20170718111638.pdfCITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
STATUS: APPLIED
ExpirationDate: 01/10/2018
Parcel No: 00741200000300
20 170963
EDMONDS
JEFFREY F BRAY BENNETT CONSTRUCTION, INC BENNETT CONSTRUCTION, INC
6808 162ND PL SW 16506 68TH AVE W 16506 68TH AVE W
EDMONDS, WA 98026 LYNNWOOD, WA 98037- LYNNWOOD, WA 98037-
(425) 743-6725 (425) 743-6725
LICENSE 4: BENNEI*984NG EXP:08/07/2012
INSTALL BATH FAN AND PET SINK IN EXISTING LAUNDRY ROOM. INSTALL STACKABLE WA SHER AND DRYER -
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 47 - Plw-nbing
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY
OCCUPANT GROUP.
OCCUPANT LOAD:
FENCE: OXO FT)
CODE: 2015
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
_M1491
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
ORD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
ORD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
I BEDROOMS: 0 BATHROOMS: 0
1 BEDROOMS: 0 BATHROOMS: 0
FRONTS EFBACK SIDESFTBAUK REAR SL-l'BACK
REQUIRED: PROPOSED: ��REQUIRED: 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.
TI [IS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS(HER DEPUTY AND ALL FEES ARE PAID
-7/,(41//-7 A'u4&-y' (--)ezgw' 0 711 0 / 7
7Y'--
Print Narne
Ae -
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUP Y A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED UBC1091IBC110/IRCIIO
lAe—'
ONLINE APPLICANT ASSESSOR OTIIER
STATUS:A��PiAD_ BLD20170963
COM)ITIONS
• 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. Cbeckthejob card for all required City inspections including final project approval and final
occupancyinspections.
• 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 vdth 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 timits
of ECC Chapter 5.30 only during the hours of 7:00amto 6:00prn on weekdays and 10:00arn 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 lirnits 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 pennit. Issuance of this permit shall Dot 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.
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 INS11FUTIONS
BUILDING (425) 771-0220 EXT. 1333 ENGINF"ING (425) 771-0220 EXT. 1326 FIRE (425) 775-7720
PUBLIC WORKS (425) 771-0235 PR&TREATMENT (425) 672-5755 RECYCLING (425) 2754801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection being
requested, Contact Name and Phone Number, Date Prefereed, and whether you tirefer morning or afternoon.
• B-Plumb Rough In
• B-Plumbing Final
• B-Mechanical Final
J DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
1h
121 5 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 #:
(95�0,r (jZ PL
Associated Permit #:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes [] No [;il
APPLICANT:
6n.060
PVne:
Is'-),,"K ano 2
Fax:
1
Address (Street, City, State, Zip):
L--VW^1,_10 00
E-Mail Address:
-3 f�� --, i
je-gWo 4-
PROPERI , V/)WNER:
JE67 / C-rW13 ill' -so-t—v
Phone:
Fax:
I
Address (Street, City, State, Zip):
E-Mail Address:
11�7 NG AGENCY:
Phone:
Fax:
^ ss (Street, City, State, Zip):
E-Mail Address:
CONTRACTOR:*
Phone:
Fax:
Address (Street, City, State, Zip):
J 5&03'7
E-Mail Address:
5_41�
WA State License #/Exp. Date:
*Contractor must have a valid City of Edmonds business license prior to doing work
Z-44 C-0 I
City Business License tt/Exp. Date:
in the City. Contact the City Clerk's Office at 425.775.2525
PLUMBING MECHANICAL TANK
DEMOLITION
DETAIL THE SCOPE OF WORK:
I declare under penalty 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 t binit a permit application to the City of
Edmonds.
;Agent/Other
Print Name: ------ 1, Owner 0 (specify):
Signature: Date:
le--1
FORM C LAB uil di n g New Folder 201 O\DONE & x-ferred to L-13 ui I di ng-New drive\Form C 2014. docx Updated: 1/17/2014
PLUMBING
Fixture Type (new and relocated)
Total #
FIXTURE COUNT
Fixture Type (new and relocated)
Total #
Water Closet (Toilet)
Pressure Reduction Valve/Pressure Regulator
Sink (Idtchen, laundry, lavatory, bar, eye wash, etc.)
Water Service Line
Tub/Shower
Drinking Fountain
Dishwasher
lothes Washer
Rose Bib
Backflow Prevention Device (e.g. RBPA, DCDA, AVB)
Water Heater Tankless? Yes [;:] No
Hydronic Heat in: Floor WallE]
Floor Drain/Floor Sink
Other:
Refrigerator water supply (for water/ice dispenser)
Other:
Equipment Type
�Mvj I MM I ���
Appliance/Equipment Information (new and relocated)
Total #
Furnace
Gas #—Elec
#
Other:— # BTUs: <100k— >100k—
Location(s)
Air Handier / VAV
Gas #—Elec
#—Other:—
#—CFM: <10k— >10k—
Location(s)
(circle selected)
AC / Compressor
Boiler / Heat Pump
Gas #—Elec
#—Other:—
# BTUs: <100k,
100k-500k, 500k-IMil
Roof Top Unit
HP:
<3,
_3-15, — 15-30 Location(s)
(circle selected)
Hydronic Heating
Gas #—Elec
#—In-Floor
—Wall Radiant— Boiler BTUs:—
Location
Exhaust Fans (single
Bath#
( Kitchen # Laundry # _01her:
#
duct)
Fireplace
Gas #—Elec
#—Other:—
# Location(s)
Dryer Duct
I
I
to IN
Appliance Type
- �� -
Appliance/Eqnipment 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
FORMC L\Building New Folder 2010\DONE & x-ferred to L-Building-New driveTorm C 2014.doex Updated: 1/] 7/2014
A,