740187.pdf`
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USE PERMIT 140181
BUILDING
DEPARTMENT
Applicant Fill ZONE NUMBER
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PERMIT APPLICATION
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ADDRESS/�% n
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NA OR NAME OF — B) I d V
PERM ISBIBLE � ACT AL
LOT COVERAGE LOT COVERAGE
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MAILINO ADDREe
PERMISSIBLE HE3031T PROPOSED HEIGHT
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TOTAL 6LU0. AREA
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P O E ...... ACTUAL LOT AREA
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REQUIRED YARDB PROPOBF.0 YARDN
REAR
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NAME FRONT BIDE REAR FRONT BIDE
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LEGAL LOT VARIANCE OR CONDITIONAL USE
ADDRESS YEB NO PERMIT NUMBER
PLANNING DEPT. APPROVAL
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CITY ELEPHONE UMBER
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STREET R/W
EXISTING STREET R/W ............Fr. DEFICIENCY THIS PROPERTY
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NAME n G/ COMP. PLAN ST. R/W ............FT. ............FT.
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r RP)MARKB
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ADD/RJTtiS
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�( QCHECKED BY
Cl<JY TELEPHONH NVffiHER
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METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
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BT E LICENSE V -041%I Cull -LICENSE NUMBER I
REMARKS
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Legal Dteerlptlon of Property (Show Below or Attach Four Copies)
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TYPE CONNECTION BY
(VERIFIED
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PERO. TEST PERMIT NUMBER
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REMARKS
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FIRE ZONE ( TYPE OF CONSTRUCTION STREET IMPROVED
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SPECIAL INSPECTOR REQUIRED
YES [] NO
OCCUPANCY GROUP
GASQ YES I] NO
RESIDENTIAL ❑ LINE
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
NEW
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OF EDMONDS. LOCAL SALES TAX
NON-RESIDENTIAL ❑ SION
SHOULD BE CODED 31.04.
ADD ElDEMOLISH O WALL NINE REMARKS
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ALTER EXCAVATE FENCE
❑ ORFILL (........ .s .......... Ft.)
ElSWIM
REPAIR ❑ INSP. El POOL
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NUMBER OF STORIES NUMBER OF
DWELLING
UNITE
Na.
NATURE
0:= TO BE DO n
Valuation
Fee Receipt
itn� Plan Cheek No.. ..........
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BUILDING
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PROPOSED UBE
PLUMBING
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aPLOT PLAN (Indicate Building setbacks, abutting streets) HEAT A GAB LINE
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FENCE
SIGN
tRETAINING WALL
SWIMMING POOL
DEMOLITION _
PRE -MOVE INSPECTION
EXCAVATION OR FILL
1�
TOTAL AMOUNT DUE ��
1
I hereby estmawledge that I have rend this aDDllcatlon; that the fn-
formnllom given Is correct; and that I am the owner, or the duly anlhor-
Ized agent of the owner. I agree to comply with city and stale laws reg.- ATTENTION APPLICATION APPROVAL
l.tlsg construction; and In doing the work authorised thereby, no person
will be employed In violation of the Labor Cade of the State of Washington THIS PERMIT This application is not a permit until
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relatingto Workmen's Camps nsatic. Iusurance. AUTHORIZES
signed by the Building Official Or his Dep -
ONLY TIM
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is no
.hall be completed In sleety day., MOVED -IN BUILDINGS shall be corn- knowledged In space provided.
Pitted In nix months.)
BIO (OWN R OR AGENT) DATE SIGNED INSPECTION D1R TOR'S SdQNATU
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DEPARTMENT_��. 1 _
CITY OF
EDMONDS DATE
NOTE: ApQlicant Subject to Plan Check Fee—
PR 6.1101
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sId—Wit., Nlvewayn, FILE
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marquee., etc.) wIB require ..Parole Permission.
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C�+1
Plan Cheek N. .....................
RESIDENTIAL
O
GAS
NEW
LINE
BUILDING DEPARTMENT
APPIIPant FII►
USE; PERMIT '37
ZONE NUMBER
SIGN
ADD
PERMIT- APPLICATION
rns,dD heavy LIBBg
,D /� _
ADDRESS JJ �? ;1 `, .. /. 6).
��
RETAINING
WALL
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ALTER
rvnalJ�T�(OR NAME OF HUB,IIN B)
DEMOLISH
EXCAVATE
C [' V 7 - (.�C.
