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BUILDING DEPARTMENT I Applicant FW ZONE NUM ER 740540 !
PERMIT APPLICATION Inside Heavy Lines AD 3 0 0 — `?
ADDRESS
NA E (O NAME OF 8UB1NES8)
(9p,/y(
PERMISSIBLE ACTUAL
/! D '• h � 7QA V.E..S• IAT COVERAGE LOT COVE AGE I
MAILING ADDREtl O
pl PERMISSIBLE HEIGHT PItOPOBED IIEIOHT
O �3 J G� ACfUAL LOT AREAz
TELEPHONE NUMBER TOTAL BLDG. AREA
CITY
�all,
Os✓VS REQUIRED YARDS PROPOSED YARDS N
NAME FRONT BIDE REAR FRONT SIDE REAR
LEGAL, LOT VARIANCE Oil COND3T[ON AL USE
L•'tl
M AUDHB YES
NO PERMIT NUMBER '
.O, PLANNING DEPT. APFROVAL PATE:
C CITY TELEPHONE NUMBER +
< I STREET R/W O
I EXISTING STREET R/W ............FT. DEFICIENCY Tills PROPERTY 'Sea.
NAME
COMP. PLAN ST. R/W ............FI'. ............F7'. W ,
REMAIiICB
y/�t
b: AD
AD RE/CBIS c, .'l r 70M.
G 4 30i' -H Nf GHE BY
TELEPHONE NUMBER
SSIZESERVICE SIZE CLEARANCE R/ECC� 'D BY
STATE LLUEENSE NUTS ER ,q CITY LICENSE NUMBER I
!J' r�JE'•'6/ — 6-V REMARKS
Legal Description of Proporly (snow Below or Attach Four Copies)
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TYPE CONNECT; N VERIFIED BY
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FIRE ZONE I TYPE OFLCSNBTItUCTPN I STYEeT IMPROVED
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SPECIAL INSPECTOR RE UIRED IOCC�CY GROUP
YES
RESIDENTIAL LINE ❑PLAN CHECKE 6Y THIS SITE 15 LOCATED IN THE CITY
NEN OF EDMONDS. LOCAL SALES TAX
NON-RESIDENTIAL SIGN .a LD BE C DED ".04.
ADD ❑ ❑
RETAINING ROMA
DEMOLISH IUCS /j/
ALTER ❑ EXCAVATE FENCE „l G ," L Q�/
OR FILL (.........,x .......... Ft.)
REPAIR PRE -MOVE El swill
INSP. POOL ��ia:-oCj(%(Y'%-%/Nf�✓Z'a��/ff'f��10%✓j
NUMBER OF STORIES I NUMBER OF
DWELLING
UNITS
NATUREW�1OyRK� TO HE N''Eff, '"' (�) Valuation Fee Receipt Na.
/dlAif/3/ -ryl/G CD/ �.�)'„"wt✓( iQ.+ ;'Inn Check Na .....................
to BUILDING L 0�
L PROPOSED USE
PLUMBING
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aPLOT PLAN (Indicate Building setbacks, abutting streets) HEAT A GAS LINE
J
� FENCE
i
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
/
TOTAL A51OUNT DUE
I hereby acknowledge that 1 have read this application; that the In-
formation given le correct; and that I an) the owner, or the duty author.
,redagent of the owner. I agree to comply with city and state laws rego.
ATTENTION
APPLICATION APPROVAL
luting eonelruclion; and In doing the work authorized thereby, an person
will be employed In violation of the Labor Code of the Stale of Wmhlaglon
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Iusurnnce.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (ExeePL DEMOLITIONS which
ONLY Title
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN DUILDINGS shall be com-
knowledged in spaceprovided.
pleled In six months.)
ATURE (OWNS "Oft AGENT)
DATE SIGNED
INSPECTION
I 'S BIG AT
DEPARTMENT
CITY OFZ,f,
,
EDMONDS
AT
NOTE: Applicant subject t0 Flan Check Fee
775-2525
Thls Permit r e work to bo done an Drlvnle property ONLY.
