700281.pdfC.
BUILDING DEPARTMENT Applicant FIR
PERMIT APPLICATION Inside Heavy Lines
e, -er- V
�Zor 3 IV 5/—
ADDRESS
CITY TELEPHONE NUM-BER
or
Z
RESIDENTIAL
GAS
LINE
NEW
NON-RESIDENTIAL
r I
SIGN
0 ---
El
DEMOLISH
Q
1tjG,17jU141rqG
WALL
0
EXCAVATE
FENCE
ALTER
El
OR FILL
(J,,0x..._<A-)
REPAIR
1:1
PRE -MOVE
swim
POOL
INSP.
NUM13ER OF STORIES
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
PROPOSED USE
PLOT PLAN (Indicate Building setbacks, abutting streets)
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 regu-
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Coda of the State of Washington
relating to Workmen's Compensation. Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
/IAP
0-7 ��
NOTE: Applicant Subject to Plan Chech. Fee
Tide Permit coven work to be done on private property ONLY.
Amy construction on the public domain (curbs, sidewalks, driveways,
marquees, etc. ) will require separate permission.
C
NO.: PERMIT
I NUMBER
u
C3 YES 13 NO
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ IV.
REMARKS
0 YES [3 NO
[] YES Ej NO
REMARKS
Plan Check No .....................
Valuation
Fee
Receipt No.
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
4�
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
APPLICATION APPROVAL
TWs application is not a permit until
signed by the Building Official or his Dep-
uty; and fees Eire paid, and receipt is ac-
linowledged in space provided.
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
APPLICATiLm & WORK PERMIT Application No. ......
CITY OF EDMONDS Building Department Permit Limit, one Year
in accordance with the accompanying Plans
construct the following work,
PLICATION Is hereby made for a permit to
Ifications:
GroundArea ................................... NO. Stories ............
Addn. .... . ......... ..............................................
..,00,4
.'2
.... Const. Type ........................................ Height ........................
................
... ...... ...
ed ...... k9 .......
Address ..// e) ..... .. 1-4::�l ................................. Use Zon/=.6../�. Fire Zone ....................
...................... .......... ............... ...
............. 7
' atle-11 .... . ..................... Sewerage .....................................
................... Block.� .................. Add'n ............................... ......................................
............. Sides.�� ..... 7 ..................
............ min. Bldg. Setbacks, Front and Rear--/---r�4
..................... Width ................
...........
............... ............. ......... t
.. . .... `4 PhonF
............... Address
............................... Address ........................................................................ Phone ................................
,by ............................................................
Address........................................................................ Phone ................................
g.�by ........................................................................
................... Phone ..............................
.............. Address .....................................................
Plbg. by .............................................................................
...............................
Heat
LBaAL DFSCRIPTION
...............................
Else (K, Bo Montgomery)
Rem
Beginning 168.711 west of SE corner of SE 1/4 of SE 1/4 of sF, 1/4 of
Sec. 23.9 T27N, R3Ei W,M,; thence north 551; thence west 122*711; ...............................
thence south55'.-, thence'east 122,711 to beginning,
(Being knoial as Lots 5 and 6s Blke 3,, olympic Viewjj ........................
......... according to unrecorded plat thereof)
...............................
.............................
with all applicable Codes and State Laws regulatingthe work.
The above is a correct statement and I agree to comply
t to the above conditions, and to compliance with the approved plans
PERMIT for the above work Is hereby approved, subjec
and specifications and Building Department notations thereon.
rERMT FEES
VALUATION
0 Bldg.
..................................
.................................
Plbg. $ ........................................
Heat.... ........................................
APPROVED:
Date..... ............................... Mact. ....... .........................
Others... $ ........................................
BUILDING D A ENT
00
By,,, ..... e.< ................................ TOTAL FEE $ ... .... \ . ...........................
covered before inspection and approval.
