BLD20190679OV ED
CITY OF EDMONDS
PHONE: (425) 771-0220 - FAX: (425) 7'71-0221
121 5TH AVENUE NORTH - EDMONDS. W A 98020
STATUS: ISSUED 06/27/2019
Expiration Date: 12/27/2019
Parcel No: 00613400000500
Peinim BLD201906791
IN WA
EDMONDS
E-j
1'Lt4,P-tkTN'OW1ER APPLICANT CONTRACTOR
5 CORNERS LLC MUDDY PAWZ DOG SPA LLC GO JO PLUMBING
C/O ERIC D ANDERSEN C/O ANDREA SKELTON C/O JOSIAH HERRERA
8406 BOWDOIN WAY 9528 DENSMORE AVE N 10426 STATE ROUTE 530
EDMONDS, WA 98020 SEATTLE, WA 98103 ARLINGTON- WA 98223
(425) 643-8557 (206) 734-6589 (206) 276-3978 EXT- 8
LICENSE #- GOJOPJP920CI EXP�02/24/2020
JOB DF—SCINP-tON
ADDINGA TUB INTO A NEW TENANT SPACE (NO T/I NEEDED) & TO EXISTING PLUMBING. replacing copper pipes that lead to
tub
VALUATION: $0
PERMIT TYPE: Commercial
PERMIT GROUP: 47 - Plumbing
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY:
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: 0 X 0 FT.)
CODE:
OTHER ------- OTHER DESC:
IZONE:
NUMBER OF STORIES- 0
VESTED DAT E-
INUMBER OF DWELLING UNIT S: 0
LOT #:
F\ISIING AREA
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
PROPOSED AREA
BASEMENT: 0 IST FLOOR 0 2ND FLOOR 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
3 RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER 0
BEDROOMS: 0 BATHROOMS: 0
BEDROOMS: 0 BATHROOMS: 0
FRONTSETBACK SIDESETBACK REAR SETBACK
REQUIRED: PROPOSED: — J=REUIRED: PROPOSED: QUIRED: PROPOSED
HEIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY VvTTH 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 APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL O1j;1,n1S1HEIR DEPUTY AND ALL FEES ARE PAID. I (,*N
IV
6
Signature Print Narne Date
Released By
ATTENTION
ITISUNLAWFUL TO USEOROCCUPY ABUILDTNG ORSTRUCTURE UNTIL A FINAL INSPECTION HASBEEN MADE AND APPROVAL ORA CERTIFICATE OF
OCCUPANCY HASBEEN GRANTED, UBC]09/IBCI 10/ IRCI 10.
= F1RE = APPLICANT = ASSESSOR 0 CITY
90
Q3
STATUS: ISSUED BLD20190679
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. Cbeck thejob 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 specifical1y requested in writing and be called out and identified. Processing
fees forsuch request shall be established by Council and shall be paid upon submittal and are non-refundable.
• Approval of any plat orplan containing provisions which do not comply with city code and forwhich 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 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, aris ing directly or indirectly from the issuance for this perinit. 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.
• Cross -Connection control assemblies, for backflow prevention, are required on the following fixtures. Verify meter/backflow
assembly type and specifications.
• IN PREMISE ISOLATION REQUIRED
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, SIDEWALKS, DRIVB/VAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT
TIME LIMrF: SEE ECDC 19.00.005(A)(6)
TO SCHEDULE INS PEC'nONS
BUILDING
ENGINEERING (425) 771-0220 EXT. 1326
1. Go to: www.edmondswa.gov
Building Department Inspections
2. Then: Servces
are now scheduled online. If you
FIRE (425) 775-7720
3. Then: Perm its/Developm ent
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 haw one already, create a
assistance during office hours.
login (upper right hand comer)
(425) 771-0220
RECYCLING (425) 276-4801
.6: Schedule your inspection
When calling for an inspection please leave 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.
• B-Preconstruction meeting
• B-Plumb Rough In
• B-Cross Connection Final
• B-Plumbing Final
• B-Other
"0 C. 1,89%)
BUILDING PERMIT
APPLICATION .... it
n W 1 4C 1 P, ='zoicl-04p7q
Building Division
121 Sth Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, permit status and inspection
scheduling information go to: www.edmondswa.gov.
PLEASE NOTE: Intake appointments are required for New Single Family
Residences, Large Additions, ADU's, New Commercial, and Major Tenant
Improvement application submittals. If plans are prepared by a profession-
al, electronic files are requested in addition to the hard copies. Please bring
electronic files on a flash drive or coordinate for electronic transfer.
Please call 425-77.1-0220 to schedule an intake appointment!
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job Site Address- WOL4
Parcel:
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: , C)" f tv yw—�'� LUC—
Mailing Address: 1 14 00 �S F— -3 W"'-
City/State/Zip: (5f-\�9VO4e— 00 ka
Phone#: LA '3L5 lo(4 -S
!2TA
Email:
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? 0 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.
ck S
Name of Applicant: PQ
Mailing Address: 6'0�'D' Avg-
City/State/Zip: 93103
Phone #:
E-mail: L 'I t
GENERAL CONTRACTOR: (if different from applicant)
General Contractor:
—T—a
Mailing Address:_ I I L'I
City/State/Zip:
Phone #:
E-mail:
STATE UBI #:
CITY OF EDMONDS BUSINESS LICENSE #:
WA STATE CONTRACTOR L & I #: (CCB) & EXPIRATION DATE;
TYPE OF PERMIT (Provide Details on Page 2)
0 Accessory Structure/
Detached Garage *Addition
El Demolition
• New Single Family / Dupi X
X Plumbing
• Fire Sprinkler
• New Commercial/ Mixed Use
0 Re -Roof
• Signs
0 Tank
t ALlrovenl.W4
0 Other
Remodel Permit fees are based on:
The value of the work performed. Indicate the value frounded to
the neare'st dolor) 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 11
1st Floor, scl ft:
2nd Floor, sq ft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
Other sq ft:
PROJECT DESCRIPTION
F
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 Nam ea- :5 k4 k4o,
5 snature IL L031 Date
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Page I of I
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ALL WORK SUBJECT
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INSPECTION FOR
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JUN 0 7 2019
BUILDING
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CITY OF EDMONDS
BUILDING DEPARTMENT
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Ln ADDRESS
OWNER
APPROVED DATE:
BLDG. OFFICIAL:
PEP%MIT NUIMBER
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