20030782.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMENAME OF BUSINESS
MAILING ADDRESS
7312 175th St SW
CITY ZIP TELEPHONE
Edmonds 980261425-745-5475
NAME
ADDRESS
CITY ZIP ITELEPHONE
NAME ICBLN -I I
ADDRESS
12601 132 Ave NE
CITY ZIP
TELEPHONE
Kirkland 98034
1425-814-3124
STATE LICENSE NUMBER
EXPIRATION DATE
CHE
FASTWHC052DF
2-16-05
PROPERTY TAX ACCOUNT PARCEL NO.
99713100000300
PERMIT EXPIRES
U F PERMIT
�7
ZONE
NUMBER
JOB
SUITE/APT#
ADDRES 7312 175th
St SW
PLAT NAMEISUBDIVISION NO.
LOT NO.
LID NO.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Apixoved
RW Permit Required
Street Us* Permit RW
EXISTING - PROPOSED
InApectionfloquited
Sidewalk Required
13't NO 13
r Industrie YES
... I � —, ' "" ___ S1
REMA%, A
1
OWNE
is open or dosed, exEansion tanks are
FIRE F EM&R on R hot water tanks per DATE us
City Code. ECDC 19.30.020 (c)
VARIA -ME: OR Cu briUMLINIz UK AUH __1NbF BOND
REQ'D POSTED
EYES 13NO S
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE . EXEMPT I ALLOWED PROPOSED I Al I OW
-ED _,,PROPOSED
NEW
7%e'FIESIDENTIAL
)klrLUMBING/MECH
ALL 01MED p
Ks (r
i1ltEa(5jWfb`sffffKC -T 9"" STEC
KS (Fr.)
REAR
OR
COMMERCIAL
COMPLIANCE
0 CHANGE OF USE
are—q. i0mc
REMODEL
MULTIFAMILY
SIGN
Cfr AREA ING REVI
IAWW—'-T 11
RE
,,....',+ANN
IL
1:1 REPAIR
GRADING
0 CYDS
o FENCE
X Fr)
REMARKS
[:] DEMOLISH
0 TANK
OTHER
oGARAGE
o RETAININGWALL
F RE SPRINKLER
CARPORT
ROCKERY
FIRE ALARM
(TYPE OF USE. BUSINESS OR ACTRI
'�_M
CHECKED BY ITYP
EEO
OCCUPANT/
GROUP
NUMBER
OF
NUMBER OF
WELLING
j
I CRITICAL
AREAS
N F�_
SPECIAL INSPECTION OCCUPANT
STORIES
UNITS
NUMBER
JAREA
REQUIRED
LOAD
DESCRIBE WORK TO BE DONE
REmove/replace
two (2)
gas water heate
REMARKS
PROGRESS INSPECTIONS PER UBC 1101111FINAL INSPECTION REO'D
inbasement b2th 40,000
btu's
VALUATION
$ 891k 449.0�
Description
FEE
Description
FEE
Plan Check
I
State Surcharge
HEAT SOURCE
GLAZING %
I
LOT SLOPE %
VESTED DATE
Building Permit
Plumbing
City!�urcharge
-
PLAN CHECK NO-
I
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I= BE DONE ON PRWATE PROPERTY ONLY. AM CONSTRUCTION ON THE PUBLIC
Grading
31 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: 180 DAYS
PERMIT UMM I YEAR - PROVIDED WORK 16 STARTED WITHIN 160 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
2 EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
BE
FROM THE ISSUANCE OF THIS PERMM ISSUANCE OF THIS PERMIT SHALL NOT
DEEMED TO MODIFY; WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapoinsp.
Total Amt. Due
0 NOR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.*
Recording Fee
Receipt N
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
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Building Official or his/her Deputy: and Fees are paid, and
receipt Is acknowledged in space provided.
WORKMEN'S COMPENSAT19N;INSURANCE AND RCYV 18.27.
OFFIC Its SIGNATURE DATE
SIGNATURE (0filNER OR A&Un
DATE SIGNED
1A
t-125)
771-022 0
-------
RELEAftb B� — DATE/
ATTENTION
Off 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
z
0
M
M
M
10
0 C:
M M
,0
0 _n
M M
0
6 Fn
z
z
0
M
RECORD
OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS
.....................
F6,
M�10t;--
:footing . ...................... .
.7=
Wall
'
P Obrdh .... ..
i e .................
,Re 61ning Wall: ...........
Slab Insulation ..........
PLUMBING::
Underground ..............
.
t v::i -
C6rFrndf6faI Fifi-al %,.
....
HEATING:
.. .. ..... .
Test
_Gas ................
Gas Piping .................
Commercial Fin I .......
EXTERIOR S14EATHING
NAILING .......................... ..
