20170411143215.pdf(q 1-0�11
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 04/11/2017 Pemihhf: B LD.-ZO 170490
Expiration Date: 10/11/2017 Projeet Addresv.. 1232 HIGMAND DR, EDINTIONDS
Parcel No: 00423000000600
GAYfgE BARRETT GAYhE BARRETT PLUMBING MASTERS NW LLC
1232 HIGHLAND DR 1232 HIGHLAND DR C/O ROBERT THOMAS
EDMONDS, WA 98020-2952 EDMONDS, WA 98020-2952 3508 105TH PLACE SE
EVERETT, WA 98208
(425) 478-0867 (425) 478-0867 (425) 948-7705
LICENSE #: PLUMBMN843QQ EXP: 11/18/2018
JOB QLSCRIPTION
WATER LINE REPAIR
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 47 - Plumbing
GRADING: N CYDS: 0
YPE OF CO STRUCTION
RETAINING WALL ROCKERY:
OCCUPANT GROUP
OCCUPANT LOAD:
FENCE: 0 X 0 FT.)
CODE: 2015
OTHER: ------- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DA E:
NUMBER OF DWELLING UNITS: 0
LOT
BASEMENT: 0 1ST FLOOR: 0 2ND FLOOR: 0
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
,3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
URD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
IBEDROOMS: 0 BATHROOMS: 0
1 BEDROOMS: 0 BATHROOMS: 0
FRONTSEFRACK SIDESFI-BACK RLMI S L-l'BA('k
REQUIRED: PROPOSED: --7REQUIRED: PROPOSED: IREQUIRED: PROPOSED
HEIGHT ALLOWED:O PROPOSED:O IREQUIRED: PROPOSED:
SETBACK NOTES:
PERMIT %PPl1O%/A1-,
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHE 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
THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID.
Print Name Date
ATTENTION
A'u.� Qo� 0-1111112-017
ed Bv// Date
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 UBCI09/ IBCI 10/ IRC1 10
ONLINE APPLICANT ASSESSOR ra;q OTMM P
I
STATUS: ISSUED BLD20170490
• City approved plastic piping may be used in water service piping provided that where metal water service piping is used for
electrical grounding purposes, replacement piping shall be of like materials (UPC 604.8). A state electrical penuit and
inspection is required if electrical grounding is altered, removed, improved, or added. Contact State Dept. of Labor &
Industries Electrical Division at 425-290-1309.
• 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 fi-om the noise limits
of ECC Chapter 5.30 only during the hours of 7:00arn to 6:00pm on weekdays and 10:00arn and 6:00prn 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 fi-om 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.
• Refer to City of Edmonds Water service line handout for approved pipe materials, inspections and other requirements.
• 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 19.00.005(A)(6)
PUBLIC WORKS (425) 771-0235 PR&TREATMENT (425) 672-5755 T RECYCLJNG (425) 2
When calling for an ins pection please leave the follo-Aing information: Permit Number, Job Site Address, Type of Inspection being
reques(ed, Contact Name and Phone Number, Date 11refereed, and mbether you prefer morning or afternoon.
. E-Water Service Line
DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
121 5�'Avenue N, Edmonds, WA 98020
"S� Q� 9.,�3 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 #:
1.11;Z yj
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? YesE] No%
Associated Permit #:
APPLICANT:
C_:E!�-e,
Phone:
-47-C 479-6S67
Fax:
Address (Street, City, State, 7ip):
E-Mail Address:
I -Z;�,Z Hia kle-&-i 1�" ye" '7,9,02Z
E!�.
PROPERTY OWNER:
be
Phone: V
Fax:
I
V- - C,*y-Le5 -wed
Address (Street, City, State, Zip):
cl.802.4
E-Mail Address:
1277Z 6,�� Wk
LENDING AGENCY:
Phone:
Fax:
t-06-tJkU L-f7=
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:*
Tkt, -PC4__�Ls�= "_g4e�
Phone:
q-,4,5, �V7 - I Co 00
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
F -I ILI 17--� P1 :;,P— -7
WA State License #/Exp. Date:
*Contractor must have a valid City of Edmonds business license prior to doing work
ness License #/Exp. Date:
in the City. Contact the City Clerk's Office at 425.775.2525
PLUMBING JAI MECHANICAL L TANKI
I DEMOLITION[
DETAIL THE SCOPE OF WORK:
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.
r
Print Name: Z - Ownerp� Agent/Other D (specify):
I
Date: !Lbl / I -f
Signature: 16� �0 , .
FORM C LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drive\Form C 2014.docx Updated: 1/17/2014
1006AL