740099.pdfBUILDING DEPARTMENT
Applicant 87II
ZONE NUMMBE R 74
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PERMIT APPLICATION
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ADDRE88
NAME (OR NAME OF BUSINESS)
Stevens Memorial Hospital
PERMISSIBLEACTVA
LOT COVERAGE LOT COVE AGE
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MAILING ADDRESSa
-PERMISSIBLE HEIGHT HOPI) SED HElONT
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21600 76th Ave. w.
s£+
TELEPHONE
CITYACTUAL
NUMHivri
LOT AREA TOTAL BLDG. AREA
9
Edmonds
774-0555
REQUIRED YARDS PROPOSED YARDS
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NAME
FRONT SIDE REAR FRONT SIDE REAR
NOT APPLICABLE
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LEOAI. LO'r VARIANCE OR CONDITIONAL USE
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ADDRESS
0 YES NO PERMIT NUMBER
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PLANNING DEPT. APPROVAL DATE:
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CITY TELEPHONE
NUMBER
1
STREET It/LV
E%ISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAME
COMP. PLAN ST. R/W ............FT. ............FT,
Mc Bride Fence Co.
REMARKS
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ADDRESS
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12538 15th N.E.
CHECKED BY
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CITY TELEPHONE
NUMBER
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$Seatillp
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EM 4-0121
METER SIZE
SERVICE SIZE CLEARANCE
CHECKED BY
STATE LICENSE NUMBERITT
LICENSE NUMBER
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M
223-02-1859 ICBP119761-5-000SC
REMARKS
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Description of Property (..ow Below or
Attach Four Copies)
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Legal
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TYPE CONNECTION VERIFIED BY
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PERC. TEST PERMIT NUMBER
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SEE ATTACHED
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REMARKS
FIRE 2 E TYPE OF CONSTRUCTION STREET IMPROVED
F•��.)C� If.YEB NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
RESIDENTIAL
CA"
E] LINE
❑YES NO
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❑ NEW
IE]
PLAN CHECK DY THIS SITE IS LOCATED IN THE CITY
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NON-RESIDENTIAL
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OF EDMONDS. LOCAL SALES TAX
❑ ADD RETAINING
WAIT'
E]
SHOLLD BE CODED 31.04.
REMARKS
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DEMOISSH
�'j FENCE
Section 12.14.040 (fence requirements)
ALTER EXCAVATE
E]OR FILL}
❑ REPAIR PRE-MOVE Ej SWIM
INSP. POOL
attached.
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO HE DONE
Vnluatlan
Fee Receipt No.
Rustake (chain link with slats)
Fence
Plan Check N......................
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BUILDING
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4
PROPOSED USE
2
PLUMBING
Security and Screening
Building
A
PLOT PLAN (IndlCol. setbacks, abutting streets)
HEAT k GAS LINE
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FENCE
OR , '� •/
SIGN
SEE ATTACHED
RETAINING WALL
SWIMMING POOL
DEMOLITION
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PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
76 (��
,
I hereby acknowledge that I have rend this nppllcntlon; that We In-
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formation given Is correct; and that I am the owner, or the duly author-
teed agent of the owner. I agree to comply with city and elate laws ngu-
ATTENTION
APPLICATION APPROVAL
batingconstruction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Biala of Washington
THIS PERMIT
This application Is not a permit until
'
miatmg to Workmen's Compensation Iruurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
{YORK NOTED
Lty; and fees are paid, and receipt is ac-
.hall be completeQ'tt nine days; MOVED•IN BUILDINGS shall be cam•
knowledged in space provided.
PI ted-In 'R athe)
S GNA RE ( WNWR O AGENT)
DATE SIGNED
INSPECTION
D1REC 810 A U 11
DEPARTMENT
y
CITY OF
EDMONDS
D
NOTE: Applicant Sulbject to Plan Check Fee
2
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PA a-Itol
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This I'ermlt coven work to be done on private property. ONLY.