Any <onstrnrlmn on the public domain (enrhe, sidewalks, driveways,
FILE
nuo,q."s, Ste.) will rrauire separate pernlisslon,
i
1
USE PERMIT
BUILDING DEPARTMENT I Applicant FLU
2O NUMBER
,
PERMIT APPLICATION EaetdD Heavy Lilley
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ADDRESS
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NAME (Oft NAME OF BUSINESS)
PERM 108.HLE me ALR'UAL y
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LOT COVERAGE LOT COVERAGE
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MAILING ADDREBB
PERMI8816LE HEIGHT PROPOSED HEIGHT
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CITY
TELEPHONE NUMBER
ACTUAL LOT AREA TOTAL BLDG. AA£A
J. (/
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REQUIRED YARDS PROPOSED YARDSJ
NAME
FRONT SIDE REAR FRONT HIDE REAR
d �
LOT VARIANCE OR CONDITIONAL USE
WLEGAL
ADDRESS
0 VES E, NO PERMIT NUMBER
i
PLANNING DEPT. API•ROVAL DATE:
J
y'
CITY
TELEPHONE NUMBER
R/tV
!
STREET
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
z
i
NAME
COMP.PLAN ST. R/W ............FT. ............FT'.
REMARKS
t COF
ADDRESS
CHECKED BY
CITY
TELEPHONE NUMBER
SERVICE SIZE °LEARAN°E
ffCKED BY
O
STATE NUa[ ER
CITY LICENSE NUMBEit
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I
I
I V """"-`'-
-LICENSE
Vj
REMARKS
Legal Description of P[epurty (Show Below
or Attach Fou[ Copies)
(,66�111/
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TYPE CONNECTl N
VERIFIED 11
O
-
PERMIT NUMBER
PE
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REM S
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FIRE ZONE TYPE OF CONSTRUCTION hjaqtLUIPhOVED
NO
SPECIAL INSPECTOR REQUIRED GROUP
TIALLINE
IOCC�CY
YES Lq
❑PLAN
NEW
LESIDEN
CHECK1 BYOTHIS SITE IS LOCATED IN THE CITY
/ OF EDMONDS. LOCAL SALES TAX
ADD❑RETAINING
N -RESIDENTIAL SIGN
❑
Y'.,'
\ //�t� `!-I SHOULD BE CODED 31.04.
RDLSARKS
DEMOLISH E]WAIT'
Q
❑J
EXCAVATE FENCE
/
i�%//�/'i/✓�i%/./G %-�Oi / �F-�1�,��V �/ / f
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ALTER ❑
OR PILL ❑ C.........:..........Ft.)
1
❑ REPAIRMPOOL
❑ PRE-OVE INSP. El
=-1r�/�-k-�U,G%
':7UMHEI; OF STORIES NUMBER OF
DWELLING
UNITS
I
NATURE }7 WORK TO BE ._D N1c ._
Valuation
Fee Receipt No.
'
Plan Check Na .....................
(J
V
BUILDING
K900
(7
4
PROPOSED USE
a
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
9
O
FENCE
j
SIGN
RETAINING WALL
I
N
SWIMMING POOL
DEhSOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
f -I- . -
I hereby acknowledge that I have read this application; that the In-
formation given Is correct; and that I am the owner, or the duly author -
teed agent of the owner. I agree to comply with city and State Tawe regu-
ATTENTION
APPLICATION APPROVAL
lacing construction; and In doing the work allthorized thereby, no person
Will beemployed In VIOlathm of the Labor Code of the Stale of Washington
TNS PERMIT
This application Is not a permit until
relating to Workmen's Compensation Iusuraace.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITION8 which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
i
shall be completed In ninety days; MOVED -IN BUILDINGS shall be aom-
knowledged in space provided.
PlOtcd In sig months.)
),
SIGNATURE IOtVNEI;OR AGENT) DATE 81ONEll
INSPECTION
DIRECTOR'S SIGNATURE/:
f
I
DEPARTMENT
j .,
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_
( r,-;1,!%,;-r.� / !' /'i
.. L
CITY OF
I 1. %/.u.. A! {-%,'----.._-
_
DATE
EDMONDS
, /I %
j�
I y...---.�._----__ .
NOTE: Applicant Subject to Plan Check Fee
775-2525
This 11ennit carers work to be done on private properly ONLY.
Any construction on the public domain (curb,, sidewalks, driveways,
INSPECTOR
marquees, etc.) will require separate permission.