20160809144023.pdfDEVELOPMENT SERVICES
COMMERCIAL & MULTI -FAMILY BUILDING
PERMIT APPLICATION
�atw 121 5`h Avenue N, Edmonds, WA 98020
City of Edmonds Phone 425.771.0220 A Fax 425.771.0221
PLEASE REFER TO THE COMMERCIAL & MULTI -FAMILY BUILDING CHECKLIST FOR SUBMITTAL REQUIREMENTS
PPRR JE5T AD RESS (Street, uite #, City State, Zip Parcel #:
Q Its. <.- O
Subdivision/Lot #: Project Valuation: $
tUVo `00
APPLICANT: Phone: Fax:
(J - _:� E
Address (Street, City, State, Zip): E-Mail Address:
PROPERTY OWNER: Phone: Fax:
S Ck tM
Address (Street, City, State, Zip): E-Mail Address:;
LENDING AGENCY: Phone: Fax:
Address (Street, City, State, Zip): E-Mail Address:
CONTRACTOR:* C o ac� C ru 12 u�5 ob 67 �1 801 1 Fax:
Address (Street, City, State, Zip) E-Mail Address
--Z i on
WA State License Oate:
*Contractor must have a valid City of Edmonds business license prior to
doing work in the City. Contact the City Clerk's Office at 425.775.2525 City Business License #/Ex .Date:
—I O ✓N
DETAIL THE SCOPE OF WO1II . 6..1.'# " ......
PROPOSED NEW SQUARE FOOTAGE FOR THIS PROJECT:
1 st Floor:. _... ..:µ.. s . ft. " Floor: _c , ft. _ 3r Floor:
Basement: s ft, Gara e: __,.____ITIT s . ft. Deck/Cvrd Porch: s ft.
Other _ITITIT.. s . ft. Retainin Wall: YesLJ No I Fire Sprinklers: Yes No
Occu anc. Grou (s): _w ........�Occu ant Load(s): __... Ty e(s) of Construction:
Gradin : Cut cu. ds. Fill t t1, ds. Cut/Fill in Critical Area: Yes 71 No
I declare under penalty of perjury laws 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 Name: __ Owner Agent/Other ❑ (specify):w,,,, _....._a�
,.. „. �,,�
Signature:,,, _._. Date:
FORME LAB uiWing New Folder 2010\130NE & x-ferred to LAuilding-New drive\Form E 2014.docx Updated: 1/17/2014
M
Equipment Type
Appliance/Equipment Information (new and relocated)
Total #
Furnace Gas # _
Elec #_-,,,,,_Other;,aITIT_mITITmm
# BTUs: <100k >100k_ Location(s)_-----,.,
II
Air Handler / VAV
Gas #
#
# CFM: <10k_ >10k_ l �octltlon(s) . __w..
(circle selected) ,�Elec
_Other: �.�-
�..www
AC / Compressor /
Boiler / Heat Pump / Gas # _Elec
#—Other ..
� ,# BTUs: <100k, 100k-500k, 500k-1Mil
Roof Top Unit lip:
<3, 3-15,
15-30 Location(s) , -
(circle selected)
Hydronic Heating Gas #_Elec
#_In -Floor
_Wall Radiant_ Boiler BTUs: , Location,,,,,,,_____
Exhaust Fans (single Bath #_Kitchen
#_Laundry # Other:,. ....
duct)
_- __ ..: ..
Fireplace Gas #_Elec
#_Other:,._..
# Location(s)._ ...............
Dryer Duct
Appliance Type
Appliance/Equipment Information (new and relocated)
Tota71#
AC Unit
BTUs:
Location(s).-..__....._ _ _ ........
Furnace
BTUs:,µ
_ Location(s):_,____,.__,,,,,,,
Water Heater
BTUs: -
_ Location(s):
Boiler
BTUs: ,
Location(s)t. ... ...w_
Other:
BTUs:
Location(s): _.,.-..........
Fireplace/Insert
BTUs: ,-- ....-
Location(s)),.. ........
Stove/Range/Oven
Dryer
Outdoor BBQ
TOTAL OUTLETS
PLUMBING
Fixture Type (new and relocated)
FIXTURE COUNY
Total # Fixture Type (new and relocated)
Total #
Water Closet (Toilet)
Pressure Reduction Valve/Pressure Regulator
Sink (kitchen, laundry, lavatory, bar, eye wash, etc.)
t Water Service Line
Tub/Shower
j Drinking Fountain
Dishwasher
Clothes Washer
Hose Bib
Backflow Prevention Device (e.g. RUPA, DCDA, Avu)
Water Heater Tankless? Yes ❑ No ❑
Hydronic Heat in: Floor ❑ Wall ❑
Floor Drain/Floor Sink
Other:
Refrigerator water supply (for water/ice dispenser)
Other:
FORM E LABuilding New Folder 2010\DONE & x-ferred to L Building -New drive\Form E 2014.docx Updated: 1/17/2014
J
a{
feood Condominium
)11110 51h Avenue S
Edmonds, WA 98020
July 13, 2016
To the City of Edmonds,
Following a recent meeting with Judy Charette and plumber Todd Crutchley (July 12,
2016) the board has agreed to the remodel of the bathroom in unit 202. Todd has
done previous work in the building and is familiar with the plumbing issues.
Sincerely yours,
David Jones
President of Edgewood Condominiums.
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