BLD20131368.pdfCITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
'c 1 �yo PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 01/24/2014 Permit #: BLD20131368
BUILDING PERMIT
Expiration Date: Project Address: 16319 75TH PL W, EDMONDS
Parcel No: 00513 100006300
DAVID FRITSCHEN DAVID FRITSCHEN HOMEOWNER EXEMPTION TAKEN
19925 13TH DR SE 19925 13TH DR SE
BOTHELL, WA 98012 BOTHELL, WA 98012
(206)271-9499 (206)271-9499
LICENSE #: EXP
t DESCRIPTION
NEW RESIDENTIAL FIRE SPRINKLER, FLOW THROUGH.
VALUATION: $5,000.00
PERMIT TYPE. Residential
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 FT)
CODE: 12
OTHER: N------- OTHER DESC:
ZONE:
NUMBER OF STORIES 0
VESTED DATE.
NUMBER OF DWELLING UNITS: 0
LOT #:
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR. 0 GARAGE. 0 DECK. 0 OTHER. 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FRONTSETBACK SIDE SETBACK;
REQUIRED PROPOSED: I REQUIRED PROPOSED REQUIRED: PROPOSED:
HEIGHT ALLOWED 0 PROPOSED.0 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
'-2 COMPENSATION INSURANCE AND RCW 18:27,
TI4ES-APPLIG60N ISDI®;I' A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEpUTY,AND ALL FEES ARE PAID
ame Date
sed
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 UBC109/ IBCI IO/ IRCI10.
ONLINE APPLICANT ASSESSOR OTHER
,A
STATUS: ISSUED BLD20131368
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.
• 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, 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.
INSPECTIONS
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)
BUILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 775-7720 ,
PUBLIC WORKS (425) 771-0235 PRE-TREATMENT (425) 672-5755 RECYCLING (425) 275-4801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection
beinE requested, Contact Name and Phone Number, Date Prefereed, and whether you prefer morning or afternoon. .
• F-Fire Sprinkler Insulation
• F-Fire Sprinkler Bucket Test
• F-Fire Sprinkler Acceptance
O-V EDP
O�
v� r DEVELOPMENT SERVICES
RESIDENTIAL BUILDING PERMIT
APPLICATION
�Si 1 g9p 121 5`h Avenue N, Edmonds, WA 98020
City of Edmonds Phone 425.771.0220 Q Fax 425.771.0221
PLEASE REFER TO THE RESIDENTMM BUILDING CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
i h_:Pl ar e W.cbMox1!S W14 9802
Parcel #:
o J310o00(o30Q
Subdivision/Lot #:
Project Valuation: $ 57
APPLICANT:
u iD f9-17sCIACM Ati A-� �fl�rt
Phone:.
�oC� I- 9� 9 T
Fax:
6-659C�
Address (Street, City, State, Zip):
E-Mail Address:
chi I ippr S e hofimal I. CoM
PROPERTY OWNER:
. v�0 �2rrSGNZP�1 ► �� S` wA(L
Phone:
ao6 �I-5V9
426-o550
TFI
Address (Street, City, State, Zip):
1 a ► -,-i-x f 02 ►A ILL W A 9 9012
E-Mail Address:
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:!
+z rr5curc r�)
Phone:
06a -9f9
FFSQqv1n 5 4 86-0590
Address (Street, City, State, Zip):
la qa 15 13A -►, �Q Si _0,0Ti4EL(_ wA 9AO 12.
E-Mail Address:
*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
WA State License #/Exp. Date:
7>9v lb r A' 9 1 D 1 2 &®ff 20
City Business License #/Exp. Date:
DETAIL SCOPE OF WORK: /ye J a(J
PROPOSED NEW SQUARE FOOTAGE FOR THIS PROJECT:
Basement: -- —sq. ft.
Select Basement Type: ❑ Finished. ❑ Unfinished
1" Floor: sq. ft.
Garage/Carport: a sq .ft.
2 Ed Floor: sq. ft.
Deck/Patio: ,5 3 sq. ft.
Retaining Wall: ❑ Yes ❑ No
Other:
s .ft
I declare under penalty of perjury laws that the information I have provided on this fornVapplication is true, correct and
complete, and that am the property owner or duly authorized agent of the property owner to submit permit application to
the City of Edmonds.
