710506.pdfBUILDING DEPARTMENT inside ltt011
PERMIT APPLICATION!
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8 STATE LI<
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' I PNUM ER
NO.: 10506
EXISTING STREET R/W ............ .
nnurp. PLAN ST. R/W ............FT.
l7 YES Cl NO
DEFICIENCY THIS PROPERTY
i] YES NO
QYES-- ---- ❑ NO
RESIDENTIAL " • �••r PLAN CHECKED BY
❑ NEW THIS SITE IS LCC',TED IN THE
g NON-RESIDENTIAL SIGN
❑ ADD RETAINING REMARIIS EDMONDS. LOCAL SALES
❑ DEMOLISH ❑ WALL TAX SHOULD BE CODED 31.04.
EXCAVATE FENCE
ALTER ❑ OR FILL ❑ (...... ....x_........ Ft.)
wim
❑ REPAIR ❑ INSPRE;. ❑ p POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS _ I 'a.,..,.., ,
�O D / t-4 , Piro Check No .... ................
Z
O
PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Bullding setbacks, abutting etrecte)
LINE
C
LRETAMNING
SIGN
WALLPOOLN
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE I I -7 � � I &5=�
I hereby acknowledge that I have read this application; that the In-
formation given u correct; and that I am the owner, or the duly author-
laws raga•
APPLICATION APPROVAL
1md agent of the owner. I agree to comply with ally and sots
izedr
ON
lating construction; and 1n doing the work authorized thereby, ao personThis
the Labor Code of the etsta of WashingtonTHIS
PERMIT
licatton is not a permit tttttil
application
will be employed In violation oI
signed by the Building Official or his Dep-
ralattng to Workmen. Compensation insurmoe.
ME
uty; and fees are paid, and receipt isac-
E: Per Li it On® Year (E=eepc DEMOLITIONS whichICD
knowledged in space provided.
o COMP ed In sty days: MOVED -IN BUILDINGS shall be oom•
shall
plete In six Oaths. DAT777
ON
e
D OWS ONATU
SIG TU ,(OWN OR AGENT)
ENT
l� �FDATns
�-7 C.
NOTE: Applicant Subject to Plan CheckFee
PR 6-1107
to be done on private property ONLY.
This Permit coven work driveways,
W�n(curbs, sidewalks,
construction
Any rnnelct'es
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5
vi y CITY OF EDMOh'm3� WASHINGVTON—DEPARTMER "OF BUILD�a16S.
C y`
BUILDING PERMIT '
Applicant hereby certifies that a plot, plan, drawings, and sufficient details to indicate i
the intention to fulfill all requirements of this code are attached hereto.
C l
Application is hereby made for permit to do the following work: O ty t
an e- iB u
................................:::
a
t t O
..................... y M
. ........................
` ....�. ............ ................................................................. � b ` 4
..................................................................................
.......:....................................._........ ti .g d'
�d...l �....-... 0 o ................................................... a ►�
,� b
42 a 'en 1
at..........�-•/ •••..... .. o
(Street number of lot and b otk numbers) 114
IL
X.................................H A d R
1. Building dimensions aze.....> I•••• ...... N H r R �................X....... /-. •-............._._._.......
2. Lot dimensions are ......... `/
3. Building will be ............. .............stories in height. M 0z
4. Number of basements ...... e ..tl•.......... ..
4
5. Occupancy of build' will be.......
eearesto ine. d
6. Buildingwb ...
d
................Estimated cost$-
.................................7. Owner .......
8. Owner's Address ............................................
9. Builder .............................................. ..................... ........ .........
....__....................................
Group No. ................. ......
10. Builders Address...................................... /
....... ...........................
....................................... ..
Life of permit.._. SQ.-�..............
11. Architect or en '.................................................................................
"
gin
ck.. • `
Date-- .. __.. --- _ >t.............19...a.J
Applicant's Signature .......... _%. ✓........ 415
Plans filed: YesNo❑(Owneragent)
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 ........................................................
$�.
2. Sewer permit fee ............................................
........._.....$._.....--.._.._.__...JR
3. Inspection and supervision fee ...........................
............. $....._...............
4. Total...................................................................
..........................
b
(Issui Olriar)
Department of Buildings
PERMIT N° _ 496 city of Edmonds
t. The building permit fa which applicant pays when permit is issued shall be based on estimated cost of the proposed. ---------------
struttute, at the rate of adds for each
$1000.00 of cost. If the actual cox of the structure, when finally determined, shill be issued the estimated
dsucht bdiscrep y more �cyen a%pis Paid. applicant agtm to pay as additional fee
of $2.00 for each $1000.00 of such excess cost. In such event no use permit
of the contract and a copy of the detailed
2: Whenever a contract for consttunion is executed for any structure costing more than $1000.00 for which a licensed architect or engineer is as required by
the Building Code of the City of Edmonds, the application for a building permit shall be accompanied by a' copy
specifications. Industries.
3, Ptiot to of
employing any labor or cotamendng work, notify the Industrial I rained f om rho¢ a the Department of Labor and Iadumfnand , Bivinestimate re
th d aollan [ha ke m nthly r oorts Of a release from the generalaconuactorsshould ewhoain turn shouldnobtain reeleasearest office f f omthe all snub ontraccon.epartment of r.'t7te relea asbouBldobe..
6a payment,
ment of Labor and Industries. The above procedures are requirements of the
attested by the DepattSnu Industrial Insurance Act.
t!!
0
Life of permit_.1:21 ........... .... .
tiara I
Plans filed: Yes 0No ❑
(Owner or his agent) II -
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: i
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1
CITY OF EDMON a WASHINGTON — DEPARTMENir BUILDINGS
NV
BUILDING PERMIT
Applicant hereby certifies that a plot, plait, drawangs, and sufficient details to indicate
the intention to fulfill all requirements of this code are attached hereto.
................................. .
(Street number or lot and block numben)
1. Building dimensions are .............................. x.......................................
2. Lot dimensions are ....... . d.................. x..... // .a ............................
3. Building will be ..........
:.............stories in height.
4. Number of basements ..................................
5. Occupancy of building sill be.....................................................................................
6. Building witVb..... feet from nea t adjoining lot line.
7. Owner .....�r ��.`....tCl.1....._.........................................
8. Owner's Address ........ ............
Y. Builder............................................................................................................................. II Group No.
10. Builder's Address............................................................................................................ :
i
11. Architect or engineer......................................................................................•--...........
1. Building permit fee .........
2. Sewer permit fee ..............
3. Inspection and supervision
4. Total ..................................
PERMIT N° 516
$......................................
$......................................
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
$1000.00 of cost. If the actual cost of the structure, when finally determined, exceeds the estimated cost by more than 3%, applicant agrees to pay an additional fee •' I
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. J�
2.- Whenever a contract for construction is executed for any %tructure costing more than $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 �
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 be obtained from the nearest office of the Department of La r and Industries." Before
`final payment, the owner should obtain a release from the general contractors'who in turq.Abould obtain release from all sublcohtractors, a releases should be G
attested by dYt,.Deparun t of Labor and Industries: The,above roceduresls)te xequiremenn of the State Industrial Insuranoe Act.
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