NOTES: No work requiring Building Department or City Engineer's inspection shall be
ngineer prior to construction of all site utilities, such as
Twenty-four (24) hour notice requested. Contact the City E
curbs, paving, driveways, sewer, water and street connections.
j
WASHINGTON D
CITY OF EDM EPARTME ar vF BUILDINGS
BUILDING PERMIT
1 .
JW�Ohejyfuertlifies that a plot, plan, drawings, and sufficient details to indicate
f
n d all requirements of this code are attached hereto.
icatigp is hereby made for permit to do the following work:
............... ................................................................................
............................
..............................................................................................................................................
x:;-
................................ $1 .............................................................................................................
...............................................................................................................................................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..........................................................................................
. . .. .. ..... .......
a ..........................
(Street number or lot zni'�i "u,mler's—)
1. Building dimensions are .... 4; ......................... X ........... ..........................
2. Lot dimensions are .................................. x .............................
.................
3. Building will be ....... / ................. stories in height.
4. Number of basements .................................
*11 be ......................................................................................
5. Occupancy of buildmi wi
6. Building be .. ...........
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.... . ... ................................ timated cost $ ... 1.1rwAw.n.k .................
8. Ow n ' ddress..%n./.. ................................
9. Budder ............................................................................................................................. Group No.
10. Builders Address ............................................................................................................
Life of permiL.Ii.
da�e
Plans filed: Yes 'a,"'NO E3
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11. Architect or en eer ....................................................................................................
Date�4�. 19
1, agent) 7
Applicant's Signature ..........
--- or- his ----
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
4. Total ..................................
PERMIT N? 477
$ ......................................
$ ......................................
,�5MI
(Issuing Officer)
Department of Buildings
City of Edmonds
1. The building permit fee which applicant pays when permit is issued shaft be based on estimated cost of the proposed structure, at the rate of $1.00 for each
$1000.00 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 $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.
2. Whenever a contract for construction Is executed for any structure costing more thin $1000.00 for which a licensed architect or 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
sl�edfications.
3. PrIair,to em6loying any labor or commencing work, notify.the Industrial Insurance Division of the Department of LfLor ankladustries, giving an estimate of
the payroll and maki-monthly reports of payrolls. F�ll instructions,sliodIdII)e obtained from the nearest office of the Department of--rA-bLr and Industries. Before
final payment, the owner should obtain a release from the general cootra�torz who in turn should obtain release from all kffub-cohtr3l�tors. The releases should be
quested by the Department of Labor and Industries. The above- procedures ate requirements of the State Industrial Insurance Act. . I
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CITY OF EDMO�wi`e-WASHINGTON DEPARTMI14-u Or BUILDINGS
BUILDING PERMIT
ant hereby certifies that a plot, plan, drawings, and sufficient details to indicate
biiit6n to fulfill all requirements of this code are attached hereto.
. ation is hereby 50e for p t to do the following work:
0 L-7 C _77'.14
................................
Joll� A
.............. Y ...................................... ....... ......... I, ......
..jR..dP AV W
...... ........ . .............
7
I ..........................
.. .......... zf .. �- -'=4 ...... 4 Q .......... .......................
at.... ... .................................................................. ............ : .................................
(Street number or lot and block numbers)
I . Building dimensions are .................................. X .......................................
2. Lot dimensions are ......... 6.. J;.Z1 ............. X .... 12\..�? ...........................
3. Building will be ........................... stories in height.
4. Number of basements .................................
Mill be ...................................................................
a ,
5. Occupancy of buildin
f RtIV-stiLdjoining lot line.
6. Building will be. /.?/,
W .... eet fir6m
7. Owner .......... I-,,./ ..... ..........................................
8. Owner's Address,-... ........ ( ......... ...... ... ..........................
..z ....................... ..... ................... .........
9. Builder ........... Y1
10. Builder's Address ..................................... ............ ... ..................... ......
u. Architect..,.�engineer ............... I .... .. . . .... ...... ............................ .
Date........... . ...............
Applicant's Signat V .... ....... (Owner .. or .. his . agent)
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Estimated cost ........
