690440.pdfBUILDING DEPARTMENT Applicant ]Fill
PERMIT APPLICATION inside Heavy Lines
NAME (OR NAME oir BUSINESS)
M r1eq/
MAILING ADDREH
Gfj� A
412.- 3 r— -
CITY UMBMA
44 "11 a ft is 1-77'1-7?2-0 _
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MNEW
RESIDENTIAL
GAS
F-1 LINE
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NON-RESIDENTIAL
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SIGN
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RETAINING
WALL
DEMOLISH
ALTER
EXCAVATE
OR FILL
PWCE
a,19_xJK'..rt.)
E] REPAIR
PRE -MOVE
INSP.
SWIM
POOL
DWELLING
UNITS
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44/
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C
i KROLL MAP NO.; PERMIT 6V044U
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5—SET13ACK STREETTSETBACK REAR YARD SETBACK
3 1 1. A VACANT SITE
OT ARE
I El YES [3 NO
RTnT.T7T_Mf%ARE& I VARIANCE NUMBER
EXISTING STREET R/W ............ FT.
COUP. PLAN ST. R/W ............ FT.
V49NO,
C] YES [J NO
Plan Check No ............
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
P
H
P
SIGN
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A
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UMBI
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t rRETAINING WA E :�:
LL
SWIMMING POOL
DEMOLITION
EM
PRE -MOVE �INSPECTIO:N
EXC V TION OR FILL
EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the in-
formation given In 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 ragul
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
relating to Workman's Compensation insurance.
NOTE: Permit Limit One Year (Except DE51OLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com.
plated in six months.)
-ffl—oNjl[11�01LE [0YW_NER_ Oft AGENT) _T DATE —SIGNED
NOTE: Appliciint Subject to Plan Check Fee
Till 1permig covers work to be done on private property ONLY.
'A" construction on the Public domain (eurbs, sidewalks, driveways,
marquees, etc.) will require separate PernliN910112-
DEFICIENCY THIS PROPERTY
BY
i
TOTAL AMOUNT DUE
ATTENTION APPLICATION APPROVAL
THIS PERMIT Tills application Is not a permit until
AUTHORIZES Signed by the Building Official or his Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ae-
lmowledged in space provided.
INSPECTION
1111,1�,11 111:11111111 1
DEPARTMENT 2p,
CITY OF DATE
EDMONDS
PR 6-1107
FILE
.X
w
I
I BUILOM
APPUGATMI, G PEW Appl. No. f.6.=� .. . .............
Building Department Permit UmiL one Y=
CITY OF EDMONDS
. . . . . . . . . . . . . the accom-
PUCATION is hereby made for a permit to construct the following work, in accordance with
AP
lans and specifications. Two ads aresubmitted herewith for approval.
panymg p
0 ff'St.
................ Parking ......................
................................. ..................................................
Work 1:::rEpai5r . . . . . . . . .
Use zone ..........
Fire zone .......... . ........
Occu........... Const. type .......................
pancy .....................
3 .... I-ot ........................ Blk..,e!�� ............. Mdn..
Address .......
....... Septic tank .......... . . ...... ....... .......................
Lot frontage ........................................ Area ....................................
t
4—
. . . . . . . . . . . . . . . . . . . . . . . . . .
................ rear .....
.............. 1. side ......
Bldg. setbacks front ..... /.40 ......... r, side..
resa- ....... �:N
?74— of )Xrt..'.d d .......... I ................... Tel o .....
Owner ..............................
Builder ....... Addresal ... ..... Tel. No, ...........................
No. . . . . . . 9 . .. . . .. .. .... .. . ... ..
Plans by .... Address .................................................... Tel.
. . .. . . . . . . .... .... .. .... . . . . . . ... . .. . . ... . ... . .. . . .... ...
. . . . . . . . . . . . . . .
Remaiks ........................................................................... ........
I I
. .. . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
......................................................... I
The above is a correct statement, and I agree t ly with all applicable Codes and State laws regulating. this
0 com
work.
Date ............
Signed Owner/Agent ........ 7- ............................................
7�
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ap,
proved pla;%. and specifications, and Building Department notations thereon.
. . . . . . . . . . . . . . .
....................... Permit fee ....... by..
'9 ......... Recd.
Valuation .............................
................. Date ............. ... . .. K-Z . . ................
Building Department, By .................................... . . . . . . . . . . . . . .
n t
s or electrical installations, nor does it permitany work to be
NOTE This permit does not cover plumbing, ewer, ets
done in the Right of Way areas. Driveways and walkways -must be Planned to meet the official grades of t
and alleys, and plans for future sidewalk development-
4
GPON T- Appl. No . . .......... ... .
AP
TUOPION �LBUILDIN ne year
Peim-dt limit, 0
Building Department
CffY OF EDMONDS
rk, in accordance with the accom,
N is hem4 made for 9. permit to construct the following wo
APPUCATIO ewith for approval.
Two sets are submitted her
panying plans- and specificadons.:
bffst.
. ...................
new alter .............................................. Parking
.......................
repair ......................
Work addn
...... ................. ...
e ....... Fire zone.
