638 PINE ST (2).pdfAPKJOATION & C71ILDING PRNIT CAppl. No. ;U.p A2�� .......
CITY. OF EDMONDS Building Department Permit limit� one year 4
in accordance with the accom-
APPL.ICATION is hereby made for a permit to construct the following work,
e submitted herewith for approval.
panying plans and specifications, Two sets ar
Off'st.
new.'.) alter
W rk a n - zlrl� ................................................................................. Parking ......................
o.k
a n repair ..... JC ........... ......
Use zone ...... f�..P ............ Fire zone ........................... .
Occupancy................................ Const. type .......................
7'
........ Addre .........
V�r ...
Address.... �� ....... 14- ................. Lot ....... Z ........... Blk ........
..... Septic tank. ... . . ......................
Lot frontage ....................................... Area....'Le
r. side ............. !�7 ......... 1, side ........ ts: ................. rear ..... . ............
Bldg. seAacks front.. ......
............. .
....... ..... . ....... Tel. No.
Owner .......... . ...... .................. ................. Addrm...
............................
Buitder .............. ..................................................... Address .................................................... Tel. No.
z
................ Tel. No .............................
Plans by ............... ....................... I ..................... .... Address ............ .......................
0
..........................
Remarks .............................................................
0-
...................
... . .. . . ... ...... . ... . .. . . ... . .. .. .. .. .. . . .. . . .. . ... .. .. .. .. . . .. . . . . . . .. . . ... . .. . . ..
..........................................
li uli this;p
The above is a correct statement, and I agree to comply with all app cable Codes and State laws reg ting
work.
Signed Date; .. .......... ......
co ti and to compliance.with t6 ap,:1
PERMIT for the above work is hereby approved, subject to the above ndi ons,
proved plans and specifications, and Building Department notations therem
. .........
Valuation Permit fee ..... V..1;2 ........... Recd
............ by .... A-tZA-7'
Building Department, By .............. ........... ............... Date .. 7--/-
NOTE This permit does not cover plumbing, sewer, or electrical installations, nor does it Permit any work to be -
done in the Right of Way areas. Driveways and walkways must be planned to meet the ojfi�ial grades of streets
and alleys, and plans for future sidewalk development-
'31
I
Appl,catlo
APPLICATI( N & WORK PERMIT n No. . . .
CITY F EDM NDS Building Department Permit Limit, one Year,
APPLICATION is hereby made for a permit to construct the following work, In accordance with the accompanying plans
and specifications:
WORK — New/Ad(IM ...... .......................................................... Ground Area. ................................... No. Stories ............
r
He
............................................................................................ Const. T7pe ......................................... lght.4..
plans Submitted ..............
e./C.6.. Fire zone ...................
......................................... Use Zon
LOCATION — Address ... ... ..
Al�zlzx. �o
....... .................
R or .... Block,, ... ... .. &dd'n. .......... .......... ..........
ecV4��
6thacks, Front and Rear.. Sides ............... . .............
..............................
Lot Area ....................................... Wi .. ..... .............. 11in. Bldg. S
.......................
Owner. .. ........
t�... ...Z& ........... ............... Address .....
Plansby .. . .................................. - ........ .......................................... Address. ............................. . .................................... . .. Phone ....................... . .......
Address ............................... 1000
...... �-- e Phone ....................... ........
Bldg. by..A//;�P� . . . . . . . . . . . . . . . . . . . . . . . . .
.................... Phone ........................ .......
Plbg. by ...... . ........................... ...................... ....................... Address ............................... ....................
I-Iesting by .................................................................. oo ............... Address ...................................................... ................. Phone ............................ .......
]Meet. by .................... ................................................. I ............ ........ Address ........................................................................ Phone ....................... ........
Remarks................................................................................ .........................
.................... . .............................................. ....................................... .................................... ............... ............... ...................................................... I ...........
. ............................................................
..................................................................................................... ................. .......................................................
.............. .......................................................................................................................................... ..
............................................................ ...... ............
The above is a correct statement and I agree to comply with all applicable Codes and State Laws regulating the work.
Signed: Owner/Agent.(:�&V� .. Address .................... ....................................................... Date ... .... . .. ....... .
ti ns an c lian with th
PERMIT for the above work Is hereby approved, subject to the above condi o d to omp ce e.approved plans
and specifications and Building Department notations thereon.
VALUAT10N
Bldg. .... $ ......... =? .........................
.................
Plbg. $ ................... ....................
APPROVED: Heat .... ..................... ..................
-3 Elect. .........................................
Date....... .............. .....................
Others... $ ..................................
BUILDING DEPARTMENT
$ ........ ;:2
By ..... Wat.. ... Hezhazt......Bldg .... lailz TOTAL FEE ............. ...
NOTES: No work requiring Building Dep ent or City Engineer's Inspection shall be covered before inspection and approval.
Twenty-four (24) hour notice r uested. Contact the City Engineer prior to construction of all site utilities, such as
water and street connections.
curbs, paving, driveways, sewer,