20050590 (3).pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Tom Monahan
MAILING ADDRESS
22005 100 Ave W
CITY ZIP TELEPHONE
Edmonds 98020 425-771-8381
NAME
EPHONE
NAME
Fast Water Heater
m ADDRESS
12601 132 AVe NE
6 ts [PERMIT EXPIRES
PERMIT
NUMBER
JOB SUITE/APT#
ADDRESS 22005 100 Ave W
PLAT NAMEISUBDIVISION NO,
rT NO
LID NO
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
RW Permit Requirmi
Street use Permit Required
EXISTING __PPnr3r)
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CITY ZIP TELEPHONE
ZIP
Kirkland 98034 r425-814-3124
STATE LICENSE NUMBER EXPIRATION DATE CHEPKEP gY
FASIIWHCO52DF 2-1 *6-( 1"
1 11111111
PROPERTY TAX ACCOUNT PARCEL NO.
00450700300006
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RESIDENTIAL
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ADDITION
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COMMERCIAL
MIXED USE
13
REMODEL
MULTIFAMILY
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REPAIR
GRADING CYDS
DEMOLISH
TANK
GARAGE
RETAINING WALL
CARPORT
ROCKERY
(TYPE OF USE, BUSINESS OR ACTIVIT ) gXPLAINI
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ENGINEER! 60ijIEW[jBY
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lie -,)Ur .1ppliances pasF,
Oil
IMC 803.2
FIREREVIE E
VARIANCE OR CU SHORELINE RADBI I INSPECTION SEPA
REO'D 01 COMPLETED EXEMPT
13YES 13N I
CA# ZONE SIGN AREA HE IGHT
WAIVER 13 ALLOWED I PROPOSED ALLOWED PROPOSED
STUDY 13
PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
COMPLIANCE OR
CHANGE OF USE z
PARKING LOTAREA PLANNING REVIEWED BY DATE
E] SIGN REQ'D PROVIDED 0.
FENCE
x FT.) REMARKS
OTHER
FIRE SPRINKLER
FIRE&ARM I
z
W
f t4� N Q_ffl_t�' TYPE OONSTRNBION C
NUMBER NUMBER OF " \ W
OF DWELLING SPECIAL INSPECTION CONSULTANT
STORIES
UNITS
REQUIRED [3 YES
DESCRIBE WORK TO BE QONE
REmove/repalce gas water heater in
REMARKS
6asement 40,000 btu's
GEOTECH REPORT
BY:
STRUCTURAL DESIGN
BY:
VALUATION
h Lc?
Description,
Plan Check
HEAT SOURCE
LOT SLOPE%
VESTED DATE
Building Permit
PLAN CHECK NO:
Plumbing
Mechanical
— THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Grading
Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.005(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 HOLD 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 PERMIT 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 A14D 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 COMPENSA��'a�NCE AND RCW 18:27.
CALL
FOR INSPECTION
(425)
771-0220
SIGNATURE (OWNER 0 =;AGENT):
DATE SIGNED
7-12-05
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 / IBC110 I IRC110.
OCCUPANT
GROUP
OCCUPANT
LOAD
FEE Description
State Surcharge
City Surcharge
Base Fee
FEE
Plan Chk. Deposit
Receipt #
Total Amt. Due
Receipt # 71D
APPLICATION APPROVAL
This application is not a parmil until signed by the
Building official or his/her Deputy: and Foes are paid, and
receipt is acknowledged in space provided.
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