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CITY OF EDMONDS
1215TH AVENUENORTH -EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 03/13/2019 Permit#: BLD20190243'.
Expiration Date: 09/13/2019 ProjectAddress: 510 FORSYTHE LN #410, EDMONDS'
Parcel No: 00762400041000
I w R11 9 � ta 116VII11MA011 2! IIIIIIIIIIIIIIIIIII&n w w M Iffu.1" �1�
CAMELOT CONDOMINIUMS CAMELOT CONDOMINIUMS MA SPECIALTY
C/O DONALD & GAIL JONES CIO DONALD & GAIL JONES CIO MOHAMMED AL MAYYAHI
5 10 FORSYTHE LN 5 10 FORSYTHE LN 1520 151 ST ST W1
EDMONDS, WA 98026 EDMONDS, WA 98026 LYNNWOOD, WA 98087
(206) 755-8370 (206) 755-8370 WS) 322-6750
V:INAN LICENSE#: MASPES*832DF EXP:03/06/2019
INTERIOR DEMO OF CONDO UNIT. REMOVE ALL CABINETS, FLOO�DMRS, CASINGS, MOULDINGAND DRYWALL
VALUATION: $0
PERMIT TYPE: Commercial
PERMIT GROUP: 23 - Demolition
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION -
RETAINING WALL ROCKERY:
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: 0 X 0 FT-)
CODL�
OT14ER: ------- OTHER DESC:
ZONE:
INUMBER OF STORIES: 0
E ST E D D A T E
INUMBER OF DWELLING UNITS: 0
ILOT #-
rNISTING AREA
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
PRO 110 S E'D A R I -A
. BASEMENT: 0 IST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER 0
13RD FLOOR- 0 GARAGE: 0 DECK: 0 OTHER: 0
BEDROOMS: 0 BAT14ROOMS: 0
1 BEDROOMS: 0 BATHROOMS: 0
FRONTSEMACK SIDESErBACK REARSErBACK
REQUIRED: PROPOSED: MR- UIRED: PROPOSED: IREQUIRED: PROPOSED
HEIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO
PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMENS COMPENSATION
INSURANCE AND RCW 18:27.
THIS APPLIC6TION IS NQr_A PERMIT UNTIL SIGNED BY THE BUILDING OFFr,1AL OR HIS/HER DEPUTY AND ALL FEES ARE PAID.
311/312-01?
Releas
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPEC71ON HAS BEEN MADE AND APPROVAL ORA CER71FICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC109/IBCI I0/IRCI 10.
= FIRE = APPLICANT = ASSESSOR = CITY
STATUS: ISSUED
BLD20190243 -
• 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 thejob card for all required City inspections including final project approval and final
occupancy inspections.
• Any request foralternate design, modification, variance orother 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.
• SoundNoise 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 7:00amto 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 the
noise limits of Cbapter 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
harrnless 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 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.
INSPECTIONS
THIS PERMIT AUTHORIZES ONLY THEWORKNOTED. THIS PERMIT COVERS WORK TO BECONEON PRIVATEPROPERTY ONLY. ANY
CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT
TIME LIMIT: SEE ECDC 19.00.005(A)(6)
TO SCHEDULE INSPECTIONS
BUILDING
ENGINEERING (425) 771-0220 EXT. 1326
1. Go to: www.edmondswa.gov
Building Department Inspections
2. Then: SeNces
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
When calling for an inspection please leaw the following 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.
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AR 06 2019
BUIL,p,
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CITY OF EDMONDS
BUILQING DEPARTMENT
WORK L),ZrV� C)
ADDRESS
OWNER_
APPROVED DATE:
BLDG. OFFICIAL:
PERMIT, NUMBER
C)
�0
BUILDING PERMIT
APPLICATION Permit #:
Development Services
Building Division
121 Sth Ave N / Edmonds, WA 98020
Il)c. 1 S91 425.771.0220
For handouts, submittal requirements, permit status and inspection
scheduling information go to: http:/Iwww.edmondswa.gov/
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job Site Addressj 1,o /-p rs V?ZA-
11
Parcel: 400 4�7"� /-7
Lot /Unit/Suite#: Subdivision:
PROPERTY OWNER:
Name:
M a i I i n g A d d r e s s;.,5 ID 1'cb-
City/State/Zip:
Phone #: 'Pe L ,
Email % IV ewes
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? 0 Yes kNo
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:
?0t Z'6'
Mailing Address: �—'4!:1 J1 &4., wx
City/State/Zip:
Phone #:Q.,6 4 P,3 :9,0
7-
E-mail:
GENERAL CONTRACTOR: (if different from applicant)
General Contractor: An C'_
(,C(
Mailing Address:
City/State/Zip:
Phone #:
E-mail:
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
CITY OF EDMONDS BUSINESS LICENSE #:
TYPE OF PERMIT (Pfovide
• Accessory Structure/
Detached Garage
Details on Page 2)
0 Addition
• Demolition
0 Mechanical
• New Single Family / Duplex
0 Plumbing
• Fire Sprinkler
0 Remodel
• New Commercial/ Mixed Use
0 Re -Roof
• Signs
0 Tank
• Tenant Improvement
0 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 0 Unfinished 0
1st Floor, sq ft:
2nd Floor, sq ft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
Othersq ft:
PROJECT DESCRIPTION
e- iwen 3
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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:Doki'�x-a 'C--' V-e W
Signature: Date 3
MARF
GENERAL COMMERCIAL DATA
Occupancy Group(s): Occupant Load(s):
Type(s) of Construction:
Fire Sprinklers: Yes El No 0
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 EQUIPMENT COUNTS (New and Relocated)
BTUs Gas Elec Other city
A/C Unit /Compressor
Air Handier /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 Ctty BTUs Qty
A/C Unit
Outdoor BBQ / Fire pit
Boiler
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
_FPSCAA Case #:
Critical Areas Determination:
Study Required [I Conditional Waiver Waiver
Fill in Place El Fill Material:
Removal El
Size of Tank (Gallons)
Critical Areas Determination:
Study Required 171 Conditional Waiver El Waiver 0
GRADE/FILL/EXCAVATE
Grading: Cut cubic yards
Fill cubic yards
Cut / Fill in Critical Area: Yes 13 No 0
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.
SCANNED
HAR 0 6 2019
plainjones@msn.com
From: Harley <Harley@ lynnmaccommercia I.corn >
Sent: Monday, February 25, 2019 10:56 PM
To: Donald Jones 1 C
Cc: logstrom@aol.com NAR 0 6 2019
Subject: Re: BOARD APPROVAL LETTER
au[ux[ye
Hi Don,
First, thank you for providing such a thorough binder of information. I can say with certainty, nobody in any of
my buildings has ever provided such a thorough project plan. It is very much appreciated.
As part of the Board's due deligence they have developed a list of questions and some thoughts about conerns
they need to address. Some of these are directly related to the project and some address concerns regarding
previous decisions made by the Board to deny similar project request from other association members. The
goal of the Board is to address all concerns and to approve as many of your requests as possible without
compromising the association. We hope that you will work with us to develop win -win solutions for both you
and the association members.
We are meeting with Board on March 8th and hope to have answers for you based on your responses to the
questions below. We will work deligently to address these issues in the case that we cannot give approval due
to lack of information.
You are authorized to begin the demolition portion of the project. Please make sure all permits are pulled and
that all contractors and sub -contractors have license, bonds, and insurance allowing them to work in multi-
family condominium complexes. Please pass on their licence, bond, and insurance information to us. Can you
please provide a tentative construction schedule?
Please do not hesitate to call should you have any questiosn.
We may have follow-up questions.
Thankyou,
Harley