20180611131935.pdfCITY OF ,ÐMONTÐS
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I2I 5TH AVENUENORTH. EDMONDS, WA 98020
PHONE: (425)771-0220 - FAX: (425)771-0221
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STATUS: ISSIIED 0611112018
Expiratinn Ðatc: i2lll l20l I
Parcel No: 0072480021 0600
#:797
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BTIILDING PERMIT
PROPRTYOWNER CONTRACTORAPPLICANT
PATRICK BRUCE DUNCAN
525 FORSYTH LN UNIT I06
EDMONDS, WA 98020
(42s) 640-8780
PATzuCK BRUCE DUNCAN
525 FORSYTH LN UNIT I06
EDMONDS, WA 98020
(42s) 640-8780
WALLNER PLUMBING INC
PO BOX 477
BOTHELL, WA 9804I
(425) 48t-3468
LICENSE #: WALLNPCOSSLH EXP:0412812019
JOB DESCRIPTION
REPLACEV/ATERHEATER
VALUATION: S0
PERMIT TYPE: Cor¡mercial PERMIT GROUP: 47 - Plunbing
GRADING: N CYDS: O TYPE OF CONSTRUCTION
RETAININGWALL ROCKERY OCCUPANT GROUP
OCCUPANT LOAD:
FF,NCIi' I OXO FT)coDF. 20 l 5
OTHER: ------- OTHER DESC:ZONE
NUMBER OF STORIES: O VESTED DATE:
NUMBER OF DWELLINGUNITS: O
BASEMENT: O IST FLOOR:0 2ND FLOOR: 0
LOT #
RASEMF,NT:O I 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 BATHROOMS:0 BEDROOMS:0 BATHROOMS:0
REOUIRED: PROPOSED:PROPOSEDREOUIREDREOUIRED: PROPOSED
REOUIRED PROPOSEDHEIGHT ALLOWED:0 PROPOSED:0
SETBACK NOTES:
SIDESETBACK REARSETBACKFRONTSETBACK
IAGREE TO COMPLY WITH CTTY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORZED
FERSON WILL BE EMH.OYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENISATION
INSURANCE AND RCW 1 8:27.
THEREBY, NO
UNTIL SIGNED THE OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID.THIS APFLICATION IS NOT A
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PERMIT APPROVAL
Dani¡e Nøßon Jraø ll,2ol3
Signature Rint Narne Date Released By Date
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTÍL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBCI O9l IBCI I O/ IRCI IO,
FIRE APPLICANT ASSESSOR CITY
CONDITIONS
STATUS: ISSUED 8LD20180797
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.
In addition to the required pressure/relief valve, an approved listed e>pans ion tank shall be installed on all hot water tanks. Per
UPC 608.
Final approval on a project or fural occupancy approval must be granted by the Building Offìcial prior to use or 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") fiom
adopted codes, ordinances or policies must be specifìcally 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 ptovisions which do not comply with city code and for which a variance has not been
specifically identified, requested and considered by the appropriate 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 fromtemporaly construction sites as a result of construction activity arç exempt flomthe noise limits
ofECC Chapter 5.30 only during the hours of 7:00amto 6:00pmon weekdays and l0:00am and 6:00pmon Saturdays, excluding
SundaysandFederalHolidays. Atallothertimesthenoiseoriginatingfromconstructionsites/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 indemnify defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all clairns for damages of
whatevernature, arising directþ orindirectfy fiomthe issuance forthis permit. Issuance ofthis permit shallnot be deemed to
modifi, waive or reduce any requirements of any Cify ordinance nor limit in any way the City's ability to enforce any ordinance
provis ion.
THIS PERMIIAUTHORZES ONLY THEWORK NOTED. THIS FERMIT COVERS WORK TO BE DONE ON PRIVATE FROFERTY ONLY. ANY
CONSTRUCTION ON THE R,IBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WLL REQUIRE SEPARATE FERMISSION. FERMIT
TIME LlMlr: SEE ECDC 19.00.005(A)(6)
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TNSPECTIONS
TO S C IIED tJL E lN S P tr--TION S
BUILDING ENGINEERTNG (425) 771-0220 EXT. 1326
1. Go to: \^,1 /v.edmondswa.gov
2. Then: Services
3. Then: Permits/Development
4. Then: Online Permit lnfo
5: lf you donÏ haw one already, create a
login (upper right hand corner)
6: Schedule your inspection
Building Department lnspections
are now scheduled online. lf you
hale diffculties, please call the
Building Department font desk for
assistance during offce hours.
