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POSTED ON KROLL MAP O.:
PERMIT F (1
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BUILDING DEPARTMENT Applicant Fill
NUMBER
H
PERMIT APPLICATION Inside Heavy Lines IOB
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ADDR SS
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NAME (01%
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Z�L�— .SIDE
ARD�BET13ACK STREET SETBACK
D I I /S!
REAR YARD SET➢/
I o�-Q' .�✓_
AD
MAILING
SE ZONE I LOT AREA
VACANT SITE
I
TELEPHONE NUMBER
VVV
Q YEB NO
HEIGHT I BUILDING AREA I VARIANCE IQUAIDEI
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PLOT PLAN APPROVED -
bTIiEET R,w
EXISTING STREET R,W�1
DEFICIENCY TFII8 PROPERTY
"'
I TELE HONE NUAIG➢ER
PLAN ST. R/W3 �OL ,
••�••FT•
67-
;03-Z/
0 Description of Property (Show Below or ALtaCn Moor uoplee'
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_ _Xjo OiL1/5� C�OZj LTA
RESIDENTIAL
LINE
NEW
❑NON-RESIDENTIAL
❑ .SIGN
❑ ADD
❑
yEAI�INTNG
❑
DEMOLISH
EXCAVATE
EN..
ALTER
FILL
OR FILL
❑ (x.......... Ft.)
❑ REPAIR
❑
IN MOVE
SWIM
POOL
DUMBER OF STORIES
NUMBER OF
�j
DWELLING
I
4
UNITS
'1ATURE OF WORK TO BE DONE
vr- du«-
,�,4.eT.Gr�•U T'
zlO
by
4 PROPOSED USE
aPLOT PLAN (Indicate Building setbacks, abuts
A7 c'f-LSD
away S10DeS not to excee(
tandard Drawing #103.
1 1 IZE I SERVICE 1SIZE I CLEARANCE
// VI
IRS 64
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V_ 1,4) loA 1. ,
rlan Check No.....�.�
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
tRETAINING
WALL
N
I
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that 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. ATTENTION
lating construction; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington TIUS PERMIT
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY TILE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
IIGNATURE (OWNER OK A ENT) DATE SIGNED INSPECTION
DEPARTMENT
71 CITY OF
ED11fONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curb@, sidewalks, driveways,
marquees, etc.) will require separate permission.
Valuation I Fee
1
No.
1A01 0, 1� �iSs
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILE
11
CITY OF EDMONDS
DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE, Sec. 306
At 21112 — 80th Place West Building Permit Number 710138
Occupancy established by this certificate:
Type H
Fire Zone III No. Stories 2
Type Const. 5 unit apt. Basement
Floor Load signs in place (per Sec. 2308 U.B.C.) — Capacity signs posted (per Sec. 3301 (i) U.B.C.)
Floor load and room capacity signs, when required, must remain (posted at all times.
THE R. M. Baltzell Apartment House HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES.
Issued this
1971
CHIEF BUILDING OFFICIAL By T06Z
This certificate shall be posted in a conspicuous public area and shall not be removed, mutilated or obscured and shall be main-
tained in legible condition at all times. Any change of occupancy requires a new certificate.
CITY OF EDMONDS
DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE, Sec. 306
At 21112 — 80th Place West Building Permit Number 710138
Occupancy established by this certificate:
Type H
Fire Zone III No. Stories 2
Type Const. 5 unit apt. Basement
Floor Load signs in place (per Sec. 2308 U.B.C.) — Capacity signs posted (per Sec. 3301 (i) U.B.C.)
Floor load and room capacity signs, when required, must remain (posted at all times.
THE R. M. Baltzell Apartment House HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES.
Issued this
1971
CHIEF BUILDING OFFICIAL By T06Z
This certificate shall be posted in a conspicuous public area and shall not be removed, mutilated or obscured and shall be main-
tained in legible condition at all times. Any change of occupancy requires a new certificate.
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