20170530131549.pdfCITY OF EDMONDS
121 5TH ANENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: ISSUED 05/30/2017 Pe rmillff: 'R LU4110 17 0 7 24
Expiration Date: 11/30/2017 tivollev. It Addreav .85 16 214 TH 13-L SWI LIMAJ 0 N D S
Parcel No: 0048660000 1000
TONY E & GINA M GALE TONY E & GINA M GALE TONY E & GINA M GALE
8516 214TH PL SW 8516 214TH PL SW 8516 214TH PL SW
EDMONDS, WA 98026-7317 EDMONDS, WA 98026-7317 EDMONDS, WA 98026-7317
(206) 719-0275 (206) 719-0275 (206) 719-0275
LICENSE #: EXP -
REPLACE GAS FURNANCE ADD A/C
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 40 - Mechanical
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION
RETAINING WALL ROCKERY:
OCCUPANT GROUP
OCCUPANT LOAD:
FENCE OXO FT)
CODE: 2017
OTHER: ------- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS: 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
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
,BEDROOMS: 0 BATHROOM& 0
1 BEDROOMS: 0 BATHROOMS: 0
FRONTSI—FRAUK
IREQUIRED: PROPOSED
SIDESVI"BACK 11 LA 11 S FI'B ACK
IREQUIRED: PROPOSED: f=QUIRED: PROPOSED:
1HEIGHT ALLOWED:O PROPOSED:O
IREQUIRED: PROPOSED:
ISETBACKNOTES:
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 RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
IIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HISMER DEPUTY AND ALL FEES ARE PAID
NLq- 30 -17 0513012-01
Print Name 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. UBC1091 IBC1 10/ IRCI 10.
ONLINE U�
APPLICANT ASSESSOR =-OTMR
STATUS: ISSUED
BLD20170724
* 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. Check the job card for all required City inspections including finalproject approval and fin at
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 7:00amto 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 indertmify 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 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
PERMITTIME LIMIT. SEE ECDC 19.00.005(A)(6)
CALL FOR INS PW.TIONS
BUILDING (425) 771-0220 EXT. 1333 ENGINMUNG (425) 771-0220 EXT. 1326 F11RE (425) 775-7720 771
I PUBLIC WORKS (425) 771-0235 1 PR&TREATMENT (425) 672-5755 1 RECYCLJNG (425) 275-480�1
When calling for an inspection please leaw the follo,"ing information: Permit Number, Job Site Address, Type of Inspection being
requested, Contact Name and Phone Number, Date Prefereed, and vvhether you prefer morning or afternoon.
. B-Mechanical Final
DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
1215 1h 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): (7600L(c
I C, I CA—) D/Vi
Parcel #:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? YesEj No X
Associated Permit #:
APPLICANT:
-F0 �j -f b-, PN Ly---
%ne-
d ( 5,'-7 1 '19Z 0 d 7 5
Address (Street, City, State, Zip :
F 5- � " PL �5 W , E 0 IV� 0 lu
E-Mail Address:
TcA_)TGf"A(9?
PROPERTY OWDLER—
6—� f
Phone:
�tc -71 7 5-
Fax:
Address (Street, City, State, Zip): q W0.2
D(40" PLC7,_UjIf��0AM5 W f\
E-Mail Address:
Tc''\_)-f 6 ALF_ 61y) Nit - L04
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:* �
Phone:
Fax:
Address (Street, City, State, Zip):
E-Mail Address:
*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
WA State License #/Exp. Date:
City Business License #/Exp. Date:
PLUMBING MECHANICAL TANKI
I DEMOLITION I I
DETAIL THE SCOPE OF WORK:
N- �b k/,/- pom P)
Ideclare underpenalty ofperjury laws that the information I have provided on this jormlapplication istrue, 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: pv L_ OwnerX Agent/Other (specify):
Signature: Date: o
FORMC LABuilding New Folder 2010\130NE & x-ferred to L-Building-New driveTorm C 2014.docx Updated: 1/17/2014
PLUMBING
Fixture Type (new and relocated)
Total #
FIXTURE COUNT
Fixture Type (new and relocated)
I
Totalr
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] No E]
Hydronic Heat in: FloorE] WallE]
Floor Drain/Floor Sink
Other:
Refrigerator water supply (for water/ice dispenser)
Other:
Equipment Type
Appliance/Equipment Information (new and relocated)
Total #
Furnace
Gas #KFI,, # Other: #'*X'11TUs: <100k >100k Location(s) CkhwL
Air Handler / VAV
(circle selected)
Gas #—Elec #—Other:— #_CFM: <10k— >10k— Location(s)
AC / Compressor
Boiler / Heat Pump I
Roof Top Unit
(circle selected)
Gas # X Elec #—Other:— # BTUs: <100k, 100k-500k, 500k-IMil
HP: <3, _��M-15, 15-30 Location(s) ti
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
Appliance Type
Appliance/Equipment Information (new and relocated)
Total #
AC Unit
BTUs: 40,Cocl Location(s): N L)
Furnace
BTUs: 40,C-C(D — Location(s):
Water Heater
BTUs: — Location(s):
Boiler
Other:
Fireplace/Insert
BTUs: Location(s):-
BTUs: Location(s):-
BTUs: Location(s):
Stove/Range/Oven
Dryer
Outdoor BBQ
TOTAL OUTLETS
FORMC L:\Building New Folder 2010\DONE & x-ferred to L-Building-New djive\Form C 2014.doex Updated: 1/17/2014