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NATUR�E/ OF WORK TO BE DONE
Valuation
Fee
Receipt No.
114 C ~
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Plan Check Na .....................
ZONE PERMIT
74057
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BUILDING DEPARTMENT
Applicant Fill
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BUILDINGt0
PERMIT APPLICATION
Inside Heavy Lines
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-POSED USE
PLUMBING
ADDRESS `�
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NAME (OR NAME OF BUSINESS)
PERMISSIBLE 7o UAL �r[�
LOT COVERAGE •� r' 1 TCOVEAGE
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p' MAILING ADDRESS
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PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAS LINE
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CITY
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TELEPHONE NUMBER
ACTUAL LOT AREA TOTAL 6LQG. AREA
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REQVIRED YAItDe PROPOSED YARDS
FENCE
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SIGN
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LEGAL LOT VARIANCE OR CONDITIONAL,USE
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DEMOLITION
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY p;
PRE -MOVE INSPECTION
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COMP.. R/W ............FT. ............FT. p'�W
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..TT. 91LE SERVICE SIZE CLEARANCE tMCK�E_ D BY/
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STATE LICENSE NUMBER �• CITY LICENSE NUMBER
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Ized agent of the owner. I agree to comply with city and .late lawn regu•
ATTENTION
APPLICATION APPROVAL
REMARKS {'
lung construction; and In doing the work authorized thereby, no person
Legal D111111ll.n of Property (Show Below or Attach Four Cople&1
25- Y If,i
will be employed In violation of the Labor Code of the State of Washington
THIN PERMIT
This Application is not a permituntll
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TYPE CON ECT10N VERIFIED BY
AUTHORIZES
signed by the Building Official or his Dep-
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NOTE: Permit limit One Year (Except DEMOLITIONS which
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PEItC. 1E.T PERMIT NUzfplt R.
&hall be completed in ninety day.; MOVED -1N BUILDINGS shall be come.
knowledged in space provided.
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910N 7'UItE (OWNER OR AGE DATE S10NE
REMARKS m
3 R•8 i TORE
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DEPARTMENT
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CITY OF
EDMONDS
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TE: AQplica)t Stf ject to Plan Check Fee
FIRE ZONE TYPE OF CONSTRUCT ON STREET IMP1IOVED
775-2525
Thl.Permit an rn work to be done on private properly ONLY.
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Any rnnatrnetten nn tlir nnbllc Amm�in (curb.. nldewniks, driveway.,
FILE
SECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
r,in�'�•r. rl r.� .III rrnalr�• nrpar.lr 1 inlaslnn.
YES �.ertr
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RESIDENTIAL
GAB
Q LINE
EJ NEW
PLAN CHECKE B THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL El BION
,�� OF EDMONDS. LOCAL SALES TAX
0 LD IE CODED 31.04.
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0 RETAINING
R ARKS
DEMOLISHWALL
DALTER
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❑ EXCAVATE E
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REPAIR F]I RE -N OVE
❑ SWINT
POOL
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NUMBER OF STORIES NUMBER OF
DWELLING
UNITS /
NATUR�E/ OF WORK TO BE DONE
Valuation
Fee
Receipt No.
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Plan Check Na .....................
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BUILDINGt0
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PLUMBING
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PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAS LINE
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FENCE
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SIGN
RETAINING WALL
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In.
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formal[.. given la correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and .late lawn regu•
ATTENTION
APPLICATION APPROVAL
lung construction; and In doing the work authorized thereby, no person
'..
will be employed In violation of the Labor Code of the State of Washington
THIN PERMIT
This Application is not a permituntll
�
relating to Workmen'. Compensation Insurance•
AUTHORIZES
signed by the Building Official or his Dep-
[
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
&hall be completed in ninety day.; MOVED -1N BUILDINGS shall be come.
knowledged in space provided.
pleted In six months.)
910N 7'UItE (OWNER OR AGE DATE S10NE
INSPECTION
3 R•8 i TORE
, I
DEPARTMENT
,^ J
CITY OF
EDMONDS
ATE
TE: AQplica)t Stf ject to Plan Check Fee
775-2525
Thl.Permit an rn work to be done on private properly ONLY.
Any rnnatrnetten nn tlir nnbllc Amm�in (curb.. nldewniks, driveway.,
FILE
r,in�'�•r. rl r.� .III rrnalr�• nrpar.lr 1 inlaslnn.
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LEGAI-
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NE
27t'l IZAr-)(=e
,OPV
50 Ll-
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95 kOC ;:-T TO
OZ B r- i N
RECORD OF INSPECTIONS
Date. Passed
Foundation
Plumbing (Partial)
(Rough)
-7
Frame
Furnace & Fuel Lines
Final