BLD20170607-APPROVED PERMIT.pdfCITY
121 5TH A VENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
Parcel No: 00592200000600
IPROPERTVOWNER1 . 1 .
JOHN MURPHY JOHN MURPHY A QUALITY HEATING'
23510 93RD AVE W 23510 93RD AVE W C/O DAVID ZAHINA
EDMONDS, WA 98020EDMONDS, WA 98020 1429 AVENUE D, #392
SNOHOMISH, WA 98290
(206)794-3326
LICENSE E; AQIjALHC86I B9 EXP.O 1 /29/201
JOB DESCRIPTION
Replace electric furnace with gas furnace.
VALUATION: $0.00
PERMIT.. 1
I 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 APPLI'4,w ' (8OS° (Yl'* A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE .PAID,
ATTENTION
IT IS 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 UBC109/ IBCI 10/ IRC 110,
ONLINE' APPLICANT ' ASSESSOR OTHFR
R
.dgt I:y.,
City of Edmonds
DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
121 5h Avenue N, Edmonds, WA 98020
Phone 425.771.0220 ft Fax 425.771.0221
PLEASE REFER TO THE PLUMBING & MECHANICAL CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip): Parcel #:
y0� 2 go A-✓ N,
Associated Permit #:
�+ "i,al Yes No ❑ 45 ri /�' X72Se h��1
IS THIS WORK ASSOCIATED WITH PI � 13 �
ANOTHER t)JI:," ��
APPLICANT: 1 O ` f� �r Phone: Fax:
Address (Street, City, State, Zip): E -Mail Address:
PROPERTY OWNER:
J40
P
Phone:
Fax:
Add .s St. t, City, SOC
1 w �' °�2
A
Mail Aci�dt� ss
LENDING AGENCY:
Address (Street, City, State, :i?'i ft ___
CONTRACTOR:*
h—Ow�/nl
�-70c—
Address (Street„ CityX
ar, Zip):
IqZ2
*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
PLUMBING I I MECHANICAL 1___1 TANK
Phone: Fax:
E -Mail Address:
Phone: Fax:
E -Mail Address:
W/ S d 1,411se #JL Oag
City Business Ldi�cense #/Exp. Date:
DEMOLITION
DETAIL THE SCOPE OF WORK:
m.. ..
I declare under penalty of perjury laws that the information I have provided on this form/application 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
Edmonds.
Print Name: OwnergAgentlOther ❑ (specify):
Signature: w... Date: lst�WZ�., .�.
.
FORM
C LABuilding New Folder 2010\DONE & x-ferred to LrBuilding-New driveTorm C 2014.docx Updated: 1/17/2014
Fixture Type (new and relocated) Total # Fixture Type (new and relocated) Total #
Water Closet (Toilet) Pressure Reduction Valve/Pressure Regulator
.......... ._.
Sink (kitchen wash, etc.)
laundry, lavatory, bar, eye wa _ .........
Water Service Line
Tub/Shower Drinking Fountain
Dishwasher __. _.. Clothes Washer
Hose Bib _ ^ ^ _ Backflow Prevention Device (e.g. RBPA, DCDA, AVB)
Water Heater Tankless? Yes ❑ No ❑ Hydronic Heat in: Floor ❑ Wall ❑
Floor Drain/Floor Sink Other:
Refrigerator water supply (for water/ice dispenser) Other:
Equipment Type
Appliance/Equipment Information (new and relocated)
Total #
Furnace
Gas 0-+W1cc #_Other:
# BTUs: <100k_ >100k_
Location(s)_...IT.,�,.
Air Handler /)
Gas #_Elec
#_Other:
#_CFM: <10k— >10k_
Location(s) .........,
(circle selected)
AC / Compressor /
Boiler / Heat Pump /
Gas #_Elec
#_Other:
______ # BTUs: <100k,
100k -500k, 500k-1Mil
Roof Top Unit
HP:
<3,
3-159 ..............-15-30 Location(s)
(circle selected)
Hydronic Heating
Gas #_Elec
#_In
-Floor _Wall Radiant_ Boiler BTUs:____-----
Location....._._ _ ._....._
Exhaust Fans (single
Bath #_Kitchen
#_Laundry # Otlrtr:. v_.._..w_..........._........
_... .._
duct)
Fireplace
Gas #_Elec
#_Other:
# IrttcsttioB(/a), _
..w ..............._.._..._ --..--.--.—
Dryer Duct
FORM C L:\Building New Folder 2010\DONE & x-ferred to L -Building -New drive\Form C 2014.docx Updated: 1/17/2014