670593.pdfI I -
1. all POSTED ON KROI-L MAP NO-: PERMIT
t4 -6 DEPARTMENT I NUMBER 670593
BUILDIN Applicant Flu
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PERMIT APPLICATION Inside Heavy Lines
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NAME
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ADDRESS
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TELEPHONE NUMBE
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NAME
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ADDRESS
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TELEPHONE 14UMBE
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STATE LICENBIG NUMBER
CITY LICENSE NUM
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BE ON' I B-Ifs— 13 NO
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WING AREA I VAIUANUM �UMBER 0,
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ST 7*71W
E=7NG STREET R/W
DEFICIENCY THIS PROPERTY 0
COMP. PLAN ST. R/W
FT.
REMARKS
�CRECKED
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NEW
RESIDENTIAL
GAS
LINE
NON-RESIDENTIAL
SIGN
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RETAINING
WALL
DALTER
DEMOLISH
EXCAVATE
PENCE
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OR FILL
El ( x Ft.)
.......... ..........
11 REPAIR
El
PRE -MOVE
INSP.
svnm
1:1 POOL
;UMBER OF STORIES
NUMBER OF
DWELLING
4
UNITS
qATURE OF WORK TO BE DONE
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TYPE OF
0 YES
2pmrg, 0 No
Permit issued subject to sheet D-1
I being completed according to Eng ineering
Dept. 1.k.
Plan Check
BUILDING
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
—I EXCAVATION OR FILL
PLUMBING
HEAT & GAS LINE
PENCE
t SIGN
N
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application: that the In-
formation given in 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- ATTENTION
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 THIS PERMIT
relating to Workman's Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Mmit One Year (Except DEMOLITIONS which %VORK NOTED
shall be completed In ninety days� MOVED -IN BUILDINGS shall be com-
pleted In six months.) 'I, � 1; 1 INSPECTION
FI—GNATURE (OWNER OR G- OATE SIGNIGL)
I DEPARTMENT
'Is77 Z_221 Z CITY OF
V D51ONDS
NOTE: AP rficant Subject to Pla?j Check Fee PR 6-1107
This Permit covers work to be done on private Property ONLY.
Any construction on the public domain (curbs, sidewalks. driveways,
murquees, etc.) will require separate permission.
Valuation Fee
I C_�-
LID 140
3 / r/
I I.D10.0 a 141,91
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
. -7 -�
FILE
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CIT I Y 0 F E Ew m) M (AD N D S
DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNAFOP BUILDING CODE, Sec. 306
f7q�ZAI- AIA- - 1-6�� 670593
At —2100 --5th AVENUE—S-E— — Building Permit Number —
occupancy established by this certificate: r, ire Zone No. Stories
H
Type Const. V.j 11OUR Basement NO
Floor Load signs — in place (per Sec. 23 08 U.B.C.) — Capacity signs posted (per Sec. 3 301 (i) U.B.C.)
Floor load and room capacity signs, wban required, must remain posted at all times.
THE APARTMT BUILDING HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES.
Issued this � 26th day of NOVEMBER 19 68
CHIEF BUILDING OFFICIAL By "-04- v a
This certificate shall be posted in a conspicuous public area and shall not d, 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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CORD 01 INSPECTIONS
Date Passed
�'Dralnap
..... .... ... ... ...... . ........
APPLICATkiwA
& WORK
PERMIT
Application No ;� ... �o .. ; . 6 3
. ... .......... .......
CITY OF EDMONDS
Building
Department
Permit Limit, One Year
Is hereby made for a permit to construct the following work, In accordance with the accompanying plans
GroundArea ................................... No. Stories ............
X-A-le ..... ....................... Const. Type ........................................ Height. .......................
CPO L> Z 77 c*
.................................. Use (21Z.. Fire zone ....................
f*L . �14� ...... ....... e ....... ------- Zon4
. rs-1,,24ecdw`1 x
'BloclL ................... Add'n. ...... t:T.7 ... . ..................... Sewerage ..............
............... Width ............................ Min. Bldg. Setbacks,. Front and Rear ............................... Sides ..............................
E
......... Phonei.�� . ....... (L:1Z6C
Address........................................................................ Phone ................................
-- - ------------
..................................................................... Address ........................................................................ Phone ........................ .......
.......................... Phone ................................
Heatingby ....................................................................................... Address ..............................................
Elect. by ........................................................................................... Address ........................................................................ Phone ........................ .......
Remarks....................................................... .......................................................................................................................................................................
The above Is a correct statement and I agree to comply with all applicable Codes and State Laws regulating the work.
..... .................................. Date...
Signed: Owner/Atgan ;r ......... 7 .......
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 PERMT FEES
00 .7 J _0
....... .......... Bldg. ............................
APPROVED:
Date.... ...... .................................
BUILDING DEPARTMENT
Wm., 11orbert., Bldg. In3p
By.....................................
i__;�Z
PIbg. $ ........................................
00
Heat.... $ ... A ............................
Elect. $ ...... = ..........................
Others ... $ ..................... — — -----
TOTAL FEB ..................
NOTES: No work requiring Bi�fding Department or (2fey 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 utilitles, such as
curbs, paving, driveways, sewer, water and street connections.