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CITY OF EDMONDS
121 5TH AVENUE NORTH -EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 04/03/2017 BLD201
Expiration Date: 10/03/2017 Project Addivss: 19703 34TH A
Parcel No: 00558700001100
CHRISTOPHER J/STRONG JESS MOORE P ERFORMNCE INSLTN&ENGY SVS INC PERFORMNCE INSLTN&ENGY SVS INC
19703 84TH AVE W CIO RYAN REED C/O RYAN REED
EDMONDS, WA 98026 12700 SW HALL BLVD #F 12700 SW HALL BLVD #F
TIGARD, OR 97223 TIGARD, OR 97223
(425) 318-9853 (503) 707-6078 (503) 707-6078
LICENSE #: PERFOIS878D9 EXP:04/01/2019
INSTALL NEW DUCTLESS HEAT PUMP
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 40 - Mechanical
GRADING. N CYDS: 0
TYPE OF C NSTRUCTION
RETAINING WALL ROCKERY:
OCCUPANT GROUP:
OCCUPANT LOAD -
FENCE: OXO FT-)
CODE: 2015
IOTHER: ------- OTHER DESC:
IZONE:
NUMBER OF STORIES: 0
VESTED DATE
NUMBER OF DWELLING UNIT S: 0
LOT #
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
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
BEDROOMS. 0 BATHROOM& 0
BEDROOMS: 0 BATHROOMS: 0
FRONTSFTRACK SIDESE11-BACK RLAR S F-11-113 AC K
REQUIRED: PROPOSED: IREQUIRED: PROPOSED: IREQUIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED:
SETBACK NOTES:
PLRMIT APPROVAL
I AGREE TO COMPLYWITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHEWORK AUTHORIZED
THEREBY,NO PERSONWILL BEEMPLOYED IN VIOLATION OF THE LABORCODE OFTHE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27
TI [IS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HISMER DEPUTY AND ALL FEES ARE PAID
A'tzz&#t, g!!� 01110312-0/7
Signature Print Name Date Releasedoy 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. UBCI 091 IBCI 10/ IRCI 10.
ONLINE APPLICANT = ASSESSOR 1z OT11FR
STATUS: ISSUED
BLD20170439
• Final approval on a projector final occupancy approval must be granted by the Building Official prior to use or occupancy of
the building or structure. Checkthejob 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.
• Sound/Noise 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 7:00amto 6:00pm on weekdays and 10:00arn 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
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 from the issuance for this permit. 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.
• 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.
• Heat pumps, AC units and similar equipment greater than 36 inches in height are not allowed within required building
setbacks.
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)
C.XLL FOR INSIIUX'TIONS
BUH-DING (425) 771-0220 EXT. 1333 --1— ENGINEERING (425) 771-0220 EXT. 1326 I—FIREN25) 775-7720
I PUBUC WORKS (425) 771-0235 1 PRE-TREATNIENT (425) 672-5755 1 RECYCLING (425) 275-480 �1
When calling for an inspection please leave the folloming information: Permit Number, Job Site Address, Type of Inspection being
requested, Contact Name and Phone Number, Date Prefereed, and mhether you prefer morning or afternoon.
. B-Mechanical Final
DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
1215 1h Avenue N, Edmonds, WA 98020
est. I Phone 425.771.0220 9 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 #:
?0 Ave W. ZJW?4qokjW A IM026
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes El No Ln
Associated Permit #:
APPLICANT:
Pec-4cnoee Tns 1Aov\ Zner6�Z
Phone: S-3
V2,5_- 313-4?
Fax:
1
Address (Street, City, State, ZY:
/5-0) f -9.,
E-Mail Address:
A. ( -�)@ ;-S444 h
PROPERTY OWNER:
Phone:
Fax:
Address (Street, City, State ip): ve- f 2026
N-70,31 7scif A
E-Mail Address:
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
I..
E-Mail Address:
WNTRACTOR:*
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
WA State License #[L-xp. Date:
*Contractor must have a valid City of Edmonds business license prior to doing work
?,--W
City Bus
s%�icense #/Exp. Date:
in the City. Contact the City Clerk's Office at 425.775.2525
PLUMBING MECHANICAL IN TANK
DEMOLITION
t0e4) ht�s�k6,g�,,
DETAIL THE SCOPE OF WORK:
i\e,,� P.- , j2
I declare underpenalty ofperjury laws that the information I have provided on this formlapplication is true, correct and complete,
and that I am theproperty owner or duly authorized agent of theproperty owner to submit apermit application to the City of
Edmonds.
TAZ Owner 0 Agent/Other rNCN (specify): C66kc 4 ONO(I
Print Name: LX
Signature: Date: q,
FORM C LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Form 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? Yes E] No E
Hydronic Heat in: FloorE] Wall 0
oor rat oor 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)
Air Handler / VAV
Gas #—Elec #—Other:— # CFM: <10k— >10k— Location(s)
(circle selected)
AC/Co
Boiler Hea(Punip
ca(
Tnjn�
Gas #—Elec #J_Other:_ #_ BTUs:—<100k, 100k-500k, sook-imil
Roof
HP: <3, 3-15, 15-30 Location(s) N)oA--� w4\\ cz� e-
(circle selected)
Hydronic Heating
Gas #—Elec #—In-Floor —Wall Radiant— Boiler BTUs: Location
Exhaust Fans (single
Bath # Kitchen #—Laundry # —0ther:_ #
duct)
Fireplace
Gas #—Elec #—Other:— # Location(s)
[Dryer Duct
Appliance Type
Appliance/Equipment Information (new and relocated)
Total #
AC Unit
BTUs: Location(s):_
Furnace
BTUs: — Location(s):
Water Heater
BTUs: — Location(s):
Boiler
BTUs: Location(s):
Other:
BTUs: Location(s);
Fireplace/Insert
BTUs: Location(s):-
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