660448.pdf4
j,
BUILDING DEPARTMENT I Applicant Fill
,PERMIT APPLI( Inside Heavy Lines
MAJLING ADDRESS
- 7 .j / , -.1 lzr
TY
OL
TELEPHONE NUMBM
PR 7,3
Z4 '57 7— /S? c-'
ADDRESS
. / &6-1-40
le— 152�flt _Z� - _/0 ?
or
1 A i
I& e-j" (- -0-
C� P el'i
SIGN
NEWD I
DEMOLISH
F
ALTER
RESIDENTIAL
NUMBER OF
I
FI
REPAIR
I
F-1 NON -RE
DWELLING
UNITS
I hereby acknowledge that I have read this application; that the In-
formation given in correct; and that I am the owner, or the duly author-
Izad agent of the owner. I agree to comply with city and state laws regu-
laung 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 Workman's Compensation Insurance.
(Except Demolitions which sha3l
NOTE: Permit Limit One Year be completed In ninety days.)
3IGNA (Owrisin n AuaivL-)
I �12,4
'7� �4�i ;?4:;iv� 1 F'7�1
NOTE: Applicant Subject to Plait Check Fee
-Two Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
0 YES
[] NO
BUILDING
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
s I AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 0-1107
k
PERMIT 660448
NUMBER
13 YE13 E] NO
J
[3 YES [3 NO
PW
1 00 1
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.
DII 7�7T` 711IGN
n
DATE
FILE
CITY OF EDMOf�bi, WASHINGTON — DEPARTMElil'-OF BUILDINGS
BUILDING PERMIT
e � I
A plicant hereby certifies that a plot, plan, drawings, and sufficient details to indicate
a �e -intention to fulfill all requirements of this code are attached hereto.
rMtio e I h f 11 urk, -
n is hatreby made for permit to jio t e o �wi r:r
it......... r/..U2 .. .. ......................
tid
.)er or o a)
1. Building dimensions are .................................. X .......................................
2. Lot dimensions are .................................. X ..............................................
3. Building will be ........................... stories in height.
4. Number of basements .................................
5. Occupancy of building will be .................................................................
6. Building wi be. ptarest adjoining lot line.
7. Ov ...... ..........................................
8. Owner's Address ........... .. ... ...... . ..
9. Builder ........ Y3 .... .. .. AO fs- . ..........
1L�4
10. Builder's Address ....... . ............. .
11. Architect or envineor ..............................................................................
19.
s Sig -nature .... ;.� ... ..
zft 0
0
U
5.N Cd 0
en
Pk
0
rn cn
Ift
"0
Cn
0>.
9W
Cd 4J W CL4 rn
0 PQ z
5 " VJ
C)
0 0
z
Estimated cost $..70..0
....... Group No . ................................................ .
Life of permiL .... 4; .........
lyle ...............
Plans filed: Yes'o No 0
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. This copy is your receipt for the following fees:
1. Building permit fee ....................................................... $ ......................................
2. Sewer permit fee ........................................................... $ ......................................
3. Inspection and supervision fee ....................................... $ ......................................
4. Total ........................................................................................................... . .......... . .... . .. I $ ... e;� . ............................
PERMIT N? 519
Ricceioby
dV �)
.... ... -*,, ..... ..........
(Issuing Officer)
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 $1.00 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 VgtCCJ to pay in additional fee
of $2.00 for each 51000.00 of such excess cost. In such event no use permit shall be issued until such "discrepancy fee" Is paid. 1�1 �
2. Whenever a contract for construction Is executed for any structure costing more than $1000.00 for which a licensed architect or engineer is not required by
',the Building Code of the City of Edmonds, the application for a building permit shall be accompanied by a copy of the contract and a copy of the detailed
"Ificado
3. Prior to employing any labor or commencing work, notify the Industriii In oce Division of the Department of Labor and Industries, giving' at� estimate of
the payroll and make monthly reports of payrolls. Full instructions should be'obtained, from the n:zrest office of the Department of Labor and Industries. BC(?FC' .
final paymint,'die owner should obtain a -release frofn�the ,
general contractors who-4nturn shoult obtain relesse.from, all Fub-cantr9ccors. The rileases sh?�dIAK
xamid by the Deparur�ent of Labor and Industrics.� ne ibove procedures are icquke"is Si9te In"duserfai Imus'ance Act.
4
0
�I`j y It . � 7 . , . I , - , t' , I � 4 , t, , , " , , , ,
." .1
t .-
It
116.1r-
A I
... .. ... .. o't
It
I L
I I
4
I
d
1 k
4
I
4 p I P It, I
II.M., TL.' - 4 ( L L L I I ' ' L , L; , ' ', 4,t�
t 'oj td
Iq
M , , � 1,
far, fa� it aI4$j;).L MI
1�j ... I"I ...
