20051150 (2).pdfDATE
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CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Price, Carol
MAILING ADDRESS
20904 Woodlake Dr
CITY ZIP TELEPHONE
Edmonds 98026 425-774-9334
NAME
ADDRESS
CBL#
Fast Water Heater
ADDRESS
12601 132 Ay�z NF
CITY ZIP TELEPHONE
Wirklnnrl 98034 425-814-3124.
STATE LICENSE NUMBER I EXPIRATION DATE JECKED BY
FASTWHC052DF 2-16-07
PROPERTY TAX ACCOUNT PARCEL NO.
00637700000700
NEW ® RESIDENTIAL 70 PLUMBING / MECH
❑
ADDITION COMMERCIAL COMPLIANCE OR
❑
❑ .MIXED USE 11CHANGE OF USE
❑ REMODEL ❑ MULTIFAMILY ❑ SIGN
❑ REPAIR ❑ GRADING❑ FENCE
CYDS ( X FT.)
❑ DEMOLISH ❑ TANK ❑ OTHER
❑
CARPORT ElROCKERY WALL ❑ FIRE ALARM LER
(TYPE OF USE, BUST OR ACTIVI Y) EXPLAIN:
NUMBER NUMBER OF
PERMIT EXPIRES
PERMIT
NUMBER
NUMBER
JOB SUITE/APT#
ADDRESS
20904 Woodlake Dr
PLAT NAME/SUBDIVISION NO. LOT NO. LID NO.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCPApproved ❑
RW Permit Required ❑
EXISTING PROPOSED Street use Permit Required ❑
inspection Requited ❑
Sidewalk Required ❑
REQUIRED DEDICATION FT Underground ❑
Wiring required ❑
METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES13 NO O z
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REMARKS tu
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OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE z
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ENGINEERING REVIEWED IIIW" V s L cr '-' a s. i& a 1" - DATE
8E 1� �,C P
FIRE REVIEWED BY
DATE
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VARIANCE OR CU
SHORELINE
OR ADB#
INSPECTION
SEPA
REQ'D
COMPLETED
EXEMPT
O YES ONO
CA#
ZONE
SIGN AREA
HEIGHT
WAIVER
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ALLOWED PROPOSED
ALLOWED PROPOSED
STUDY O
LOT COVERAGE
REQUIRED SETBACKS (FT.)
PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED
FRONT
SIDE REAR
FRONT UR SIDE REAR
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PARKING
LOT AREA
PLANNING REVIEWED BY DATE
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REQ'D r PROVIDED
aces, EMC 803.70 I
OCCUPANT
GROUP !
OFDWELLING SPECIAL INSPECTION CONSULTANT OCCUPANT
j STORIE 47,
UNITS REQUIRED 13 YES LOAD
DESrp F WORK TO BE DONE
Remove/replace gas water-heate REMARKS z
in garage 40 000.btu'saddition
GEOTECH REP
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STRUCTURAL t
BY: pangion tank shnil he
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VALUATION install d on all hot water tanks.
$ UPC
Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE LOT SLOPE% VESTED DATE
Building Permit City Surcharge
PLAN CHECK NO: Plumbing Base Fee
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO MBChanICBI
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
J SEPARATE PERMISSION,
Engr. Review
w PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
L PERMIT LIMIT: SEE ECDC 19.00.005(A)(6) Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
N 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 _ f„
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape insp. Total Amt. Due
= NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT 1 AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- This application Is not a permit unlit signed by the
CALL Building Official or his/her Deputy and Foos are paid, and
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 FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27,
PIFIALSSRIN URE DAT
SIGNATURE (OW GE T �� DATE SIGNED (425)
12-15-05 771=0220 ikELt/Csti5 BY �A TE
ATTENTION EXT' 1.333
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 YELLOW -INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC110. PINK • OWNER GOLD ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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