750128.pdfPRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE 1.12 / tI a
I hereby acknowladge that I have rand this application; that the In. U
tormntion given le correct; and that I am the owner, or the duly author -
(zed agent of the owner. I agree to eamD1Y with cltY and elate laws rasa- ATTENTION APPLICATION APPROVAL
taring construction; and In doing the work authorized thereby, no Berson
will Us
employed In v10I.R.. of Ne Labor Code of the State of Washington THIS PERMIT This application Is not a permit until
relating to workmen'. Compensation Inaurance. AUTIIORIZEtl Signed by the Building Official or his Dep.
ONLY THE
NOTE: Permit Limit One Year (Except DE51OLITION'S which WORK NOTED uty; and fees are paid, and receipt is ae-
ahall be completed In ninety day.; MOVED -IN BUILDINGS shall be cam- knowledged in space provided. -
p c ed In elx months.)
3 ATU E p{VN 7i R ENT DATE ZI Bib EU INSPECTION D �pR's lONATU
1 DEPARTMENT ,
7 Z. CITY OF i
EDMONDS DATE
NOTE: Applicant Subject to Plan Check Fee
775.2525
Any
Permit onyer. work Public
be done (c Private properly ONLY.
Any construction ., rite public domnln ecurb.. Permission.
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ONE NDMBPERMIER �JUIiV
BUILDING DEPARTMENT Applicant FM
Linos
-
PERMIT APPLICATION Inside Heavy
JOB
ADDRESS
ME (OR NAME OF BUSINESS)
ACTUAL
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1—
PERMISSIBLE
LOT COVERAGE e.I „r-).91 LOT COVEIIAOE
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PERMISSIBLE HEIGHT PltOP08EU (GRT
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CITY
TELEPHONE NUMBER
ACTUAL LOT AREA TOTAL, B!LDO. AI{EA
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EXISTING STREET R/ �''j-('' FT. DEFICIENCY THIS PROPERTY
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NAME
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REMARKSCC Driveway slopes not to euceed those
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KD—DRESS
indicated on Standard Dwg No 103
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CITY
NUMBER
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METER SIZE SERVICE SIZE CLEA A CEED
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STATE LICENSE NUMBERCITY
LICENSE NUMBER
REMARKS
Legal Description of Property (show Below
or Attach Four Copies)
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FIRE ZONE TYPE O/F CON�ST/DUCTION HT 11,/ %IMPROVED
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8P CIAL INSPECTOR REIUIRED OCCUPANCY GROUP
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RESIDENTIAL
❑ GAS
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PLAN CHECKE IIY THIS SITE IS LOCATED IN THE CITY
El NON-RESIDENTIAL
OF EDMONDS. LOCAL SALES TAX
Biax
HO LD BE CODED 31.04.
ADD ❑ ETAINING
❑ RWALL
DEMOLISH
FENCE
❑ ALTER EXCAVATE
OR FILL (....,................Ft.)
REPAIR ❑ INSP.MOVE O swim
POOL
NUMBER OF STORIES NUMBER OF
DWEL
I LING
r•'�lziy�+N\ UNITS
NATURE OF,`SWORK TOO BE
Valuation
Foe
Receipt No.
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Flan Check N
BUILDING
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PLUMBING
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rLN (Indicate Building setbacks, abutting
streets)
HEAT & GAS LINE
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O
FENCE
SIGN
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RETAINING WALL
nl
KI
HWIAfMINO POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE 1.12 / tI a
I hereby acknowladge that I have rand this application; that the In. U
tormntion given le correct; and that I am the owner, or the duly author -
(zed agent of the owner. I agree to eamD1Y with cltY and elate laws rasa- ATTENTION APPLICATION APPROVAL
taring construction; and In doing the work authorized thereby, no Berson
will Us
employed In v10I.R.. of Ne Labor Code of the State of Washington THIS PERMIT This application Is not a permit until
relating to workmen'. Compensation Inaurance. AUTIIORIZEtl Signed by the Building Official or his Dep.
ONLY THE
NOTE: Permit Limit One Year (Except DE51OLITION'S which WORK NOTED uty; and fees are paid, and receipt is ae-
ahall be completed In ninety day.; MOVED -IN BUILDINGS shall be cam- knowledged in space provided. -
p c ed In elx months.)
3 ATU E p{VN 7i R ENT DATE ZI Bib EU INSPECTION D �pR's lONATU
1 DEPARTMENT ,
7 Z. CITY OF i
EDMONDS DATE
NOTE: Applicant Subject to Plan Check Fee
775.2525
Any
Permit onyer. work Public
be done (c Private properly ONLY.
Any construction ., rite public domnln ecurb.. Permission.
drlyew.yy
mnrquer., etc.) xiil rrgWre separate Dermis.lon. FILE
e