680529.pdfP
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BUILDING DEPARTMENT I Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
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0 LICENSE NUMBERqA CITY LICENSE NUMME
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50.
RESIDENTLILL
M
GAS
LINE
ADD
IQ NON-RESIDENTuLL I
El
SIGN
RETAINING
DEMOLISH
DWALL
ALTER
EXCAVATE
OR FIT-T
FENCE
( x Ft.)
PRE -MOVE
........ . . ........
Swim
REPAIR
El INSP.
POOL
FUMBER OF STORIES
NUMBER OF
DWELIMG
UNITS
iATURE OF WORK TO BE DONE
APr.
P L h 60
� WME
RESS
io� 'Z
RD SETBACK STREET E
PERMIT
NUMBER 680529
1�4. J,4 e I
IACK REAR YARD SETBA
VA9ANW SITE
13 YES )<NO
STREET R/W DEFICIENCY THIS PROPERTY
LAN ST. R/W !;�a ... FT. ..._0 ... FT.
indicated on Standard Drawing #103.
YES
ce I :i=*. A t (
Plan Check
PROPOSED USE
BUILDING
PLOT PLAN (Indicate Building setbacks, abutting streets) PLUMBING
BEAT & GAS LINE jt2
FENCE
SIGN
RETAINING WALL
SWIMMING 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-
ized agent of the owner. I agree to comply with city and state laws regu- AT=NTIOIq
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 TIM PERMIT
relating to Workmens Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Umit One Your (Except DEMOLITIONS which WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
31ONATURE (OWNER OR AGENT) DATE SIGNED INSPECTION
DEPARTMENT
CITY OF
V EDMONDS
NOTE: APPlicant Subject to Plan Check Fee PR 41-1107
This Permit coven work to be done an private property ONLY.
Any construction an the public domain (carbs, aldewalkst, driveways,
marquees, ate.) will require separate permission.
a-fiis 13 NO
Valuation Fee
1 <45:0�
I I X(. C-R-�
APPLICATION APPROVAL
I
No.
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.
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V.
CITY OF EDMONDSo WASHINGTO
BUILDING PERMIT-
itIereby certikes that a plot, plan, drawings, and sufficient details to indicate
ntion to fulfiU all. requirements of this code are attached hereto.
� I .
Lti ' hFeby.maop for permit to do the following work:
M/19 A
......................
.... ...............
. ....................
- R
... .... .......... . ..........
.............................. Block...... ..... ;� ....................................................
............ . ...... __.M.-O . . . .... . .. . .. . .... . .... . .........
..... . .... . .... . . - ---------
.............. .............
at ... .......... . ..... �.. . . .................. . .. . . .... . ...
X ....... ..
........................
Building dimension
............
2. Lot dimensions ........... X .....
'3. Building will. be ........ ............. stories.
.4. Basement ....... . uio .......
............................
5. Occupancy of building will be ........
L
.6 . ........... &7 feet from �he neareff a joining me.
.... ............................
------------- -- " C*Z * 0**-" �
Address ....... .......... . ...... . .......
8. Owner's
9 Builder ......... a4e-* ............................................................... . .... . ...............
10. Builder's Addres& ......... . .. . .............................................. . ..................
........ .........
...................... .......
... ...............
.... .......... �q .....
(owner or his agent)
Permission is hereby granted to do the work described hereon, accoiding to the approved plans and specifications pertaining hereto,
subject to compliance with the ordinances of the City of Edmonds.
PERMIT NOO 686
Estimated cost
Life of permit .... 0/ I.Ift.! ........
date
Plans filed: Yes 91_� No El
$ 2. t! . . . ...................
... ........
Rece* �c Y
. . ...... . .... . .... . .........
Issuing Officer)
Department of Buildings
City of Edmonds
t . : . I
I 'ne building permit fee which applicant pays when permit is issued shall be based on estimated cost of the proposcd structure, at the rate of $2.00 for each
$100�.00 of cost. U 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 thin $1000.00 for which a licensed architect or engineer Is Or 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 in 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. 'rhe releases should be
attested by the Department of Labor and Industries. 'Me above procedures are requirements of the State Industrial insurance Act.
t
t) Lln)
C
CITY OF EDMONDSs WASHINGTON
BUILDING PERMIT
-1 indicate
Applicant hereby certifies that a plot, plan, drawings, , nd sufficient details to
the intention to fulfill all requirements of this code are attached hereto.
