740447.pdfi
BUILDING DEPARTMENT AppllcantFLU
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PERMIT akt 740447
PERMIT APPLICATION Insldc Heavy Lines
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ADDRESS
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NAME (OR NAME OF BUSINESS)2
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PERMISSIBLE % ACTUAL y
IAT COVERAGE /� LOT COVERAGE Olt„/
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MAILINU ADDRESS
3 J
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YE t%IIBBIBLE IIEIGlIT3
PROPOSED HEIGHT
010 3 [7� - �/ AUE , if' •
CITY
TELEPRONE NUMBER
ACTUAL LOT AREA
290.�o rlf
TOTAL BLDG. AR A
T.
E D m o yi -Y
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F.q 7HID AfiUB
PROPOSED YAFtU9
NAME
FRONT BIDE
REAR FRONT SIDE REAR
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LEany Lar AR
ANCE OR CONDITIONAL USK
ADDRESS
NO PERMIT NUMBER
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PLA P V E,,
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CITY TELEPHONE NUMBER
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EXISTIN BEET R/W ............FT.
...NC- THIS PROPERTY
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NAME
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COMP. PLAN ST. R/W ............FT.
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ADDRESS
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TELEPHONE NUMBER
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STATE LICENSE NUMBER
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CITY LICENSE NUMBER
METER SIZE
SERVICE SIZE
CLEARANCE
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Legal Description of Property (Show Below or Attach Four Copies)
REMARK.
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TYPE CONNECTION
VERIFIED BY
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TEST
PERMIT NUMBER-
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REMARK.
REMARKS
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FIRE ZONE TYPE OF CONBTRU ION .TREE IMPROVED
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ES 0 NO
SPECIAL INSPECT�ORREVUIRED OCCUPANCY GROUP
RESIDENTIAL
El GAS
❑ YES ❑'PO�
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El NEW
LINE
PLAN CHECKED HY
THIS SITE IS LOCATED IN THE CITY
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NON-RESIDENTIAL
El SIGN
OF EDMONDS. LOCAL SALES TAX
SHOULDCODED 31.04.
ADD
❑ WAIy KING
R ARKS
-BE
DEMOLISH
0 ALTER EXCAVATE. FENCE
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OR FILL El (.....................Ft.)
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El REPAIR Cj PRE-MOVE SWI bi
INSPI. POOL
NUMBER OF —STORIES
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
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Valuation
Fee— Receipt No.
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Plon Check No.....................
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BUILDING
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PROP08ED U8E
PLUMBING
PLOT PLAN (Indlcalo BUBdln6 eelbncka, nbutlln6 elrce[e)
IiEAT A GAB LINE
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PENCE
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SIGN
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RETAINING WALL
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SWIMMING POOL
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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 have rand this application; that the in.
formation given iscorrect; and that I ace the owner, or the duly author•
I:ed agent of the owner. I agree to comD1Y with city and elate laws rasa-
Inting conetructlon; and In doing the work authorized thereby, no person
ATTENTION
APPLICATION APPROVAL
A
will be' employed In violation of the Labor Code of the State of Washington
to workmen's
THIS PERMIT
This application is not a permit until
relating Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
R'ORK NOTED
ut and fees are aid, and receipt is ac-
Y; P p
.hall 6e completed In ninety days; MOVED-IN BUILDINGS shall 6e com•
knowledged in space
plcted In ala months.)
provided.
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SIGNATDH (OWNER OR AGENT) DATE elONED
INSPECTION
I R. 8IO ATUR
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DEPARTMENT
CITY OF
ED51OND8
I
DATE
NOTE: Applicant Subject to PfdH Check Fee
Thle 1'rnnll c to be done o n private properly ONLY.
775-ZSZS
j,,,work
Any Conetruetlun on ibe public domain ('.,be. sidewalks, driveways,
I
mnrpueee, etc.) will rreulrs separate 1—mlWan.
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