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22015 99TH PL W.pdf�q SHINGTOW CITY OF EDMONDSo WA BUILDING PERMIT Applicant hereby certifies that a plot, plan, drawings, and sufficient details to indicate the intention to fulfill all requirements of this code are attached hereto. Application is hereby made for permit to do the following work: ............................................... .......... ............................................................................ ......................................................................................................................... . . ..... . ...................... . ............................ . ...................... . ................ . .... . .... . ...... . . ................... ..... . ................................................................................. ......... Lot....................................................... Block . ............................. .. ....... ..... ....... .. ................................... . ............................ '/ " 'P 41- 1. Building dimensions ..................... ... I ...... A ................................ 2. Lot dimensions ................. �/�' ........ X ...... ...... ....... 3. Building will be ............. / ........... stories. 4. Basement ............ 5. occupancy of building will be ................ 6. t from th"earest-adjoining linem wn .......... ............. --------- �-1 ............... ........ 7. ....... ............... ............. . .... ..... 8. Owner's Address....ck� 9. Builder ..... o ............ ...... M,**** ............ . ............... --------------- ...... 0 ......... . ...... W— ...... 10. Builder's Address ...... ol -------- *10—W �0'0—*****"1"0 ........... 00* ..... ----------------------------------------- Datc— .............. 19;n�� .............. ........ ................. (owner or his agent) This Space Is For City Inspector Only Permission is hereby granted to do the work described hereon, according to the approved plans and specifications pertaining herew, subject to compliance with the ordinances of the City of Edmonds. PERMIT N? 1026 A Estimated cost -$ .. .. r .... 7 - - -------- Life of permit .......... dat e IPlans filed: Yes'n---'No 0 1 ........... ReZd Zb ..... ......... . .... . ... (Issuing wil;'5— Ir Z Delpartm:t o ' uildings City of Edmonds i. The building permit fee which applicant pays when permit is issued shall be based on estimated cost of the proposed structure, at the rate of $2.00 for each Sl000.00 of cost. If the actual cost of the structure. when finally determined. exceeds the estimated cost by more than 59fe. applicant agrees to pay an additional fee of $2.00 for each $1000.00 of such excess cost. 2. Whenever a contract for construction Is executed for any structure costing more than $1000.00 for which a licensed architect or engineer Is not required by the Building Code of the City of Edmonds, the application for a building permit shall be accompanied by a copy of the contract and a copy of the deta I iW specifications. 3. Prior to employing any labor or commencing work, notify the Industrial Insurance Division of the Department of Labor and Industries, giving an estimateof the payroll and make monthly reports of payrolls. Full instructions should be obtained from the nearest office of the Department of Labor and Industries. Before final payment, the owner should obtain a release from the general contractors who in turn should obtain release from all sub -contractors. The releases should be Ftttcsted by the Department of Labor and Industries. 7be above procedures are requirements of the State Industrial Insurance Act. I V UGATION V VILDING PERMIT Appl. No . ..... I ............ EDMONDS Building Department Permit limit, 9.n � year in accordance with the accom, �'APPLICATION is hereby made for a permit to construct the following work p lans and specifications. Two sets are submitted herewith for approval. Off'st. 000/alter new, 60Z C a0calnrepair ............... ................................................................... C12 . . . . . . . . . . ....................... . ....... Fire zone ........................... pancy ............................... Const. type ......... Use zone .... A .......... t ........ .... Blk .......... Addn ... A ......... ... / ... r ............... . . ... ......... Septic tank .......................................................... ........................... frontage ........................................ Area ........ Bldg. set -backs front ........................... r. side ............................. L side .............................. rear ............................... dress..../ .-e� ... . ... No ....... ..................... Owner.. . .......................... Address .......... ......... ....... ......... ............ Tel. No ..................... Builder .......................................... Plansby .................................................................. Address .................................................... Tel. No .............................. Remarks.................................................................................................................................................................................. .......................................... ................. . ......................... ...................................................................... ................................... ................................................................................................ ................................................................................................ The above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this work. Signeo . ........... ....... ...... Addre Date... ss ........................................... PERMIT for the above work is hereby approv4 subje& to the above conditions, and to compliance with the ap, proved plans and specifications, and Building Department notations thereon. Valuation ...................... Z..&r-O .............. Permit fee .... 7Z� ................... Recd. by..-'IjUg ... /-)� ................ BuildingDepartment, By ........................................... IWO.-C.-C ................. Date ....... Alt ........ ................................. This Permit does not cover Plumbing, Sewer or Electrical installations.