20170217132616.pdfC I l� 11p
C"ITY OF EDMONDS
1215TH AVENUE NORTH - EDMONDS, WA 98020`
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 02/17/2017 ��� Iff �� ���� NINE 11 1),
7����
BUILDING PERMIT
Expiration Date: 08/17/201/
PROPERTY OWNER
JEANETTE'FONG
APPLICANT
SENIOR SERVICES/SNOHOMISH CNTY
CONTRACTOR
SENIOR SERVICES/SQOHOMISH CNTY
8621 244TH ST SW
C/O JAMES LEE
C/O JAMES LEE
EDMONDS, WA 98026
11627 AIRPORT RD.
11627 AIRPORT RD,
,
SUITE B
SUITE B
EVERETT,'WA 982048714 "
EVERETT 'WA 982048714
(425)355-1112
(425)355-1112
LICENSE #: senioss243oh EXP 01 /20/2018
, WSCRIPTION
LIKE FOR LIKE EI .ECTRIC FURNANCE REPLA CEMENT
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 WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27,,
411,4 1> `I�CATIONISNOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR 1I15+IlER DEPUTY Ah D1 L14 t L:hSARE PAID,
V, ��' (10 11, iv.\, /1'LGQ 1.�fi 0 17 ,W 17
falatwa Print Name .Date.: Released r�Pae
l
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/ IBC110/ 1RCI 10,
ONLINE APPLICANT ASSESSOR En OTHER VAS
• 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. Check the 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 or policies 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 forwhich a variance 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.
• Sound/Noise originating from temporary construction sites as a result of construction activity are exempt fromthe 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
hamiless 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 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.
• Installation, use and maintenance of equipment and components shall be per manufacturer's specifications, installation
instructions, and applicable state codes. 'Provide manufacture's installation instructions on site for Building Inspector.
1001
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)CALL FOR INSPECTIONS
PUBLIC WORKS 4' 771-0235 PRE-TREATMENT (4 3 672-5755 RECYCLING (425)275-4801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection being
m'eTies ls Contact Name and Phone Number Date Pt^e6ree andwhether you; •efer morning or afternoon.
• B-Mechanical 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 #:
Associated Permit #:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes ❑ No
APPLI('ANT: ,
( " 5 t /\ t
tttlt,n ss (Stye t, City, State, Zip).
A,C-
PROPERTY OWNER:',,
J (.Ct vl P_ 4Q
Address (Street, City, State, Zip):�iL 2(
AGENCY:
(Street, City, State, Zip):
1
M
CONTRACTOR:*
A ry
s ..
*Contractor must have a valid City of Edmonds business license prior to doing work
in the City. Contact the City Clerk's Office at 425.775.2525
PLUMBING I I MECHANICAL
TANK
Fax:
Address:
A
n r®,3`6t��fi SSSC
Phone:
E-Mail Address:
Phone:
E-Mail Address:
Fax:.
Fax:
Phone: Fax
�F2s. 2 T 22ZI
E-Mail Address:
� W e e #t"[;x . Date:
St V, lat Scents? 0.
City Business License 4t/Ex a,. Date:
DEMOLITION
DETAIL THE SCOPE OF WORK _s �..... " .h�. C�.... ....
1 < < . c"C
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. GPrint Name: `1fZQ' Owner ❑ Agent/Other (specify):
_ .. _ ... A ... __...
Signature: .__.... _.. ,:: Date: �� .... ...
FORM C L'hBuapGtl6, g New Folder 201000NF & x-ferred to L Building -New driveTorm C 2014.doex Updated: 1/17/2014
Fixture Type (new and relocated)
Total #
Fixture Type (new and relocated)
Total #
Water Closet (Toilet)
_....�. .................
Pressure Reduction Valve/Pressure Regulator
, .......Y._ ._.,..__u..
(.............._.. , bar, eye wash, etc.)
Sink kitchenlaundry, lavatory
Water Service Line
Tub/Shower
Drinking Fountain
Dishwasher
Clothes Washer
Hose Bib ��....�
Backflow Prevention Device (e.g. RBPA, DCDA, AVB)
Water Heater Tankless? Yes ❑ No ❑
�....._ ..
....... W
Hydronic Heat in: Floor ❑ Wall ❑
Floor Drain/Floor Sink
ther:
lo
Refrigerator water supply (for water/ice dispenser)
ther:
Equipment Type
Appliance/Equipment Information (new and relocated)
Total #
Furnace
Gas #.____.. Elec #.Mtltlxcr:
.. # ...... BTUs: <100k_ >100k_ Location(s)_._._,
Air Handler / VAV
Gas #_Elec #_Other: # CFM: <10k_ >10k_ Location(s) __
(circle selected)
AC / Compressor /
Boiler / Heat Pump /
Gas #_Elec #_Other:...................................................... # BTUs: <100k, ................... ......100k-500k, 500k-1Mil
Roof Top Unit
HP:. .........<3, 3-15, .............. ............. .15-30 Location(s) ^ w.....�ww _ _.........
(circle selected)
Hydronic Heating
Gas #_Elec #_In -Floor _Wall Radiant/ Boiler BTUs ___- _ ....._ Location-.., _,._._
Exhaust Fans (single
Bath #_Kitchen #_Laundry # —,Other:.,..,w. � .. �... .. � .......� �.�..�- . � .....__...
duct)
Fireplace I Gas #_Elec #_Other: # Location(s)
Dryer Duct
FORM C L:\Building New Folder 2010\DONE & x-ferred to L Building -New drive\Form C 2014.docx Updated: 1/17/2014