740463.pdfc
RMIT
BUILDING DEPARTMENT ,pplicant Fill ZONE NUMBER 740463
PERMIT APPLICATIONInside Ifeavy Lines
NAME (OR NAME OF BUSINESS)
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CC T—I Y TELEPHONE N MHSR
NAME
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(ACTUAL
PERMISBIBLE ^e
LOT COVERAGE
LOT COVE AGE
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
TOTAL BLDG. AREA
REQUIRED YARDS PROPOSED YARDS
FRONT BIDE REAR FRONT BIDE REAR
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VARIANCE OR CONDITIONAL UBE
PERMSIT NUMBER
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PLANNING DEPT. APPROVAL DATE:
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CITY TELEPHONE NUMBER
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STREET
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EXISTING TREET R/W ............FT.
DEFICIENCY THIS PROPERTY
NAME
COMP. PLAN 8T. A/W ............F1'.
............FT.
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REMARKS
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CHECKED BY D
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TELEPHONE NUMBER
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81LE SERVICE SIZE CLEARANCE
CHECKED BY
STATE LICENBD NUMHER
CITY LICENSE NUMBER
METER
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REMARKS
Legal Descrlpllon of Property (Show Below or Attach Four Copies)
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TYPE CONNECTION
VERIFIED BY
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PERC. TEST
PERMIT NUMBER d.
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REMARKS
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
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YES [] NO
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SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
El RESIDENTIAL
GAB
❑ YES NO
NEW
LINE
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
EjNON-RESIDENTIAL
❑ BION
OF EDMONDS. LOCAL SALES TAX
ADD ❑RETAIMN0
DEMOLISH WALL
REMARKS
SHOl1LD BE CODED 31.04.
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ALTER ❑ PEN Cx-
❑ ORFILLEXCAVATE
........ Ft.)
REPAIR ❑ PRE-INSP. MiOVE swim
POOL
NUMBER OF STORIESI NUMDER OF
DWELLING
UNITS
N RE O WORK TO H DONE .-
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Valuation
Fee Receipt No.
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Plan Cheek No .....................
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BUILDING
PROPOSED USE
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PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT &GAB LINE
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FENCE
SIGN
tRETAINING
WALL
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SWIMMING POOL
DEMOLITION
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PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TO AL AMOUNT DUE
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I hereby acknowledge that I have read this application; that the In.
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[ormntlan given le correct; and that I aca the owner, or the duly auther-
Ized agent of the owner. I agree to comply with City and state laws raga-
ATTENTION
APPLICATION APPROVAL
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toting 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
This application Is not a permit until
relating to Workmen's Compensation Insuraaos.
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 cern-
knowledged in space provided.
pl<led In mix moalhs.)
0610NATURE '-R OR AGENT)
DATE d3GNED
INSPECTION
D CTOR•B IONAT RE
DEPARTMENT
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CITY OF
IM1W'�£•1✓/"�,
EDMOND3
DATE
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NOTE: Applicant Subject to Plan Check Fee
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This Permit covers work to be done on private property ONLY.
Any construction an the public domain (..,be, sidewalks, driveways,
FILE
marquee., ate.) will reeniro separate perMsslon.
sesssmsnd
PERT
BUILDING DEPARTMENT AppH.tFM USE NUMBER r; •St��
PERMIT APPLICATION Inside Healy Llnoe D ,
ADDRESS
NAME (OR NAME OF BUSINESS)
PERMISSIBLE ACTUAL l 1
,L� • LOT COVERAGE LOT COVERAGE
PERMISSIBLE HEIGHT PROPOSED HEIGHT
Cl ACTUAL LOT AREA TOTAL BLDG. AREA - '
'1�- P ONE NUMBB.A
REQUIRED YAItllS PROPOSED YARDS i
NAME FRONT AIDE: RF'Alt FRONT B(UI: REAR
ADOREtl5
LEGAL LOT VARIANCE OR CONDITIONAL USE
F+ EI YES � NO PE}iMIT NUMBER
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CITY -
REMARKS
TELEPHONE NUMBER
CHECKED BY
METER SIZE I SERVICE SIZE I CLEARANCE I
CHECKED BY
REMARKS
NAME
VERIFIED BY
PE TE
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ADDRESS
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❑ LINE
❑ No
SCHECKED ❑BY
CITY
TELEPHONE NUMBER
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NEW
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BTAE LICENSH NUMBER
CITY LICENSE NUMBER
THIS SITE IS LOCATED IN THE CITY
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Legal Description of Property (Show Below or Attach Four Copies)
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slax
SHOULD BE CODED 31.04.
