680344.pdfL
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DEPARTMENT
APPLICATION
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NEW
ALTER
ElREPAIR
Applimnt =
Inside Heavy Lines
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RESIDENTL&L
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GAS
LINE
ISTON-RESMENTZAL
SIGN
DEMOLISH
RETAINING
WALL
EXCAVATE
on PILL
PENCE
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PRE -MOVE
INSP.
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POOL
DWELLING
UNITS
I hereby —knowledge that I have read this; application; that the In-
formation given to correct; and that I am the owner, or the duly author-
Ized agent of the owner. I &gne to comply with city and state laws regu-
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
nl&Ung to Workmens Compensation Insurance.
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shall hp completed In ninety days; MOVED -IN BUILDINGS shall be oom-
pletedon six months.)
NOTE: ApPlicant Subject to Plan Check Fee
-iiii—Permit coven work to be done on private property ONLY.
Any construction ou the public domain (curb$, sidewalks, driveways,
marquees, ate.) will require sepwale permission.
C.
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E=SnNG STREET R/W
COMP. PLAN ST. R/W ....... ... FT.
13 YES 13 NO
I
Plan Check No....
BUILDING
PLUMBING
PERMIT
NUMBER
VACANT arm
C3 YES - C3 NO
DEFICIENCY THIS PROPERTY
Valuation
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BEAT & GAS LINE
PENCE e) n
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
MCCAVATION OR FILL
TOTAL AMOUNT DUE I I I—, I /I �"
ATMNTION APPLICATION APPROVAL
THIS PERMIT This application Is not a permit until
AUTHORIZES
ONLY THE signed by the Building Official or his Dep-
WORK NOTED uty; and fees are paid, and receipt is ac-
knowledged in space provided.
.INSPECTION ;DMIRX On's BIG A
DEPARTMENT
CITY OF DATE
EDMONDS
PH 6-U97 ri
FIX
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APPLICATION BUILDING PERMIT Appl. No..
........ . ........
Permit JiMik
WY. OF EDMONDS Butid Departm' one year
APPLICATION is hereby made for a permit to construct the following work, hi accordance with the accom�
panying plans and specifications. Two sets are submitted herewith for approval.
t Off -St.
new alter
.................................. P g ............
Work addn --rtpair ........................... arkin . ......
Occupancy ................................ Const. type ................................ U zon�.-e7::-L ............. Fire zone ................... *..
'Address ............................... .................. �f
Lot ....................... lk ........................ Addn ......................................
1A)t frontage . ....................................... Area ........................................... Septic tank .........................................................
Bldg. set4xwlm — front ........................... r. side ... .......................... 1. side .............................. rear ...............................
>
--:rl . ............ Address ....... J ... .. .... . z � I r I .
Owner.. ......... ......................... e No ..............................
Builder .................. /.'a� ...................
.................................. Address ............................... . Tele No .............................
A AA.,
Plans- - ----- ..................
................
A1
of mul NE� of'sw� of Saco 230 Twp 27 No
so 148 fte of Be 150 fto
ereof .........
Range 3 BoWeNe LESS the Be 30 ft, and the S 20 fte th ..........
for road
.7
The above is a correct statement, and I agree to comply with all applicable Codes and State laws r%idating "Ithis
work.
lAgent. D te.
- -'�Address ............................................ a
Signed Owner, .................
PERMff for the above work is hereby approved, subject to the above conditions, and to compliance with the ;ip-,
proved plans and specifications, and Building Department notations thereon.
Valuation ............... 8.0.t? ........... Permit fee ...... /-C ............... Recd. by
Building Department, By ......................................... .......... Date .... ..... �& ..................................
This Permit does -not cover Plumbing, Sewer or Electrical installations.
I
APPLICATI" & WORK PERMIT
Application No. . . . . . . .........
Building Department Permit Limit, One Year
CITY OF EDMONDS
APPLICATION is hereby made for a permit to construct the following work, in accordance with the accompanying plans
and specifications:
........... Ground Area. ................................... NO. Stories ............
WORK — New/Addn. ................................
t
...... ....................
PlansSubmitted ........................................................ : ...... ....................................... Const. Type .................................. Height...
Address ... ................................... Use Zone.A?.... Fire Zone ................
LOCATION ... /2
So. 1481 of E 1501 of NW 1/4 of NE 1/4 of SW 1/4 of Sec 23 Twnp 27N R3E WM less the E 301
th qkjor. roailldIn .............................. ........................................... . ..................... sewerage ....................... 7 ...........
304AAA22 ... ...... !�ft ......... .......
...... . ......... Sides....
........ ........... . .
Loot Area ...... . ........................ I ........ WIduL4Z--e ............ Min. Bldg: Setbacks, Front and Rear 4
oneA1.410
Owner. . .... .. ....... ........... ..... .................. Address ..... .......................................................... Ph ...... ..........
.............................................. Address ....................................................................... Phone ....................... . .......
Plan by .........................
by..
Bldg. by.. ............................ Phone ....................... . .......
........ Address ............................................
Plbg. by ............................................................................. ... Address ........................................................................ Phone ................................
Heatingby ........................................................................................ Address ............................................ ............................ Phone ................................
Elect, by ...................................................................................... .... Address ........................................................................ Phone ........... .......... .......
Remarks.................................................................................... .................................
..................................................................................................... ....................................................................................................................................... I ......
..........
T
........................................................................................................ ...............................................................................................................................
........................................................................................................................................................................................................................................ .......
The above is a correct statement and I agree to comply with all applicable Codes and State Laws regulating the work.
Date..Z.2 . ...... ...
.Signed: Owner/Agent.. .... Address ............................................................................ .
............
ERMIT for the a ove work Is hereby approved, subject to the above conditions, and to compliance with the approved PI a
P MIT fort e
and specifications and Building Department notations thereon.
VALUATION PEBMT VMS
Bldg.
- - . . ................
$
Plbg. - - - - $ ........................................
Heat.... $ ........................................ P
APPROVED:
Lalm..!�r Elect. ........................................
Date...... ........ .......................
BUILDING DEPARTMONT Others... $ ........................................
Wm., Her'�erf 01 Bldg.�
TOTAL FEE! $ W .................
By..................................................
No requiring Building Department or C ity Engineer's inspection shall be covered before inspection and approval.
NOTES: work
Twenty-four (24) hour notice requested. Contact the City E ngineer prior to construction of all site utilities, such as
curbs, paving, driveways, sewer, water and street connections.
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