BLD20110841.pdfOF EDMO�
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
S90
STATUS: ISSUED 10/4/2011
Expiration Date: 4/4/2012
Parcel No: 00434400600300
WILLIAM & DONA FOX WILLIAM & DONA FOX
117 4TH AVE NORTH 1 17 4TH AVE NORTH
EDMONDS,, WA 98020 EDMONDS_ WA 98020
(425)772-8549 (425)772-8549
HOMEOWNER EXEMPTION TAKEN
LICENSE #: EXP:
NEW GAS PIPING TO 94k BTU BOILER IN BASEMENT.
w 10
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 47 - Plumbing
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N 0 X 0 FT.)
CODE: 09
OTHER: N ----- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS: 0
LOT #:
BASEMENT: 0 IST FLOOR: 0 2ND FLOOR: 0
BASEMENT: 0 1ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FRONTSETBACK SIDE SETBACK REAR SETBACK
E UIRED: PROPOSED: I REQUIRED: PROPOSED: RE UIRED: PROPOSED:
[EIGHT ALLOWED:O PROPOSED:O I REQUIRED: PROPOSED:
ETBACK NOTES:
1 AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE 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 AP LICATION I OT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY D ALL FEES ARE PAID.
& /
Signatu a Print Name Date Released By ffate
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC109/ IBC110/ IRCI10.
ONLINE APPLICANT ASSESSOR OTHER
STATUS: ISSUED BLD20110841
• Gas pipe test must be observed by City Building Inspector, affidavits shall not be accepted.
• 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 the job card for all required City inspections including final project approval and final
occupancy inspections.
• Provide combustion air per IMC Chapter 7 for commercial and multi -family residential installations, and IRC Chapter 17 for
one and two-family dwellings.
• 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.
• Sound/Noise 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 7:00am to 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 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 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.
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)
CALL FOR INSPECTIONS
BUILDING 425 771-0220 EXT, 1333 ENGINEERING 425) 771-0220 EXT. 1326 FIRE 425 775-7720
PUBLIC WORKS (425).771-0235 1 PRE-TREATMENT 425) 672-5755 1 RECYCLING 425) 275-4801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection
being reauested, Contact Name and Phone Number, Date Prefereed, and whether you prefer morning or afternoon.
• B -Gas Test/Pipe
• B -Mechanical Final
11/7/2011 4:01:25 PM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 1 of 1
of E°M�ti Inspection
Comments
BLD20110841
47 - Plumbing
Applied: 10/04/2011
Issued: 10/04/2011
Expires:
04/04/2012
R90
Address: 117 4TH AVE N, EDMONDS
INSPECTION
DATE
ACTION
1128 - B -Gas Test/Pipe
_ _INSPECTOR
10/26/2011
STEINIKE
COR
Comment: Left door tag!
1128 - B -Gas Test/Pipe
10/27/2011
LAWLER
COR
Comment: left correction notice
1128 - B -Gas Test/Pipe
10/28/2011
STEINIKE
CMP
Comment:
1156 - B -Mechanical Final
11/04/2011
STEINIKE
CMP
Comment:
11/7/2011 4:01:25 PM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 1 of 1