20020563.pdfFA
DATE RECEIVED
712
PERMIT EXPIRES
CITY OF EDMONDS
USE PERM T
ZONE NUMIBER,;iZnl�
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT#
ADDRESS 19115 92nd Ave W
OWNER NAMEINAME OF BUSINESS
"I as
'A
---- [7 —
PLAT NAMEISUDDIVISION NO. O�7 LID 110.
_911 Essi,
LID FEE S
19115 92nd Ave W
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP ....
7W
an- .—ane .d
CITY zip
ONE
EXISTING — PROPOSED— 1,.�S.`Iad
_1401111�
0
11
Edmonds 98020
ITIEL11
425-672-3279
REQUIRED -sann
� I =V1.
NAME
T
1. FIIft�URE
RV RED
%�O
esul;
ADDRESS
REMARKS I unne,
OWNEfVCOt2,ACrOR RESPO OLIDRAINAGE
CITY ZIP
NAME
Fast Water Heater
L D,5
ENGINEERINt—
ADDRESS
01;tpi 11 tl,;eetrical Permit from i
12601 132 Ave NE
_ustrie&TE
-abor & Ind
CITY
TEL PHONE
9 8 OZIP
Kirkland 34
425-814-3124
STATE LICENSE NUMBER
EXPIRATION
_ -_ cu SHORELINE OR ADS# I INSRED
!ION PDONED
By 1) DST
DYES E3NO
FAgTkjHr,Q52QL_
2-16-03F
SEPA REVIEW AREA EIGHT
"
PROPERTY TAX ACCOUNT PARCEL NO.
PT AIIAE'.' PROPOSED I ALLOWS
COMPLETE . .... 0 . PROPOSED
NEW
RESIDENTIAL
MECH
LOT COVERAGE
r W SEVIACM40.1 V0419TS1
PLUMBING I
AL ED PROP
LOW WP REMLR�ft (,fM
ADDITION
0 COMMERCIAL
[3 C MPLIANCE OR
CHANGE OF USE
SEEM INSTALL -D NEAR
REMODEL
APARTMENT
[] SIGN
PARKING
REGO 1ROVIII10
I LOT*MjWAMN8MWq(WF DATE
0 REPAIR
Ij GRADING BYGE
E] F NCE
( _ X Fit
I
REMARKS
DEMOLISH
[3 TANK
OTHER
ci GARAGE
CARPORT
o RETAINING WALL
ROOKERY
RENEWAL
JLZ
............
(ME OF USE, BUSINESS OR ACTMM
W
CHECKED Typ!��
ONSTR?T N
Im .. UPx
NUMBER
UMBER
OF
NUMBER 0
TIWELLING'
CRITICA1
AREAS
SPECIAL INSPECTOR AREA OCCU NT
T.111E.
UNITS
N it
UMBER
SQUIRED
R YES
LOAD
DESCRIBE WORK TO BE DONE
Romove/—lace aaS Water heater Nin
Quitside gloSet (not a mobile ..
40,QOO bitu's
d 1,
PROGRESS INSPECTIONS PER UEIC 1081FINAL INSPECTION REO'D
PURSUANTTO UPC 605.2
AWATER SERVICE SHUTOIT-
21,11, 1
LINE AS InTltNTER`S-.�It� �U1L'1'1'1'1'1"G
VALUATION $
FEE Description FEE
/"/_&�
Plan Check
HEAT SOURCE GIAZING % LOT SLOPE %
Building
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMITAUTHORIZES ONLY THEW RKNOTED. THIS PERMIT COVERS WORK TO
IC 0 - DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCITON ON THE PUBLIC
Grading
Recording Fee
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, UIRE
MARQUEES, ETC.) vRUREQ
SEPARATE PERMISSION,
Engr. Review
City Surcharge
'SOTADRAT'gle
PERMIT UM M I YFAPRE- PMfl`o"V11pU0`WT01R0NRr WITH IN 180 DAYS
Engr. Inspection
State Surcharge
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
-ILICANT ON BEHALF OF HIS OR HER SPOUSE , HEIRS. ASSIGNS AND SUCCESORG
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARM EBB THE CITY OF
EDMONDS, WASHINGTON, III OFFICIALS. EMPLOYEES, MAD AGENTS FROM ANY AND
Fire Review
Receipt #
ALL CLAIMS FO DAMAGES OFWHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FSOM T14E ISSUNCE 'IF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
—
Fire Inspection
Total Amount Due
DEEMED TO MOD IFY WAIVE OR REDUCE ANY REQUIREMENT OF NYCITYORDINANICE
NOR LIMIT IN ANY WAY THE CITYS ASIUTY TO ENFORCE MY ORDINANCE PROVISION.-
Landscapoinsp.
Receipt #
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
—
APPLICATION APPROVAL
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
THE OWNS . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
Thi-ppli.sil-lanet. by Me
TIGN; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LAS OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Building Official c, Milner Deputy; and Fees are paid, and
—.1in I...kI.dqd In ap ... pr.Ad.d.
WORKMENS COMPENSAT ,
10 CE AND RCVV 10,27�
DATE
SIGNATURE (OWNER 08 hbEf WE SIGNED
(425)
IN&Z
Z__
I
z�
. . ir
RELEA-SED BY
ATTENTION
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-
CATE OF OCCUPANCY HAS BEEN GRANTED, UBC SECTION 109
FAX
ORIGINAL - FILE - YELLOW - INSPECTOR
PINK,OWNER - COLD -ASSESSOR
tolol
z
0
n
OX
C IT
M 0
0
80
C
--13:
x M
M Z
JD -4
6
0 -n
"n
In IT
a 0;
0
0
(j)
M 0
Z
7-f
X
CID
z
0
I
SETBACKS .................
FOUNDATION:
Footing .............
Wall -W-1- ...............
Pier/Porch .................
Retaining Wall ...........
Slab 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 ...........
z