Print Name: JP�U rca. k S-�_e_�a r-ROwner ❑ Agent/Other (specify):
Signature: Date: �4= 1 I Z
FORM A LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Form A.doc Updated: 10/2011
OF EDA,
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oirp
City of Edmonds
Equipment Type
DEVELOPMENT SERVICES
RESIDENTIAL BUILDING PERMIT
APPLICATION FORM A
121 5`' Avenue N, Edmonds, WA 98020
Phone 425.771.0220 Q Fax 425.771.0221
Appfiance/Equipment Information (new and relocated) Total #
Furnace
#_Gas #_Elec #_Other: BTUs: <100k_ >100k_ Location
Air Handler/ACNAV
#_Gas #_Elec #_Other: CFM: <100k_ >100k_ Location
Boiler/Compressor/
Heat Pump/Roof Top
Unit
# Gas #_Elec # Other: BTUs: <100k, 100k-500k, 500k-lMil
HP: <3, 3-15, 15-30 Location
Hydronic Heating
#_Gas #_Elec _In -Floor, Wall Radiant, Boiler BTUs: Location
Exhaust Fans (single
duct)
Location: #_Bath #_Kitchen # Laundry # _Other:
Fireplace
#_Gas #_Elec #_Other: Location
Other
Number of Outlets
Fixture/Appliance Type
AC Unit --------------- BTUs: Location:
Furnace --------------- BTUs: Location:
Water Heater --------- BTUs: Location:
Boiler ------------------ BTUs: Location:
Fireplace/Insert BTUs: Location:
Stove/Range/Oven:
Dryer
Outdoor BBQ:
Other:
TOTAL OUTLETS
PLUATRING
Number Fixture Type Number Fixture Type
Water Closet (Toilet)
Refrigerator water supply (for water/ice dispenser)
Sink (kitchen, laundry, lavatory, bar, eye wash, etc.)
Water Service Line
Tub/Shower
-
Drinking Fountain
Dishwasher
Bidet/Urinal
Hose Bib
Pressure Reduction Valve/Pressure Regulator
Water Heater Tankless? Yes No_
Backflow Prevention Device (e.g. RBPA, DCDA, AVB) .
Expansion Tank for Water Heater
Hydronic Heat in: Floor Wall
Floor Drain/Floor Sink
Other:
Clothes Washer
Other:
FORM A L:\Building New Folder 2010\DONE & x-fecred to L-Building-New drive\Form A.doc Updated: 10/2011
DEVELOPMENT SERVICES
= RESIDENTIAL BUILDING CHECKLIST
121 5'h Avenue N, Edmonds, WA 98020
�Sr 1 g9° Phone 425.771.0220 It Fax 425.771.0221
City of Edmonds
PROJECT ADDRESS: - I G, 3 ( 9 ? 5 +'-, "� 6 cc! (,lW &IN� 0 IAJ � S,.
Plans shall beof sufficient clarity to indicate the location, nature, and extent of the work proposed, and conform to the provisions of
the adopted International Codes and City Ordinances.
f)Y
y
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CA
SUBMITTAL REQUIREMENTS
The number indicates the number of copies for
if applicable). Check marks indicate
additional submittal requirement
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Application Form A
1
1
1
1
1
1
1
Site Plan
3
3
3
3
. 3
3
3'
Reduced Site Plan 11 X 14 or 8 '/2 x l l)
1
1
1
1
1
1
Architectural Construction Drawings
2
2
2
2
2
Structural Drawing and Calculations
2
2
2
2
2
Energy Code Compliance (shown on plans)
✓
✓
✓
Site Classification Worksheet (stormwater)
3
3
3
Drainage Plan/Stormwater Plan
3
3
3
E72A Completed Detail or Drainage Report
3
3
3
Grading Plan/Excavation/Fill
3
3
3
Critical Areas Determination or Checklist
1
1
1
1
1
Geotechnical Report > 14% slope '
3
3
3
3
Washington State Contractors License
✓
✓
✓
✓
✓
✓
✓
Contractor's City of Edmonds Business License
✓
✓
✓
✓
✓
✓
✓
Plan Check Fee (due upon submittal)
✓
✓
✓
✓
✓
✓
✓
Peer Review Fee
✓
✓
✓
✓
New one -family, two-family and townhouses
with living space greater than 3,000 sq. ft.
re uires Fire Sprinkler Plans and calculations.
3
Handouts and Standard Details may be found on the City's website www.ci.edmonds.wa.us or can be obtained at City Hall
during normal business hours.
Plans/calc� lation/reports prepared by state licensed architects or professional engineers must be stamped and signed by the
design professional.
Sidehill or steep slope construction is not considered conventional construction and soils reports are required for lots with
15% or more slope, unless determined unnecessary by the Building Official.
