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670306.pdfI IPUS1616PIVIV 90 16 F 1% IS I 11116 91 1 Applicant Fill PERMIT APPLICAT I Inside Heavy Lines AkBa.,a� MAILING ADDRESS 0 ")_A LIPLrr S�T r CITY TE-LEPHONE NUMBER 1 106-7. NAME Le-6- /A ADDRMSK_ NUMBER ILEPHONE Loq NAME AL- CLwJ57(2 - CO ADDRESS 2,S-Z-1 -5T CITY TELEPHONE NUMBER 8 -6ewr� r I LA. -2>-77+�), STATE LICENSE NUMBER 73— C:) i Z6G. CITY LICENSE NUMBER I Legal Description of Property (Show Below or Attach Four Copies) z & 0 T GAS NEW RESIDENTU LINE 10 NON -RESIDE TIAL SIGN ADD RETAINING F� DEMOLISH F3 WALL ALTER EXCAVATE PENCE F� OR FILL El ( x Ft.) ........ . .......... PnE_MOVE SMM REPAIR 1:1 INSP. POOL OF STORIES NUMBER OF DWELLING UNITS 0 0EZA-) T>09(z-nT1C:)W_�rS 0 Z"I 4L-T67Z PROPOSED USE y -5 PLOT PLAN (Indicate Building setbacks, abutting streets) &O.C.P0 N .ir// EXISTING STREET R/W .......... . FT. 1,400:' 0 YES 0 NO Plan Check No ............ II ��_ - �� �0 4E:4�=' - I hereby acknowledge that I have read thin application; that the in- formation given Is correct; and that I am the owner, or the duly author. land agent of the owner. I agree to comply with city and state lawn regu- IaUng 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 Worlamen's Compensation Insurance. NOTE: Permit Limit One Your (Except DE310FATIONS which shall be completed in ninety days; MOVED -IN BUILDINGS shall be com. plated In six months.) I NOTE: APPlicant Subject to Plan Check Fee This Pern-at covers work to be done on private property ONLY. Any construction on the public domain (curbs, sidewalks, driveways, marquees, ete.),will require separate permission. BUILDING --lRue HEAT & GAS LINE PENCE SIGN RETAINING WALL SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FULL TOTAL AMOUNT DUE ATTENTION THIs PERMIT AUTHORIZES ONLY THE WORK NOTED INSPECTION DEPARTMENT CITY OF EDMONDS Pn 6-1107 PERMIT NUMBER 6703Q6 ACK VACANT SITE E3 YES (3 NO VARIANCE NUMBER Aw DEFICIENCY THIS PROPERTY, 0 1z STREE 13 YES Valuation F as 00 a MOD APPLICATION APPROVAL; A This application is not a permit until signed by the Building Official or his DS13- uty; and fees are paid, and receipt is ac- knowledged in space provided. , '_4 � FILE I 'IN .,.f I If 11 If I IN If 1 -1. fibI I kIt1f If by, If ffir4A%tIItf IN I I I f 4, 1 1 fy -Xb� I I I I I If 1 9 1 1 1 If I I I 1 1. 1 f -.t.- 1 11, 1 to M 1 1 1 1 4 If 10 1 If I I Yjjv I f, I I I I: I I 11 1 1 1 1 If I- I NI I IN, If I:bb, I I I I I I I III I I, IN I I I m I .... I N, 11 1 11 1 11 1 It I I I I I . I.I. I I I I -'. ... I I I t e; V � I , I `I,�I N If I I I If I 1 0 1 1. If "1 9 f III,j f II� N b. 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Application is hereb ade /for permit to do wing work- .................................. .... . ......... 0 0 ............................. ........................................................................................................ ................................................................................................................................................ for .............................. L . ......... S 0 a - I >% ................................................................................................................................................ -M 119 �n :Z3 -a 0 ................................................................................................................................................ M ., ..................................................................................................................................... . ......... d 0 UD 0 0 w............... #..# ................. ...... ..................... ................ # .................................... # ...... 0 .................................... 6 s at............. ## ........... ## s�� r. . ....................... ............... . ..... (Street nUn&e'r or or an o numbers) C14 rn 1. Building dimensions are .. # ............... X .... 0 .......... ................. P4 U.) 2. Lot dimensions are .... # ...................... X Z, 3. Building will be ............................ stories in height. 0 D r: 0 4. Number of basement� ......... # d 0 5. Occupancy of building will be ............................. ....... ...... ............... .......... Building wiU be ............. . .... feet from nearest d* fitiiig I t line. -1 .0 CL 7. Owner .................. ........... ....................... ...... Estimated cost . ig �0 .... 8. Owner�s Address .... ................ .,%,fBuilder .............................. .. / .... ... ...................... . ....... ............. Group No. ................... 10. Builder's Address ...... # .......... ............................. ............... 11. Archi �t or t eer ..... ................................. ......... .............. Life of p ermit... ....................... Date ......... 7.. .,. . .... date 7 ......... ­19 -cf t r­ Applicant's Signatu Plans filed: ...... . ..... Yes 1 0 (Owner or his W;; -_ I I :C i. i Permission is hereby granted to do the work described hereon, according to the approved plans an .Subject to compliance with the ordinances of the City of Edmonds. d specifications per�g ereto, This copy is your receipt for the following fees: 1. Building permit fee .............................................. ......... .................... $ ............. 2. Sewer permit fee ........................................................... 3. Inspection and supervision fee ....................................... $ o . