660344.pdf3
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BUILDING DEPARTMENT I Applicant FIB
PERMIT APPLICATION inside Heavy Lines
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Li
NEW
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Li SIGN
ADD
I
DEMOLISH
FENCE
ALTER
RESIDENTIAL
NUMBER OF
I
F�
REPAIR
F�
NON-RESIDENTIAL
DWELLING
UNITS
I hereby acknowledge that I have read thin 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 Workmeas Compensation Insurance.
(Except Demolitions which shall
NOTE: Permit Umit One Your be completed in ninety days.)
NOTE: Applicant Subject to Plan Cbeck Fee
_jj58 Pendt coven work to be dean on private property ONLY.
Any construction an the public domain (curbos sidewaiks, driveways,
marquees, etc.) will require separate pennifislon.
Ilk,
13 YES [3 NO
BUILDING
I
VALUATION
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
SIGN PERMIT
5
FEE
DEMOLITION
6
PERMIT FEE
PLAN CHECK
7
FEE
8 1 AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
PERMIT
NUMBER 660344 1 1
I I 69-aa I
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 acknowledged in space provided.
I
FILE
El
'Ile ...
. . . . . . . . . . . . .
...... ------
. It"
BUILD . ING PERMIT
Appl. No . ...... ...................
�,.OVEDMONDS Building, Department Permit limit, one year
1n accordance with the accom-
H is hereby made for a permit to construct the following work,
and specifications. Two sets are submitted herewith for approvaL
Off'st
&"alter
ew.............................................. Parking .......................
... .............
:addn repair .............. .....................................
1410
cy .... ............. :r ...... Const. type ...... 0< ................ Use zone ... ................. Fire zone ... 73 ...................
....................... Addn .............................. !..7
.F
. .................. .........
dress ........ -f .... .
frontage .......................................
-Septic tank .............
t
..... rear .............................
... ..... ...
Bldg ............... ..........
%
front r. side .......... 1. side .............
ell Nc ....
Address. ... ........ A .............. T
. ...... .. .
Tel. N
........... ..................
Address. ....
.................
_;'Bui
................ ......
Mel lid :?Zz .
Address........ ........................................... Tel. No... ............. .........
Pby ............................. ............................. ..
.......................... ........ ..................
.......................................
Remaxk& .................... ..................................... .....................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
................................................ ...............................................................................................
............................
....................
The above is a correct statement, an . d I agree to comply with all applicable Codes and State laws regulating this,
work.
Signed Owner/Agena4p-.7 ......................... . ... dress ............................................ Date...
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ap-
proved plans and specifications, and Building Department notations thereon.
Permit fee ..... 41L-) ............... Recd.
... 40,32V
by .....
Valuation ......... /..
Building Department, BY ................................. &IN-ni .......................
6,1152 ....................... I..
ewer or Electrical installations.
This pennit does not cover Plumbing, S
APPLIOATION BUILDING PERMIT Appl. No.
....... ...
CITY OF EDMONDS Bulkling Departmmt Permit limit, one year
lowing work, in acoordancC with the accom,
APPUCATION is hereby made for a permit to construct the fol
mitted herewith for approval.
panying plans and specifications. Two sets are sub
Off'st.
new alter
-51-0 ................................................... Parking . . .................
Work addn epair
r ......... ..... .. z1r. a—
Ah . . . . I ".
.......... Fire zone ......................
se zone ......
Occupancy ................................ Const. type ................................ U
Lot ........ ............... Blk ....................... Addn ......................
Ad ................
dress ........ .............................................
Area. ........................................... Septic tank ............................................ . ...........
Lot frontage ......................................
....................... 1. side ............................. rear ...............................
front ............................ r. side ......
.......... Bldg. set,backs
........................
......... .... Addres& ......... 4; :!E�-e!&eTel. No..95:!
....................
Builder ........ .. ................... Address. ................................................... Tel. No .........
....................................
..............................
Plans by ................................................................. Address ........ ............. Tel. No ...............................
.................................
Remarks.................................................................................................................................................
