20030483.pdfI
DATE RECEIVED -7
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
Donald Stoulil
OW
C
NER
15 MANLING ADDRESS
232 4th Ave S #202___
CITY ZIP TELEPHONE
Edmonds 98020 425-774-2731
N M
A E
ADDRESS
CITY
ZIP ITELEPHONE
NAME
Fast Water Heater
ADDRESS
12601 132 Ave NE
CITY ZIP
Kirkland 98034
STATE LICENSE NUMBER
N
TELEPHONE
425-814-3124
PROPERTY TAX ACCOUNT PARCEL NO.
00845900020200
NEW '-fa-_'FIESIDENTIAL
ADDITION COMMERCIAL
REMODEL L-9 MULTIFAMILY
REPAIR GRADING CYDS
0 DEMOLISH TANK
GARAGE RETAJNINGWALL
CARPORT ROCKERY
(ME OF USE, BUSINESS R APFIVITY) eN..
NUMBER NUMBER OF
OF DWELLING
STORIES UNITS
DESCRIBE WORK To BE DONE
PERMIT EXPIRES
USE PERMIT 9, -,o
ZONE NUMBER v?7
JOB
SUITE/APT#
ADDRESS 232 4th Ave S
202
PLAT NAME/SUBDiVISION NO.
LOT NO.
LID No.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
RW Permit Requited
Street Use Permit Req'd
EXISTING — PROPOSED
Inanecilon Reaulred
REOUIRYJLJ�E
Undergirwid
g required
METERtl2hMik UNE"ZE"CW.
7U
FOR EROSION
DATE
1 sGuairuiess Of whether tile - trr Nq I I
is nn.11 Ap I Pansion tankg�fjr_e"
FIRE R ""Our ex
Evf on ag ot water tanks 01 0
I N
SEPA REVIEW SIGN AMA nciuni
COMPLETE EXEMPT ALLOWED , PROPOSED I ALLOWED PROPOSED
PLUMBING / MECH
ALLCWED
'��D
LL&PAW
0
COMPLIANCE OR
CHANGE OF USE
PAW
0
SIGN
R
FENCE
kEO
FT)
REMARKS
OTHER
FIRE SPRINKLER
FIREALARM
AREAS
NUMBER
heater in utility closet
43.000 btus
PLAN CHECK NO:
% LOT SLOPE %
VESTED DATE
sETTGACKS (Fr.) PROPOSED SETBACKS (FF.)
7 4FRONT L/R SIDE' REAR
r
L MUIMO W WE &A L
A"I RE =0
E 0
CHECKED BY TYP N OCCUPANT I
GRO At�
SPECIAL INSPEC`TION AREA OCCUPANT
IT! LOAD
REQUIRED [] YES
REMARKS
PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REaD
Description FEE Description FEE
DeSCriipt'an
rg
Plan Check State kSSurcharge
Ci S rge
Building Permit City Surcharge
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
3 SEPARATE PERMISSION.
-
Engr. Review
PERMIT APPLICATION: ISO DAYS
M. PERMIT UMM 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
a EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Inspection
Receipt #
FROM THE ISSUANCE OF THIS PERMrr. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscape Insp.
Total Amt. Due
NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
Receipt #
Recording Fee
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
Building Official or his/her Deputy: and Face are paid, and
TION; AND IN DOING TH 1111�-&THORIZED THEREBY, NO PERSON WILL BE EMPLOYED
WO
IN VIOLATION OF THE LAB HINGTON RELATING TO
E fITC EOFTHESTATEOFWAS
FOR INSPECTION
receipt Is acknovviedged In space provided.
WORKMEN'S COMPENSATM INSU CE AND RCW 18.27.
O�DCIALr.SIGNFURE If �'T
SIGNATURE (0 ')R G
DATE SIGN D
(425)
/E
'*7 '.d97
771-0220
RELEASED By ATE
77TENTION 7--
M 1333
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 YELLON. 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
2
I
4rvc/4?90,F
: .0IP A'*
ol
4
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m
O.Cl
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c
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MM
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a
DATE RECEIVED
LPERMIT EXPIRES
USE PERMIT V
ZONE
q
CITY OF EDMONDS
NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB SUrrE/APT#
ADDRESS
232 4th Ave S 202
OWNER NAMEINAME OF BUSINESS
PLAT NAME/SUEIDIVISION NO. LOT NO. L D NO.
