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NUMBE OF STORIE
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NUMBER OF
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REPAIR
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DWELLING
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 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 Workmens Compensation Insurance.
NOTE: PERMIT LIMIT ONE YEAR
� X-19
FILE
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0 YES
- - - - - - - - - - -
PERMIT
NUM13ER
640335
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BUILDING
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VALUATION
BUILDING PERMIT
2
FEE
—
_iLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
DEMOLITION
5
PERMIT FEE
6
AMOUNT DUE
ATMNTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PH 6-1107
LDING SETBACKS
NOTE: 'TO E'"13 LINES
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APPLICATION APPROVAL
This application is not a permit until
signed by the Director of Building Inspec-
tion, or his deputy; and fees are paid, and
receipt is aelmowledged in space provided.
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4PPIRATION & BUILMA PUNIT
Ap 1.
CITY I OF EDMONDS Building Department Permit limit, on
APPUCATION is hereby
made for a permit to construct the following work, in accordance with,
the accom,
PanYing plans and specifications. Two sets are submitted herewith for app,
al.
new
alter
Work addn repair ...... Off -St.
-4�. ................................................................ Parl; cr
. . . . . . . . . . . . . . . . . . . .
Occupancy ................................ Const. type ............................... Use zone ... ..... Fire zone ...........................
Address./
......... .......... BI .... ..... n
Ar"
.............
Lot frontage ........................................ ............. Septic tanke-;e�
Bldg. setbacks — front .. i� ............. r- side .. . .......... side .... .. ?�.±
7-
.. ........... Address. ..... !�114 ......... 3 ...... 11410 ...... Te 1. No ..............................
� ................................. C ......... 7 1 .....
I No
Plansby .............................. ................................. Address ..............
This permit covers work to be done ....................................... Tel. No .........
Remaiks,on..,prlva.ta ... pr.Qp.q:rJty ... Q!-tLx le
'ny construction on the public domain .................. .........
............... .. .......................
-0 so ate permission. IF ............................................................
will recfuil r:L�r, 1W
The above is a correct statement, and I agree to comply with all applicable Codes and State law—s—regulatin
work.
Signed Owner/Agent-- Address
e4� .............
Dat
PERMIT for the above work is hereby approved, subject to the, above conditions, and to compliance with I the ap,
Proved plans and specifications, and Building Department notations therem.
Valuation ........ ................. Permit fee .....
. ............ Recd.
Building Department, By ............................. ......... Date .... 4:z. ...............
..... 17
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 official I grades of streets,
and alleys, and Plans for future sidewalk development.
I
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N,_
& WORK PERM�-��"_ -
Application No.
S Building Department Permit Limit, One Year
by made for A permit to construct the following work, in accordance with the accompanying pi
ans
....... .......................................................
......................... Ground Area ................................... No. Stories ............
... ... ............................................................................. Const. Type ........................................ Height .......................
....................................... lt� ..................... ........ Use Zone .................... Fire Zone ....................
. ..................... Sewerage
CIL ................... Add'n ..............................
WidtIL ........................... Min. Bldg. Setbacks, Front and Rear ............................... Sides ..............................
................................. ..................... Address ...... ...... Phone......—
............. . ......
�e * *-* *�*r*-'e —o -z- _x�
. ............................................................. Address ................................... . ................................... Phone ....................... . .......
....................... Address .....................................................
Phone ....... ............... . .......
LECIAL DESCRIPTION
............................. Phone ...............................
(Dale E, Baker)
ut�
.............. ...... ........ ...... ............. ....... ....... .................. .......... Phone ................................
t�lof Tract 42,t Plat of Talbot Park.9 according to
�','Plkiit,'bthereof.-recorded..in.. Vol, 12 -of Platsi,'page .107 ..... ........ .. ........................................
Phone........................ .......
�:records of.Snohomish County., Washington.9 described
.... . ................... ..................................................
Beginning at a point on the north line of said tract
160,,Te6t�West ..of .-its-, northeast corner
thence South. . ........................................................................
parallel 'with the west line of said tract., to the
sotith.. line .-thereof; ... thence west on the said south line-.... ......
. ........................................................................
140 feetto the southeast corner of the land conveyed
to""George'-Gerald. Ramsey and �Alma. Marie Remseys his..wife,,.... . ......... ............
tK , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deed filed for record under Auditor's File No* 1168952-
&eV Trorth'.9 'pdrik I I W-gfPfivt'il�)& Wgi- �T-ial-6e,,4�d state Laws regulating the work.
ne
to the north line thereof; thence east 140 feet to the Point
........... ..........
................................. Date ......
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
PERMIT IMES
....... 7 ........................ Bldg. $ ........ . . 5�
.............................
0
PIbg- $ ........................................
APPROVED: Heat .... ............
1�d ......................
e-774�', _5
Date .....
............. Elect. $ .......................................
BUILDING DEPARTMENT
Others... $ ...................................
By............................... . ... ........ 0
.......................... TOTAL FEE $ ........................................
NOTES: No work requiring Building 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.