20170106104348.pdf4es
I1215TH A`4'EJNEIE,NQk1° _ EDMONDS, WA 98020PHONE; �425 7710220 - FAX: (425) 771-0221
Parcel No: 00434209100900
JOHN L & VIRGINIA B BEZUG SOUTH WEST PLBG& WTRHTRS INC SOUTHWEST PLBG& WTRHTRS INC
714 ALDER ST C/O WILLIAM BUCKINGHAM C/O WILLIAM BUCKINGHAM
EDMONDS, WA 98020 2401 SW ALASKA ST -
2401 SW ALASKA ST
(709) 400-4946 SEATTLE, WA 98106
SEATTLE, WA 98106
(206)932-1777 (206)932-1777
LICENSE#:SOUTHWP071C6 EXP:04/01/2017..
REPLACEWA TEk SERVICE LINE FROM METER TO HOUSE.
VALUATION: ' $0.00
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE
.STATE OF WA SHINGTON REL
ATING
WORKMEN'S COMPENSATION INSURANCE AND RCW i 1S2 7;; NG TO
TIRS'APPI („. IJQN IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR R S41ER DEPUTY AND ALL FEES ARE PAID.
17
18rnatcr Print Name Date Released
Date
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC109/ IBCI 10/ IRC110.
ED ONLINE APPLICANT ASSESSOR OTFIERA"'-�
STATUS: ISSUED BLD2017004
� T'trr^sarant tD,t
il'C 605,2 a water service slrutolt's'llaall be installed orr tlre;water lire as it order's the burldntg
• City approved plastic piping,i y be oscd in water,scrvicc.pipirlg providedthat where metal wajc ,&etvtce pdprng is used for
electrical rertrrrding,prrrpose p replacerr nt piping shill tie of like rr teria)s (tif)C t .8). A state electrical permit and
inspection is, required if electrical grodnciing is altered,, rer loved, in moved, or:'added. Contact State �pta ol'ta ors&
Industries Electrical Division at 25.290-13K
` final approv fort a project orfinal ogetrptrnc approval rr�rstbe granted by the Building Clticial prior to use or occupancy, of
the building or struct rre. Dec the job card i"or all required City inspections including final project approval and final
occupancy inspectlons,
Any, request ;for'ariternate design, modification, vaekince or other administrative deviation (Thereinafter `variance') from
adopted codas, ordinances or policies n-rst be specifically requested in,writing and be called out and, identified. Processing
fees for such request, slrall be established by Co uncil;And shull.be paid upon ubrthsttaLl and are rlom�-r rlaclable�.,
ar Approvalofany plat or plancontain ing.provisions, which do not complY with city code and tpr rvlhich a variance has not been
specifically identitied, requeated,and.cortsidered by theappropriate city official in accordange with the appropriate provision
of City code or state law does not approve any iterns not to code specrtrcatiorla
Sound/Noise origirt:atlrhg fronrternlaorarY construction sites a a result of cbr'wstructiort activity are c iTrpt finrtttlhenoise limits
n,
o E(,CChapter 5,30 only'dutirrg the Tours of 7.�rnio'6.00prn on vveelt'days and l0.ililarlaarld 6,00prnorh Satrirdays, er irrdirrg
Srrbpays and -pedoal Holidays,, At all other tinies,the noise+or5ginatiag /activities musk corjply. it .tlrg
noise litnits of`Chapter 5.30, unlcss avariance has been , ranted pur^suantlo rIOC'530..1 0.
aw pplieaut, on behalf oflns or lrer spouse,1roirs,, assigns, arhd,succes ors at interests, agrees to indeninify,deten,ril and,hold
harmless the CitY OfI?dlnorrds, Washington, its officials,, ern ioyees,and agents fvmany and all claims, for (tantages of
whattever nature, arisirlagdirectly or indirectly front the issuance for this pertnit. Issuance of this, pennit shall not be deemed to
Ir dif o vraiwe orreduce arrY'requirgb rrts ofany C'it ordinaocc norlinrivin any way the City" ability to enforce any ordinance
provision.
Owner/Contractor to provide Water Service Line asbuilt at final inspection. See City Standards for requirements.
