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BUILDING DEPARTMENT
Applicant Fill
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PERMIT APPLICATION
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JOB ADDRESS
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NAME (OR NAME OF/BUSINESS)
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SIDE YARD SETBACK
STREET SETBACK REAR YARD SETBACK
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MAILING ADDREBB
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LOT AREA
VACANT BITE
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TELEPHONE NUMBER
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HEIGHT
BUILDING
AREA VARIANCE NUMBEIt
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NAME
PLOT PLAN APPROVED
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ADDRESS
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STREET R/W
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EXISTING STREET R/W
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DEFICIENCY THIS PROPERTY
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CITY
TELEPHONE NUMBER
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COMP. PLAN ST. R/W
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REMARKS
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CHECKED BY
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TELEPHONE NUMBER
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METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
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STATE LICENSE NUMBER
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REMARKS
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; Legal Description of Property (Show Below
or Attach Four Copies)
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NEW
RESIDENTIAL
❑
GAS
LINE
NON-RESIDENTIAL
❑
BION
ADD
RETAININE
❑
DEMOLISH
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WALL
EX❑
FENCEx
ALTER
❑
OR
Ft.)
❑ REPAIR
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PRE -swim
INSP.
..........
POOL
IUMBER OF STORIES
NUMBER OF
DWELLING
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UNITS
1
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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-
latlog construction; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DE51OLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
(� l - r A //.. cr) — ;?/
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domadn (curbs, sidewalks, driveways,
marquees, etc,) win require separate permission.
V
I_L1__. I y N I O YES ❑ NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
i] YES *�IONO I i=— 2 4
THIS SITE IS LOCATFD 1hI Tut-
REMARKS CITY OF EDMONDS. LOCAL SALES
TAX SHOULD RF ronFn o t nA
mbs- S-8 (50UI?d IJALL.
Plan Check No.........
BUILDING
PLUMBING C�
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HEAT do GAS LINE S
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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ATTENTION
APPLICATION APPROVAL
THIS PERMIT
This application is not a permit until
AUTHORIZES
signed by the Building Official or his Dep-
THE
ut and fees are aid, and receipt is ac-
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knowledged in space provided.
INSPECTION
DIILECTQ 'S BIGNATU
DEPARTMENT
CITY OF
L
DATE
EDMONDS
PR B-1107
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DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE, Sec. 306
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At 7833 — 196th Southwest _. Building Permit Number 7 Number------- I ',
Occupancy established by this certificate: 1
Fire Zone jjj No. Stories
F-2 and H
Type Coast. COm. Alter 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 roan rapacity signs, when required, inusl remain posted at all livtes.
Manufacturing portion of the
THE E. C. Collier building HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE. AND WITH UNIFORM BUILDING CODES.
Issued this _1Q .__.,_—_ _—day of 1071
CHIEF BUILDING OFFICIAL By
This certificate shall be posted it, a conNpleuons public area and Hhall not be removed, mu listed or obscured and shall be main-
tained in legible condition at all times. Any change of occupancy requires a new certificate.