680439.pdfa
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—POSTED ON KROLL MAP
NO.:
PERMIT
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BUILDING DEPARTMENT Applicant Fin
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NUMBER
680439
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PERMIT APPLICATION
JOB ADDRESS
NAM (OR NAME OF BUSINESS
SIDE YARD SETBACK
STREET SETBACK FmrAR YARD SETBACK
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USE ZONE
LOT A
VACANT SITE
CITY wz"rauNlli NUMBX3
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!rIption of Property (Show Below o;
NEW
RESIDENTIAL
M
GAS
LINE
NON-RESIDENTIAL
SIGN
RETAINING
DEMOLISH
WAIJ
ALTER
EXCAVATE
FENCE
Ft.)
OR FILL
( .......... x ..........
REPAIR
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PRE -MOVE
INSP.
swim
POOL
IUMBER OF STORIES
I INUUMBBER Ob,
DWELLING
UNITS
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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 rcgu-
lattng 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 Workmea'a Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
plated In nix months.)
NOTE: Applicant Sitbjecl to Plats Check Fce
This permit covers work to be done on private property ONLY.
Any construction an the public domain (curbs, sidewalks, driveways.
marquees, etc.) will require separate pernihislon.
EXISTIN STREET rt/W .4.9.FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W.O.O.—n-r. — j.0 .. Fr. —
indicated on Standard Drawing #103.
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SPEUIAM�N SPECTOIr REQUIRED OCCUPANCY GROUP
0 YES UKIF I
Plan Check No .....................
BUILDING
PLUMBING
BEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATMNTION
THIS PER511T
AUTHORIZES
ONLY TIEE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
Pn 6-1107
Valuation
I T IGO
Fee
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No.
APPLICATION APPROVAL
This application is not a permit until
Signed by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
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