740218.pdfi
USE
ZONE
PERMIT 7,,018
NuhIBIUt /_2
BUILDING
DEPARTMENT Applicant FW
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PERMIT APPLICATION IDeldo Heavy Line.
ADDRESS
Oli NAME OF BUS1NEStl)
2NALIE
LOT CO ER a
COVERAGE
AT�IqT
LOT COYESYAGEILING
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ICES.
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
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BLDGA REA
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CITY
TELEPHONE NUMBER ACTUAL LOT AREA
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TOTAL
REQUIRED YARDS
PROPOSED YARUB
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NAME FRONT SIDE
REAR FRONT BIDE REAR
N
ADDRESS
LEGAL LOT VARIANCE OR CONDITIONAL USE
PERMIT NUMBER
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El YES ONO
PLANNING DEPT. APPROVAL DATE.
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C1TY TELEPHONE NUMHEft
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STREET R/W
EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
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NAME
COMP. PLAN BT. R/W ............FT.
............F"P.
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REMARKS
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ADDRESS
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BY
CITY
TELEPHONE NUMBER
(CHECKED
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METER 131LE SERVICE SIZE CLEARANCE
CHECKED BY
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STATE LICENSE NUMB
CITY LICENSE NUMBER
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REMARKS
Legal Dee.crlptlon o[ Property (.how' or A,....F- Copin)
/Below
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TYPE CONNECTION
VERIFIED BY
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PERC. TEST
PERMIT NUMBER
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REMARKS
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
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NO
0 YES [I
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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❑ GAB
RESIDENTIAL LINE
❑ YES (j NO
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1
NEW
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL s1GN
OF EDMONDS. LOCAL SALES TAX
ADD ❑
❑ RETAINING
REMARKS
SHOLRD BE CODED 31.04..
DEMOLISH
ElALTER EXCAVATE FENCE
OR FILL.........PRE-
1�
SWIM
El REPAIR 1 I
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❑ INSP. Lam/ POOL
AF's / /
NUMBER OF STORIES NUMBER OF
DWELLING
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UNITS
1
NATURE OF WORK To BE DONE
Valuation FRcctlpt
Valuation
No-
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G _I _Ir/Ci C-
Plan Check No.....................
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BUILDING
PROPOSED USE
PLUMBING
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PLOT PLAN (Indicate Building eeLDneke, abutting e[roete)
HEAT do GAS LINE
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FENCE
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ffiCN
1
RETAINING WALL
N
1
SWIMMING POOL
DEMOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1 hereby acknowledge that I have read this application; that the In-
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formation given Is correct; and that I am the owner, or the duly author-
1
(zed agent of the owner. I agree to comply with city and .late law. nSO-
ATTENTION
APPLICATION APPROVAL
lat(ng comlruction; and In doing the work authorised thereby, no person
Willbe employed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
ralatloir to Workmen's Compensation losuranes.
AUTnORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (E.I.pl DEMOLITIONS which
ONLY TIRE
WORK NOTED
uty, and fees are paid, and receipt 1s ae-
,hall be completed In ninety days; MOVED-IN BUILDINGS .hall be cam-
knowledged in .pace provided.
pitied In els month..)
SIONATUR (ONNER O AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
DIRE�sTOR'B e1GNATUiiiEEE
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C/ �G-
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CITY OF
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EDhiONDB
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NOTE: Applicant Subject to Plan Check Fee
PA a-uoI
This Permit coven work to be done on private property ONLY.
Any construction no the puhlla domaln (enzbs, sidewalks, driveways,
FILM
nmrqueee, etc.) will require separate permisslon.
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NUMBER -r
USE PERMIT
ER �/1f1�I I C� fff
BUILDING DEPARTMENT Applicant ZONE cantFill V/r 1
PERMIT APPLICATION I Inside Heavy Lines
NAME !OR NAME OF BUBINEBH)
C3TY LEFHONE NUMBER
NAME'
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ADDRESS
]D
ADDRESS,yny
PFIRb1Itl8iBLH/-� •
IAT COVERAGE
ACT JAL °t'
LOT COVESiAOF.
PERMISSIBLE IIEIGHT
PROPOSED !(EIGHT
ACTUAL LOT AREA
'IOTKl. BLDG. AREA
REQUIRED YARDS PROPOSED YARDS
FRON81DE REAR FRONT HIDE REAR
T
A�'
PLANNING DEPT. APPROVAL
LEGAL LOT
YES ❑ NO
AIilA NCE OR CONDITIONAL UHE
PERMIT NUMBER
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ALTER ❑ EXCAVATE
(.........s..........Ft. I
OR FILL
PRE -MOVE SWIM
REPAIR [:]
INSP. POOL
i� n f _ _
�� I en
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A�'
PLANNING DEPT. APPROVAL
DATE:
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UNITS
4c
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NATURE OF WORK TO BE DONE
CITY r TELEPKONE NUMBER
Plan Check Nn .....................
