710045.pdfk I (=
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BUILDING DEPARTMENT I
PERMIT APPLICATION
C� ! 1
710045
POSTED ON KROLL MAP NO.; PERMIT
tppl[cant Fill NUMBER !
de Heavy Lines OB D JDRESS
MAILING ADDREBU //
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TELEPHONE NUMBER
NA E
WADDRESS
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CITY
TELEPHONE NUMBER
1776 -G'l
or
sm YARD SETBACK
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STREET SETBACK I
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REAR Y D BTBAC
UBL•U
LOT AREA
VACANT SITE
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El YES ❑NO
HEIGHT
(BUILDING AREA
(VARIANCE NUMBER
la PLOT FLAN AI'YnV V r U
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKB
❑ YES ❑ NO
RESIDENTIAL
El
6A8 ❑ YES ❑ NO
LINE
NEW
PLAN CHECKED BY
❑ NON-RESIDENTIAL
❑
SIGN
❑ ADD
DEMOLISH
RETAINING REMARKS
WALL
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ALTER ❑ ORFILL EXCAVATE
❑
FENC.'t_........Fl.) --j'{—
REPAIR El PRE -MOVE
SWIM
POOL
INSP.
(UMBER OF STORIES
NUMBER OF
DWELLING
I
UNITS
7ATURE OF WORK TO BE DONE
1
Valuation I
Fee
. / J / "1 J • --r—
Plan Check No .....................
BUILDING
PLUMBING 3
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
N
ISWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
n
No.
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S�AL"�
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TOTAL AMOUNT DUE
In-
I hereby acknowledge that I have read this application; t]no
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formation given Is correct; and that I am the owner, or the dor-
Ixed agent of the owner. I agree to comply with city and stategu-
lating construction; and In doing the work authorised therebyson
ATTENPION
A
6'� A APPROVAL
pPf Ll\rMTI®N MPl"R®Vi1L
APPLICATION
will be employed In violation of the Labor Code of the State of ton
THIS PERMIT
This application is not a permit until
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relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIich
shall be completed In ninety days; MOVED -IN BUILDINGS shm-
AUTHORIZES ONLY TILE
WORK NOTED
signed by the Building Official or hie Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.pleted
in six months.)
ER OK AGENT) DATE 8INSPECTION
GTE: Applican uhject to Plan Check Fee
OFV/
EDhiOND$
PR 0-1107
DIR OR'S 6NATU EDEPARTMENT/CITY
DAT
FILE
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
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APPL)CATION & BL. AIN PERMIT `� SFr--, �� .lam
CITY OF EDMONDS Building Department Permit limit, year
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APPLICATION is hereby made for a permit to construct the following work, in accordance with the accom•
"t lip` panying plans and specifications. Two sets are submitted herewith for approval.
new •-,alter Off -St.
Work addn repair ,Parking
Occupancy............ ... Const. type ..............................: Use zone....�1 ............... Fire zone................... ...... '
Address.... �� {%........................�.............. Lot..................__.... Blk ........................ Addn ...................................... t,
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Lotfrontage ........................................ Area ........................................... Septic tank .......................................................
Bldg. set -backs — front ............................ r. side ............................. 1. side ............................. rear................................
`�.�/..—rc .:'Address................ �
Owner- .............................................. :! .......... .................................. ...---
Builder..............................---...................... Address.................................................... Tel. No ............................. '
Plansby.................................................................. Address.................................................... Tel. No .............................
Remarks............................................................................................................................................................. .
This permit covers work to be done 1
•............................ r
A::-r noactruction on tho publ-le domain
.....................E.e.:.: :. a..... r.. i. •'.e vo...F ...sl............... :......PlTqu-eer>..................... ................... ......... ...................
.. .....
�.,,•_.i 1 c^uir� oc-:rr._� s n,
The above is a correct statement, and I agree to comply wi a lieable Codes and State laws regulating this i J gu g
work
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Signed Owner/Age�r ... Date ..�.'l`�
... .._.._:r.. .......:�.:.:........_... Address ..........................................
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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. / y
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Recd. by..........� ...::t: - 1 ..
�G`.`"�---t ' ............... Penait fee.......... .c � rM•
Valuation..._....�....................... ....._. .. ............./.
....... Date ..............: �...- ! '' ... . ..
G�'
Building Department B.......................... .....
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This Permit does not cover Plumbing, Sewer or Electrical installations.
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APPLICATI6.4 & WORK PERMIT
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Application No. ... .....
CITY. OF EDMONDS Building Department Permit Limit, one Year
APPLICATION is hereby made for a permit to construct the following work, in accordance with the accompanying plans
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s� and specifications:
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WORK — New/Addn. EleC, Installation Ground Area ................... ........... No. Stories............
Plans Submitted ................ Const. Type ....................................... Height.,......................
z}.
9509 — 196th SoWe
LOCATION — Address `/..
...................................................................................................._................ Use Zone............ �.. Fire Zone..................
Y,
RecordedLot ............... _... Block................... Add'n...... .............. .................. ...................... ............................... Sewerage..,.................................
Lot Area..............._..,%....me*............ Width............................ Min. Bldg, Setbacks, Front and Rear................................ Sides ....... ........... _... ...
Owner .... ...lrl yne Button Aaaresa.. Same as above .... Phone....... 162
Plans by..._..",..",,*g»....... _.._..... ................. _............. too ...... ............. Address..._"... ... .........._..»...... _................................. Phone.. ...... ........
....._.......
b Self
Bld g. y..._................_....._..._....._................................................ Address............. ... ....................._ .................... »..»....... Phone........ ... ............_.......
Plbg. by..........._..............6"099.......... ..................... ............................ Address...............:........................... ...... .__........ 000.... Phone............ 111.0...... _.......
Heatingby,.. ..... "I ...... .............................. ...._....... .......... _....... ......... Address .......... ..111,................. be. ...... ....................... ... Phone., ..... ................_.....
Elect. by......._ .................._.......... .......... ......_......,... .... I ...... ............. . Addresa.........__.........._..Ito.........6.....**..*.._...006#.... Phone ... I.." ... I .... ......._...... 0
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......11111 111.............011,106.1.............................11111....._...................16.........................."911111111111..»........_...._.._.........._............600000.....,................I...I...........0_
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The above is a correct statement and I agree to comply with all applicable Codes and State Laws regulating the work.
...- __- Samo as above r_... 3/15/63
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PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the approved plans
and specifications and Building Department notations thereon,
VALUATION PERNM FEES
$..... _ ...-..0..*#......00............
Date......... 31i51�?3....................................................
11 b a
Bldg. ....$..._...... ........_..... _...........
Plbg. ....$1-1--,.....I...... .............. "I ... 1.
Heat....$1,........ I'll .... 11... I ...............
Elect. .... $.. 3.00..........................
Others...$...............I...................0.... i
...... TOTAL FEE$3.00.......................
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NOTES: No work requiring Building Department or City Engineer's inspection shall be covered before inspection and approval.
Twenty-four (24) hour notice requested. Contact the City Engineer prior to construction of all site utilities, such as
curbs, paving, driveways, sewer, water and street connections.
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