Donald Stoulil
MAILING ADDRESS
L�13 FEE S
232 4th Ave S #202
TESCP AP
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Penrift Required
Street Use Permit
CITY ZIP TELEPHONE
EXI 41111111 Sidevialk Raqt red
Edmonds 98020 1425-774-2731
REI UTyPD0Tft_L_VeW TMHWetM Underground
Wiring require 13 1
NAME
ME QUIRED
i
C�gPapp�jknjeegftl`l
YES13 NO E3
UV
z
15
ADDRESS
RE
Ow%
CITY ZIP TELEPHONE
TELEPHON
'A.
"A
NAME
r
coon 6f wl*er the'viater em
Past Water Heater
ENGINEE dosed. expansion tankfAffire
ADDRESS
I
12601 132 Ave NE
FIRE R E
"Ude, ECDC 19.30.020( OAT.
123
CITY ZIP TELEPHONE
Kirkland 98034 1425-814-3124
VARIANCE OR CU RELINEORADBI INSPECTION BOND
STATE LICENSE NUMBER EXPIRATION DATE REO'D POSTED
[3YEs ONO
PASTWHC052DF 2-16-05
SEPA REVIEW SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO.
TE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
.00845900020200
X ,
NEW ESIDENTIAL LUMBING MECH
SETBACKS (FT.)
A W FR NITR SIDE REAR
sgi keg
COMPLIANCE OR
ADDITION COMMERCIAL
State L Or & Industried
CHANGE OF USE
REMODEL MULTIFAMILY SIGN
DATE
RECID I P 011 1 IDED
GRADING FENCE
[:3 REPAIR CYDS I _ X_F7)
REMARKS
OTHER
DEMOLISH TANK
GARAGE RETAININGWALL FIRE SPRINKLER
FIRE ALARM
CARPORT ROCKERY
_11TYPIE.OE-LISF.,BUSINESS ORAffivinry).Exp��K.,_
f7 h h, I / 0 1
OCCUPZT�X
CHECKED BY TYP==N
14,1
GROUP
0 B
NUMBER NUM ER OF RrrjbAL
OF WELLING CAREAS
SPECIAL INSPECTION JAR EA OCCUPANT
STORIES UNITS UMBER
Al�:
REQUIRED LOAD
[] YES
DESCRIBE WOR14 TO BE DONE
Remove/RNMdU replace- cfas water
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO 'D
heater in utility closet
43,000 btus
W FIJI EN,
VALUAnON
$ 449.00
Description
FEE
DescriptIon
FEE
Plan Check
State Surcharge
HEAT SOURCE GLAZNG % LOT SLOPE %
Building Permit City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PARMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t= E%DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU C
BU
Gradirlb
a DaWN (C�RBS, SIDEWALKS. DRIVIEWAYS�MAROILifES.FC.).WILLREGUI
:3 IIIIEVARATE PER0891OW
t:
Engr. Review
PERMIT APPILICATION: 180 DAYS
PERMIT LIMM I YEAR - PROVIDED WORK 15 STARTED WTTHIN 1130 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 INDEMNIFX DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection Receipt #
IALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
PERMIT SHALL NOT BE
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS
91 DEEMED TO MODIFY; WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapainsp. Total Amt. Due
UK
Imew
0 NOR LIMIT IN ANY WAY THE cnys ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMMATION
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 unfit signed by the
TION; AND IN DOING THE WO5KAUTHORIZED THERE BY, NO PERSON WILL BE EMPLOYED
Building Official or his/her Deputy: and Face are paid, and
IN VIOLATION OF THE IAB9fR CO()E OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION receipt Is acknowledged In space provided.
WORKMEN-S CC1MPENSATRhNSUfANCE AND RCW 18.27.
OF S. SIGNjaURE
SIGNATURE (o DATE SIGNED
R
"�FJCIAI
(425)
7 77TE�
oe 6:17
771-0220
RELEASED BV DATE
ATTENTION
M 1333
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