740409.pdf'
740409
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BUILDING DEPART M E N T Appucant Fill
NUMBER
APPLICATION InAldo Heavy Linos
JOB
PERMIT
ADDRESS_FLE
NAME lOR NAME OF HUBINE88)
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LOT COVERAGE
LOT COVERAGE LOT COVESYAGEPERM
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MAILING ADDRE88
HEIGHT PROPOSED HEIGHT
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TELEPH/OiNE NUMBER
ACTUAL LOT AREA TOTAL BLDG. AREA
ACTT L LOT
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REQUIRED YARDtl PROPOSED YARDS
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NAME
FRONT SIDE REAR FRONT SIDE REAR
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LEGA LOTVARIANCE OR CONDITIONAL.USE
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ADDRESS
0 YES ❑ NO PERMIT NUMBER
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DEPT. APPROVAL DATE:
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TELEPHONE NUMBER
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STREET R/Wp
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAMEC
COMP. PLAN 8T. R/W ............FT. ............FT.
REMARKS
ADDRESS
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CHECKED HY
OITY
TELEPHONE NUMBER
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METER SIZE
SERVICE SIZE
CLEARANCE
CHECKED BY
STATE LICENSE NUMBER
CITY LICENSE NUMBERas
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REMARKS
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Legal Description of Property (Show Below or Attach Four Copies)
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TYPECONNECTION VERIFIED BY
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PERC. TEST PERMIT NUMBER
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REMARKS
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IOCCUPAANNCY
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RESIDENTIAL
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CHECKED BY
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NEW
PLAN THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIALOF
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EDMONDS. LOCAL SALES TAX
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RETAINING
SHOULD BE CODED 31.04.
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DEMOLISH ❑ WALL
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EXCAVATE'
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❑ OR FILL E (.....................Ft.)
❑REPAIR PRE-MOVESwim
E]INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
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NATURE OCF/WORK TO BE DONE
Vahmilon
Fee Receipt No.
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PROPOSED UeE
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PLUMBING
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PLOT PLAN (Indicate Building setbacks, nbutling streets)
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DEMOLITION,
PRE-MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
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I hereby acknowledge that I 6nvo rend this application; that the 1n•
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formation given Is correct; And that I am the owner, or the duty nuthor•
Ized Agent of the owner. I agree to comply with city and elate laws reg..
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work autharized thereby, no person
will be employed In Violation of the Labor Code of the Slate of Wmhington
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 is ac-
shall be completed In ninety days; MOVED-IN BUILDINGS shall be corn•
knowledged in space provided.
pleted In six months.)
SIGNATURE (OWN 'It Olt AGENT) I DATE SIGNED
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INSPECTION
DEPARTMENT
IRE O ' SI NATU-
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CITY OF
NOTE: Applicant Subject to Plan Check Fee
EDbfOND$
775-2525
ATE �7
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Thle Ver ever
It rs work 10 be done an private property ONLY.
Any eonslruetlon on the nubile domain (curbs, sidewalks, driveways'
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marquees, etc.) will require eellarate perileelcn.
7r
EDMONDS
NOTE: Applicant Subject to Plan Check Fce775-2825 7 y `
Thla 1'-rmlt curers Work I. be dune en privet- property ONLY.
Any Co..,ruclle. on the public dennnin froth., sidewalks, ftl• aye,
marquees, etc.) will requlra separate pertnls.ion. INSPECTOR
ONE PERMIT
ILDING DEPARTMENT
PERMIT APPLICATION I Inside Heavy Lines
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ADDREBB jv/ J(,-G•G/
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NAME OF
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NAME (OR BUSINESS)
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PERMISSIBLE e' ACTUAL l
LOTCOVERAGE LOT COVE AGE
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MAILING ADDREBBO
PEItM11tltlI8LE HEIGHT PROPOSED HEIGHT
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CITY
TELEPHONE NUMBER
ACTUAL LOT AREA TOTAL BLDG. AREA
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REQUIRED YARDS PROPOSED YARDS
NAME
FRONT SIDE REAR FRONT SIDE REAR
FADDRESS
LEGA LOT VARIA EOR CONDITIONAL USE
PERMIT NUMBER
+
13 YES C] NO
PLANNING DEPT. APPROVAL f DATE;
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CITY'TELEPHONE
NUMBER
STREET RIW O
EXISTING STREET R/W ............ FT. `DEFICIENCY THIS PROPERTY
NAME
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COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
ADDRESS
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owN�R
CHECKED DY
CITY
TELEPHONE NUMBER
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N TER BILE I SERVICE 131ZE
I CLEARANCE
I CHECUCED BY
STATE LICENSE NUMBER
CITY LICENSE NUMBER
REMARKS
Legal Description of Properly (Show Below or Attach Four Copies)
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TYPE CONNECTION
VERIFIED BY
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PERC. TEST
PERMIT NUMBER )l,
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REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET 1MIPROVED
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SPEC AL INSPECTOR REQUIRED OCCUPANCY GROUP -
❑ RESIDENTIAL
❑ GASLINE
❑ YES �.NO- .-J -'/
❑ NEW
PLAN CHECKED BY LOCATED
NON•REBIDENTSAL
SIGN
El SIGN
01 LOCAL SALES TAX
F]ADD❑
RETAININGR9A—.BDEMOT
SHOULD BE CODED 31.04.
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E FENCE
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ALTER OR FILL (..........x..........Fl.)
❑ ❑
E] REPAIR [:] PRE -MOVE SWIM
INSP. ❑ POOL.
)'/J �1 'iii )fir �,i7: �.� l• /%.l !/3
NUMBER OF STORIES NUMBER
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee
Receipt No.
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Plan Cheek N
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BUILDING
60
—ac
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PROPOSED USE
-
PLUMBING
aPLOT
PLAN (Indicate 11 g c uttina .tree(.)
HEAT k GAS LINE
FENCE
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SIGN
- -
RETAINING WALL
-
N
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
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EXCAVATION OR FILL
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TOTAL AMOUNT DUE
I hereby acknowledge that I have read Hill; application; that the In.
to—'k'" given Ie correct; and that I am the owner, or the duly author -
1x 1 .gent of the owner. I agree to comply With city and elate )awe rag.-
ATTENTION
APPLICATION APPROVAL
laths conatrucllon; and I. doing the work authoriaad thereby, be Dcrson
Will be employed In vloatlon .1 the Labor code .1 lha State of Waehagton
THIS PERMIT
This application is not a permit until
r.l...g to Workmen's Compeneation Ipaurenee.
AUTHORIZES
Sighed by the Building Official or his De
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIIE
WORK NOTED
uty; and fees are paid, and receipt is aC-
.hell be completed In ninety days; MOVEDAN BUILDINGS shall be conn-
knoWledged in space provided.
plated In eIx months.)
B10NATU3tE (OWNER Oft AGENT) DATE SIGNED
INSPECTION
D RECTOR'S SIGNATUI )
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DEPARTMENT
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,� r . ,, ,. S
CITY OF
�.,/'(/L•�...�/,
ATE
EDMONDS
NOTE: Applicant Subject to Plan Check Fce775-2825 7 y `
Thla 1'-rmlt curers Work I. be dune en privet- property ONLY.
Any Co..,ruclle. on the public dennnin froth., sidewalks, ftl• aye,
marquees, etc.) will requlra separate pertnls.ion. INSPECTOR