Application is hereby made for permit to do the following work:
A.................. . .... . ................ . ........................................................
..... . .... . ................ . .......... . .... . ..... ... . .... . ................ . ..............
........... . .......... . ...................... . ..................................................
Lot....................................................... Block ....... . ..................
..... . .... . .......... . ................ . .......... . ....................... . ................ . ..
. .... . .... . ................ . .... . ........
........... . ...................... . .... . ..........
................... I .... . .... . .... . ... I ....... . ...
1:V6 ..... . ...........
...............
at .... . ....... ..... ..........
1. Building dimensions ................................ X .......................
2. Lot dimensions ................................ X ...............................
3, Building will be ........................ stories.
4. Basement ........................
5. occupancy of building will be ........................................
6. feet from Vthn nearest adjoining line.
7. Owner. .... ..... ..........
8. Owner's ddr . ............................. .........
9. Builder .... ( - ----- ... . ........... . ..
�3ze ..... �0** '.' ** *
10. Builder's Address...., ............. ...............
..................
I R ......
Dam— ............
...........
(owner or his agentc)-- ................
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 N9 902
Estimated cost $ .... ��Irl...
Life of permit. ............ Ai-�;
Plans filed: Yes 0/�No 0
$ ......
R 6C
eilvej Y
...........
Ussuing 01ficer)
Department of Buildings
City of Edmonds
1. The building permit fee which applicant pays when permit Is Issued shall be based on estimated cast of the proposed structure, at the rate of $2.00 for each
cl a can an additional fee
Sl000.00 of cost. U the actual cost of the structure, when finally determined, exceeds the estimated cost by more than 5 v, PPII t agrees to Pay
of $2.00 for each $1000-00 Of such excess cost.
in $1 for whi a licensed architect or engineer Is not required by
2. Whenever a contract for construction is executed for any structure cost g more than 00000 ch
pplication for a building permit shall be accompanied by a copy of the contract and a copy of the detailed
the Building Code of the City of Edmonds, the a
specifications.
3. prior to employing any labor or commencing work, notify the Industrial Insurance Division of the Department of Labor and Industries, giving in 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 InclustrIes. Before
final payment, the owner shduld obtain a release from the general contractors who In turts should obtain release from all sub -contractors. The releases should be
of Labor and Industries. Ile above procedures an sequirements of the State Industrial Insurance Act.
quested by the Department
APPLICATION
BUILDING PERMIT
Appl. No
. .. ........................
CITY OF EDMONDS
Building Department
Permit limit, one year
APPUCATION is hereby made for a permit to construct the following work, in accordance with the accom,
g plans and specifications. Two sets are submitted herewith for approval.
anyin
,�p
new alter Off -St.
Work addn repair .....
.................. ......................................................... Parking ......................
Occupancy ................................ Const. type ............................... . .....
Use zone .... ........ Fire zone ...........................
Address... 40 ...... ]Lot ........................ Blk ........................ Addn ......................................
t
Lot frontage ....................................... Area ............................................ Septic tank ..............................
................... ........
Bldg. set -backs front ........................... r. side. ............................. 1. side ............. ................ rear ...............................
Owner.%z,.*e-- ........... .. ress. ............................ No ............ . ..............
Builder .... Address, ................. Aaa . ....... ......... Tel. No .............................
" '111�1'17
Plansby ................................................................. Address ........................ I ............................ Tel. No .............................
Remarks .................................................................................................
.................................................................................
................................................................................................ .......................................................... .......................................
I ........................................................................................ .................................................... I .............................................
The above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this
work.
Signed Owner/Agent .............................................................. Address ............................................ Date ... e5�-914' 10,
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 thereon.
X-eP
............. — .......... .. . ..... Recd. by .....
Valuation ........... .................. PerEcdt.fee..
Building Department, By ..................................................... Date ...............
'V-9V . ..................... ..
This Permit does not cover Plumbing, Sewer or Electrical i"stallations.