BLD2013-0099OV EQV
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 02/26/2013 Permit#: BLD20130099
Expiration Date: 02/26/2014 i Project Address: 21727 76TH AVE W #G1 EDMONDS
Parcel No: 00580700002701
PROPERTY OWNER APPLICANT CONTRACTOR
MAHONEY FAMILY DENTISTRY CROWN FIRE PROTECTION, INC. CROWN FIRE PROTECTION, INC.
VENTURES LLC VDV PO BOX 12113 PO BOX 12113
9222 SE SHORELAND DR MILL CREEK, WA 98082 MILL CREEK, WA 98082
BELLEVUE, WA 98004
(425) 481-7669
LICENSE #: CROWNFP044LL EXP:04/08/2013
JOB DESCRIPTION
FIRE SPRINKLER ALTERATION 1"I -J 1-
VALUATION: $1,800.00
PERMIT TYPE: Commercial
PERMIT GROUP: 30 - Fire Sprinkler
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N ( 0 X 0 Fr.)
CODE: 09
OTHER: N OT14ER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS: 0
LOT 4:
EXISTINC. AREA
IBA ffM—ffN—T-7-- I ST FLOOR:16 - 2ND FLOOR: 0
PROPOSED ARE,k
0 1 ST FLOOR: 0 2ND FLOOR: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0_
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
I�RONTSETBACK SIDE SETBACK REAR SETBACK
REQUIRED: PROPOSED: I REQUIRED: PROPOSED: --P92i1ED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O I REQUIRED: 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 WORKMEN'S
COMPENSATION INSURANCE AND RCW 18:27.
THISakNPUCATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY,*.ND ALL FEES ARE PAID.
Date
y
Date
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC] 09/ IBCI 10/ IRC 110.
ONLINE APPLICANT ASSESSOR 10 OTHER
El;;GNJ
STATUS: ISSUED BLD20130099
CONDITIONS
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.
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 7:00am 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 the 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 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.
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY 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)
I BUILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 775-7720 1
PUBLIC WORKS (425) 771-0235 PRE-TREATMENT (425) 672-5755 RECYCLING (425) 2
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection
beine reauested. Contact Name and Phone Number. Date Prefereed. and whether vou Drefer mornine or afternoon.
. F-Fire Alarm System Acceptance
Inspection Comments
Pc- BLD20130099 30 - Fire Sprinkler
Applied: 01/28/2013 Issued: 02/26/2013
Address: 21727 76TH AVE W#G, EDMONDS
INSPECTION DATE
1930 - F-Fire Sprinkler Acceptance 03/18/2013
Comment: APPROVED
Expires: 02/26/2014
INSPECTOR ACTION
SMITHM CMP
5/23/2013 12:50:29 PM Page 1 of 1
OV ED4
DEVELOPMENT SERVICES
COMMERCIAL & MULTI-FAMELY BUILDING
PERMIT APPLICATION
oz 121 5h Avenue N, Edmonds, WA 98020
St. JS9
City of Edmonds Phone 425.771.0220!9 Fax 425.771.0221
PLEASE REFER TO THE COMMER CIAL & MULTI-FAM[L Y B UILDING CHECKLIST FOR SUBMITTAL REQ UIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
'2-.Z—j =4 0 6, �'I�
Parcel #:
Subdivision/Lot #:
Project Valuation: $
k tou
APPLICANT:
C,fpvjc\
Phone:
Fax:
Address (Street, City, State, Zip):
6 cxteQ6 qt0%_L
E-Mail Address:
0 e 5,, -kcAe ro� p, 0 r-n
PROPERTY OWNER:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:*
Cv-n\'i (\\ ? MIC
Phone:
L4?_SN'07"9
Fax:
I L�'n q 3
Address (Street, City State, Zip):
6-D* '\\3 1 MM bY,2-
E-Mail Address
� e�s (" L &C (-(0'j ft co p-
*Contractor must have a valid City ofEdmonds business license prior to
doing work in the City. Contact the City Clerk's Office at 425.775.2525
WA State Lic se #/Exp. Date: I
C/M W �\. D 0 LALA t_ L Li. T. %S
City Business Li'Cense #/Exp. Date:
DETAIL SCOPE OF WORK: P
+C (W) 0'j
PROPOSED NEW SQUARE FOOTAGE
FOR TMS PROJECT:
Basement: —sq. ft.
Garage: sq, ft,
1" Floor: sq. ft.
Deck: sq. ft.
2 d Floor: t4 sq. ft.
Other: sq. ft.
7—Floor: sq. ft.
1 Occupancy: Occupancy Load:
Retaining Wall: 0 Yes El No
Grading: cyds.
I Type of Construction:
Ideclare underpenalty ofperjuty laws that the information Ihaveprovided on thisform/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: �3C_ D Owner OlAgent/Other (specify):
Signature: bYVIM Date: \3
FORME LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Form E.doc Updated: 10/2011
I TS--7,- 7-1- S
D E P, A R, 711.1 v 1E -Ni 71' C I
REGISTERED AS PROVIDED BY LAW AS
CONST CONTR FIRE PRO S
REGIST. A EXP. DATE
CCBO CROWNFP044LL .4/8/2013
EFFEC . TIVE DATE 6/13/1996
CROWN FIRE PROTECTION INC
PO BOX 12113
MILL CREEK WA 98082
F625-052-000 (8/97)
I, Karen M. Abel, verify that tfiis is a copy of Crown Fire Protection's contractor's
license:
Date:
Signed: fn a�ek
Karen M. Abel, President
Notary: Date:
Jo WJAbbel
My commission expires: October 25, 2012