690314.pdfZ4
t �,.IUILDING DEPARTMEN
PERMIT APPLICATION
NAME (OR NAJdE OF DUBIN 88)
FAZ
F] ADD
ALTER
REPAIR
9M
N.
0
or
Applicant FBI
Inside Heavy Linen
4�
It
RESIDENTIAL
GAS
I.JNE
NON-RESIDENTIAL
SIGN
DEMOLISH
RETAINING
WALT
EXCAVATE
OR FILL
FENCE
( ........ . x .......... Ft.)
PRE -MOVE
INSP.
El
swim
POOL
DWELLING
UNITS
I hereby acknowledge that I have read this application; thht 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; and irk doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted in six months.)
NOTE: APPlicant SubjeFt to Plan Check Fee
TNS peradt coven work to be done an Prinift PrOPWY ONLY -
Any eonstraction on the pubtle domMa (embs, 01dowAlks, dfIv6w8W5,
merquees, ata.) win require upffirMe Permission.
KISTIIM STREET R/W ............ FT.
COMP. PLAN ST. R/W ........... XT.
FIRE ZONE I TYPE OF
C� YES
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
PERMIT
NUMBER 690314
1P.
1ACK
'7EEAR YARD SETBACK
VACANT SITE
13 YES [3 NO
X
MA
VARIANCE NUMBER
DEFICIENCY THIS PROPERTY
............ FT.
CHECKED BY
,RANCE
CHECKED BY
BY I I
I
Im.
Fee . I Receipt No.
ATTENTION APPLICATION APPROVAL
TIUS PEU�HT This application is not a permit until
AUTHORIZES eigned 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
DIRECTOR 8 GNATMIUL
DEPARTMENT
CITY OF
EDMONDS DAT114V
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CITY OF EDMM�Ss WASHINGTON — DEPARTMEN�.OF BUILDINGS
BUILDING PERMIT
: hereby certifies that a plot, plan, drawings, and sufficient details to indicate
ion to fulfill all requirements of this code are attached hereto.
�n is hereby made for permit to do the following work:
.......... i ......... I ...... ;� ... ..
.......... I* .... ..............
— -- — --- (Street number or lot and block numbers)
. . ............... X ..... ..................
Building dimension ......
R1 Lot dimensions are .................................. X ..............................................
3 Building will be ........... ...... stones in height.
.................................
4. Number of basements.
5. occupancy of building will be ....................................................................
6. Building wX be.... t fr nearest adjoining lot line.
7. Owner ... vmer4i:2 .......... s� ......... ...............................
T*
8. .... .. ....................... 0 ......
9. Builder.i:::::::!� ........................................... ............................................
10. Builder's Address ..................... 0 ....................................... 0 ............ 0 ... 0 ..........
11. Architect or engineer...r.... �. . .... ................... 0 ............................
0
(Owner or his agent)
0
0
04
04
C)
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.0 0
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Estimated cost $ .... 4:5 ...........
....... Group No . .......................... ! .....................
....... Life of permit,!:!:�;-" ...... .... ..........
date
Plans filed: Yes No
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. This copy. is your receipt for the following fees:
1. Building permit fee ....................................................... .............................
2. Sewer permit fee ............................................................ $ ......................................
3. Inspection and supervision fee ........................................ $ ...................................... 0
4. Total ........................................................................................................... . .......... . ........ ... . .......
.................
Rec
01
......... . 00
..6
....... 40
.............
(Issuing Officer)
Department of Buildings
City of Edmonds
PERMIT N? 408
1. kThe building permit fee which applicant pays when permit is issued shall be based on estimated cost of the proposed structure, at the rate of $1.00 for each
$t000.00 of cost. If the actual cost of the structure, when finally determined, exceeds the estimated cost by more than So/c, applicant agrees to pay an additional fee
of $2.00 for each $1000-00 of such excess cost. In such event no use permit shall be issued until such "discrepancy fee" Is paid.
I �
2. Whenever a contract for construction Is executed for any structure costing more than S1000.00 for which a licensed architect at 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 may 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 Depart -eat of Labor and Industries. Before
finla 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
th Department of Labor and Industlies. Thi above pKocedures are requirements of the,State Industrial Insurance Act.
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RJOATION (�,BUILOING FEW Appl. No . .................... ..............
MONDS Building Deparbwat Permit. limito one, yea . r
is hereby made for a permit to construct the following work, in accordance with the accam,
roval.
','and specifications. Two sets are submitted herewith for app
Off -St.
n alter
W��, iddn repair ...... ................ f ........................................................................................ Parking
.... Use zone.e.2 Fire zone ...........................
cy_w ............................... Const. type ............................ .....
Ar'
Addn ......................................
Lot ........................ Blk.::f..i ...........
..f ......... zo ......................
............. Area ........................................... Septic tank .........................................................
K Lot frontage ...........................
................. 1. side .............................. rear ...............................
UT r. side ............
Pldg. set -backs front ............
-Ad
dres& ......
Owne .......... Tel. N
...............
r .................
............................
Builder .......... ..... .................................................
Tel. No.
Address ......
0 .............................
Plans by .................................................................
Address .................................................... Tel. N
Remarks....................................................................................................................................... 7 ..........................................
................................................................................................ ................................................................................................
. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The I above is a correct statement, and I agree to comply with all applica le Codes and Stat w re lat 9
e la 8 gu in this
work.
Signed- Owner/
plianc� with the.
PERMIT for the above work is herebY approved, subject to the above conditions, and to com ap,
proved plans and specifications, and Building Department notations thereon.
ermi m -
Valuation .................................................... P tf ... .....................
...... Recd. by.'../O�'-/- .... 4
... ............ .... ..... e.) .... ..........
Building Department, By ............................. al ..................................... Date ............. 4E.
MKICATIONC-1 BVILDIIIG FRUIT
ff. . T:QV EDMONDS Building Departn"M
A
L
A. hereby made for a permit to construct the following work, in accordance with the accom,
f Ltions. Two sets axe
submitted herewith for approval.
Off'st.
er
................................................................... Parking .................... 7'
repair ........... .
se zone ..... ?Y=Nt.A.. Fire zone ...........................
.......................... U
........ Const. type .....
.A
...................................
Lot ........................ Blk ........................ Addn..
.....................
4� ................
........... Area ..................................... Septic tank .........................................................
r. side ............................. 1. side .............................. rear ...........................
0 . . . . . . . .
Tel. N
............ Address. .... !�_z .... - - L
A
A&
Address ..........................................
'REWIfIci
............................................................
.. ...
Address
Plansby ..................................................................
..........................................
Remarks...........................................................................................................................
Tel. No .............................
Tel. No .............................
............................................
............................................
.....................................................................................................
................................
o comply with all applicable Codes and State laws regulating this
The above is a correct statement, and I agree t
work.
................ Date.z.
Signed Owner/Agent./�
I ..... . ... dress ............................
the above conditions, and to compliance with the ap,
PERMIT for the above work is hereby approved, subject to
and Building Department notations thereon.
proved plans and specifications,
by..---( ....... .............. ... ...
fee ...... .................. Reed.
....... ................ Permit
Date ......... B ................
.......... ..
Building Department, By---V/4i� ................................. .
P
2ing, sewer, or electrical installations, nor does it Permit any work to be
NOTE This permit does not cover plum] ys: and walkways must be planned to meet the official grades of streets
clone in the Right of Way areas. Drivewa
and alleys, and plans for future sidewalk development.
I