740239.pdfl
..Y� I �/ 10 YES 13 NO
DWELLING
SPECIAL INSPECTOR REQUIREDOCCUPANCY
BUILDING DEPARTMENT
Appmm�t Fill
Zo�rrE % PERMIT
740239
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PERMIT APPLICATION
Inside Heavy Lines
SOH
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ZE]RESIDENTIAL
E] NEW
-
NON-RESIDENTIAL
NAME (OR E
NAME OF HESINBB)
LINE
SIGN
ADDRESS
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ALTER
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DEMOLISH
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Il OPE R� �• �UG�Q/Q� t) - ��
PERMIee1HLE " ACTUAL
LOT COVERAGE �Lr�O LOT COVEn GE �
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EXCAVATE
❑
MAILING "OR be
PERM38.IBLE HEIGHT PROPOSED HEIGHT
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PRE -MOVE
PLUMBING
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Sup O m A 111% ST' •$Ox .3.s `
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P80NE NUMHx:R
ACTUAL LOT AREA TOTAL BLDG. AREA
Q PLOT PLAN (Intllcate Building Setbacks, abutting Streets)
BEAT R GAB LINE
T) M o D 6a,as �,
77R/ Sso a'
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p
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REQUIRED YARDS PROPOSED YARDS
FENCE
NAME
FRONT BIDE REAR FRONT B3UE REAR
BION
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LOT❑
ADDRESSLEG
B NO VERMINCE OR NUMBERNUI IONAL U
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CC'
CITYTELEPHONE
NUMBER
P O DEP Al O A
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DEMOLITION
ET / TRV
:T-7
EXISTS SEET R/ .QST. DEFICIENCY THIS PROPERTY
O
PRE -MOVE INSPECTION
NAME
/
(�
COMP. PLAN 8T. R/ ... &Til'. ...OFT.
7
EXCAVATION OR FILL
ADDRESS
REMARKS Driveway slopes not to exceed those
indicated Standard DwT No. 103
o
w
�(I
TOTAL AMOUNT DUE
on
I hereby acknowledge that I have this
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C
-al T—Y
TELEPHONE NUMBER
��V V,r N 1
� D.
C E D
Iormntlon given L correct; and that I am the owner, or the duly author-
ent a he er. I agree mply with city and ato
Llaetdinggcoastructlon:nand ppOnon
oo
I
ATTENTION
APPLICATION APPROVAL
will be employed In violation of the Labor Coda of the State of Washington
relating to Workman's Compensation Insurance.
METER SIZE
SERVICE SITE
CLEARANCE
CHEC D B
V
.TATE LICENSE NUMBER
CITY CENBE NUMHER
which
{YORK NOTED
uty; and fees are paid, and receipt Is nc-
I
plat( be completed In ninety days; MOVE0.7N BUII.DIN08 shall be Cem-
knowled In ace C
i`0.'
ed
g p provided.
Legal Description at Property (Snow Below or Attach Four Copies)
REMARK.
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TYPE CONNECTIONVERIFIED
BY
,
CITY OF
\
NOTE: Applicant Subject to Plan Check Fee
EDMOND$
DATE
0..
coven work be done on private property ONLY.
PERC. TEST
PERMIT NUMBER41
S
Anyny construction on the public domain (eurbp. Sidewalks, driVewye,
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m
REMARKS
FIRE ZON➢ i mvnu� nor awaamnr.rvc.nv , o.,.o �, �... ...............
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NUMBER OF STORIES NUMBER OF
..Y� I �/ 10 YES 13 NO
DWELLING
SPECIAL INSPECTOR REQUIREDOCCUPANCY
GROUP
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GAS
❑ YES 'K0NO
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ZE]RESIDENTIAL
E] NEW
-
NON-RESIDENTIAL
-/� 7
0-1...._!.
LINE
SIGN
PLAN CHECHED RYTHIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
�Y�
® ADD
ALTER
I
DEMOLISH
❑
WAIT[N6
-- cH0 I D 6 ODED 31.04.
R ARKS
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❑
EXCAVATE
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(ENC.a.......... Ft.)
67, 06
j
PRE -MOVE
PLUMBING
SWIM.
-
REPAIR ❑ INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNIT.
NATURE WORK TO BE DONE
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'(1 Ai 1�1'-TY"'o
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Valuation
Fee
ReceiptNo.
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- -�•�e�
Plan Check Na.
Zq, sa
.
LyPROPOSED USE
6,
BUILDING
//
67, 06
j
PLUMBING
W
Q PLOT PLAN (Intllcate Building Setbacks, abutting Streets)
BEAT R GAB LINE
S
p
FENCE
! i
BION
j
RETAINING WALL
N
i
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
7
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have this
read applleatlon; that theIn-
jJ
Iormntlon given L correct; and that I am the owner, or the duly author-
ent a he er. I agree mply with city and ato
Llaetdinggcoastructlon:nand ppOnon
m doingt thea work authorlsod thereby, DO
ATTENTION
APPLICATION APPROVAL
will be employed In violation of the Labor Coda of the State of Washington
relating to Workman's Compensation Insurance.
T1118 FE11511T
This application (. not a permit until
NOTE: Permit Limit One Year (Except DEMOLITIONS
AUTHORIZES
ONLY TILE
signed by the Building Official or his Dep-
which
{YORK NOTED
uty; and fees are paid, and receipt Is nc-
plat( be completed In ninety days; MOVE0.7N BUII.DIN08 shall be Cem-
knowled In ace C
ixmonths.)
plated In six months.)
ed
g p provided.
SIGNATURE (OWNER OR AGENT)
,.
/)!X
DATE B ONED
INSPECTIONB�
DEPARTMENT
1
1 TOR•e TU ./.'
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-
L• Hy
oC�z^IFIL
• ,V;
'I
,
CITY OF
'
NOTE: Applicant Subject to Plan Check Fee
EDMOND$
DATE
'
coven work be done on private property ONLY.
PB 6-1107Permit
tr
Anyny construction on the public domain (eurbp. Sidewalks, driVewye,
d
AIL^
CITY OF EDMONDS
DEPARTMENT OF BUILDINGS
TEMPORARY
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE, Sec. 306
i
i
At 841n Main Strant Building Permit Number 740719
Occupancy established by this certificate:
F-2 Fire Zone I I No. Stories i J
Type Const. V Basement NO
Floor Load signs in place (per Sec. 23o8 U.B.C.) — Capacity signs posted (per Sec. i}os (i) U.S.C.)
Floor load and room capacity signs, when required, mast remain posted at all tidies.
i
THE addition HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES. r
Issued this 18th day of Deremher �gZ4—
CHIEF BUILDING OFFICIAL By
This certificate shall be posted in a conspicuous public area and shall not be removed, mutilated or obscured and shall be main-
tained in legible condition at all times. Any change of occupancy requires a new certificate.
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BOWICIN WAY 142FT 4/L TO POB ALSO LESS
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