20050035.pdfDATE RECEIVED
FCITY OF EDMONDS
C CONSTRUCTION PERMIT APPLICATION
0
OWNER NAMENAME OF BUSINESS
NA
M
Heidi/Ken Koren
Lm MAILING ADDRESS
U
24206 77 Pl W
0
CITY ZIP TELEPHONE
Ino 98026
Edmonds 425-673-1461
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I NAME
ADDRESS
CITY ZIP
NAME
FAst Water Heater
ADDRESS
12601 132 Ave NE
CITY ZIP
Kirkland 98034
STATE LICENSE NUMBER
FASTWHC052DF
PROPERTY TAX ACCOUNT PARCEL NO
TELEPHONE
CBL 0
PERMIT EXPIRES
IJSE PERMIT Z,
ZONE
DD
NUMBER
JOB SUITE/APT#
ADDRESS
24206 77 Pl W
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved E3
RW Porinn Required 13
EXISTING — PROPOSED
street use Permit Roq'd E3
inspection Required E3
Sidownik nequirod E3
REQUIRED DEDICATION FT
Underground
wiring required E3
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES13 NO 13
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REMARKS
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
L&A
In addition
to the
required
installed on all hot water tanks,
FIRE r.!!1.7W1n BY W
0:
TELEPHONE
425-814-3124 VARIANCE OR CU SHORELINE (111 ADB11 I INSPECTION BOND
EXPIRATION DATE CHErr_kEl) BY REO'D POSTED
2-16-0V-1 4110 1 1 EIYES EINO S
S PA REVIEW SIGN AREA-
COMPI hu �M*LAOM
F � TT' `en t con n ecto s req u
_ _ Ce7o r
EXP
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NEW
ADDITION
REMODEL
REPAIR
DEMOLISH
GARAGE
CARPO
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13
RESIDENTIAL
COMMERCIAL
MULTIFAMILY
GRADING DS
CY
TANK
RETAINING WALL
ROCKERY
X5fy_PLUMBINq/ MECH
S�A�NCE OR
11 CHANGE OF USE
SIGN
FENCE x FT)
Ei OTHER
FIRE SPRINKLER
FIRE ALARM
ALLOWithmughEm
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htvNWSVACePR .
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PARKING
REG D I PROVIDED
LOT AREA
PLANNING REVIEWED BY
REMARKS
D SETBAqKS (Fr.)
REAR
0
z
9
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DATE
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
A�*
CHECKED BY In"INVITT
C( D OCCUPANT
GROUP 92
M NUMBER NUMBER OF CRITICAL
0 OF DWELLING AREAS
SPECIAL INSPECI -ibN AREA
OCCUPA�T.
LOAD
0 STORIES UNITS NUMBER
REQUIRED Y1
DESCRIBE WORK TO BE DONE
Remove/replace gas water heater in
REMARKS
93
3
PROGRESS INSPECTIONS PER UBC 108/113C109/1RC109 FINAL INSPECTION REOD, 9
hall closet 40400 hi-W _q
VALUATION
Description FEE Description FEE
Plan Check
State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE %
Building Permit
City Surcharge
"7
PLAN CHECK NO: VESTED DATE
Plumbing
Base Fee
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.
Engr. Review
W PERMIT APPLICATION: 180 DAYS
CL PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
(A 'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk. Deposit
9 IN INTEREST, AGREES TO INDEMNIFN� DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
IALL CLAJMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
SHALL NOT BE
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT
Landscapelnsp.
Total Amt. Due
9 DEEMED TO MODIFX WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
01 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
Receipt #
4�j
1 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
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
Building Official or his/lier Deputy: and Fees are paid, and
receipt is acknowledged in space provided.
WORKMEN'S COMPENSAT�Ihl =URANCE AND RCW 18.27.
OFFUMIALS IG U E --) TE
SIGNATURE (OWNER fp GEN DATE SIG ED
(425)
771-0220
ATI!
REL�A�S
ATTENTION
Off 1333
ITIS UNLAWFULTO USEOR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVALOR ACERTIFICATE OF OCCU-
ORIGINAL - FILE YELLOW - INSPECTOR
PANCY HAS BEEN GRANTED. UBC109/lBC110/lRC110.
PINK -OWNER GOLD -ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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