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NAME (OR NAME OF BUSINESS)
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NUMBER
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COVEEIAOE
OSED HEIGHT y
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PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
[] YES ❑ NO
❑ YES [] NO
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
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Plan Check No .....................
RESIDENTIAL
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NUMBER OF
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UNITS
7.\TUBE OF; K TO BE DONE
PERMIT
NUMBER
740404
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COVEEIAOE
OSED HEIGHT y
L] YES ❑ NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
[] YES ❑ NO
❑ YES [] NO
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REM S _
„o�✓�p eL 7�0 If 6, s
Plan Check No .....................
BUILDING
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FENCE
SIGN
RETAINING WALL
BWIMMIN6 POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have reed this application; that the In.
V
formation Elven le correct: and that I am the owner, or the duly aulhor-
Ized agent of the owner. I agree to comply with city and state laws regu•
ATTENTION
APPLICATION APPROVAL
let ing conetivetloa; and m doing the work authorized thereby, no person
wt li be employed In Violation of the Labor Code of the Slate of Washington
THIS PERMIT
This application Is not a permit until
relating to Workmen's Compensation Insurance•
AUTHORIZES
signed 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 IB ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be Cann.
ImoWledged in space provided.
pleted In six months.)
Sl TVRE (OWNER OR AO T)
DATE SIGNED
INSPECTIOND3
TOR'8 BI TU -
DEPARTMENT
V,�?•
CITY OF
EDAIONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
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775-2525
This Permit sayers Work la be done an private property ONLY.
Any ennrtrncll,.n an the Publlc domain (curb., .Ide,rnike, drlveway.,
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ry e,� rl r.! „III r Inlr, neln,rut,• p„rml�.inn.