740506.pdfI
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USE PERMIT
NUstHER
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BUILDING DEPART MENTZo11E
Appllcanc Flu
PERMIT APPLICATION Inside heavy Linos
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ADDRfiAS
NAME (OR NAME OF BUSINESS)/
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COVERAGEJ ,�`r /ACq• CAOLVESYAOE L
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LOT
I IIOI OBELI HEIGHT 1 .1
PEItD1ItleIDLE HEIOtIT/ ( !
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MAILING A DREGS
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C I_ TELEPHONE NUMHKR
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ACTUAL LOT A 7 TOTAL BLD�Gt. ARCA��
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—�FgUIIlED YARDS PR—U... YARUtl
FRONT HIDE REAR FRONT tlIDE REAR
NAME
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L(:GAL LOT VARIANCE OR CONDITIONAL
W ADD) ESS
® YES NO PERMIT NUMBER
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Pi.AN INO j9PT. YROV I(� / DA 1
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CITY
TELEPHONE NUMBER
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STRE'TR/{V f••,,rr��
EXISTING STREET R/tP�l-� .G1F'T• DEFICIENCY(�THIS PROPERTY
NAMEA
COMP. PLAN ST. A/ � ..... •"^"""'FT' a
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REMARKS
C AbDRESH
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OR CKEDBY
UC CITY
TELEPHONE NUMBER
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METER SIZE SERVICE SIZE CLEARANCE
CH C BY
O STATE LICENBD NUMBER
CLTY LICENBE NUMBER
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REMARKS
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Legal Deserlptlon of Property (Show Below
Or Attach our gplee
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TYPE CONNECTION VE IED BY
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PERC. TEST PEITJIT NUMBER
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WREMARKS
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FIRE ZONE OFCQNSTRUCTAOR STREET IMPROVED
(TYPE
•.� I O YES ❑ NO
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SPECIAL INSPECTOR REOUIREU OCC CY GROUP
GAB
❑ YES
NEW
RESIDENTIAL
FJ LINE
PLAN CHECHED RV THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
NON-RESIDENTIAL
Els1oN
N'1' SHOULD BE CODED 3104.
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ADD RETAINING
DEMOLISH WALL
REMARKS
�y�cj�pr
c
EXCAVATE FENCE
ALTER OA FILL (..........Z..........Fl.)
lJ(,
I
REPAIR ❑ PRE-MOVE ❑ swlnf
INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
�J UNITS
NATUREF WORK TO H DO E
Vnlunllon Fec Rroolpt No.
II
I'lon Cheek No.....................
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BUILDING
F�
C, PROPOSED USE
PLUMBING
ya
38
LINE b0 —
a PLOT PLAN (Intllcnm Bulldln6 eetbnCka, abultin6 etrcete)
HEAT & GAS �
h
8
PENCE
SIGN
tRETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
I
i,
TOTAL AMOUNT DUE
I hereby acknowledge that I have road this nppllcallon; that Lha
In' f1V
lormatlpn given Is correct; and that I aM the Owner, or the duly author.
Ized agent at the owner. I agree to COMPLY with City and elite laws regu-
ATTENTION APPLICATION APPROVAL
Iating cenetruetlon; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of W-hl.gton THIS 1'ER511T This application is not a permit until
,.
relauog to workmen`s Compeneauon Imurenee.
AUTHORIZES signed by the Building Official Or his Dep-
i
NOTE: Permit mif One Year (E.C.Pt DEMOLITIONS which
ONLY TIRE uty; and fees are paid, and receipt is Be
WOUR NOTED
yi
a pl ed In pety day.; MOVED-IN BUILDINGS shall be core• nowledged in space provided.
.hall be ]l
K
pitted 1 e t Ont
INSPECTION DIRECTOR' IGNATU
`I
SIGN U ( N R OR AGENT) DATE ON
DEPARTMENT
CITY OF
DATE
EDNIONDS
T Appli"nt Subject to Plan 7177Fce
775-2525
This 1`erntit fey work to be done on private property ONLY.
Any consirucllun On Ilio publlo domain (curbs,eldewalks, driveways. FILE
marquees, ele.) will require separate permleelon.
