740514.pdf•
Plan Check N
BUILDING
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aPROPOSED UBE
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ANN
USE PERMIT 14
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BUILDING DEPARTMENT Applicant Fill
ZONE i S ` NUMBER
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PERMIT APPLICATION Inside Heavy Lines
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ADDRESS
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RETAINING WALL
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NAME (OR NAME OF BU81NE08)
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CITY TELEPHONE NUMBER
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ACTUAL LOT EN TOTAL BL AREA
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REQUIRED YARDS PRO OBED YARDS a
NAME
REAR FRONT
FRONT SIDE SIDE REAR
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I hereby acknowledgethat t haus rend this application; that the In-
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LEGAL LOT VAR ASCE OR CONDITIONAL US£
licit agent of In. owned I agree to comply with city and .late Jews regu•
ADD .Es.
[a YES NO PER?, NUMBER
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PLA G D P'f. �PPRO L / DA E:
CITY TELEPHONE NUMBER
STREET K/W
EXISTING BTREET R//�.....!vF'T. DEFICIENCY THIS PROPERTY
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relating to workmen's Compensation Insurance.
NAME
COMP.PLAN 8T. R/ti ... ..D.....FT. W
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
RIImARKB Driveway slopes not to exceed those
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ADDRESS
indicated on Standard Dwg. No.103 W
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DEPARTMENT
METER SIZE SERVICE SIZE CLEARANCE C
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STATE LICENSE NUMBER CITY LICENSE NUMBER
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EDMONDS
NOTE: Applicant subject to Plan Check Fee
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Legal cscrlption of Property (dhow or Attach Four Coplee)
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Thle 1'rnnit rayrre work In ba done on Drlvote property ONLY.
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REMARKS in
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FIRE ZONE TYPE OF C=SUCTION STREET IMPROVED
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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RESIDENTIAL GAN8
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NEW LIE
PLAN CHEC ED BY THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
OF EDMONDS. LOCAL SALES TAX
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SIGN
SHOULD BE CODED 31.04.
ADD RETAINING
WALL
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DEMOLISH
EXCAVATD FENCE
ALTER ❑
FILL x.
OR (. ..... .......... Ft.)
❑ REPAIR PRE-A'OVE SWIM
INSP. POOL
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NUMBER OF STORIES NUM ER OF
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Plan Check N
BUILDING
aPROPOSED UBE
PLUMBING
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o PLOT PLAN(Indicate Building setbacks, abutting streets)
HEAT & GAS L1NEI—rlv
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ANN
FENCE
SIGN
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RETAINING WALL
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SWIMMING POOL
DFMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledgethat t haus rend this application; that the In-
formation given is correct; and that 1 nun the owner, or the duty author -
licit agent of In. owned I agree to comply with city and .late Jews regu•
ATTENTION
APPLICATION APPROVAL
paling eonetructlon; and In doing the work authorised 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 ac -
shall be completed In sleety day.; MOVED -IN BUILDINGS shall be Som-
knowledged In space provided.
pleted In six months.) '
UItE (OWNER R A T) D T - SiGNED
INSPECTION
C RD E'S SIGNATURE
DEPARTMENT
CITY of
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EDMONDS
DATE
NOTE: Applicant subject to Plan Check Fee
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775-2525
Thle 1'rnnit rayrre work In ba done on Drlvote property ONLY.
Any ran.l nlrtlnn nn the public dbe, eldranlNn, drlvew0.ye'
FILE
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