660568.pdfPOWMID ON KROLL MAP NO.: I BUILDING
DEPARTME
ROUD ING mT Applicant Fill
PERMIT APPLICATION Inside Heiii-y T2-Hos
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SPEC INSPE�UA�L` OCCUPANCY GROUP
0 YES
PLAN CHECKED BY
VALUATION TOTAL FIER
BUILDING
WORK TO BE DONE I VALUATION
BUILDING PERMIT
2 FEE
PLUMBING
3 PERMIT FEE
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HEAT & GAS LINE
NUMBER OF STORIES 4 PERMIT FEE
NEW Ej SIGN SIGN PERMIT
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ADD DEMOLISH ENCE —
DEMOLITION
BE F 6 PERMIT FEE
ALTER RESIDENTIAL NUM R 0
DWE LING PLAN CHECKIg
REPAIR NON-RESIDENTIAL UNITS 7 FEE
PROPOSED USE
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I hereby acknowledge that I have read this application; that the in-
formatlon given In correct; and that I am the owner, or the duly author- ATTENTION �PPLICATION APPROVAL
Ized agent of the owner. I agree to comply with city and state laws regu- THIS PE101IT This application Is not a permit until
lating construction; and in doing the work authorized thereby, no person AUTHORIZES
will be employed In violation of the Labor Code of the State of Washington ONLY TIEE signed by the Director of Building Inspec-
relating to Workmenlo Compensation Insurance. WORK NOTED tion, or his deputy; and fees are paid, and
11,cepl Demolitions which $hall receipt is aclmowledged in space provided.
NOTE: Permit Limit One Year be completed In ninety days.)
ER OR AGENT) DATE ONE INSPECTION DIRECTOR'S SIGNAT.URE ,
SIGNA'rtlRE (OWN DEPARTMENT
7c z CITY OF e!4�
EDIVIONDS //r
NOTE: Appficant Subject to Plan Check Fee Pit 6-1107
This Permit covers work to be done on private property ONLY.
Any construction an the public domain (curbs, sidewalks, driveways, FILE 4
marquees, etc.) will rrquire nrparate permlKslon.
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CITY OF EDMONDS M
DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE, Sec. 306
19601 &ad Place Went Building Permit Number 660568
At
Occupancy established by this certificate:
Fire Zone No. Stories
Basement
5 PIO-x Type Const.� V YES
Floor Load signs inplace (perSec. 2.3o8 U.B.C.)— Capacity signs —posted (per Sec...3301 (i) U-
Floor load and room capacity signs, when required, must remain posted at all times.
THE Apartomt Buildixg HAS BEEN INSPECTED AND APPROVED AS CO I MPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING'CODES.
Issued this ?-8th day of AUgUA 19�7
BC)
CHIEF BUILDING OFFICIAL By
This certificate shall be posted in a conspicuous public area and shall not be remo ed, mutilated or obscured and shall be main-
tained In legible condition at all times. Any change of occupancy requires a new certificate.
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