650473.pdfBUILDING DEPARTMENT
PERMIT APPLICATION
Applicant Fill
Inside Heavy Lines
POSTED ON KROLL MAP NO.: BUILDING
PERMIT 650473
NUMBER
JOB ADDRESS
NAM (0 NAME OF BUSINESS)
Zdc A3 E'ci Y- (-3ci
BIDE YARD SETBACK
STREET SETBACK
REAR YARD SETRA4
MAILING ADDRES
OL 6^ 7L
USWONE
LOT AREA
VACANT SrM
(0,
rl YEA [3 NO
OITY
TELEPHONE NUMBFIR
HEIGH.
BUILDING AREA
VAYLIANCE NUMBER
NAM
PLOT PLAN APF
ADDRESS
REMARKS
CITY
TELEPHONE NURBM
NAME
/41 'eQ 74 CO.
REMARKS
�Zo V
METER aZE
CLEARANCE
CHECKED BY
CITY
TELEPHONE NUMBER
al
REMARKS
3T#TE LICENSE NUMBbR
CITY LICENSE NUMBER
TYPE CONNECTION VEXUPIED BY
Legal Description of Property (N or Attach Four Copies)
PERC. TEST PERMIT NUMBER
Z
FIRE VONE TYP STREET IMPROVE
E OF CONSTRUCTION
E3 YES 1:3 NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
YES 0 NO
PLAN CHECKED BY
VALUATION
TOTAL F19
BUILDING
VALUATION
WORK TO BE DONE
BUILDING PERMIT
2
FEE
3
PLUMBING
PERMIT FEE
Z
HEAT & GAS LINE
4
PERMIT FEE
NEW
ADD
E28H
SIGN
I HFENCE
NUMBER OF STO ES
5
SIGN PERMIT
FEE
. . .
............ 7�
-
!rZ
6
DEMOLITION
PERMIT ME
ALTER
RESIDENTLALL
HER OF
REPAIR
NON-RESIDENTIAL
D=LLING
UNITS
7
PLAN CHECK
FEE
I hereby acknowledge that I have read this application; that the in-
formation given Is correct; and that I ILM 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 allthorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
r6latlng to Workman's Compensation Inaurance.
NOTE: Permit Limit One Year lExcepl Demolitions which shall
be completed In ninety days.)
NOTE: Applicant Subject t(Pla. Che'c'k �ee
This Permit covers work to be done onprivate property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
81 AMOUNT DUE
I
ATTENTION APPLICATION APPROVAL
TIUS PERMIT This application is not a permit until
AUTHORIZES
ONLY signed by the Director of Building Inspec-
THE
WORK NOTED tion, or his deputy; and fees are paid, and
receipt is ackn ged in space provided.
%well
INSPECTION DIA—ECTOR'S
DEPARTMENT
112
1
CITY OF
EDMONDS
PR 6-1107
FILE
ILDING PERMIT Appl. No . ......
'UPUCATION
Permit limit� one year
CITY OF EDMONDS Building DbPartment
7
construct the following work, in accordance with the accom.
UCATION is hereby made for a permit to
APP submitted herewith for approval.
panying plans and specifications. Two sets are
Off'st
new .................. Parldng ......................
Z .. ........
.... wu.tlz ............... ........
Work addn repair
Use zone ........ . . ..—/ ..... Fire zone ..........................
............ .. .. ........
Const. type .............
,Occupancy ................................
.... Lot ...... .........
9BIk ..... 6 ............. Add
Address...
..............................................
.............. Area ........................................... Septic tank .........
Lot frontage ...........................
1. side ...................... ...... rear .................................
Bldg. setbacks — front ........................... r. side . ........................
............... Tel. No .............................
..... Address. ....................................
Owner................................................................
................ Tel. No ......................... 7...
Builder.................................................................... Address ............................. ......
..........
..... Address .................................... ............... Tel. No .................. 7
I 'i :'. " � o
Plansby ............................................................
... VAG
S..P.Crolt..-CaLvers ... work
... to ... be .. d=o--
Remarldhi
on privale Property ONLY. 1-4
............
i.on...oa...the ... puhl
rquees
driveways, Mal
... rcaujro ... saparata..p.er nte ..Qe .. 0.-h.a� ... ed.-I
.................
ith all applicable Codes and State, laws regula
t comp y wi
the above isa correct statemen nd agr
work.
C
dress..... t ......... Date . ..... ..........
Signed Owner/Agent .. .. ...... ... .... ....
pliance with the
the above conditions,� and tocom ap,
proved, subject to
PERMff for the above work is hereby ap'
t notations
and Building Departmen thereorL
proved plans and specifications,
................ Recd.
................... permit fee..
Valuation ......................
................. Date.. I., .............. !7....
Building Department, By ............ .........................
ctrical.installatiom.
This permit does not coi)er Plumbing, Sewer or Ele
Pi,
Z I,
a
r777"7777-77
Appl. No.
KJOATION BUILDING PERMIT
�yeu
Permit limit,, one
F -EDMONDS Building DePartmeRt
k, in accordance with the'accom,
ON "is hereby made for a permit to construct the following - wo
nd ecifications. Two sets are submitted herewith for approval..
anym :plans a sp
'Off -St.
. .. .. . .......
Z alter .................... Parking
.11 ��. I ........... 1!!!!? .........
jddn repair ......
'Fire ..........
Use zone .... .......... zone .................
............. ...... Const. type. ...........................
......... . /
Lot ...................... Blk. ..... Ad .................. I ............
dn .........
...... .......
........ .... .......
..........................
.................... Septic tank .............. .................
rontage....... ............................... Area .......................
rear.......... ......... .............
front........................... r. side ............................. 1. side .......... I ....................
0,
.... 01
....... Address./d..I.Y" .................................... Tel
ir. _e . . .... ......................
TetNo ............. ...............
........................
Address. ...........................
Budder............ ........ ........ ................................
.................. Tel. No .............................
Address ..................................
......................................
Plans by ..................
......................................................
.................................
.......................................................
;K Remarks.., ............................
all applicable Codes and State. laws regulating this,
comply with
ent, and I agree to
above is a: correct statem
�,wor
Date .......................
"i Address...
.,StgnpA- 0 r/Agent ..... .. . ...................... ....... I .........
wne
7 --- ............ .................. ....
with the ap,
&nnrUtinns. and to com ance