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FRONT SIDE REAR FRONT BIDE REARLEGAL
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BUILDING DEPARTMENT
AppLlxint Flll
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PER
740570
--- VARIANCE OR CONDITIONAL USE
LOT❑
PERMIT APPLICATION
IIl81do Heavy Linos
JOB
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ADDRESS -7 ^
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NAM' R NAME OF SUBINEBB)
TELEPHONE NUMBER
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NUMBER OF
PERMISSIBLE ^
LOT COVERAGEa
ACTUAL
LOT CO A.E
NAME
MAI O ADDRESS
COMP. PLAN 8T. R/W ............FT. ..........,.FT. w
PERMIS818LE HEIOIIT
PROPOSED HEIGHT
PLOT PLAN (Intllenle Building setbacks, abutting Streets)
REMARKS
UNITE
ADDRESS
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4 _____ mar.vnranum
NrrMAF.R
ACTUAL LOT AREA
TOTAL .... AREA 7.
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F PERC. TEST PERMIT NUMBER fa
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--- VARIANCE OR CONDITIONAL USE
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NADDRESS
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0 YES NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
aCITY
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TELEPHONE NUMBER
FIRE ZONEI TYPE OF CONSTRUCTION I e❑TYEBT IMP❑ROVOED
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NUMBER OF
STREET R/W G
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAME
DWELLING
COMP. PLAN 8T. R/W ............FT. ..........,.FT. w
a/VV
PLOT PLAN (Intllenle Building setbacks, abutting Streets)
REMARKS
UNITE
ADDRESS
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PENCE
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SIGN
CHECKED BY
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TELEPHONE NUMBER
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SWIMMING POOL
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DEMOLITION,
METER BIZ. SERVICE SIZE CLEARANCE
CHECKED BY
STATE LICENSE NUMBER
CITY LICENSE NUMBEN
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F PERC. TEST PERMIT NUMBER fa
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REMARKS
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REPAIR
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SWIM
FIRE ZONEI TYPE OF CONSTRUCTION I e❑TYEBT IMP❑ROVOED
iUhiBER OF STORIES
NUMBER OF
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NON-RESIDENTIAL
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ORCFILL
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PRE-MOVEO
SWIM
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iUhiBER OF STORIES
NUMBER OF
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DWELLING
PLOT PLAN (Intllenle Building setbacks, abutting Streets)
HEAT A GAB LINE
UNITE
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21
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NO
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
Fence requirements - section 12.14.040
attached.
r •'tet'—
Plan Check No ................. ...
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BUILDING
PROPOSED USE
PLUMBING
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PLOT PLAN (Intllenle Building setbacks, abutting Streets)
HEAT A GAB LINE
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PENCE
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SIGN
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RETAINING WALL
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SWIMMING POOL
DEMOLITION,
PRE -MOVE INSPECTION
-
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
1 hereby acknowledge that I have read this application; that the In.
formation given 1s correct; and that I am the owner, or the duly author-
r
Ized agent of the owner. I agree to comply with city and elate Tawe regu•
ATTENTION
APPLICATION APPROVAL
letfng construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
TIDH PERMIT
This application is not a permit until
'
relating to Workmen'e Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DE51OLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt Is ac -
.hall be completed In ninety days; MOVED -IN BOILDING8 shall 6o nom•
knowledged in space provided.
plated In elz months.)
SIGNATURE (OWNER OR GENT) - DA E 81 ED
INSPECTION
DI OR'8 8 i;7ATU - --' -.-.�
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DEPARTMENT
��
CITY OF
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NOTE: Applicant Subject t Ian Check Fee
EDMONDS
DATE
775-2525
Thle 1'en101, a wd 1, la be don rlvate properly ONLY.
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