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740464
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BUILDING DEPARTMENT Applicant Fill
ETR
I InsldB Heavy Lines
PERMIT APPLICATION
DREBB
AD o D 6 - -76
NAME
(OR NAME OF BUSINESS)
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PP:RMItltlIBLE ACTUAL
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LOT COVERAGE LOT COVESRAOE
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MAILING ADDRESS
PERMISSIBLE HEIGHT PROPOSED HEIGHT S
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3
10` �i-�
es
ACTUAL LOT AREA TOTAL. HLUO. AREA
ClZO4O
TEQL PIIONr3 NU DER
REQUIRED YARDS PROPOSED YA7iD8
REAR
NAME IIIJJJ��� J
F -BUNT 8[UE REAR FRONT BLUE
LEGAL. LOT VAIL ANCE Olt CONDITIONAL USE
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ADDRESS
0 YEW (3 NO PERMIT NUMBER
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PLANNING DEPT. APPROVAL DATE:
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CITY
T LEPHONb NUMDEIt
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BTIS
EXISTING eTREF.T R/ W ............FT. DEFICIENCY THIS PROPERTY
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NAME `
COhfP. PLAN 8T. R/W ............1. ............FT.
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C?iC�n Vnxk�nckREMARKS
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ADDRESS
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(CHECKED BY
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C1TELEPHONE NUMDER
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METER SI
SERVICE e11E
CLEARANCE
CHECHED SY
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STATE LICENSE UAL EfIL_
C3TY LICENSE NUMBER
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Legal Description or Properly (Show Below or Attach Four Copies)
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TYPE CONNECTION V RIFLED HY
PERC. TEST PERMIT NUMBER
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REMARKS
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JFIRE
ZONETYPE OF CONSTRUCTION STREET IMPROVED
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YES [I NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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EJ❑GAS
RESIDENTIAL
LINE
❑YEB ❑ NO I
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HED BY
PLAN CHECTHIS SITE IS LOCATED IN THE CITY
NEW
NON-RESIDENTIAL
❑ SIGN
OF EDMONDS. LOCAL SALES TAX
31 04
SHOULD BE CODED
ADD WAIS KING
❑
REMARKS
DEMOLISH
FENCE
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�/C L.SJ IJ/C/L /Ci' `�4. /�"�tY
❑ ALTER OR FILL EXCAVATE (.......... x..........Ft.)
REPAIR E] SWI
NP.PRE-❑ POOL(
NUMBER OF STORIES NUMBER Oil
DWELLING
I
UNITS
it
NATUR,,Ett OF 1 OA-•$�—TO BE DONE
Valuation
Fee
Reeelpl No.
5 �\ 1XCQS
1rU\
Plan Check No .....................
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IIUILDING
,
LO
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PROPOSED USE
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PLUMBING
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PLOT PLAN (Indicate Bulidlng setback., abutting streets)
HEAT & GAS LINE
FENCE
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SIGN
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1
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
�0
3o
TOTAL AMOUNT DOE
3S
I hereby acknawledgo that I have read this applieatlon; that the In-
J
formation given Is correct; and that I are the owner, or the duly aulhor-
tred agent of the owner. I agree to comply with city and stale laws regu-
ATTENTION
APPLICATION APPROVAL
lating eonetruethm; and In doing the work authorized thereby, no person
Will he employed In violation of the Labor Code of the Slate of Washington
THIS PER511T
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit limit One Year (Except DE1loLITIONS which
ONLY TILE
WORK NOTED
uty; and fees are plod, and receipt Is no -
she] completed In ninety days; MOVED -IN BUILDINGS shall be corn-
knowledged in space provided.
Noted In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
SLOF ATURPI
I
-'
l O-
rDAT!E
CITY OF
EDIILOND$
E: Applicant Subject to Plan Check Fee
___ _
775-2525
This Permit coven work to be done on private property ONLY.
Any eonatruetlon on the public domnln (eurbe, eldewalke, driveways.
FILE/
amrq: re.. et a.) will reaulre neparole permleelon.
Title Permll enure work to be done an private properly ONLY.
