20020782.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMERIAME OF BUSINESS
&� P40&)l"
MAILING ADDRESS
9101E5 —I S14
CITY ZIP ITELEPHONE
Q/t_44�ls Qati2- --n .1- -'3& j S
CITY
ADDRESS
14-5�50 Aa4YA
CITY ZIP
S
1-0-776—
I TELEPHONE
STAT LICENSE NUMBER EXP;r DATE
17 ,
/ P"-?
I
PROPERTY TAX ACCOUNT PARCE' NO
004-'-d� 000 0��-/ 0'�-
NEW V RESIDENTIAL PLUMBING I MEC
ADDITION 0 COMMERCIAL
Ei C MPLIANCE OR
CHANGE OF USE
[j REMODEL APARTMENT
SIGN
REPAIR GRADING C,,,S
F NCE
( X Fn
0 DEMOLISH 0 TANK
0 OTHER
o GARAGE o RETAINING WALL
CARPORT ROOKERY
El RENEWAL
ITYPE OF US IVITY) EXPLAIN:
'Sj
�NUMSER
OF
S TORIES
ja OF
NO
CRITICAL
AREAS
NUMBER A
DESCRIBE WORK TO BE DONE
[PERMITEXPIRES
US9__
ZONE
PE.'m'm..TR 7
JOB SUITFJAPT#
ADDRESS
PLAT NAMEISUBDIVISION NQ
LOT NO,
LIO No.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL
STREET MAP
EXISTING — PROPOSED
—
REQUIRED DEDICATION—
FT —
METER SIZE I
LINE SIZE
NO, .1 IIXTUR�a
PRV REQUIRED
I
YEsI3 NO 13
SHA-L BE INSTALLED CN THE
FIRE REVIEWED BY DATE
VARIANCE R
'B iND
Sol DST
0AT4E. GON ED
APRESSI tEREG1U.A3DR=" ONO
$EPA REV A&AYS.
A&M-1. V.Wtn&Q.N HE HT
OMPLETE PROPOSED
�Xp I TH WATE I SHUTOFI I
Lo COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACK$ (Fr.)
ALLOWED PROPOSED FRONT SIDE RFAR FRONT LIR SIDE REAR 0
PARKING I LOT AREA rZZ;;� -1. .1 DATE
AEQ'D I PROVIDED
OHErK10 BY I TYP
'91PECIAL INSPECT
REQUIRED 0 YES
V VALUATION $
A AN $
LU T'O
Description
Plan Chec'k
HEAT SOURCE GLAZING %
LOT SLOPE %
EIESTEI)DATE
I
Building
Plumbing
PLAN CHECK NO:
Mechanical
THIS PERMIT AUTHORDES ONLY THE WO KNOTED. THIS PERMIT COVERS WORK TO
IT
THE PH.
BE DONE ON PRIVATE PROPEF11Y ONLY. ANY CONSTRUCTION ON _E PUBUC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMITAPPUCATION: INDAYS
PERMITUM I YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
IN ..EAEST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE ell 01
2 IDMONDI, WASHINGTON, ITS OIFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALLCIAMS PON DAMAGES OF WHATEVER, NATURE, ARISING DIRECTLY OR INDMECTLY
Fire Review
FROM THE ISSUANCE OF THIS PERMrT. SSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO
Fire Inspection
MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landsc
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT AM THE OW ER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE W K AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
CALL
FFOR
IN VIOLATION OF THE e..-S .1 THE STATE .1 WASHINGTON RELATING TO
INSPECTR
N IN
WORKMENS COMPENSA N INS NCE AND RCW 16.27,
E SIGN
'(425)
771-0220
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
'71-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
Iojal
FAX
00 UPANT
GROUP ,
� F E
E Description I FEE
15ASE_ 30-
eA
Recording Fee
City Surcharge
State Surcharge
Plan Chk Deposit
Receipt #
Total Amount Due 60�5. IF
APPLICATION APPROVAI
Thlsappi,ati..]��..p.-I,..til.ton�dby..
�jIdR,gOfZ.I.,hI0h�,D.pWy; dFpid,.nd
.ipI ikI.dpd I. �p p—ld.,L
qELEAbED BY L11 DO(TE
ORIGINAL -FILE - YELLOW -INSPECTOR
PINK.OWNFR - GOLD -ASSESSOR
z
171
9
C M
MID
0
80
C
X M
M z
CA
0 -n
'i
M ITI
0 C'0
M 0
z
z
z
ITI
"s W-LOW
O-CrY F2=00
Aw
m m
Or
-n
m M
jo -c
o
C ca
M C),
z
74
0-f A'L-f-f
to —4 2- o" A.,A-
& 77�
7-A
eA,4 "�t
CA C. 'f-d
AIPY7"e—
Tr
19'C
-144—ce- rz�
e, A-c
-fl_+, 17-c 11— k Ir gr�jE4
e—ow- As
10 If E U. .4 ji
4. g-c-u
4-4
.2
=Pfl
, 4c ^41 j.ipf- "�tv—
r_ rD A-- XA-- f-q7 A --I
41,
"aln:
,k,e c;* . . . . . . . . . . . . . . . k-
44@� 4-e-f- !rA-� A
t e gt&A- Al "j" 1, c-/ �A 11
c A r?'m " I t r rdr j 4-,v 1,
A sijqe St, -f
4, Aa vft� -a
4
A 16-14-6 2,--
f-A r ., -,�JIJ Od
-e
m m
m m
IN
MEMORANDUM
Date: February 4, 2003
01
To: Jeannine Graf, Building Official
MI
From: Duane Bowman Development Services Director�
Subject: Brooks Hot Water Heater
m
Because we know that the hot water beater was installed correctly and Mr. Brooks claims to have
0
obtained a permit Years ago with the tanks original installation, I do not believe it necessary to
M,
m
pursue this matter fin-ther..
C
n
m m"
Fn
C (n,
V)�
m 0;
zq!�
City of Edmonds
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ................
FOUNDATIOW
Footing . .......... ...........
Wall ..........
Pier/Porch
Retaining Wall ...........
Slab Insulation ...........
PLUMBING: p
Underground .............
M1
Rough -in ...................
Commercial Final
HEATING:
Gas Test_... ..........
Gas Piping
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING
INSULATION ...................
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ................
z
0,
C
m
0 C
:0 C
�:,
m
m z
to -4
C 2
0 _T1
m T
a Cn
0
0
C
To
z
z
m