660185.pdf12
:".]BUILDING DEPARTMENT I Applicant M
. PERMIT APPLICA Inside Heavy Lines
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Idl, I I Legal DescrIptior
I
e-^" yj
or
r/ �;2 ;L ,
[3 YES [j NO
TO BE DONE
1
I
BUILDING
VALUATION
2
2
BUILDING PERMIT
FEE
3
PLUMBING
PERMIT FEE
10FO
4 4
HEAT & GAS LIKE
PERMIT FEE
N NzW7
E
ADD
DEMOLISH
1
SIGN
PENCE
IBUR
NUMBER OF STORIES
RIES
1
5
SIGN PERMIT
FEE
DEMOLITION
PERMIT FEE
ALTER
REPAIR
RESIDENTIAL
NO]
UMBER
DWELLING
UNITS
7
PLAN CHECK
FEE
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.
I&Ung cOnEtrUction; 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 One Year (Except Demolitions which shell
be completed In ninety days.)
6,0
&NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, drivewaysp
Marquees, etc.) will require separate permission.
8 1 AMOUNT DUE
No.: BUILDING
PERMIT
NUMPER 61
;P4 .
STREET SETBACK REAR
LOT AREA VACAD
1 0 YES
NO
CBER
14
.ECKED 13Y
STREET IMPROVED
El "a 0 ITO
IOUP
ATTENTION I APPLICATION APPROVAL
TIUS PERMIT This application is not a permit until
AUTHORIZES
ONLY THE signed by the Director of Building Inspec-
WORK NOTED I tion, or his deputy; and fees are paid, and
receipt is acknowledged in space provided.
INSPECTION - ZD1 CTOR:�r
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
FILE
(roff OF EDMONDSo WASHINGTON
BUILDING PERMIT
'�licant hereby certifies that a plot, plan, drawings, and sufficient details to indicate
theIntention
to fulfill all requirements of this code are attached hereto.
Application is hereby made for permit to do the following work:
....................................................................... . ...... . .
..... . .... ..... . ................
.. . .................................................................. . .........
Block....... . ...................... . ........... ...........................
nsions................. ;2..� ....... X ................................
will be ........................ Stories.
�cupancy of building will
This Space Is For
City Inspector Only
feet from thp d* line.
. .. ...... near9t a ining
7 Own—
er.. . ......
0
.81 Owner's Address ........... . ....................... .................. . .......... . ...
9. Builder .... . ........................ ................................................. . .... . ...............
10. Builder's Address .......................................................................... . .......... . ...................
...................................................................................................
All
Da-- r ....... 19.
(Owner
0 allerz
T i ion is hereby granted to do the work described hereon, according to the approved plans and specifications pertaining hereto,
ermiss
'subject to compliance with the ordinances of the City of Fdmonds.
PERMIT N? 9,80
atimated cost $./e��roo
........................
Life of permit ......... (e/C7
I Plans filed: Yes 0 No [I I
$ ........ ......... ... . ,
Re
Dep=t of Buildings
City of Edmonds
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 $2.00 foreacb
p000.0o of cost. If the actual cost of the structure, when finally determined, exceeds the estimated cost by more than 5ch, applicant agrees to pay an additional ift
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 required 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 detlW
specifications.
3. Prior to employing any labor or commencing work, notify the Industrial Insurance Division of the Department of Labor and Industries, giving an estfinateof
the 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 it= all sub -contractors. The releases should he
attested by the Department of Labor and Industries. 'Me above procedures am requirements of the State Industrial Insurance Act.
ow
I
A, .......... .
i I'V CITY OF EDMONDS, WASH GTON
'N", IN
BUILDING PERMIT
reby certifies . that a plot, plan, drawings, and sufficient details to indicate This Space Is For
�to fulfill all requirements of this code are attached hereto.
City Inspector Only
6 1 lereby made for permit to do the following work:
. . .. . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . .
............................................................... ....... .........
. .........
.................................................. . ...... . ..........
............... . . .... . .... . .. . .. . .. . . ....
...... ..............................
ensions.... . . ..................... X ..... 4.12� ..............
0 ris .... 76 .................... X ........ ..........
w be ............. / ........ stories.
ill
ment, ........................
upancy of building will be ... / ..... SA�-,q( ........................................
...... Jeet from the nearest I
her ....... 4�j P ......... %
Address
'�,]`8 Own '7 ....... .................. . ...............
B` der .... . ... ........................... . . ... ................. . .... . ......... ... .
........... 7-:7 Ix
Builder's Address. .......... . .......................................................................... . ..................
Date... .1 ......................... 19
............. f .............................
(owne—C-0—t ... h* ............
Permission is hereby granted to do the work described hereon, according to the approved plans and specifications pertaining heret%
subject to compliance with the ordinances of the City of Edmonds.
Estimated cost $.Az
.......................
Life of permit ............... do. - t - e ........
.................... . .......
Recqjvt,d by 1-1
PERMIT N9 737 j��Ing officer)
Plans filed: Yes T1 No Department of Buildings
City of Edmonds
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 $2.00 for each
$1000.00 of cost. If th6 actual cost of the structure, when finally determined, exceeds the estimated cost by more thin Wo, 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 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 a building permit shall be accornp�aled by a copy of the contract and a copy of the detailed
specifications.
3. Prior to employing any labor or commencing work, notify the Industrial Insurance Division of the Department of Labor and lo.dustries. giving an estimate of
the payroll and make monthly reports Of Payrolls- Full inumcdons should be obtained from the nearest office of the Department of Labor and Induittles. Before
final payment, the owner should obtain a release from the general contractors who in turn should obtain release from all sub -contractors. 7be releases; should be
attested br the Department of Labor and Industries. The above procedures are requirements of the State Industrial Insurance Act.
I
0
OATION BUILDING PUNIT Appl. No.
'EDMONDS Builcling DepartmeW Permit limik one year
ON is hereby made for a permit to construct the following work, in accordance with the acoom-,
and, specifications. Two sets are submitted herewith for approval.
[T.
12.0 Off -St.
,��x 'air ....... ............ Parking ................ I ......
................. WA"AL ............................... I
............................
lilt zone ..... e ........ Fire zone ...........................
.............. Const. type ............................... Use
........ Lot ........................ Blk ........................ Addn ...................................... . d
--- - ----------- ..............
is
Area ........................................... septic tank ..........................................................
1� ...............................
front........................... r. side ............................. 1. side .............................. rear ........................ I .......
P a-,A-JTel. No .............................
. ........ 7.7Z ...... //A-2 .. . .....................
.............. . Addres&
............
dress ................... Tel. No .............................
............................................................. Ad ...........................
by....................................... Address .................................................... Tel. No .............................
"Remarks ........................................................................................................................................................... ......................
......................................................................................... ................................................................................................
. .............
................................ ........................... I ................................... ................................................................................. .
agree to comply with all applicable Codes and State laws regulating this
The.above is a correct statement, and I
k.
wor
gn -Owner/A
�Si' ed gent. Address ............................................ D a t e..
...... ........ .... . ..
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ar
proved plans and specifications, and Building Department notations thereon.
0-1-0
......................... Permit fee ...... ................... Recd. by ... .... z . ....... .........
Valuation ........
...............
Building Department, By ............................. .......................... Date ............
This Permit does riot cover Plumbing, Sewer or Electrical installations-