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640399.pdfI'Buildina Permit Applicant Fill Inside Heavv Lir (L BUILDING PERMIT NUMBER 640399 1_9E 1 7 .2a A) �WAMAING ADDRESS A Al— 'Pap— /,)0—. SIDE YARD SET BACK REAR YA CITY I rj. TELEPHONE NUMBER PR USE ZONE 1 MAP NUMBER VACANT SI 13 YES 13 NO NAME BUILDING AREA. LOT AREA VARIANCE NUMBU ADDRESS HEIGHT ALL BUILDING SETBACKS I.NOTE: TO EAVE LINES CITY TELEPHONE NUMBER REMARKS NAM S FA, 7-r L_E: F-A -r no 6 'ADDRE938 1104 K) 6, Encroachment Perml! PERMIT NUMBER STREET GRADE Cru Required 0 YES 0 NO CITY -OA LO r1j - TELEPHONE NUMB METER SIZE SERVICE SIZE CLEARANCE CHECKED STATE LICENSE NUMBER 57 cl G7 -I— CITY LICENSE NUMBER REMARKS LOT BLOCK TRACT TYPE CONNECTION VERIFIED BY PERO. TEST PERMIT NUMBER FIRE ZONE TYPE OF CONSTRUCTION SO �TIXP�ROVI I I [] YES 13 NO SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP 0 YES E ] NO PI,&N CHECKED BY WORK TO HE DONE L P_ A L) NO. OF BLOGG. PERIBILD0. -rOTAL FK; BUILDING VALUATION (2,1 Ir CAJ, P__ 2 BUILDING PERMIT FEE ER NEW ElADD DEMOLISH NUMBER OF STORIES 3 PLUMBING PERMIT FEE HEAT & GAS LINE PERMIT FEE ALTER REPAIR RESIDENTIAL NON-RESIDENTIAL NUMBER OF DW'ELIJNG UNITS 5 5 DEMOLITION PERMIT FEE I hereby acknowledge that I have read this application; that the In- formation given to 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 WorkMeU'S Compensation Insurance. NOTE: PERMIT LIMIT ONE YEAR FIIX i b-.)L- S- - � 61 AMOUNT DUE 11 I ATTENTION APPLICATION APPROVAL THIS PERMIT This application is not a perinit until AUTHORIZES signed by the Director of Building Inspec- ONLY THE WORK NOTED tion, or his deputy; and fees are paid, and receipt Is aclmowledged In space provided. INSPECTION �T�M^W��TMWAWTT�=_. . I CITY OF EDMONDS DATEEZ/ Y/o /-2 PR 6.1107 X r V V y' NDS, WASHINGTON CITY OF EDMO BUILDING PERMIT t details to indicate This Space, Is For A hcant hereby certifies that a plot, plan, drawings, and sufficien erin on to fulfill all requirements of this code are attached hereto. City Inspector Only to do the following work: pp ca ti hereby made for permit .......... ......................... ..... J' . . . ........ . ............ . ....................................... ...................... . .......... . ......... ........... — ....... C ..... ..................... .... ..... . . . . ....... d . ... . .......... . ......... ......................... . . ... . ................................................................................... ................ . ................ . .... . .... . ...... . .... . .... . ......... .... . ...................................................... .......... . ......... . ........... k ........ ............. �Jk ............................ ....... ....... .. Lot . ...... ..... ...... Block ........ 6 .... ------ ............................. ................. . .... . .... . .......... . ............................................ 15� --- - ------ - ---- - ---- - --------- .............................. . ....................... . .. . . .. . . .. . .. . .... . .... . ......... ... ...... ..................................... .................... . .. .............. . ...... . . ...... . .. ..... . .... . .... . .... . .... . ............ Z ................... at .................. .. ... ............................... . .... . .... . ... S ..................... ....... X ..... . sc� Idin dimension ...................... 1. Bui g X ..... ......................... 2. Lot dimensions ................ A ........ Z ......... stories. 3. Building will be ......... 4: Basement ........................ .................................... .................... 5. Occupancy of building will be.. V fpn the nearest adjoialp'4! line. ....... fee . ........... 717 - .......... ............... 7. Owner ............. e� . .......... . ... ;;; ......................... 8-Owner's A' ................................. .......... ......... 9. Bader ..................................... ............................ . .... . ............... 10. Builder's Address ....................................................................................... . ................... ........... ....................................................................................... 4 .......... Dal ... 4 ....... 19.,* Permission is hereby granted to do the work described hereon, according to the approved plans and specifications pertaining hereto, subject to compliance with the ordinances of the City of Edmonds. Estimated cost $Aer Life of permit . . . . . . . . . . . . . . . . . . . . . . . ...... Ric date ..... . ........... ........ .. ... . ... fficer) (Issuing PERMIT N? 835 Plans filed: Yes M--�xo Department of uildings City of Edmonds i. The building permit fee which applicant pays when permit is issued shall be based on estimated cost of the proposed structure, at the rate of $2.00 for each $100o.