740277.pdf7 1
BUILDING DEPARTMENT ZQNE gC PERMIT
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Applicant Fill
PERMIT APPLICATION
Inside Heavy Linea On .
ADDREBB
NAME (OR NAME OF "VSINESB) , I /
al MAI NO AD B -
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/�P �)aLG%Q �4yll")L+F'. SD(1vv1
TELEPHONE NUMBER
i p' ✓Y106 )G{ i WQ s�) lI /Yc it �i % L� 1/ I
NAME1
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W ADDRESS
CITY TELEPHO
ts51 3 u ZNE NUMBER
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NAME
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et
ADDRESS —
H CITY TELEPHONE NUMBER
FRONT BIDE REAR FRONT BIDE REAR
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VA
LEGA OT RIANCE OR CONDIT ONAL USE
�] NO PERMIT NUMBER .� f �_.17 7
CISTIPO STREET R/VL4/1 �V,
COMP. PLAN ST. R/1401
]MARKS
Driveway s
'^.*T.v DEFICIENCY
}pTHIS PROPERTY
....)..1...FT.
not to exceed those
Dwg. No. 103-
1.�� .u. f�XIS—r, 66WIQ: IR
ey%s7 —
ITRUCT10,N STREET IMPROVED
ti GJ Cw YES 0.-
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NO7D (OCCUPANCY GROUP
❑ RESIDENTIAL
❑ GAS
LINE
❑ YES NO
Z
PLAN HECKED BY
THIS SITE IS LOCATED IN THE CITY
NEW
❑ ADD
NON-RESIDENTIAL
❑ SIGN
RETAININGA
UTtJ�M
REMARKS
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
❑ DEMOLISH 1:1
�� 'j�Ml
�W ���
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❑ ALTER EXCAVATE FENCE
❑ OR FILL ❑ (X Ft.)
` •`-^ �' I `—�` t��0' F
.......... ..........
❑ REPAIR ❑ swim
1
END IZFQ9
FDR.- SITE 1HftV&14W
INBPMOVE ❑
POOL
relating to Workmen's Compensation Ineurauoe.
AUTHORIZES
NUh16ER OF STORIES NUMBER OF
DWELLING )V1 /.7
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
f UNITE
ehall be completed In nicety days; MOVED -IN BUILDINGS shall be com-
NATURE OF WORK TO BE DONE .. . / C,
pleled In SIX mgothe.)
Valuatlan
Fee Receipt
ONATURE (OWNER A NT)
DATE SIO ED
INSPECTION
Plan check Nmf.~.�.'.�'.�
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7
/U ICCJ_� IY'I /IJ is+GrJ%�/Kw'il
BUILDING
s
PROPOSED USE f
T�
f'f/J�Il�C%
PLUMBING
r 0
/-
HEAT A GAS LINE
TE: Applicant Subject to Plan Check Fee
PR 8-1107_
.� PLOT PLAN (lndle� dltling eetbneke, abutting n ... lel'
tl
Thls Permit coven work to be done on private property ONLY.
FENCE
Any eonslructlou on the public domma (.-be, sM-walk., driveway.,
SIGN
marquee., etc.) will require .rpae.te Isalon.
�c'vtct N
RETAINING WALL
SWIMMING POOL
^JC. i
DEMOLITION
' •, ` Ar /
(
PRE -MOVE INSPECTION
�_. 1i.Z�/i
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I
/ _/Y
50PU
I hereby acknowledge that I have read this application; that the In.
T"
formation given Is correct; and that I am the owner, or the duly author -
Seed .gent of the owner. I .gree to comply with city and elate lane regu-
ATTENTION
APPLICATION APPROVAL
Intlnr. construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Waahlogton
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Ineurauoe.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
ehall be completed In nicety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
pleled In SIX mgothe.)
ONATURE (OWNER A NT)
DATE SIO ED
INSPECTION
DI TOR'B BIG TURF
/
7
DEPARTMENT
CITY OF
r
EDMONDS
TE: Applicant Subject to Plan Check Fee
PR 8-1107_
Thls Permit coven work to be done on private property ONLY.
Any eonslructlou on the public domma (.-be, sM-walk., driveway.,
marquee., etc.) will require .rpae.te Isalon.
I
RECORD OF INSPECTIONS
Date Pa� ssed�
Foundation
Plumbing (Partial)
'
(Rough)
Frame
Furnace & Fuel Lines
Final —=—? /�►"� .
-7902-77
RECORD OF INSPECTIONS
Date Passed
Drainage --- -----
ewer
SParking
/'�'} //jam
!` U
Landscaping /::—E --�—/
C�
Fire Dept.
I
I
CITE( OF E®1lIIIONDS
DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE, See. 306
At 141 Dayton Street Building Permit Number 7110277
Occupancy established by this certificate: II I
Fire Zone No. Stories -
p_2 IV—N
Type Const. Easement
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 _ALASKA NORTHHSST PUBLISHING HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES.
Issued this _ 17th day of January 9 77
CHIEF BUILDING OFFICIAL By
This certificate shall be posted in a conspicuous public area and shall not be removed, mutilated or obscured and shai: be main-
tained in legible condition at all times. Any change of occupancy requires a new certificate.
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