740242.pdfr
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13 U I L D I N G DEPARTMENT Appilcaat Flu OBNE NUMBIER 740242
PERMIT APPLICATION I Inaldo Heavy Lines IIB
ADDREsB
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NEW RESIDENTIAL ❑ LRNE
NON-RESIDENTIAL ❑ BION
ADD ❑ DEMOLISH WAININC
AVAT
eI.TER ❑ OROFILL E (.C.z.O.Q.Ft.)
REPAIR ❑ PIREPMOVE OI. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
9'7- `f
Plan Cheok No .....................
ACTUAL
LOT COVERAGE'
I.OT COVESYAOE
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
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ACTUAL LOT AREA
TOTAL BLDG. AREA
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REQUIRED YARDS
PROPOSED YARDS
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FRONT SIDE REAR
FRONT SIDE REAR
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FENCE
LEGAL. LOT VARIANCE Olt CONDITIONAL USE
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0 YES ❑ NO PERMIT NUMBER
PLANNING DEPT. APPROVAL
DATE:
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STREET R/W
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EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT.
............FT.
M
REMARKS
PRE -MOVE INSPECTION
0 YES Ej NO
SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
0 YES ri NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04
REMARKS
Valuation I Fee
Plan Cheok No .....................
HUILDIN6
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PROPOSED USE
PLUMBING
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P PLOT PLAN (Indlcate Building setbaelm. abutting streets)
HEAT k OAS LINE
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FENCE
wJ 0 Q O Q
o4 V
r O v
BION
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
,
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I pereby ackow
nletlge that I have [Sad this application; that the In.
formation given Is correct: and that I am the owner, or the duly author-
,zedagent o[ the owner. I agree to Comply with city and stale laws regu•
ATTENTION
APPLICATION APPROVAL
latin6 Constraellon; and m dolpg ths work authorized thereby no person
will be employed in violation of the Labor Code of the State of Washington
THIS PERMIT
This application Is not a permit until
relating to Workmen's Compensation Ipaurancs.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS whleh
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
.hall be completed In Nasty days; MOVED -IN BUILBINGS shall be corn•
knowledged in space provided.
ploled In six ...the.)
SIGNATURE (OWNER OR AGE T)DATE
SIGNED
INSPECTION
DEPARTMENT/l
Dl TOR'S RIONAT E
`yam
CITY OF
NOTE: Applicant Subject to Plan Check Fee
EDMONDS
PR a-aoI
DATE
_
This Permit coven work to be done on private property ONLY.
Any eonstruzUe. on the pubs, domain (Sorbs, sldewslke, driveways,
FILE
maue!., etc.) wW require separate pe eamlon.
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PERM7:.J ".^ `
BUILDINUSE
G DEPARTMENT ApplicantFlll
ZONE NUMflIER
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1
PERMIT APPLICATION Inside Heavy Lines
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1
ADDRESS %rt.-1 � i (�•� �%^---
AD
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NAME 01{ NAME OF
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��-� (%�.(jJ.
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PERMISBIBLE n ACTUAL
LOT COVERAGE LOT COVERAGE
1'1 .(�,Jl
AILING ADDREI
PERMISSIBLE HNIG11T PROPOSED HEIGHT
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CITY / _ � ,
T PHON NUMHk:R
ACTUAL LOT AREA TOTAL BLDG. AREA
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(/p L,.•7'v t_.-y-.�6 -f
REQUIRED YARDS PROPOSED YARDS
NAME
FRONT SIDK RF:AI3 FRONT SIU.: REAR
ADDRESS
7
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I,F.GAI. L07' VARIANCE OIL CONDITIONAL USE
YE8 NO PERMIT NUMBER
..�L
PLANNING DEPT. APPROVAL DATE:
G9i
C
CITY
I TELEPHONE NUMBER
STREET R/W
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EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAME
COMP. PLAN 8T. R/W ............FT. ............FT,
REMARKS
MM
ADDRESS
67
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CKECKED BY
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CITY TELEPHONE NUMBER
1
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METER SIZE SERVICE SIZE CLEARANCE
CHECKED BY
STATE LICENSE. NUMBERY
C)TLICENSE NUMBER
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p,
%
,
IREMARKS
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Legal Description of Property (Show Below or Attach Four Copies)
TYPE CONNECTION
VERIFIED BY
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ly"
PERC. TEST
PERMIT NUMBER
y,
ra
REMARKS
m-
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aa?
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FIRE ZONE TYPE OF CONSTRUCTIONSTREET IMPROVED
�+
0 YES 0 NO
I
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
YEB 0 NO
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NEW
[L12luD..TIA.,❑GA80
LINEPLAN
CHECKED BYTHIS SITE IS LOCATED IN THE CITY
r
N-RESIDENTIAL
❑
OF EDMONDS. LOCAL SALES TAX
SIGN
SHOULD BE CODED 31.04.
❑ ADD ❑ RETAINING
F] DEMOLISH Aiy KING
REMARKS
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❑ ALTER EXCAVATE FENCE
D
OR FILL (..f, �...s.c
❑ p ....Ft.)
1
❑ REPAIR PRE-MOVE SWIM
❑ ❑
INSP. POOL
NUMBER OF STORIES NUMBER OF
j
DWELLING
UNITS
NATURE OF WORK TO HE DONE
Valuation
Fee
Receipt No.
i I
Pian Check No.....................
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S I� C
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BUILDING
PROPOSED USE
I
PLUMBING
p
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PLOT PLAN (Indicate Building setback., abutting et—ta)
HEAT & GAS LINE
at
FENCE
��((
!+G o O •'_"�"
I C> Q
%
SIGN
_
RETAINING WALL
N
_
I
SWIMMING POOL
! I
DEMOLITION
-
PRE-MOVE INSPECTION
EXCAVATION OR FILL
1
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
n(
/
tormatlon given Is correct; and that I am the owner, or the duly author.
Iced agent of the owner. I agree to comply with city and state Iowa rosu-
ATTENTION
APPLICATION APPROVAL
Istln6 construction; nad in doing the work authorised the by, no Pero..
will he employed In violation of the Labor Code of the State of Washington
TINS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
j
I
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY TZE
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be completed In meaty day.; MOVED-IN BUILDINGS shall be com.
knowledged In space provided.
I
pleted In six months.)
i
SIGNATURE (OWNER OR AGENT)
DATE etGNED
INSPECTION
DIR R•S BMTU
C • \Y S r� Z
-� b
'7 .v /
DEPARTMENT
_.__.
.,
CITY OF
NOTE: Applicant Subject to Plan Check Fee-1/
EDbIONDS
rB e•uoo
DATE
1
This Permit toren wprk to be done on private property ONLY.
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Aayfeon.m,tehd)pn68o d". (.obs, aidewdlt/.�drlveL�ayL
.� t,
INSPECTOR
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mluone.Se:wW ,repair. .ePa+ate puauulylK s ,{ 5
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