BLD20181571E btf
ITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
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STATUS: ISSUED 12/28/2018 Permit#: BLD20181.571
BUILDING PERMIT
Expiration Date: 06/28/2019 Project Address: 121 3RD- AVIE N, EDMONDS,
Parcel No: 00434400700401
I w M11 w DA hVIVOKI 1 0 0 W—VII 14 J W."k A
OMBU SALON NEWWAY ENERGY INC. NEWWAY ENERGY INC.
131 3RD AVE N C/O ADRIAN BADELITA C/O ADRIAN BADELIT A
EDMONDS, WA 98020-3208 13405 KENWANDA DR 13405 KENWANDA DR
SNOHOMISH, WA 98296 SNOHOMISH, WA 98296
(425) 770-4620 (425) 770-4620
LICENSE #: NEWWAEH899BO EXP:O 1/20/2019
JOB DESCRIPTION
PLUMBrNGFOR SALON CHANGEOF OCCUPANCY. CHANGE EXISTING DRA FNAGE FOR SOMEFIXTURES, AND ADDNEW
FIXTURES.
VALUATION: $0
PERMIT TYPE: Commercial
PERMIT GROUP: 47 - Plurnbing
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY:
OCCUPANT GROUP: B
LOAD:
FENCE: 0 X 0 FT.)
.00CUPANT
CODE: 2015
IOTHER: ------- OTHER DESC:
lZONE:
INUMBER OF 8 ORIES: 0
1 VESTED DATE:
INUMBER OF DWELLING UNITS: 0
ILOT #-
MSTING ARFA
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
PROPOS 9) ARE.,%
f9ASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOk 0 GARAGE 0 DECK: 0 OTHER7 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
BEDROOMS: 0 BATHROOMS: 0
IBEDROOMS: 0 BATHROOMS: 0
FRONTSMACK SIDESLTBACK REARSEMACK
REQUIRED: PROPOSED: MRQUIRED: PROPOSED: REQUIRED: PROPOSED -
HEIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED:
SETBACK NOTES:
PERMIT APPROVAL
I AGREETO COMPLY WITH CITY AND STATELAWS REGULATING CONSTRUCTION AND IN DOING THEWORK AUTHORIZED THEREBY, NO
PERSONWILL BE EMPLOYED INVIOLATION 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 OR HIS/HER D9:1UTY AND ALL FEES ARE PAID.
s?Nzvb'� Z294,e--�z ItAgAz&)f, 12/28/18
Signature
Date
Date
ATTENTION
IT IS UNLAWFUL TO USE OR 0 CCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBCI 09/ IBC I 10/ IRCI 10.
= FIRE = APPLICANT = ASSESSOR �A CITY
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STATUS: ISSUED BLD20181571
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 thejob card for all required City inspections including final project approval and final
occupancy inspections.
• Any request foraltemate 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.
• Sound/Noise originating from temporary construction s ites 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 pen -nit. 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 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, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT
TIME LIMrr: 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 ha\e one already, create a
assistance during office hours.
login (upper right hand corner)
(425) 771-0220
RECYCLING (425) 275-4801
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.
• E-Cross Connection Final
• B-Preconstruction meeting
• B-Plumb Ground Work
• B-Plumb Rough In
• B-Cross Connection Final
• B-Plumbing Final
BUILDING PERMIT Office Use Only
APPLICATION Permit #:
Development Services
Building Division
121 Sth Ave IN / Edmonds, WA 98020
�'7c. 199� 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)
I
Job Site Address: 3 V Al _2—,jU1jA�C
Parcel:
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name:
Mailing Address:
City/State/Zip:
Phone #:
Email:
I
Di-li6G� S#z-OAI
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? El Yes El 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: Ai)f-14Aj (3k)ttZt_1"p TL
Mailing Address
City/State/Zip:
Phone #:
E-mail: 30E 6,A-Q
Cc
GENERAL CONTRACTOR: (if different from applicant)
General Contractor.
Mailing Address: 't c-) "i W
City/State/Zip: 'Z st,
Phone #: 2L 4"6 ;? '0
E-mail:
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
CITY OF EDMONDS BUSINESS LICENSE #:
NRD2-y5o�_> -qla'd
P//7
TYPE OF PERMIT (Provide
Details on Page 2)
El Accessory Structure/
0 Addition
. Detached Garage
El Demolition
0 Mechanical
0 New Single Family/ Duplex
XPlumbing
%
Fire Sprinkler
0 Remodel
El New Commercial/ Mixed Use
I] Re -Roof
0 Signs
0 Tank
El 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 El
Ist Floor, sq ft:
2nd Floor, sq ft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
Other scl ft:
PROJECT DESCRIPTION
c Aouuqe ex,
(LA e
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
7
/!%=��)_Date
Signat&M
/F
GENERAL COMMERCIAL DATA
Occupancy Group(s): Occupant Load(s):
Type(s) of Construction:
Fire Sprinklers: Yes El No D
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 Qty
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-Reductionl-Regulator Valve -
Floor Drain/Sink
Refrigerator Water Supply
Hose Bibs
Water Heater - Tankless? Y or N
Hydronic Heat
Water Service Line
Sinks
Other:
Toilets
2-
Other:
GAS/FUIEL CONNECTION COUNTS (New, Relocated or re-pipedi
BTUs Qty BTUs Qty
A/C Unit
Outdoor BBQ/ Fire pit
Boiler
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
I
I
Other:
I
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 Surveyclone? Y/N
T_PSCAA C.�e #:
Critical Areas Determination:
Study Required El Conditional Waiver 0 Waiver 0
Fill in Place El Fill Material:
Removal E]
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: YesEl 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.
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