660430.pdf%4
Ln NEW I E] I LJ SIGN ——]
nADD DEMOLISH I n FENCE I
LJ ALTER " RESIDENTIAL I NUMBER OF
MREPAIR I M NON-RESIDENTIAL I UNWIETLSLING I
1-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.
(Except Demolitions which shall
NOTE: Permit Limit One Your be completed in ninety days.)
46
NOTE: Applicant Subject to Plan Check Fee
d-
BUILDING
1
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
00
.5
ATTENTION I APPLICATION APPROVAL
THIS PERMIT This application Is not a perrait 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 DIRE,9T a BIG:
DEPARTMENT
OITY OF
EDMONDS D^A�
PH 6-1107 CI
This permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidowalksp driverways, FILE
,marquees, etc.) will require separate permission. I
r-7
0D
4
f
�.j
a I
APPLICA" `ON & WORK PERMI'�,, Application NO.
CITY OF EDMONDS Building Department Permit Limit, One Year
ON is hereby made for a perm,it to construct the following work, in accordance with the accompanying plans
7
so.....
,Mqw�/Addn. ',A�4 ..... .................................................... Ground Area ................................... NO. Storl .....
.......................
Const Type .......... .................. Height
6itted ........... . ..... .............
. . ............
.................. Use ZO
ne ... 16—rf.. Fire Zone ....................
N,— Address ... .... ...... . ........ . .... (.1
k"l;( X-0
...... Sewerage ....................................
y . .......... Ipck. . .. . ..... dd'fn ... 12 ...........
.7... Width ... / ..... A2 ........... Min. Bldg. Setbacks, Front and Rear ... .......... �ti ......... Sides
4
..................... Address�Z-Ir
.............................. ; ..... Phone ....................... . .......
Address ....................................
.... Phone.
. ..............
.27z
........................ Address../
� ... . .......
A.ddrew .. ... .. . .....
Q
�'11`1t� .............. ................
L , description,for Permit No. 282-63 ....... .............. . .......
... ........ I .......... __ I I � 1:5t_t5,16_ _. ... ......
C -a T-ai-& Ballinger Land Company's Plat NO* is less the N 1001 thereof
'-Of--GOvernment ... toot 5 v .......................
W-1201 - 'thereof .- together with- that :Portion'
77
P;6111111 )t 5 Block Lake Ballinger Land
-4) lying E of the E line of Lc isg"*_
5 27
W- line 331 ... of --right-ofmway-of ..Northwest ...................
-Plat Noe-19 and W of the
'amany 5
orth and South lines of said Lot S. Block 3
Tftct on
i Company and between N
............
pmducs
............. d East*
7
...................................
.....................................................................................................................
.......................... . ..............................................................
all applicable Codes and State Laws regulating the work.
The above is a correct statement and I agree to comply with
Signed: Ovimer/Agent- Address ... e..
.............
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the approved plans
and specifications and Building Department notations thereon.
VALUATION PERMIT FEES
Arf .
Bldg . . . . . $--=4 ..... t, .....
Plbg. .... $ ..... ......................
APPROVED: Heat .... $ .......... 3 ........................
Elect. $ ........................................
Date.......... . P-1 .............. (.'?, C� .........................
BUILDING DEPARTMENT Others ... $ ........................................
By ... W.m ...... H - e - r - b - e - r - t A*..t_1MSP.1 - - - TOTAL FEE
.. . .. .. . .. ... .... ... ........................... .... ... .
NOTES: No work requiring Building Department or City Engineer's inspection shall be covered before inspection and approval.
Twenty-four (24) hour notice requested. Contact the City Engineer prior to construction of all site utilities, such as
curbs, paving, driveways, sewer, water and street connections.
6 31:
p
Z4
Or.
it I .-iVof
q� L: � I - t.:,, 1p
.44
d M
p
I L p
4 1,
d
LZ
ire
r
d
rp t 4
If L r
4
0 U 4 p
L
4
p I d
t,q r
p
L
r
,7 -�7!: 7
I d
'4 1 4 4 r k
.1 LL,
ro, 4
L
Air 4
e" -71
4
I d I I . . . . . . . f r'L
L
'4L, r
dd
r
a
4
RECORD OF INSPECTIONS.
Date Passed
Foundation
Plumbing (Partial)
(Rough)
Frame
Furnace & Fueltines
Finn!