650111.pdf9
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ADDRESS
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SIR �
PERMIT
NUMBER
6501 1 1
YES
ALL BUILDING SETBACKS
NOTE: TO EAVE LINES
Required
NEW
DEMOLISH
AMD
I /
ALTER
RESIDENTIAL
NUMBER OF
I
REPAIR
NON-RESIDENTIAL
DWELLING
I UNITS
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 ==aw-.*#AVj
PLOT IVAN CHECK & APPROVED
F71LE
13 NO
STREET IMPREVED
13 YE ri No
[] YES 0 NO
BUILDING
I
VALUATION
BUILDING PERMT
2
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
DEMOLITION
51
PERMIT FEE
—6
1 AMOUNT DUE
ATTENTION
APPLICATION APPROVAL
THIS rEnMIT
This application Is not a pernilt until
AUTHORIZES
signed by the Director of Building Inspec-
ONLY THE
WORK NOTED
tion, or his deputy; and fees are paid, and
receipt is aclmowlejlged in space provided.
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
I
APPLJOATION �'%UILDING PERMIT
R..
CITY OF EDMONDS Building Departmen?
foll g work, in accordance with the accom,
APPLICATION is hereby made for a permit to construct the oviin
d specifications. Two sets are submitted herewith for approval.
panying plans an
Off,st.
er
-e
new alt e_C--c --� king ............
V___ " ..... .............................. . ..........
Work addn repair ....... ez4�ev—....,4 .................... Par
Use zone ....... ...... Fire zone ............................
Occupancy................................ Const. type ...............................
Jo
t ........................ Blk ........................ Addn ......................................
Address ..... ay.
.................................
..........
A-- S tic tank ...........................................
............................................
Lot frontage ........................................
1. side .............................. rear ...............................
Bldg. set -backs front ............................ r. side. ...........................
No .............................
..... .. Address. ...... 6.�aZ
n r.. . ......................
.. ..........
Ow
Bu
*el. N ..
.............. ........................ Address..-,.�2-3 ei�� ...................
...... Address .................................................... . Tel. No .............................
Plans by ...........................................................
...................................... ....................
Remarks ...........................................................................................................
......................................................................................................................................................................... 77 ...............
The I above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this
work.
Address ............................................
Jgl�
e-,� -------- - ---
Signed Owner/A
and to compliance with the ap
PERMIT for the. above work is hereby approved, subject to the, above conditions,
proved plans and specifications, and Building'Department notations thereon.
. . . . . . . . .
x
.................
.............. Permit fm ............... Recd. by ......... ri..
Valuation .............. ........
Building Department, By ............................... - Date. ................. .....
NOTE This permit does, -not cover plumbing, sewer, or electrical irstallationsolor does it permit any work, to be.
done in the Right of Way areas. Driveways and walkways must be Planned to meet the official grades of streets
and alleys, and plans for future sidewalk development -
Appl. No . ................. ..........
Permit limit, one year
Pass
fe,
CITY OF EDMONDS, WASHINGTON
BUILDING PERMIT
4 to indicate This Sp
that a plot, plan drawings, and sufficient detail ace Is For
*61i t' hereby certifies
p of 'this code are attached hereto. City Inspector Only
le intention to fulfill all requirement"
do the following work:
Application is hereby made for permit to
........ . .........
.. . ...................................................... : ........
............ . .........
.....................................
..... . .......
.............................................................. . .........
............................................
............ . ..............
.......... . .......... . .... . ...... . .. . . .... .
................................ . ................ . ...................... .
.. . .... . .........
.. . ....... ............... ....... . .... . .......... . ......... ................................................
/ .............. Block ....... . ........... i ..................................................
LD
.... I.Yffi .. . . .. . . .... . ......
..... UJt .... 7] ww(
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. ............................ .
. . .... . .... . ................ . ....
..... . .... . ...
....... . .................. . .. . . .... . ...
..........................................
at .... .. 4-JO.
..............
1. Building dimensions ..... J.0 ................. X .....
2. Ut dimensions ........ ... .... X .... ................. .......
.................. stories.
3. Building will be ......
4. Basement ........................
.....................................
occupancy of building will be ........
g me.
et front the nea d* i i li
r3bidjoinin
6 . ......... ............
......................................................
7. Owner.
. .......... . ...
.....................................
8, Owner s Add 6 ......... z4z� ..... S
....................................... ...... ... ...........
9. Buil
der ......... ........ 11 .................... ..........
