740413.pdf•
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TOTAL AMOUNT DUE
Plan Check No .....................
BUILDING
y PROPOSED USE
formation given Is correct; and that I am the owner, or the duly Author-
PLUMBING
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PLOT PLAN (Indicate Building setbacks, abutting etreete)
ATTENTION
HEAT A GAB LINE
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.
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B U I LD I N G
DEP ART MEN T AppnGant Fin
USE
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PERMIT
flY 740413
plcled In six months.)
SIGN
Inetdo Heavy Lines
PERMIT APPLICATION
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NAME NAME
DUBIN )
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PEItAI ItltlIDLE r/s
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DEMOLITION
NOTE:
PRE -MOVE INSPECTION
Tbls 1'ermlt c rolk In be done an Pth'nle ProPetlY ONLY.
LOT COVERAGE
LOT COVES AGE
separate
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REAR FRONT SIDE REAR
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LEGAL LOT VARIANCE OIL CONDITIONAL UBE
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ADDRESS
YF❑ NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
1
CITY
NUMBESTER
(TELEPHONE
EXIBT NG STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
NAME
COMP. PLAN ST. R/W ............FT.
............FT.
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REMARKS
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ADDRESS
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67
CITY
TELEPHONE NUMBER
(CHECKED
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METER BILE SERVICE SIZE
CLEARANCE
CHECKED BY
STATE LICENSE NUMBER
CITY LICENSE NUMBER
REMARKS
Legal D.a. 1ptton of Property (Show Below or Attach Four Copies)
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PER0. TEST
PERMIT NUMBER
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REMARKS
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
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SPECIAL INSPECTOR REQUIRED GROUP
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RESIDENTIAL E]LINE
❑ YES ElNO
IOCCUPANCY
PLAN CHECKED IIY
THIS SITE IS LOCATED IN THE CITY
EDMONDS. LOCAL SALES TAX
ADD
NON-RESIDENTIAL E]]SIGN
RETAINING
DEMOLISH WAIT'
REMARKS
SHOULD BE CODED 31.04.
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ALTER
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ORCAVAT FILL
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NUMBER OF STORIES NUMIIER OF
DWELLING
UN1T8
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TOTAL AMOUNT DUE
Plan Check No .....................
BUILDING
y PROPOSED USE
formation given Is correct; and that I am the owner, or the duly Author-
PLUMBING
O
PLOT PLAN (Indicate Building setbacks, abutting etreete)
ATTENTION
HEAT A GAB LINE
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In nlnsty days; MOVED -IN BUILDINGS shall be -no.
FENCE
plcled In six months.)
SIGN
DATE SIGNED
tRETAINING
WALL
N
CITY OF
SWIMMING POOL
EDMONDS
DEMOLITION
NOTE:
PRE -MOVE INSPECTION
Tbls 1'ermlt c rolk In be done an Pth'nle ProPetlY ONLY.
EXCAVATION OR FILL
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in Space provided.
D1R// TOR'D B Nf/TU `� I
FILE
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this apPlleatlDn; that the In-
formation given Is correct; and that I am the owner, or the duly Author-
Ized agent of the owner. I agree to comply with city and elate laws regu•
ATTENTION
leting construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In nlnsty days; MOVED -IN BUILDINGS shall be -no.
plcled In six months.)
31 ATDItE I.", ER Olt AGENT) _
DATE SIGNED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
Applicant Subject to Plats Check Fee
NOTE:
775-2525
Tbls 1'ermlt c rolk In be done an Pth'nle ProPetlY ONLY.
Any construction on lite publicdomain (curbs,
sidewalks, drivaay.,
separate
mnrquere, e eur
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in Space provided.
D1R// TOR'D B Nf/TU `� I
FILE