740597.pdf`
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In -
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[SCI f •'�
ized agent of the owner. 1 .gree to comply with city and state law. regu-
ATTENTION
laling construction; and In doing the work authorized thereby, no person
B U I L D I N G DEPARTMENT
Applicant Fin
NUMB 740597
islating to Workmen's Compensation Insurance.
FIRE ZONE TYP- FCO`Nep TRU ION STREET IMPROVED
.qF-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIRE
WORK NOTED
ah borompieled in ninety days: MOVED -IN BUILDINGS Shall be com-
plete n six monlltn.)
1v I ry
PERMIT APPLICATION
Inside Heavy Lines
A DDxE88
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SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
NAME (OR NAME OF BUSINESS)
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INE
PLAN CHECKED
THIS SITE IS LOCATED IN THE CITY
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REMARKS
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BUILDING
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TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In -
forma Rod given le correct; and that I am the owner, or the duly author-
[SCI f •'�
ized agent of the owner. 1 .gree to comply with city and state law. regu-
ATTENTION
laling construction; and In doing the work authorized thereby, no person
will be employed In vlolallon of the Labor Code of the Stale of Washington
THIS PERMIT
islating to Workmen's Compensation Insurance.
FIRE ZONE TYP- FCO`Nep TRU ION STREET IMPROVED
.qF-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIRE
WORK NOTED
ah borompieled in ninety days: MOVED -IN BUILDINGS Shall be com-
plete n six monlltn.)
1v I ry
I O YESj. NO
INSPECTION
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
CITY OF
❑By0
NOTE: Applicant Subject to Plays Cheek Pee
GASYES
j�7
❑
RESIDENTIAL
❑
INE
PLAN CHECKED
THIS SITE IS LOCATED IN THE CITY
01 EDMONDS. SALES TAX
Y❑�
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NON-RESIDENTA
ElBION
SHOULDULD BECSO ED 31.04.
ADD
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WALL MNG
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NUMBER 03•' STORIESI DUELER OF
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BUILDING
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PROPOSED USE
PLUMBING��
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HEAT & GAB LINE21
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PLOT PLAN (Indicate
Building
Setbacks, abutting
streets)
PENCE
SIGN
tRETAINING
WALL
N
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DEMOLITION
PRE -MOVE. INSPECTION
EXCAVATION OR FILL
Thll 1'rr It -1— work In Ins done oa private properly ONLY.
Any const ruct len an the ""aIle demaln (curbs, "w"',drirewaya,
mureuee., rlc.) will rraulre eeparele Perlin.....
//79• 'qCl y6 SA
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILE
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In -
forma Rod given le correct; and that I am the owner, or the duly author-
ized agent of the owner. 1 .gree to comply with city and state law. regu-
ATTENTION
laling construction; and In doing the work authorized thereby, no person
will be employed In vlolallon of the Labor Code of the Stale of Washington
THIS PERMIT
islating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIRE
WORK NOTED
ah borompieled in ninety days: MOVED -IN BUILDINGS Shall be com-
plete n six monlltn.)
II TU1tE OWNER OR AO T)
DATE 810NED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plays Cheek Pee
775-2525
Thll 1'rr It -1— work In Ins done oa private properly ONLY.
Any const ruct len an the ""aIle demaln (curbs, "w"',drirewaya,
mureuee., rlc.) will rraulre eeparele Perlin.....
//79• 'qCl y6 SA
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILE
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REMARKS
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ADDRESS
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11.. t� � ' i'•J � YES 13 NO
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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RESIDENTIAL LINE
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PLAN CHECKED Y D
THIS SITE IS LOCATED IN THE CITY
-71� OF EDMONDS. LOCAL SALES TAX
NON-RESIDENTIAL s1GN
❑
S.Y SHOULD BE CODED 31.04.
❑ ADD
REMA 9
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❑ DEMOLISH E]RETAINING
WA
EXCAVATE FELL
NCE
tt r
ALTER
OR FILL ❑ (......... .x ........ .Ft.)
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❑ REPAIR ❑ PRE -MOVE D SWI M
INSP. POOL
/`/ Il t _4,1 ! � f /•�1 r.. / -+t' �' �
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NUMBER OF STORIES NUMBER OF
DWELLING
j UNITS
NATURE OF WORK TO BE DONE
Fee Receipt No.
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-
Plan Check N .....................I�!r
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BUILDING /l
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PROPOSED USE!O
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PLUMBINC j6 _ r ,• ;,?t
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aPLOT
PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAS LINE
I
n
FENCE
SIGN
1
1
RETAINING WALL
y
IN
SWIMMING POOL
DEMOLITION
i
_
PRE -MOVE INSPECTION
EXCAVATION OR FILL
i
TOTAL AMOUNT DUE
I hereby acknowledge that I have rend this application; that the In.
formation given is correct; and that I am. the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and elate law. regu•
ATTENTION
APPLICATION APPROVAL
'
lating construction; and In doing the work authorized thereby, no person
will beemployed in violation of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
retail. to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (EXcept DEMOLITIONS which
ONLY THF,
WORK NOTED
uty; and Pees are paid, and receipt is ac-
ahnll bo compacted In ninety days; blOVED-IN BUILDINGS shall be com.
knowledged in space provided.
pleled In sIX months,)
SIGNATURE (OWNER OR AGENT)DATE
SIGNED
INSPECTION
DIRECTOWS SIGNATURE
'
DEPARTMENT
/
"
,CITY OF
ED51ONDS
nnrE
_
NOTE: Applicant Subject to Flan Check Fee
77S-2S2S
1
'
n work to be done on prate property ONLY.
Till. Permit e iv
Any eonetructlun on the public domoln (curbs, sld,walk,, drlveways'
-
INSPECTOR
marquees, etc.) will require separate permleslon.
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RECORD OF INSPECTIONS
Date Passed
U Foundation
n y� Plumbing (Partial)
(Rough)
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Furnace & Fuel Lines
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