20050545.pdfDATE RECEIVED
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1PERMIT EXPIRES
CITY OF EDMONDS
PERMIT
NUMBER 5-0
JOB SUITEIAPTH
CONSTRUCTION PERMIT APPLICATION
ADDRESS
7703 205 P1 SVI
OWNER NAME�NAME OF BUSINESS
PLAT NAMEISUBDIVISION NO.
LOT NO.
LID NO.
Tyler VanderPloeg
LID FEE $
M
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MAILINGADDRESS
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCPAppfoved
RW Permit Required
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7708 205th P1 SW
0
Street use Permit Required
CITY ZIP
TELEPHONE
EXISTING PROPOSED
Inspection Required
EDmorids 98026
1425-673-8587
REQUIRED DEDICATION PUkSUM-1.'r0xjPC 60
tidewalk Required
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-NAME.
SIZE
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LEPHONE
NAME CBL#,�,
Fast Water HEater
ADDRESS
12601 132 Ave NE
CITY ZIP I TELEPHONE
Kirkland 98034 1425-814-3124
STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY
FASTWI-IC052DF 2-16-07
PROPERTY TAX ACCOUNT PARCEL NO.
00434000001100
NEW
RESIDENTIAL
COMMERCIAL
MIXED USE
REMODEL
MULTIFAMILY
REPAIR
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GRADING CYDS
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DEMOLISH
TANK
GARAGE
RETAINING WALL
CARPORT
ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVITY) E PLAIN
I A ( qr -
PLuMBING/MECH
COMPLIANCE OR
CHANGE OF USE
SIGN
FENCE
Li I X FT.)
OTHER
FIRE SPRINKLER
FIREALARM
YE S 13 NO 13
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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ENGINEERING REVIEWED BY DATE
FIRE REVIEWED BY DATE
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WAIVE t%j*ES�RjjPb6 ALLO D PROPOSED
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LtL66WtWU 1j'7R1bUFI1e6'�ETi�C�s_(FT.) I PROPOSED JETBACKS (FT.)
ALLOJ FRONT SIDE REAR RONT U SIDE REAR
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PARKING LOTAREA I PLANNING REVIEWEDBY DATE
REQ'D PROVIDED I
W - — - a 11 1 1 V
W NUMBER NUMBER OF
0 OF DWELLING SPECIAL INSPECTION
in STORIES UNITS
0
REQUIRED 13YES
DESCRIBE WORK TO BE DONE
Remov6/replace gas water heater REMARKS
in utinty room 40,000 btu s
GEOTECH REPORT
BY;
STRUCTURAL DESIGN
BY:
'VALUATION
Description
Plan Check
HEAT SOURQE
LOT SLOPE%
VESTED DATE
Building Permit
PLAN CHIf CK NO:
Plumbing
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Grading
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS. SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
Engr. Review
SEPARATE PERMISSION.
PERMIT APPLICATION: SEE ECDC i9.00.005(A)(5)
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
OAPPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESSORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND 14OLD HARMLESS THE CITY OF
EDMONDS. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERL41T SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION
Fire Review
Fire Inspection
Landscapelnsp.
-
Recording Fee
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 BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION NURANCE AND RCW 10:27.
CALL
FOR INSPECTION
(425)
SIGNATURE (0
DATE SIGNED
771-0220
ATTENTION EXT. 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 I IBC110 I IRC110.
OCCUPANT
LOAD
FEE Description
State Surcharge
City Surcharge
0/1) Base Fee
n9i
FEE
Plan Chk. Deposit
Receipt #
Total Amt. Due -1,0 ';� In
Receipt # (e�f 1 ('6 T
APPLICATION APPROVAL
This application is not a permit until signed by the
Building Official or his1her Deputy: and Foes are paid. and
receipt is acknowledged in space provided
10/04 PRESS HARD - YOU ARE MAKING 4 COPIES
ORIGINAL -FILE YELLOW -INSPECTOR
PINK - OWNER GOLD - ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION*
Footing ......................
Wall.
Pier/Porch ....... .........
Retaining Wall ...........
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Slab Insulation ..........
0
PLUMBING:
Underground .............
Rough -in ...................
3:.
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C
Commercial Final ......
M 0
HEATING:
0
0 C
Gas Test ......................
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Pas Piping ........ ........
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Equipment .... ............
Commercial. Final ...
EXTERIOR SHEATHING
-4
NAILING ..........................
M M
FRAMING ........................
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0 F-
0 M
FIRST FLOOR FRAMING...
C 0)
Cn*
INSULATION ...................
J Q 0
Z
Floor Insulation .........
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Wall Insulation ...........
Ceiling Insulation .......
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SHEETROCK NAILING ...
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SPECIAL INSPECTION
0
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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