740395.pdff
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BUILDING DEPARTMENT Applicant Fm ZONE_ �.� NUMDER
USE PERMIT
740395
Inside Hea Linos —job
PERMIT A PLIC�AJJTION ADDRESS
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_ 2�'BUSINESS) COVE��IOYAGELT COWEREGE LOT
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VARIAN CONDITIONAL USF.
ADDRESS
YES [0]N
PEHMIT IBER
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TEL NUMBER
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R/WISTING
ETRE R
f.,.l..arii f'. DEFICIENCY THIS PROPERTY
NAME
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COMP. PLAN ST. R/yRc'M1.y..� ..y,J....FT.
nEMARxe
Driveway
,slopes not toexceed those
t0 ADDRE88
indicated on Standard Dwg. No. 103
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I HE KED BY
CITY
I TELEONE 1'I UMBER
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METER 81LE SERVICE 512E CLEARANCE
CH C ED BY
STATE LICENSE NUMBER
CITY L[CEN E NU EH
6
REMAIUCB
Legal Description of Property lehow claw ar Atlnea Four Coplee)
TYPE CONNECTION
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PERC. TEST
PERA,NUMBER
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FIRE ZONE TYPEOF
NeTRU ION eT1tE IatPROVED
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E9 ❑ NO
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GROUP
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aRESIDENTIAL
❑ LINE
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IOCCUPANCY
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u NEw
CHECKED Y
THIS SITE IS LOC TED IN THE CITY
❑ NON-RESIDENTIAL
❑ SIGN
-
Of EDMONDS. LOCAL SALES TAX
❑ Ann
ARKS
SHOULD CODED 31.04.
❑ DEMOLISH ❑ WALL
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❑ REPAIR PRE -MOVE sw1Af
❑ INSP. ❑ POOL
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NUAIBEIt OF STORIES NUMBER OF
DWELLING
�4/ 7- ,� EK -7 UNITS
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NATURRE/PF j�E-�D^ONE
Valuation
Fee Receipt Ni
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Plan Check No .....................
BUILDING
[O
Y PROPOSED USE
PLUMHIN6
HEAT & GAS LINE
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/
PLOT PLAN (Indicate Building setbacks, Abutting streets)
e7
PENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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I hereby acknowledge that I have reatl this application;hat the In-
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formatlan elven le correct; and that I am the owner, ly author.
Iced Agent of the owner. I agree to comply with city anlaws regu.
ATTENTION
APPLICATION APPROVAL
Paling construction; and In doing the work authorized no person
Will be employed In violation of the Labor Code of the SWashington
THIS PERMIT
This application is not a permit unti
relating to Workmen's Compensation Insurance.AUTHORIZES
signed by the Building Official or his Dep
NOTE: rmit Lim- ��@ Y@Qr (Excspt DENS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is Be
elmil q c Ipleted Inn a ays; AIOVED-1N HUILUIlt be Som.
]cnowledged in apace provided.
plet 1 Ix months.
Sl RE (OW 1 R A /.
NED
INSPECTION
OR, SIONATUR
DEPARTMENT
CITY OF'
t
ED NDS
A E
NOTE: Applrc It abject to Plan d1jecklFee—
775-2525
Title Permit Covers work In Iw done on private properly ONLY.
Any construction on lite public domain (curb•, eldeWalk•. drivewaye,
ple perndulon.
marquee, Slee WIII require •.)aro
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PERMIT APPLICATION Inside Heavy Llnae
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NAME (OR NAMH Of' BUSINESS) _ ii
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ING ADU EBB ,. j
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T LEPHONE NUMBER
ACTUAL LOT AA TOTAL BLDG. AREA
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NAME
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FRONT BIDE AFAR FRON'P BIDE REAR
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TELEPHONE NUMBER
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STREET R/tY
EXISTING STREET RAW=.`./�$• DEFICIENCY THIS PROPERTY
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NAME
COMP. PLAN sT. R/W C.j�/1L.k"r. ._(...FT.
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REMARKS ,
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ADDRESS
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CHECKED BY
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CITY
PHOONE NUMBER
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METER SIZEBY
C!IH'E
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ENSE NUMBER
tlTA�.T�
CITY LICENSE
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IARANCE
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REMARKS
Legal Deserlptimt 1 Mope ty (Show a tow or Atmeh Four Copies)
TYPE CONNECTION VERIFIED BY
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PERC.-TE�T T� PEHI1 T NUMBER
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REMARKS
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FIRE ZONE TYPE OF CONSTHU71ON STREET IMPROVED;
U'YES ❑ NO
'SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
1
RE8lDENTIAL
LINE
AS
❑ YES Q
-New
PLANCHECKED BY /
_ THIS SITE IS LOCATED'IN THE CITY
El NON-RESIDENTIAL
ElSIGN.'.'/moi/--'
OF EDMONDS. LOCAL SALES TAX
/ SHOULD BE CODED 31.04.
l
❑ ADD ❑ RETAINING
QDEMOLISH WALL
REMARKS ` I / I
1 / ! �.) ✓f �' [?/: ('/.{�, (//
'
❑FENCE
/ /• `/!
I ,,,. , . _�_ { 1,. 1- ,_.: I ...I . •
.... :. , i
ALTER ❑ OR FILL (........ _........... Ft')
REPAIR PRE -MOVE 0 SWIM
INSP. POOL
�i
L j]: �
NUMBER OF STORIES NUMBER OF
-
DWELLING
• J-/ r f /"L: G. UNITS
I
NATURE OF WORT{ TO HE DONE
Valuation
Fee
Receipt No.
�'�/ .. t r !� •� C ! /l i ,;: t N
Plan Cheek N ..0
1
BUILDING
l
i
G
PROPOSED USE
`a!
PLUMBING
a2
PLOT PLAN (Indicate Building Betbacks, abutting streets)
HEAT & GAS LINE
7--
FENCE
I
SIGN
RETAINING WALL
'
Ge
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application: that the In•
formation given Is correct: and that I am the owner, or the duly author.
,zedagent of the owner. I agree to comply With city and State law, regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work allthariZed thereby, no person
' Willbe employed In violation of the Labor Cade of the State of Washington
THIS PERMIT
This application is not a permit until
retailing to Workmen's Compensation Insurance,
AUTHORIZES
signed by the Building Official Or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIRE
WORK NOTED
uty; and fees are paid, and receipt is ac
Shalt be completed in ninety days; MOVED -IN BUILDINGS Shot[ be cern.
knowledged In space provided.
pleted In six months.) -
)
d IONATU1tE (OWNER OR AGENT) . DATE BIG Ell �
INSPECTION
DRE TOR tl S10NATURE�
'
-
I
DEPARTMENT
! / ,
,
CITY OF
EDMOND3
Fee
NOTE: Applicant Subject to Plan Check
775.2525
TitlePermit coven work UI be dens an private PrapellY ONLY.
Any construction on the public dumaln (curbs, sidewalks, drivew"s,
INSPECTOR
Marquees, etc.) will require eepsuale permission,
Y;