670225.pdfUILDING DEPARTMENT I Applicant Fill
Inside Heavy Lines
PERMIT APPLICATION
4AMM (OR N"1111 OF-1-308INE88)
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in -
PERMIT
NUMBER 670225
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11 43
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REAR YARD SETBACK
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I VARIANCE NUMI 11
~ I &,-� ,
�Rx A/W
CSFWG STREET R/W
COMP. PLAN ST. R/W
31d �
[3 YES
LINE
LEJ�RESIDENTIAL
E] No AL SIGN
RETAINING
MDEMOLISH WALL
ALTER F1 EXCAVATE PENCE
OR FILL x Ft.)
......... ..........
REPAIR PRE -MOVE swim
INSP. POOL
NUMBER OF
DIVELLING
UNITS
Plan Check No .....................
PROPOSED
7
BUILDING
PLOT PLAN (Indicate Building setbacks, abutting streets)
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
JV
RETAINING WALL
" 0
D4
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
"I
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In.
formation given to correct; and that I am the owner, or the duly author-
lzed agent of the owner, I &Me to comply with city and state laws regu.
ATTENTION
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
THIS PERMT
relating to Workmen's Compensation Insurance.
AUTHORIZES
ONLY THE
40TE: Permit Limit One Your (Except DEMOLITIONS which
WORK NOTZD
,hall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
-leted In six monthu.)
DAWN SIGNED
INSPECTION
(0
r_7
DEPARTMENT
cITy OF
EDMONDS
NOTE: APPlicaut Subject to Plan Check Fee
PR 6-1107
This Permit covers - work to be done on Private Property ONLY.
Iny construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
DEFIOIENCY.TMS PROPERTY
Valuation
I
13 TE13
NO
oil
Fee Receipt No.
6"T, a C?
I qe,1,01 mi
APPLICATION APPROVAL
This application is not a perrait until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
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APPLICA'"ON & WORK PERMI!�. Application No . ......... . Z
A
Building Department Permit Limit, One Year
CITY OF EDMONDS
ork, In accordance with the accompanying plans
APPLICATION is hereby made for a p t to construct the following w
and specifications:
No. Stories ............
Ground Area ...................................
WOBK — New/Addn. .......
Height .......................
� I : ms .................. ...
PlansSubmitted ....................................................................................... . ................. C
...... LUse Zone..cS .......... Fire Zone ....................
LOCATION— Address .......... Z/ ..7 ............................................. .. ....
Recorded Lot .. ..... Block. ................... Add'n.-A&I ......... ..................... . ..................... Sewerage ... of I ....... �--
and Rear.,a.2.-.t�2 ....... .........
Loot Area..Jg..�q .. . ..... ............... Min. 'Bldg. Setbacks, Front
XL_3�
Owner ..... Address ... 1.2 Je'�:L ........ 4-z
.......... ........ W .... . . ..........................
T7!
........... Phone ........................ .......
Planby ............................................... ......... ....... ...... ...... Address. ............................. . .............................
Phone........................ .......
.................................................................... ...
............ Address
........................................... ............
Bldg. by
Address........................................... ............................ Phone ................................
Plbg. by ................ ........................
.............. Address. ................................ ............. ..................... Phone ................................
Heatingby ............ ....... ................................................
Address........................................................................ Phone ...............................
Elect. by ..........................................................................
C�
............................................................................................. .........
Remarks................................................................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
...................................................................................................................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...............................................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ffi . . ..........
...................................................
........................
The above is a correct statement and I agree to comply with all applicable Codes and State Laws regulating the work.
signed: owner/
Address....
. PrALI�r ....
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the approved planE
and specifications and Building Department notations thereon.
VALUATION PL1%N[[T FEES
Bldg. ......
Plbg. ...........
APPROVED: Heat .... $ ......... 5 .........................
Date............ Ln/�` . ........... ...................... Elect ..... $ ........................................
BUILDING DEPARTMENT Others ... $ .........................................
Wm., Herbert,:..B1dg - — --------- TOTAL FEE
By.................................. ...........
NOTES: No work requiring Building Department or City Engineer's inspection shall be covered before inspection and approval.
Twenty-four (24) hour notice requested. Contact the city Engineer prior to construction of all site utilities, such as
curbs, paving, driveways, sewer, water and street connections.
J:
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........ ....
............... . .....
APPLICATILA A WORK PERMIT Application No..31.y"
CITY OF EDMONDS Building Department Permit Limit, One Year
APPLICATION is hereby made for a permit to construct the following work, in accordance with the accompanying plans
�'."�"!-.:iLzid;'spectfications:
.................
wom New/Addn.
.......................... ....... .................... ........................... Ground Area ...... ............ No. Stories ..... �L
......... .................. Const. Type ............................
plan Sub . ............. Height . .......................
_4i1tted. ...... . J
rAn WO-7
Address ...................................................................................................................... Use Zonee .... Fire Zone ....................
LOCATION
...........................
........... Add'n.Xx .... . .... .. . ..................... Sewerage ......
Recorded Lot ... / ........... Block. ........
Let Area .... ................. Width.. .... 2( ............... Min. Bldg. Setbacks, Front and Rear ... ...... ? . . ...... Sides .... ..... ......
-P Phone./,
Addresa... 2 .�j
......................... ..... ....
Owner..
Plansby ........................................................................................... Address ........................................................................ Phone ....................... . .......
Bldg. by ...... ..... ..... ............................................ Address ........................................................................ Phone .................... . ..........
Plbg. by..
.... . ...............................................I Address ........................................................................ Phone ................................
Heatingby ....................................................................................... Address ............................................ 7 .......................... Phone ........................ .......
Elect. by ........................................................................................... Address ....................................................................... Phone ................................
I . . . . I . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . .
......................................
..........................................................................I ......................................................................................................................................................................
.................................................................................................................................................................................................................................................I
The above is a correct statement and I agree to comply with all applicable Codes and State Laws regulating the work.
e�e-1 r-z��
Signed: Owner/Agen .... ........... Address ............................................................................ Date.. � ... ...
64 ..............
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the approved plans
and specifications and Building Department notations thereon.
VALUATION PERMIT FMEI�
$ 10 ...... .. . ... Bldg . .... $&V� SI. ..........
Remarks
APPROVED:
PlbgI .... $ ... L3 ....... . ...............
Heat.... $ ...... 3 ............................
.......... ................... Elect. ........................................
Date ................. J
BUILDING DEPARTMENT Others ... ...........
$
Vim .. Herb
By......................... .................. TOTAL FEE .. ... ... .... ..........
NOTES: No work requiring Building Department or City Engineer's Inspection shall be covered before Inspection and approval.
Twenty-four (24) hour notice requested. Contact the City Engineer prior to construction of all site utilities, such as
curbs, paving, driveways, sewer, water and street connections.