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CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Tina Raghu
MAILING ADDRESS
737 Puget Lane
CITY ZIP TELEPHONE
Edmonds 98020 1425-775-8274
NAME
L"I 93.114&
CITY ZIP
TELEPHONE
PERMIT EXPIRES
PERMIT
N U M B E R RM
JOB SUITEIAPT#
ADDRESS
737 Pu2et Lane
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
TESCF Approved 13
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
RAF Permit Required E3
Street Use Permit Ren'd El
EXISTING - PROPOSED
inspection Required 13
Sidewalk Required
REQUIRED DEDICATION- FT
underground
Wiring required C3
METER SIZE
LINE SIZE
NO, OF FIXTURES
PAV REQUIRED
YES 1:1 NO 13
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CTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
0
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NAME Fast Water Heater- CBL # 1 9,_�Cz
ADDRESS
12601 132 Ave NE
CITY ZIP TELEPHONE
Kirkland 98034 425-814-3124
STATE LICENSE NUMBER EXPIRATION DATE I CH.ECIE�,By
FASTWHC052DF 2-16-05 k 'I
PROPERTY TAX ACCOUNT PARCEL NO.
00479400000400
NEW
7RESIDENTIAL
7
ADDITION
COMME RCIAL
REMODEL
MULTIFAMILY
REPAIR
GRADING CYDS
DEMOLISH
TANK
GARAGE
RETAINING WALL
CARPORT
ROCKERY
(TYPE OF USE, BU�IVESS OR 4CTIVlrO EXPLAIN
NUMBER NUMBER OF
OF DWELLING
STORIES UNITS
DESCRIBE WORK TO BE DONE
PLUMBING I MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
EFENCE
] ( X� FT)
OTHER
FIRE SPRINKLER
FIRE ALARM
CRITICAL
AREAS
NUMBER
emove/replace gas walze
n aaraae 40,000 btuts
HEAT SOURCE I GLAZING %
ENGINEERING REVIEWED BY DATE
FIRE REVIEWED BY DATE
VARIANCE OR CU
SEPA REVIEW
COMPLETE EXEMPT
EXP I
LOT COVERAGE
ALLOWED PROPOSED
PARKING
REOID I PROVIDED
REMARKS
SHORELINE OR ADBI I INSPECTION I BOND
REO'D POSTED
DYES ONO S
SIGN AREA HEIGHT
ALLOWED PROPOSED I ALLOWED . PROPOSED
REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.)
FRONT SIDE REAR FRONT LJR SIDE REAR
LOT AREA I PLANNING REVIEWED BY
CHECKED BY I TYPE OF CON
SPECIAL INSPECTION JAREA
REQUIRED [:] YES I
DATE
OCCUPANT
GROUP
OCCUPANT
LOAD
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heater REMARKS z
A PER UBC 108/FINAL INSPECTION RE01D F3
PROGRESS INSPECTIONS md _j
LOT SLOPE %
PLAN CHECK NO: VESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
LU
IL PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 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 I HIS PERMIT SHALL NOT 13E
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
2 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION
I HEREBY 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 Willi CITY AND STATE LAWS REGULATING CONSTRUC.
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
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
SIGNATURE (OWNER Off AGENT� DATE SIGNED
/4 2/11
VALUATION
Description
FEE
Description
FEE
Plan Check
State Surcharge
Building Permit
City Surcharge
Plumbing
:7,0
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Plan Chk. Deposit
Fire Inspection
Receipt #
Landscapelnsp.
Total Amt. Due
Recording Fee
Receipt #
CALL
FOR INSPECTION
(425)
771-0220
APPLICATION APPROVAL
This application is not a permit until signed by the
Building official or his/her Deputy: and Fees are paid, and
receipt is acknowledged in space provided.
OFFIPI LS SIGNAT RE DATE
lo lk�
'
ILEASED
BY-
/ DAIE
A17ENTION t:A I I jjj
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
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
ORIGINAL - FILE YELLOW - INSPECTOR
PINK - OWNER GOLD - ASSESSOR
GREEN - ACCOUNTING
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171
t =
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
—i -n
PLUMBING:
0
M
C:
Underground .............
M 0
0
Rough -In ...................
0
0 C:
Commercial Final ......
M
M z
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HEATING:
C
Gas Test ....................
C/)
Gas Piping .................
o -n
_n
Equipment .................
t -i
Commercial Final .......
M M
0-0)
0 r-
EXTERIOR SHEATHING
C) M
NAILING ..........................
1= CD
FRAMING ........................
M 0
Z
--I
FIRST FLOOR FRAMING ...
INSULATION ...................
>
Floor Insulation 1 ........
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Wall Insulation ...........
Cl)
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Ceiling Insulation .......
0
SHEETROCK NAILING ...
0
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SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
"*3 h /_0
OCCUPANCY ............ I- � v