20180611131857.pdftil
CTTY OF EDMONÐS
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I2I 5TH AVENTIENORTH - EDMONDS, WA 98020
PHONE: (425)771-0220 - FAX: (425)77t-0221
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STATUS: ISSIIED 06llll20t8
Expiration Date :'i,2 lll 12018
Parcel No: 0072480021 1000
IB
BIIILDING PERMIT
PROPERTYOWNR CONTRACTORAPPLICANT
CHRISTA JEFFERY
525 FORSYTH LN #I IO
EDMONDS, WA 98020
(206) 37s-0 l 83
CHRISTA JEFFERY
525 FORSYTH LN #I IO
EDMONDS, WA 98020
(206) 37s-0 l 83
WALLNER PLUMBING INL
PO BOX 477
BOTHELL, WA 9804 I
(42s) 48t-3468
LICENSE #: WALLNPCOS 8LH F.XP O4t28l20t9
JOB DESCRIPTION
REPLACEV/ATERHEATER
VALUATION: $0
PERMIT GROUP: 47 - PlrunbingPERMIT TYPE: Commercial
TYPE OF CONSTRUCTION:CYDS: OGRADING: N
OCCI]PANT GROUPRETAINING WALL ROCKERY
OCCUPANT LOAD
CODE:2015FENCE: ( 0X0 FT.)
ZONE:OTHER: ------- OTHER DESC
VESTED DATENUMBER OF STORIES: O
IST FLOOR:0 2ND FLOOR: 0
LOT #
BASEMENT:O
OF DWELLINGUNITS: O
FI,OOR: O
DECK:0 OTHER:03RD FLOOR:0 GARAGE:03RD FLOOR:0 GARAGE:0 DECK:0 OTHER:0
BEDROOMS:0 BATHROOMS:0BEDROOMS:0 BATHROOMS:0
PIÌOPOSED AIIFÂ[XIS'I'IN(; ARE{
PROPOSED:PROPOSEDPROPOSED
PROPOSEDIREDHE,IGFIT ALLOWED:0 PROPOSED:0
SETBACK NOTES:
REARSETBACKSIDESE-TBACKFRONTSUTBACK
TING CONSTRUCTION AND IN DOING THE WORK AUTHORZED THEREBY, NO
PERSON WILL BE EMH.OYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RE.ATING TO WORKMEN'S COMFENSATION
INSURANCE AND RCW 1 8:27.
IAGREE TO COMPLY WTH CTTY AND STATE LAWS REGULA
THIS AFPLICATION IS NOTA FERMT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID.
PERMIT APPROVAL
LA Døni¡ø Nøßon Junø ll,2ol8
Signature Print Name Date Released By Date
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTL A FINAL INSPECT'ION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBCI O9l IBCI IOi IRCI I O.
FIRE APPLICANT ASSESSOR
CONDITIONS
STATUS: ISSUED 8LD20180798
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 folBuilding Inspector.
In addition to the required pressure/reliefvalve, an approved listed e>pansion tank shall be installed on all hot watertanks. Per
UPC 608.
Final approval on a project or final occupancy approval must be granted by the Building Offcial prior to use oÍ occupancy of
the building or structure. Checkthe job card for all required City inspections including final project approval and final
occupancy inspections.
Any request for altemate design, modification, variance or other administrative deviation (hereinafter "variance") û'om
adopted codes, ordinances or policies must be specificalþ 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-refi.lndable.
Approval of any plat or plan containing pt'ovisions which do not comply with city code and for which a variance has not been
specificalþ identified, requested and considered by the appropliate cify official in accordance with the appropriate provision
ofcity code or state law does not approve any items not to code specification.
Sound/Noise originating fiomtemporary construction sites as a result of construction activity are exempt fi'omthe noise limits
ofECC Chapter 5.30 onþ during the hours of 7:00amto 6:00pm on weekdays and 10:00am and 6:00pmon Saturdays, excluding
SundaysandFederalHolidays. Atallothertimesthenoiseoriginatingfiomconstructionsites/activitiesmustcompþwiththe
noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30. 120.
Applicant, on behalf ofhis or her spouse, heirs, assigns, and successors in interests, agrees to indemni|l defend and hold
harmless the City of Edmonds, Washington, its offìcials, employees, and agents from any and all claims for damages of
whatever nature, aris ing directþ or indirectþ fi'om the issuance for this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requit'ements of any Cify ordinance nor limit in any way the City's ability to enforce any ordinance
provision.
THIS FERMTT AUTHORIZ ES ONLY THE WORK NOTED. THIS FERMT COVERS WORK TO BE DONE ON FRIVATE FROPERry ONLY. ANY
CONSTRUCTION ON THE R,,BLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WLL REQUIRE SEPARATE FERMISSION. PERMIT
TIME LlMll-: SEE ECDC r 9.00.005(A)(6)
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TO SCHEDULE INSPTTTIONS
BUILDING ENGTNEERTNG (425) 771-0220 EXT. 1326
1. Go to: un¡nry.edmondswa.gov
2. Then: Senices
3. Then: Permits/Dewlopment
4. Then: Online Permit lnfo
5: lf you don't har,e one already, create a
login (upper right hand corner)
6: Schedule your ¡nspection
Building Department lnspections
are now scheduled online. lf you
haw dificulties, please call the
Building Department font desk for
assistance during offce hours.