Any construction on the public dental. (curb., U' walks, driveways,
FILE
marquees, etc.) will require separate. Is.lon.
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BUILDING DEPARTMENT ZONE NUMBER
\,.•_ Applicant Fill
PERMIT APPLICATION Inside Heavy Lincs -oh
ADDRESS
—11 NAME (OR NAME OF BUe1NES8) 1
Pr:ItefltltllBLF ,o ACTUAL
stevena Memorini Hospital LOT COVERAGE I.OT COVESQAOE ,
/ AI NO A n 88 pEitDiINSISLE HEIGHT PROPOSED HEIGHT O �
21600 76th Ave. W.
CITY TELE PRONE NUMBER ACTUAL LOT AREA TOTAL BLDG. AREA 1 i
Edriondr 774-0555 _ _ REQUIIiF.O_VAilDd PROP08ED YARDS
t� NAME
U ADDREBB
NOT APPLICABLE
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CITY TELEPkIONE I
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Mc Bride Fence Co.
C ADDRESS
12.538 15th N.E.
CITY
/ F
O Seettl!
O STATE LICENSE NUDIBE.
223-02-1859
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l'. SEE ATTACHED
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BP119761-5-000SC
YES [3 NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
�/4., I CHECKED BY
Nfi�
FIRE ZONE I TYPE OF CONBTRUCTION STREET IaSPROVED
[] YES 13 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
❑ RESIDENTIAL
GA8
E]LINE
Q YES 0 NO
NEW
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
El NON-RESIDENTIAL
E] elGN
SALES TAX
OFSHOULD EDMUNDS. LOCED
1
i
ADD
REMARKS.
3AL1.04.
BE COD
DEMOLISH WALL
ElDEMOLISH
EXCAVATE FENCE'
Section 1.14.040
(fence requirements)
ALTER ❑
OR FILL (6.:.2x. Fl.)
REPAIR ❑ PRE-MOVE❑P. PWI I
INSOOL
attached.
NUSIBER OF STORIES
NUMBER OF
DWELLING
I
UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee
Receint No.
Fence Icustake (chain link with slats)
rien Check N. .....................
O
7 1 4
BUILDING
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PROPOSED UBE
I
PLUMBING
Security and Screening
PLOT PLAN Building
HEAT & GAS LINE
(Indicate setbacks, abutting streets)
O
FENCE
�J
SIGN
SEI-ATTACHEDt
�
�.,
RETAINING WALL
N
i
SWIMMING POOL
DEMOLITION
f�
PRE -MOVE INSPECTION
EXCAVATION OR FILL
uz) 17G7 ��
i
TOTAL AMODNT DUE
I hereby acknowledge that 1 have read this application; that the In.
formation given is correct; and that I am the owner, or the duly author-
Ized agent of tae owner. I agree to comply with city and state levee rosu-
ATTENTION
APPLICATION APPROVAL
... copetntetion; and m doing the work authorized thereby, no person
will employed In violation of the Labor Code of the State of Washington
THIS PER511T
This application is not a permit until
j
ralatlpg to Workmen's Compensation Insurance.
t.
AUTHORIZES
signed by the Building Official Or his Dep-
1
NOTE: Permit Limit One Year (Except DEA90TATIONS which
ONLY TILE
WORK NOTED
uty: and fees are paid, and receipt is ac -
shell be complett.4 nitdays; MOVED -IN BUILDINGS shall be cam-
knowledged in space provided.
(5F
D.tedil. a onthl.)
GNA IiE J R O `GENT)
/� ��, � (
DATE SIGNED
INSPECTION
DEPARTMENT
DIRE%�$� BA
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CITY OF
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EDIhIONDB
D—
ATE
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NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This Permit covers work to be done on private property ONLY.
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Any construction ap the public domain (.-be, I— alk., drivewsrs,
marquee., etc./ will require sePa<ste( jwon.
INSPECTOR
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