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Plan Check No._ .................
BUILDING
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4 PROPOSED USE
PLUMBING
BUILDING DEPARTMENT APPlleallt Fill
USE
NEUMB Tx 740468
PLAN (Indlcnto Building eetbncka, abutting streets)
HEAT k GAS LINE
PERMIT APPLICATION Inside Heavy Lines
JOB
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ADDRItEHB
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SIGN
NAME (OR NAME OF BUSINESS)
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WALL
N
PEMItlSIULL•' ACb
T AL
SWIMMING POOL
m
MAILING ADDRESS
LOT COVERAGE LOT COVERAGE
PERMISSIBLE. HEIGHT PROPOSED HEIGHT
Oc
PRE -MOVE INSPECTION
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EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the In-
TOTAL AMOUNT DUE
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CITY
TELEPHONE NUMUES
ACTUAL LOT AREA TOTAL BLDG. AREA
Izedatinagent of the owner. I agree to comply with city and elate laws regu-
lg construction;
ATTENTION
APPLICATION APPROVAL
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and 1. doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Wuhlogton
REQUIRED YARDS PROPOSED YARDS
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AUTHORIZES
signed by the BuildingOfficial Or his De
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NAME
FRONT HIDE REAR FRONT SIDE REAR
ONLY TIIE
WORK NOTED
ilty; and fees are paid, and receipt is ac-
WADDRESS
knowledged in space provided.
4"'pleted In six months.)
LEGAL LOT VARIANCE Olt CONDITIONAL USE
INSPECTION
DEPARTMENT
DIRECT 'e S10NA RID , �`/•!"—^•
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0 YES I]NO PERMIT NUMBER
CITY OF
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PLANNING DEPT. APPROVAL DATE:
EDMONDS
DATE
CITY
TELEPHONE NUMBE)l.
775.2525
1
This !'rani! ,, i -es work to Un done on prlv¢te VrolKrty UNLI'.
STREETR/tV
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
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Any eons! roctlan on the public dom¢In (curb., sidewalks, driveways,
NAME
mw•Queesmr.) 11111 require .epar.te permleslaa,
FILE
COMP. PLAN BT. R/W ............FT. ............FT.
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REMARKS
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ADDRESS
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BY
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CITY
TELEPHONE NUMBER
(CHECKED
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METER SIZE
SERVICE SIZE
CLEARANCE
CHECKED BY
STATE LICENSE NUMBER
CITY LICENSE NUMBER
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Legal Description of Property (Show Below or Attach Four Capt..)
REMARHS
TYPE CONNECTION VERIFIED BY
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PERC. TEST I PERMIT IIUIIIIER
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REMARKS
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
I YES 0 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
RESIDENTIAL GAS
NEWLEI LINE
❑ YES NO
PLAN CHECKED IIY THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL SIGN
OF EDMON DS. LOCAL SALES TAX
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El ADD RETAIMNC
REMARKS SHOULD BE CODED 31.04.
ElDEMOLISH WALL
ALTER rI/tQ
E]ORCFILLTE w `rjc.FENC2.....Ft.)
-
REPAIR ❑ INSP. ❑ POOL
NUMBER OF STORIES NUMIIER OF
DWELLING
UNITS
NATURE OF WORK O HE DONE
Valuation
Fee I Rcn
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Plan Check No._ .................
BUILDING
(r
4 PROPOSED USE
PLUMBING
aPLOT
PLAN (Indlcnto Building eetbncka, abutting streets)
HEAT k GAS LINE
E
FENCE
1`llQ Off` ^ O O
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
t
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the In-
TOTAL AMOUNT DUE
^�' Q ? S3
..[ .] J
O
formnllon given Is correct; and that I am the owner, or the duly author.
Izedatinagent of the owner. I agree to comply with city and elate laws regu-
lg construction;
ATTENTION
APPLICATION APPROVAL
and 1. doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Wuhlogton
THIB PERMIT
This application is not a permit until
relatingto Workmen's Compensation Insurance.
AUTHORIZES
signed by the BuildingOfficial Or his De
p -
'
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIIE
WORK NOTED
ilty; and fees are paid, and receipt is ac-
shallbe completed In ninety days; MOVED -IN BUILDINGS shall be wm•
knowledged in space provided.
4"'pleted In six months.)
SIONATUHIs (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
DIRECT 'e S10NA RID , �`/•!"—^•
/a
CITY OF
NOTE: Ahhlicant Subject to Plan Cbeek Fre
EDMONDS
DATE
---
775.2525
1
This !'rani! ,, i -es work to Un done on prlv¢te VrolKrty UNLI'.
Any eons! roctlan on the public dom¢In (curb., sidewalks, driveways,
mw•Queesmr.) 11111 require .epar.te permleslaa,
FILE