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20030155.pdfq 3 DATE RECEIVED e CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS Bryan Janssen MAILING ADDRESS 19420 84 Ave W CITY ZIP TELEPHONE Edmonds 98026 425-776-8008 NAME ADDRESS CITY ZIP ITELEPHONE Q-4 (PIRES USE PERMIT ZONE (?I t) NUMBER X JOB SUITE/APT# ADDRESS 19420 84 Ave W PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. I I LID FEE$ Req'd METE 1NAW n i %'W FWMpft tir, PRv R UIRED NO ode. ECDC 19.30-020(c) 1 YESE3 [REIMAR z I I - - I I OWANER/ NTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE NAME CBL mmg, 33 gr 1. vent connlixtors Fast Water Heater ft*19TREVIVVED B anceM recl on fuel-buridngaPPH ADDRESS I C 12601 132 Ave NE 1 waid ups", FIR Xrld rED7y7 Lu 11 CITY ZIP —ITELEPHONE IE Kirkland 98034 425-814-3124 VARIANCEORCU INSPECTION BOND STATE LICENSE NUMBER EXPI jSHORELINEORAD REO'D POSTED CIYES 13NO 1$ 11 FASTWHC052DF 2-16-0 — SEPA REVIEW SIGN AR HEIGHT LO D PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED I 27041800312100 - E i-rilAt - - .. - Eb Amo S AC pRoPOSj) SETBACKS (Fr.) NEW RESIDENTIAL Q PLUMBING / MECH A 0 OPOSED W FRONT R SIDE REAR COMPLIANCE OR COMMERCIAL ADDITION 0 CHANGE OF USE 6T__AREA PLANNING REVI EWED BY DATE 13 REMODEL 0 muLnFAmy [] SIGN RE . GRADING [3 FENCE 11 REPAIR 1:1 CYDS ( _X_FT) REMARKS 0 DEMOLISH 1:1 TANK o OTHER GARAGE RETAINING WALL FIRE SPRINKLER 1:1 CARPORT 11 ROCKFRY 0 FIRE ALARM (TYPE OF USE. BUSINESS OR N: C9 OCCUPANTV"�2 CHECKED BY ITYP GROUP NUMBER NUMBER OF' —CRITICAL DWELLING AREAS SPECIAL INSPECTION OCCUPANT LOAD OF STORIES UNITS NUMBER JAREA REQUIRED [3YES DESCRIBE WORK TO BE DONE Pater in Remn)je plage-gas wgte REMARKS PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REO'D garage on stand 38,000 btu's Qb Urc%) Rp vAwArnm $ Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing 1 Mechanical 7 THIS PERMIT AUTHOREMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO h BE DONE 0.4 PRIVATE PROPERTY ONLI ANY CONSTRUCTION ON THE PUBLIC Grading a DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review PERMIT APPLICATION: 11130 DAYS PERMIT UMIr I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS Engr. Inspection SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION Fire Review Plan Chk. Deposit 'APPUCAK ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS OF IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # EDMONDS, WASHINGTON. ITS ALL CLAIMS FOR DAMAGES OF WHATEVER MATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due DEEMED TO MODIFY, LIMIT IN ANY WAY THE CnYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # ziNOR ---- THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL 1 HEREBY ACKNOWLEDGE GIVEN is CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application Is not a permit until signed by the THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building Official or his/her Deputy: and Fees are paid, and TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided.. WORKMEN'S COMPENSATIO:,!!SRANCE AND RCW 18.27. OFFICIAL DfE - SIGNATURE (0 ER 0 E DATE SIGNED 1A 5) , �SVGWURE, %42 - 771-0 220 TE—LE—AsE. 1) ATf EXT 1333 ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW -INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. uBC SECTION 109 PINK -OWNER GOLD -ASSESSOR ARE MAKING 5 COPIES