740635.pdfBUILDING
DEPARTMENT Applicant FM
ZEE NUMt I> 740635
1
PERMIT APPLICATION Inside Heavy Lines
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DDRESS
ADDRESS A
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NAME (OWN /Ol fF/ BUHNESS)
OPERMISSIBLE
q ALCTTUCAOLVEiAGELOT COVERAGE
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MAILING ADDRESS
PERMISSIBLE HEIGHT PROPOSED HEIGHT
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CITY TELEPHONNUMBER
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ACTUAL LOT AREA TOTAL BLDG. AREA
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REQUIRED YARDSPROPOSED YARDS
FRONT SIDE: REAR FRONT BIDE REAR
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NAME
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ADDRESS
LEGAL LOT VARIANCE OR CONDITIONAL USE
0 YESO NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
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QC
1, _
CITY
TELEPHONE NUMBER
STREET R/W
ISTING DEFICIENCY THIS PROPERTY
NAME
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1 / Y t d- C._S
OMP. PLAN BT. R/W ..........-FT. •
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REMARKS
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A
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I CHECKED BY
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ADDRESS
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(�(/Q C�/ .Q
TELEPHONE NUMBER
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METER BILE SERVICE 812E
CLEARANCE
CHECKED BY
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STAT'''E')) LICENSEE NUMBER!
CITY LICENSE NUMBER
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REMARKS
Legal Description of Property (snow Below or Attach Four Copies)
TYPE CONNECTION
VERIFIED BY
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PERC. TEST
I PERMIT NUMBER
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REMARKS
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES [3 NO
SPECIAL INSPECTOR REQUIRED
GROUP
❑PLAN
IOCCUPANCY
® RESIDENTIAL ❑ LINE
xew
NON-RESIDENTIAL ElSIGN
ADDSHOULD
RETAINING
ElDEMOLESH WAIT'
ALTER EXCAVATE FENCE
OR FILL (.......... x..........Ft.)
CHECKED❑BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
BE CODED 31.04.
REMARKS
REPAIR ❑ INSPEfOVE O FIWIBI
POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NA RflOF WORK TO BE DONE
Valuation
Fee Receipt
No.
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Plan Check No .....................
BUILDING
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0, PROPOSED USE
PLUMBING C Q
30'
O PLOT PLAN (Intllcato Building setback., abutting e[rCela) HEAT d: GAS LINE
O FENCE
SIGN 11
RETAINING WALL f
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUEO
I hereby acknowledge that I have read this application; that the In- t
formation given Is correct; and that I and the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and elate laws raga. ATTENTION APPLICATION APPROVAL
lating construction; and In doing the work autbar:zed thereby, no person
will be employed In violation of the Labor Code of the State of Washington THIS PERMIT This application is not a permit until
relating to Workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep -
ONLY THE
NOTE: Permit Limit One Your (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is Be
shall be completed In ninety days; MOVED -Ili BUILDINGS shall be com. llnowledged in space provided.
pleted In six menthe.)
BIGNATU E (Ory ER ENT) DATE SIGNED INSPECTION Dl OR'8 BFONATUIiE ear
(✓� � DEPARTMENT '� � if _•�j'•i—.. y.
CITY OF /•` �' 'i:i-1 •''i
EDDIONDS DAT
NOTE: Applicant Subject to Plan Clieck Fre
775-2525 I
This 1'ermlt Coven work to be done on private property ONLY.
Any Construction on the public domain (curbs, sidewalks, dAvew".. FILE
rnarquers, CIC.) trilt. require separate pernllsdon.
C7),
USE PERMIT
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ONE NUMBER - •` 7
BUILDING DEPARTMENT App llcant FLU
PERMIT APPLICATION I Insldo Heavy Lines ADDRESS
NAME (OR NAME OF BUSINESS)
PERMISSIBLEACTUAL
LOT COVERAGE' LOT COVIAAGE
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MAILtNO A �DREBBO
PER.111S.18LE HEIGHT PROPOSED HEIGHT
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BLDG. AREA
CITY
TELEPHONE NUMBER ACTUAL LOT AREA TOTAL
REQUIRED YARDS PROPOSED YARD.
