 WAC for Washington State laws
governing electronic documents. An interpretative guideline from the Board of Registration for Professional Engineers and Land
Surveyors can be found at http://www.dol.wa.gov/business/engineersiandsurveyors/docs/eDocsinterpretiveGuideline.pdf. These
laws and requirements are subject to change and the submitting parties are responsible for keeping apprised of any such changes.
Please acknowledge that you understand these requirements and have verified the electronic documents being submitted meet the
City of Edmonds submittal requirements by checking the box below. If you have questions, contact permit processing
at onlinepermits@edmondswa.gov or 425-771-0220.
Yes, I acknowledge.
Supplemental Name: Critical Area Determination - Clearing and Grading
A site specific Critical Area Determination, issued by the Planning Division is required for any ground disturbing activities at the time
of application. A determination is valid for 5 years from the date in which the determination was made; after such date the city shall
require a new determination.
Does the property have a current Critical Area Determination on file with the City?
YES
If you answered YES, what is the Critical Area # (CRAXXXX-XXXX)?
If you answered NO, please apply prior to submitting for your permit. You can apply through MBP, Land Use, Critical Areas.
N/A
Supplemental Name: Demolition - Asbestos
Asbestos
Asbestos is a carcinogen that is easily transported by air and breathed into the lungs so it must be handled very carefully. Prior to
performing any renovation or demolition, Puget Sound Clean Air Agency (Clean Air Agency) and Washington Department of Labor
and Industries (L&I) regulations require an asbestos survey be performed to determine if there are asbestos -containing materials in
the work area or structure. The asbestos survey must be conducted by an EPA certified (AHERA) Building Inspector and be kept on
the work site during the entire demolition project, including site cleanup.
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Jurisdiction: Edmonds
Project Name: Swimming Pool Demo
Application ID: 893183
A Clean Air Agency "notification", which may entail a waiting period of up to 10 days, is required for ALL demolition projects and
those renovation projects containing asbestos, except the renovation of a single-family dwelling performed by the homeowner living
in the residence. All asbestos must be removed by an L & I certified asbestos abatement contractor before any demolition activities
begin and be properly disposed of in accordance with state regulations.
For more information, please contact Puget Sound Clean Air Agency through their web site at www.pscleanair.org/asbestos or by
phone at 1-800-552-3565 and the Department of Labor and Industry through their website at
http://www.ini.wa.gov/TradesLicensing/LicensingReq/Asbestos or by phone at 360-902-5435.
Did you have an AHERA Asbestos Survey done?
Eel
Enter the PSCAA number obtained through Puget Sound Clear Air.
If you have not applied for one yet go to: www.pscleanair.org/asbestos