....................... Use zon
Const. Me..
Occupancy ...................................
T-
Blk....................... Addn ......... ................ . ....
Lot....... . ... . .........
Address .....
.................................... .
.... . .....
............... Septic tank.
...........................
J, Area..
Lot, frontage ...........
1. side .. .................... rear ................................
........................... .......
front. ........................... r. side..
wrlcr 5tet-backs I A
Appl. No, .....................
.............
APKIOATION BUILDING PERMIT
permit limit, one year,
Building Depariment
"ey CITY OF EIDMONDS
in accordance With the
acoDm
struct the following work,
APPUCATION is hereby made for a permit to cOn
sets are submitted herewith for approval.
g plans and specifications. TWO
panyin
Off -St.
......................
new alter
Work addn ��`repair ........... ..... ft ... .......................................... Parking
. .. . .....
..................... use zone .... Fire zone ........... .................
occupancy ................................. Const. type� ..........
.t ........................ Blk ........................ Addn ......................................
Address ................. je ............ 3.k-� . ... ....
Septic tank .........................................................
Area ............................... .........
J.0t frontage--
.....................................
.............. r. side ............................. 1. side ........................... rear ................................
Bldg� set-baCks front ..............
0
el. 14
z T
...................... .......
dress...
owner ..... .
. . . . . . . . . . . . . . . . . . . . .
........ Tel. No.....
Address ................ 7 . . . . . . .
Builder...................................................................
Address.................................................... Tel. No ...... ...................
Plansby ......................................................
..................... ......
Remarks ...... 9A
.......... <�f . ....
.......................................................
............................
.....................................................................................
........................
and State laws regulating this
-with all applicable Codes
t, and I agree to comply
The above is a correct statemen
work.
..............
Date
Signed Owner/Agent.4
ap.
ns and to compliancevvit4 the
'PERMIT, for the above work is hereby approved, subject to the above conditio,
proved plans and specifications, and Building Department notations thereon. yel
fee ...... ................. Recd.,by I. -
Valuation ............. 1.0 .. ... ................ Pexrrdt . ........... ..
....................... ........
Date...
Building Department, By . . . .. . . . . . . .. . . ....... . .... WIWI. . . . . . . . . . . . . . . . . . . . . . .
ric4l installations nor does it permit any work to be
e
This permit does not cover plumbing, s wer, or elect ects
and walkways must
NOTE be planned io meet the Official grades 6 str
done in the Right of Way areas. Driveways
and alleys, and plans for future sidewalk development.
c
e
w
it
h
............
�jt any w
i
w,
L i ....
ION BUILDING PERMIT
APPLICAT
CITY OF EDMONDS Building Department
CATION is hereby made for a permit to construct the following work, in accordance with the atcom-
9 plans and specifications. Two sets are submitted herewith for approval.
Off -St.
new alter
,,0',W6rk addn repair ............................. :7 .......................................................................... . ..... Parking ......... . ....... .
................... Con e ............................... Use zone ... Fire zone .................. ........
ancy .............
S; -p ................ . ...........
................ Blk ........................ Addn .........
....................... Lot .......
r ... 15"�v 2 ...........................
.......................................................
ntage . ................
Lot fri ..................................
-P ..... Septic tank..
-P ...................... Area ....
0
Bldg. setbacks front ............................ r. side ............................. 1. side ............................. rear ...............................
ewl
3& .................
Tel.
Owne........................ ...... Address ..... �t .. . ................ No
Addres& ................................................... Tel. No .............. I ............ —
Builder ............. w ........... .............
........................... F
Address.................................................... Tel. No .............................
Plans by .................................................................
Remarks................................... I .............................................................................................................................................. ..
this
t, and I agree to comply with all applicable Codes and State laws r%u! ;iting
The above is a correct statemen
work.
Signed Owner/Agent. Address ... ......................
...................
PERMIT for the above work is hereby approved, subject tDthe above. conditions, and to compliance wiiii, Ithet api,
proved plans and specifications, and Building Department notations thereon.
..............
it fm ....... ................. Recd. by ..... ...... ......
7
Valuation ..... ............... Perm
Building Department, By ............................................ ............................... ..
. ................... Date.
..........
INSPECTION RECORD
Fdn, OK ............................................ Frame, OK ............. . .................
Final, OK ................................. ......
!CATION �-BUILDING PERMIT
ED - M - ONDS Building DepadmeRt
C- Appl. No . ...... I .................
..........
permit limit, one year
with the accom
ON. is hereby made for a permit to construct the following works in accordance
specifications. Two sets are submitted herewith for approval.
ilans and
..... Off -St.
ew
Parking ............ I ..........
W.'addnv repair ..... ....... 22 ........ e
Aq
Const. type .............................. Use zone. e::� ................ Fire zone .............................
tcupancy ................................ I a,7- -:Z' , 0.-
0
Uk .... / . ............... Addn....
-5.0 -7 ........................ Lot .......................
.... . .. .......................
r V
,ontage ................ ................ lt4am .......... . ............................... Septic tank .............................. cc .............. % .........
............
.................... ..........................