FRONT BIDE REAR
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NAME FRONT BIDE REAR
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y
LEGAL LOT VARIANCE OR CONDITIONAL USE
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ADDRESS YES❑ NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
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y
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CITY TELEPHONE NUMBER
STREET U/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
N
NAME
_ _ L / .. COMP. PLAN BT. R/W ............FT. ............FT.
- V _7 S C. { If / (V S REMARKS
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ADDREBB
CHECKED BY
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CITY
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TELEPHONE NUMBER
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I yJ (J t' � A�Q METER elLE SERVICE SIZE CLEARANCE
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CHECKED BY
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STATE LICENSE NUalBER
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CITY LICENSE NUMBER
REMARKS
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EXCAVATION OR FILL
Legal Description of Property (Show Below or Attach Four Copies)
TOTAL AMOUNT DUE
TYPE- N ! VE
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PE Cir/ FI T. E N A E
AW
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REMARK.
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lating construction; and In doing the work authorlred thereby, no person
Y
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x•111 be employed In violation of the Labor Code of the Slate of Washington
FIRE ZONE I TYPE OF CONBTRUCTION STREET IMPROVEDi
YES NO
This application is not a permit until
1
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (E.e.pt DEMOLITIONS which
ONLY TILE
WORK NOTED
RESIDENTIAL INE OLANSCHECKED❑BYO
� THIS SITE IS LOCATED IN THE CITY
NEW
LOCAL SALES TAX
NON-RESIDENTIAL 0 BION OPSHOULD BEDMONDECOS. DED 31.0,.
F -]]ADD ❑ RETAINING REMARKS
DEMOLISH F WALL
shall be completed In ninety days: MOVED -IN BUILDINGS shall be wm-
ALTER ❑
ORFILLEXCAVATE ❑ G.- x .......... Ft.)
pleted In sl. months.)
❑ REPAIR ❑ INSPAIOVE El SWIM
POOL
81GNATURE (OWNER OR AUENT) DATE SIGNED
INSPECTION
DEPARTMENT-
DI4ECTOR'S 191¢NATURE• ',%->-,',-- j '— =•
i��.; q
NUMBER OF STORIES NUMBER OF
DWELLING
I
CITY OF
UNITS
EDIIIOND9
NATI'llWORK TO HE ONE _ - I Valuation ( Fee Reccipl
No.
BUILDING
[[[Oral
PROPOSED USE
PLUMBING
1-/ /-'
Up
W
O PLOT PLAN (Indlente Building eclbneke nbulttn6 .['este)
HEAT @GAS LINE
FENCE
SIGN
)I
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
1—
PRE -MOVE INSPECTION
+
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have rend this application; that the In-
formation given le correct; and that I am the owner, or the duly author.
Ired .gent of the owner. I agree to comply with city and elate I.W. reg".
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorlred thereby, no person
x•111 be employed In violation of the Labor Code of the Slate of Washington
THIS PERMIT
This application is not a permit until
'.lating to Workmen's Compensation Insurance.
AUTIIO1UF8
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (E.e.pt DEMOLITIONS which
ONLY TILE
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days: MOVED -IN BUILDINGS shall be wm-
Imowledged in space provided.
pleted In sl. months.)
81GNATURE (OWNER OR AUENT) DATE SIGNED
INSPECTION
DEPARTMENT-
DI4ECTOR'S 191¢NATURE• ',%->-,',-- j '— =•
i��.; q
CITY OF
'
EDIIIOND9
DATE
NOTE: Applicant Subject to Plan Cbeek Fee
PMt r reM work In I. done on private property ONLY.
775-2525This
Any construction .n the public (curbs, driveways,
INSPECTOR
equine permission.
murnuers, etc.) x'111 .'.airs separate permiselon.
ue
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