,
EXISTING BTRF.F.T R/W ............FT.
DEFICIENCY THIS PROPERTY
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a
PLUMBING
NAME
COMP. PLAN ST. R/W ............Fr.
............FT,
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HEAT GAS LINE
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B
REMARKS
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CC
ADDRSS
.. -e�T. 'f'•"�
BION
z
RETAINING WALL
N
CHECKED BY
SWIMMING POOL
CITY
U TELEPHONE NUMBER
I
I
it
!
II
EXCAVATION OR FILL
�'^ (�•'r
METER SIZE SERVICE SIZE
CLEARANCE CHECKED BY
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I hereby acknowledge that I have read WU application; that the fn•
GA07
M>;l�CITY LICENSE NUMBER
STATE LICENSE NUR
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I I
1
iced agent of the owner. I agree to comply with city and state laws ""'u-
ATTENTION
APPLICATION APPROVAL
toting constructloa; and to doing the work authorised thereby, no person
l.7
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Iasurance.
AUTHORIZES
REMARKS
NOTE: Permit limit One Year (Eicspt DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
Legal Description
of Pr perty (Show Below or Attach Four Copies)
knowledged in space provided.
pleted in six months.)
-
-
SIGNATURE-; (OWNER OR AGENT) DATE STONED
INSPECTION
DIR- OR's IUNATU E
(/; �. , _1p�n _
TYPE CONNECTION
VERIFIED BY
.,...(•= - , .'. .. .. _
CITY OF
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EDNOND3
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17/
This Permit coven work to be done on privsle property ONLY.
PH 6-1107
—
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PER
Rb UMBER
0.•
morns..• etc.) wW rspmre ..Pante permission.
D
REMA ULJm
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FIR ZONE I TYPE OF CONSTRUCTION STREET IMPROVED
NO
Wi
YES Ej
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
a O
RESIDENTIAL LINE
NEW
g
PLANSCHECKElBY
THIS SITE 15 LOCATED IN THE CITY
NON-RESIDENTIAL
❑
OF EDMONDS. LOCAL SALES TAX
31.04,
int—�—,y1t ADD
RETAINING
REMARKS
SHOULD BE CODED
`
El DEMOLISH WAIT'
I
FENCE
ALTER ❑ EXCAVATE
(.........s..........Ft. I
OR FILL
PRE -MOVE SWIM
REPAIR [:]
INSP. POOL
i� n f _ _
�� I en
I
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
I
Valentina Fee Receipt No. �
NATURE OF WORK TO BE DONE
--) • •.
Plan Check Nn .....................
q PROPOSED USE 1
BUILDING
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a
PLUMBING
I
�A
i
PLOT PLAN (Indicate Building setbacks, abutting sttoets)
HEAT GAS LINE
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B
�
FENCE
.. -e�T. 'f'•"�
BION
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
I
PRE -MOVE INSPECTION
II
EXCAVATION OR FILL
I
TOTAL AMOUNT DUE
L^ I •%.
I hereby acknowledge that I have read WU application; that the fn•
1 ! -=
formation given is correct: and that I am the owner, or the duly author-
1
iced agent of the owner. I agree to comply with city and state laws ""'u-
ATTENTION
APPLICATION APPROVAL
toting constructloa; and to doing the work authorised thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Iasurance.
AUTHORIZES
Signed by the Building Official Or his Dep -
NOTE: Permit limit One Year (Eicspt DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed to maely days; AIOVED-IN BUILDINGS shall be com-
knowledged in space provided.
pleted in six months.)
-
-
SIGNATURE-; (OWNER OR AGENT) DATE STONED
INSPECTION
DIR- OR's IUNATU E
i
DEPARTMENT
_
.,...(•= - , .'. .. .. _
CITY OF
---
EDNOND3
DATE
( 4�OTE: Applicant Subject to Pian Check Fee
17/
This Permit coven work to be done on privsle property ONLY.
PH 6-1107
—
/
Any construction an the public domain (cobs, sidewalks, drlvewgs.
INSPECTOR
morns..• etc.) wW rspmre ..Pante permission.
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RECORD OF INSPECTIONS
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bit' Pissed
,:Foundation
Plumbing (Partial)
(Rough)
:,Frame
Furnace & Fuel Lines
'Final 1
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