FORM A LABuilding New Folder 2010\DONF & x-ferred to L-Building-New drive\Form A doc Updated: 10/2011
y �F 3E��MO,�
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
Inc. 1890
PHONE: (425) 771-0220 - FAX: (425) 771-0221
BUILDING APPLICATION ACCEPTANCE
Monday, December 09, 2013
This Application has been accepted by the City of Edmonds for review. More information and changes may be
required during this process. The review target date is: Monday, December 23, 2013
Your City Contact is: MARIE HARRISON
Application Number: BLD20131368
Project Address: 16319 75TH PL W, EDMONDS
PROP
DAVID FRITSCHEN DAVID FRITSCHEN
19925 13TH DR SE 19925 13TH DR SE
BOTHELL, WA 98012 BOTHELL, WA 98012
(206) 271-9499 (206) 271-9499
Work Description:
NEW RESIDENTIAL FIRE SPRINKLER, FLOW THROUGH.
Outstanding Items at Time of Submittal:
I HEREBY WLEDGE IFLDING
EAD THIS APPLICATION THAT THE INFORMATION GIVEN IS CORRECT
Y�-T1T�T AM T E �QWTHE DULY AUTHORIZED AGENT OF THE PROPERTY OWNER TO SUBMIT
/ A PERMIT APPLICATION TO THE CITY.
OR AGENT) PRINT NAME
f 2—
DATE SIGNED
To view up to date information about your application please visit the City of Edmonds Development Services
website at http://www.cl.edmonds.wa.us.
EXEMPTION FROM CONTRACTOR
REGISTRATION VERIFICATION
FORM D
The undersigned property owner or authorized person as described below, has applied for a
building permit from the City of Edmonds and claims that he/she/it. is exempt from providing
contractor registration in accordance with the provisions of RCW 18.27. The property owner or
authorized person, by their signature below, hereby verifies to the City of Edmonds that:
❑ Value of work under $500.00. The aggregate contract price of labor and materials and all
other items required for the project is less than $500.00 and is not part of a larger operation
to be undertaken on the property. This exemption does not apply to a person who advertises -
or puts -out any sign or card or other device which might indicate to the public that lie/she is
a contractor, or that he/she is qualified to engage in the business of contractor. RCW
18.27.090(9).
❑ Owner who contracts for a project. A property owner contracting with registered
contractors for the project, and who him/herself is not performing any activity of a
contractor for the purpose of leasing or selling improved property that he/she has owned for
less than twelve months. RCW 18.27.090(11).
C% Work performed personally on own. property. Anyone personally working on property
he/she owns, or at which he/sheresides, as long as the property owner, or resident, does not
perform any activity of a contractor on his/her property for the. purpose of selling,
demolishing, or leasing the property. RCW 18.27.090(12).
❑ Use of own employees. Property. owner using him/herself or his/her own employees to
perform maintenance, repair, and. alteration work in or upon his/her own property. RCW
18.27.090(13).
❑ Licensed Architect, engineer, electrician or plumber. All work performed under this
permit will be performed by an architect, civil or professional engineer, certified electrician
or certified plumber operating within the scope of his/her certification. RCW 18.72.090(14).
❑ Other. Specify which provision of RCW 18.27.090 applies:
THE UNDERSIGNED PROPERTY OWNER OR AUTHORIZED PERSON HEREBY VERIFIES
THAT ALL INFORMATION PROVIDED ON THIS FORM IS TRUE AND ACCURATE TO THE
BEST OF HIS OR HER KNOWLEDGE AND ACKNOWLEDGES THAT 'IF ANY OF THE
INFORMATION PROVIDED ON THIS FORM IS FALSE HE OR SHE UNDERSTANDS THAT THE
BUILDING PERMIT WILL BE IMMEDIATELY REVOKED AND ALL FEES PAID FORFEITED.
DATED this day of l���M�;�, 20L
Print Name
WITNESS
Signature
Print Name
L:\TEMP\BUILDING\HANDOUTS REVISED IN 2009\PREVIOUS HANDOUTS\FORMS\CONTRACTOR EXEMPTION FORM
D.DOCREVISED 7/07
Inspection Comments
BLD20131368
30 - Fire Sprinkler
PERMITTRAX
Applied: 12/09/2013
Issued: 01/24/2014
Expires:
03/27/2016
Address: 16319 75TH PL W, EDMONDS
NNSPECTION ,
~DATE
INSPECTOR "
ACTION
1916 - F-Fire Sprinkler Insulation
_
07/14/2014
KZWEBER
COM
-Comment: Partial cover approval in "guest room".
by JT
1915 - F-Fire Sprinkler Insulation
01/12/2015
WESTFALL
CMP
Comment: Insulation accepted. Ok to cover
1920 - F-Fire Sprinkler Bucket Test
09/11/2014
KZWEBER
CMP
Comment: Approved. 30+ gpm, JT
1930 - F-Fire Sprinkler Acceptance
06/18/2015
KZWEBER
CMP
Comment: Approved.
6/26/2015 3:50:24 PM Page 1 of 1