20020877.pdfDATE RECEIVED
CITY OF EDMONDS
USE
Z.NE PERMIT
NUM'ER
CONSTRUCTION PERMIT APPLICATION
JOB SUITEJAPT#
ADDRESS 23117 102 Pl W
OWNER NAMEINAME OF BUSINESS
PLAT NAMEISUBDIVISION NO.
LID NO.
LID FEE S
Simon Pedersen
MAILING ADDRESS
23117 102 Pl W
PUBLIC FIGHT OF WAY PER OFFICIAL STREET MAP
EX"T'N
TRESU
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Is
CITY
Edmonds 98z01P20
ITELEPHONE
206-542-3033
P
I
NAME
MEIER
!St..; Ct�NFr
1XITuiEM
aWV EQUIRED
YES E3 No 0
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ADDRESS
REMARKS is,
OVVNE;7jCdr&4GiOF� REiSIQ E F04 EROSION CONTROIJDRAINAJE
CITY ZIP
ITILIP"ON1
NAME
Fast Water Heater
END
IWIN16FI, connectors DATE
Imaly'rW au - -tc-
ADDRESS
12601 132 Ave NE
77
FIR
8' G
tMaNd spaces.. UNIC' 815.1.7 DATE
CITY ZIP
TELEPHO E
Kirkland 98034
425 - 814-3124
STATE LICENSE NUMBER EXPIRATION DATE
FASTWHC052DF 2-16-b3
I CHECKED BY
d)J—
VARIANCEORCU I
SH00111"IOIADBI
INSPECTION
RE 'D
E3YES 13NO
BOND
POSTED
5
4
PROPERTY TAX ACCOU PARCEL NO,
SEPA REVIEW
COMPLETE EXEMPT
SIGN ""A
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
Is
0 0610700201605
I
ENT L
NEW LSID IA LUMBING I MECH
ADDITION ON, 'Al C MPLIANCE OR
CHANGE OF USE
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11 W, AREA
�ING REVIEWED By -UTE
FENCE
0 REPAIR GRADING CYOS ( _ X _FT)
REMARKS
DEMOLISH TANK rl OTHER
GARAGE RETAINING WALL F] ESPRINKLER
CARPORT ROCKERY FIRE ALARM
ITYPE OF USE. BUSINESS OR ACTIV
CHECKEDBY
TYPE 0N,0NSTF,1,W
Cqp?) OR
CDUPAX�7
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NUMBER
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STORIES
N NIGER
DUMILIN"
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GRRIOA1
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L.
r..ACDUPANT
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REMARKS
PROGRESS INSPECTIONS PER UBC 100/FINAL INSPECTION REO'D
2
qaraqe on stand
40,000 btus'
VALUATION
$ 449-nQ
12 Lgt—1
Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE I �Nr LOT SIOPE %
Building Permit City Surcharge
PLAIN CHVA441gN— VESTED DATE
Plumbing
THIS PERMIT AUTHORIZES ONLY THE WO K NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
S PARATE PERMISSION,
PE MITAPPLICATION: INDAYS
Mechanical
Grading
Engr. Revi"
PERMITLIMFE I YEAR - PROVIDED WORK is STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FORMOREINFOR ATION
Engr. Inspection
'APPLI Ann, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Fire Review Plan Chk. Deposit
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS 011111AL1, EMPLOYEES, AND AGENTS 11011 ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT IIIIIANIE OF THIS PERMIT SHALL NOT E
D EMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINAN" E
C
NOR LIMIT IN ANY WAY THE CITYS ABILITY To ENFORCE ANY ORDINANCE PROVISION. -
4��l
Fire Inspection Receipt N
Landscapeinsp. Total Amt. Due
Recording Fee Receipt N ;-Sl s
I
HERE -.NOW1E..E THAT I HAVE READ THIS A'--l.NZ THAT THE INFORMATION
GIVE" IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
7ION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LA87 �GUE 01 THE STATE 01 WASHINGTON FIELATIN. TO
Is WORKMEN'S C MPENSATIO I� B RANCE AND RCW 18,27.
IIGNATUII E DATE SIGNED
APPLICATION APPROVAL
CALL Roil This appliestion is not a remit until signed by In.
dIng Offiel.1 ., tester Deputy: end Fees old Full, end
FOR INSPECTION -.In, Is ack—lodghol i—p— peo,ldod.
DATE
(4125)
a 771 .2.0 l(IfLIASED .1
-02 1 DATE
ATTENTION
E)ff 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
ORI INAL-FILE YELLOW - INSPECTOR
PIGNK-OWNER GOLD -ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
`:'FOUNDATION:
Footing ............
Wall ..........................
Pier/Porch .. ...............
z
Retaining Wall ...........
Stab Insulation
:-4 :5
PLUMBING:
IT!
Underground .............
0
Rough -in ...................
-40
0 C
Commercial Final
MT�
HEATING:
10-4
4
C 2
Gas Test ....................
Gas Piping
Equipment
20
Commercial Final
M M
EXTERIOR SHEATHING
0
0
NAILING .........................
C co
FRAMING .....................
R1 C)
FIRST FLOOR FRAMING
INSULATION .............
3:
Floor Insulation
z
Wall Insulation
Ceiling Insulation
z
SHEErROCK NAILING
0
M
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
yv)
OCCUPANCY ..................
4:9404- 47 7 #0 -0