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BUILDING DEPARTMENT AppltcantI'M �S"O
PERMIT APPLICATION I II1BIdB Heavy Lines ,G a C
ADORES
NAME (OR NAME OF BUe1NEe8)
��/ /. PERMISSIBLE ACTUAL % 1
LOT COVERAGES ?C /J LOT COVEItAOE
MAI NNO]A D H -Gei-r J✓ L PROPOS ED HEIGHT
PEItt118SSHLE HEIOIIT rGt
3° rc
ACTUAL LOT AREA TOTAL BLDG. AREA
CIT TELEP,HyONE UMHh.R 1
/ (! PROPOSED YARDS
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REQUIRED YARDS r
FRONT SIDE REAR FRONT BIDE REAR
AME
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GAL LOTUBE 3
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ADDRESS
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TELEPHONE NUMBER
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STREETR/W
EXISTING' STREET R/W ............FT. DEFICIENCY THIS PROPERTY
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NAME
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CITY
TELEPHONE NUMBER
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METER B3LE SERVICE 872E
CLEARANCE
CAECKED HY
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STATE LICENSE NUMBER
I CITY LICENSE NUMBER
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Legal Description of Property (Show Below or Attach Four Copies)
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TYPE CONNECTION
I VERIFIED BY
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PERC. TEST
PERMIT V ...
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REMARKS
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TYPE OF C, NIT 182REE le1PRNO
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SPECIAL INSPECTOR GROUP
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ED Y IN THE CITY
RESIDENTIAL
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LINE
NEW
PLAN CHEC THIS SITE IS LOCATED
LSALES TAX
NON-RESIDENTIAL
11 SIGN
OF EDMODS.
CODED 3OCAL
SHOULD BE 1.04.
ADD DEMOLISHE]WATI.AilKING
RK9
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ALTER ❑ ORCAVATPILLE ❑ (ENC x... Ft.)
REPAIR ❑ PRE -IN PMOVE EDSWIM
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r
NUMBER OF STORIES NUMBER OF
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DWELLING
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UNITS
NATURE OF WORK TO BE DONE
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VAlunllan
Fee Rceclpt No.
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BUILDING
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PR/ OSED UBE C
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PLUMBING
PLOT PLAN (Indicalo Building setbaeka, abutting streets)
HEAT @ GAS LINE
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FENCE
SIGN
RETAINING WALL
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SWIMMING POOL
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DEMOLITION
r
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this apPllcatlPn; that the fn-
formation glvcn Is eerreet; and that I — the owner, or the duly author -
Ind ascot of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
'
lath. construction; and In doing the work authorized thereby, no person
Will be employed In vlolntlon 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
{PORK NOTED
uty; and fees are paid, find receipt is ac -
.hall be completed fn ntaety days; MOVED -IN BUILDINGS shall be Co.-
knowledged in space provided.
pleled In nix months.)
S1GNA'rUR6 ( WNER OR AGENT) ,.
DATE SIGNED
INSPECTION
3 O SIGN TU
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av ! ~
DEPARTMENT
f
CITY OF
- ----
EDBIONDS
DA a
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NOTE: Applicant Subject to Plan Check Fees
-
775 -2525
This Permit r ..,it lu be done on prirmle ProPerty ONLY.
Any eouelruellan on the public domain (curbs, sidewalks, driveways,
FILEmarquees,
etc.) will require separate permission.
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USE( PERMIT '7,4 ') '
BUILDING DEPARTMENT Applicant Fin E°"E >—� ND"BE"
t PERMIT APPLICATION I Inside Heavy Lines
NAME (OR NAME OF BUSINESS)
MAI NO AD HEEBB
CITY
, TELEPHONE NUMBER
NAME
14 ADDRESS
ADDRESS II , —
(.
�/WW` . (/V
A"
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P...AHBBIHLE
ACTUAL
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
LOT COVERAGES :,I
LOT COVERAGE
❑
J J A)
m
\
C�
F
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
��,•�. �i
7�
I SERVICE SIZE
STATE LICENSE NUMBER
ACTUAL LOT AREA
TOTAL BLDG. AREA
NUTfDER OF STORIES
REQUIRED YARDS
PROPOSED YARDS
FRONT HIDE HEAR
FRONT SIDE
REAR
DWELLING
TYPE CONNECTION
VERIFIED BY
LEGA' LOT VARIANCE OR CONDITIONAL USE
17.1 YES II NO PERMIT NUMBER
O �
4 F
)
PLAN TDATE:(
„n.
