BLD2022-1566 1229274_PAPER APPLICATION_11-14-2022_10_37_15_Building_Permit_Application_-_8730_Main_St_Edmonds (3)Inc. I89'i
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.aov.
To apply for permits, schedule inspections, or check application status
go to: www.Tybuildingpermit.com
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job site Address: 8730 Main St Edmonds, WA9802"
Parcel: 003736-005-004-04
Lot /Unit/Suite #: Subdivision:
BUSINESS OR PROPERTY OWNER:
Name. Ivan & Jean Lindhart
Mailing Address: 1034 8th Avenue
City/State/Zip: South Edmonds, WA 98020
Phone #:
Email:
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:
I APPLICANT / CONTACT INFORMATION:
Name of Applicant: Linda Williams, Agent
Mailing Address: 12672 Limonite Avenue, 3E-185
City/State/Zip: Eastvale, CA 92880
Phone #: 949-373-6377
E-mail: linda@amwireco.com
GENERAL CONTRACTOR: (If different from applicant)
General Contractor: Mastec Network Solutions
Mailing Address:22263 68th Avenue, S
City/State/Zip: Kent, WA 98032
Phone #: 949-373-6377
E-mail: linda@amwireco.com
STATE UBI #: 603 235 974
CITY OF EDMONDS BUSINESS LICENSE #:
WA STATE CONTRACTOR L & I #: (CCB) & EXPIRATION DATE:
05-14-2023
=P-r_'t4_
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 I
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:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
# of NEW Bedrooms: # of NEW Bathrooms:
PROJECT
` 6ma- X��
i
i
i
I
i
i
I
i
I
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 I
i
Edmonds.
Print Name: Linda Williams
opuuy wy,aa by tt,aa wuiama i
Linda Williams Data' 2022.11.0312:1616
Signature: -07"o9 Date
GENERAL• DATA
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
MECHANICAL• • . • -.
BTUs Gas / Elec / Other Qty
A/C Unit /Compressor
Air Handler/VAV
Boiler
Dryer Duct
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
Other:
PLUMBING FIXTURE COUNTS (New, Relocated or re piped)
Qty Qty
Clothes Washer
Tub/ Showers
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
Other:
Toilets
Other:
GAS/FUEL CONNECTION COUNTS (New, Relocated 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 . piped)
Qty
Qty
Carbon Dioxide
Nitrous Oxide
Helium
Oxygen
Medical Air
Other:
Medical - Surgical Vacuum Other:
• •
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 cubic yards
Fill cubic yards
Cut / Fill in Critical Area: Yes ❑ No ❑
GENERAL.• •
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.
ATTACHMENT "A"
PROJECT DESCRIPTION
Project Name: DECOMMISSION SPRINT ROOFTOP TELECOM
FAC I LTY
Site Name: PINE RIDGE
Site Address: 8730 MAIN STREET, EDMONDS, WA 98026
APN: 003736-005-004-04
GPS Location: LAT: 47.8104450 N / LONG-122.3521720 W
Site Type: UNMANNED TELECOMMUNICATIONS FACILITY
WOOD POLE
SPRINT / TMOBILE PROPOSES TO MODIFY AN EXISTING UNMANNED
WIRELESS COMMUNICATIONS FACILITY. THIS MODIFICATION WILL
CONSIST OF THE FOLLOWING:
WOOD POLE EQUIPMENT:
• REMOVE EXISTING (2) PANEL ANTENNAS (1 PER SECTOR, TOTAL 2)
• REMOVE EXISTING (2) RRU'S (2 PER SECTOR)
• REMOVE EXISTING MOUNTING HARDWARE
• REMOVE EXISTING COAX AND LINES
GROUND EQUIPMENT:
• REMOVE EXISTING (1) WOODEN FENCE ENCLOSURE
• REMOVE EXISTING (1) CONCRETE PAD
• REMOVE EXISTING (1) MMBS-BBU CABINET
• REMOVE EXISTING (2) RRUS
• REMOVE EXISTING (2) GPS ANTENNAS
• REMOVE EXISTING (1) PPC BOX
• REMOVE EXISTING (1) METER BOX
• REMOVE EXISTING (1) TELCO CABINET
• REMOVE EXISTING (1) AAV BOX
Cascade #: SE63XC212