GroupNo . ................................................
Life of permit. ................................
...........
due
Plans filed: Yes P� 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 fce .................................................. ...........................
..... ............. — 1
2. Sewer permit fee ....................................................... Fss ... .... . $'�" ...............
3. Inspection and supervision fee .........................
4. Total .................................................................
PERMIT
AIIG I iwl
388
...................................
................ . ........... . ......... $ .... ;2-
.................................
Rece
.. ... .. .. . .........
(Issuing Officer)
Department of Buildings
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 $1.00 for each
Sl000.00 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 $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.
2. Whenever a contract for construction Is executed for &!ty structure costing more thin $1000.00 for which a licensed architect or engineer Is not required by
the Building Code ef 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 an estimate of
the payroll and make monthly reports of payrolls. Full instructions should he 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
atteited by the.ppartment of Labor and Industries 77heabove ptocedures" 2 uirevnc;.us of the State kdVstrial InsiVrifice Act.
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I
TLICATION BUILDING PERMIT Appl. No.
I F MONDS Building Department �Permit limit,,one, yearb
ED
accordance with the accom
PUCATION is hereby made for a permit to construct the following work, in
and specifications. Two sets are submitted herewith for approvaL
91- plans
Off -St.
ter tv�� .............. Parldn ...................
dn w"-A ........... 01 ............................. 9
repair .........
se zone .... /fn ..... ........ Fire zone ...........................
Occupancy; ............................... Const. type ..... ...................... U
17Z.................................
.............................. 1A)t ........ ............... Blk ........................ Addn .....
.:1.Address....`5 ............................
................ ...........
............................
. . . . . Area ........................................... Septic tank..
1.40t frontage..
................................
.............................
1. side .............................. rear....
Bldg. get4acks front ........................... r. side ...........................
. V7
. . . . . . . . . . . . . . . . . . .
owner ... .. ...
? .......
N
Address. ...... 10�K ..................... .......
............ 7-
..........................
Builder ....
............................. Address .................................................... Tel, No...
Address ................................ ............... I ......
............. ..... Tel. No ........
Plansby ........ .........................................................
Remarks.................................................................................................... ...................................... ......................................
............................................................................ I..., ......
.............................................................................. .......
. ..................
.......................
..................... .............................................................. ...... I
...........................................................................
ent, and I agree to comply with all applicable Codes and State laws. regulating this
'The above is a correct statem
work.
Signed Owner/Agen ........... Address ............................................
the above conditions, and to compliance with the ap-
PERMIT for the above work is hereby approved, subject to
..4
proved plans and specifications, and Building Department notations thereon.
Reed. ....... . ............ . ............ .
Valuation .......... % ... IL . .. .................... Permit fee .......... .............
0.0 ............................
Building Department, By ......................... ztulcz:�A .......................... Date... & . . . . . . . . .
This pennit does not cover Plumbing, Sewer or Electrical installations.
- f�4 -�P ... I , : ,
VVIZ,V',,��,APPUGATION �411
ILDING PERMIT'
Appl. No . ..... ..........
Permit limit., one year
EDMONDS Building Department
CITY OF
following work, in accordance with the accom,
CATION is hereby made for a permit to construct the
lar4 d if ons. Two sm. are submitted herewith for approval.
.-p
an Bpt= icati
off -St.
new P,' alter ........................... Parking .......................
repair
or addn ........
.................
Fire zone ..........
se zone ... e
ancy................................ C, onst. type ................................ U
p-,, Z4,�! ....... Blk ....... I ............... Addn 6�k
-4z 4!?�K ............... Lot... . ........... . ..........
r....... .. ...................
Lotfrontage ........................................ Area ........................ .................. Septic tank r.Aa..o.et ...................................
setbacks — front ......... V ......... r. side ............ 1. side ............ *-fy; ....... rear ............
BIdg
N 0.
ress. .... ..... 54 .....
