20040358.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
Bob Trent
MAILING ADDRESS
9931 234th St SW
CITY ZIP TELEPHONE
Edmonds 9: 1206-542-8062
NAME
I.-
L)
W
t: ADDRESS
'JC
L)
0:
CITY ZIP TELEPHONE
NAME
CBL 4
. - —1
PERMIT EXPIRES
USE
ZONE
PERMIT
NUMBER
'JOB
SUITE/APT#
ADDRESS
9931 234th St SW
PLAT NAME/SUBDIVISION NO.
PUBLIC RIGHT OF
WAY PER OFFICIAL STREET MAP
FiW Permit Rorititiod
Street USH permit Roq'd
EXISTING —
PROPOSED—�
inspection Refit"f0d E3
5,dow.11t, Hequirod E3
REQUIRE[) DEDICATION— FT
Undefgtotind
Waing roqt1ited
METER SIZE
LINE SIZE
NO, OF FIXTURES
pRv REQUIRED
I
I
YES CI 140 C]
REMARKS
OWNE RAO+00.W��""UX
.EQjLF
.aMQNXQ=OL/DRAINAGE
1'ype B or L vent connectors
req
F uIred on ruel-burning appliances in
I t2II1hCntCd Spaces. UMC 81b.1.7
W
z
z
E5
z
W
Fast Water Heater ��V, ENGINEERING REVtEWED_By_____
cc ADDRESS
0
12601 132 AVe NE
FIRE REVIEWED BY DATE
cc
CITY ZIP TELEPHONE
0
U rkland 98034 425-814-3124 BOND
— VARIANCE OR CU SHORELINE OR ADS# INSPECTION
NUMBER EXPIRATION DATE LICKED BY, REO'D POSTED
OYES ONO S
TT4HC052QF 2-16-05 SEPA REVIEW SIGN AREA HEIGHT
PROPER ACCOUNT PARCEL NO COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
TWX
U07 8900000100 EXP
F� NEW RESIDENTIAL 12 PLUMBING MECH LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT)
ALLOWED PROPOSED FRONT SIDE REAR FRONT QRSIDE REAR 0
z
COMPLIANCE OR E
5] ADDITION COMMERCIAL El CHANGE OF USE z
PARKING PLANNIN13 REVIEWED BY DATE 5
1:1 REMODEL F� MULTIFAMILY SIGN REO'D I PROVIDED LOT AREA
GRADING FENCE
1:1 REPAIR CYDS ( x Fr) REMARKS
DEMOLISH TANK D OTHER
GARAGE Ei RETAINING WALL FIRE SPRINKLER
z CARPORT ROCKERY FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CHECKED BY TYPE OFICOISTR C 1911 CO3DE OCCUPANT
iE A� GROUP
0— Ic
U) All X,
us NUMBER NUMBER OF CRITICAL
C' OF SPECIAL INSPECTION JAREA OCCUPANT
M DWELLING AREAS
0 STORIE UNITS NUMBER REQUIRED LOAD
DESCRIBE WORK TO BE DONE
Remove/replace gas water heater REMARKS z
PROGRESS INSPECTIONS PER UBC 108/171NAL INSPECTION RE01D F3
_j
in garage 40,000 btu's GAS PIPE TEST MUST BE
QRS plim-
VALUATION BY 611:Y !NSPECTOR
or
UWAVITSW SHALL NOU11
.7!01: AilingbTinn
�� a 1%#�, I I -Li
Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge
Base Fee Vq
PLAN CHECK NO: VESTED DATE Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
cc PERMIT APPLICATION: 180 DAYS
CWL PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Ln '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 #
Ir ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTIYORINDIREC11-Y
x FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
0 Landscapelnsp. Total Amt. Due
_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.,
ml Recording Fee Receipt # g/
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPIIOVAL
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- This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL Building Official 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.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
OF iALS SIGNATURE DATE
SIGNATURE (707w OR 6�N DATE SIGNED (425)
Z,
771-0220 RELEASE!D'BY DATC7
A17ENTION EX7 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
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
z
0
1
0
1711
—1 -n
Fn
0 M
C
M 0
0
C)
0 C
M
M Z
C) --I
C _z
x
Cn
0 -n
n
—i
M M
0
0
0 M
C: Cl)
9 Cf)
M
Z
7-1
3:
z
--I
M
Cl)
z
0
i
0
ITI
a
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....
FOUNDATION:
Fo ti 9, .............
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ......
HEATING:
Gas Test ....................
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING ..........................
FRAMING ........................
FIRST FLOOR W ING...
INSULATION . .........
..........
- p's"u"I'Ation, .........
4A
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR 2- d
OCCUPANCY ..................
a I
z
0
i
0
ITI
-n
0 M
C
M 0
0
0
0 C
M
ITIZ
C: _Z
0 -n
n
M M
a
0
0 M
C c?)
MCI)
Q 0
Z r—
z
z
0
0
M