680223.pdfBUILDING DEPARTMENT
PERMIT APPLICATION
NANX (OR NAMS OW BUSINESS)
a ADDA10511
'a'o&
Applicant FM
Inside Heavy Lines
tion of Property (Bnow Below or Attach Four Copies)
r
EIRESIDENTIAL
n
GAS
LINE
NEW
ElNON-RESMENTIAL
n
SIGN
DEMOLISH
RETAINING
WALL
FiALTER
EXCAVATE
OR FILL
PENCE
( x Ft.)
.... ..... .. .......
E] REPAIR
PRE -MOVE
INSP.
SWIM
POOL
NUMBER OF
DWELLING
UNITS
AL
WaSTING STREET R/W
COUP. PLAN ST. R/W ............ FT
0 YES 13 NO
PERMIT
NUMBER 6 223
ACK REAR YAJtD BET=CK
VACANT SM
El YES 13 NO
MA I VARIANCE NUMBER 111
DEP70JENCY THIS PROPERTY
[3 YES [3 No
Walkway aunt be 5' min, arcnissid pools,
Pence wolat be installed.
A, 33.1in
Plan Check No .......
BUILDING
PLUMBING
HEAT & GAS LINE
t
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
OLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby "knowledge that I have read this application; that the In-
formation given Is 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-
lating construction; mid in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
relating to WorkraWs CompaUSLU00, Insurance.
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shoal be completed In ninety days; MOVED -IN BUILDINGS shall be oom-
plated in six Months-)
SIONATU (0 OR AGENT) DAT Y!IGNED
7k 9
NOTE: Applicant Subject to Plan Check F e
This permit coven work to be done an private, PrOPOrty ONLY -
Any construction an the public domain (curbs, s1dawalkso driveways,
marquess, etc.) will Main separate permission.
Valuation
Fee
LTMNTION
APPLICATION APPROVAL
TMS PERMT
This application is not a perndt until
AUTHORIZES
signed by the Building Official or his Dep-
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION
D 10
DEPARTMENT
CFI!Y OF
FMMONDS
DATE-
PR 6-1107
rum
kqo'y
—777
.14 iL
T
n
PARCEL A: That portio of the East 1/2 of the NEJ of the SEJ of the
M. described as follows:
of Section
NW* 24, Township 27 N.R. 3 E.W
j of the SEJ of the NWJ
the Southeast corner of the NE
Be inning at
9
00081 West along the East line of said NWg 92.9 feet*
ce North
then
the 89041124" West 170 feet; thence South 0*0 East
nee North
parallel to East line 92.9 feet to a point on the South line of
NEJ of the SEJ of the NWJ; thence soutn 89*41458" Fast along
said
Sout
In line 170 feet to point of beginning.
PA
RCEL B: ALSO. that port1nn of thR NWJ ofSection 24,
Fu-4 and
iF W: of Said Section 24,
e soutn line of the oi the Stt Of tne N
described as follows:
The East 170 feet of tbe-following:
MEJ of the SEJ of the NWJ,
i Beginning at the Southeast corner of the
Section 24; thence South 7.9 feet; thence Westerly along a fence line
3 4.82 feet; thence North 6.1 feet to the said South line of the
2
of the SEJ of the NWJ; thence East to the point of beginning.
NE
ALL situate in the County of Snohomish, State of Washington.
RECORD OF INSPECTIONS
Date Passed
Foundation
Plumbing (Partial)
(Rough)
Frame
Furnace & Fuel Lines--Y—z
F- 76
Final
)F INSPECTIONS
RECORD
Date Passed
Drainage
Sewer
parking ----
Landscaping
Fire Dept. -------------
oil
CATY OF EDMONDS, WASHINGTOti
BUILDING PERMIT
Applicant hereby certifies that a plot, plan, drawings, and sufficient details to indicate
the intention to fulfill all requirements of this code are attached hereto.
Application is hereby made for permit to do the following work:
----------------------- . .............. I . . .........
Lot....................................................... Block ...............................................
OF '_4
.......... X ... $?
1. Building dimensions ... ...
2. Lot dimensions ... WC) ............... X ...... /';L-() ............
3. Building will be ...... t ............... stories.
4. Basement ... 61 . . ..........
5. Occupancy of building will be ...... P ..................................
6. .../D- ....... pfe,,t frt,.the earest adjoining line.
Owner.
............ f .... . .......................................................
7.
8. Owner's Address. ..... V ... 9 .... .......... . ................ . .......... . ...
9. Builder ..................... r74. *.. E ........... ............................................ . .... . ...............
10. Builder's Address ................................ 7 ...................................................... . ...................
------------------------------------------------- -- -
Date. .........................
.............................
I agent)
This Space Is For
City Inspector Only,
C
Permission is hereby granted to do the work described hereon, according to the approved plans and specifications pertaining hereto,
subject to compliance with the ordinances of the City of Edmonds.
PERMIT N? .' 635
4o
Estimated cost $11rD,040...
Life of permit...
IPlans filed: Ye/, No 0
s.0.70a .........................
R
Department of Buildings
City of Edmonds
1. 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
$1000.00 of cost. If the actual cost of the structure, when finally determined, exceeds the estimated cost by more than 5% applicant agrees to pay an additional fe.e
of $2.00 for each $1000.00 of such excess cost.
