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20030791.pdfDATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEINAME OF BUSINESS MAILING ADDRESS 20114 83rd Ave W CITY ZIP TELEPHONE Edmonds 98026 1425-776-5428 NAME ADDRESS CITY ZIP ITELEPHONE NAME CBL 10 East Water Heater ADDRESS _q� 12601 132 Ave NE CITY ZIP TELEPHONE Kirkland 98034 1425-814-3124 STATE LICENSE NUMBER EXPIRATION DATE - c FASTWHCO52DF 2-16-051 4' PROPERTY TAX Accouwr PARCEL NO. 004112 0000402 Immommummamm PERMIT EXPIRES U§E PERMIT ZONE NUMBER JOB SUITE/APT# ADDRESS 20114 83rd Ave W PLAT NAMEISUBDIVISION NO. I LOT NO. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP LL"W"r REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION 111red mn fud-bur,�,.tng applia igated space& UMC 815.1- REVIEWED BY FIRE REVIEWED BY VARIAN( SEP, COMPLE7 EXP LID NO. LID FEE TESCP App"rved RW PerrNt Required shpot V11faffrift Raced IqL*.d kod a ".Iad 13 PRV tEOUIRED NO 13 z QR.R�AF.__ ices in I DATE are P4 is 00PI; ror dosed, ex'!$ 'I "rcnnIfA N 0 $ W%Tde. EMU IMAM ray -HEIGH ALLOWED F Lj OND_ ISTED IOPOSED 13 NEW G1 ADDITION REMODEL RESIDENTIAL 9 COMMERCIAL MULTIFAMILY 1115< LUMBING / MECH P COMPLIANCE OR CHANGE OF USE SIGN LOT COVERAGE ALLOWED PROPOSED REQUIRED SETBACKS (FT.) FRONT SIDE REAR PROPOSED SETBACKS (Fr.) FRONT L/RSIDE REAR I z PARKING REOD I PROVIDED LOT AREA _[PIJWW��EWED By DATE REPAIR GRADING I CYDS FENCE I x FT) REMARKS DEMOLISH TANK OTHER GARAGE CARPORT RETAININGWALL ROCKERY FIRE SPRINKLER FIRE ALARM UWE OF USE. BUSINESS OR ACT N: CHECKED BY TYPE CID OCCUPAR NUMBER NUMBER OF CRITICAL GROUP I PC17r f X. 'y OF DWELLING UNITS AREAS ON' SPECIAL INSPECTI OCCUPANT ITORIES NUMBER JAREA REQUIRED LOAD [] DESCRIBE WORK To BE DONE YES REmove/rg2jace gas water heater REMARKS PROGRESS INSPECTIONS PER UBC IGS/FINAL INSPECTION REQ'O in utility room 40,000 btu's 1 ?a A P/ P i k" f-) Description FEE Plan Check Description FEE State Surcharge HEAT SOURCE GL40NG % LOT SLOPE % Building Permit City Surcharge PLAN CHECK NO: VESTED DATE Plumbing 112 /r I laeae,, J, , / THIS PERMIT AUTHORIM ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO Mechanical 2 BE DONE ON PRAIATIE PROPERTY ONLX ANY CONSTRUCTION ON THE PU13LIC DOMAIN (CURDS, SIDEWALKS. DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading SEPARATE PERMISSION. PERMITAPPILICATION: Engr. Review 180DAYS 916 PERMIT UMrP i YEAR - PROVIDED WORK 18 STARTED WITHIN I eO DAYS SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection 'APPUCANT 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 ALL CLAIMS FOR DAMAGES Fire Inspection Receipt # 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 Landscapelnsp. Total Amt. Due NOR LIMIT IN ANY WAY THE CIIYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. - I Recording Fee Receipt # I HER EBY 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 APPLICATION APPROVAL 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 CALL This application is not a permit until signed by the IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEWS COMPEN NCE AND RCW 18.27. FOR INSPECTION Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowledged in space provided. — IGNATURE (OWN 0 E� I DATE SIGNED A, E (A-25) OFFICIALS SIGNATURE DATE 2 w 771-0220 IbATE f AITENTION Off 1333 RELEASED BY 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 OR:GINAL-FILE YELLOW- INSPECTOR PNK-OWNER GOLD -ASSESSOR 04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING -4 :-n ra � OM a MO 0 -40 0 C 10 z 0 `Tl *�" 9 M M gas 0 R C9 z 0 11 0 M RECORD OF INSPECTIONS INSPECTOR DATE APPROVED S BACKS ..................... ET FOUND ATIOW, Footing...................... wall.......................... Pier/Porch ................. Retaining Wall' :Slab Insulation ........... PLUMBING-' m: MYnd rground. ......... Rough -In ................... C ommercial F nal ...... m 10 HEATINGv I -0k Gas.,Test ............. ....... Gas Piping ................. rf Equipment ..'