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S�­ 4. Total ............. Received b Y'4 —4a.P4., iR ..... . PERMIT N? 326 permit fee 4 0 - 1. The building which Applicant Pays when permit is issued shall be based On estimated cost of the proposed Structure, at the rate of $1.00 for each $1000.00 of cost. U the actual cost of the structure. when finally determined. exceeds the estimated cost by more than 5 4. of-$2.00 for each $1000.00 of such excess cost. In Such event no use permit shall be issued until such "discrepancy fee 0/0, applicant agrees to Pay an additional fee Is paid. VN ;never a contract for construction is executed for any structu re cutting more than $1000-00 for which a licensed architect or en8laeu IS not'reqUired by �g Code of the ary of Edmonds, the application for a building permit shall be accompanied by a copy of the contract and a copy of derailed 'L rior to employing any labor -or commencing work, notify the Industrial Insurance Division of the Department of Labor and Industrks, giving an the payroll and make monthly reports of payroll,. Full instructions should be obtained from the nearest office of the Department of Labor'and Indui&I"'.4L':bdmj, natefed by the Department of Labor and Industries. (1, - final Payment, the owner should obtain a release from the general contractors who In turn should obtain release from all sub -contractors. "a The above procedures are requirements of the State Industrial Insurance Act. TY OF EDMONDS, WASHINGT BUILDING PERMIT es, t a plot, plan, drawings, and sufficient details to indicate This Space Is For ents. of this code are attached hereto. City Inspector Only y�made for permit to do the following. work: . ... .. ........ -A* ....... ..... . .... . .................... ..................................... ............... Tz.K. . . . .. ...... ................................................................. . . . ......... ... ..................... . .................................................................. . ...... . . 7 . .... . .......... . ...... . .. . . .... . ......... . ........ ............... . .... . ............................ ............................................... . .......... .......... . .... . ......................... .W.?� ............................. Block .... 4?::��-3 ................................................... . ......... . .... . .... . .... . .......... . ........................................ . ...................... . .. . . .... . ...... . .... . .... . . .. . . ......... ................... . ...................... . ...................... . .......... . ..... .................... . ..... ------ - - ----- ................................................... ......... .... at.... . ...... ..... -- ----- 1. Building dimensions .. ............. X ...... 5�� ...................... 2. Lot dimensions ........... Ko ............. X ....... I.J..a ............ 3. Building will be ....... / .............. stories. 4. Basement ........................ 5. Occiapzincy of building will be .................. .... ................ ........................................... 6. ................... feet f in the nearest a in' g line. 7. Owner .......... . ..... . . ....... .. ............... .................................. . .......... . ... 8. Owner's Add ........... .. . ... ...... .. .. ...... .. ... ... ........ .................... 9. Builder ...................... . ...................................... ....... . ..... 7 ........................ . ..................... 10. Builder's Address ....................................................................................... . ................... .......................................................................... . ....................... Date...... Y .................. 19 .......... vne 'bed hereon, according to the appro7ed plans and Spec cations pertaining ereto, Permission is hereby granted to do the work descri ifi h subject to compliance with the ordinances of the City of Edmonds. I . 11 :x Estimated cost $-4.0.0.0 ........ LC-1 $.:.-.? ............................. Life of permits�e._ �... R date 653 PERMIT N9 enaLAment,6f Buildings, Plans filed: Yes R`�No El D Cii� of Edmoridi�, J� i. The building Permit fee which applicant pays when permit Is Issued shall be based on estimated cost of the proposed structure, at the rate of $2.00 for each $I000.00 of cost. If the actual cost of the structure, when finally determined, exceeds the estimated cost by mote than 501o. applicant agrees to,pay an'additional fee of $2.00 for each $1000.00 of such excess cost. 2. Whinever a contract for construction Is executed for any structure costing more than $1000.00 for which a licensed architect or eagineer,19 not required by the Building Code of the City of Edmonds, the application for a building permit shall be accompanied by a copy of the contract and. a copy PU the detailed . ....... specifications. j. 3. Prior to employing any labor or commencing work, notify the Industrial Insurance Division of the Departmentof Lab r and Industries, giving in estimate of 0 the P2yt0I1 and make monthly reports of payrolls. Full instructions should be obtained from the nearest office of the Department of Labor and Industries. Before final payment, the owner should obtain a release from the general contractors who in Men should obtain release from all sub -contractors. The releases should.be 4 attested by the Department of Labor and Industries. Ile above procedures are requirements of the State Industrial Insurance Act. Y,