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ECKED DY IN THE CITY
❑ NEN
u
BUILDING
BUILDING DEPARTMENTzoNE
Applicant Fill
UBE PERMIT
NUMBER
will be employed In violation of the Labor Code of the Slate of Washington
NON-RESIDENTIAL
APPLICATION Inaldo Heavy Lines
SIGN
// OF
�...-�-- SHOULDEDMONDBE CODED 31.04.
ADD
PERMIT
A ✓ t�
ADDRESS / [��
'AIKING
{
NAME (on NAME OF BUSINESS) `
liAUCAL /
PEhl ltle IILE %
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LOT COVERAGE LOT COVERAGE
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at MAILING ADDRESS
PERMIH81BLE HEIGHT PROPOSED HEIGHT
FENCE
I
% '� h
TOTAL BLDG. AREA
z
775-2525
iUMBER OF STORIES NUMBER OF
TELEPHONE NUMBj�R^
ACTUAL LOT AREA
a
mnrpueea, rte.) will require separate permleelen.
CITY
REQUIRED YARDS PROPOSED YARDS
REAR
1
UNITS
FRONT SIDE REAR FRONT BIDE
.remr,— nu Tn nt,. DONF.I
NAME
Valen Hon Fee I Receipt
PRE -MOVE INSPECTION
ARIANCE OR CONDITIONAL
EXCAVATION OR FILL
IUj
NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
CITY
TELEPHONE NUMBER
STREET
EXISTINGG STREET R/W ............FT. DEFICIENCY THIS PROPERTY
O
NAME
COMP. PLAN ST. R/V,' ............Fr. ............FT.
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CHECXED BY
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CITY
NUMHER
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METER 812E SEA CE SIZE CLEARANCE
CHECKED BY
O STATE LICENSE NUa ER
CITY LICENSE NUMBEN
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REMARKS
Legal Description of Property is Below o[ AllnCh Fou[ Copl is)
TYPE C NNECTION
VERIFIED BY1
/O
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PERC. TEST
PERbSIT —NUMBER
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REMARKS
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FIRE ZONE YPE OFNBTRUCTI/pN S�TRE/E�1' IMPROVED
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f a_or_e C-C� 112.4.0
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RESIDENTIAL
❑
GAB
LINE
U �"� � _ I Ci
ECKED DY IN THE CITY
❑ NEN
u
BUILDING
PROPOSED USE
PLTHIS SITE IS LOCATED
S. LOCAL SALES TAX
will be employed In violation of the Labor Code of the Slate of Washington
NON-RESIDENTIAL
❑
SIGN
// OF
�...-�-- SHOULDEDMONDBE CODED 31.04.
ADD
U
'AIKING
1
MARK9
actb¢Cks, nbutlln6 elreete)
❑ DEMOLISH
_j
WALL
ALTEREXCAVATE
E] OR FILL
�
FENCE
(.......... x .......... Ft.)
�j/�!/r>"SJy F����-//(/� / 4F/ //�v ` / /✓
FENCE
EDMOND$
PRE -REPAIR ❑
INSP.
El
POOL
775-2525
iUMBER OF STORIES NUMBER OF
tRETAINING
WALL
mnrpueea, rte.) will require separate permleelen.
DWELLING
I
Z
UNITS
.remr,— nu Tn nt,. DONF.I
Valen Hon Fee I Receipt
f a_or_e C-C� 112.4.0
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1 hereby acknowledge that I have read this application; that the In-
flan Check NI .....................
4
p _
-
Ired agent of the owner. I agree to comply with city and state Tawe regu-
BUILDING
PROPOSED USE
/
will be employed In violation of the Labor Code of the Slate of Washington
Tills PERMIT
relating to Workmen's COMPendatian Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
PLUMBING
U
Pitted In six months.)
PLOT PLAN (Indicate Building
actb¢Cks, nbutlln6 elreete)
DATE SIGNED
HEAT & GAS LINE
DEPARTMENT
�
CITY OF
FENCE
EDMOND$
NOTE: Applicant Subject to Plan Check FIT
SIGN
775-2525
Tills 1'e blit cIven rrork to he done on private property ONLY.
tRETAINING
WALL
mnrpueea, rte.) will require separate permleelen.
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
No.
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.
IR R' SIGN TURL
D TE -----�"
FILE
TOTAL AMOUNT DUE
1 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-
Ired agent of the owner. I agree to comply with city and state Tawe regu-
ATTENTION
lating constructlon; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington
Tills PERMIT
relating to Workmen's COMPendatian Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
WORK NOTED
shall be Completed In ninety day.; MOVED -IN BUILDINGS shall be win.
Pitted In six months.)
I1G T IiE (Ol'NER It AQEC'1'r)
DATE SIGNED
INSPECTION
DEPARTMENT
CITY OF
EDMOND$
NOTE: Applicant Subject to Plan Check FIT
775-2525
Tills 1'e blit cIven rrork to he done on private property ONLY.
Any cunetructlnn onthe public domaln (curbs, sidewalks, d"l—sly.,
mnrpueea, rte.) will require separate permleelen.
No.
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.
IR R' SIGN TURL
D TE -----�"
FILE