RESUB1 BLD2021-1323+APPLICATION-UPDATED+11.21.2021_11.48.49_AM+2531698100
RESUB
Nov 22 2021 BUILDING PERMIT
CITY OFEDMONDS APPLICATION
>EVELOPMENT SERVICES
DEPARTMENT 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.mvbuildinppermit.com
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job Site Address: 611 Sater Lane
Parcel: 270324-002-225
Lot /Unit/Suite #: Subdivision:
BUSINESS OR PROPERTY OWNER:
Name: Chris & Carole Crall
Mailing Address: 611 Sater Lane
City/State/Zip: Edmonds WA 98020-3002
Phone #: 206.856.9665 -Carole
Email: cscrall@carrisgroup.com
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:
APPLICANT / CONTACT INFORMATION:
Name of Applicant: Daniel Corcoran
Mailing Address: 1429 NW 51 st St Ste 1
City/State/Zip: Seattle WA 98107
Phone #: 206-604-0735
E-mail: daniel@studioDEC.com
GENERAL CONTRACTOR: (If different from applicant)
General Contractor: owner - see above
Mailing Address:
City/State/Zip:
Phone #:
E-mail:
STATE UBI #:
CITY OF EDMONDS BUSINESS LICENSE #:
WA STATE CONTRACTOR L & I #: (CCB) & EXPIRATION DATE:
Office Use.
FPermit #: BLD2021-1323
TYPE OF PERMIT (Provide
Details on Page 2)
❑ Accessory Structure/
Addition
Detached Garage
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
the nearest dollar) of all equipment, materials, labor, overhead,
and the profit for the work indicated on this application.
Valuation: 280,000
PROPOSED.. FOR THIS APPLICATION
Basement sg ft: Finished❑ Unfinished ❑
1st Floor, sg ft:
2nd Floor, sgft:
98 sf
Garage/Carport:, sg ft:
Deck/Covered Porch/Patio:
# of NEW Bedrooms:
# of NEW Bathrooms:
PROJECT
Interior remodel to both levels and upper
floor addition of 98 sf of heated space (84
at east, 14 at entry) and conversion of 64
sf at existing ground floor garage to
heated space.
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
Edmonds.
Print Name: Daniel E Corcoran
Signature: Date 9.13.21
COMMERCIALGENERAL
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
EQUIPMENTMECHANICAL •
BTUs Gas / Elec / Other Qty
A/C Unit /Compressor
Air Handler /VAV
Boiler
Dryer Duct
elec
Exhaust Fans
kitch, 2 baths
3
Fireplace
Furnace
60k
gas dV
1
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
Other:
COUNTSPLUMBING FIXTURE
Qty Qty
Clothes Washer
1 R
Tub/Showers 1R, 1N
2
Dishwasher
1 R
Backflow Device (RPBA, DCDA, AVB)
Drinking Fountain
Pressure Reduction/ Regulator Valve
Floor Drain/Sink
Refrigerator Water Supply
1 R
Hose Bibs
Water Heater - Tankless? Y do
1 N
Hydronic Heat
Water Service Line existing
Sinks 2N, 2R
4
Other:
Toilets 1R, 1N
2
Other:
COUNTSGAS/FUIEL CONNECTION d or re piped)
BTUs Qty BTUs Qty
A/C Unit
Outdoor BBQ/ Fire pit
Boiler
Stove/Range/Oven
Dryer
Water Heater
50 k
1
Fireplace/ Insert
Other:
Furnace
6 0 k
1 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:
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
GRADE/FILL/EXCAVATE
Grading: Cut 0 cubic yards
Fill 0 cubic yards
FCut / 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.