20050654.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Tom Manolides
MAILING ADDRESS
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3: 719 9 Ave N
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CITY ZIP TELEPHONE
Edmonds 98020 425-778-5414
NAME
TELEPHONE
PERMIT EXPIRES
PERMIT
NUMBER
JOB SUITEIAPT#
ADDRESS
719 9 Ave N
PLAT NAMEISUBDIVISION NO. I LOT NO.
LID NO.
Go FEE S
Permit Requited
Required
PRV REQUIRED
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Fast Water Heater
ADDRESS
12601 132 Ave NE
CITY ZIP TELEPHONE
Kirkland 98034 425-814-3124
STATE t IrFNSF N1IMRFR - EXPIRATION DATE I CHECKED BY]
FASTWHC052DF
2-16-071
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PROPERTY TAX ACCOUNT PARCEL NO.
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27032400216600
NEW
RESIDENTIAL
PLUMBING if MECH
ADDITION
COMMERCIAL
COMPLIANCE OR
USE
MIXED USE
CHANGE OF
REMODEL
MULTIFAMILY
SIGN
REPAIR GRADING
CYDS
E:]
FENCE
X FT.)
1:1 DEMOLISH 13 TANK
OTHER
IGARAGE RE TAINING WALL
3 0
FIRE SPRINKLER
CARPORT ROCKERY
FIREALARM
(TYPE OF USE, BUSINESS OR AC�IVITJ
EXPLAIN; I
NUMBER NUMBER OF
PUBLIC RIGHT OF W0"0OFl[2A"TAI!2fr^P —
EXISTING
REQUIRED DEDICATIOAFMAVff S SHALL N
METER SIZE LINE SIZEBF tRVEs
I IAML
181T119,knz
ENGINEERING REVIEWED BY DATE
FIRE REViqWnr97'— DATE
In addition to the required
listed 4xpansion tantnsimlnp�n COMPLETT I EXEMPT
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CAN 3113N 7UTEA "I
WAIVER AIL�LOWED PROPOSED PROPOSED
STUDY 13 1 lRiq
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
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PARKING LOTAREA PLANNING REVIEWED BY ._,,...,DATE
REQ'I�
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REMAt0�
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OF
STORIES
7
DWELLING
UNITS
1
SPECIAL INSPECTION
REQUIRED 13YES
DESCRIBE WORK TO BE DONE
Remove/replace gas water heater in
REMARKS
garage, 70,000, bitu's
GEOTECH REPORT
BY:
STRUCTURAL DESIGN
BY:
VALUATION
$
Description
LID. h I I
Plan Check
HEAT SOURCE
LOTSLOPE%
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
9 DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQUIRE
I= SEPARATE PERMISSION.
Grading
Engr. Review
a
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. Ins . pection
"APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSOR S
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
x FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
0-j DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITY'S A131LITY TO ENFORCE ANY ORDINANCE PROVISION.'
Fire Review
Fire Inspection
Landscapeinsp.
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
OCCUPANT
GROUP
CONSULTANT OCCUPANT
I LOAD
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC. CALL
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE U�a92 CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
WORKMEN'S COMPENS���CE AND RCW 18:27.
LSIGNATURE (OWNE GE DATE SIGJNEO (425)
771-0220
FEE Description
State Surcharge
City Surcharge
Base Fee
FEE
f,
Plan Chk. Deposit
Receipt #
Total Amt. Due L5, oc.
1 Receipt # akqll�
APPLICATION APPROVAL
This application is not a permit until signed by the
Building Official or his/her Deputy: and Foes are paid. and
receipt is acknowledled in space provided
ATTENTION t:A L I .3a-3
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI-
FICATE OFOCCUPANCY HAS BEEN GRANTED. UBC1091 IBC110 / IRC110.
10/04 PRESS HARD - YOU ARE MAKING 4 COPIES
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PINK -OWNER GOLD - ASSESSOR
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