BLD20170410.pdfSTATUS: ISSUED 03/27/2
Expiration Date 09/27/2(
Parcel No: 00434208504000
PROPERTV OWNER
DANIEL J & ELISABETH C O'BRIEN
302 7TH AVE N
EDMONDS, WA 98020-3010
(425)361-5802
Replace waterline to house,
VALUATION: $0.00'
'CITY
1215TH A VENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 -`FAX: (425) 77.1-0221'
302 7TH AVE N
EDMONDS, WA 98020-3010
(425) 361-5802
CONTRACTOR
DANIEL 0 & ELISABETH C O BRIEN
302 7TH AVE N
EDMONDS, WA 98020-.3010'
(425) 361-5802
LICENSE 4:- EXP;
Ii 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 PPLICAT (M IS NOT r,PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID,_
Signature Print Nares Date Released Data
ATTENTION
ITIS 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/ IBC1 10/ IRCI 10„
m;
ONLINE ` APPLICANT ASSESSOR �1
BLD201704110
• Pursuant to UPC 605.2 a water service shutoff shall be installed on the water line as it enters the building.
• City approved plastic piping may be used in water service piping provided that where metal water service piping is used for
electrical grounding purposes, replacement piping shall be of like materials (UPC 604.8). A state electrical permit and
inspection is required if electrical grounding is altered, removed, improved, or added. Contact State Dept. of labor &
Industries Electrical Division at 425-290-1309.
• 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.
• 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.
0 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.
• Refer to City of Edmonds Water service'fine `handout for approved pipe materials, inspections and other requirements.
• Owner/Contractor to provide Water Service Line asbuilt at final inspection. See City Standards for requirements.
INSPECTIONS
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.
PERMITTIME'LIMIT: SEE ECDC 19,00,005(A)(6)
PUBLIC WORKS (425)771-0235 PRF TREATAIENT (425) 672-5755 RECYCLING 425 275-4801
When calling for an inspection please lease the following information: Permit Number, Job Site Address, Type of Inspection being
reggestcA Contact Name and Phone Nuinber Irate Prefereed. and Aiether you lEcter.morning or afternoon.
E -Water Service Line
1' L D al,r
1✓ r DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
1215" Avenue N, Edmonds, WA 98020
Sa 1 yak) Phone 425.771.0220 ft Fax 425.771.0221
City of Edmonds
PLEASE REFER TO THE PLUMBING & MECHANICAL CHECKLIST FOR SUBMITTAL REQUIREMENTS
PR" OBJECT ADDRESS (Street, Suite #, City State, Zip):
Parcel #:
�J /7--)
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes ❑ No ry
Associated Permit #:
APPLICANT:`
1;,r
Phone: Fax:
Address (Street, Cit St , Zip): v�
E -Mail A dr 8s: D r cv
PROPERTY OWNER: l'
I^1L>,
Phone: Fax:
s ,
Address (Street, City, Slate, Zip):7 h hoe f�
E -Mail Address:
LENDING AGENCY:
Phone: Fax:
Address (Street, City, State, Zip);
E -Mail Address:
CONTRACTOR:*
Phone: Fax:
Address (Street, City, State, 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:' k' .- ....... .
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 V1 ice' f h 1 e Owner ❑ Agent/Other ❑ (specify): ,.... „m
_
_....
Signature: Date:_ wm ...
._.__�...
FORM C LABuilding New Folder 2010\DONE & x-ferred to L -Building -New driveTonn 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, laundry, lavatory, bar, eye wash, etc Water mm
• � ) Service Line
_......_ ........� ,__ww .......w
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 _..... _. _..._....._.
upply (for water/ice dispenser) Other:
........ . . . .
NIECIIANICAL
Equipment Type Appliance/Equipment Information (new and relocated) Total #
Furnace II Gas # Flee #._....___Other:___________------- #_ BTUs: <100k,___. >100k_ Location(s)
Air Handler / VAV
Gas #Elec
#_
Other:
#._____CFM: <10k_ >10k_ Location(s)_
(circle selected)
,___...............
__
AC /Compressor /
Boiler / Heat Pump /
Gas #_Elec
#_Other:
#.............. BTUs:............,�<100k,.......,,,,,,,,,,,,,,,,,,,,,,,,,,_100k-SOOk, 500k-1Mil
Roof Top Unit
HP:
<3,
3-15. ...............
_15-30 Location(s) ...... ..w ............
(circle selected)
Hydronic Heating
Gas #_Elec
#_In
-Floor
_Wall Radiant_ Boiler BTUs: — Location.......,..
Exhaust Fans (single
Bath #_Kitchen
#_Laundry # ....... __�....... �...
duct)
Fireplace 1 Gas #_Elec #_Other: # l.,otatlon(s)
Dryer Duct
]."ORM C LABuilding New Folder 2010\130NE & x-ferred to L Building -New drive\Form C 2014.docx Updated: 1/17/2014