640275.pdfBuilding
Permit ApplicationlInside
Applicant Fill
Heavy L
NAME (OR NAME OF BUSINESS)
&) Westgate Builders
MAILING ADIJUNW3
22615 100th "est
CITY TELEPHONE NUMBP;11
Edmonds, wash 1Pr B-0818
NAME
Chuck Lee
ADDRESS
CITY TE
Mountlake T rrace 1Pr 6-2969
NAM
hlike Rizzuto
ADDRESS
IRI
22615 100th West
CITY
TELEPHONE NUMBER
Ramonds. 'wash
Pr_6__DB1EL_
5 1 ILeanne Lane
NEW LU DEMOLISH
ADD
FT ALTER SIDENTIAL NU ER OF
DV��E ING
REPAIR NON-RESIDENTIAL UNITS
USE
l ,Z�t�
e- a � Pee -
I hereby acknowledge that I have read this application; that the In-
formation given Is correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree 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's Compensation Insurance.
NOTE: PERMIT LIMIT ONE YEAR
PLOT
FILE
tAN FILE NUMBER
OB ADDRESS ;;P� -7
1IDE YARD
, RD
SET BACK kjAn XA
50—
/ I / r
'USE —ZONE
S"',
P N MBER VACANT SITE
UA U
:] YES 0 NO
0
3UILDING AREA
LOT AREA VARIANCE NUMBN
L BUILDING SETBACKS
NOTE: AL EAVE LINES
REMARKS
Encroachment 17erznK PERMIT NUMBER STREET GRADE CHECKI
C6
Required
Z
IA
r-1 YES (-1 NO
RVIC CHECKED BY
METER SIZE BEY E SIZE
(f A k ICLEARANUN
I
RVMARKB
PERO. TEST
PEFJR ER
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES No
TP—ECIAL INSPECTOR REQU CCUPANCY GROUP
0 YES [] NO
PLAN CHECKED BY
NO. OF HLOGS. PERIOLDC.. TOTAL 1111K
BUILDING
1
VALUATION
— _51JILDING
PERMIT
Z,
2 FEE
PLUMBING
PERMIT FEE
HEAT & GAS LINE
4 PERMIT FEE
DEMOLITION
5 PERMIT FEE
AMOUNT DUE
6
AT=MrION
APPLICATION APPROVAL
THIS PERMIT
This application is not a permit until
AUTHORIZES
signed by the Director of Building Inspec-
ONLY THE
tion, or his deputy; and fees are paid, and
WORK NOTED
receipt is acknowledged In space provided.
INSPECTION
—DIRE SIGNATURE
DEPARTMENT
CITY OF
EDAIO"S
DATE
PR 6-1107
BUILDING PERMIT Appl. No . ........... .....................
limit, one year
OF EDMONDS Building Department Permit
nstruct the following work, in accordance vnth the accom-
APPLICATION is hereby made for a permit to co
submitted herewith for approval.
I and specifications. Two sets are
g pans
new - ,alter Off'st.
t6X "k dd vo' repair .................... 1K ......................... .................................................. Parking ......................
Wor a n
—Y ........ Fire zone ...........................
Use zonel .....
cupancy ................................ ConA. type,,..A'Z�.: .................
ress.... /;6 ... iot ....... . ............... Blk ........................ Addn.* .....................................
......... Septic tank ..........................................................
t frontage ........................................ Area ...................................
-.;�l rear ...............................
Bldg. setbacks — front ...... ...... r. side .......... sidee .........
. ......... .
Address..Z�S;��,52! ........... Tel. No ..................
........ ..
Owner.
Builder.............. .............. I .......... Address .................................................... Tel. No .............................
Plansby ................................................................... Address ................ Tel. No ...............................
.............................................................................................................. . .........
Remarks .........................................................
................................................................................................................................................................................................
........................................................................ ....................... ....................................................... I .........................................
Ile above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this�
work.
Signed Owner/Agent/���`�.,.-k' ress ............................................ Date.7-:?�7
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the aP'
proved plans and specifications, and Building Department notations thereon.
1611-0— &-0 ... . . .. ZZ ....
Valuation ........... 40.xt.-.e ........................... Permit fee ....... .................. Reed. by ...... ?7 .
V/ -7- /.,>- - 4a .................
BuildingDepartment, By ...................... . . .................................. Date ........... ...................................
This permit does not cover Plumbing, Sewer or Electrical install4ti0"s-