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POSTED ON KRO
RUILDIMG
DEPARTMFNT
Applicant Fill
PERMIT APPLICATION Inside Ilonvy Linesr
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NAME tee+ "�'r �'1 OF nrtarv�nv)
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BACI
MAILING ADDRESS
4 / 3 J
CITY
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TELEIPH/ONE NUMBERGHT
NO.: PERMIT
NUMBER
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710236
1
YARD SETBACK
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❑ YES ❑ NO 11
VARIANCE NUMBER y
V ' ,
W ADDRE 38 I
STREET R/W '-
V EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY ,
CITY TELEPHONE NUMBER I
COMP. PLAN ST. R/W ............FT. ............FT. a
REMARKS
NAME
COYNOKe
C6 ADDRESS x
F9 14
I CHECKED BY�
CITY I TELEPHONE NUMBER
H
x
o METER SIZE SERVICE SIZE CLEARANCE CHECKED BY }
U STATE LICENSE NUMBER CITY LICENSE; NUMBER I I I ,
REMARKS g
Legal Description lof Property (Show Below or
or Attach
_ Four Copies)
T,Cftc T ./ 3 r ��(P//� / t° 7� �1 Cb/tom TYPE CONNECTION I VERIFIED BY
G:C'].?UE.'�) /r/fi _ PERC. TEST I PERMIT NUMBER
0 f" M /<. P,15i Z 0, REMARKS �
W r FIRE ZONE � TYPE OF CONSTRUCTION STREET IDSPROVED
SPECIAL INSPECTOR REQUIRED ,�-
(OCCUPANCY GROUP
[3GAS ❑ YES NO
❑I'S NEW RESIDENTIAL � LINE PLAN CIiECKED BY SITE ED IIV —THE
❑
NON-RESIDENTIAL ❑ SIGN CITY OF EDMIONDS. LOCAL SALE `.1
ADD ❑ DEMOLISH WALL KING REMARKSTAX J t5 .04. f
ALTER ❑ OilFILL
EXCAVATE ❑ FENCE x.......... Ft.)
REPAIR PRE -SWIM
❑ IN P. POOL -
NUMBER OF STORIES I NUMBER OF
1 DWELLING
UNITS
NATURE OF WORK TO BE DONE Valuation Fee Receipt No.
T
Plan Check No .....................
O BUILDING
W PROPOSED USE
PLUMBING 3t - s0
Lk
a 10)
PLOT PLAN UndlCalO Bullding etbacks, abu Ing streets) HEAT do GAB LINE
37
FENCE
SIGN
tRETAINING WALL
I ]
SWIMMING POOL rr
DEMOLITION.
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE 7
I hereby acknowledge that I have read this application; that the In- 0 J IMP 7
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 regu- ATTENTION APPLICATION APPROVAL
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 THIS PERMIT This application is not a permit until
relating to Workmen's Compensation Insurance. AUTHORIZES Signed by the Building Official or his Dep-
ONLY THE lity; p p
and fees are aid and receipt is ac- 4
NOTE: Permit Limit One Year (Except (DEMOLITIONS which WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com- knowledged in space provided.
pleted In six months.)
SIGNATURE (OWNER OR AGENT) DATE 836NEU INSPECTION DI 'CTOR'8 GNA RP t
/ \ DEPARTMENT�Ilaj 1 ,l
LCL�c- vt t CITY OF
EDIIIONDS DATE )
T
NOTE: Applicant Sshject to Plan Check Fee � }
PR 0-1307
This 1'ennit coven work to be dune on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways, FILE
macpuees, etc.) will repulre separate permission.
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RECORD OF INSPECTIONS
.Date Passed
Foundation
/6-��`�
Plumbing (Partial) _
_
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(Rough)
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Frame
'AeeRa— OeGv/d«!
=Furnace
&Fuel Lines
_
Final
,
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RECORD OF INSPECTIONS,
Date Passed,
Drainage
Sewer
'
Parking
f:
Landscaping
Fire Dept.
-12
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