20020177.pdfDATE RECEIVED 1Z,;,h ;� I I PERMIT EXPIRES
USE PERMIT
CITY OF EDMONDS ZONE 11�5(0 UMBER ZO)�-,0/7-7
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
ADDRESS 854 Maple St
`WNEA NAMERIAME OF BUSINESS a
PLAT NAMEISUBDIVISION NO. I LOT 1(!L LID NO.
LID FEE S
854 Maple St PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP .... 1"'V11"d
See. Ed
;try ZIP ITELEPHONE EXISTING — PROPOSED
Edmonds 98020 1425-775-4986 REQUIRED DEDICATION— FT —
ware—ead
IAME METER SIZE I LINE 1111 NO. 01 1l11UI11 'E11V REQUIR D
S C3 No 13 3
,DDRESS REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROLMRAINAGE
CITY ZIP
ITELENIONE
NAME
FAst Water Heater
ENGINEERING REVIEWEDIDATE
ADDIE11
12601 132 AVe NE
CITY zip
—
HE
FIRE RE AEAUay"
required on fuel -burning applianc in
Kirkland 98 34
0
ITELEPH
425-814-3124
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STATE LICENSE NUMBER
EXPIRATION DATE ONE Y
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REGO POSTEr
2-16-03 I
- -
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
__LASTWHCO52DF
4
PROPERTY TAX ACCOUNT PARCEL NO.
SEPA REVIEW
COMPLETE, EXEMPT
004 4207 n
EXP
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NEW RESIDENTIAL
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LOT Or EC411111111MMUK111`111M),
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PR BE. ICT�ST.IjSIGE REAR RO
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0 CHANGE OF USE
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0 REMODEL APARTMENT
0 SIGN
1 FW90de E -1', 2
REG'. I .
[3 REPAIR GRADING ,as [j r NCE
( _ X Fit
REMARKS
0 DEMOLISH [j TANK
0 OTHER
o GARAGE Ei RETAINING WALL
RENEWAL
CARPORT HOOKERY
OWE OF USE, BUSINESS OR
CCUPANT
MPIAIN:
7
GROUP
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CHECKED BY TY=ION 17�
NU.UER 'UMBER .1
OF WELL NO
CRITICAL
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SPECIAL INSPECT ZCCUPANT
2_+ �a' NITS
NUMBER IV
REQUIRED[] yj LOAD
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1�egfo e/rplce cfas water heater
REMARKS
PROGRESS INSPECTIONS PER URIC IOS/FINAL INSPECTION REaD
A-1, V,4-11 I or An.
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7-75,77---
Plan Check
HEAT SOURCE GLAZING 14 LOT SLOPE
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PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLYTHE WORK NOTED. THIS PERMIT COVERS WORK TO
I: BE DONE ON PRIVATE PROPERTY ONLY. AM CONSTRUCTION ON THE PUBLIC
Grading
Recording Fee
D U
OMAIN (CURBS. SIDERIIALKS, DRIVEWAYS )VULL REG IRE
SEPARATE PERM;a=10d"C"S'a"C'
Engr. Review
City Surcharge 57'
PER ITAPPLICATION: INDAYS
PERMIT Endra I YEAFi 0 WORK IS STARTED WITHIN ISODAYS
Engr. Inspection
State Surcharge
SEE BACK Of PINK PERMIT MR MORE INFORMATION
-APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE — r OF
Receipt #
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMA ES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Review
. ...........
111011 THE ISSUANCE OF THIS PIFU0117. ISSUANCE (11 THIS PERMIT SHALL NOT BE
DBENED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Fire Inspection
u 5�
Total Amount D a
N B Dan IN ANY WAY THE CG)rS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapemsp.,
Receipt #
I HEREBY ACKNOWLEDGE THAT I .. HEAD THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN 'a CORRECT, AND THAT I AM THE OWNER, OR TH DULY AUTHORIZED AGENT OF
THE OWNER. I AGRE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
application esnot a permit untlislillad by Me
TKIN; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL 85 EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Buill""
core Official orhamer Carney: and ornampaid.and
1pt 1, ackemalodged In space provided.
WORKMENe COMPENSATI , SURANCE AND RCW 18.27.
DATE
SIGNATURE low �IG DATE SIGNED
(425)
ZM2L
If IT I _V��v
RELEASED BY 1// DATE
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221 1
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
PINK - OWNER - GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ......... .
FOUNDATION;
Footing ............
wall _ ....................
Pier/Porch .................
Retaining Weill
Stab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final
HEATING:
GasTest ....................
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ....................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
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