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BUILDING DEPARTMENT Applloantm
PERMIT APPLICATION Trial de Heavy Lines
N (OR NAME OF BUSINESS)
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CITY TELEPHONE NUMBER
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NAME
Property (Unow Below or
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i "'0 I NUMBER 680365
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EXISTING STREET
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R/W A10— FT.
DEFICIENCY
THIS PROPERTY
COMP. PLAN art
R/W ..to ..MO
... CL... In,
REMARKS
Driveway
slopes not
to exdeed
those
indicated
on StainTaird
Drawing
#103.
U Iff NEW RESIDENTIAL LMTLINE
NON-RESIDENTIAL ❑ SIGN
❑ ADD DEMOLISH RETAINING
ALTER ❑ OR EXCCE
AVATE
II ❑ (•....N..x.......... Ft.)
REPAIR ^ PRE -MOVE ^ SWIM
' { INSP. I ( POOL
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I hereby acknowledge that I have read this appllcatlon; that the in-
formation given is correct; and that I am the owner, or the duly author-
ised agent of the owner. I agree to comply Vith city and state laws regu-
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
relating to Workmen's Compensation Insurance,
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS sball be com-
pleted in six months.)
NOTE: Applicant Subject to Plan Check Fee
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (earbs, sidewalks, driveways,
comquees, etc.) will require separate permission.
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MEM
Valuation
Plan Check No, ..........
No.
BUILDING az 2Zr
PLUMBING
s
HEAT d: OAS LINE AT
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION APPLICATION APPROVAL
THIS PERMIT This application is not a permit until
IZES
ONLY THE Signed by the Building Official or his Dep-
NLY M
WORK NOTED uty; and fees are paid, and receipt is ac-
lmowledged in space provided.
INSPECTION DIRECTOR'S SIGNATURE
DEPARTMENT
CITY OF DATII `
EDMONDS 9
PR d-1101
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RECORD OF INSPECTIONS -
Date Passed,
coo
Drainage q
Sewer
Parking
Landscaping
t
Fire Dept. —
-RECORD OF INSPECTIONS
IL
Date Passed
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� Foundation
b Plumbing (Partial)
(Rough) —�-
Frame
Furnace & Fuel.Line �
Final