680159.pdfPOSTED ON PERMIT
BUILDING DEPARTMENT kMOLL MAP NO.: NUMBER
Applicant F / 0 C? r- 1 680159
PERMIT APPLICATION Inside Heavy Lines jOB A.DDI,gg .7 Sr-
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NAMM (OR NAME OF BUSINESS)
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DORN ENTERPMES SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK
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MAILING ADDRESS to M
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P.0, Box 145 USE ZONE LOT AREA VACANT SITE
CITY TELEPHONE NUMBER [3 YES �0'
L�mnwoodq Was Pr, 8-3111 HEIGHT BUILDING AIMA VARIANCE NUMBER
PW
NAME
Charles Pribbs PLOT PLAN APPI�OVED
41
ADDRESS
224ol - 39th W, STnEFVU/W
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CITY TE—LEPRONE NUMBER EXISTING STREET R/W ..(QJQ.YT. DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R/W ............ FT.
Mtlk, Terr.9 Wne Pr. 8-3111 RELLARKS ........ .
NAME
DORN ENTEMIUS R�W ig oiitgiap nf nitjr IiMit�q
F-4
— Standard Drawings and Sp6bifications for
ADDRES13
PO. Box 145 Street and Utilities Construction.. Ord. 1356;Q
and APWA Const. Standards
N
TELEPHONE NUMBER
shall be followed.
Lyraiwoode Wrie, Pr. 8-3111 "ETER SIZE SEIIVWE SIZE
z
M. UL �rUpUny tonow =eLOW or
Lot 15 and the pa
.1"
HoWeir
Block #1 Ha&&WA4
of
NEW
DX RESIDENTIAL
El
GAS
LINE
ADD
NON-RESIDENTLILL
SIGI;
DEMOLISH
RETAINING
WALL
EXCAVATE
FENCE
ALTER
OR FILL
( x Ft.)
PRE -MOVE
........ . ..........
swim
REPAIR
El
INSP.
POOL
UMBER OF STORIES
NUMBER OF
2
DWELLING
UNITS
28
(12 & 16)
Is I CLEJ.'
S,aA-�L�
0 YES
6
Plan Check No ....................
PROPOSED USE
Rentals
BUILDING
PLOT PLAN (Indicate Building setbacks, abutting streets)
PLUMR NG
HEAT & GAS LINE Ca
PENCE
SIGN
N
RETAINING WALL
SWIM NO POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given is correct; and that I am the owner, or the duly author-
lzed agent of the owner. I agree to comply with city and state lawn regu-
ATTENTION
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of tho Labor Code of the State of Washington
THIS rEni%[IT
relating to Workman's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVEDIN BUILDINGS shall be oom-
Vl<ed In six months.)
SfORA-rURE (OW DATE SIGNED
P
INSPECTION
v4c�h. *1.14
4A/68
vleoz
DEPARTMENT
, ad
CITY OF
11 11NE
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 0-1107
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbeg shlawalkas driveways,
marquees, etc.) will require separate permission.
, - 1 14.e
[3 YES
Valuation Fee
- 0
I Ain A5 1
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-
Itnowledged in space provided.
I
I
I
. N . . " , ____ __ - . -
DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE, Sec. 306
At 23333 — 13th S-E� Building Permit Number #6"9
Occupancy established by this certificate:
Fire Zone TT No. Stoiles -r-r
H
Floor Load signs
Type Const. V T HOUR Basement yF11q
in place (per Sec. 23o8 U.B.C.) — Capacity signs posted (per Sec. 3301 (i) U.B.C.)
Floor load and room capacity signs, when required, inust remain posted at all times.
THE APARTMENT BUILDING (28) HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES.
Issued this 20th —day of MAY 19 69
CHIEF BUILDING OFFICIAL By
This certificate shall be posted in a conspicuous public area and shall not be removed, m(fil'ated or obscured and shall be main-
tained in legible condition at all times. Any change of occupancy requires a new certificate.
S7 — 9
V�lj
RECORD OF INSPECTIONS
Date Passed
Drainage
Sewer
Parking
Landscaping
Fire Dept.
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