740123.pdfBUILDING DEPARTMENT Applicant Fill
ZONE r/ Q-, NUMBER 740123
PERMIT APPLICATION Inside Heavy Lines
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ADDRESS
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BUILDING
NAME (OR NAME OF BUSINESS)
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Y PROPOSED USE
PERMISSIBLEC ACTUAL J
LOT COVERAGE 3s /O LOT COVERAGE
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PERMISSIBLE IIEIGHT Q PH/OLPOBED f�it'pI�6HT
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PLOT PLAN (Intlleate Bullding Setbacks, anulling a[teele)
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ACTUAL LOT A-dREA TOTAL HL��
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REQUIRED ED YARDS PROPOSED YARDS
FRONT SIDE REAR FRO T S)DE REAR
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LOT VARIANCE OR CO. ITIONAL USE
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TELEPHONE NUMBER
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EXI9 O STREET R,kV . DEFICIENCY THIS PROPERTY
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REMARKS Driveway slopes not to exceed those
indicated on Standard Dwg. No. 103
m ADDRESS
SWIMMING POOL
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TELEPHONE NUMBER
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PRE -MOVE INSPECTION
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SERVICE SIZE CLEARAN E
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STATE LICENSE NUM CiTX CJENSE NUMBER
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Legal Deacrlptlan of Properly (Show Bolow or All 1h Faur Cuples)
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TOTAL AMOUNT DOE
i hereby acknowledge that I have read this application; that
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FERC. TEST PERM
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and doing the work aulhcrlaad thereby, no person
will beemployed In violation of the Labor Code of the State of Washington
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This application Is not B permit until
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rebuilt, to Workmen's Compensation Insurance,
REMARKS
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FIRE ZONE TYPE OF CONSTRUCTION E IMPROVED
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YE9 � NO
WORE NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety day.; MOVED -IN BUILDINGS .hall be wm-
SPECIAL INSPECTOR QUIRED
OCCUPANCY GROUP
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RESIDENTIAL ❑ LGASINE
DATE 8! NED
AN Y THIS SITE IS LOCATED IN THE CITY
PLAN/VS
NEW
NON-RESIDENTIAL SIGN
ADD
l.n.OF EDMONDS. LOCAL SALES TAX
SHOJI A gp r'f1DFn it Od
RETAINING
ElDEMOLISH WALL
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ALTER EXCAVATE FENCE
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NUMBER OF STORIES NUMHER OF
DATE
DWELLING
UNITS
NOTE: Applicant Subject to Plan Check Fee
NATURE OF WORK TO BE DONE
valuation
Fee Receipt No.
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PLOT PLAN (Intlleate Bullding Setbacks, anulling a[teele)
HEAT A GAB LINE
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FENCE
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SWIMMING POOL
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DEMOLITION
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PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DOE
i hereby acknowledge that I have read this application; that
the In -
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lion given la correct; and that I athe owner, or the duly author -
lied agent of the owner. I agree to comply with City Sad State laws regu-
lating construction; In
ATTENTION
APPLICATION APPROVAL
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and doing the work aulhcrlaad thereby, no person
will beemployed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application Is not B permit until
rebuilt, to Workmen's Compensation Insurance,
AUTItORIZES
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ONLY THE
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
WORE NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety day.; MOVED -IN BUILDINGS .hall be wm-
knowledged In space provided.
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pleted In .Ix months.)
es GNAT n%(OWNER OR {.GEN ) i
DATE 8! NED
INSPECTION
NA REDEPARTMENT
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CITY OF
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EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
This t'rnnit tt,rrre work in be done on privnln property ONLY.
PR 6.1107
Any r Irlructlon o, lila Public demaln teu.b., nldewalk., drlvnw ,
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