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640269.pdf.4 1vilding Permit A P plication Applicant F1H 'LAN FILE NUMBER nside Heavy Line NAME (OR NAME OF BUSINESS) 13, 1/* JOB ADDRE813 XAILJNG ADDRESS o Box SIDE YARD SET PERMIT NUMBER 640269 -70 1 A k>-" 1 10 YES To Ct) et y- F-1 NEW El DEMOLJSH NUMBER OF STORIES D_aDD I I I a -ALTER I r-1 ...D.NTIAL LIMBER OF NDWELLJNG n REPAIRI Fq_NON-RESIDENTIAL I UNITS I hereby acknowledge that I have read this application; that the In- formation given in correct; and that I am the owner, or the duly author- ized agent of the owner. I &use to comply with city and state laws regu- lating 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 -a Compensation Insurance. NOTE: PERMIT LIMIT ONE YEAR :NATURE (OWNER OR AGMT) DATE SIGNED I PLOT pDCN CHECK & APPROVED FILE ALL BUILDING SETBACKS NOTE: TO EAVE LINES REMARKS - Encroachment Permit PERMIT NUMBER STREET GRJ Required nYES 1`1 NO [] YES [3 NO [3 NO [] YES 13 NO ow I Z 1 BUILDING VALUATION 2 BUILDING PERMIT FEE ry PLUMBING 3 PERMIT FEE HEAT & GAS LINE 4 PERMIT FEE DEMOLITION 5 PERMIT PEE 6 AMOUNT DUE ATMNTION APPLICATION APPROVAL TM8 PERMIT This application is not a permit until AUTHORIZES signed by the Director of Building Inspec- ONLY THE WORK NOTED tion, or his deputy; and fees are paid, and receipt is acknowledged in space provided. INSPECTION DIRE VC-INATURE DEPARTMENT e, CITY OF C- '.4 '00 EDMONDS PH 6-1107 a APPLICA�dON & WORK PERM6� CITY OF EDMONDS Building Department CATION is hereby made for 4fications: I . . . . . . ..... . ... . ................... 0 ........... BloclL ...... . .................. a permit to construct the following work, in accordance with the accompanying plans ................................... No. Stories ............ ... . ....... .. . ....... . ............ ........ �9 . ... ... ....... 41 ................................................. Const. Type ...................................... Height.. or ........................................... Use Zonei 6 e=4w.. Fire Zone .................... --------------------- ---- .......... Area. ....................................... Width. ........................... V9 C;t—1 .............. Sewerage .................................... ?Bldg. Setbacks, Front and Rear ............................... Sides .............................. a.:.. Phon.�� er. . ....... ................. Address ..... ....................... 20, Plansby ........................................................................................... Address ........................................................................ Phone ....................... Bldg.,by- Address ........................................................................ Phone ................................ Wi PIbg. by ........................................................................................... Address ........................................................................ Phone ................................ Heatingby ....................................................................................... Address ........................................................................ Phone ................................ .......................... Address ........................................................................ Phone ................................ Elect. by ................................................................. .............................................................................................................................. ................................................................................................ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . ............................ ................................................................................................................................................................................................ The above Is a correct statement and I agree to comply with all applicable Codes and State T.Aws regulating the work. % Wgned: Owner/Agent.�J.&:�a .... Addressz.4..� ....................................... �. Date.�Z?/--Z2 PERMIT for the above work Is hereby approved, subject to the above conditions, and to compliance with the approved plans and specifications and Building Department notations thereon. VALUATION PERN[IT FEES 0 $.;R .. Bldg. $ ..................... 6)..0 ........... .......... Plbg. .... $ ..... Z.0.....O..o .......... APPROVED: Heat .... $ .......... ......... Dat 7 Elect. $ .......... ....... ..... ... /..( ......................................... .......... 7. Others ... $ ........................................ BUILDING DEPARTMENT $ ...... 7.2-0 ............... TOTAL FEE By ... .... ...... NOTES: No work requiring Building Department or City Ei0neer's inspection shall be covered before inspection and approval. Twenty-four (24) hour notice requested. Contact the City Engineer prior to construction of all site utilities, such as curbs, paving, driveways, sewer, water and street connections. APPLICATICA & V06W PERMIT CITY OF EDMONDS Building Department Application No. Permit Limit, One Year with the anying plans accomp ,1�,'�APPLICATION is hereby made for a pern-dt to construct the following work, in accordance and specifications: ... ........................... Ground Area ................................... No. Stories ............ WOBK — New/Addn . ............ Const. Type ..................... Height ....................... Width. ........................... bUn. Bldg. Setbacks, Front and Rear ................................ Sides .............................. Phone........................ ....... Address........................................................................ Phone ........................ ....... ................. . . . .... Address .... /9":z/ .... Phone ... Address........................................................................ Phone ................................ ....................... ress........................................................................ Phone ......... Fe"Llng by ................................................................... Add A -------------------------------- Phone ................................ The above is a correct statement and I agree to comply with all applicable cocies ana ritate Liaws rurswm�zr, wo ww--- Signed: Owner/Agen��O.'11.�:�- �.. Address .......................... : ................................................. V PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the approved plans and specifications and Building Department notations thereon. VALUATION rERN" FEES Bldg. $ ........................................ $ ........................................ APPRO VED.. Date............ ? ............................... BUILDING DEPARTMENT Wm., Herbert.,, Bldg. V2�, - -------- ...................... .......... Plbg. .... $ ........................................ Heat.... $ ........................................ Elect. ... .$ ........................................ Others... $ ....... 124e.4� ......... 2 TOTAL FEE $ ....... ........... NOTES: No work requiring Buildinrf//Department or City Engineer's Inspection shall be covered before inspection and approval. Twenty-four (24) hour notice requested. Contact the City Engineer prior to construction of all site utilities, such as curbs, paving, driveways, sewer, water and street connections. I