20030830A.pdf4
DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Queenie Enriquez
MAILING ADDRESS
19015 78 Pl W
CITY ZIP TELEPHONE
Pr1Mr%r%r14= o A n,> r% A7r._r.7n_1A7A
NAME
ADDRESS
CITY ZIP ITELEPHONE
NAME C
Past Water HEater
ADDRESS
12601 132 Ave NE
CITY ZIP TELEPHONE
Kirkland 98034 1 425-814-3124
STATE LICENSE NUMBER EXPIRATION DATE I 911a
FASTWHC052DF 2-16-051111,
PROPERTY TAX ACCOUNT PARCEL NO.
005729000001000
0 NEW RESIDENTIAL
)9 ADDITION COMMERCIAL
p
[3 REMODEL [3 muLnFAmiLy
0 REPAIR GRADING CYDS
0 DEMOLISH TANK
c3GARAGE RETAJNINGWALL
CARPORT 13 RocKERY
(TYPE OF USE, BUSINESS OR ACTIVT�EXPLAIN:
S
NUMBER NUMBER OF
OF DWELLING
STORIES UNITS
DESCRIBE WOhK TO BE DONE
USE
ZONE
JOB
ADDRESS
19 C
1)/ 1
PERMIT EXPIRES �! /Z"7 7
' 1 11
PERMIT
NUMBE
SUITE/APT#
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
IES.111 Ap=,
RW "W
Street Use Peffnft Wd
EXISTING - PROPOSED
Inspectlon Required
81
Sldowatk Required
REQUIRED DEDICATION- FT
Undararound
lwinmngr uked 13
METER SIZE
LINE SIZE
NO, OF FIXTURES
PRV REQUIRED
I
YES 13 NO E3
REMARKS
OWNER/CO!tT�6r,1QA RESPONSIBLE- FOR"EROM TROUDRAINAGE
i. v_,:nt cv,
FIRE REVIEWED BY
DATE
DATE
BY VARIANCE OR CU SHORELINE OR ADB I I I INSPECTION I BOND
REO'D POSTED
13YEs 13NO $
SEPA REVIEW SIGN AREAPOS I HEIGHT
COMPLETE . EXEMPT ALLOWED . PRO ED ALLOWED , PROPOSED
PLUMBING I MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
o FENCE
Fri
OTHER
FIRE SPRINKLER
FIRE ALARM
CRITICAL
AREAS
NUMBER
outside shed 38,,000 btu's
k I^ I\ a A It % t_ e n' Ln. in /T
GLAZING % LOT SLOPE %
LOT C
ALLOWED
PA I
REMARKS
I: the
R=A
WlygEFIE
IrPMR GOWPM
requVed
IRE ET CKS (FT.
r Pi Pam
r
n all hot water ta
n
PFIOPPStD SETS)
t8M eNGIDI
per
UE
T 0
T 4jWfL4@!@6.
Fo" BY DATE
CHECKED BY ITYPE ca. OCCUPANT
) GROUP
SPECIAL INSPECTION AREA OCCUPAiFT
REQUIRED [:] YES LOAD
'KS (Fr.)
REAR
116
REMARKS
PROGRESS INSPECTIONS PER USC 11081FINAL INSPECTION REG'D
449-00 A
Description FEE Description FEE
Plan Check State Surcharge
Building Permit City Surcharge
PLAN CHECK NO:
VESTED DATE
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
I: BE DONE ON PRIVATE PROPERTV ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
2 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
3
SEPARATE PERMISSION.
1=
Engr. Review
PERMITAPPUCATION: 180 DAYS
PERMIT UMM I YEAR - PROVIDED WORK 15 STARTIED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
PIPUTERE
Fire Review
Plan Chk. Deposit
ALl=,
T, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS 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
OF ANY CITY ORDINANCE
Landscapeinsp.
Total Amt. Due
2—
DEEMED TO MODIFY WAIVE OR REDUCE ANY REQUIREMENT
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 0111cial 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.
WORKMERS COMPENSATIjWIIN�RA14C AND RCW 18.27.
M_
OFFICIA79 871GATURE DATE
SIGNATURE OWN�rpOR 4PENT)
D ATE SIGNED
(425)
Y,
fi Z ////-4
".2
6�9�
771-0220
RELEASED BY UA k:
ATTENTION f I
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
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