GREEN - ACCOUNTING 04/02 PRESS HARD -YOU . s 4 Q10ATE RECEIVED_2 1 "21 A k.001 I PERMIT EXPIRES CITY OF EDMONDS USE ZONE PERMIT K2n NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS 19420 8 4 Ave W OWNER NAMEINAME OF BUSINESS Bryan Janssen PLAT NAMEISUBDIVISION N LID NO. MAILING ADDRESS LID FEE $ 19420 84 Ave V1 PUBLIC HT OF WAY PER OFFICIAL STREET MAP T9SCP AppM"d Rw ftrffA noquww CITY ZIP TELEPHONE EXISTIN -A Ift (a wuk Edmonds 98026 425-776-8008 REQUIRE MI-1k NAME METER PRV REC ARED 1 d A 0111A fifth s13 q 0 13 ADDRESS REMARKJ OWNERICUMIRALRUN CITY ZIP ffA)AE Fast Water Heater ADDRESS 12601 132 Ave NE TELEPHONE WMR- I NY ENGINE INTITE&E By n req ;@onfueJ-burrIngspp1Ia&Fs1n spow, 5111 FIRE RIIEWED BY DATE CITY ZIP TELEPHONE Kirkland 98034 425-314-3124 VARIANCE OR CU SHORELINEORADBO I INSPECTION REO'D STATE, LICENSE NUMBER EXPIRATION BAT [3Y ES ONO 9ASTWHC052DF 2-16-0 SEPA REVIEW SIGN AREA PROPERTY, TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT . WED ALLO PROPOSED ALLO 800312100. EXP . no Oman [3 NE�" RESIDENTIAL PLUMBING/MECH &OUR& i go A sit [3 ADDITION COMMERCIAL COMPLIANCE OR 13 CHANGE OF USE doshiesi �=BOND POSTED EIQHT- PA6PO6ED, SETBACKS (FT)' IR SIDE REAR cc LOT AREA DATE MULnFAMILY R REMODEL El siGN IL REPAIR [j GRADING o FENCE CYDS X REMARKS OTHER DEMOLISH TANK It A U 0 V L GARAGE RETAININGWALL 0 FIRE SPRINKLER CARPORT ROCKERY. FIRE ALARM USE e 4 occu GROUP MI. 177A ZULU NUMBER OF NUMBER CRITICAL � OF DWELLING AREAS SPECIAL INSPECTION JAREA OCCUPARt' LOAD STORIES UNITS NUMBER REQUIRED 0 YES DESCRIBE WORK TO BE DONE Remove/replace gas water heater in REMARKS PROGRESS INSPECTIONS PA UBC 1168iFINAL INSPECTION REaD garage on stand 38,000 btu s V 'nON ALUA $ 449.00 Description FEE Description FEE Plan Check State Surcharge HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing 20 Mechanical THIS PERMIT AUTHORUMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 13E DONE ON PiwArE PROPERI'llY ONLZ ANY CONSMUCTION ON THE PUBLIC Grading :M3 DOMAIN (CURBS, SIDEWALIKS, DRIMVAVS, MAROU REQUIRE r v. !7 Engr. 7 15 PFRUFTAPPLICATIOW 160DAYS PERMIT ILIMM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT. 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 OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND . Fire Inspection Receipt # ALL CLAI MS FOR DAMAGES OF WHATEVER NATURE. APJSING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapeinsp. Total Amt. Duo EE ED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR umrr IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Recording Fee Receipt # I HEREBY 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 OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. CALL This application Is not a permit until signed by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/lier Deputy: and Fees are paid, and IN VIOLATION OF,THE LABOR CODE OF 1HE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORKMEN'S COMPENSAT103JWZ�RANMAND RCW 18.27. �'UR OFFICIAL GN D)�TE SIGNATURE I ER 0 A ENb j DATE SIGNED (425) 771-0220 RELEASEIT Ilrf DATA A*ffENTION I M 133 IT IS UNLAWFUL TO USE OR- OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- 'ORIGINAL - FILE YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN -ACCOUNTING =i `-In- 551 M M -1 § 0 C :2 z C z 9 3! � us 0 _n "�'n 9 M M 0) 17n C 0 z 0 j 0 M