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 I in 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 more than $1000.00 for which a licensed architect or engineer Is not requited by the Building Code of the City of Edmonds, the application for a building permit shall be accompanied by a copy of the contract and a copy of the detailed Specifications. Prior to employing any labor or commencing work, notify the Industrial Insurance Division of the Department of Labor and industries, giving an estimate of the 3 payroll and make monthly reports of payrolls. Full Instructions should be obtained from the nearest office of the Department of Labor and Industries. Before final payment, the owner should obtain a release from the general contractors who in turn should obtain release from all sub -contractors. The releases should be Ruested by the Department of Labor and Industries. 'rhe above procedures are requirements of the State Industrial Insurance Act. (ing ffice n =nt 4ofufld rn CITY, OF EDIVIO�04'2 WASHINGTON DEPARTIV10�OF BUILDINGS BUILDING PERMIT r certifies that a plot, plan, drawings, and sufficient details to indicate fulfill all requirements of this code are attached hereto. �� made farormitto do the following work: --------- ---- ;7 .................................................... o numbers) (Street number or lot an 0,4 dimensions are ............ !�� ............. x ..... ..................... dimensions are ...... 6A ............ x ............ /.; ........................... Wing will be .............. / ........... stories in height.' 4. Number of basements ....... 21A. 5 Occui3ancy of building will be ........... ........................................... g a 6 J4 0 t! zo 0 OA.5 >1 04 -0 *00 U 04 0 0 zi 0 Cd 7? 01 Q ��Q U0 0 0 W & 4i o K A 0 A, �4 Cn W P4 rn z 6. Building will be ... Ze ....... feet from nearest adjoininj lot line. 7. Owner ............. 4 ... Estimated cost $ ..... .... . 2/4? . . ........................ 8. owner's Address ....... ............................. Group No . .................. ..w ................... ...... 9. Builder ....................... d ...... ................ Buildees Address ................................... .. .... 1,2 Architector engineer .......................... .................................................................. Life of permit ............................................ date 41 '7- 00 Date............. A ........... 7 . ............ �11& ........ Plans filed: "Yes No Applicant's Signature ............... ...................................................................... (owner or his agent) Permission is hereby granted to do the work described hereon, according to the approved plans and specifications pertaining hereto, ipt for the following fees: subject to compliance with the ordinances of the City of Edmonds. This copy is your rece 47 e? 1. Building permit fm ....................................................... s ........ ....... . ....... 2. Sewer permit fee ........................................................... $ ...................................... 3. Inspection and supervision fee ........................................ $ ...................................... 4. Total ...................................................................................................................... . ........ $ ................................ T) -.1 L �1.r PERMIT 369 ece V Y ............ ...... - - �ils�s;uyfr�so Department of Buildings City of Edmonds I. The building permit fee which applicant pays when permit Is issued shall be based on estimated cost of the proposed structure, at the rate of SIM for each Sl000.00 of cost. If the actual cost of the structure, when finally determined. exceeds the estimated cost by more than Solo, applicant agrees to pay an additional fee of,$2.OD for each $1000-00 of such excess cott� In such event no use permit shall be issued until such "discrepancy fee" Is paid. \ .. 4 for,constfuctlonill �Fxe��u�ed for any structure costing more than $1000.00 for which a licensed architect or engineer Is not required -2'� Whe �cvcr.z contract 7 IldlAg Code of the Ci nds,,the application for a building permit shall be accom6a.AIed`bjtpt copy of the contract and a copy of the detailed 11 '�ons. o, lei, giving an estimate of :ior to employing any labor or commer�clng work, notify the Industrial Insurance Division of the Department of Labor and Industr -monthly -rof Payroll& quil -iostructions.should be,obtained from the nearest office of the Department of Labor #4,djndustries. Before zoillind make report$ f . I _ payflaZi?, the owner should obtain a' releise from the generat contractors who In 'turn should obtain rcl�&�q,'frok all sub -contractors. �The releases should be attested by the , of Labor and Indust"ries. The aboic procedures are reqt;lrements of the State Induserial Insurance Act. pirtment o, 0