20050284.pdfW DATE RECEIVED
C1W OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Tesfaslassie Debesai
MAILING ADDRESS
19702 82 P1 W
CITY ZIP ITELEPHONE
Edmonds, 98026 425-712-8936
NAME
ADDRESS
CITY ZIP ITELEPHONE
NAME
CBLJ
FAst WAter Heater
ADDRESS
12601 132 AVe NE
CITY, ZIP
TELEPHONE
Kirkland 98034
1425-814-3124
STATE LICENSE NUMBER EXPIRATION DATE
CHECK
FASTWHC052DF
2-16-0
PROPERTY TAX ACCOUNT PARCEL NO.
\4
00595000002500
1:1 NEW FL] RESIDENTIAL
PLU MBING / MECH
ADDITION COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
REMODEL MULTIFAMILY
SIGN
GRADING
REPAIR CYDS
FENCE
X_
DEMOLISH TANK
OTHER
GARAGE RETAINING WALL
CARPORT
FIRE SPRINKLER
ROCKERY
FIRE ALARM
(rYPE OF USE, BUSINESS OR CTIVITY) EXPLAIN
�Tf I �7 h a
�_LA.A cujr\Al
-
NUMBER
NUMBER OF
C
CRITICAL
OF
DWELLING
RI
TAREAS
STORIES
UNITS j
U1
NUMBER
DESCRIBE WORK TO BE DONE
REmove/replace gas
water heater
in ba sement closet
off bathroom
An nnn
PERMIT EXPIRES 1 () iLl �113
EUSE PERMIT
ZONE
USE
ONE NUMBER.
JOB SUITE/APT#
ADDRESS 19702 32 P1 W
T NO. 711E,; NO.
PLAT NAME/SUBDIVISION NO.
L
I LID FEES
PUB 9 13' U1-QV-WAY""ff'0FF!CrAL STREET MAP
I D or 1, velit connectors r(
EXIII I PC PRPPOSED
.11ing qLPPI13111CC n
REQtkftU WQIA�_ FT �Mff
METfR%5fM"Vj' -UNE-SIZE I"A0'QE_EQau IRED
RE'r
YESP No E3 9
W
LLI
REMARKS z
z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE 5
Z
w
BY
FIRE REVIEWED BY
DATE
cc
WrL
VARIANCE OR Cu B BOND
PSY TWTSIBS AM'IMT POSTED
J)r Jif%f%EL MONO S
SEPA REVIEW W&GRWK10% 6 164 0 HEIGHT
COMPLETE EXEMPT ALLOWED I PRO POSED ALLOWED PROPOSED
EXP I I
LOT CC WPRAG&� Arpeull'Ahcl -GfiTQAQ96-jFT4- CKS (Fr.)
ALLOWED jWpfiffajj:jjR0tT treE r REAR* REAR
n 0 equix eff0NT L/R SID
LAMG�REM M-W Wft 5
PARKII I 1A MR lop
R
Y)�
0
dr1i %"Jlut .
REO'D I F F1 expans on tank shall be 06
we 2
F79 REMARKS =411bL4 3110111. URI JAIA 111UTL WHtCj- tH1110.
CHECKED BY I TYPE OFQMSTRUCTIO CODE OCCUPANT
-7 GROUP
VL U
SPECIAL INSPECTION JAREA OCCUPANT
REQUIRED LOAD
REMARKS
PROGRESS INSPEC71ONS PER LIBC 108/IBC109/IRC109 FINAL INSPECTION REO'D
rU-RSUANT' TO UPC 608
AID BUM)
Wiwi
W'kL--v v !Ll
VALUATION
SMUTOFF
$
Description.
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE GLAZING % LOT SLOP E %
I
j
Building Permit
City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing CIA/a
Base Fee
j :)C) oo.
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
1= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
t SEPARATE PERMISSION.
Engr. Review
Lu PERMIT APPILICATION: 180DAYS
CL PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
CO 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
Plan Chk, Deposit
9 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 #
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMFT. ISSUANCE OF THIS PERMIT SHALL NOT BE
A DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapelnsp.
Total Amt. Due
01 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.0
Recording Fee
Receipt # c�2 6) i io
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT T14E INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; ANU T HAT 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 pefinit until signed by Ilia
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
Building Olficial 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 COMPENSATION 14URANCE AND RCW 18.27.
OFFIq44,LS SIGNATURE DATE
P,/AGENY D
SIGNATURE 5NER 0 ATE SIPNED .
(425)
N
\'
�'l AUV K,
A Ile;
771-0220
A,
RELEASE 13) ATE
ATTENTION
E)ff 1333
IT IS UNLAWFULTO USE OR OCCUPYABUILDING OR STRUCTURE UNTILAFINAL
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBCI09/IBC110/IRC110.
ORIGINAL - FILE YELLOW - INSPECTOR
PINK - OWNER GOLD - ASSESSOR
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
z
0
1
0
M
-n
M
C
M 0
0
0
0 C:
M
M Z
jc) -4
C _z
CD
0 -n
n
M M
0
0
0 M
C (1)
90)
M 0
Z r-
3:
z
W
z
0
11
0
M