20040452.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Alan Weiss
MAILING ADDRESS
6811 157th Fil SW
CITY ZIP I TELEPHONE
Edmonds 98026 425-743-3656
NAME
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ADDRESS
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Ir
CITY ZIP TELEPHONE
USE
ZONE
JOB
ADDRESS
6811 157th Pl SW
PLAT NAME"SUBDIVISION NO. L'=TNO,
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING - PROPOSED
REQUIRED DEDICATION- FT
METER SIZE I LINE SIZE I NO. OF FIXTURES
PERMIT EXPIRES Z
PERMIT
NUMBER
SUITE/APT#
4
LID NO.
LID FEE $
1 ESCP Apploved
E3
RW Permit Required
Street use Permit Req'd
E3
it,spection Sequacd
13
Sidewalk Required
[3
Underg(mind
0
Wieng required
PRV REQUIRED
YES 0 NO 1:3
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
NAME CBL $0 IU UPC 605.2
Fast Water Heater ENGINEERING REVIEVS A WATER- SURVIeE SHUTGW-
ADDRESS IALL 13JUI INSTALLED ON TEW
LIN13- AS IT -
12601 132 Ave NE FIRE REVIEWED BY T= In 9—Ri DATE
CITY ZIP TELEPHONE
Kirkland 98034 4 2 5- 814 - 312 4
STATE LICENSE NUMBER EXPIRATION DATE I I�JECKED BY U SHORELINE OR ADB#
FASTWHC052DF 2-16-05 /1! 11A I, ") 1_1 I
PROPERTY TAX ACCOUNT PARCEL NO.
00757200000400
M
NEW
RESIDENTIAL
El
ADDITION
COMMERCIAL
E]
REMODEL
MULTIFAMILY
REPAIR
GRADING CYDS
DEMOLISH
TANK
oGARAGE
RETAINING WALL
CARPORT
ROCKERY
(TYPE OF USE. BUSINESSjj)p ACTIVITY) EXPLAIN:
U)
uj NUMBER
OF
DWEL
0 STORIES
UNITS
DESCRIBE WORK TO BE DONE
REmove/reolace
Fil PLUMBING/MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
oFENCE
( X FT)
OTHER
FIRE SPRINKLER
FIRE ALARM
CRITICAL
AREAS
NUMBER
INSPECTION I BOND
REQ'D POSTED
DYES ONO S
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED
EXP I
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (Fr.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT LJR SIDE HEAR
PARKING
REO'D I PROVIDED
LOT AREA I PLANNING REVIEWED BY DATE
REMARKS -_ ___1
A PRESSURE REGULATog vAT yF_ (min
SHALL BE INSTALLED NEAR '
CHECKED BY
SPECIAL INSPECTION
REQUIREDE] YES -
CODE
OCCUPANT
GROUP
OCCUPANT
LOAD
0
Z
cc
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6
z
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5
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as water heater REMARKS a
z
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D
btus 9n
unheated spacm UMC 815.1.7
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
:3 SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
W
a. PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 160 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ILI) 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
M IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Ir
4 ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTiY OR INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
0
_j DEEMED TO MODIF'� WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 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 WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING Ti IE WORK AUTHORIZED TI IEREBY. 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 (OWNE fAGENT DATE SIGNED
VALUATION
I
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscapelnsp.
Recording Fee
CALL
FOR INSPECTION
(425)
771-0220
ATTENTION I E)ff 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FEE Description
State Surcharge
City Surcharge
2A Base Fee
FEE
Plan Chk. Deposit
Receipt #_
Total Amt. Due
Receipt #
APPLICATION APPROVAI
I his application is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
�tcccipt is acknowledged in space provided.
OF ��,SIGPA,URE DATE
REIFASED BY DA-6
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
ORIGINAL - FILE YELLOW - INSPECTOR
PINK - OWNEn GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS--! ....................
FOUNDATIO
Foot�
ing ......................
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 FRAMING...
IN.SULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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