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BUILDING DEPARTMENT Applicant Fill
°� PE MIT APPLICATION Inside Heavy Lined
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BTATE LICENSE NUMB?
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TELEPHONE NUMBS:
CITY LICENSE NUM!
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RESIDENTIAL -
GAS
LINE-
NEW
❑ NON-RESIDENTIAL
❑
SIGN
❑
ADD ❑ DEMOLISH
ALL KING
❑
ALTER ❑ ORFILL
❑
(ENC.xFt. )
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ElREPAIR
❑ PRE-MOVEO
POOL
DUMBER OF STORIES
NUMBER OF
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DWELLING
I UNITE
POSTED ON KROL MAP NO.: PERMIT 710281/ D9 )5 I NUMBER
JOB ADDRESS �
a?,3 79— I
SIDE YARD SETBACK STREET SETBACK I REAR YARD SETBACK
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YES ❑ NO
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F.XISTIN6 STREET R/W ... ..FT. DEFICIENCY
//�THIS PROPERTY
COMP. PLAN ST. R/W ....FT. ...D...FT.
REMARKS
nrivewav slope not to exceed those indicated
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ED BY
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17// f' I i"P•0*N YES 13 NO
S 'CIAL INSPECTOR REQUIRED OCCUPANC SOUP
YES IXNO I /
PLAN CHECK
REMARKS t66P,��96NE 7-7 b Z
Plan Check No-:0—H.1.
BUILDING
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PROPOSED USE
PLUMBING
U
aPLOT
HEAT dr GAS LINE
PLAN (Indicate Building setbacks, abutting streets)
31
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FENCE
SIGN
TRETAINING
WALL
IdWIMMIN6
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 lawn regu-
ATTENTION
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
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
31GN$TURE )ONNER R AGED)
DATE SIGNED
INSPECTION
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DEPARTMENT
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3/3 y
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This Permit coven work to be done on prlvnte property ONLY.
Any construction on the public domain (curbs, A dewalks, driveways,
marquees, etc.) will require separate parmisslon.
Valuation
9
Fee
� S�o
APPLICATION APPROVAL
No.
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
0
CITY • EDMONDS��
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Floor Load signs in place (per Sec. 23o8 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 tunes.
THE APARTMENT (hF Plex) HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES.
Issued this _ 30th
da of January
Y
Ig
73
CHIEF BUILDING OFFICIAL By
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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Landscaping —