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LD.ING DEPARTMENT
IMIT APPLICATION
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Applicant Fill
Inside Ileavy Lines
NEW
El nESIDENTIA
10
ED
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LIZ 1E
NON -RESIDE: TIAL
F�
IBIGN
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RETAINING
DDEMOLISH
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WALL
EXCAVATE
FENCE
ALTER
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on FILL
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REPAIR
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PRE -MOVE
INSP.
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swim
POOL
DWELLING
UNITS
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P NO.:
PERMIT
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NUMBER b90292
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OSTIA- STREET R/W ............ FT.
COUP. PLAN ST. R/W ............ FT -
V4,30
[3 YES
Plan Check No .....................
05/
BUILDING
-FR—OPOSED USE
PLUMBING
HEAT & GAS LINE
PLOT PLAN (Indicate Building setbacks, abutting streets)
tRETAINING
N
FENCE
SIGN
WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1h e In'
I hereby acknowledge that I have read this application; that the in-
ou or
formation given is correct; and that I am the owner, or the duly author-
U`
r a gu
ized agent of the owner. I agree to comply with city and state lawn regu-
ATTENTION
person
lating construction; and In doing 116 work authorized thereby. no person
Ihington
will be employed In violation of the Labor Code of the State of Washington
TIUS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
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NOTE: Permit Limit One Year (Except DEMOLITIONS which
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ONLY THE
WORK NOTED
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shall be completed In ninety days; MOVED -IN BUILDINGS shall be oom-
pleted In six months.)
ED
�R N D TE SIGN ED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, drivewa7s,
marquees, etc.) Will require BePAmte Per"35100-
VACANT BITE
13 YES '14
MEA, I VARIANCE NUMBER I Fk
DEFICIENCY THIS PROPERTY
Valuation
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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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