690232.pdfr
I
C.
BUILDING DEPARTMENT Applicant M
PERMIT APPLICATION udde Heavy unes
Nis a
CE
CITY wic"PlioNE NUMB&H,
;r nMA�jni 1 �7 '7 /j - '? 140
I I I 1 .0 �,c - /. 2 .3 - '51— t0lle 9 —
�1
RESIDENTIAL
GAS
LINE
NEW
NON-RESIDENTIAL
SIGN
DADD
RETAINING
0
WALL
DEMOLISH
ALTER
EXCAVATE
FENCE
OR FILL
. ........
REPAIR
PRE -MOVE
INSP.
SWIM
POOL
NUMBER 0
DWELLING
UNITS
IA5URE bF_W0jM TO PE DONE/
EN KROLL MAP NO.: PERMIT
I NUMBER 9 0 c;2 3 oZ—
HEBB
c5_ — S") U
RD SETBACK BTRERrr SETBACK REAR YARD'BETBACK
NE LOT AREA. VACANT SITE
— 6 1 [3 YES 13 NO
i utninima AREA I VARULNOM NUMBER IN
FlISREET R/W ...... DEFICIENCY Tma PROPERTY
PLAN ST. R/W .......... XT.
S.74DRI-1 TYPE OF_=ON I k1wHrig
4-r4 13 YES
ECIAL INSPECTOR OCCUPANCY GROUP
YES 7;.-" 1 �— I
Plan Check
P 01 � a USE I BUILDING
PILOT P Indicate Building setbacks, &butting streets) PLUM33ING
HEAT & GAS LINE
PENCE
Mole SIGN
RETAnUNG WALL
0
t�eio�l SWIMIUNG POOL
DEMOLITION
PRE -MOVE INSPECTION
t
EXCAVATION OR FILL
XQZ. AMOUNT DUE
I hereby acknowledge that I have read this &PPllC&ti0n; that the In'
formation given to 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 ngu- ATTENTION
l&ting construcUon; and In doing the work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington THIS PERMIT
relating to Workman's Compensation IMU=04. AUTBOWZES
ONLY TM
NOTE: Permit Limit One Your (Except DEMOLITIONS which WORK NOTED
&hall be completed in ninety days; MoVrJ)-IN BUILDINGS ahaal be com-
plated in six months.)
SIGNED INSPECTION
-81-ONAT RE (OWNP1.01011 AGENT) DEPARTUENT
CITY OF
L EDMONDS
NOTE: Applicant Subject to Plan Check Fee PIL 6-1107
_jW. P0,Wt coven work to be done on private VMP"tY ONLY -
Any construction an the public domain (carbll, sidewalks. driveways,
marquess, eta.) will require separate permission.
No.
2
APPLICATION APPROVAL
This application to not a perrait until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
0,3
ruja
T
�j
OF EDMONDSs WASHINGTO�-
BUILDING PERMIT
4 f
cant hereby certifies. that a p =ot, plan, drawings, and sufficient details to indicate
ion, to fula aU rNuirements of this code are attached hereto.
,,.*,�hereby made for permit to do the following work:
. ... .... . .........
.. .......... . .................. - - ---------- ........ x
�;'- �A* A . A 10
.........................................
.14 ............. .......
I A T—
.......................... *1 ------- - - .......
fldMg dimensions ft)(32 . .............. .......
-7
.........
Its Sr ................ ff
Airhe ions ..1D
g will be .... 1 ................. stories.
asem- ......... /7
..................................
ccupan of building will b
line.
f f theL
6 , -neares a�jo ng
......... eet ron t a�j'o
........ ...
. .......................................
0 ....
ii::�-:7 wn .. /Z' -11�.
.... IE�
= ... / .. ....................................... . .......... . ...
8. owner's Address..
9r. Builder ........ ... .................................................... : .......... . .....................
10. Builder's Address. ........ . . ................................................................................................
**"* --- -------------------------------
Date!/2,3 ..................... ... 194
....... ;4--zdA-;r .......................
agent)
This Space Is For . . 1 4 1
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. I
PERMIT N? 589
&0
Estimated cost a.00 1) —
. ....................
Life of permit ... ly--4i�e ........
Plans filed:, Yes E� No
$-4K ..............................
7 Rec V Y
. .. . .... . .... . ...
(Issuing Officer)
Department of Buildings
City of Edmonds
1. The building permit fee which applicant pays when permit Is issued shalt be based on estimated cost of the propnsed structure, at the rate of $2.00 for each
$l000.00 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 Sz.00 for each $1000.00 of such excess cost-
2. Whenever 2 contract for construction Is executed for any structure testing more than $1660.0046r which a licensed architect or engineer Is not required by
the Building Code of. the.City of Edmonds, thi,application for a building permit. shalt be.,,jLccgmpxnfed by a copy of the -contrait and copy 'of'*the'detailed
specihcidons.
3. FrIor'to employing any labor of 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. The releases should be
Arrested by the Department of Labor and Industries. 'Me above procedures are requirements of the State Industrial Insurance Act.
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