660483.pdfGITY
DING PEPARTMEN
MIT APPLICATION
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Applicant IS
Inside Heavy Lines
77;7
0 YES
13 NO
OF
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T
PLUMB NG
PERMIT FEE'
HEAT & GAB LINE
4 PERMIT FEE
NEW SIGN � wMNMICPERMIT
5
ADD I DEME03LIBIL I Lj FENCE FEE
R DEMOLITION
ALTER I Lj RESIDENTIAL NUMBER 01" 6 PERMIT FEE
DWELLING PLAN CHECK
REPAIR NON-RESIDENTIAL I UNITS 7 FEE
8 1 AMOUNT DUE
I hereby acknowledge that I have read this application: that the In-
ATTENTION
formation given Is correct; and that I am the Owner, or the duly allthOr-
Ized agent of the owner. I agree to comply with city and state laws regu-
THIS PERMIT
lating construction; and In doing the work authorized thereby, no person
AUTHORIZES
will be employed in violation of the Labor "a of the State of Washington
ONLY THE
relating to Workmen's Camps i nNation Insurance.
WORK NOTED
(Except Demolitions which shall
NOTE: Permit Limit One Year be completed In ninety days.)
JIGNATURE (OWNER OR EN DATE SIGNED
INSPECTION
DEPARTMENT
cITY OF
vw
EDMONDS
Applicant Subject to Plan Check Fee
PR 6-1107
This Pennit covers work to be done on private property ONLY.
Any construction an the public domain (curbs. sidewalks, driveways,
marquees, etc.) will require separate permission.
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0 YES 13 NO
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4; a
0 YES [3 NO
RAI
APPLICATION APPROVAL
This application is not a permit until
signed by the Director of Building Inspee-
tion, or his deputy; and fees are paid, and
receipt is acknowledged in space provided.
FILE
APPIMATION (BUILOMB MMff G
Appl. No . ...................
Permit limik one Year
MONDS Building DepadmM
V-C-Iff OF ED
with coom
AIJON is hereby made for a permit to construct the followmg wOrko In aCCOrda= the a
are submitted herewith for approval..
g plans and specifications. Two 8113
off'st.
new: alter
.......................................................... Parking .... ..................
W It d repair ..... ......
or a dh.
Jse zone ... zone .........................
C................................ Const. type ...............................
Y
............... Addn ......................................
........ ........ Lot
. ............
ge... ........... I ....................... Area ........................................... Septic tank ..........................................................
........ . . . . . . . .
........................... r. side ............................. 1. side .............................. rear ...............................
Of
...................... Address ...... ..................... Te ......................
er.. No...
.............
...................... Addresc ................................................... Tel. No ........... ................
r
Address................................................... Tel. No ........................
Remarks..................................................................................................................................................................................
................................................................................................................................................................................................
des and State laws regulating this
The above is a correct statement, and I agree to comply with all applicable Co
work.
M,
. . .... . ........ .... . ... Address ................... . ....................... D ..... ...
Signed Owner/Ag .............. ... ...
PlElUM 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. 2
.......... ..........
......... OL .............................. Recd. by .. .............
Valuation ..................................... permit fee..
By.z?0;/.%.Z ................. �7 ......... ... Date ............. .... . ... ................
Building Department
NOTE -- This permit does -not cover Plumbing, sewer, or el.'Ctrical installations, nor does it permit any work to be
done in the Right of Way areas. Driveways and walkways must be planned to meet the official grades of streets
and alleys, and plans for future sidewalk development.
f
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T1,
ATION
BUILBING PERMIT
Appl. No ..................... / ........
.
OF EDMONDS
Bulkling Department
Permit limit, one year
ATION is hereby made for a permit to construct the following work, in accordance with the accom-
N:,.,,panymg plans and specifications. Two sets are submitted herewith for approval.
Yv
ter . .... Off -St.
'Work addn repair ... . .................
.................................................... 4 ............................ Parking ...... . .. . .......
Occupancy ............................... Const. type ............................... Use zone ...... . . .... Fire zone ... . ......................
Address. ... .. Lot ....... ................ Blk ....................... Addn ......................................
Lotfrontage ....................................... Area ........................................... Septic tank .........................................................
X�,
Bldg. set -backs front ............................ r. side ............................. 1. side .............................. rear ..................
.............
Owner.... ......................... -Address ......... e�� .... t ........ Tel. N ...........
0 ...................
Build drew.. Tel . ..... A.7 7.
............................................ Ad .........
Plansby ...................... I ........................................... 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.
Signed Owner/Agen ............ . .. Address ............................................ Date
..............
-9�K -14�
PERMIT for �e�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.
4!� -W/ 4?�-6
g;� 40 0 Permit fee... d. by....
Valuation .......................................... ............................ Rec
Building Department, By ..... ................................ ................... Date .... ..........................
INSPECTION RECORD
Fdn, OK ..... ...................................... Frame, OK .................................................... Final, OK ....................................... .
This Permit does not cover Plumbing, Sewer or Electrical installations.
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