740611.pdfPERMIT
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DEPARTMENT APPRIant Fill ZO ZONE NUMBER 74061 1
PPLICATION Meld. Heavy Lino. ,OB
ADDRESS / � r•� /' /%� OF BUSINESS)ACT AL JA QW -3 LOT COVERAGE LOT COVERAGESSHEIGHT PROPOSED HEIGHT -4,. ACTUAL LOT AREA TOTAL BLDG. AREA
NAME
FRONT BIDE REAR FRONT SIDE REAR
Valuation
ADDRESS
LEGAL LOT VARIANCE OR CONDITIONAL USE
YES (] NO PERAfIT NUMBER
FWJ+
I C] YES 13 NO
PLANNING DEPT. APPROVAL DATE:
CITY 11
TELEPHONE NUMBER
STREET A/W
I t
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
NAME
SPECIAL INSPECTORREQUIRED
REMARKB
al ADDRESS
[OFr
RE.IDENTIAL
CHECKED BY
(IG
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CITY
TELEPHONE NUMBER
YO
I
tO
W PROPOSED USE
METER SIZE I SERVICE SIZE
I CLEARANCE
I CHECKED BY
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PERC. TEST PERMIT NUMBER C.
7 r
W REMARKS m
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FIRE ZONE I TYPE OF CONSTRUCTION I STREET IMPROVED
Valuation
Fee Receipt No.
I, I
I C] YES 13 NO
Plan Check N o .....................
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Z
SPECIAL INSPECTORREQUIRED
OCCUPANCY GROUP
NEN
RE.IDENTIAL
GAS
LINE
❑PLAN gCHECKEIa
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YO
THIS SITE IS LOCATED IN THE CITY
tO
W PROPOSED USE
NON-REBIDENTiAL
I
J
SIGN
�q
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
❑
ADD
ALTER
DE
EXCAVA
ElEl
RETAINING
WAIT'
FENCE
REMARKS
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAB LINE
❑ OR FILL :..........Ft.)
❑
REPAIR
F]PIPRE-MOVEElPOOL
if
O
FENCE
fUA[OER 04' BTORIE9
9ION
i'.
OF
I
RETAINING WALL
UN TBER
SWIMMING POOL
I'
Valuation
Fee Receipt No.
I, I
Plan Check N o .....................
I t
Z
1
i
BUILDING
tO
W PROPOSED USE
I
J
�q
PLUMBING
l;
U
!
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAB LINE
O
O
FENCE
�I
9ION
i'.
RETAINING WALL
SWIMMING POOL
I'
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknoWedge that I have read this appllcatlen; that the In-
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formation given Is correct; and that I am the owner, or the duty Author-
-
lied agent of the owner. I agree to comply with city and elate laws regu.
ATTENTION
APPLICATION APPROVAL
lating c...tructlon; and In doing the work authorised thereby, no person
will be employed In violation of the Labor Code of the State of Washington
T11118 PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOT Permit Limit One Year xcept DEMOLITION8 which
ONLY THE
uty; and fees are paid, and receipt Is ac-
.hall mpleled In ninety days; MOV IN BUILDINGS shall be com-
WORK NOTED
dged in Spac pTGVlded.
Pitt 1 six months.)
All E T DATE ONE
INSPECTION
1 TOR'6 8! AT E
�1111111WNEII
r
/
DEPARTMENT
CITY OF
EDMONDS
DATE
NOTE: A plicdf)t SffGjeet to Plan CGrck' ee
%iri-25ZrJ
Tills Permit c erswork to be done on private
pMk.ad ONLY.
Any ronrlructl ton the public dmm�ln (curb.. Mdewnike, drh'eresys,
. nlui rlr.r .r 111 r.luln' erinmtr I.rrn.lenlon,
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RECORD OF INSPECTIONS i
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Date Passed
Foundation
�.
Plumbing (Partial)
`
(Rough)
`. .
Frame
i. .
Furnace & Fuel Lines-
ines
Final
Final
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