20040189.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Richard Nealson
MAILING ADDRESS
21308 92nd Pl W
CITY ZIP TELEPHONE
Edmonds 98020 425-778-9769
NAME
USE
ZONE
JOB
ADDRESS
PLAT NAMEISUBDIVISION NO.
LERMIT EXPIRES
P
PERMIT 4
NUMBER 4'1P14_011Y1_1
SUITE/APT#
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PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING.
14EQUIRED 0R@gWR_f,-q nf whettiff _2
METER SI; CIS DQREQrZL0oqe oeyjw
LID NO.
LID FEE $
TESCP Approved
RW Permit Required
Street Use Permit Roq'd
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ADDRESS
REMARKS
City Code. EUX 19,30.020 (0
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ITRACTOR RESPONSIBLE FOR EROSION CON'TF(OL/DRAINAGE
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CITY ZIP
NE
NAME
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Fast Nater Heater
ENGINEEINCLYPeWo Wor L DATE
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ADDRESS
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12601 132 Ave NE
FIRE RE IEV ted SpaCe& UIVI 431.5.1JATE
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CITY ZIP
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Kirkland 98034
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425-814-3124
VARIANCE OR CU SHORELINE OR AD1111
_TrELEPHONE
STATE LICENSE NUMBER EXPIRATION DATE
7j)y
REO'D POSTED
I IS
FASTWHC052DF
]INSPECTION
YES ONO
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
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PROPERTY TAX ACCOUNT PARCEL NO.
W
00479300000800
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EXP
1:1 NEW UCRESIDENTIAL PLUMBING / MECH
LOT COVERAGE
REQUIRED SETBACKS (Fr,)
PROPOSED SETBACKS (FT)
ALLOWED PROPOSED
FRONT SIDE REAR
FRONT UR SIDE HEAR
ADDITION COMMERCIAL COMPLIANCE OR
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CHANGE OF USE
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FIEQ'D PROVIDED
LOTIPLANNING
REVIEWED BY DATE
REMODEL MULTIFAMILY SIGN
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REPAIR GRADING FENCE
CYDS
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REMARKS
x FT)
DEMOLISH TANK 1:1 OTHER
o GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT
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ROCKERY FIRE ALARM
(TYPE OF USE, BUSINESS OR AC�Ivr E IN:
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OCCUPANT
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ITYPEPICrNSTRIJIETION
GROUP
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NUMBER
NUMBER OF
CRITICAL
;TION'
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OF
STORIES TL
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AREAS
NUMBER
REQUIREDE] YES
JAHEA
LOAD
DESCRIBE WORK TO BE DONE
REMARKS
REmove/replace gas water heater
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PROGRESS INSPECTIONS PER UBC 1 08/171NAL INSPECTION REO'D
in daylight basement wash room.
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000 btus
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HEAT SOURCE
GLAZING %
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.
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Lu PERMIT APPLICATION: 1180DAYS
EL 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
cn
�j IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF 1 HIS PERMIT SHALL NOT BE
_j DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS 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 WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VI'6LATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATIQN-INSURANCE AND RCW 18.27.
SIGNATURE (OWN_U OR WENT)_) DATL SIGNED
VALUATION
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
LandscapeInsp.
Recording Fee
CALL
FOR INSPECTION
(425)
771-0220
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FEE Description FEE
State Surcharge
City Surcharge 1 45
Base Fee__T �_21_)
Plan Chk. Deposit
Receipt #
Total Amt. Due
Receipt N
APPLICATION APPROVA_[�r
This application is not a permit until signed by the
Building Official or his/her Deputy: and Fees are Paid, and
receipt is ac,knowlodged in space Provided.
OFFa1A S up DATE
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ATTENTION . I E)ff 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL L
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
DA
ORIGINAL -FILE YELLOW. INSPECTOR
PINK -OWNER GOLD -ASSESSOR
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RECORD OF INSPECTIONS
7 DATE APPROVED
INSPECTOR
----------------
SETBACKS .....................
FOUNDATION:
Footing......................
W.a . ..............
Piei/pofch'* .................
RetainiQg.Wall
-Slab'ln§ul'6t!orf ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ...... .
HEATING:
GasTest ....... ............
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING..........................
FRAMING........................
FIRST FLOOR FRAMING...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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