20040843.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
MAILING ADDRESS
17922 Talbot Rd
CITY ZIP
Edmonds 98026
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ADDRESS
CITY
ZIP
TELEPHONE
425-774-0585
TELEPHONE
NAME
CBL
Fast Water Heater
ADDRESS
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12601 132 Ave NE
12
CITY ZIP
TELEPHONE
0
Kirkland 98034j
425-814-3124
STATE LICENSE NUMBER EXPIRATION DATE
I EHECKED BY
FASTWHCO52DF
2-16-0-5
PROPERTY TAX ACCOUNT PARCEL NO.
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00594400004203
NEW RESIDENTIAL
QXPLUMBING / MECH
ADDITION COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
REMODEL MULTIFAMILY
SIGN
E] GRADING
REPAIR CYOS
FENCE
13 ( X FT)
DEMOLISH TANK
1:1 OTHER
GARAGE RETAINING WALL
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FIRE SPRINKLER
11 FIRE ALARM
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CARPORT ROCKERY
(TYPE OF USE, BUSINESA OR ACTIVITY) EXPLAIN:
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IA
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NUMBER
NUMBER OF
CRITICAL
DWELLING
AREAS
UNITS
NUMBER
DESCRIBE WORK TO BE DONE
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USE
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ADDRESS
PERMIT EXPIRES
PERMIT
N U M El E R
SUITEIAPT#
17922 Talbot Rd
FLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP AppcovWd
AW Permit Required
13
[3
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Street Use Permit Fleci'd
E3
EXISTING - PROPOSED
Inspection Required
E3
Sionwalk Required
13
REQUIRED DEDICATION- FT
Underground
Wiring required
13
METER SIZE
LINE SIZE
I
NO. OF FIXTURES
I
PRV REQUIRED
YES 13 NO 1:1
REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
In addition to the reguired
ressure/relief valve, an approved
listed expansion tank shall be
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ENGINEERINI3ftj'7qtn d on all hot water za
FIRE REVI
VARIANCE OR CU
SEPA REVIEW
COMPLETE , EXEMPT
EXP
LOT COVERAGE
ALLOWED PROPOSED
PARKING
REO'D I PROVIDED
REMARKS
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Ill
DATE W
SHORELINE ORAIIIII I INSPECTION BOND
REO'D POSTED
OYES ONO S
SIGN AREA HEIGHT
ALLOWE D , PROPOSED ALLOWED , PROPOSED
REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT)
FRONT SIDE REAR FRONT LJR SIDE REAR
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LOT AREA.] PLANNING REVIEWED BY DATE IL
unheated
CHECKED BY ITYPE CODE OICIPAN
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SPECIAL INSPECTION JAREA' OCCUPANT
REQUIRED LOAD
REMARKS z
PROGRESS INSPECTIONS PER UBC 1081IBC109/IRC109 FINAL INSPECTION REQ'D
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VALUATION
449 00
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
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
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PERMIT APPLICATION: 180DAYS
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PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
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'APPLICANT, ON BEHALF OF HIS OR FIER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt It
ALL CLAIMS FOR DAMAGES OFWHATEVER NATURE. ARISING DIRECTLY OR INDIRECT I Y
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF I HIS PERMIT SHALL NOT BE
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Total Amt. Due
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMEN1 OF ANY CITY ORDINANCE
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NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
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Recording Fee
Receipt #
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
This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
OF WASHINGTON RELATING TO
Building Olficial or his/tier Deputy and Fees are paid, and
FOR INSPECTION receipt is acknowledged in space provided.
IN VIOLATION OF THE LABOR CODE OF THE STATE
WORKMEN'S COMPENSATION INSURANCE AND FICW 18 27.
19)WURE DATE
SIGNATURE (OWNEIj O�/WE�N�) DATE SIGNED
(425)
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LI:L 95, 771-0220 TIM FAS
ATTENTION T� EXT 1333
IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVALOR A CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC1091IBC110/IRC110.
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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ORIGINAL - FILE YELLOW - INSPECTOR
PINK - OWNER GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ......................
FOUNDATION:
Footing ......................
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 ...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
The illitilis Ml,,,,.c Miltol,
Thompsoll, I tCI,,j)0I-,II.y c0litract
inspectol. Col. tile City.
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