20050434.pdf' DATE RECEIVED .r
lo < PERMIT EXPIRES
CITY OF EDMONDS NUMBER
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT"
ADDRESS
OWNER NAMEINAME OF BUSINESS 738 Spruce St
Rand/Keri Ingham PLAT NAME ISUBDIVISION NO. LOT NO. LID NO.
W MAILINGADDRESS FEES
3
738 Spruce St PUBLIC RIGHT OF WPfil17 T p ESC roved
O �/n'�VY ogmrR o
ertnil Rnyurod D
CITY LIP TELEPHONE EXISTING ---� I� rVIV � I ocoon Roquued O
Edmonds 98020 425-774-8859 REQUIRED DEDI�ATI N �y�• ��N eugrowa .O
Winn required
NAME METER SIZE I SIZEA'C�!.'� S PRV REQUIRED
t7
F YES � NO O =
Iuu �
t ADDRESS REMA • w
w
OWNE T 0�0� ROL/DRAINAG _
17
a t Z
CITY ZIP TELEPHONE ressure/relleh Valveg an approved
W
listed expansion tanks a e
NAME CB installed on a o water
Fast Water Heater ENGIN I I Y DATE I
z ADDRESS .., ... �....-..._.. _..• .
1.2601 132 Ave NE
FIRE REVIEWED BY �iTId.SUAN I TO USC ATE
CITY ZIP TELEPHONE ApR ,MUREREGULATORVALVE0
Kirkland 98034 425-814-3124 LL
SEPA
STATE LICENSE NUMBER EXPIRATION DATE HECKED BY VARIANCE OR CU yy-�S
C V Y� COMPLETEDED
EXEMPT
FASTWHC052DF 2-16-07 WATERI Y
NO
C PROPERTY TAX ACCOUNT PARCEL NO. CAN — `HA�✓gNEBg NSTALM O T�IEIGH EIGHT
UJI 00434500501600 STUDY O INE •AS ITC ��
❑ / LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
NEW RESIDENTIAL �pLUMBING MECH
ALLOWED PROPOSED FRONT SIDE REA E REAR
1G� Vw-� ❑ COMMERCIAL COMPLIANCE OR +,,,,,,- ��"""""'•""Y+
tOCS required
❑ MIXED USE ❑ CHANGE OF USE Z
REMODEL%0tV'ff)AiAFtz;:�I[� p�DAT❑ ❑ MULTIFAMILY ❑ SIGN REQ�J 1�i11<i aC C 803.2
GRADING FENCE
❑ REPAIR ❑ CYDS ❑ I. X FT.) REM fWAR11 -a
❑ DEMOLISH ❑ TANK ❑ OTHER
GARAGE RETAINING Z ❑ CARPORT ❑ WALL ❑ FIRE LER
ROCKERY FIRE.ALARM
I= (TYPE OF USE, BUSINESS OR CTIVITYXP
'hL/J TYPE OF CONSTRUCT ON CODE OCCUPANT
U /� GROUP
Lj
0 NUMBER — / NUMBER OF NT '
OF � DWELLING � SPECIAL INSPECTION CONSULTANT OCCUPANT
O
STORIES UNITS LOAD
-� REQUIRED O YES
DESCRIBE WORK TO BE DONE
Remove Ore lace gas waLe heater in qara a REMARKS z
D
40,000 btu ' s GEOTECH REPORT m
BY:
STRUCTURAL DESIGN
BY:
NO 1XW am ( VALUATION
L $
Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE LOT SLOPE% VESTED DATE f P�
Building Permit City Surcharge 1 . , V
PLAN CHECK NO: Plumbing, Base Fee , , )6
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO Mechanical
iBE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBIC Grading
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,) WILL REQUIRE
I= SEPARATE PERMISSION.
Engr. Review
W PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
oI PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr• Inspection
*APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
II EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
rALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
= FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,•
Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT 1 AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application is not a permituntil signed by the
CALL
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC• Building Official or his/her Deputy: and Fees are aid, and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED 0 p Y' p
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27. O IA GW" ATE
SIGNATURE (OWNE GENT): w DATE SIGNED (425)
lee
✓0"0 771 -0220 RELE bATE
ATTENTION EXT. 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL . FILE YELLOW • INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC109 / IBC110 / IRC1100 PINK • OWNER GOLD • ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
Z
0
m
Co. _
C
m0
�O
On
C
_ M
M
10
Z
N
Q
M m0. !.
ON
n r
C �
CCO)
r Z r
i
-'i
= i
I) Z
I
Z i
0
n
M
M