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BUILDING DEPARTMENT I Applicant Fill ZONE Ir, ( -UR-.- 750143
PERMIT APPLICATION -U-.-
Inside Heavy Linos AD 'ff V
ADDRESS 306 Main Street
NAME (OR NAME OF BUSINESS)
PERMISSIBLE ^o ACTUAL r('p
RAINIER BANK LOT COVERAGE LOT COVAAGE
C MAILING ADDRESS
(a PEI0118dIHLE HF.IGIiT PROPOSED HEIGHT A
306 Main Street
O CITY TELEPHONE NUMBER ACTUAL LOT AREA TOTAL BLDG. AREA z
Edmonds, Washington REQUIRED YARDS PROPOSED YARDS w
NAME FRONT BIDE REAR FRONT SIDE REAR
yADDRESS LEGAL LOT VARIANCE OR CONDITIONAL USE
N ClYES NO PERMIT NUMBER
PLANNING DEPT, APPROVAL K37fL DATE:
CITY (TELEPHONE NUMBER
STREET R/W O
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY z
NAME COMP. PLAN 8T. R/W ............FT. ............FT. {.Wp�1
REMARKS M
C ADDRESS x
(D// �/ ��(p"- �(�/ I
Et CHECKED BY W
CITY TELEPHONE NUMBER
V e// METER SIZE SERVICE SIZE I CLEARANCE I CHECKED BY
9 TE LICENSE NUMBER CITY LICENSE NUMBER ttltl
_ va _ /e o P S REMAR^
KS
C
Legal Description or Property (Show Below or Attach Four Copies) I,,. �(' S �k CC II
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TYPE CONNECTION VERIFIED BY I ,I
X.
O �
PERC. TEST I PERMIT NUMBER
U r
;d REMARKS
C"FASr
FIRE IE TYPEDA-CONSTRUCTION STREET IMPROVED
14t
• YES El NO
SPECIAL INSPECTOR REQUIREDOCCUPANCY
❑ YES NO
ROUP
I F-7-
RESIDENTIAL G�`8
❑
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
LINE
NEW
i
j�
NON-RESIDENTIAL ❑ aION
SHOULD BE CODED 31 045ALE5 TAX
❑LZ'
ADD RETAINING
WALL
REMARKS
❑DEMOLISH
ALTER CAVATE ❑ FEN
J )O �H�
N
I 1 `r \ `1�.•�\ I 1 1 ��)
u .
❑ ORFILL .x .......... Ft.)
PRE -MOVE SWIM
tUJW
b
REPAIR
Ei POOL
�teR�«iP
�6aO^
.INSP.
j
NU¢7DEIt Ol^ STORIES NUMBER OF
DWELLING
UNITS
I!'
NATURE OF WORK TO HE DONE
Valuation
Fee
Receipt No.
I
Plumbing
Plan Cheek No.
I
BUILDING
(dishwasher & sink)
PROPOSED USE
W
PLUMBING (2)
Ceo0
5.00
PLOT PLAN (Indicate BntldMg ectbacke, abutting et,oct.)
HEAT A GAS LINE
0
PENCE
SIGN
tRETAINING
WALL
N
SWIMMING POOL
_
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I haus recd this application; that the In.
TOTAL AMOUNT DUE
5.00
_
tiongiven Is correct; and that I and the owner, or the duly author.
(zed agent of the owner. I agree to Comply with city and state laws regu-
ATTENTION
APPLICATION APPROVAL
Iating conetructlon; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington
THIS PEI951IT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZED
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY Tiff
WORK NOTED
Ut and fees are paid, and receiptis 8C-
yi P
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shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
Itnowledged in apace provided.
pleted In six months.)
SI ATURE (OWNER OR AGENT)ID E a1 NE
INSPECTION
DIRECT '8 SIG A U E
g'
DEPARTMENT
CITY OF
EDMONDS
DAT
NOTE: Appficant Subject to Plan Cbeck Fee
This Permit covers work to be don an private Dropeliy ONLY.
775-2525
Any rnnetnwtinn on the public domain (rnthn, nld,walk., driveways,
rrua"•. en.� t, 111 r,•,lelrrnrpnrntr perinlnnlrm.
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