20040038.pdfFDATE RECEIVED
C1W OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Gary Collins
MAILING ADDRESS
8629 240th St SW #B5
CITY ZIP TELEPHONE
Edmonds 6 425-776-7796
NAME
13
Uj
t: ADDRESS
cc
CITY ZIP
TELEPHONE
NAME CBL.,is —
Fast Water Heater
ADDRESS
12601 132 Ave NE
CITY ZIP TELEPHONE
Kirkland 98034 425-814-3124
STATE LICENSE NUMBER EXPIRATION DATE BY
FASTWHC052DF 2-16-05 J�17 I
PROPERTY TAX ACCOUNT PARCEL NO
El NEW
13
RESIDENTIAL
_40"r"'ITION
E]j
COMMERCIAL
REMODEL
MULTIFAMILY
REPAIR
GRADING CYDS
DEMOLISH
TANK
GARAGE
CARPnRT
RETAINING WALL
ROCKERY
(TYPE OF USE, BUSINE45S OR ACT(VIT)0 EXPLAIN
DKPLUMBING/MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
( X FT)
OTHER
FIRE SPRINKLER
FIRE ALARM , /) 4
_V-1 Iuf -)I k' IV V
U)
uj NUMBER NUMBER OF CRITICAL
OF
ii�j DWELLING AREAS
0 STORIES UNITS NUMBER
DESCRIBE WORK TO BE DONE
—Remove/replce gas water heater in
I basement closet near stairs
1 34.000 btu's
PERMIT EXPIRES
USE PERMIT
ZONE N U M B E R.;;�
JOB
ADDRESS 8629 240 St SW
but I nffiv
B5
......
I
PLAT NAME/SUBDIVISION NO. LOT NO.
LID NO
LID FEE $
T ;SCP Approved
IJ
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
RW Perryid Required
13
stmot uso Pormit Roq'd
EXISTING - PROPOSED
1115p,tion irequitod
sine*'111, ReqUirod
E3
REQUIRED DEDICATION- F-1
Undefgirriond
Wiring required
METER SIZE
LINE SIZE
NO. OF FIXTURES
PFIV REQUIRED
I
I
YES 0 NO 13
REMARKS
OWNER/CONTRAC1OR RESPONSIBLE FOR EROSION CONTROLYDRAINAGE
Regardless of whether the water systen
is open or doszed, eXpansion tanks are
requVed on ail not water tan.rs per'
ENGINE
FIRE REVIEWED BY
COMILETE , EXEMPT
EXP
LOT COVERAGE
ALLOWED PROPOSED
PARKING
REO'D I PROVIDED
REMARKS
CHECKED BY
SPECIAL INSPECTIO
REQUIRED [] YES
DATE
on
- =0
REQUIRED SETBACKS (FT) PROPOSED SETBACKS (Fr.)
FRONT SIDE REAR I FRONT LJR SIDE REAR
LOT AREA I PLANNING REVIEWED BY
AREA
DATE
GROUP t
OCCUPANT
LOAD
cc
W
z
z
a
z
Uj
W
0
z
z
z
REMARKS a
z
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D F3
D
VALUATION
Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge
PLAN CHECK NO: VESTED DATE Plumbing Base Fee
Mechanical 0
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PU13LIC
2 Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION. Engr. Review
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
U) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
t3 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 INDIREC'ILY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOI BE
DEEMED TO MODIFN� WAIVE OR REDUCE ANY REQUIREMENT OF ANY C11Y ORDINANCE Landscape Insp. Total Amt. Due 0 "D
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
x -_ - Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION 9!�V�_
GIVEN is CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGEN1 OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL I his application is not a perinit until signed by the
TION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or hisitrof Deputy: and Fees are paid, and
IN V;6LATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged on space provide
WORKMEN'S COMPENSATION INSU RANCE AND RCW 18.27. CIALS S ILI E
/ I TE
SIGNATURE (OWNER 0 DATE SIGNE (425)
__,,);GNAIL),
DAT
771-0220 RJEASED BY
ATTENTION EXT 1333 (
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CAIE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 'WjA
PRESS HARD -YOU AR
09/03 MA ING 4
Al- - FILE - YELLOW - INSPECTOR
OR
I GIN
'LKj'eWNER - GOLD -ASSESSOR
OPI 9
z
0
1
0
M
zi
M
M
0
0
0 C:
M
M z
r') --I
C _z
x
Cl)
0 _n
n
M M
0
0
0 M
cl)
W
M 0
z 17'
;U
--I
X
z
z
0
1
0
M
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACK9': ......................
FOUNDATION.
Footing * ......... ......
Wall..........................
Pier/Porch . .................
'14A
slab (nsuIatib*n.,---.--�.'-.
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ......
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR FRAMING ...
INSULATION ...................
Floor Insulation .....
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
VAL FOR
FINAL APPRO
OCCUPANCY ..................
tViF 00 59
z
0
i
0
ITI
--i -n
ITI
C
M 0
0
-40
0 C
M
M z
C _Z
o -n
-n
M ITI
0 -0)
0 r-
0 IT!
C (1)
F. C/)
M 0
Z
:-I
>
z
z
0
0
ITI