BLD2020-0835+City_Application+8.11.2020_10.44.47_AM'0(c. 18y'
BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 5th Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements go to: www.edmondswa.gov.
To apply for permits, schedule inspections, or check application status
go to: www.mvbuildingpermit.com
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job Site Address: 10624 Nottingham Rd
Parcel: 00571300101800
Lot /Unit/Suite #: TR 18 Subdivision: Sherwood Villas,
BUSINESS OR PROPERTY OWNER:
Name: Georgia Ragsdale
Mailing Address:
1037 NE 65th St. #160
City/State/Zip: Seattle, WA 98115
Phone #: (310) 709-5319
Email: girags@gmail.com
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? Yes F 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:
Name of Applicant: Regan McClellan
Mailing Address: 3309 Wallingford Ave N
City/State/Zip: Seattle, WA 98103
Phone #: 206.729.0480
E-mail: regan@mccarch.com
GENERAL CONTRACTOR: (If different from applicant)
General Contractor: Bakstad Construction, LLC
Mailing Address: 4701 SW Admiral Way #249
City/State/Zip: Seattle, WA 98116
Phone #: 206.355.0277
E-mail: info@bakstadconstruction.com
STATE UBI #: 602 874 735
CITY OF EDMONDS BUSINESS LICENSE #:
WA STATE CONTRACTOR L & I #: (CCB) & EXPIRATION DATE:
BAKSTCL924QG 1 1 /29/2020
Office Use Oniy
TYPE OF PERMIT (Provide
Details on ..
❑Accessory Structure/
Addition
❑
Detached Garage
Demolition
Mechanical
New Single Family/Duplex
Plumbing
Fire Sprinkler
R1 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.
000
Valuation: 80,000
PROPOSED NEW SQUARE FOOTAGE
FOR THIS APPLICATION
Basement sq ft: Finished Unfinished ❑
1st Floor, sq ft:
0
2nd Floor, sqft:
0
Garage/Carport:, sq ft:
O
Deck/Covered Porch/Patio:
96
# of NEW Bedrooms: 1 # of NEW Bathrooms:
PROJECT•
Remodel of existing single family home:
1st Floor - Bdrm 1 - Demolition of existing window & wall
abv/below, new patio door w/ small exterior patio to be
added
2nd Floor - Demolition of existing interior & exterior walls,
windows & interior doors, and plumbing fixtures. New layout
to create one large main bedroom, walk-in closet and
bathroom. New larger windows to be added on South and
East Elevations. Bath windows on West elevation to be
replaced with new windows. New interior framing, exterior
framing, plumbing fixtures, lighting and mechanical revisions.
Main bedroom to have new electric fireplace unit, no new
venting to be required.
Exterior: New larger windows added. Requires changes to
Downspouts and electric utility connection. Siding to be
replaced as necessary.
Print Name: Regan McClellan AIA
Signaturet.� Date $ 11.2020
COMMERCIALGENERAL
Occupancy Group(s): R-3 Occupant Load(s): 14 (200 gross)
Type(s) of Construction: V-B Fire Sprinklers: Yes❑ No-1
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
Exhaust Fans
90 cfm
Elec
2
Fireplace
Furnace
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
Other:
COUNTSPLUMBING FIXTURE
Qty Qty
Clothes Washer
Tub/ Showers
2
Dishwasher
Backflow Device (RPBA, DCDA, AVB)
Drinking Fountain
Pressure Reduction/ Regulator Valve
Floor Drain/Sink
Refrigerator Water Supply
Hose Bibs
Water Heater - Tankless? Y or N
Hydronic Heat
Water Service Line
Sinks
2
Other:
Toilets
1
Other:
CONNECTION COUNTSd or re piped)
BTUs Qty BTUs Qty
A/C Unit
Outdoor BBQ/ Fire pit
Boiler
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
Other:
Furnace
Other:
COUNTSMEDICAL GAS, AIR VACUUM
Relocated or re piped)
Qty Qty
Carbon Dioxide
Nitrous Oxide
Helium
Oxygen
Medical Air
Other:
Medical - Surgical Vacuum
Other:
DEMOLITION
Type of structure to be demolished: Interior/Exterior Walls
Square footage of structure to be demolished: 0
AHERA Survey done? Y❑/ N❑
PSCAA Case #:
Critical Areas Determination:
Study Required ❑ Conditional Waiver El Waiver❑
Fill in Place ❑ Fill Material:
Removal ❑
Size of Tank (Gallons)
Critical Areas Determination:
Study Required Conditional Waiver Waiver
Grading: Cut __ cubic yards
Fill _ 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.