ADD RETAINING
DEMOLIAH WALL
REMARKS
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ALTER ❑ ORCFILL AVATE ❑ FENCE
_........ Ft.)
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W
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PLANNING DEPT. APPROVAL DATE:
STREET H/W
EXISTING STREET R/W ....... .... FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
I
CHECKED BY
METER SIZE I SERVICE SIZE I CLEARANCE I
CHECKED BY
REMARKS
TYPE CONNECTION
VERIFIED BY
PE TE
A
P
OCCUPANCY GROUP
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�
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
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xO
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SPECIgL INSPECTOR REQUIRED
OCCUPANCY GROUP
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❑ LINE
❑ No
SCHECKED ❑BY
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f
NEW
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i
THIS SITE IS LOCATED IN THE CITY
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NON-RESIDENTIAL
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
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YES Ej NO
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SPECIgL INSPECTOR REQUIRED
OCCUPANCY GROUP
RESIDENTIAL
❑ LINE
❑ No
SCHECKED ❑BY
I
NEW
PLAN
THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
OF EDMONDS. LOCAL SALES TAX
slax
SHOULD BE CODED 31.04.
ADD RETAINING
DEMOLIAH WALL
REMARKS
I
ALTER ❑ ORCFILL AVATE ❑ FENCE
_........ Ft.)
ElREPAIR 0 IRE -MOVE ❑ SWIi
POONUMBER
OF STORIES NUMBER OF
DWELLING
I
UNITS
NA OF WORK TO BE DONE' -
Valuation
Fee
Receipt No.
/ /
/Ju
Plan Check Nn.....................
BUILDING
PLUMBING
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7'o
PLOT PLAN (Indicate Building setbacks, abutting street.)
HEAT k GAA LINE
b
O
FENCE
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1
SIGN
RETAINING WALL
N
_
SWIMMING POOL
DEMOLITION
-
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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/
TOTAL AMOUNT DUE
0
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I hereby acknowledge that I have read this application; that the In.
'�-'
-�
formation given 1. correct; and that I = the owner, or the duly anthar-
Ized agent of the owner. I agree to compiY with elty and elate inwe rogu-
ATTENTION
APPLICATION APPROVAL
letmg construction; and In doing the work authorized thereby, no person
will be employed In Wolatlon of the L.bor Cods o! the Slate o[ Wmblagton
THIS PERMIT
This application is not a permit until
relntlbg to Workmen'. Compensation Insurance.
AUTHORIZER
Signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORN THE
Uty; and fees are paid, and receipt is ac -
.hall be completed In ninety days; MOVED -IN BUILDINGS .hall be coin-
knowledged in space provided.
'
Dleted In six months.)
SIGNATURE (OWNER OR AGENT)DATE
SIGNED
INSPECTION
DIREC OR'S SIGNATU
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DEPARTMENT
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CITY OF
EDbIOND$
DA.TW
NOTE: Applicant Subject to Plan Check FeePB
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6-1107t
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This Permit coven work to be done on private property ONLY.
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Any construction on the public domain (curbs, sidewalks, driveways,
INSPECTOR
marouees, etc.) wIll rcaWre separate permlulon.
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'. RECORD-OF INSREC,
Dat;' P�s.ea
Foundation —_
PIUMbing (Pnrt?ai)
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Furnace & Fuel Lines
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