20050544.pdfDATE RECEIVED
[PERMITEXPIRES
CITY OF EDMONDS
PERMIT o (L-q L-1
NUMBER
IOB SUITEIAPT#
CONSTRUCTION PERMIT APPL ICATION
ADDRESS
8721 240th St SW
OWNER NAMEINAME OF BUSINESS
PLAT NAME/SUBDIVISION NO.
LID NO.
LID FEE S
Anthony Remedios
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MAILING ADDRESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCPApproved [3
RW Permit Required [3
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8721 240th St SW
0
EXISTING PR?WRS(JANTT0 FMC 8-
Street Use Permit Requited 0
Inspection Required 0
CITY ZIP
TELEPHONE
Edmonds 98CI26 1425-776-5048
A PRMIJRF REGPLATORVALV
REQUIRED DEDICATION
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NAME
METER SIZE PRVREQUIRED
YESO NOO
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ADDRESS
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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CITY ZIP
TELEPHONE
Pervait frata
NAME
712dustrie:.,
FAst Water Heater
ENGINEERING REVIEWED BY �--DATE"
ADDRESS
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12601 132 Ave NE
FIRE REVIEWED BY DATE
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CITY ZIP
TELEPHONE
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425-814-3124
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REPAIR GRADING E:] FENCE
CYDS X FT.)
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REMARKS
DEMOLISH TANK E:] OTHER
GARAGE RETAINING WALL FIRE SPRINKLER
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CARPORT ROCKERY FIRE ALARM
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NUMBER
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NUMBER OF
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SPECIAL INSPECTIOR
SULTANT
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LOAD
DESCRIBE WORK TO BE DONE
REmove/replace gas water heater
REMARKS
in laundry room 40,000 bitu's
GEOTECH REPORT
BY:
STRUCTURAL DESIGN
BY:
VALUATION
$
Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE
O'A 'A
LOTSLOPE%
VESTED DATE
Building Permit
City Surcharge
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Base Fee
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Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Grading
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BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
Engr. Inspection
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PERMIT LIMIT., SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
V) *APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit
U 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 ft
05
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
ANY CITY ORDINANCE Landscapelnsp. Total Amt. Due
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF QO
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0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
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 This application is not a perinit until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building official or his/her Deputy: and Fees are paid, and
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED receipt is acknowledged in space provided
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION . - I
�S CW 18:27.
WORKMEN - S COMPENSTMtGkj, URANCEANDIR OF L GNA RE ATE
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BGNA DATE
7-7-05 771-0220 RELEA E 5
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ATTENTION EXT. 1333
IT I.R t1N1 AWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE ANDAPPROVAL OR A CERTI- ORIGINAL -FILE YELLOW - INSPECTOI
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 I IRC110. PINK -OWNER GOLD ASSESSOR
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