640320.pdfWAI -91 Mi-
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CITY
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irill PERMIT
Lineal INUMDER 640320
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HIVE YARD OrT ISAUK REAR YARD
V e cfo
v— PI
SIT. ONE NUMIMIt -Tiffl ZONE rdAP NUMBER ACANT SITE
0 YES 0 NO
BUILDING AREA LO REA VARIANCE NUMBE
film L BUILDING SETBACKS
1/ 107! 4.1 TO EAVE LINES
_q 00--j4L I - I N9TE:
Required
ri YES rl NO
13 YES NO
L-
SPECIAL INSPECT
P
[3 YES [3 NO
P
PLAN CHECKED BY
L
WORK TO BE DONE
BUILDING
I
VALUATION
f7
BUILDING PERMIT
2
FEE
fy
NUMBER OF
PLUMBING
2— NEW
DEMOLISH
1:1 ADD
3
PERMIT FEE
HEAT & GAS LINE
PERMIT FEE
1:1
F
ALTER
REPAIR
RESIDENTIAL
NON-RESIDENTIAL
ER OF
rxLLING
UNITS
1
5
5
DEMOLITION
PERMIT FEE
61 AMOUNT DUE
I hereby acknowledge that I have read this Application; that the In-
ATTIUNTION
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-
THIS PERMIT
lating construction; and in doing the work authorized thereby, no person
AUTHORIZES
will be employed in violation of the Labor Code of the State of Washington
ONLY THE
relating to Workmen's Compensation Insurance.
WORK NOTED
NOTE: PERMIT LIMIT ONE YEAR
INSPECTION
SIGNAJ)rU
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DEPARTMENT
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CITY OF
EDMONDS
I
PLOT PLAN CHEO I
'T�T'
7
PR a-1107
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......... .
APPLICATI
ON BUILDING PERMIT
Appl. No . .........
rmit limit, one ear
r- EDMONDS Buildinci Departmen?. Pe
LICATION is hereby made for a permit to construct the following work, in accordance with the,, accom'.
plans and specifications. Two sets are submitted herewith for approval.
9
new. �,�alter Off-stg�
...................
. ............... ................... Parkin
aAdn repair V ..... ....................................................................
Use zone... ........ Fire zone .. ........................
cupancy................................ Const. type ...... . ....................
.... Add
r L"o't/ ..... Blk ............
5i Z.ia.4 Septic tank ........... ..............
Iot frontage ........................................ Area ............
Nt 45 e5 ......... 1. side ............. ....... rear .................. ...........
front .......... .......... r. side .............
Bldg. setbacks
............
"Ek �-�dd .... .... Tel. No�al
. .... ... ress.
W, Owner..<,,5�, ..
..........................
.. . ...............
................... Tel.. No ..........
------ Address .................................
C,
CITY OF EDMONDSs WASHINGTO�
7q,
BUILDING PERMIT 4
Riicant hereby certifies that a plot, plan, drawings, an d sufficient details to indicate
This Space Is
For
z', intention to fulfill all requirements of this code are attached hereto.
City Insp�ecicr
Only
pplicat ion is hereby ma for pe it to do the following work:
.. .......... . .... .. . .. . . ........... . .................................................... ...................... . .........
... . ..... .. .. . .... ...... .. ........ ....... .. ..................... ............... ....... . .........
........... . .... . .... . .........
............ ................... ... . ........... .........
........... . .... . ...... . .. . . .... . .........
... . ......... .................... . .......... . .... . ...................................................... . .... .
7--* ..... .... .
.............................. Block .......... ................................. .. ..
� ... . .... . .... . .... . .... . ... ............................................................ ......... ... . .... . .... . .........
.... . .... . .... . .... . .... . .... . ...................... ......... . .......... . .... . ...... .... . .. . . .. . ........ . .... . .... . .........
9RU . .. . .....
.. . ...... . ... . ....
. .... . .... . ... .......... .. . ...........
. ................
'at .......
............... . ...................... . . .... . ...
. ................
Building di
PRO, mensions ........ V-_5 ............... X .... 1A
.2--.1 ......... X-J—.74 ................
2 Lot dimensions ........ 1&0
3. Bui i
IdIng wilft be ......... ............. stories.
4'. Base .........
ment
............
..........................................
5 OCF'u ancy of building will be ................................
_P
'-2 rom t earest adjoinin ne.
6 f h
...................
7; Owner ... W . .............. .. ................. .... . .........................................
8. Owner's Address.. ...// ....... .......................... L_
9. Builder ............... ........ ............ ...
..................... ... .. ...
10. Buildees Addres& .......... / ... If- 11 ....
........................................................................................... . ...
Date .......... ... 19.4 ....
....................
!W!OC ... .
-bed hereon, according to the approved plans and specifications pertair�k hereto.
Permission is hereby granted to do the work descn
subject to compliance with the ordinances of the City of Edmonds.
Estimated cost
$ ... .......................
Life of permit...
date R4ec �;l
... . .... . ...
c;;�
PERMIT N 04 629 Plans filed: Yes No El Department of Buildings
City of Edmonds
at the rate of $2.00 for each
1. ne building permit fee which applicant pays when permit is Issued shall be based on estimated cost of the proposed structure,
$1000.00 of cost. If the actual cost of the structure, when finally determined, exceeds the estimated cost by more than 5%. 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 move than Sl000.00 for which a licensed architect or engine" Is not required by
application for a building permit shall be accompanied by a copy of the contract and a copy, of the detailed
the Building Code of the City of Edmonds, the
specifications.
3. Prior to employing any labor or commencing work, notify the Industrial Insurance Division Of the'Department of Labor and Industries, giving in estimatinf.
Q the'nearcat office of the Department of Labor and Industries Before
ao' 'Who in cum siiduld'obtaln'telea
Lyroll and make monthly reports of payrolls. Full instructions should be obtained frot
the p; ;j from all sub -contractors. 'rhe releases
final payment, the owner should obtain a release from the general contra rs US Insurance Act.
Attested by the Department of Labor and Industries. The above procedures are requiremen of the State Industrial
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