20030625.pdfI
DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Candice Bishop
MAILING ADDRESS
908 Hindley Lane
CITY ZIP TELEPHONE
Edmonds 98020 425-778-6575
NAME
ADDRESS
CITY
ZIP ITELEPHONE
NAME CBL#
All Climate Heating & A/C
ADDRESS
14715 N.E. 95th Unit B
CITY ZIP I TELEPHONE
Redmond 98052 425-746-3077
STATE LICENSE NUMBER EXPIRATION DATE 4
ALLCLHAOOOCB 2-24-04
03
PERMIT EXPIRES
USE PERMIT
ZONE
NUMBER
JOB
ADDRESS
SUITE/APT#
tan (Z
PLAT NAME/SUBDIVISION NO.
aa�
LOT NO.
LID NO.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
if.sur Approved
RW Perm" Required
Street U&o Perm it Req'd
EXISTING - PROPOSED
Inspection Required
Sidewalk Required
REQUIRED DEDICATION-- FT
Underlirotand
Wkingrequired
METER SIZE
LINE SIZE
I
I NO. OF FIXTURES
PRV REQUIRED
YES 13 NO 13
NEW
RESIDENTIAL PLUMBING / MECH
ADDITION
COMMERCIAL COMPLIANCE OR
CHANGE OF USE
REMODEL
MULTIFAMILY SIGN
REPAIR
0 GRADING CYDS
[3 FENCE
( - X FT)
DEMOLISH
1:1 TANK
OTHER
0
oGARAGE
-1 RETAININGWALL
1:3
FIRE SPRINKLER
0 FIRE ALARM
CARPORT
ROCKERY
M&E OF USE. BUSINESS OR ACTIV
NUMBER
OF
NUMBER OF
DWELLING
I
C RITICAL
AREAS
STORIES
I
UNITS
NUMBER
DESCRIBE WORK
replace
TO BE DONE
existing gas furnace with new gas
furnace,
replace water heater with gas water
heater including gas 44,1wa-to w/h
lob
HEA
gas T SOURCE GLAZING % LOT SLOPE %
PLAN CHECK NO: VESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
h BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBILIC
11 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
3 SEPARATE PERMISSION.
PERMIT APPUCATION: 150 DAYS
CIL PERMIT LIMM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICMT; ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
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-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE L&Deff-COU OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENS
,fliClIffIM"CE AND RCW 18.27.
SIGNATURE (OWNER OR AGE ATE SIGNED
T 8-14-03
ITS SHALL NU
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DATE
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SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED ROPOSED
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PA L MO BY DA
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REQ`D
[REMARKS
CHECKED BY ITYPE
OCCUPANT
SPECIIILINSPECIION JAREA OCCUPANT
REQUIRED [3 YES I LOAD I
$ 31,01 "
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
CALL
FOR INSPECTION
(425)
771-0220
2
NS PER UBC 1108MINAL INSPECTION REO'D 9
FEE Description FEE
State Surcharge
City Surcharge
ATTENTION EXT 133 r
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
Plan Chk. Deposit
Receipt #
Total Amt. Due M95
I Receipt # ffio
APPLICATION APPROVAL
This application Is not a permit until signed by the
Oat or his/her Deputy: and Foes are paid, and
pt lwrknowledgpd In space proy)dod.
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
ORIGINAL -FILE YELLON-INSPECTOR
PINK -OWNER GOLD -ASSESSOR
GREEN - ACCOUNTING