BLD20190707OV EQII�f
PHONE: (425) 771-0220 - FAX: (425) 771-0221
CITY OF EDMONDS
121 5TH A VENUE NORTH -EDMONDS, WA 98020
Expiration Date:
Parcel No: 00434400600100
Project Address: 111 4TH AVE N, EDMONDSI
PA011PAII-YOWNIN APPLICANT CONTRACTOR
SAI KAI LLC SHUBERT HO CUSTOM WOODWORK
C/O SHUBERT HO PO BOX 1952 C/O CONSTANTINE MAVROMATIS
229 3RD AVE S STE 301 EDMONDS, WA 98020 1312 3RD ST
EDMONDS, WA 98020 KIRKLAND, WA 98033
(425) 643-8400 (206) 588-5148 (425) 828-2579
LICENSE #: CUSTOW* 178RR EXP�I 0/19/2020
JOB DESCRIPTION
WALL SIGN FOR NEW SUSHI RESTAURANT - SAN KAI
VALUATION: $0
PERMIT TYPE: Commercial
PERMIT GROUP:'O-�:�Sjgn
GRADING: N CYDS: 0
TYPE,01.CQNSTRUCT ION -
RETAINING WALL ROCKERY:
OCCUPANT dW_6TJP-._
LOAD:
_OCCUPANT
FENCE: 0 X 0 FT.)
CODE
OTHER - ------- OTHERDESC:
IZONE� BDI
INUMBER OF STORIES: 0
VESTED DATE:
INUMBER OF DWELLING UNIT S: 0
LOT 4:
EUSTING ARFA
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
PROPOSEDAREA
rBASEMENT 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK:O OTHER 0
13RD FLOOR: 0 GARAGE: 0 DECK:O OTHER: 0
BEDROOMS: 0 BATHROOMS: 0
1BEDROOMS: 0 BATHROOMS 0
FIZONT S EFB ACK SIDESLTBACK REARSETBACK
REQUIRED: PROPOSED: 7477U _IRME D: PROPOSED: IREQUIRED: PROPOSED.
HEIGHT ALLOWED:O PROPOSED:0 IREQUIRED: PROPOSED:
SETBACK NOTES:
IAGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THEWORK AUTHORIZED THEREBY, NO
PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION
INSURANCE AND RCW 18:27.
,,,—THI,�APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR NIS/HA DEPUTY AND ALL FEES ARE PAID.
<� �'o� 1-11 IV) A/ 11 q:��) 0 \'N ��R" �g I t
8ignalure Print Name uale t ReVased By Date
ATTENTTON
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED.UBC109/IBCI 10/ IRCI 10.
FW APPLICANT ASSESSOR E<crlry
STATUS: ISSUED BLD20190707
CONDITIONS
• All new, extended, re -built or relocated electrical utility and/or service shall be placed underground.
• 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.
• Any request for alternate design, modification, variance or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable.
Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any items not to code specification.
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 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must comply with tile
noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120,
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 fromthe 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.
I INSPECII]IONS
THIS PERMIT AUTHORIZ_ES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY
CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDB/VALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT
TIME LIMIT: SEE ECDC 19.00.005(A)(6)
BUILDING
ENGINEERING (425) 771-0220 EXT. 1326
1. Go to: www.edmondswa.gov
Building Department Inspections
2. Then: Ser\Aces
are now scheduled online. If you
FIRE (425) 775-7720
3. Then: Perm its/Development
have difficulties, please call the
4. Then: Online Permit Info
Building Department front desk for
PUBLIC WORKS (425) 771-0235
5: If you don't have one already, create a
assistance during office hours.
login (upper right hand comer)
(425) 771-0220
RECYCLING (425) 275-4801
6: Schedule your inspection
I I
When calling for an inspection please leave the follovving information: Permit Number, Job Site Address, Type of Inspection
— being requested, Contact Name and Phone Number, Date Preferred, and whether you prefer morning or afternoon.
