750008.pdft
I 1
BUILDING DEPARTMENT Applicant Fin °� NUMBER _
PERMIT APPLICATION Inside Heavy Linos ID
ADDRESS
:A�7NAME OF BUS1N BB) �J )
PERMISSIBLE t
LOT COVERAGE LOT COVE�AOE
A L1 6DDRE - (O r t
/ ,J PERM",""
HEIGHT PROP08ED 11E3 HT C f
13 kviz
CITY TELEPHONE NUMBER AC� P AL LO AR a �� TO L B AREA L
_Q f3. Si� S �
�JC(�:Gi S REQNIRED YARUS PROPOSED YARDS a i
NAME NT SIDE REAR FRONT BIDE REAR
ADDRESS NLEGAI, I LOT
• P VAROR IANCE CONDITIONAL UBE p
t,.� CRYES 0 NO PERMIT NUMBER .-�-iD ►(�
tsj PLANN 6 P APPR VAL // ATE• �!
CITY TELEPHONE NUMBER
STREET R/W
EXISTING STREET RJ DEFICIENCY THIS PROPERTY
NAME r1)
COMP. PLAN ST. R/ '� ...�7. _..'. P. ,(.../.....FT. W
G ADDRESS
REMARKS NM Driveway slopes not to exceed
C� 15-031 ,%%myfH Ave ^ those indicated on 3landard Dwg. No. 103 w
C CITY ' TELEPHONE NUMBER CHE Y II
g
METER SIZE SERVICE
SIZE CLEARANCE CHE B
9�T� 10E'8NUMBER � � 0 �) CITY LICENSE NUMBER
3 REMARKS alga
C 1
Legal Description, of Property
%(Show
Below or Allnrli Four Copies) � 4r,
U r"C' cc%s.C�C7 Ci SlN fTYPE CONNECTION I VERIFI HY I
O '
_ 1
PERC. TEST" I p N IHER �
n W
W r I
0
REMARKS
in
.i FIRE ZONE TYPE OF CONSTRUCTI
'-I'r I_
eTYEST IM❑ NOED
/If -fay/ 1,;,
1
SPECIAL INSPECTOORRRREQUIRED OCCUPANCY GROUP
i
❑ RESIDENTIAL
GAS
❑
C
YES _
!_
❑ NEW
LINE
11-
SITE IS LOCATED IN THE CITY
❑
NON•REBIDENTIAL
❑ SIGN
tEp
4THIS
OF EDMONDS. LOCAL SALES TAX
HO L BE CODED 31.04.
j
i
ADD
❑ YALL FnNC
❑
DEMOLISH
ALTER EXCAVATE FENCE
�%L
I��.�wRr'��
I n �^ // CT
FO Imo+ JI I:�
❑ OR FILL ❑ G.........r:..........Ft.)
,
❑ REPAIR PRE•DIOVE BNIM
1��
jHPR-OU�hdL�1�
oNGLUDrWC.�—
i
❑ INSP, ❑ POOL
NUMBER OF S RIES NUMBER OFIWP
Y
DWELLING
I
1
UNITS
NATURE OF WORK,(T7O 8E D
-/O -NE
Fee RecclPl No.
flan Chrel, No .....................
[O
BUILDING
/ayr/�/./I P• -n,
�J(�7' (lO
`
0. PROPOSED USE
PLUMBING
!
eT eN T
�L•• I L-Y�G1/JI
PLOOTT P
PLAN (Indieato Building setbacks, abutting Streets)
HEAT & GAB LINE
n
FENCE
� •ysy
T1Fe'�
_
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR OR FILL
TOTAL AMOUNT DUE
I hereby ncknowledRo that I have read this application; that the In.
(.,melt'" Riven Is '.,earl; and that I am the "or'or the duty author.
tied aRant of the owner. / agree to comply with city and .tate levee raga
IatIng construction; and In dol. lh-_ work authorized thereby, no person
ATTENTION
APPLICATION APPROVAL
will be employed In vlolatlon of the Labor Code of the Slate of Weahington
relating to Workmen's Comp ...alien Insurance.
THIS PERMIT
This application is not a permit until
NOTE: Permit Limit One Year
AUTHORIZES
ONLY THE
Signed by the Building Official or his Dep-
(Except DEMOLITIONS which
shall be completed In nicely days; MOVED -IN BUILDINGS shall be cam•
WORIC NOTED
uty; and fees are paid, and receipt is ac-
i
plated in elz m.nthe.)
knowledged in space provided,
e/IIGG,7NATUM_ (OIVNLIt OR AGENT) DATE SIGNED
INSPECTION
D1REC O 'e 810 U
(� �L+•l•t..rle/� F�w-••LL ���/ /9 I�
DEPARTMENT
CITY OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
�
This Permit even work to Iw don party ONLY.
n private pr.
775-2525
Any construction an lite public domain (turbo, sidewalks, driveways,
i
Imrrm,ree, M1.1wwill ,,.cure .Stearn(, Irrrnd.slnn. _
FILE
t — , \71,-- -- — -
CITY OF EDMON
DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE, Sec. 306
At 655 EDMONDS WAY Building Permit Number 750008
Occupancy established by this certificate:
Fire Zone I I No. Stories I
F-2
Type Const. V—N Basement
1
Floor Load signs in place (per Sec. 2308 U.B.C.) — Capacity signs posted (per Sec. 3301 (i) U.B.C,) i
Floor load and room capacity signs, when required, must remain posted at all times.
THE MEDICAL OFFICE HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES.
Issued this 76th day of April 19 79
1 CHIEF BUILDING OFFICIAL By
r 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.