20040472.pdfDATE RECEIVED U
C1W OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMENAME OF BUSINESS
mi(-hael/Lili Gav
MAILING ADDRESS
925 Olympic Ave
CITY ZIP
Edmonds 98020
NAME
I.-
L)
ul
t: ADDRESS
cc
CITY ZIP
NAME
TELEPHONE
425-778-4397
TELEPHONE
Fast Watel Heater
ADDRESS
12601 132 Ave NE
CITY ZIP FTELEPHONE
CBL
K i -rk 1- and 9 80 3 4 14 2 5- 814 - 312 4
STATE LICENSE NUMBER EXPIRATION DATE CHE
FASTWHCO52DF 2-16-05 (M,"
PROPERTY TAX ACCOUNT PARCEL NO.
005489000 01212
NEW
0
RESIDENTIAL
ED,
ADDITION
1:1
COMMERCIAL
ED
REMODEL
MULTIFAMILY
r7
REPAIR
13
GRADING CYDS
DEMOLISH
1:1
TANK
GARAGE
CARPORT
m
RETAINING WALL
ROCKERY
(TYPE OF USE, BUSINESS O"CTIVITy),fX�PL-A,1.N:j
NUMBER NUMBER OF
OF DWELLING
STORIES UNITS
DESCRIBE WORK TO BE DONE
ce
3
PERMIT EXPIRES
USE PERMIT
ZONE NUMBER
JOB
ADDRESS 925 OlymPic Ave
PLAT NAME/SUBDIVISION NO. LOT NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING — PROPOSED
REQUIRED DEDICATION. Fr
METER SIZE I LINE SIZE NO. OF FIXTURES
, q 71,'
SUITE/APT#
LID NO.
LID FEE $
TESCP Approved
RW Permit Required
Street Use Permit Roq'd
Inspection Required
Sidewalk Required
Underground
Wiring required
PRV REQUIRED
YES 13 NO E3
rREMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
REM RKs
OwNER/cc
Regardless of.whe!hPr,jhe water syme
is open or dosed iimanqion tanks are
required on aTFFot 'wvaier tanks per
A .020(C) DATE
ENG NEER,&fibt,AR*. Eeoc iq=
FIRE REVIEWED BY
11121111:1
,Y 1 VARIANCE OR CU SHORELINEORADBO I INSfECTION I BOND
I R O'D POSTED
I.-, I I OYES ONO S
99C PLUMBING / MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
EiFENCE
( X FT)
OTHER
FIRE SPRINKLER
FIRE ALARM
CRITICAL
AREAS
NUMBER
�Las water heater
00 btu's
SEPA REVIEW
COMPLETE EXEMPT
SIGN AREA
ALLOWED PROPOSED
HEIGHT
ALLOWED PROPOSED
EXP ,
,
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (Fr.)
FRONT SIDE BEAR FRONT LiRSIDE REAR
tjjjftLQt(n"SWED BY DATE
IRPARKING
"Opf"'
UMC 8
CHECKED BY ITYPE F CONSTRUTTION LIU
GROUP
SPECIAL INSPECTION JAREA OCCUPANT
I REQUIRED [] YES I I LOAD
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REMARKS )N REQ'D 3
PROGRESS INSPECTIONS PER UBC 108/ IBC109/ IRC109 FINAL INSPECTIC 9
VALUATION
Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT GLAZING % LOT SLOPE % Building Permit
City Surcharge
Base Fee
PLAN CHECK NO: VESTED DATE Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
2
Engr. Review
fr
W
PERMIT APPLICATION: 180 DAYS
IL
PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 160 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
ALI. CLAIMS FOR DAMAGES OF WHAT EVER NATURE, ARISING DIRECTLY Oil INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Landscapelnsp.
:
Total Amt. Due
611
5 DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
A
Receipt #
L
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY 10 ENFORCE ANY ORDINANCE PROVISION.' —
Recording Fee
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION APPLICATION APPROVAL
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- CALL I his application is not a pennit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED TliEREBY, NO PERSON WILL BE EMPLOYED Building ollicial or his/tier Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF TIIE STATE OF WASHINGTON RELATING TO FORINSPE C Or mccipt is acknowledged in space providyd.
WORKMEN'S COMPENSATION NSURANCE AND RCW 111,27. 0! 11C SIGNATURE �TE
0 DATE SIGNED , U
SIGNATURE (0 R OR (425)
_A 4
.
771-0220 HE S
ATTENTION EXT 1333
ITIS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVALOR A CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/IBC110/iRC110.
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
BY
ORIGINAL - FILE YELLOW - INSPECTOR
PINK -OWNER GOLD -ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SEtBAdkS . ...................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial'Final ...... ===.;i_
HEATING*
Gas Td9t,:...! .................
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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