I
BUILDING DEPARTMENT Applicant FLUIT
ZONE 7< PERMNUMBER ( I
PERMIT APPLICATION Inside llenvy Lines
NAME 1011 NAME OF HUSINESS)
MA— ILIN iTD nE 8 . .
h l
CITY TE EPHONE NUMBER
NAME l
W
ADOKJ 8
O
ADDRESS
C
PERMISSIBLE^
ACTUAL /
L OT COVERAGES %
LOT COVERAGE
PERMISSIBLE HEIGHT,
PROPOSED HEIGHT ,
ACTUAL LOT AREA
TOTAL BLDG. AREA.
ii 11tED YARDS
P OPOSED YARDd
FRONT HIDE REAR
FRONT SIDE REAR
u, �
L .GAll LOT VAIs ANC,
OR CONDITIONAL USE
YES 0 NO PERMIT NUMBER
H
LANNINGDEPT. �1PPRIVQL, ,DATE!
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CITY
TELEPHONE NUMBER
/ 1 �-1 1 l)
STREET R/N .. I
EXISTING STREET f;l.:IV. DEFICIENCY THIS PROPERTY
a I
NAME
r d /
•_. �• •.
COMP. PLAN ST. R/EV'::...:.:.VT- .,....:.._FT.
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'REMARKS
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ADD SEtl
,
h
U�CHECKED
AY
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CITY
TELEPHONE NUMBER
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ilk;fWl%t=.l'.:,tlfli`.1>.IiGIP.t/"`
METER SIZE SERVICE SIZE CLEARANCE
CHECKED BY
STATE LICENSE NUb1HEIt
CITY LICENSE NUMHER
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F
I
REMARKS'•... i
'
,
Legal Description of Property (Show Below or Atlaeh Four Ooplee)
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TYPB CONNECTION VERIFIED BY
• c iC.' PERMIT NUM ER
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REMAR Li
V
se
O
''•lj
FIRE TYPE OF)CON8TRUCT;O T MPROVED
(ZONE_ I
j NO
_YF
SPECIAL INSPECTOR REQUIRED OCCURANCY GROUPEl
CA8
O RESIDENTIAL LINE
NEw
'❑
1 {
❑ YES _`Ej NO i ��� •,J-..- I
PLAN CHECKED B THIS SITE IS LOCATED IN THE CITY
LOCAL SALES TAX
NON-RESIDENTIAL SIGN
OF EDMONDS.
i'•" L'
ADD RETAINING
SHOULD BE CODED 31.04.
REMARKS
DEMOLISH WALL
❑❑
,�•
-•
1 \l`;
EXCAVATE FENCE
-'f" f i..i �-�•
(-'��. \ _ CJL-l.
1-�!t.�:-.- i f -s _.•
ALTER
OR FILL (.........x_........Fl.)
I !
REPAIR
INBPMOVE POOL
❑ El
NUMBER OF STORIES NUbIDER OF
DWELLING
I
4
.7 UNITS°
NATURE OF- VORK TO BE 1) E
Valuation
Fee Receipt No.
I
_ ......... - ' - - " ...
Pion Check No .....................
BUILDING
wy/�y/ t3 ��
� i7f-!'t•1��
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4
'%y
PROPOSED USE
PLUMHIN6
i,?�-C
-
OPLOT
PLAN (Indicate Building ectbnckan`bu`tling dreaus)
HEAT & GAS LINE
/
PENCE
1
I
SIGN
tRETAINING
WALL
IN
SWIMMING POOL
DEMOLITION
I
-
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I
TOTAL A31OUNT DUE
I hereby acknowledge that I have rend this application; that the In.
formation given la correct; and that I nm the owner, or the duly author-
lzed agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
APPLICATION APPROVAL
lather 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 Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
utyi and fees are paid, and receipt Is ae-
ahall bo completed In nlnsty days; MOVED -1N BUILDINGS shall be coca-
knowledged in space provided.
plated In six month,.)
1t
d1GNATUE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIRECTOR'S SIGNATURE
'
DEPARTMENT
"
,-
CITY OF
EDMONDS
DATE !
NOTE: Applicant Subject to Plan Check Fee
775-2$2$
I
Title Ile nit Bovero work to be done on private property t ONLY.
Any the domain (curbs, dul—.7s,
1
construction on public sidewalks,
INSPECTOR
marquees, ale.) will require separate permission.
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