1, , , -tt, 4
lit UmAtIo, p-tiLlt Ott I t
&4twolt, 91n�
It I wr 2joqtV(jf) &.1; Vtj) :F 11"i I t 4q %V%C 1
ItUCLIalf, coolkot
110 0
Vat, tk IT"
tlt4 la 1411(f.
lit Irl"Ill Till I
orlif Via froc. 111;Tu
fit: (IQ jut ®rlifil P.)ooQ'tt10 llu�Wj. t.Coj P)I. UI aftit t1l,lat, ... ...
M If t q]c fivo.- cat 2 1 �tof.
VVII-WILf, t I I q
f.400111tr*
It , % t . "
c"'t tt� t Cal P
Itl I It, c u if t a* i., at, %
fat 111 If tIt tj
r L I. Lit .
tt
It L
d I tt.
dr L
L I - It
t
c
'fix
OW.; L L I I
It
It
.1..I off
L ALI L , LI1. I
a
I.ItItt
. . . . . I . . . .
. . I. . . . . ..... . k� 4
.. I . . . . . . . . . . . I . . I . . .
L L I L, 4 , , LI V1.
100 L . - 4 1
. ; , j L ".,, I It t, Z,
r L 11 11.1 1 1 1 - I%,
�4 1- '1,-7 1
I I p It Ld'
L , ��, �1
: , , �40
niq �)J!D�ttl fro I
It -
I I .
. . . . . . . . . . I . . . . - - - I I it
brUfM
.1 1 tl
It . . I I . . I . . . . . I . . I I p . . . . . . . . . . . . . ictt
tI)L,
. . . . . . . . . . . .
Ittj
C&I U r
X
corit br pi, f:pr;'
1.�,
if C11.11jetj .1.1:t1lij lu
()I COW b I It
It I
no J)bLrjlr.rq - 't L
-t: "Ito Aft
C, L Cf. it 14 . epIN to , to A 11
a, I-tl
Y.
It
Not
. A, L Sint
z tt%
It
I . . . . I . . . . . .
at'
..............
vZON si;mk.
I I V) r, L .-j I ? .1.11
CT4)i!D Y100 It
It
It t" :t4
at
77111 W.. AL
I . '. . I. - r p I A
a' t NIL, at� L r
. . . Lk- .1 .4
- ]4 It
Fr �L� 't
...........
7]�
[L., .4 1.() L) I �ta4-,l 1.a,tt: it c I J'�) q L, ld:ar� I
33mirpoia, if -GI Ij,. t it It th�
4
1i rI It L,
It It
It it I
CY "`5
t I I
fIttl[
.!tt III)s Ira
YL. 4t,I1 Itt L
21
lit
r4
# it
I� It f.1 t
ILI
It X -tII7k
It
VITt"
It P-11
4 "t t ; N
1 4 tr� .
I r I . . . . . . . . . . . . .
It . . . . . . . . . . . . . I . . . I
tt—�� 1; L 1* 6 x ) �;tl 6 1 L �i
Ld
dIIII,
"ItItt'
cu
t.11 ti I . . _ I I
lIkEw 1 $1 , It I I I $I)
it
Ak L
L It
-77,71. 7
/ �/ Ir---
APPUGATION UBUILDING PONIT C), Appl. No.
�CITY OF EDMONDS Building Department Permit limik one year
APPUCATION is hereby made for a permit to construct the following work, in accordance with the acoom,
patiying plans and specifications. Two sets are submitted herewith for approval.
Off'st.
a ter
new
..............
d repair .............................................. ............ �// ............................. Parking ........
Work ad n
one,,t..."L .... Fire zone ... ........................
Occupancy; ............................... Const. type. .............. IQ .....
7;
6-A— ........ Blk ......... I Addn.gMpee ..... ......... .
'Address.. ... ..... .
'-Lot frontage .....................
Area ......................................... Septic tank .........................................................
................... A
........ r. side ............................. 1. side . .. . .............. rear ...........
'Bldg. set -backs front.--.. ........
�VIL ..... ..... Address.....,,-�.57 No ... 4EZ
Owner.'/Or
-law;-�-61-. Address .................................................... Tel. No .... ........................
Builder .................... ..............................................
...... Tel. No .............................
J,� ................................................................. Address ..............................................
Plans by.
...........................................................................
T: i . r . . I I � I I
.......................................................................................................
em
vr
................................................................................................................................................................................................
The above is a correct statement, and I agree to comply with all applicable Codes and, State laws regulating this
work
Signed Own�r/Agefft.Il..Io..�/*�*/"*`.,.Io� .......................... ... Address ..........
............. 4�4te ....... ffi
PERMIT for the above work is hereby, approved, subject to the,above conditions, and to compliance with.theap�,
proved plans and specifications, and Building Department notations thereon.
C> 0
Recd. by
Valuation .................... Permit fee .............. ..........
.............. . .......... ... ....
21�
Building Department, By ..................... �0� .............. . .................... Date ................ ;.27n ... .............................. 7 ........
to be'
NOTE This permit does not cover plumbing, sewer, or electrical installations, nor does it permit any work
done in the Right of Way areas. Driveways and walkways must be planned to meet the official grades 01,7ects.
and alleys, and plans for future sidewalk development.
E
9