20050901.pdfI
DATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Patrick Donahoo
MAILINGADDRESS
17324 73 Ave W
CITY ZIP TELEPHONE
Edmonds 98026 1425-742-8760
NAME
0 PERMIT EXPIRES
PERMIT
NUMBER gm/
JOB SUITE/APT#
ADDRESS
17324 73 Ave W
PLAT NAMEISUBDIVISION NO.
.. 1
W)
Fast Water
Heater
19...,
ADDRESS
12601 132
Ave NE
CITY
Z17
TELEPHONE
Kirkland
9803 4
425-814-3124
STATE LICENSE NUMBER
EXPIRATION DATE
C
FASTWHC052DF
2-16-07
PEC
)B
PROPERTY TAX ACCOUNT PARCEL NO.
00 513100013901
NEW
Fj] RESIDENTIAL
FeUMJW21
MECH
A . DDITION
COMMERCIAL
COMPLIANCE OR
OF USE
MIXED USE
CHANGE
LID NO.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved
RW Permit Required
U
El
Street Use Permit Reclutied
13
a
EXISTING"PROPOSED"
Vo Vent jollnectors I
a"11 R 1
INUE'r
13
13
REQUIR:D
Witmorequired
E3
METEI t SIZE LINE
SIZEn
PRVREOUI ED
till -oil 11 unhem-tel
sl)m,--es. INIGESV.2
REMARKS
W
W
z
OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
0
z
W
ENGINEERING REVIEWED BY DATE
FIRE RE IEWED BY W
pressure/relief valve an appro4d
OR Fin ARRI.-
#
VARII 11PIMETTIll OR ADB# IN�;jjW4 SEPA
t compt- ED I EXEMPT
D
installed on all hot w4lo r
I
YES
U No
CA# I UPC P�-5ZONE
SIGN AREA
IGHT
WAIVER 13--- .. ,
ALLOWED PROPOSED
ALLOWED PROPOSED
STUDY 13
I
,
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
FRONT SIDE REAR
I
FRONT URSIDE REAR
z
PARKING LOTAREA I PLANNING REVIEWED BY DATE
REMODEL MULTIFAMILY SIGN REQ*O I PROVIDED
GRADING FENCE I
REPAIR CYDS ( X FT.) REMARKS
DEMOLISH
TANK
E] OTHER
GARAGE
RETAINING WALL
E]
FIRE SPRINKLER
1Lu
CARPORT
ROCKERY
FIREALARM
0
R
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
1
Z-3)
NUMBER
NUMBER OF
OF
STORIES
WELLING
UNITS
SPECIAL INSPECTION
REQUIRED 13YES
DESCRIBE WORK TO BE DONE
Remove/replace gas water heater in
REMARKS
basement utility.room 40,000 btu's
GEOTECH REPORT
BY:
STRUCTURAL DESIGN
BY:
MIMI
VALUATION
$
Description
Plan Check
HEATSOURCE
LOTSLOPE%
VESTED DATE
Building Permit
PLAN CHECK NO:
P lumbing
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 (CURB5, SIDEWALKS, DRIVEW"S. 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. Insp6clion
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 HE
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.i
Fire Review
Fire Inspection
LandscapeInsp.
Recording Foe
I EREBY ACKNOWLEDGE THAT I HAVE READ -THIS APPLICATION! THAT THE INFORMATION
GIVEN IS CORREC7; 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 RANCE AND RCW 10:27.
CALL
FOR INSPECTIO
(425)
771-0220
SIGNATURE (OWNER T� jl�
DATE SIGNED
10-4-05
0 SUPANT
G CR Up
,3_
CONSULTANT OCCUPANT
I LOAD
E
FEE Description
State Surcharge
City Surcharge
Base Fee
FEE
Plan Chk. Deposit
Receipt ft
Total Arnt. Due
Receipt #
APPLICATION APPMAL
This application I, not it punuit until signotl by tno
Buiumitl OHicial or hisiher DuPuIY and refis ave paid anrl
ruceipt i6acknoMull9f1d III sPilcl! PrOvl(lilld
DAT%
DATE
ATTENTION 1:7% L 1 JJJ
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL -FILE YEI. LOW -INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC1091 IBC110 if IRC110- PINK - OWNFR GOLD ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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