(425) 771-0220
FIRE (425) 775-7720
PUBL| C WORKS (42s1771-023s
RECYCLT NG (4251 27 s4801
When calli ng for an tn S pecti on please ea\e the followi ng inform ation:Perm it N umber Job S ite Address Type of lnspection
Contact Nam e and P hone Num ber Date Prefened and whether m orni or aftern oon.
B-Plumbing Final
¿c. 18
BUITDING PERMIT
APPLICATION
Developmenl Services
Building Division
l2l sth Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, perm¡t status and inspection
scheduling information go to: @
JOB SITE INFORMATION/LOCAT¡ON: (Where the work is taking place!
lnh site A.ddress: SZs
Parcel:
Lot/Unit/Suitef: I IA Subdivision:
PROPERW OWNER:
Name: C
Mailing Address:+
city/state/Zip:
Ph'one #: fu¿-'- 413- o l"-9
Email: C.
OWNER INSTALTATION: *lf yes, read and sign*
Will work be performed by the property owner? D Yes
I own, reside in, or will reside in the completed structure.
This installation is being made on property that I own which is
not intended for sale, lease, rent, or exchange according to
RCW 18.27.090.
Owner Signature:
APPttCANT / CONTACT INFORMATION:
Name of Applicat: Sa+ne-, a.S oW l**'
Mailing Address:
City/State/Zip:
Phone #:
E-mail:
GENERAT CONTRACTOR: (lf different from applicant)
General Contractor:
Mailing Address
City/State/Zip:
Phone #:4zs ^Abl'z*u
K"
t-mai| W4 wa,
wA STATE CONTRACTOR L & I f (CCB) & EXPIRATION DATE:
gPermit #:
lff rct; lJse tf nir
tr AdditionI Accessory Structure/
Detached Garage
tr Mechanicaltr Demolition
(elumbins! New Single Family / Duplex
n Remocieitr Fire Sprinkler
tr Re-Rooftr New Commercial/ Mixed Use
! Tank! Signs
tr Other! Tenant lmprovement
Remodel Permil fees ore bosed on:
The volue of the work performed. lndicole the volue (rounded lo
the neoresl dollor) of oll equipment, moteriols, lobor, overheod,
ond the profit for the workindicoted on lhis opplicolion.
Voluolion
Finished tr Unfinished EBasement sq ft
1st Floor, sq ft:
2nd Floor, sq ft
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
I certify that the information I have provided on this form/appl¡cation is true,
correct and complete, and that I am the property owner or duly authorized
Other sq ft:
ate
property to submit a perm¡t
Print Name:
S¡gnature:
to the City ofagent of the
Edmonds.
TYPE Ot PERMIT (Provide Deloíls on Poge 2)
PROPOSED NEW SQUNNE FOOTAGE FOR THIS APPLICATION
PROJECT DESCRIPTION
CITY OF EDMONDS BUSINESS TICENSE $:
a
Occupancy Group(s):Occupant Load(s):
Type(s) of Construction:Fire Sprinklers: Yes fl No E
WA STATE ENERGY CODE: lf your project affects the building envelope,
mechanical systems, and/or lighting, you must complete the
appropriate WSEC forms.
DEFERRED SUBMITTALS: All commercial building permits that will require
associated plumbing, mechanical, fire sprinkler, and/or fire alarm
perm¡ts are applied for separately.
Tl / CHANGE OF USE / NEW BLDG: tnclude TRAFFTC tMpACT worksheet
BTUs Gas / Elec / Other ety
A/C Unit /Compressor
Air Handler /VAV
Boiler
Dryer Duct
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
Other:
Qtv Qtv
Clothes Washer Tub/ Showers
Dishwasher Backflow Device (RPBA, DCDA, AVB)
Drinking Fountain Pressure Reduction/ Regulator Valve
Floor Drain/Sink Refrigerator Water Supply
Hose Bibs Water Heater - Tankless? t o@ I
Hydronic Heat Water Service L¡ne
Sinks Other:
Toilets Other
GENERAL COMMERCIAL DATA
MECHANICAL EQUIPMENT COUNTS (New and Relocated)
PLUMBING FIXTURE COUNTS (New, Relocated or re-piped)
BTUs Qty BTUs Qty
A/C Unit Outdoor BBQ/ Fire pit
Boiler Stove/Range/Oven
Dryer Water Heater
Fireplace/ lnsert Other:
Furnace Other:
Qtv Qtv
Carbon Dioxide Nitrous Oxide
Helium Oxygen
Medical Air Other:
Medical - Surgical Vacuum
Type of structure to be demolished:
Other:
Square footage of structure to be demolished
AHERA Surveydone? Y/N PSCAA Case #:
Critical Areas Determination:
Study Required E Conditional Waiver E Waiver E
Fill in Place ! Fill Material:
Removal n Size of Tank (Gallons)
Critical Areas Determination:
Study Required E Conditional Waiver E Waiver E
Grading: Cut cubic yards
cubic yardsFill
Cut / Fill in Critical Area: yes E No E
APPLICATIONS: Applications are valid for a maximum of l year
ESLHA Applications, 2 years.
LICENSING: All contractors and subcontractors are required to be licensed
with Washington State Department of Labor & lndustr¡es and have a
current City of Edmonds Business License.
GAS/FUEL CONNECTTON COUNTS (New, Relocated or re-piped)
MEDICAL GAS, AIR VACUUM COUNTS
(New, Relocated or re-piped)
DEMOLITION
TANK
GRADE/FILL/EXCAVATE
GENERAL PROVISIONS