20030783.pdfDATE RECEIVED
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CITY OF MONDS
USE PERMIT
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NUMBER
CONSTRUCTION PERMIT APPLICATION
JOB SUITEIAPT#
ADDRESS
23118 75 Ave W
OWNER NAMEINAME OF BUSINESS
Jim Jones
PLAT NAMEISUBDIVISION 7� LID NO.
MAILING ADDRESS
LID FEE $
23118 75 Ave W
TESCP Approved
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP RW Permit Required
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CITY ZIP ELEPHONE
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Edmonds 98026 25-776-6451
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REMARKS
OWNER/CO
Regardless of whether the We( SYB'e
CITY ZIP ONE
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NAME
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FAst Water Heater
ENGINEERINt ikE%AEWED BY is
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ADDRESS
12601 132 Ave NE
FIRE I EIVED 151
CITY ZIP TELEPHONE
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T425-81
Type B or L vent connectors
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Kirkland 98034 4-3124
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STATE LICENSE NUMBER EXPIRATION DATE P TED
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FASTWHC052DF 2-16L-05 WX
PROPERTY TAX ACCOUNT PARCEL NO.
COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PRO POSED
00488800400305
,
EXP
NEW ESIDENTIAL LUMBINGIMECH
LOT COVERAGE REQUIRED SETBACKS (Ft) PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
COMPLIANCE OR
COMMERCIAL 0
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CHANGE OF USE
REMODEL MULTIFAMILY 0 SIGN
PARKING DATE
I LOT AREA PLANNING REVIEWED BY
RECID I PROV IDED
IL
[3 FENCE
REPAIR GRADING CYDS X FT)
REMARKS
DEMOLISH -rANK OTHER
GARAGE 0 RETtJNINGWALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
(TYPE OF USE, BUSINESS OR A�OT�r
CHECKED BY ITYPE
1=1 CW OCCUPANIT�
GRO
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NUMBER NUMBER OF F-C-R—ITICAL
OF DWELLING AREAS
A-
SPECIAL INSPECTION OCCUPANT
STORIES UNITS NUMBER
IAREA
REQUIRED LOAD
DESCRIBE WORK TO BE DONE
RErnove/renlace. water heater in
REMARKS
-gas
PROGRESS INSPECTIONS PER UBC I GO/FINAL INSPECTION REaD
garage 40r000 btus
M0, MW 6 0121
VALUATION
449.00
Description
FEE
Description
FEE
Plan Chefk
State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE %
Building Permit City Surcharge /5
PLAN CHECK NO: VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORUMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPEMY ONLY. ANY CONSTRUCT11ON ON THE PUBUC
Grading
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) VALL REQUIRE
SEPARATE PERMISSION.
Engr. Review
5 PERMITAPPUCATION: ISO DAYS
PERMIT UMM I YEAR - PROVIDED WORK IS STAKED WIITHIN 100 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICAK 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
NOT
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL HE
Landscapeinsp. Total Amt. Due
9 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.-
#
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 Oftlal or histher Deputy: and Foos are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION receipt Is acknowledged In space provided.
WORKMEN'S COMPENSATIOJASURANCE AND RCW 18.27.
SIGNATURE (0 ER OR&E" DATE SIGNED
OFFICIALSJIGNYAT RE E
(425)
71, j
-022 6ATE1
771 0
RELEASED BY
ENTION
M 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI-
ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER GOLD -ASSESSOR
G4/02 PRESS HARD -YOU ARE
MAKING 5 COPIES GREEN - ACCOUNTING
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