20020415.pdfDATE RECEIVED
CITY OF EDMONDS
"BE PERMIT
,ONE P,
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CONSTRUCTION PERMIT APPLICATION
SUITEIAPT#
'AOS
OWNER NAMEINAME OF BUSINESS
RES S
21 105 Shell Vallev R
FLAT NAME/SUBDIVISION NOL 0.
T777
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MAILING ADDRe q
LID FEE
211 05 Shell Valley Rd
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP IF— An",
Aw A—l'.
S...' P.- A'd
CITY ZIP IT11 PHONE
E iSTING— PROPOSED— 1--a a'qd Cl
13
Edmonds 98026 425-778-6878
NAME
METtlwe. 15 Mark WIPWMI 0
vvlurning
requi� ed oil to app1h 0 C3
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ADDRESS
tell - - 01�/
p2atSCReLSE FOUR LE'R'O'SION CONTROUDRAINAGE
TELEPHONE
Fast Water Heater
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-RE—wous"tem
ADDRE11
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tanks are
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12601 132 Ave NE
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WE
FIRE REIR (dHKS POPE
CITY zip TELEPHONE
t12�-_ECD�"19.30.020 (C)
Kirkland 425-a]4-�124
9 8 Q 3 41
STATE LICENSE NUMBER EXP
VARIANCE OR CU SHORELINE OR ADB# I BOND
RE -D PosTec
E3YES a NO
'i -P-A'O—PmEmR"W-T—AX"EACaC'O'IU'gWaPARCEL
Review or EIGHT
NO.
COMPLETE EXEMPT F& P,7% ft'ED PROPOSED
5WRE
ar
01711716001,00707
'� _PVIC FF ,
NEW PLUMBING I MECH
OVERA ET.A.". o"
LOWE ,a in. E REAR
A LOT C ong ktfo Wfflc Iff
12 ADDITION o C MPLIAN E OR
MCI
CHANGE OF USE
DATE
0 REMODEL [I SIGN
XM
0 REPAIR GRADING C,.S F NCE
_x—FT)
0 DEMOLISH [3 TANK OTHER
AIIM-SIPHON Dr, V I IiLE J�j�Z�D.
[3 GARAGE E3 RETAINING WALL [3 RENEWAL
CARPORT —i ROCKERY
ITYPE OF USE. 8��
OCCUPANT
�EXPLAIW
TYPE
CHECKED BY ITYPE
H E C X Y
GROUP 95
ILIM.I. Nu... .1 CRITICAL lk
OF DWELL NG AREAS
C TOR
B ECIA1 IMPE1
A N ED
G E
STORIES NITS NUMBER
E u I "S
REQUIRED E]
'L
DESCRIBE WORK TO BE DONE
REMARKS
RE A
-
PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION REO`G
P 0 Er
-er
Remove/replace gas water
heater in back closet(t Iti h m
34,000 btu's
$Descripflon
VALUATION $ 4 4 9. 0 0
I FEE Description FEE
I V
Plan Check
HEAT SOURCE GLAZING % LOT SLOPE %
Building
PLAN CHECK NO: VESTED DATE
—PROPERTY
Plumbing
—ON
Mechanical
THIS PERMIT AUTHORIZES ONLY THEWO KNITTED. THIS PERMIT COVERS WORK TO
BE DONE PRRIATE ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading Recording Fee
a RE
GAILAUN (CUFIBS, SIDEWALKS, DRIVEWAYS MARQUEES, ETC.I WILL REQUI
t: SEPARATE PEAMi$SION.
Engr. Review City Surcharge
PER IT APPLICATION: 180 DAYS
PERMIT UMM I Y EAR-PROVIDEDWOR HISTARTEDWITHIN INDAYS
Engr. Inspection State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLicM.E. ON BEHALF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation Plan Chk Deposit
IN INTEREST, AGREES TO NDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
WS
Receipt #
EDMONDS, WAIHINGTOII* OFFICIALS, EMPLOYEES, AND AGEN16 FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
";T' "
Fire Review
M a E
I HALL N B
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Fire Inspection Total Amount Due
NY CITY ORDINANCE
DEEMED TO MODIFY. WAIVE OR RE UCE ANY REQUIREMENT OF MY CITY ORDINANCE
I o' "c""ON *
2 NOR LIMIT IN ANY WAY THE CIWS ABILITY TO ENFORCE ANY ORDINANCE PROVISION�
Landscapoinsp. Recei.t
I riF MATT.N
I HERESY ACKNOWLEDG THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROVAL
ENT OF
GIVEN IS CORRECT, MD THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
Thia.ppnfawi.. lV n., a -ii algrod by ine
CALL
W
TION; AND IN DOING THE WORK AUTH RIZED THEREBY, NO PERSON WILL BE EMPLOYED
LA
CODE OF THE STATE OF WASHINGTON RELATING TO
6,11ding Offlaial., an.1h., M`PTY'i`WdI4e193 are paid, an
FOR INSPECTION aaalpl Ikn.wI.d,.d h.p.a. P1.1dad.
I
�iDR�JOENS COMPENSAM IFPRVRANCE AND ACW 16,2T
oFFIc 111"ATIRE DATE
kTE SIGNED
(425)
s RELEASED BY DATE
ATTENTION 7-
EXT 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX PINK - OWNER GOLD - ASSESSOR
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0
ITI
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ....................
FOUNdATIO
Footing ..........
z
wall ...........
Pier/Porch .................
0
Retaining Wall ...........
Slab Insulation ..........
ca
3:
ITI
PLUMBING:
ITI
0
Underground .............
0 1 1
C
Rough -In
IT
bc.rnmerciial Final . ......
HEATING:
Gas Test ....................
(0)
0
Gas Piping .................
n
Equipment ..........
ITIM
0
Commercial Final
0
0
C
EXTERIOR SHEATHING
NAILING ..........................
Irg 0
z
FRAMING .....................
FIRST FLOOR FRAMING
INSULATION ..........
z
Floor Insulation
V)
Wall Insulation ...........
Ceiling Insulation
IT
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................