700270.pdfM
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'POSTED ON XROLL MAP NO.:
PERMIT
BUILDING DEPARTMENT
AppU=t FIII
NUMBER,
70
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ERMIT APPLICATION
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NAME
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0 STATE LICENSE Nnh BER CITY I
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Legal Description of Property (Show pelow or Alto(
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RESIDENTIAL
El
GAS
LINE
NEW
I
El
NON-RESIDENTIAL
El
SIGN
ADD
RErAINING
WALL
DEMOLIqTT
ALTER
EXCAVATE
OR FULL
PENCE
( x Ft.)
.......... .........
REPAIR
PRE-ISIOVE
INSP.
SWIM
POOL
IUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
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00
1 0
SMTBACK
[3 NO
4UMBER
E�M?NG" STREET R/W 50--FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W_4Y0FT- FT.
REMARKS
Driveway slopes not to exceed those
indicated on Standard Drawing #103.
111 3
9:5"EW a fL
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OF
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Plan Check No .....................
do
BUILDING
PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
23
FENCE
SIGN
ILI)
RETAINING WALL
Ll N
C11 2 Ll
SWIMMING POOL
DEMOLITION
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d
PRE -MOVE INSPECTION
C/
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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-
lzed agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
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
TILIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
LSIONATURE (0 IE4 04t AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
M,
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PH 0-1107
This Permit covers work to be done on private property ONLY.
Any construction on the Public domain (curbs, sidewalks, dtiveways,
marquees, etc.) will require separate permission.
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3TRE MPROVED
or E] No
�OUP
Valuation I Fee
M
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-
Imowledged in space provided.
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