670056.pdfI
BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
NAME (OR NAME OF BUSINESS)
MAILING ADDRESS
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CITY TELEPRUNN NUM1311"
NAME
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REPAIR
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DWELLING
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1 UNITS
I 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.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety daya; 31OVED-IN BUILDINGS shall be Com-
Pleted In six mtnths.1
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Valuation I Fee
Plan Check No S_
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
No.
A=NTION APPLICATION APPROVAL
THIS PERMIT This application is not a permit until
AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ac-
knowledged in space provided.
JRE _(O%VNER OR T) DATE SIGNED INSPECTION
Zer DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Cbeck Fee PR 6-2107
This permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, xldeiwOks. driveways,
marquees, etc.) will require separate permission.
FILE
I
CITY OF EDMONDS
DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE, Sec. 306
At —8b'—do—o* Building Permit Number 670056
occupancy established by this certificate: Fire Zone III No. stories
10 unit Apartmext Type Const. V — 1 Hour Basement
Floor Load signs � in place (perSCC. 23 o8 U.B.C.) — Capacity signs . posted (per Sec. 3 3 01 (i) U.B.C.)
Floor load and room capacity signs, when required, inust reinain posted at all times.
THE APartMeSt BU"d'*g HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES.
Issued this 15th day of Augmt 19 67
CHIEF BUILDING OFFICIAL By
This certificate shall be posted in a conspicuous public area and shall not be removed, mutilated or obscured and shall be main-
tained In legible condition at all times. Any change of occupancy requires a new certificate.