20050068.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Meggs, Becky
M MAILING ADDRESS
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CITY ZIP ITELEPHONE
RRxx 206-
Edmonds 9802 ARRX-546-327
NAME
ADDRESS
CITY ZIP FELEPHONE
NAME �Z=77
JOB
ADDRESS
9417 23
PERMIT EXPIRES
PERMIT
N U M B E R. -7�YL/
SUITE/APT#
5th P1 SW
P LAT NAME/SUBDIVISION NO. LOT NO.
LID NO.
LID FEE S
TESCP Approved El
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
RW Permit Required 13
Street Use Permit Flect'd [3
EXISTING - PROPOSED
Inspection Required C3
Sidewalk Required CI
REQUIRED DEDICATION FT
Underground
Wiring required E3
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YES E3 NO 13
tu
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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Fagt Water Heater
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pansion tanK
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ENGINEi
RING A - By DATE
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ADDRESS
12601 132 Ave NE
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FIRE R
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CITY - ZIP
Kirkland 98034
TELEPHONE
r�4125-814-3124
VARIANCE OR CU
SHORELINE OR AD1311
INSPECTION
REO'D
BOND
POSTED
STATE LICENSE NUMBER EXPIRATION DATE
CHECKED BY
FASTWHC052DF
OYES ONO
S .
SEPA REVIEW
SIGN AREA .
HEIG HT
PROPERTYTAX A7'ouNT PARCEL NO.
00447600001700
COMPLETE EXEMPT
EXP
ALLOWED I PROPOSED
ALLOWED PROPOSED,
NEW RESIDENTIAL PLUMBING MECH
COMPLIANCE OR
ADDITION COMMERCIAL CHANGE OF USE
REMODEL MULTIFAMILY SIGN
LOT COVERAGE
ALLOWED PROPOSED
REQUIRED SETBACKS (Fr.)
FRONT SIDE REAR
PROPOSED SETBACKS (Fr.)
FRONT URSIDE REAR
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PARKING
REQ'D I PROVIDED
LOT AREA
PLANNING REVIEWED BY DATE
REPAIR GRADING CYOS FENCE x FT)
REMARKS
DEMOLISH TANK OTHER
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o GARAGE RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM
JTYPE OF USE, BU ACTIV11,Y) EXPLAIN-
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CHECKED BY
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NUMBE
OF
STOI`12�/�6r
NUMBER OF
DWELLING
I UNITS
CRITICAL
AREAS
NUMBER
SPECIAL INSPECTION
REQUIRED [j YES
OCCUPANT
LOAD
DESCRIBE WORK TO BE DONE
RemnypIrpplace gas water heater
REMARKS
PROGRESS INSPECTIONS PER UBC 108/IBC109jIRC109 FINAL INSPECTION REO'D
utility room 40 .000 btu's
5
M
VALUATION
Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE %
I Building Permit City Surcharge
PLAN CHECK NO: VESTED DATE Plumbing Base Fee _i5214
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
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIM 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
OAPPLICANT, ON BEHALF OF HIS OR HER 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 #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
Landscapelnsp. Total Amt. Due
D TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
OR LIMIT IN ANY WAY THE C17YS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.,
Recording Fee Receipt # 4�1 22 1:
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION WPPLICATION APPROVAI
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 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 COMPENSATIO�rN I
7::_, OFFICIALS SIGNATURE DATE
_9URANCE AND RCW 18.27.
SIGNATURE (OW .I R q N DATE SIGNED (425)
!-V --- � /c � It:
771-0220
_._1 D 7 t
ATTE TION EXT 1333 1
IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILA FINAL
INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCU-
PANCYHAS BEEN GRANTED. UBC109/ IBC11.0/ IRC11O..
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
ORIGINAL -FILE YELLOW- INSPECTOR
PINK -OWNER GOLD!ASSESSOR
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