20050870.pdfDATE RECEIVED
I cf/,aqA95 PERMIT EXPIRES. -,')I
CITY OF EDMONDS PERMIT 0
NUMBER 6Y7
CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPTP
ADDRESS
OWNER NAME/NAME OF BUSINESS 19-715 82nd P1 W
Caughell, Jeremy PLAT NAME/SUBDIVISION NO. L07 NO. LID NO.
MAILINGADDRESS
U1 LID rEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved E3
0 19715 82nd Pi W RW Permit Required 13
Street use Parma Required E3
CITY ZIP TELEPHONE EXISTING PROPOSED inspection Radioed 0
Sidewalk Required CI
Edmonds 98026 425-774-2309 REQUIRED DEDICATION FT Undpfgfound C3
Wiring inquired
NAME METER SIZE LINE SIZE NO, OF FIXTURES PRV REQUIRED
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CITY ZIP TELEPHONE listed expansion tank shall be
unstalled on all hot water tanks,
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upc 608
Fast Water Heater ENGINEERING REVIEW ED BY DATE
NAME
ADDRESS
o;- yer., QI1,j1jnvfprc rix
12601 132 Ave NE
FIRE RE\, RMOM-burnhic, Ippliances passineATE
CITY zip TELEPHONE
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U through unheated stIlaces. MC 8012.
Kirkland 98034 425-814-3124
STATE LICENSE NUMBER EXPIRATION DATE ED BY VARIA qt"FMD�, DrrTinN QPPA
CI YREO'D COMPLETED I EXEMPT
FASTWHC052DF 2-16-07 Es 13NOI
-j PROPERTY TAX ACCOUNT PARCEL NO. CA# ZONE SIGN ARE A HEIGHT
V WAIVER ALLOWED I PROPOSED ALLOWED PROPOSED
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LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
NEW 13 RESIDENTIAL. CLUM:B:INJGMECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
ADDITION 1:1 COMMERCIAL COMPLIANCE OR
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0 1:1 MIXED USE CHANGE OF USE z
PARKING LOTAREA PLANNING REVIEWED BY DATE
REMODEL 1:1 MULTIFAMILY El SIGN REQ 'D I PROVIDED
REPAIR GRADING FENCE
11 CYDS X FT.) REMARKS
DEMOLISH TANK OTHER
Ei GARAGE o RETAINING WALL FIRE SPRINKLER
z CARPORT ROCKERY FIRE ALARM
I=- (TYPE OF USE. BUSINESS OR ACTIYITY) EXPLAIP:
IL TYPeIW--GQNSTRUCT OCCUPAN�
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0 OF DWELLING SPECIAL INSPECTION CONSULTANT OCCUPANT
STORIES UNITS
LOAD
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71 DESCRIBE WORK TO BE DON REQUIRE
REmove/replace gas water heater in REMARKS 0
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garage 38,000 btu's GEOTECH REPORT
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BY:
STRUCTURAL DESIGN
BY:
VALUATION
$
Description FEE Description FEE
HEAT SOURCE LOT SLOPE% VESTED DATE Plan Check State Surcharge
Building Permit City Surcharge
PLAN CHECK NO: Plumbing 00 Base Fee '0(D
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 Grading
_j SEPARATE PERMISSION.
t: Engr. Review
0: PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
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PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection
Fire Review Plan Chk. Deposit
in APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS
ul
_j IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
M 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 PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE LandscapeInsp. Total Anil. Due "S'
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
0 Recording Fee 113 --- ipt # Rl.�465�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION PLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application is not a purnit until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building Official of his/her Deputy and reesn(t) and. d
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED receipt isacknowlettgod in space p(qvided
IN VIOLATION or THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION
WORKMEN'S COMPENSATIO
,tWVURANCE AND RCW 18:27. O,�51 N U E DATI
SIGNATURE (OWNER OR GEYT): DATE SIGNED (425)
9-27-05 91n
771-0220 -firm,_--wsw Y EAT 1`1
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ATTENTION EXT. 1333
ITISUNLAWFULTOUSEOROCCUPYA BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL -FILF YELLOW -INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC110. PINK -OWNER GOLD - ASSESSOR
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