740450.pdf1
NATURE OF WORK TO HE DONE
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Valuation
Fee Receirt No.
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EXCAVATION OR FILL
BUILDING
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PROPOSED USE
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FENCE
SIGN
RETAINING WALL
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SWIMMING POOL
DEMOLITION
PRE MOVE INSPECTION
ZONE BER 740450
1 hereby acknowledge that I have reed this application; that the In.
TOTAL AMOUNT DUE
BUILDING DEPARTMENT
Applicant Fill
.Pru
PERMIT APPLICATION
Inside IIenvy Lines
APPLICATION APPROVAL
IntlnR construction; and In doing the work authorised thereby, no person
A DDREdO
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will be employed In vlolntkm of the Labor Code of the Stale of Washington
THIS PERMIT
NAME (OR NAME OF BUSINESS) / V (P tJ•/
relating to Workmen's Compensation Insurance.
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signed by the Building Official or his Dep -
Pt:RD1E 'e ACTUAL
LOT COhillVER": LOT COV&GE
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ONLY THE
WORK NOTED
MAILING ADDRESSfl PEILV ISSIBLE HEI<iHT PILO POSED HEIGHT
shall be completed In ninety days; MOVED -IN BUILDINGS shell be com-
4"
TOTAL
AREA TOTAL DLDG. AREA
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plated In six month..)
CITY
TELEPHONE NUM(B}LR ACTUAL LOT
IIGNAT ITE (OWNER Oft AGENT) DATE SIGNED
INSPECTION
IR S d1GN URE
IEQUIRED YARDd PROPOSED YARDH
SIDE REAR
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DEPARTMENT
NA lE FRONT AIDE REAR FRONT
NADDRESS
CITY OF
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LEGAL LOT VARIANCE OR CONDITIONAL USE
NUMBER
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NOTE: Applicant Subject to Plan Check Fce
0 VES 0 NO PERMIT
775-2525
PLANNING DEPT. APPROVAL DATE:
This Penult r ,,,it to be done on private properly ONLY.
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CITY TELEPHONE NUMBER
Any const rued., on the public domain (curbs, sldewalks, driveways.
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STREET R/lV
EXISTING STREET R/W ............FT. DEFICIENCY TIiIB PROPERTY
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TELEPHONE NUMBER ,`5'�7AI /
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METER SIZE SERVICE SIZE CLEARANCE
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31`ATE LICENSE N MBER CITY LICENSE NUMBER
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REMARKS
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Legal Description of Property (Show Below
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NEW
PLAN CHECI D Y THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL ❑ SIGN
OF EDMONDS. LOCAL SALES TAX
ADD
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NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
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NATURE OF WORK TO HE DONE
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Valuation
Fee Receirt No.
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EXCAVATION OR FILL
BUILDING
SS ///E���//J
PROPOSED USE
PLUMBING
PLOT PLAN (Indlenm Building setbacks, abutting .creel.) HEAT A 6A8 LINE
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE MOVE INSPECTION
1 hereby acknowledge that I have reed this application; that the In.
TOTAL AMOUNT DUE
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EXCAVATION OR FILL
1 hereby acknowledge that I have reed this application; that the In.
TOTAL AMOUNT DUE
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formation given Is correct: and that I am the owner, or the duly author-
Ired agent of the owner. I agree to comply with city and state law. mgu-
ATTENTION
APPLICATION APPROVAL
IntlnR construction; and In doing the work authorised thereby, no person
will be employed In vlolntkm of the Labor Code of the Stale 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 DEMOLITIONH which
ONLY THE
WORK NOTED
uty; find fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shell be com-
knowledged in space provided.
plated In six month..)
IIGNAT ITE (OWNER Oft AGENT) DATE SIGNED
INSPECTION
IR S d1GN URE
DEPARTMENT
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CITY OF
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ED11fOND5
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NOTE: Applicant Subject to Plan Check Fce
775-2525
This Penult r ,,,it to be done on private properly ONLY.
Any const rued., on the public domain (curbs, sldewalks, driveways.
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m-ri-es, etc.) will require separate pe—I.Ilon.
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USEPERMIT
BUILDING DEPARTMENT Applicant Fm ZONE NUMBER `l
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PERMIT APPLICATION Inside Heavy Lines
NAME ((Olt NAME OF BUBINEBS)
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CITY TELEPHONE NUMBER
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NAME
WA.D.S.
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ADDRESS / / ')0
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LOT COVERAOfie
LOT COVESiAOE
PEUMIUSIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
TOTAL BLDG. AREA
REQUIRED YARDS
FRONT Mop, REAR
PROPOSED YARDS
FRONT HIDE REAR
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TELEPHONE NUMBER
STREET R/W
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NllE[HER OF STORIES NUMBER OF
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METER SIZE
SIZE
CLEARANCE
CIIEGKED BY
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STATE LICENSE NVaIHER
CITY LICENSE NUMBER
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PLUMBING
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PLOT PLAN (Indicate Building setbacks,abutting streets)
HEAT k GAS LINE
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Legal Dcecripllon of Yropetty (d aw ..law or Attach Four Coplee)
Legal
R EMARHB
PENCE
TYPE CONNECTION
VERIFIED BY
SIGN
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TRETAINING
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PERO. TEST PERMIT NUMBER
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SWIMMING POOL
LIVU
DEMOLITION
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FIRE ZZONEE. TYPE OF CONSTRUCTION STREET IMPROVED
EXCAVATION OR FILL
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I hereby acknowledge that I have read this application; that the In.
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
ATTENTION
❑ YES [3 0 1. J- ,
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laling canetruellaa; and In doing the work authorized thereby, no person
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CA8
RESIDENTIAL E]LINE
El NEW
NON-RESIDENTIAL-'-
SIGN
ADD ❑� RETAINING
DEMOLISH WALL
PLAN CHECKED Y
� THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
."�;-^f /moi,, SHOULD BE CODED 31.04.
REMARKS! !
ALTER EXCAVATE ElPENCE
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❑ OR FILL f.......... x .......... Ft.)
El REPAIR PRE -MOVE El SWIM
INBP. POOL
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NllE[HER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO DE DONE
Valuation Fee Rocolpt No.
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Pian Check No .....................
3 q
BUILDING
PROPOSED USE
a
PLUMBING
—� C
PLOT PLAN (Indicate Building setbacks,abutting streets)
HEAT k GAS LINE
'
PENCE
SIGN
TRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In.
--
m
formation given le correct; and that I athe owner, or the duly author-
ized agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
laling canetruellaa; 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
This application Is not a permit until
relatlag to Workmen's Camp ensatlon Insurance,
AUTHORIZES
Signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except IrEatO1.1TIONd whieb
WORK THE
uty: and fees are paid, and receipt Is ac-
ehall be completed In ninety days; MOVED -IN BUILDINGS Shall be core.
Itno_wledged In space provided.
pleted In six months.)
SIGNATQRE.(OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
DIRECTOR'S SIGNATURE}/
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CITY OF
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NOTE: Applicant Subject to Plan CGeck Fre
775.2525
Thls Pemdt raven work to be done on prlrale property ONLY.-�
-
Any canetruetion on the public domain (curb.. sidewalk., driveways,
marquee., etc.) will require separate Plrmleslon,
INSPECTOR