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE' PROPERTY ONLY. ANY CONSTRUCTION ON; THE
PUBLIC DOMAIN (CURBS,: SIDEWALKS, ;DRIVEWAYS, MARQUEES,', ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC 1900.005(A)(6)
illtll�L11Nt `25 71-0201 'f.' l"333' IIGIN „ II+CI �12,a 771�0220 EXd . 1;126 l"t 25 7757I,
pldltl If"WORKS 2 771-0235 ]'RE."IF+�A"j'"Irw'"I � 672-5755 RECI'CLING 2� 275-4801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection being
r'ec cafe Contact Name and Phone Nrirrrlkaer, Date p ureter°ee ;and tw#rether 111vou prefer rtratr'nln ,or alter°nnarrr.
1rWater Service Line
..........
o'a� (tti
uw DEVELOPMENT 5I11Z V 1C 1�?;,S
�^N
PLUMBING, MECHANICAL, '1' K, ; DEMOLITION
PERMIT APPLICA'14ON
q,�j121 5"' Avenue N, Edmonds, WA 98020
City of Edmonds Phone 425.771.0220 9 Fax 425.771.0221
TO THE PLUMBING & MECHANICAL CHECKLIST FOR SIlLM17IAL pF�lIIIlFYlIhNI;S'
PROJECT a1l�l�It�R�F�Il ;
�,S (°stt�t„ red #, City Itittattr„ ;�il�): Parcel #:
THIS WORK ASSOCIATEll WITH ANOTHER PROJECT? Yes F-I No Associated Permit #:
APPLICANT:
Address (Street, City, tit,rt, Zi
41 C „Sly .. (J4, j
PROPERTY OWNER:
Address(Street, City, State, Zip):
LENDING AGENCY:
Address (Street, City, State, Zip)
('ONT1tAC'j'O1I:
, 1.
Addtes,„ (,Street, ("I'ly Sttac, Zip}:
*Contractor must have a valid City of pdrnorjds business license prior to doing work
in the City. Contact the City Clerk's (>ffice at 425,77 „2525
PLUMBING
DETAIL THE SCOPE 01t VNI(1RK: I
l/lECIIA NICA, L
TANK
Phone: _
Fax:
2- , l-7 ti-7
'-Mail Address:
Phone:=�ay.
E-Mail Address:
:Phone:
Fax:
E-Mail Address:
Phone:
Fax„
E-Mail Address:
WA State License 10/1 xp. Date:
b , ry
City Business License #/Exp. Date:
DEMOLITION
[declare under penalty of perjury laws that the information I have provided on this or
Edmonds, tn%rpfrlicwtttion is true, correct and complete,
and that I am the property owner or duly authorized agent of the property owner to submit a permit application to the City of
Print Nanie° °,. �r j.4Af C Owner A
.....gent/Other (specify)
_e.
Signature:
Date:
FORM C LABuilding New Folder 2010\DONE & x-fened to L-Building-New driveTorm C 2014.docx
Updated: l / 17/20 l 4
Fixture Type (new and relocated)
Equipment Type
Furnace
Air Handier / VAV
(circle selected)
AC / Compressor /
Boiler / Heat Pump /
Roof Top Unit
(circle selected)
Hydronic Heating
Exhaust Fans (single
duct)
Fireplace
Dryer Duct
Appliance/Equipment Information (new and relocated)
Gas # Elec # Other: >100k 1 of alion(s) .. _.
Gas #_Elec #_Other: #_CFM: <Iok_>10k_ Location(s
Gas # _.Elec Other: It BTUs:__ <100k, 100k-SOOk, _ .. 500k-1Mil
HP: <3, 3-15, 15-30 Location(s) .__-... ..... .. ........_
Gas #..._Elec # .....In -Floor ,,,,,,,.Wall Radiant_._.,_,._ Boiler BTUs m_�Locati
„�
Bath #_Kitchen #_Laundry # _00)
Gas #,Elec # __ ,Other:. ----#--
Total #
Total #
fiCJRM C L:\Building New Foldex 2010\DONE & x-feried to L-Buildkig-New drive\Form C 2014.docx
Updated: 1 / l 7/2014