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670125
1ACIC
RVAR YARD SETBACK
VACANT SITE
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VAR1�14R'NUITitt
DEiICI MNCY MIS PROPERTY
CTIECXED BY
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APOMICATION A00hOVAL
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& WORK PERM11C Application No.
APPLICA�_.,,
Permit Limit, One,year.
Building Department
CITY OF EDMONDS
g plans
mit to construct the following work, in accordance with the accompanYin
APPLICATION Is hereby made f4ora er
and specifications:
No. Stories ... ........
GroundArea ....................................
WORKNew/Addn . ..... ...................... ....................
Const. Type ............. ]!r .................. Height. .......................
'4
Submitted ........... 44 .................. 7 .....
Plans
... Fire Zone ..................... .
...................
......................... Use Zone...
CATION Address ... ....... . 4 . ...... ...
. ...........
LO I
erage...
7, 3v .............. . ..................... Sew ..................... I .......
/ ....... Add'n ............ ..... ............ .................. %
Recorded Lot ................... Block.....?
Rear................................ Sides ..............................
!?9 X.��.5a ................ Width ......................... Bldg. Setbacks, Front and
Lot Arell . .......
............................... A ...
Own,..&.0.e4 .... ddress../Y. ..........
. ...... .... .. .............. ..
.... phone ........................ .......
..........
..............................
........... Address ......................................
plans by ..........................
............................. .
.................. Phone..
........... Address .................................... 7 .................
Bldg. by ........................
.. ............
............
..... Phone...
........... Address ...................................................................
plbg. by .... ..............................
...... Phone .................................
...............................
............ Address ...................................
eatingby ....................................... ...................................
...... Phone .................................
............. Address ..................................
It
Elect. by ..................................
....................................
....................... . ..................... .
................... ...........
Remarks...............................
....................................................
................................
...............................
.......................
.........................................................................
...............................
.....................
...............................................................
.......................................................... ....................................
...............................................................
............................................................................... ....................................
...............................................................................................
...............................
mply with all applicable Codes and State Laws regulating the.work.
The above Is a correct statement and I a ee �o op
... ...... Date ............... 1Z.5-=4
.... IV �-�
signed: owner/Agent. ... .... .... . . .......... Address
ed plans
subject to the above conditions, and to compliance with the approv
PERMIT for the above work is hereby approved
and specifications and Building Department notations thereon. FERNaT FEES
VALUATION
. ....... ...
Bldg. $ .........
;7
Plbg. . . . . $ ........ .......
......... .
Heat . . . . $ ........ .
APPROVED:
Elect. $ ............................. I ...........
.......... ..................................
.... .... ....
Date....
others. . . ........................................
BUILDING DEPARTMENT
/ .. Y--.6
E $...
ft., Her.ber.t.,, Bldg. Insp. TOTAL FE
BY........................................
al
ore inspection and aPPrOv .... .. j,1,
neer's inspection shall be covered bef
uIlding Department or city Engi
NOTES: NO work requiring B or to construction of all site utilities, such as
Twenty-four (24) hour notice requested. Contact the city Engineer pri
ections.
curbs, paving, driveways, sewer, water and street conn
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. . . . . . . . .
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CITY OF EDMONI)Sr WASHINGTON
BUILDING PERMIT
Applicant hereby certifies that a pl0tv plan, drawings, and sufficient details to indicate This Space Is For
ts of this code are attached hereto,
City InspeCtOr Only
the intention to fulfill all requiremen
Application is hereby made for permit to do the following work:
..J ....................... .. ............................. ...
. ... . ................ ..... V, e-. �- ......
. .......... . .. ......
............................. ............................................................................................
. .. . .. . . .... . .........
.................. .............
..... . .................................................... . .... . ..............
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .
....................... . ................ . .... . ............................... ...................................
Block............ / ....... F ..............
............... . .. . .... . ...... . ...... . .... . .... . .........
.................. . .......... . ...................... . .
..... . .... . .... . ....
......... . .. . . .. . .... . .. . .. . . .. . . .........
..... . .... . .......... . .......... . ............................ . ... ...................
.... . .... . .. . .....
..... . .......... r . ........
....................
..................... ... ---- ---------------------------
.. ...........
a,t ............... /
1. Building dimensions ...................... ....................
2. Lot dimensions ............. X ......... zlt� .................
b'':
3. Building will be ......... ............ stories.
4. Basement ........................
an of building will be ....... ..... .... ...............................
5. Occup
6 feet from.the nearest adjoining line.
.................... .......................................................................
er ... .....
7. Own
.........................
8. Owner's Address ........... k ................... . ..................... . .......... . ...
.................. . .....................
9. Builder ......... ........ ..........................
............. . ...................
is, ------
. . . ............... :n ........................
10. Builder's Ad
.......................................
............................................................
............. 19..
W.7 ........
Date ....... ..... 7
...........
.... ............
......... agent)
h
to do the work described hereon, according to the approved plansand spedficationspertainIng,_1
Permission is hereby granted.
pliance with the ordinances Of the City of Edmonds.
subject to com
d cost $Zer--�
Estimate .....................
$ ... ...........................
Life of permit ..............................
date R
%tau g-
Z
ent .�Build*
PERMIT 868 Plans filed: Yes M No 0 ep M954
monds.
�ty of. Ed,
o d strucm at the rate Of $2-00 1
lich applicant pays When permit 13 issued shall be based on estimated cost of the prop se . , re
i. The building Permit fee wl en finally determined, exceeds the estimated cost by more than Wo, applicant agrees to pay an additional fee."-.,
$1000.00 of cost. If the actual cost of the structure, wh
of $2.00 for each $1000-00 of such . excess cost. for any structure c I ostlog more than $1000-00 for which a licensed architect Or engineer Is slat required by,
Copy Of the "derall
2. Whene ction Is executed a copy of the contract '=d a
ver a contract for congru for a building permit shall be accompanied by
the Building Code of the City of FAmonds, the application. 1Y
o',
1, giving an estimate
specifications. of Labor and Industries
rk, notify the Industrial insurance Division of the Department Befo
3. Prior to employing any labor of commencing wo Dep2rtmentLof Labor and Industries BefO
the payroll and make monthly reports of payrolb. Full lnumctiOns should be obtained from the nearest office Of the
o in turn should obtain release from all.subcontmctots. The relcises.6110nad.
final payment. the owner should obmin a release from the geocrat contractors wh the State Industrial Insurance Act.
attested by the Department of Labor and Industries. 'rhe above procedures are requirements of
FPERMIT 68 Dep t
ed
Of
cc
be
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