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BLD2021-0810+Supplementals+6.14.2021_1.14.20_AM+2246956Og FDAI OM MyBuildingPermit.com Jurisdiction: Edmonds Project Name: Quantum Homes LLC, Lot 1 Application ID: 976923 Supplemental Name: Authorization Statement - Building All provisions of laws and ordinances governing this type of work will be complied with. I certify under penalty of perjury that the information provided on this application is true and correct and, further that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to hold harmless the City of Edmonds as to any claim (including costs, expenses, and attorney's fees incurred in investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of Edmonds, but only where such claim arises out of the reliance of the City, including its officers and employees, upon the accuracy of the information supplied to the City as part of this application. I hereby authorize the City representatives to inspect my property Monday -Friday between the hours of 8:00 a.m. and 5:00 p.m. during this permit application process for verifying site conditions. Yes The City of Edmonds makes permit applications available to the public in an effort to make its processes as transparent as possible. By signing or initialing this document, I acknowledge that any and all information submitted as part of this application, is public information. I further acknowledge and agree that this permit application, and any and all documents related thereto, may be disclosed by the City of Edmonds to the public without redaction. Enter your digital signature below. Dante Palmaffy Supplemental Name: Electronic Submittals - Building Electronic documents submitted to the City of Edmonds for plan review and permit issuance must be provided in a format that does not prevent the City from making code comments on the documents during review or from making the documents ready for permit issuance. Documents submitted in any manner that prevents the City from completing the review and permit issuance process, including but not limited to submitting documents that are locked, may result in additional review time, permitting delays, and/or cancellation of the permit application if the problem is not resolved by the applicant in a timely manner. Please refer to chapter 18.43 RCW, chapter 18.210 RCW, chapter 196-23 WAC and chapter 196-33 WAC for Washington State laws governing electronic documents. An interpretative guideline from the Board of Registration for Professional Engineers and Land Surveyors can be found at http://www.dol.wa.gov/business/engineersiandsurveyors/docs/eDocsinterpretiveGuideline.pdf. These laws and requirements are subject to change and the submitting parties are responsible for keeping apprised of any such changes. Please acknowledge that you understand these requirements and have verified the electronic documents being submitted meet the City of Edmonds submittal requirements by checking the box below. If you have questions, contact permit processing at onlinepermits@edmondswa.gov or 425-771-0220. Yes, I acknowledge. Supplemental Name: Critical Area Determination - Clearing and Grading A site specific Critical Area Determination, issued by the Planning Division is required for any ground disturbing activities at the time of application. A determination is valid for 5 years from the date in which the determination was made; after such date the city shall require a new determination. Does the property have a current Critical Area Determination on file with the City? YES If you answered YES, what is the Critical Area # (CRAXXXX-XXXX)? If you answered NO, please apply prior to submitting for your permit. You can apply through MBP, Land Use, Critical Areas. CRA2017-0167 Supplemental Name: Plumbing Fixtures - Residential Building Permits Enter the number of plumbing fixtures being installed, altered, repaired, added or relocated: Water Heater(s). ENTER QTY and specify GAS or ELECTRIC 2, Gas, Tankless Plumbing fixture(s) on one trap or set of fixtures on one trap - Includes sinks, toilets, tubs, showers, etc. ENTER CITY . of to.y � v d 4 ;P Jurisdiction: Edmonds Project Name: Quantum Homes LLC, Lot 1 Application 1D: 976923 24 Drain(s) w/in footprint of building (rainwater systems, roof deck drains, etc.) ENTER QTY it Re -pipe. Drain(s), vent(s) or water piping for each fixture served. ENTER QTY 0 Water service line(s) - replacement or repair only. ENTER QTY A Water service line(s) - New only. ENTER QTY 1 Water treating equipment (water softener). ENTER QTY Backflow protective device(s) - 2" and smaller. ENTER QTY N Backflow protective device(s) - Over 2". ENTER QTY �] Graywater system(s) or reclaimed water system(s) in addition to fixtures. ENTER QTY 0 Non -grease waste pre-treatment interceptor(s) - Oil/water separator. ENTER QTY 0 Medical gas piping system(s). ENTER QTY Grease trap(s) - HGI inside building. ENTER QTY 0 Gravity grease interceptor(s) - GGI. ENTER QTY �] Supplemental Name: Mechanical Equipment - Residential Building Permits Enter the number of mechanical equipment units being installed or relocated: Furnace(s) - Forced -air or gravity -type, includes ducts and appliance vents. ENTER QTY 1 Air handler(s) - Includes ducts (Diffusers, blowers, etc.) - Up to and including 10,000 cfm (4719 Lls). ENTER QTY 1 Air handler(s) - Includes ducts (Diffusers, blowers, etc.) - Over 10,000 cfm (4719 L/s). ENTER QTY MyBuildingPermitxom Gas Heater(s) - Suspended, recessed wall or floor -mounted units. ENTER QTY . of to.y � v d 4 ;P Jurisdiction: Edmonds Project Name: Quantum Homes LLC, Lot 1 Application 1D: 976923 Hydronic Heating System(s). Enter QTY Appliance Vent(s) - Type B, BW, L gas vent, etc. ENTER QTY N Incinerator(s). ENTER QTY A MyBuildingPermitxom Ventilation and Exhaust - Fan(s) connected to single duct (bath, laundry, kitchen exhaust) or each system which is not a portion of any heating or air-conditioning system. ENTER QTY 7 Hood(s) - Type 1, Type 2 or Fume Hood including ducts. ENTER QTY AND TYPE A Gas Piping - New or relocated. ENTER QTY 1 Boiler(s) or Compressors(s) - Up to and including 50 HP (176 KW). ENTER QTY Boiler(s) or Compressors(s) - Over 50 HP (176 KW). ENTER QTY Ell Absorption System(s), Air Conditioning System(s) or Heat Pump(s) - Up to and including 1,750,000 Btu/h (512.9 kW). ENTER QTY 1 Absorption System(s), Air Conditioning System(s) or Heat Pump(s) - Over 1,750,000 Btu/h (512.9 kW). ENTER QTY 0 Roof Mounted HVAC Units are: Not applicable Each appliance or piece of equipment regulated by the IMC for which no other item is listed (Fire dampers, ductless mini -split systems, etc.) ENTER QTY and EQUIPMENT ITEM A