FRAMING .......... .........
FIRST FLOOR FRAMING...
INSULATION . ...................
floor. Insulation
.........
Wall Insulation . ............ .
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL -INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
.
I
:q Own
m
0
m
c:
ic
C)�
0,
=1 I
a
DATE RECEIVED PERMIT EXPIRES �1 / Y_
PERMIT ZM_
ZONE
CITY OF EDMONDS NUMBER
JOB SUITE/APT#
CONSTRUCtION PERMIT APPLICATION ADDRESS 2.2217312 1751:�-i St Sw
I OWNER NAMEINAME OF BUSINESS
PLAT NAME/SUBDIVISION N
LOT NO.
LID NO.
Mark Shabley
MAILING ADDRESS
LID FEE
I ESCP AM;;;T
Rw Pefffo R6quirl
%W
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
7312 175th St W
su" U" P*F"
CITY
ZIP
EXISTING — PROPOSED
hapecoon Roqukw
sw*wa* PA)qukw
Edmonds
ITELEPHONE
98026 425-745-5475
REQUIRED DEDICATION—
FT
urodKoroww
WWO roqdnd 13
O"*Ml REQUIRED
NAME METER SIZE LINE StIZE _ _flila,811��
*I
_ftj 1)eroot ft
ht
am NO 13
ADDRESS
RE
OW E%2NACjf5ff,
,WS&
j*d"tAffiTROL/DRAl
CITY ZIP
TELEPHONE
NAME
1
_FASt t4ater Heater ENGINEERING REVIEWED BY DATE
x
ADDRESS
12601 132 Ave NE
FIRE R
a 8
CITY ZIP TELEPHONE is open or dosed, expan;s11ont8*8 8r
=e,-.ik,t1n,eIor
Kirkland 98034 425-814-3124
STATE LICENSE NUMBER EXPIRATION DATE C 11611 191-19ftLIN111005 BOND
C 'D STEO
ity 30.
Cod;. ECDC 19. " 8NO
0 S
FASTWHCO52DF 2-16-05 --SIWAREA
SEPPA"ffPVMW— HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED', PROPOSED ALLOWED PROPOSED
3
tj
99713100000300 ,
,
EXP
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS fFT.)
51�RESIDENTIAL UMBING MECH REAR
NEW ALLOWED PROPOSED FROjff___SWL_A&A&—
) 4 _� �__t - I
COMMERCIAL COMPLIANCE OR ec rs
CHANGE OF USE im ftrl 1. vAnt COTM
9E
ir
LOTfRWj. 96
MULnFAMILY RECI fin uigi_ fim"v"ic"i
REMODEL SIGN U
UMC 815.1.7
REPAIR GRADING CYOS FENCE X FT) REMA
DEMOLISH TANK Ea OTHER
o GARAGE RErAINING WALL FIRE SPRINKLER
13 ALARM
CARPO RT I—_ ROCKERY FIRE
CHECKED BY CO3 E OCCUPANTg3
.i
cc
GROUP
ITYPMFM
NUMBER N BER OF CRITICAL
OF UM AREAS SPECIAL INSPECTION JAREA OCCUPANT
DWELLING
STORIES UNITS NUMBER REQUIRED LOAD
[] YES
DESCRIBE WORK TO BE DONE
REmove/replace two (2) ga water heate REMARKS
PROGRESS INSPECTIONS PER UBC 1108/FINAL INSPECTION REaD
in basement both 40,000 bUtAs
A Ph
A 1111 Pit—INKIIN
U ft / V-) -01 No 19 All 1! 1 1L_ I I
VALUATION W Ilia aIIIIIIIIIIIII I now
$ WIR 449.0
Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE % LOT SLOPE % Building Permit City Syrcharge
PLAN CHECK NO, VESTED DATE Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DOME ON PRIVATE PROPERTY ONLX ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWAM. DRIVEWAVS, MARQUEb, FTC.) WILL REQUIRE
SEPARATE PERMISSION. 1*
Engr. Review
PERMIT APPLICATION: 180DAYS
CL PERMIT UMM I 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
...... S. WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGEWS FROM ANY AND Fire Inspection Receipt #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscape Insp. Total Amt. Due
9 DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee Receipt III
I HERE13Y 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 OMcIW or his/her Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged in space provided.
WORKMENS CCIMPENSATiq�JRURAN 04TE I
CE AND RCW 18.27. OFFICIALS SIGfjATURE.
SIGNATURE (0 DATE SIGNED 142
'AIER.7R
V1497 771-0220 _bATE/
RELEASY6 13V
ATTENTION Off 1 33
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 HABEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD -ASSESSOR
04/02 U ARE MAKING 5 COPIES GREEN - ACCOUNTING
PRESS HARD -YO