(425) 771-0220
F|RE (425) 775-7720
PUBLT C WORKS (425) 77't -0235
RECYCLT NG (4251 27 s4801
When calling for an inspect ion please leave the following information: Permit Number, Job Site Address, Type of lnspection
Contact Name and Phone Number Date P and whether mornt or afternoon
B-Plumbing Final
c. 18
BUILDING PERMIT
APPTICATION
Developmenl Services
Building Division
l21 sth Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, perm¡t status and inspection
scheduling information go to: http://www.edmondswa.eov/
JOB SITE INFORMATION/IOCATION: (Where the work is taking place)
Job Site Address:
Parcel
Lot/unit/suitefj LÞ(? subdivision
PROPERTY OWNER:
Name:B.oebuvr*'n
Mailing Address: S"-S 6r=u{n Ln+ 84.,(
CitV/State/Zip
Phone#: 4ZS' ê4-Ð- gTbO
Email: Å
OWNER INSTALLATION: *lf yes, read and sign*
Willwork be performed by the property owner? I Ves ! tlo
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:
APPTICANT / CONTACT INFORMATION:
Name of Applicant:Satua.< outtræ
Mailing Address
City/State/Zip:
Phone #:
E-mail:
GENERAT CONTRACTOR: (lf different from applicant)
General Contractor
Mailing Address:
City/State/Zip
Phone #:4zs - 4*l - 34bb
E-mail:
wAsrATE CONTRACTOR r & | f (CCB) & EXPTRATTON DATE:
L-{-l
tu¿¡aotä Õ1q'7Permil #
.f f Iice Use tlr rlt
n Accessory Structure/
Detached Garage
! Addition
tr Demolition ! Mechanical
! New Single Family / Duplex fttumnine
-
F:---.----:.-l-l-.-Lr rrf e )pf ll rKler -
ñ-.---l-ltJ flEl I tuucl
tr New Commercial/ Mixed Use tr Re-Roof
! Signs tr Tank
E Tenant lmprovement U Other
Remodel Permll fees qre bqsed on:
The volue of The work performed. lndicoTe the volue (rounded to
.the neorest dollor) of oll equipment, moleriols, lobor, overheod,
ond the profit for the work indicoted on this opplicoiion.
Voluolion:
Finished tr Unfinished trBasement sq ft:
1st Floor, sq ft:
2nd Floor, sqft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
I certify that the information I have provided on this form/applicâtion 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
Other sq ft:
ß (-
o,r" t/t//8
-
Signature:
Edmonds.
Print Name:
IYPE OF PERMIT (Provide Detoils on Poge 2)
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
PROJECT DESCRIPTION
CITY OF EDMONDS BUSINESS LICENSE #:
Occupancy Group(s)Occupant Load(s)
Type(s) of Construction Fire Sprinklers: Yes E 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
permits are applied for separately.
Tl / CHANGE OF USE / NEW BLDG: lnclude TRAFFIC IMPACT worksheet
BTUS Gas / Elec / Other Qty
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? Y q@ t
Hydronic Heat Water Service Line
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 Other:
Type of structure to be demolished:
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 E Size of Tank (Gallons)
Critical Areas Determination:
Study Required E Conditional Waiver I Waiver n
Grading: Cut _ cubic yards
cubic yardsFill
Cut / Fill in Critical Area: Yes ! No D
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 & lndusÎries and have a
current City of Edmonds Business License.
GAS/FUEL CONNECTION COUNTS (New, Relocated or re-piped)
MEDICAL GAS, AIR VACUUM COUNTS
(New, Relocated or re-piped)
DEMOLITION
TANK
GRADE/FILL/EXCAVATE
GENERAL PROVISIONS