740408.pdf/ /P— - I 0 YES [3 NO —11
PLANNING DEPT. APPROVAL DATE:
id CITY
TELEPHONE NUMBER
STREET R/tV
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PERC. TEST
NEW
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
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LINE
COMP. PLAN 9T. R/W ............Fr. ............FT.
REMARKS
This application is not a permit until
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NON-RESIDENTIAL
CHECKED BY
C�T/•E7LEPHONE
uty; and fees are paid, and receipt Is ac -
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METER BILE
I SERVICE SIZE
CLEARANCE
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C'TYLICENSE NUMBER
REMA}iK8
I Legal Description of Property (Show Below
or Attach Four Cocks)
DEMOLISH
BUILDING DEPARTMENT
Applicant FW
ZONE NUMBER 740408
PERMIT APPLICATION
I Inside Heavy Lines
,OB
ADDRESS FO
I TYPE OF -CONSTRUCTION I STREET IMPROVED
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REPAIR ❑ PRE -N PMOVE
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PERMISSIBLE HEIOIIT PROPOSED HEIGHT
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ACTUAL LOT AREA TOTAL BLDG. AREA
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REQUIRED YARDS PROPOSED YARDS
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Valuation
NAME
FRONT SIDE REAR FRONT BIDE REAR
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LEGAL LOT - VARIANCE OR CONDITIONAL USE
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BUILDING
/ /P— - I 0 YES [3 NO —11
PLANNING DEPT. APPROVAL DATE:
id CITY
TELEPHONE NUMBER
STREET R/tV
!c
�Or
y
PERC. TEST
NEW
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
N
LINE
COMP. PLAN 9T. R/W ............Fr. ............FT.
REMARKS
This application is not a permit until
C ARESB d /
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e t
NON-RESIDENTIAL
CHECKED BY
C�T/•E7LEPHONE
uty; and fees are paid, and receipt Is ac -
0
O
rNUMBER
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METER BILE
I SERVICE SIZE
CLEARANCE
I CHECKED BY
BT LI ENSE NUM�B7JER
7s�
C'TYLICENSE NUMBER
REMA}iK8
I Legal Description of Property (Show Below
or Attach Four Cocks)
/ /P— - I 0 YES [3 NO —11
RESIDENTIAL
GAB
❑ YES ❑ NO
formation given is correct; and that I am the owner, or the duly outhcr-
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PERC. TEST
NEW
PERMIT NUMBER
1:4
LINE
n
THIS SITE IS LOCATED IN THE CITY
This application is not a permit until
I
AUTHORIZES
NON-RESIDENTIAL
�
REMARKS
uty; and fees are paid, and receipt Is ac -
OF EDMONDS. LOCAL SALES TAX
WORK NOTED
knowledged In space provided.
ElSHOULD
ADD
RETAINING
REMARKS
BE CODED 3104
DEPARTMENT
]aj
DEMOLISH
O
EDMOND$
allegesNOTE:
1 plicast Subject to Plan Check Fee
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FIRE ZOOIto
I TYPE OF -CONSTRUCTION I STREET IMPROVED
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/ /P— - I 0 YES [3 NO —11
I hereby acknowtetlge that I have read this application; that Ne In-
RESIDENTIAL
GAB
❑ YES ❑ NO
formation given is correct; and that I am the owner, or the duly outhcr-
APPLICATION APPROVAL
NEW
lating construction; and In doing the work authorized thereby, no person
LINE
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
This application is not a permit until
role Ing to Workmen's Compensation Insurance.
AUTHORIZES
NON-RESIDENTIAL
�
SIGN
uty; and fees are paid, and receipt Is ac -
OF EDMONDS. LOCAL SALES TAX
WORK NOTED
knowledged In space provided.
ElSHOULD
ADD
RETAINING
REMARKS
BE CODED 3104
DEPARTMENT
]aj
DEMOLISH
WALT
EDMOND$
allegesNOTE:
1 plicast Subject to Plan Check Fee
Int ALTER
❑
FENCE
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REPAIR ❑ PRE -N PMOVE
❑
SWIM
POOL
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12-7 S
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fUT3DER OF STORIES NUb1DER ON
DWELLING
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UNITS
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Valuation
Fee Receipt No.
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BUILDING
rROPOBED USE
PLUMBING
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HEAT k GAB LINE
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
—
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I hereby acknowtetlge that I have read this application; that Ne In-
TOTAL AMOUNT DUE
formation given is correct; and that I am the owner, or the duly outhcr-
APPLICATION APPROVAL
Izrd agent of the owner. I agree to comply with city and state "we rag'- ATTENTION
lating construction; and In doing the work authorized thereby, no person
will be employed In Violation of the Labor Coda of the Stale of Weahmglon
THIS PERMIT
This application is not a permit until
role Ing to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONH which
ONLY TIRE
uty; and fees are paid, and receipt Is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com.
WORK NOTED
knowledged In space provided.
pleled In elx months.)
IIGNATUI;E ( WNER OR AGENT
INSPECTION
DIRECTOR' SIONATU
DEPARTMENT
]aj
CITY OF
DATE
EDMOND$
allegesNOTE:
1 plicast Subject to Plan Check Fee
TillsI'erntit rnvero t ork to be done an Private properly ONLY.
775-2525
Any ronslnlrtlnn on the public domain (eurbn, sidewalks, drlcewaye,
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FILE
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17,
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RECO-- ROO INSPECT
Date Passed
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