Owner . ..... Add .... ........ ........ .. Tel . . ..........................
......... ....... .........
Address ...... .............. Tel. No ..........................
...... ................................
Builder .................. / ........................................
Address.................................................... Tel. No .............................. .. .
Plans by .................................................................
Remarks..................................................................................................................................................... ......
.............................................................................................................. .
. .............................................................................
. ................... ..................................... ............................................................
....................................................................... ....
The ab ove is a correct statoeR\t, and I agree to comply with all applicable Codes and State laws regul-iting:"
work.
ner/AgL& . ...... 2* Address ............................................ Date..3 ....
Signed Ow
P . ERMIT 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.
Valuation ............... Recd. by ..... ......................
...................... Permit fee .......
BuildingDepartment, By .......................................................................... Date ............................................................. 1 .7.
This Permit does rzot cover Plumbing, Sewer or Electrical installations.
115-63
APPLIC
AT14,,4 & WORK PERMIT Application No . ............................
11ding Department Permit Limit, One Year
In accordance with the accompanying plans
ION is hereby made for a permit to construct the fOUOW'ng work
�'APPLICAT
and specifications:
Fence & patio Cover Ground Area. .... . ... ........................ NO- StOrIeL ...........
New/Addn . ... . ...............................................................
.... Height .............. ........
................. Const. Type. ...................................
. .................................. ..
aiwa,shubmitted .... .. .....................................
Zone .. Me Zone ...................
530 - 4th Ave* So .......... .... . ..... . .. . ................... use
1A)CAnON — Address ......... . ............... . .......... . .. . .............
r
. .................. . ...
...e ......... ....... Sewerese ...........
"'�.Rscorded TA -Block . . ...... ........ Add....(,
411hp. fenClides ....... 4t ... .......
............... 3� Bldg. Setbacks, Front and Hear.. T-F ........... ....
lot Are&...-- . ....................... Width ............ '15
PR - 6-1870
.... Address.... 530..m..�th kye, So none ............ . ........
...... . ......
... ...................... ...................
Phone....................... .. . ...
Plansby..—.-.-. . ...... . . . .. . .. . ...... . ....
Bift. by .. . .... . ... . .. ... . ... . ............... . ..... .. . ................... Address. ...... . . . . .............. . ... ................. . ................ Phone ....................... .......
.............. Phone ............... . ..... . .......
Address. .. . ...... . .............. . ............. . ......... . ..
Mg. by . . . .. . ........ . ....... . . .. . ................
Phone........................ .......
...... Address. ...... . ........................... ....... .................
Heatingby ............... . ........................................................
Phone ..................... . ........
....................
... . .......... . ...... . ... Address. .. ....................... . ...... . .............
Elect. by ......................................................
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Remarks.............. . . .................................................................................... . .......... . .. . .
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The above is a correct statement and I agree to comply with all applicable codes and State L&WO regulating the work.
Same as above 11/15/63
... Address .... .......... . ......................... ... Date.=.z .. A ......... ....
Signed: Owrter/Agent- 7E9 .......
subject to the above OOnditIOMB, and to compliance with the approved plans
PERMIT for the above work Is hereby approved,
and specifications and Building Department notations thereon.
VALUAT110N PERNOLT FEW
Bldg. ... .... . ...................
....... ........
Plbg. $ ....................... . ...............
Heat.... $ ............... . ...... . .. . ...........
APPROVED:
Date............. ........... ...................... Elect. ........................... . ...........
BUILDING DEPARThUU*TT Others ... $ ........................................
'444dlfry 'iT'113P TOTAL FZE $ ..... . ............. . ....
Wm. .......... g ........................ ...... .
BY................. ........
NOTES: No work requiring Building Department or City Engineer's Inspection shall be covered before inspection and approval-
struction of all site utilities, such as
Twenty-four (24) hour notice requested. contact the City Engineer prior to con
sewer, water and street connections.
curbs, paving, driveways,
5-
tion
t 6 Y ar