2. Whenever a contract for construction is executed for any structure costing more than $1000.00 for which a licensed architect or engineer Is not required by
the Building Code of the City of Edmonds, the application for a building permit &hill be accompanied by a copy of the contract. and a copy of the detailed
specifications.
3. Prior to employing any labor or commencing work, notify the Industrial Insurance Division of the Department of Labor and Indusorles, giving an estimate of
the payroll 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 turn should obtain release from 211 sub -contractors. The releaso should be
attested by the Department of Labor and Industries. The above procedures an requirements of the State Industrial Insurance Act.
I
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-1
HFUCHION & 1�:,ILDING FEW
CITY OF EDMONDS Building Departnwat
APPUCATION is hereby.made for a permit to construct the following worko in accordance with the accom'
panying plans and specifications wo sets are submitted herewith for approval.
Off -St.
alter.......................................... Parldng ......................
Work addn repair . ..... ........................................ ..................
...... Const. type ............................... t Use zone..Iz.-.� ......... Fire 2;one ...........................
Occupancy ..........................
Address..7i;:2/-L..— ..g .... ;�.i... Lot ....................... Lft ...... ...... Adqn.. ... . ........
... NA
Lotfrontage ........................................ AA&Im .......... . ............................... Septic tank .... . gi4l(� ......................
Bldg. ad4wjm f t ......................... r. side ............................. I. side ............................. rear ................................
r9n
..... itk Address. ................................................... Tel. No .............................
Owner ... .... .. . . ................... ................
Address ... :7Z
z1- � 7:�. !&Tel.
.. ................ a 'I " *
.... .........
Builder .. f ......... ... .....
Plansby ................................................................. Address .................................................... Tel. No .............................
tobe done .............................................................................................
Remarks.-T-his.-p-ermit .. QJQIQX�9! ... WS?ft ............................
on Private proportY ONLY.
public domain
........ 9 ......................................................................................
.............. .................... mar-4uee
sideual!�6,, dr-iveways,
L r C V Re.ra.t e ... perm . i . S.8 i.0.n ......................................................................................
. .... .... ......... . . .... . .. .
The above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating -this
worIL
................ D7ao,
Signed Owner/Agent.-y4e.-c . .. ... �._�ddressg.Yg'L/Y�--Y
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ap-
proved plans and specifications, and Building Department notations th n.
Mo
.. . .. . .....
Valuatiort ........ ....0 . ............. Permit fee.....3.6= ............... Reod b ........ . ..... . .......... .... ... .....
...... ....
....... .. ..... . Cm .7 .... . ..... ................... .
Building Department, By ......................................... . ................ Date.
This Permit does not cover Plumbing, Sewer or Electrical installations.
V
C
CITY OF EDMONDS, WASHINGTO�_N
BUILDING PERMIT
Applicant hereby certifies that a plot, plan, drawings, and sufficient details to indicate
r the intention to fulfill A requirements of this code are attached hereto.
Applicatloq is hereby made for permit to do the following work:
...... . .... . .... . ......................................................................... * ", .. .... *
. ............................................................. .... . .........
=1-
............................................................................................................ .......... ..........
.. ............................................................................................................................
........................................................................................................................................
Lot....................................................... Block ............................... . .......................................
........................................................................................... ....................................
7j
..... . ... .................. . .... . ................ . .... . .... . .......... . .... . .... . .......... . .. . . .. . . .. . .. . .. . . .... . .........
........ . ... ........
.................... �.'. � .................................................................... . . .... . ...
X ......
I . Building dimensions ................... . 7 ... ..........................
X ...... .........
2. Lot dimensions ..........................
3. Building will be .......... / .......... stories.
4. Basement .......... I/ .........
5. Occupanmr of building will be ........ ..........................................................................
6 . ...... .... ........ feet from the neargam-adjoining line.
e
7. Owner .... .. I ...
.... ...... _a
.............................. .............................. ........
8. Owne ' Add Z�V.e: 96
reps... :�5 ...
rs ....................................
9. Builder ..... ?�c ............. .... . ............. . .... . ...............
10. Builder's Address. .. . . . ......... ............
........ ...............
.......................................................................... . ........
Date .. .......
...........
......... . ....
(Ownpr 00"s agent)
This Space Is For
City Inspector Only
Permission is hereby granted to do the work described hereon, according to the approved plans and specifications pertaining hereto,
subject to compliance with the ordinances of the City of Edmonds.
PERMIT. W? 920
Estimated cost I
Life of permit. ....... .. I
ate
Plans filed: Yes 0_'�No 0
—1
00-6
1�4z_ �
$ .................................
Rec M
V,
..... ...........
Department of Buildings
City of Edmonds
1. 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
$1000.00 of cost. If the actual cost of the structure, when finally determined. exceeds the estimated cost by more than 5%, applicant agrees to pay an additional fee
of $2.00 for each $1000.00 of such excess cost.
2. Whenever a contract for construction is executed for any structure costing more than $10DO.00 for which a licensed architect or engineer is 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 of the detailed
specifications.
3. Prior to employing any labor or commencing work, notify the Industrial Insurance Division of the Department of Labor and Industries, giving an estimate of
the payroll 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 turn should obtain release from all sub -contractors. The releases should be
satested by the Department of Labor and Industries. 7be above procedures are requirements of the State Industrial Insurance Act.
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