PENCE
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�r"�-�
ACTUAL /
I.ILiT COVERAOEo
x..........FI.)
D PLOT PLAN (Indicate Bullding setbacks, abutting elroete)
REPAIR
Y "� ,V[1 /
INSP
IAT COVERAGE
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MA3LING ADDHEB —
1�7�
PEILNiItltlIHLE SIEIOII'r PROPOSED I{EIGHT
POOL
LUMBER OF STORIES
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01T/y
plior(ne UM 8:R
ACTUAL LOT AREA TOTAL BLDG. AREA
SIGN
�/ IM•
RETAINING WALL
"'" '^��>\-'FY'I-"""�" /
REQUIRED YARDS PROPOSED YARDS
NAME
FRONT e{DE HEAR FRONT HIDE REAR
ADDRESS
LEGAL LOT VARIANCE OR CONDITIONAL USE
�y
YES NO PERMIT NUMBER
EXCAVATION OR FILL
PLANNING DEPT. APPROVAL DATE:
CITY ELEPHONE NUMBER
G
STREET R/W
EXISTING STREET R/W ............IT. DEFICIENCY THIS PROPERTY
1 ` O OEz
NAM➢
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�/0
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COMP. PLAN ST. A/W ............FT. ............FT.
REMARKS
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formation given Ie earrect; and that I am the owner, or the duly author-
ADD r SO ,20
,
r l� (CHECKED BY W i,
C1 T
- I EI.EPHON➢ NUMBER
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( METER SIZE I SERVICE SIZE CLEARANCE I CHECKED DY
STATE LICENS➢ NUMBER CITY LICENSE NUMBER ttnDl
REMARK8 a i.
Legal Description of Property (Show Below or Attach Four Copies)
TYPE CONNECTION VERIFIED BYIn
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M77/
PERMIT NUMBER 01
e'lltE ZONE I TYPE OF
SPECIAL INSPECTOR REQ
YES [] NO
Valuation
YES [3 NO
Plan Cheek N. .....................
RESIDENTIAL
O
GAS
NEW
LINE
0
BUILDING
NON-RESIDENTIAL
❑
SIGN
ADD
❑
RETAINING
WALL
i
ALTER
PLUMBING
DEMOLISH
EXCAVATE
❑
PENCE
W `
❑
ORPILL
x..........FI.)
D PLOT PLAN (Indicate Bullding setbacks, abutting elroete)
REPAIR
❑
INSP
m
.
O
POOL
LUMBER OF STORIES
NUMBER OF
I
SIGN
I DWELLING
RETAINING WALL
e'lltE ZONE I TYPE OF
SPECIAL INSPECTOR REQ
YES [] NO
Valuation
YES [3 NO
Plan Cheek N. .....................
0
BUILDING
PROPOSED UBE
i
Q o �,
PLUMBING
`` Q •0
W `
D PLOT PLAN (Indicate Bullding setbacks, abutting elroete)
HEAT & GAS LINE
m
I
FENCE
I
SIGN
RETAINING WALL
eWIMMIN6 POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
1 ` O OEz
TOTAL AMOUNT DUE.
Ihereby sekoawledge that I Lave rand this sDPllcnlln; that the In-
formation given Ie earrect; and that I am the owner, or the duly author-
lsed agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
APPLICATION APPROVAL
lello6 'contraction; nod la doing the work authorised thereby, no person
will be employed fn vlolotlo. of the Labor Cads of the State of Washington
THIN PERMIT
This application is not a permit until
relaling to Workmca'e Comp.neallon Inaurance.
AUTHORIZES
by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
.hall be campleled In .hely days; MOVED -Iii BUILDINGS shall be corn-
knowledged in space proVided.
lete?1Tjnth.,)
BIO TUItE (OWNS
OR AGENT)
INSPECTION
DtR ORS 62 ATU
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DEPARTMENT
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CITY OF.
NOTE: Applicant Subject to Plan Check Fee
EDMONDS
Pn d -Moa
DATE J
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This Permit coven worn to be done on private property ONLY.
Any eonetructlon on the public domain (eurbe, eldewalka, driveway.,
INSPECTOR
marquees, els.) will rmulm separate permission.
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Date Passed
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Plumbing (Partial) 3 7 j
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