20170206135423.pdf1215TH AVENUE NORTH-'EDMONDS, WA 98020
CITY O�F EDMONDS
PHONE: (425) 771-0220'- FAX: (425) 771-0221
4t�o
STATUS: ISSUED 02/06/2017
Expiration Date: 08/07/2017
Parcel No:
JOHN J & BARBARA B COUILLIARDTOTAL PLUMBING SOLUTNSNW_LLC TOTAL PLUMBING SOLUTNSNW LLC
8706 182ND PL SW C/O TIM HUTCHINS C/O TIM HUTCHINS
EDMONDS, WA 98026-5340 17110 1 ] TH PL W 17110 11 TH PL W
LYNNWOOD, WA 98037 LYNNWOOD, WA 98037
(425)322-8095(425)322-8095
LICENSE'#: TOTALPS840PD EXP:111/0412018
MOVE W/C, MOVE/ ADD LAVATORY SINK; MOVE SHOWER WITHIN EXISTING SPACE.
VALUATION: $0.00
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND INDOINGTHE'WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATINGTO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27,
TlvllaALILICXLINOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS✓HER DEPUTY AND ALL FEES ARE PAID,
Signature Print Name Date" Released By Date
ATTENTION
ITIS 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/ IBC110/ IRC110,
ONLINE APPLICANT ASSESSOR Y90TIlIER
ATUS: ISSUED
BLD20170180
• Final approval on a project or final occupancy approval must be granted by the Building Official prior to use or occupancy of
the building or structure. Checkthe job card for all required City inspections including final project approval and final
occupancy inspections.
Any request for alternate design, modification, variance or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances orpolicies must be specifically, requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable.
• Approval of any plat or plan containing provisions which do not comply with city code and for which avariance has not been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any items not to code specification.
• SoundNoise originating from temporary construction sites as a result of construction activity are exempt ifrom the noise limits
of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must comply with the
noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, 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,fromthe issuance for this permit. Issuance`ofthis permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance nor limit in any way the City's ability to enforce any ordinance
provision.
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 19.00.005(A)(6)
BRIDIN 4'2 771-0220 EXT " 131 3 FNGINEERJNG 25 771-6225 EXT. 1326 FIRE 425 775�, Z720
• B-Plumb Rough In
0 &Plumbing Final...
DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
121 5`h Avenue N, Edmonds, WA 98020
Phone 425.771.0220 ft Fax 425.771.0221
City of Edmonds
PLEASE REFER TO THE PLUMBING & MECHANICAL CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip): Parcel :
:00 IaA a -7000I2.0
Associated Permit #:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes No,®
APPLICANT
: Phone: _ Fax:
9 f + &7)" I : 7 0(,i". �d 9�
S � y,_t date, Zip): � I.• ,�.,. E- °)1�i Address:
Address ("Greet C:tt S. p .,.... .� �` �, ..
Phone. 1 Fax:
Address (Street, City State Zip): E-Mail Address:2� Lcxf
LENDING AGENCY: Phone: Fax:
Address (Street, City, State, Zip): E-Mail Address:
CON'I "i"OBI:* 0 Phone: Fax
A,M,o /Quest City .(Ztnty 'J:iei)l E-Mail Address:
G L 60 OLLZ
WA State License i1/Exp, Date:
*Contractor must have a valid City of Edmonds business license prior to doing work 11PSIRL2
in the City. Contact the City Clerk's Office at 425.775.2525 City Business License #/Exp. Date:
PLUMBING M MECHANICAL [._1 TANK _ _ _ DEMOLITION
DETAIL THE SCOPE OF WORK ....... A.VICI 4-1
.,
_.......... �...� W ........ ..... �� -_ -- _ _. .. .. ......_.
I declare under penalty of perjury laws that the information I have provided on this form/application 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
Edmonds.
Print Name a�` �._� 4* w...��..._ .:�� OwnerT9 Agent/Other (specify): ❑ (sP .._W ..._ _. ........._._.
Signature: Date: _.- ..m._..
FORM C L:\Building New Folder 2010\DONE & x-ferred to L-Building-New drive\Form C 2014.docx Updated: 1/17/2014
Fixture Type (new and relocated)
Total #
Fixture Type (new and relocated)
Total #
Water Closet (Toilet)
Pressure Reduction Valve/Pressure Regulator
Sink (kitchen, laundry, lavatory, bar, eye wash, etc.)
Water Service Line
Tub/Shower
-
Drinking Fountain
Dishwasher �-...........��--��
w..� .. .....
Clothes Washer
_.Hose Bib --..�......�........_�.....
Backflow Prevention Device (e.g. RBPA, DCDA, AVB)
Water Heater Tankless? Yes ❑ No ❑
Hydronic Heat in: Floor ❑ Wall ❑
Floor Drain/Floor Sink
..............
Other:
.......... ----.-
Refrigerator water supply (for water/ice dispenser)
Other:
Equipment Type
Appliance/Equipment Information (new and relocated)
Total #
Furnace
Gas #_Elec
#_Other:
# BTUs: <100k_ >100k_
Location(s)_, _ -, .---......IT
Air Handler / VAV
Gas #_Elec
#_Other:_.,,
dk�CFM: <lOk__ >lOk_
Location(s)
(circle selected)
AC / Compressor /
Boiler / Heat Pump /
Gas #_Elec
#..................Other:...........................................
# BTUs: <100k,....................................100k-500k,
_ w�500k-1Mil
Roof Top Unit
HP:
<3,
3-15, .............15-30 Location(s)-
�.........n _ ..........
(circle selected)
Hydronic Heating
Gas #_-----
Elec #In
-Floor _Wall Radiant_ Boiler BTUs:.-------------
Location..,mmmmm.
Exhaust Fans (single
Bath #_Kitchen
#_Laundry #
#-..-..
duct)
Fireplace
Gas #_Elec
#_Other:
# Location(s)
Dryer Duct
FORM C LABuilding New Folder 2010\DONE & x-ferred to LAuilding-New drive\Form C 2014.docx Updated: 1/17/2014