4et,ba&is front ........................... r. side ....... 1. side..
��.ATel. N,;'— ...........
.. ................... .
.......... Addres& ......... ....
V
....................
",Zo ;-0 T . .....
Tel. leo.--� ...
-�Bul
A�ddress . ... .. ....
ild ................................... ... ........
f
.......... I'll, --------- -
................... 1.9i4KP9 .....
ste.) will require separate permission.
complywith all applicable code6 and State laws regulating this
The above is a correct statement, and I agree to
work.
r ss
..... Datp—/
Signed Owner/Agent., Ad
dress...
the above conditions, and to complianci with the'aP-
subject to
PERMIT for the above work is hereby approved,
otations thereom
proved plans and specifications, and Building Department n
'e Recd. by.. ... ... ...
Valuatim ............ /4:2k Permit fee .....
0 ...........
..........................
................. Date ......... .....
Building Department, BY ..................................
inSt4allations.
rmit does Tlot coocr plutnbing, Sewer or Electrical
This Pe
14,
*�4
C
CITY OF EDMONI)Sr WASHINGTON
Rm n ima PFRMIT
V
and sufficient details to indicate
Applicant hereby certifies thata Plot, plan, drawings,
the intention to fulfill all requirements of this code are attached hereto.
Application is hereby made for permit to do the following work:
-- ---- - -- - -----
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.............................. Block .. ........... ..............
........... . .. . ... ... ........ . X * ' "r
_A� ....
. .. . . .... . ...... . .... . ..... . .....
........... . .... . .......... . .......... . ...................... . ................ . ................
...................... ....................................... .................................. . .. . . .. . . ..
. ............. . .. . . .. . ...... . ...... . .... . .. . . ........
C.................. ------- — -- — ------------
1. Building dimensions ................................ X ................................
2. Lot dimensions ................................ x ................................
3. Building will be ........................ stories.
4. Basement ........................
5. occupancy of building will be ......................................................................................
This Space Is For
City Inspector Only
wil
d'
6. eet frq,�l the nearrpt pjoihing line.
7.- Owner ......
8. Owner's Ad ess ........................................................................................... . .......... . ...
........... . .....................
9. Builder ..........................................................................................
10. Builder's Address ...................................................................................... . ... -------- \J%
..................................................
...........
............. ...
.........................
Date.
.... . ..........
0 1 ... ien��
(owner 4is Wa
pertaining hereto,
Permission is hereby granted to do the ork de.scrribed hereon, according to the approved plans and specifications
subject to compliance with the ordinances of the 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 ach
$1000.00 of cost. If the actual cost of the structure, when finally determined, exceeds the estimated cost by more than Wo, applicant agrees to pay in additionZee
of $2.00 for each $1000.00 of such excess Cost.
00 for which a licensed architect or engineer is not required by
2. Whenever a contract for construction is executed for any structure costing more than $1000.
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 at 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,
-contractors.
obtain a release from the general contractors who in tum should obtain release from all sub "a releases should be
final payment, the owner should
Attested by the Department of Labor and Industries. 'rhe above procedures are requirements of the State Industrial Insurance Act.
.7,
"AILDIN
PPLIGATION 0 PERMIT Appl. No.
ffy- OF EDMONDS Building Department Permit limit, one year
to construct the following work, in accordance with the accom,
ON is hereby made for a permit
submitted herewith for appr�val.
,Tland and specifications. Two sets are
Off'st.
alter
......... ......................
.................. ................... .............. Parking
t addn repair
Use zone. d ...... Fire zone ............................
.................... .......... Const. type' .............................
.......... Lot.. ........... Blk .... ....... ------
r .............. ----------- /
. .....................................
...........
Area ............... ................. Septic tank ......
frontage ......................................
R� 1. side ......... ..... rear ....... .... . .........
front ...... P5 ...... 4". r. side .......
rg,
. ... . .....
d rem
.±�,�Ta Nop ... .. ..
z k,
-0� .. .. ... ... ...
It- t
..................... Address .................................................... Tel. No .............................
d
er ..............................................
B
R
Tel. No .............................
................. Address ....................................................
Plans by .................................................
..................................................................I.
Remarks...............................................................................................................
work to be done
This permit covers
on privato Proper 01MY. ...... .......................................................................................... .......
.............................
.......................................... 7 ..... . .... .... ..
domain
Any constkructvion on the public
(curbs, sidcwalku, driveways, marquees .......................................................... .................... III— ........... ... . ...
......................................................... .......... .
................ t., rmission.,
require, separate pe
plywith all applicable Codes and State laws regulating �this'
The above is a correct statement, and I agree to com .... . .
work.
(2W ........... . ... Address ............ Date4 ....
gent . .. .........
Signed Owner/A
the above conditions, and to compliance with! the apo
PERMIT for the above work is hereby
subject to
approved
Building DepartraentnotationsthereorL
proved plans and specifications,
Recd. ....... ......... ............. ...........
...................... Permit fee., ..........................
Valuation .........
Building. Department, BY ..................................... .. . ............. . .. ....
This Permit does -not coluer Plumbing, Sewer or Electrical instdilations.
"j,