Building Permit (3)RIVATE
PROPERTY WIRELESS Permit
City of Edmonds
PERMIT NUM
EdmondsP 98020BLD2021-17314
ML
www.edmondswa.gov
Type: PRIVATE PROPERTY
Subtype: ELIGIBLE FACILITIES REQUEST
Status: ISSUED
WIRELESS
Parcel No: 27032400207100
Site Address: 410 4TH AVE N EDMONDS,WA 98020-3119
Applied: 12/23/2021
Subdivision: 004342
Lot: 0
Issued: 12/16/2022
Fire Sprinklers:
Lot Area: Zoning:
Final:
Valuation: $90,000.00
Occupancy Type: Construction Type:
Expiration Date: 12/11/2023
Code Edition: 0
No. Stories: 0 # of Dwelling Units: 0
Issued by: BAC
Scope of Work: DISH WIRELESS- ANTENNAS MODIFICATIONS/ADDITIONS **EFR**
WA State Contractor L & I #: SILVEL*792RB
NAME TYPE
NAME
ADDRESS
PHONE
EMAIL
APPLICANT
MIKE SLOTEMAKER
12303 434TH AVE SE, NORTH
(206)214-8954
MIKE.SLOTEMAKER@GREYSKIESWIRE
BEND WA 98045
LESS.COM
12303 434TH AVE SE, NORTH
mike.slotemaker@greyskieswireless.c
CONTACT
GREY SKIES WIRELESS
(206)214-8954
BEND WA 98045
om
2561 152nd Ave NE, REDMOND
CONTRACTOR
SILVERTECH LLC
WA 98052
EDMONDS PUBLIC
FACILITIES
121 5TH AVE N, EDMONDS WA
OWNER
DISTRICT
98020
FEE INFORMATION
DESCRIPTION
ACCOUNT AMOUNT
PAID
PAID DATE
RECEIPT #
CITY TECHNOLOGY FEE CHARGED
001.000.321.99.100.00
$40.00
$40.00
1/19/22
R17409
PER PERMIT
COMMERCIAL STATE SURCHARGE
001.000.237.150
$25.00
$25.00
1/19/22
R17411
PERMIT FEE - COMMERCIAL
001.000.322.10.000.00
$1,216.00
$1,216.00
1/19/22
R17411
PLAN REVIEW FEE - COMMERCIAL
001.000.345.83.000.00
$1,033.60
$1,033.60
1/19/22
R17409
TOTALS: $2,314.60
$2,314.60
7
CONDITION TYPE
STATUS
NOTES
Printed: Friday, December 16, 2022 11:42:08 AM 1 of 2
PRIVATE " PROPERTY
WIRELESPerCity mit
-
• • •
98020 1
www.edmondswa.gov
/ 4253T•
1- HOLD HARMLESS - 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 of 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. 2
- PERMIT DISCLOSURE - Any request for alternate design, modification, variance or other
administrative deviation from adopted codes ordinances or policies must be specifically
requested in writing and be called out and identified. Processing fees for such requests
shall be established by Council and shall be paid upon submittal and are nonrefundable.
3- SOUND OR NOISE - Sound/Noise originating from temporary construction sites as a
ALL BUILDING PERMITS
FOR
result of construction activity are exempt from the noise limits of ECC Chapter 5.30 only
INFORMATION
during the hours of 7:00am to 6:00pm on weekdays and 10:00am to 6:00pm on
Saturdays, excluding 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. 4 -
OCCUPANCY - 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. 5 - PLUMBING - Plumbing contractor license laws are regulated by Chapter
18.106 RCW. Property owners who hire an unlicensed plumber may assume the risks and
potential monetary liability for work performed by unlicensed plumbing contractors. For
more information contact L&I Department of Licensing at 1-800-647-0982.
ELECTRICAL PERMIT
FOR
Obtain Electrical Permit from State Department of Labor and Industries 425-290-1309.
NFORMATION
Installation, use and maintenance of equipment and components shall be per
MANUFACTURER SPECS
FOR
manufacturers specifications, installation instructions, and applicable state codes.
INFORMATION
provide manufactures installation instructions on site for Building Inspector.
REQUIRED SPECIAL
FOR
SI required for epoxy anchors.
INSPECTIONS
INFORMATION
INSPECTIONTYPE INSPECTOR
COMPLETED RESULT
NOTES
!������
x BUILDING FINAL**
B-5 BLDG SPECIAL
Please provide inspection reports for epoxy anchors
INSPECTION
to eric.carter@edmondswa.gov prior to final
inspection. Inspection agency shall provide certified
inspector.
Printed: Friday, December 16, 2022 11:42:08 AM 2 of 2