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ENG20170588-APPROVED PERMIT.pdf40'1,1941, 'O"ITY OF EDMONDS121 5TH AVENUE NORTH-,EDMONDS, WA`98020 cls" PHONE: (425) 771-0220 - FAX: (425) 771-0221 J l / Jf IiYDI i i l iiJ �J /Jllf rrnrr' «rrrru ➢irrl ripU'lf 11 Inr/mm�1g41 1/011411ra STATUS: ISSUED 05/02/2017BUILDING PERMIT ��1;111if1��i1��N�fi�„,r,,,,�l, Expiration Date: 11/02/2017 �� rL;��dln%/ rn� ,/,�l lxm�flll%; 1 1. � /urOr riiiitl f(lir /GfmUr%��/iiiiG��a/lir �'lier///l % Parcel No: 00642900000500 1P�., OWNER APPLICANTCONTRACTOR WORKS FAMILY LIVING TRUST WATER WATER 523 MAPLE ST UNIT 201 C/O VOYA BELIC C/O VOYA BELIC EDMONDS, WA 98020 5320 28TH AVE NW D-7 5320 28TH AVE NW D-7 SEATTLE, WA 98107 D-7 SEATTLE, WA 98107 (206)383-0508 LICENSE #- WATER"996LO EXP:02/02/2018 JOB DESCRIPTION Replace water heater. VALUATION:; $0.00 PERMIT TYPE: Residential PERMIT GROUP' 47 - Plumbing GRADING:N CYDS 0 TYPE OF CONSTRUCTION RETAINING WALL ROCKERY' OCCUPANT GROUP OCCUPANT LOAD: FENCE ( 0 X 0 FT) CODE OTHER ------- OTHER DESC ZONE" NUMBER OF STORIES. 0 VESTED DATE: , NUMBER OF DWELLING UNITS: 4 MS'I1NC,AREA PRO POS ED AREA BASEMENT. 0 1 ST FLOOR. 0 2ND FLOOR 0 BASEMENT 0 1 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 FRONT Ef RACK SIDESETBACK REQUIRED: PROPOSED. REQUIRED: PROPOSED, REQUIRED PROPOSED HEIGHT ALLOWED:O PROPOSED:O REQUIRED. PROPOSED SETBACK NOTES: APPROVALPERMIT I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORKAUTHORIZED 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, THISAPPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID, � M 1 nature rint Name Date Released 80)”Date ATTENTION ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNT1L A FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED UBC109/ IBCI 10/ IRCI 10, ONLINE APPLICANT ASSESSOR OTHER DEVELOPMENT SERVICES PLUMBING, MECHANICAL, TANK, & DEMOLITION PERMIT APPLICATION 1215 1h Avenue N, Edmonds, WA 98020 s r. li Phone 425.771.0220 A 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 #: eSZ e, SAC. C) 1 Associated Permit #: IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes ❑ No ❑ APPLICANT: Phone: Fax: Address (Street, City, Stat� Zip): r A / E -Mail Address: PROPERTY OWNER: Phone: If Address (Street, City, State, Zip): E -Mail Address: °L LENDING AGENCY: Phone: Fax: Address (Street, City, State, Zip): E -Mail Address: CONTRACTOR:* i A / A Phone: Fax: VvY�� Address (Streel, .lty, Slate, Zip): E -Mail Address: WA State License #/Exp. Date: *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 City Business License #/Exp. Date: PLUMBING MECHANICAL TANK DEMOLITION DETAIL THE SCOPE OF WORK _........� ..,,,, ". ........._. 61,_,_Ae.. `A ...... - _ —w . . . ....... . ..... --- ------- . . ..... -- Ideclare under penalty of perjurylaws 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: ......—Owner A ent/Other ❑ (specrfy):....... ...._.._... ....... _ Date: .m Signature: __.... _. FORM C LABuilding New Folder 2010\DONE & x-ferred to L Building -New driveTorm C 2014.docx Updated: 1/17/2014 PLUMBING FIXTURE COUNT Fixture Type (new and relocated) TotaIII Fixture Type (new and relocated)Water Closet (Toilet) Re X� Pressure � duction Valve/Pressure Regulator Sink (kitchen, laundry, lavatory, bar, eye wash, etc.) Water Service Line Tub/Shower Drinking Fountain . ,.. .........ww ..._ ....._....... 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: FORM C LABuilding New Folder 2010\130NE & x-ferred to L Building -New drive\Form C 2014.docx Updated: 1/17/2014