Any construction on the public domain (curb., Sidewalks, driveway.,
marquee., ale.) will require separate permission.
BUILDING DEPARTMENT Applicant Fill
ZONE NUMBER
I
Heavy Linos
PERMIT APPLICATION Inside
on
NAME (OR NAME OF BUSINESS)
•'1
SIBLEE
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y,
LOTCOVERAOLACTTUAL
COVESYAOE
!,
9AII.INOADDAE88
PERMISSIBLE HEIGHT PROPOSED HEIGHT
O
CITY
T LEYHONE NUMB&R
ACTUAL LOT AREA TOTAL BLDG. AREA
1
' ..'\ \
REQUIRED YARDS PROPOSED YARDS P,
FRONT SIDE REAR FRONT BIDE REAR
NAME
1I
USE
r
LEGAL LOT VARIANCE OR CONDITIONAL
NUMBER
N
ADDRESS ``
❑ YES0 NO PERMIT
PLANNING DEPT. APPROVAL DATE!
111
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CITY
T PHONL NUMHbii
t j,1;
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STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY TR28 PROPERTY
V
NAMHI
COMP. PLAN ST. R/W Fr. ............FT.
W _
-!- y.-1.1 Imo., l .
REMARKS
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ADDRESS
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CHECKED BY
CITY
TELEPHONE NUMBER
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METER SIZE SERVICE SIZE CLEARANCE
CHECKED BY
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STATE LICENSE NUD HEIt
CITY LICENeh NUMBER
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r
Jl/f
I
Legal Descrlptlon oV Property (show Beluw or Attach Faur Copies)
7 7 "17
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TY E CONNEC ON VERIFIED BY
Fi
PE—TE6�'� f:rr� ./ . I PERMIT NUMBER
REMARKS
W
j`FIRE
ZONE TYPE OF CONST Q7'IIH+j 1M1SPROVED
\t
I
I
Y 0 NO
I
_
SPECIAL INSPECTOR REQUIRED
OCCUPA
RESIDENTIAL
GAS
❑ LINE
[3YES O NO
NEW
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
El NON-RESIDENTIAL
SIGN
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
ADD
RETAINING
REMARKS
❑ DEMOLISH ❑
EXCAVATE FENCE
�" %-. ) ri%' -_ / ..' :' �- /.: 1,� f� •
i
ALTER ❑
OR FILL (......._z.......... Ft.)
❑REPAIR Ei PRE-MOVE SWIM
INSP. � POOL
f --.
NUMBER OF STORIES NUMBER OF
DNELLINo
UNITS
NATURE OF WORK TO HE DONE
Valuation
Fee
Receipt No.
•
flan Cheek Nn.....................
BUILDING
['xj
4
PROPOSED USE
PLUMBING
li U:J
V
PLOT PLAN (Indicate Building setbacks, abutting strente)
HEAT & GAS LINE
7
li
FENCE
I
SIGN
RETAINING WALL
,
N
ISWIMMING
POOL
DEMOLITION
!
I
PRE-MOVE INSPECTION
EXCAVATION OR FILL
I
I
TOTAL AMOUNT DUE
? --
at I have read this application; at the In-
I bereby acknowledge Npl
formation given IS correct; and that I ar, the owner, or the duly author-
Ized agent oI the owner. I agree to comply with city and state laws regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
will be employed In vlolillbm of the Labor Code of the Stale of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Imuran".
AUTHORIZES
signed by the Building Official Or his Dep-
'
NOTE: Permit Limit One Year (Elccept 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 cam-
knowledged in space provided.
pleted In SIX months.)
SIGNATURE (OWNER Olt AGENT) DATE
INSPECTION
DIREOTOR'S SIGNATUR !•
DEPARTMENT
(E(
)SIGNEDL•'
•
CITY OF
EDMONDS
DATE 1.
i
NOTE: Applicant Subject to Plan Check Fee
775.2525
Title Permll enure work to be done an private properly ONLY.
Any construction on the public domain (curb., Sidewalks, driveway.,
marquee., ale.) will require separate permission.
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