* B-Building Final
% .0 C. Is 9\3
BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 5th Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, permit status and inspection
scheduling information go to: http://www.edmondswa.gov
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job Site Address: [it q th A vg- KL 9 50>0
Parcel:
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: WA&ut S-_O�kt- PA4P.Chjktb_
Mailing Address: �3 145' rE: �,s R-
City/State/Zip: LA I" -
Phone #: 14 21L-� 43 - 8 4 00
E rn a i 1: IL-14 A 4A,- 0,. ��- 0 S-C CZ_�
U
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? El Yes )k 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: S "6A'r�
Mailing Address: Fu B'D Y. I em-'-L
City/State/Zip:
Phone#: Ol'Wr 418
E-mail: S (2)
GENERAL CONTRACTOR: (if different from applicant)
General Contractor: CV&,J�VAk WMALA_�
Mailing Address: E0 A-jLbX
City/State/Zip: U-4w-4-A& i V4 I
Phone#: 90t, ";�%S S_ 14'9
E-mail: (; tw 6-al-t1k V-1b 0
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
C 1-4- SZO Vo'o 126 9K �Xp-. lolxc'/2�6
CITY OF EDMONDS BUSINESS LICENSE #:
Office Use Only
Permit #: 5 LZ7Z4L) I
TYPE OF PERMIT (Provide
Details on Page 2)
• Accessory Structure/
0 Addition
Detached Garage
• Demolition
Mechanical
El New Single Family / Duplex
Plumbing
13 Fire Sprinkler
0 Remodel
El New Commercial/ Mixed Use
El Re -Roof
;&Signs
El Tank
ATenant Improvement
El 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:
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
Basement sq ft: Finished El Unfinished E1
Ist Floor, sq ft:
t-.�)Cro
2nd Floor, sq ft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
other sq ft:
PROJECT DESCRIPTION
S�6-1t'd F:�612_ �Aiew
�_7c�t
—SAA
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:
Signature-.__�� Date
GENERAL COMMERCIAL DATA
Occupancy Group(s): J5 Occupant'Load(s):
Type(s) of Construction:
Fire Sprinklers: Yes 11 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
-1
MECHANICAL EQUIPMENT COUNTS (New and Relocated)
BTUs Gas Elec Other Qty
A/C Unit /Compressor
I Z J4
Air Handier /VAV
Boiler
Dryer Duct
Exhaust Fans H'DOD
Fireplace
Furnace
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
let, 004)
Other:
PLUMBING FIXTURE COUNTS (New, Relocated or re -piped)
Qty QtY
Clothes Washer
Tub/ Showers
Dishwasher
Backflow DevicODCDA, AVB)
Drinking Fountain
Pressure Reduction/ Regulator Valve
Floor Drain/Sink
Refrigerator Water Supply
Hose Bibs
Water Heater - Tankless 0 r 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
-1MW1;;
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
Other:
Furnace Other:
MEDICAL GAS, AIR VACUUM COUNTS
(New, 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
TPSC Case #:
Critical Areas Determination:
Study Required El Conditional Waiver El Waiver El
Fill in Place El Fill Material:
Removal El
Size of Tank (Gallons)
Critical Areas Determination:
Study Required 0 Conditional Waiver El Waiver El
GRADE/FILL/EXCAVATE
Grading: Cut cubic yards
Fill cubic yards
Cut / Fill in Critical Area: Yes 0 No El
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.
the shining sun
A r
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APPROVED
ALL WORK SUBJECT
1EI111.2
MUST BE
TOFIELD
Rjerior W" �fttlrg dtlall& WaD Signs Actilchet!
IQ _rri., -I& of sobd ynwowy, cc=" o, st� &hall be
Sign Material and Mounting:
—Sign Material: MDO
PLANS
INSPECTION F ORini[c],
COMPLIANCE
O� �wejy u�W by cnea� ofinetal anctim, bolts
0, Of aw 1,MR vw'�' L.& (9-5 =) diame-
ter and s.' be '.'k4dd a t 'O"t 5 ind'. (m n) wood
blocks "It ROt bc ocd f-1 —hw-g-, c-00jX in the �54 Of
ahaclicti to buiililinp �ith 11- of wood A wall
—Face Application: printed vinyi adhesive
—Mounting Hardware: Metal concrete BLUE Tapcon bolts mounted directly to the face of the sign.
Additional adhesive will be applied prior to mounting on the back of the sign. Bolts places at each 90
ON JOB SITE..
CODE
�4 signs
nor be supponed by anchorages &cz=4 to an
degree corner of the sign, then no more than 24" spacing.
sign shall
'ka"d P"Pct wall.
H111.3 Extension. WOH signs 4.1] " _WA above the "
—Light Fixtures existing, no new work there.
of ttK wAtt ot *yond tf�e m44 of the -all to which the signs
scope of
work
= amscbw UWCS-' such ngns Ounforns W Lhc rcqvi�--
r- -( sig-, pr*,dn slp� - gr-in� siz-
it
25
'No commercial sign shall be illuminated after
11:00 PM unliess the commercW enterprise Is
open for business and then may mmain on
onl� as long as the entemrise is open."
Sign material and mounti":
-sign material: MDO
4ace application: printed
vinyl adhesive 1-011
16
-mounting hardware: metal
concrete bolts motinte<1
directly to the faceof the
Si 9A, Addit6nal edlit1i;e
VAII be "iLd prior to
mounting on the back of
-C the sign. bolt
0
I.- -light fi)(ILIMS: Will have 9w&tt
D led bulbs for equivilent Ww
-r- lighting, Told1wattisge=27i
0
Occupant
Suite # Area
Suite 111 1,380
Area Analysis performed in accordance with ANSI/BOMA Z65.5 — 2010
7050 WINDOW
L
complies per 20.60.03( Wall signs IMaximurn area and height.
31-2 51-611
S a n K a I
S a n K a I
4th ave North
7050 WINDOW
exist 6watt LED uplighting
existing awning
Original Sign Design Elements (LOGO)
7AP RO EDBYPLANNING
CITYCr911
Ury
CITY OF EDMONDS
BUILDING DEPAR_"7,1FNT
WORK G
ADDRESS
OWNER
APPROVEDD;�,i]L
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