.................................................... . ...................
10. Builder's Address.
. .... ............ . ...
..................... . . ..........................
................. T
---- - - -------
Date.. ..... ..........
. ........... ..... .... e
............ (o"er or his agent)
ork described hereon, according to the approved plans and specifications pertaining heretor
Permission is hereby granted to do the w
th the ordinances of the City of Edmonds.
subject to compliance wi
FPERM1ffT INK? 1021
)ays when permit is issued shall be based on estimated cost of the proposed structure, at the rate of $2.00 for each
1. The building Permit fee which applicant I than 5%, applicant agrees to pay art additional fee
$1000.Oo of cost. if the actual cost of the structure, when finally determined, exceeds the estimated cost by more
of $2.00 for each $1000-00 Of such excess cost- to costing more than $1000.00 for which a licensed architect of engine" is not required by
2. Whenever a contract for construction is executed for any structu
the Building Code of the City of Edmonds, the application for a building Permit shall be accompanied by a copy of the contract mind & copy of the detailed
specificadoas.
3. Prior to employing any labor or commencing work, notify the Industrial Insurance Division of the Department of Labor and Industries. giving an estimate Of
Full instructions should be obtained from the nearest office of the Depart cat of Labor and Industries. Before
the payroll and make monthly reports of payroll$. e from all sub -contractors. The releases should be
ayment, the owner should obtain a release from the general contractors who in turn should obtain releas
final P Ores are requirements of the State Industrial Insurance Act.
attested by the Department of Labor and Industries. Ile above proced
J�
"0.
AVW�,
NJ
DEPARTME�j OF BUILDINGS
CITY OF EDMOLS. WASHINGTON
BUILDING PERMIT
�2 Applicant hereby certifies that a plot, plan, drawings, and sufficient details to indicate
the intention to fulfill all requirements of this code are attached hereto.
Z.
41
0
Application is hereby made for permit to do the following work: C b 13
.................
.. .................. ........................................................................
.............. . ........ ............................................................................
...... . ........
. ........... . ..................................................................................................................
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..... iwx: .2 >',
at.... . .......... ........... A V, ..................... . .........
(Street number or lot and block n C14 en
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0
FL
. ............. X 7.� . . .............. In Pk rn
1. Building dimensions are ..........
2. Lot dimensions are .... ............ X ....... ....................... en
:D
L
3. Building will be ..... / .................. stories in height. r. 0
0
4. Number of basements...., -.-I- . ....... z
I be .......
............................ . ...... .....
5. Occupancy of buildin
Building� be .... .... ... feet from Wne.a est acdHoiningia line.
9/7" 0_4/
ge C& ......... ............... Estimated cost $ .... X .. ......
7.
.... . ......... .. ...
8. Owner's Address ... A-10 .. ........... 4� ........................................
9. Builder .......... Group No . ................................................
........................................................................................................... .......
Builder's Address ............................................................................................................
11. Ard�tect or en ......................................................................................... Life of permit-...
gmeer .......... .... . . ... .....
date
Date./
Plans filed: Yes' No 11.
Applicant's Signature ................................................... 1 .............
(Owner or his ageni), .....
Permission is hereby granted to do the work described hereon, according to the approved plans and specfficationg pertaining hereto,
subject to comphance with the ordinances of the City of Edmonds, This copy is your receipt for the, following fees:
/VOO
1. Building permit fee ......................................................... $ ... /..v ...........................
2. Sewer permit fee ............................................................ $ .......................... ............
3. Inspection and supervision fee ........................................ $ ......................................
4. Total .................................................. ...................................................... . .......... . .... . .. .............. . . .......
r�> Receivd&by Ar
1. 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 $1.00 for each
Sl000.00 of cost. if the a . crual 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. In such event no use permit shall be issued until such "discrepancy fee" is paid.
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 required by
the Building Code of the City of Edmonds, the application for s, building permit shall be accompanied by a copy of the contract and a copy of the detailed
specifications.
3� labor or commencing work, notify the Industrial Insurance Division of the Department of Labor and Industries, giving an estimate of
the a reports of payrolls. Full las't'ructions should be obtained from the nearest office of the Department of Labor and Industries. Before
final d obtaln-a-releaseJEom the gen",contritctors who in turn shoulf-phtaiNte.�easj from all sub -contractors. 71c releases should -be
'tuened 't.
Labor i6d-lndustr1es;- The Ab6ve ocedures are requirements of kt,State- n ustrial Insurance Act.