710232.pdfm
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BUILDING DEPARTMENT
PERMIT APPLICATION
NAME (o
George Sullivan
MAILING ADDRESS
8503 - 200th S.W.
CITY
Edmonds
NAME
Same
Applicant Fill
Inside Heavy Lines
776 -06 2 5
Sec
19 Twp 27 Rare 04 RT -
31) NTAX1
NW
1/4 BEG SE 000 SE 1/4 NE 1/4
NW
1/4 TH S 89*04 2019 333.6FT
TPB
;a
TH
NO 1* 32 20W 188FT TH S 89*04
a 20
W 8OFT TH SO 5* 00 20W
189.3 FT
TH
N89#04 20E 10OFT TP3
❑
❑ RESIDENTIAL ❑
NEW
GAS
LINE
❑ NON-RESIDENTIAL ❑
ADD
SIGN
❑ DEMOLISH a
WA01 LLNING
ALTER EXAVA❑ OROFILLTE ❑
FE
(ENC x.......... Ft.)
❑
REPAIRPRE-
El INSP. ❑
swim
POOL
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 lawn 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 Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
.►'.. Lit `_
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done an private properly ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
►4
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NUMBER 710232
End
13 YES �O
STREET R/W�®
EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT.
............FT.
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REMARKS
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CHECKED BY
METER SIZE SERVICE SIZE
CLEARANCE
CHECKED BY
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REMARKS
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YPE- N T!
I VERIFIED BY
PERC. TEST
PERMIT NUMBER
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REMARKS
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FIRE ZOr I TYPE OF J; RU N
❑ YES
STREET IMPROVED
❑ YES h&O
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L 10USA 1. /, 6AJ
Valuation I Fee
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DE ,IOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE I I 1.be
No.
ATTENTION APPLICATION APPROVAL
TIUS PERMIT This application is not a permit until
AUTHORIZES signed by the Building Official or his Dep-
ONLY THE WORK NOTED uty, and fees are paid, and receipt
t is ac-
knowledged in space provided.
INSPECTION DIRECT SIGN
DEPARTMENT
CITY OF DATE
EDIIIONDS
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