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Building PermitType: DEMO Subtype: COM PRIMARY STRUCTURE DEMO I Status: ISSUED Parcel No: 00580700000401 Subdivision: 005807 Fire Sprinklers: Valuation: $0.00 Code Edition: 0 Site Address: 21200 72ND AVE W EDMONDS,WA 98026-7700 Lot: 0 Lot Area: Zoning: Occupancy Type: Construction Type: No. Stories: 0 # of Dwelling Units: 0 Scope of Work: ANTHOLOGY -DEMO BUILDING HAVE PSCAA# Applied: 1/20/2022 Issued: 3/8/2022 Final: Expiration Date: 9/4/2022 Issued by: NED I WA State Contractor L & I #: CADBCCC801PR I CONTACTS NAME TYPE NAME ADDRESS PHONE EMAIL APPLICANT MICHAEL DUGGAN 130 E. RANDOLPH STREET, (312)248-2091 MDUGGAN@CA-VENTURES.COM CHICAGO IL 60601 CONTACT CA SENIOR EDMONDS 130 E. RANDOLPH STREET, (312)248-2091 mduggan@ca-ventures.com PROPERTY OWNER, LLC CHICAGO IL 60601 CONTRACTOR CADB CATALYST 130 E RANDOLPH ST STE 2100, (312)466-4016 osmith@catalystconstructiongrp.com CONSTRUCTION CHICAGO IL 60601 DEVELOPER CADB CATALYST 130 E RANDOLPH ST STE 2100, (312)466-4016 osmith@catalystconstructiongrp.com CONSTRUCTION CHICAGO IL 60601 OWNER JAS GROUP LLC 154 LAKE WASHINGTON BLVD E, (218)818-8386 SEATTLE WA 98112 PRIOR DICKSON COMPANY 3315 SOUTH PINE RD, TACOMA (253)472-4489 CONTRACTOR WA 98409 FEE INFORMATION DESCRIPTION ACCOUNT AMOUNT PAID PAID DATE RECEIPT # CITY TECHNOLOGY FEE CHARGED 001.000.321.99.100.00 $40.00 $40.00 1/26/22 R17631 PER PERMIT COMMERCIAL STATE SURCHARGE 001.000.237.150 $25.00 $25.00 1/26/22 R17631 DEMO - SUB COM BLDG PERMIT 001.000.322.10.000.00 $150.00 $150.00 1/26/22 R17631 FEE DEMO - SUB COM BLDG PLAN 001.000.345.83.000.00 $100.00 $100.00 1/26/22 R17631 REVIEW FEE DEMO - SUB COM ENG INSP FEE 001.000.341.82.000.00 $150.00 $150.00 1/26/22 R17631 DEMO - SUB COM ENG REVIEW FEE 001.000.341.82.000.00 $100.00 $100.00 1/26/22 R17631 TOTALS: $565.00 $565.00 CONDITIONS CONDITION TYPE STATUS NOTES It is the owner's responsibility to repair/replace all damage of utilities or frontage DAMAGE TO FRONTAGE FOR improvements in City right of Ways or Easements to City Standards caused by or IMPROVEMENTS INFORMATION occurring during the permitted project. Printed: Tuesday, March 08, 2022 12:58:55 PM 1 of 2 DEMO Permit PERMIT NUM of Edmonds EdmondsCity 98020 1 11 ondswa.gov1.02 FOR Maintain erosion and sedimentation control per City and SWMMW standard ESC REQ INFORMATION requirements. 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 FOR officials, employees, and agents from any and all claims for damages of whatever nature, HOLD HARMLESS INFORMATION 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. 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 FOR 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding SOUND OR NOISE INFORMATION 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. FOR All utilities shall be located prior to any excavation. New locates shall be called for if at UTILITY LOCATES INFORMATION time of excavation, original locates are no longer identifiable. COMPLETED RESt SEQID INSPECTION TYPE INSPECTOR DATE A-1 PLANNING PRECON A-1 TESC AND MOBILIZE E-6 DEMO WATER AVB X-2 ENGINEERING FINAL X-3 BUILDING FINAL" E-6 DEMO SEWER CAP A-1 ENGINEERING PRECON Printed: Tuesday, March 08, 2022 12:58:55 PM 2 of 2