BLD20191121OV EID)Af
PHONE: (425) 771-0220 - FAX: (425) 771-0221
CITY OF EDMONDS
121 5TH AVOqUE NORTH - EDMONDS, WA 98020
C. I
STATUS: ISSUED 10/23/2019 Pennit#: BLD20191121
BUILDING PERMIT
Expiration Date: 04/23/2020 Project Address: 201 5TH AVE S, EDMONDS
Parcel No: 00434212100100
PRIP PEATV ONVN ER APPLICANT CONTRACTOR
OLD MILL TOWN CITY PLUMBING INC CITY PLUMBING INC
C/O RH OLD MILL TOWN ASSOCIATES CIO JOSEPH PAPERNIK III CIO JOSEPH PAPERNIK III
LLC 11432 47TH AVE NE 11432 47TH AVE NE
PO BOX 5003 MARYSVILLE, WA 98271 MARYSVILLE, WA 98271
BELLEVUE, WA 98009-5003
(360) 454-0481 (360) 454-0481
LICENSE 9: CITYPI*955KJ EXP:08/08/2020
JOB DESCRIPTION
BRING4" WASTEAND I" WATERLINE INTO NEW SPACE. SUITES D-1 & D-2.
VALUATION: $0
PERMIT TYPE- Commercial
PERMIT GROUP: 47 - Phimbing
GRADING: N CYDS: 0
TYPE OF CO STRUCTION:
RETAINING WALL ROCKERY:
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: 0 X 0 FT.)
CODE:
JOTHER: ------- OTHER DESC
ZONE:
[NUMBER OF STORIES: 0
J1,
VESTED DATE:
INUMBER OF DWELLING UNITS: 0
ILOT #-
LXISTINGARF-k
0 1 ST FLOOR: 0 2ND FLOOR: 0
11 R 0 P0 S ED A 111--%
1 BASEM EN : 0 1 ST FLOOR: 0 2ND FLOOR 0
13 RD FLOOR: 0 GARAGE� 0 DECK: 0 OTHER: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
1BEDROOMS.- 0 BAT HROOMS- 0
1 BEDROOMS: 0 BATHROOMS: 0
FRONTSFFBACK SIDESETBACK RLARSETBACK
FJ--QUIRED: PROPOSED IREQUIRED: PROPOSED: IREQUIRED: PROPOSED
HEIGHT ALLOWED:O PROPOSED 0 IREQUIRED: PROPOSED
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHOREED 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.
-1]
HIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL CIP"IS/HER DE[31,� ALL FEES ARE PAID.
5;;_111_� -
Signature Print
Date
Released By
Date
ATTENTION
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/ IBC1 10/ rRCI M
= FIRE = APPLICANT = ASSESSOR I?" rry
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