The above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this
work.
ate . .... . ..... ... f/
Signed Owner/Agent.,.,,(,
f ... Aile.lddress .... D
e above conditions, and to compliance with the ap,
PERMIT for the above work is hereby approved, subject to th
proved plans and specifications, and Building Department notations thereon.
-'2 . ............... Recd. by ....
Valuation ............ V. .................................... Permit fee ........... ell. .............. I ... .
W. .............. .........
............ ................... Date ........................ .......... ....
Building Department, By ..........................................
INSPECTION RECORD
Fdn, OK
I
Frame, OK
.................... Final, OY, .......................................
This Permit does not cover Plumbing, Sewer or Electrical installations.
AN
ION BUILDING Pow Z 4.
APPLIOAT Appl. No.
BulklIng Departmmt Permit limit� one year
CITY OF EDMONDS
a
CATION is hereby made for a permit tDconstruct the following work, in accordance with the coom.
AMU
and specifications. Two sets are submitted herewith for approval.
Oanying plans
Off -St.
new
_,Ater
. . ...........
repair ............ :: ............. . .................................. Parking - - -----
Work addn
....................... Const. type ............................... Use zone ....... ...... Fire zone .................. . .. . ....
Occupancy ........
1�16
elf.
Addn ......................................
....................
A�1dress.....1-Ze ............................ . .. . ..... 1ot ....... ................ Blk....
1,ot frontage ....................................... Area ............................................ Septic tank. ............................................ . ...........
Bldg. set -backs front ........................... r. side ......... 3 ............... 1. side ............................. rear ................................
Owner.4�5- —4� C� '00 ............................
.. . .. ......... -Address. ........ ............... Tel. No.
............................
Builder .......................................... . .. . ................... Address ................................................... Tel. No.
........... Tel. No .............................
Address ........................................
Plans by ...............................................................
Remarks..................................................................................................................................................................................
t, and I agree to comply with all applicable Codes and State laws regulating this
The above is a correct statemen
work..
Signed Owner/Agent()'--- ddress ...... ?.1-5.-I� .... 41P a.
PERMIT for the above work is hereby'approved, subject tDthe above conditions, and to compliance with the ap-
ns, and Building Department notations thereon.
proved plans and specificatio
Permit fee ........... ........... Recd. by ... ... . ...... .. .
Valuation .............. Q ................
000 Al
Building Department, By ........... ................................. .... Date .... ..............................
INSPECTION RECORD
Fdn, OK ............................................ Frame, OK ............. . ..................................... Final, OY . .......................................
This Permit does not cover Plumbing, Sewer or Electrical installdtio�s.
�tff OF EDMONDS,
WASHINGTON
BUILDING
PERMIT
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.
ermit to do the 1ollowing work:
Application is hereby made for p
.......... . ................. .......................................................... L ....
......................... . .... . ..............................................................
. .......... . .........
........... . .................................. . ........................................................................
........................ ................................................................
.....................................
..... . ................ . ...................... . .... . .............................................................................. . .........
Lot........................................................ Block ........................................................................
..... . .......... . .... . ............................ . ................ . .... . ................ . .... . .. . . .... . ...... . .... . .... . .........
1. Building dimensions ................................ X ..................
2. Lot dimensions ................................ x ..........................
3. Building will be ........................ stories.
4. Basement .........................
5. Occupancy of building will be ....................................
6 . ........................ feet from the nearest adjoining line.
7. Owner ... 411'Idl-1.1ze� ....... . ........... 2
8. Owner's Address .....
9. Builder ................
10. Beilder's Address .... . ......... y ............
7
Date..e; . .......................... 1
- JO
....... I
....................................................................................
(Owner or his agent)
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 V6T ..............
$ ........ .. ........
y
Receive
.... . .... . ...
(Issuing 011i
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 the actual cost of the structure, when finally determined, exceeds the estimated cost by more than 5%, applicant agrees to pay 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 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 detalled
specifications.
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
the payroll and make mooddy 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 canKactors who in turn should obtain release from all sub -contractors. The releases should be
sucested by the Department of Labor and Industries. Ile above procedures are requirements of the State Industrial Insurance Act.
K
PERMIT N? 949
Life of vermit ..........
Plans filed: Yes 13 No