* ............ 111" Comrnercial. Final ....... W EXTERIOR SHEATHING Fn NAILING ........ ............ Wo FRAMING� ............ f FIRST FLOOR FRAMING... INSULATION ................... Floor Insulation ......... Wall Insulation .... ...... Ceiling Insulation ....... 51, C) SHEETROCK NAILING ... m SPECIAL INSPECTION ... MISCELLANEOUS .......... FINAL APPROVAL FOR 7 DATE RECEIVELt k"11 PERMIT EX PIRES ZW/ CITY OF EDMONDS Uft ZONE PERMIT �00_3__0_7q ITT NUMBER CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT# ADDRESS 20114 83rd Ave W OWNER NAME/NAME OF BUSINESS PLAT NAME/SUBDIVISION NO. LOT NO. LID NO. MAILING ADDRESS 20114 83rd Ave W CITY ZIP TELEPHONE Edmonds 98026 1425-776-5428 NAME ADDRESS CITY NAME i r ZIP TELEPHONE Heater ADDRESS 12601 132 Ave NE CITY ZIP TELEPHONE Kirkland 98034 425-814-3124 STATE LICENSE NUMBER EXPIRATION DATE FASTW-HC052DP 2- PROPERTY TAX ACCOUNT PARCEL NO. rk n A j i i n n n n n A n PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTI PROPOSED -- REQUIfD:@b*0ht_E4Qt4rjQat_P4 METER 14C Llftfthrnr A01 UD FEE $ TESCP Approved RW Pamit Required Street use Pdmgt Req`d t 6,10.1.111k Ret. es PRV R Y M ES 13 REMARKS OWNER/CONTRACTOR RESPO44BLE FOR EROSION CONTROLIDRAINAGE FIRE SEVIEWED BY VARIANCE OR CU SHORELINEORADS4 I INSPECTION I 13OND REO'D POSTED 13YEs ONO S SEPA SIGN AREA HEIGHT "Qu POSED COMPLET 0 of wh or the tar WIRED NO 13 EXP NEW RESIDENTIAL LOT C Impf CKS (FT) LUMBING/MECH ALLOWED R*W FM(;flRha #ft UR SID REAR 15<P ADDITION COMMERCIAL COMPLIANCE OR 1:3 CHANGE OF USE REMODEL I" MULTIFAMILY PARK EA NNIN _BV D [:1 SIGN REOD REPAIR GRADING CYDS [3 FENCE ( _ X_FT) REMARKS DEMOLISH [3 TANK OTHER [3GARAGE CARPORT [:3 RETAINING WALL ROCKERY FIRE SPRINKLER FIRE ALARM 2. _10ACTIYr.M. EW.. N. jt�� _E_9 'M CHECKED BY N OCCUPANTJ7 f— V ITYPE 72 GROUP, NUMBER NUMBERf OF' CRITICAL OF DWELLING AREAS SPECIAL INSPECTION* OCCUPANT STORIES UNITS NUMBER JAREA REQUIRED [:] YES LOAD DESCRIBE WORITO BE DONE REmove/reolace gas water heater REMARKS PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION REO'D in utility room 40,000 btu's A VALUATION Description FEE Descriptlon FEE Plan Check State Surcharge HEAT SOURCE GLAZING LOT SLOPE % T Building Permit City Surcharge 302 PLAN CHECK NO- VESTED DATE Plumbing Mechanical THIS PERMff AUTHORIZES ONl1V THE WORK NOTED. THIS PERMIT COVERS WORK TO ft BE DOME ON PRIVATE PROPERTV ONIX AM CONSTRUCTION ON THE PUBLIC Grading XM DOMAIN (CURBS, SIMVAUCS, DRIVEWAYS, MAIRGUE1, ETC.),rLL REQUIRE It- a WARATEPERMASSION.' 0, -'M Engr. Review I PERMITAPPILICATIOW ISODAYS 06 PERMIT LIMM 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 P!an Chk. Deposit IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE Crrf OF� EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLJDYEES. AND AGENTS FROM.ANY AND Fire Inspection Receipt # ALL CLAIMS FOR DAMAGES OF WHATEVER NATU80, ANSING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE Landscape Insp. Total Amt. Due 91 DEEMED TO MODIFY WAPIE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE 2 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.- Recording Fee Receipt # I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLIrATION; THAT THE INFORMATION APPLICATION API ITROVAL GIVEN IS CORRE" 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 �od TNs application Is not a permit untflosignod by the TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED Building Official or Ws/her Deputy: and Foes are paid, and IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt Is acknowledged In space provided. WORMERS COMPENSATI CE AND RCW` 18.27. OFFICIALS SIGNATURE DATE SIGNATURE (OWN OR A66M DATE SIGNED (425) 771-0220 RELEA§ED BY .0ATE 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 V�, 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 C In Is 0 C � K M 0 In III � 32 C M M Das 0 F n M C) z z z 0 4 0 ITI _L&L4__