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DATE RECEIVED . —7
;;— 17—() ERMI EXPIRES
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C1W OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINAME OF BUSINESS
Kim Austnes
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W
MAILING ADDRESS
9903 242 Fil SW
0
CITY ZIP i
TELEPHONE
EDmonds 98020
206-546-6102
NAME
ADDRESS
CITY ZIP
TELEPHONE
NAME
CBL#
Fast Water Heater
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0
ADDRESS
8
12601 132 Ave NE
CITY ZIP
TELEPHONE
0
Kirkland 98034
425-814-3124
STATE LICENSE NUMBER EXPIRATION DATE
CHECKED BY
FASTWHC052DF 2-16.-07
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PROPERTY TAX ACCOUNT PARCEL NO.
00746900001400
E
1:1 NEW E] RESIDENTIAL PLUM13ING MECH
ADDITION COMMERCIAL COMPLIANCE OR
CHANGE OF USE
REMODEL MULTIFAMILY SIGN.
GRADING FENCE
REPAIR rYDS ( X FT)
DEMOLISH TANK OTHER
GARAGE ci RETAINING WALL FIRE SPRINKLER
CARPORT ROCKERY FIRE ALARM .
(rYPE OF USE, BUSINESS OR ACTIVITY) E PLAIN:
�fe A4
13
NUM13ER
NUMBER OF
IT'
CRITICAL
OF 'j
DWELLING
7AREAS
0
STORIES gg tSp iVKn1f
UNITS
UM(
NUMBER
DESCRIBE WORK TO BE DONE
REmove/replace gas water heater in
basement closet 36,000.btu's
Fvmau 12-com Uh I
1+"�
.
nQ
HEAT SOURCE
GLAZING %
T
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
SEPARATE PERMISSION.
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PERMIT APPLICATION: ISO DAYS
PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
N INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2
EDMONDS, WASHINGTON, ITS OFFICIALS. EMPLOYEES, AND AGENTS FROM ANY AND
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ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE.
9
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0
NOR LIMIT IN ANY WAY THE CITTS 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 THE WORK AUTHORIZED THEREBY, NO PERSON WILL 13E EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WUHKMt:N'S COMPENSATION INSURANCE AND RCW 18.27.
SIGNATURE (OWNER AeEN
DATE SIGNED.
USE PERMIT
ONE NUMBER 0)(m'
on SUITE/APT#
ADDRESS
9903 242 P1 SW
PLAT NAME/SUBDIVISION NO. I LOT NO.
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
EXISTING - PROPOSED
REQUIRED DEDICATION- FT
LID NO.
LID FEE S
TESCP Approved
RW Permit Required
Street Use Permit Roq'd
Inspection Required
Sidewalk Required
Underground
1 1, 81ftl d
PRV [EQUIRED
YES NO 13
REMA
OWNETt0tedT&XP"8iQft 9Ank06bAJftL/DI
I installed on all hot water tank&
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REVIEWED BY DATE
FIRE REVIEW -D BY DATE Lu
VARIANCE OR CU "i I Unto - A"I! OR-AU11 69114TWPI 'V) BOND
POSTED
AVRE
v ur. IN STAM
SEPA REVIEW HEIGHT
COMPLETE EXEMPT ALLOWED , PROPOSED
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT)
r
Rot
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kLLOWED PROPOSED FRONT SIDE REAR FRONT QRSIDE REAR
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�IHECKED BY TYPE OF
,VNSTRUCTION CODE. OCCUP
GROU�ANT
b 63 R:3
SPECIAL INSPECTION JAREA OCCUPANT
REQUIRED LOAD
1EMARKS
IROGRESS INSPECTIONS PER UBC'108/ IBC109/IRC109 FINAL INSPECTION REO'D
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VALUATION
$ 4 ')0
Description
Plan Check
Building Permit
Plumbing
Mechanical
Grading
Engr. Review
Engr. Inspection
FEE Description
State Surcharge
City Surcharge
LO'A� Base Fee
FEE
Fire Review Plan Chk. Deposit
Fire Inspection Receipt #
Landscapeinsp. Total Amt. Due (06� C-0
Recording Fee Receipt #
APPLICATION APPROVAL
This application is not a permit until signed by the
CALL Building Official or his/her Deputy: and Fees are paid, and
FOR INSPECTION receipt Is acknowledged in space provided.
OIF E
\i4l A.BkS!� A UR DATE
(425) ITOS
iv I -
771-0220 REL DATE
ATTENTION EXT 1333 \'j
IT IS UNLAWFULTO USE OR OCCUPYA BUILDING OR STRUCTURE UNTILA FINAL
INSPECTION HAS BEEN MADE AND APPROVALOR A CERTIFICATE OF OCCLI- ORIGINAL -FILE YELLOW- INSPECTOR
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110. PINK -OWNER GOLD -ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
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RECORD OF INSPECTIONS