20170321161930.pdfCITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 03/21/2017 pmft*
Expiration Date: 09/21/2017 h-tijeo -kddrc,�s: 321 1 1-THANT N, EDMON DS'
Parcel No: 00507200001900
DOUGLANE THE HEAT AND AC GUYS INC THE HEAT AND AC GUYS INC
321 12TH AVE N C/O JOHN ARCHER C/O JOHN ARCHER
EDMONDS, WA 98020-2930 22526 44TH AVE W 22526 44TH AVE W
MOUNTLAKE TERRACE, WA 98043 MOUNTLAKE TERRACE, WA 98043
(425) 582-7200 (425) 582-7200
LICENSE #: HEATAHA842PD EXP: 10/04/2018
SEPERATE PERMIT NEEDED FOR ACTUAL FIXTURES
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 47 - Plwnbing
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY:
OCCUPANT GROUP:
OCCUPANT LOAD.
FENCE: 0 X 0 FT.)
CODE: 2015
OTHER: ------- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE
NUMBER OF DWELLING UNITS: 0
LOT 4
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
ORD FLOOR� 0 GARAGE: 0 DECK: 0 OTHER: 0
BEDROOMS: 0 BATHROOMS: 0
1 BEDROOMS: 0 BATHROOMS: 0
FRONTSETBACK SIDESETBACK REARSErBACK
REQUIRED: PROPOSED: JPEQUIRED: PROPOSED: IREQUIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULAT ING CONSTRUCTION AND IN DOINGTHE 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.
THIS APPV(QP7O4S NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID,
Print Name - Date Released W Date
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC109/ IBCI 10/ IRC1 10.
ONLINE APPLICANT = ASSESSOR EU�OTIIER
STATUS: ISSUED BLD20170391
CONDITIONS
• 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 thejob 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 for which 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.
• SoundNoise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00arn to 6:00pm on weekdays and I 0:00arn and 6:00prn on Saturdays, excluding
Sundays and Federal Holidays. At all othertimes 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
harniless 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 pernit. Issuance of this 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.
I INSPLCTIONS
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
BUILDING (425)771-0220EXT. 1333 ENGINEERING (425) 771-0220 EXT. 1326 FIRE (425) 775-7720
PUBLIC WORKS (425) 771-0235 PR&TREATMINT (425) 672-5755 RECYCLING (425) 275-4801
When calling for an inspection please leave the folloming information: Permit Number, Job Site Address, Type of Inspection being
recptested, Contact Name and Phone Number, Date Preferee(l, and vdiether vou w-cfer morninp- or afternoon.
• B-Gas Test/Pipe
• B-Plumbing Final
4
DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
1215 1h Avenue N, Edmonds, WA 98020
Phone 425.771.0220 It Fax 425.771.0221
City of Edmonds
PLEASE REFER TO THE PLUMBING & MECHANICAL CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
SZ, I -�L
2' AV L AJ
Parcel #:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes No
Associated Permit #:
APPLLCIANT:
-C
Phone:
j
Fax,
Address (Street, Ckity' t te, Zip):
Ij t 1 149
Ir— Ai 4'— hlL--I— 1A-1A '2�9X-DW-)
F,,;M a i I A rcss:
Phone: Fax:
PROPERTY OWNER:
Address (Street, City, State, Z*
1� & X;�<
_ , I L 7p-
E-Mail Address:
LENDING AGENCY: A
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
-CONTRACTOR:*
"i9q-T-,n. A
Phone:
Fax:
_dress (Street, ity. Z*
Ad C' St
qL-�� i \A M LA-.)-k LP �i
E-Mail Ajdlre��s:
0
e- Ao
4MAAState
*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
f-icense 4t/Exlp. Date:
4F=-A—ri4qf4 D
City BU *ness License #;//Exp. Date:
W 0 NO I I MINN N MAIN I MO
PLUMBING MECHANICAL TANK
DEMOLITION
DETAIL THE SCOPE OF WORK:-"—O C,46 Tu ;L
I declare underpenalty ofperjury laws that the information I have provided on this formlapplication 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: Owner E Agent/Other Z-*("'Pecify):
Signature: Date:,
C-0/m
FORM C LABuilding New Folder 201 O\DONE & x-ferred to L-Building-New driveTorru C 2014.docx Updated: 1/17/2014
PLUMBING
FIXTURE COUNT
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
Clothes Washer
Hose Bib
Backflow Prevention Device (e.g. RBPA, DCDA, AVB)
Water Heater Tankless? YesE] NoE]
Hydronic Heat in: FloorE] Wall 0
Floor Drain/Floor Sink
Other:
Refrigerator water supply (for water/ice dispenser)
Other:
MECHANICAL
Equipment Type
Appliance/Equipment Information (new and relocated)
Total #
Furnace
Gas #—Elec
#_0(her:_
# BTUs: <100k— >100k_
Location(s)
Air Handler / VAV
(circle selected)
Gas #—Elec
#—Other:—
#—CFM: <10k— >10k—
Location(s)
AC / Compressor
Boiler / Heat Pump
Roof Top Unit
(circle selected)
Gas #—Elec
HP:
#—Other:—
<3,
#_ BTUs:—<100k,
_3-15, 15-30 Location(s)
100k-500k, 500k-lMil
Hydronic Heating
Gas #—Elec
#—In-Floor
—Wall Radiant— Boiler BTUs:
Location
Exhaust Fans (single
duct)
Bath #—Kitchen
#—Laundry # —Other:
#
Fireplace
Gas #—Elec
#—Other:—
# Location(s)__
Dryer Duct
I
FUEL GAS
I
Appliance Type
Appliance/Equipment Information (new and relocated)
Total r
AC Unit
BTUs: Location(s):-
Furnace
BTU's: —I IzQk�, Location(s):_U$A47-
Water Heater
BTUs: 1!�Jq K Location(s):
Boiler
BTUs: Location(s):_
Other:
BTUs: Location(s):_
Fireplace/Insert fLIA.;o
BTUs: Location(s): GS VVI-r.
Stove/Range/Oven
Dryer
Outdoor BBQ
TOTAL OUTLETS
FORM C LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Form C 2014.docx Updated: 1/17/2014