680153.pdfNON
POSTED ON Kit LL MAP NO.: PERMIT
NUMBER 680153
BUILDING DEPARTMENT Applicant FIR
inside Heavy Linea JOB ADDRE80
PERMIT APPLICATION
NAME (on 14AMIU OF BUSINESS)
-IS—ETBACIC REAR YARD SETBACK
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RE13B
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Ui�aEZONE LOT AREA VACANT SITIG
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HEIGHT id ZMA I NCE NUMBER a,
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35� /Wc.�X'
NAME
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PLOT PLANA.PPUOVEL)
STREg"/W
EXISTING STREErr R/W 4:; 0-FT. DEFICIENCY TIHS PROPERTY
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COMP. PLAN ST. R/W
REMARKS
NAME
BY
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WECLALL INSPECTOR- REQU11MU
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RESIDENTIAL
GAS
I'LNE
[] YES NO
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NEW
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NON-RESIDENTULL
1:1 SIGN
ADD
ElDEMOLISH
RETAINING
WALL
F-1 ALTER EXCAVATE FENCE
n OR FILL El ( ........ . x .......... Vt.)
Ej REPAIR PRE -MOVE SWIM
M INSP. D POOL
M-81
NUMBER OF
DWELLING
UNITS
DrA—TURE OF WORK TO BE DONE
� r< � - T -M f.!;(j z) IN
Valuation Fee -Receipt No.
z
Plan Check No..$1=6.. 12
-RA—UPOSED USE
BUILDING -C//
PLOT PLAN (100 cate Build
ng netbacka, abutting strects)
FLUZU31NG
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HEAT & GAS LINE.
FENCE
t
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
4
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EXCAVATION OR FILL
_( --------------
TOTAL AMOUNT DUE
I hereby acknowledge that I have read UIM application; that the In-
formation given to correct; and that I am the Owner, or the duly aumor-
lzed agent of the owner. I agree to cOmPly' with city aa(% state laws regu-
ArMNTION
APPLICATION APPROVAL
lating C0nstML'Ucn; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slats of Washington
THIS PERMT
This application is not a pernlit until
relating to Workmen'S Compensation Insurance.
AUTHGIUZES
signed by the Building Official or his Dep-
NOTE: Permit Limit one Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
Imowledged in space provided.
pleted in six months.)
INSPECTION
DEPARTMENT
'S �IBIGGZ-AREMI
DIRE 'OR'S BIG
7
SI U (0
R AGEN DATE SIGNED
CITY OF
'A)
EDMONDS
E: k, licant Subject to Plan Check Fee
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Pit 6.1107
-12
This Permit covers work to be done an private Property ONLY -
construction on the public donuan (curbs, sidewalks, driveways,
TME
Amy
marquess, etc.) will require separate Pemimsl0n-
I
r Building Permit Number
At !7M. 1962 q_W_ 680153
Occupancy established by this certificate: Fire Zone TTT No. Stories 3
I Type Const. , � Basement I've%
Floor Load signs in place (per Sec. 2.3o8 U.B.C.) — Capacity signs posted (per Sec, 3301 (i) U.B.C.)
Floor load and roonx capacity signs, when required, must renwin posted at all tivies.
THE ARAR-0-TM BUII DING ( W ).— HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES.
Issued this 23rel —day of 19
�A t r
CHIEF BUILDING OFFICIAL By 04.
This certificate shall be posted in a conspicuous public area and shall not be remC�, rnuti ated or obscured and shall be main-
tained In legible condition at all times. Any change of occupancy requires a new certificate.
-1
0
DANIEL J. EVANS
GOVERNOR
9K4M=4K4WW.49XQWAW
MINX-NNAN]
WALLACE LANE. M.D.. M.P.H.
ACTING DIRRCTOR
0
STATE OF WASHINGTON
3DH!1=�-&1=R-rrMM-1\Trr (DT' 14H!-&Ljrr14
PUBLIC HEALTH BUILDING, OLYMPIA. WASHINGTON 98501
SEATTLE REGIONAL OFFICE
1309 Smith Tower
Seattles Washington 98104
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CERTIFICATE OF POOL INSPECTION
On J0,<9 theKtA A,,-, - A a� :i pool
orwas inspected by
locatedat 7'72,n— wa�
a representative o�--the-W'a-sr1in-gton-S-Cate Departmp-nt of 4ealth and/or the
County Health Department and . was found to be constructed essentially as
shown on the approved plans. It is provided with the proper incidental
equipment and, in general, conforms with the requirements of the Rules
and Regulations of the State Department of Health. Therefore5 permission
is hereby granted to open the �ool-for operAtion� with the following
provisions:.
by:
Concurrence:
Very truly yours,
arian, , I
County Health Department
original to Pool Owner
Copy to County Health Department
Copy . to State Health Department
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