CITY
TELEPHONE NUMBER
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAME
REMARKS
❑
ADDRESS
m
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C�
F
CITY
TELEPHO E NUMBER
��,•�. �i
METER SIZE
I SERVICE SIZE
STATE LICENSE NUMBER
CITY LSCENeE NUMBER
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
NUTfDER OF STORIES
NUMBER OF
Legal UeserlPllon of Properly (Show Below or A[tech Four Copies)
REMARKS
J
O YES UNo
I
DWELLING
TYPE CONNECTION
VERIFIED BY
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O �
E 1 ES'll /
P RMIT.SI BE_R
V
PLAN TDATE:(
„n.
STREET R/W
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
❑
ENC
I % V 0-yiE ` []NO
CHECKED BY
/VA
��,•�. �i
METER SIZE
I SERVICE SIZE
CLEARANCE
QHECK Dt
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
NUTfDER OF STORIES
NUMBER OF
I Y
REMARKS
J
O YES UNo
I
DWELLING
TYPE CONNECTION
VERIFIED BY
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�J o� /(%iJ
E 1 ES'll /
P RMIT.SI BE_R
NATURE OF NORK TO BE DON£
NON-RESIDENTIALs1aN
-' OF EDMONDS. LOCAL SALES TAX
!� �-„-�"
SIGN
❑
;d
ElDEMOLISH
L]
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
1
❑
ENC
I % V 0-yiE ` []NO
BUILDING
OR FILLS
(...........Ft.)
REPAIR❑
I SPASOVE
❑
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
NUTfDER OF STORIES
NUMBER OF
O
aPLOT
RESIDENTIAL
6Aa
❑ LINE
O YES UNo
I
DWELLING
HEAT & GAS LINE
NEW
�J o� /(%iJ
PLAN CHECKED �Y THIS SITE i5 LOCATED IN THE CITY
n
NATURE OF NORK TO BE DON£
NON-RESIDENTIALs1aN
-' OF EDMONDS. LOCAL SALES TAX
!� �-„-�"
SIGN
❑
1
tRETAINING
�;:;.{., .11:� SHOULD BE CODED 31.04.
ADD
ElDEMOLISH
L]
RETAIWALL KING
ALTER
❑
ENC
O
BUILDING
OR FILLS
(...........Ft.)
REPAIR❑
I SPASOVE
❑
POOL
NUTfDER OF STORIES
NUMBER OF
O
aPLOT
DWELLING
HEAT & GAS LINE
�J o� /(%iJ
UNITS
NATURE OF NORK TO BE DON£
FENCE
r
Valuation Fee Recelpl No.
• , .r .. ,- - 1.� .., Jfr
Plan Check Nn .....................
�
O
BUILDING
PROPOSED UBE
PLUMBING
I
O
aPLOT
PLAN (Indicate Building Setback., abutting streets)
HEAT & GAS LINE
�J o� /(%iJ
SSSS- _-
FENCE
(
SIGN
1
tRETAINING
WALL
_
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
._ QJ ��, 5• C%.. '
I
I heresy acknowledge that I have read this application; that the In.
�•v -- .� J
tormnllon m given le correct; and that I nthe owner, or the duly author-
--
Seed agent of the owner. I agree to comply with city and state law. regu-
ATTENTION
APPLICATION APPROVAL
tall.. conetructlon; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Cade of the State of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen'a Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DE31OLITIONS which
ONLY TILE
WORK NOTED
uty; and fees are paid, and receipt is ac-
.hallbe completed fn bluely days; MOVED -IN BUILDINGS eh¢II be cons-
knowledged In apace provided.
1
pleled 1..1. menthe.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIRFy OR'S BIGNATU E .'
_
DEPARTMENT
_
.. ..- •:J
�`%•
�DA�1:
CITY OF
,-J'., ,.�
Applicant io Plan Check Fee
EDMONDS
%
NOTE: Subject
775-2525
This P<rmlt c rern ,.,it to b. done on private property ONLY.
,
Any cenetructlen on it,. publle domain (curb., e)dewalke, drly .Y.,
morgue., em.) will mq.1m Separate, p"rolumn.
INSPECTOR