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Plan Check No .....................
BUILDING
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PLUMBING
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PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAS LINE
BUILDING DEPARTMENT Applicant Fill
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NU BER l 50174
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PERMIT APPLICATION Inside Ileavy Lines
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ADDRESS ;Z �
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SIGN
NAME (OR NAME OF BUBINEBB)
PERMItldIp I.E me I
AGT At,ry
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LIT COVERAGE
LOT COVERAGE
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MAILING ADDREBB�
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PEIt:.ildtl[➢LE HEIOIIT
PItOPOaED Il ElOH'f
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EXCAVATION OR FILL
TOTAL BLDG. AREA
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TOTAL AMOUNT DUE
NUMBER
CITY TELEPHONE UMBER
ACTUAL LOT AREA
formnth" glv.n le correct; and that I am the owner, or the duly author-
MCIA)JN5 �2- a -p 57 V
REQUIRED YARDSPROPOSED
ized agent of the owner. I agree to comply with city and state laws regu•
ATTENTION
APPLICATION APPROVAL
FRONT SIDE
REAR FRONT BIDE REAR
;S
will be employed In violation of the Labor Code of the Slate of Washington
NAME
This application Is not a permit HI
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official Or his D
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
utyt and fees are paid, and receipt Is
shall be completed In ninety day.; MOVED -IN BUILDINGS shall be wm•
knowledged In space provided.
LEGAL LOT VARIANCE Olt CONDITIONAL USE
ADDRESS
YESNO PERMIT
NUMBER
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PLANNING DEPT, APPROVAL
DATE:
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CITY TELEPHONE NUMBER
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775-2525
STREET G ST
EXISTING STREET R/W
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............FT. DEFICIENCY THIS PROPERTY 'Lr.
NAME
COMP. PLAN ST. R/W
..........,.FT.
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etr.l velli reaulre separate pertnls.lon.
3CS T r L u n^ B t N G
REMARKS
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ADDRESS /r� '1 •' �
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CHECKED BY
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CITY TELEPHpONE/NUMBER
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METER SIZE I SERVICE SIZDCLEARANCE CHECKED BY
STATE LICENSE NUMBER / CITY LICENSE NUMBER
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REMARKd
Legal Description Of Property (dhow Below or Attach Four Copies)
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, ,mak- x 1?x3
TYPE CONNECTION
VERIFIED BY
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PERC. TEST
PERMIT NUMBER0..
WREMARKS
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FIREy TYPE OF CONSTRUCTION STREET IMPROVED
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SPECIAL INSPECTOR RE UIREDOCCUPANCY GROUP
GAS
® RESIDENTIAL ❑ LINE
❑ YES D..I0—
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NEW
PLAN CHECKED DY
THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL s1GN
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S. LOCAL SALES TAX
❑ ADD SNC
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RFa ARKS
ULD CODED 31.04.
SHOULD BE
SH
F-1 DEMOLISH ❑ WALL
ALTER EXCAVATE FENCE
OR FILL (.......... I .......... Ft.)',
REPAIR ❑ PRE-INSP. ElSWIM
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
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Plan Check No .....................
BUILDING
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4a PROPOSED USE
PLUMBING
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U
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAS LINE
9
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FENCE
SIGN
RETAINING WALL
N
1
SWIMMING POOL
_
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
OO
I hereby acknowledgo that I have read this application; that the In-
formnth" glv.n le correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu•
ATTENTION
APPLICATION APPROVAL
MIME construction; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington
THIS PERMIT
This application Is not a permit HI
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official Or his D
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
utyt and fees are paid, and receipt Is
shall be completed In ninety day.; MOVED -IN BUILDINGS shall be wm•
knowledged In space provided.
pleted In six months.)
SIGN A E (OWNER Olt AGENT) DATE SIGNED
INSPECTION
DIR C OR' dl NATU
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DEPARTMENT
CITY OF
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EDAtONDB
DATE
DATE
NOTE: Applicant Subject to Plan Check Fee
775-2525
This P—nit r e work to be done an private property ONLY,
Any construct tun an tho public dunmin (curbs, eldewalks, driveways,
FILEmaryures,
etr.l velli reaulre separate pertnls.lon.
UB£
PERMIT
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BUILDING DEPARTMENT
Applicant Fin
ZONE
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NUMBER 750 174
1
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PERMIT APPLICATION
Inside Heavy Linos
JOB
ADDRESS
TL V
NAME (OR NAME OF BUSINESS)
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PERMIfBS1BLE ms
ACTUAL %%'.
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IAT COVERAGE
LOT COVERAGE
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MAIL( O ADDRE88O
PEILMISBIBLE HEIGHT
PROPOSED HEIGHT
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CITY` ' TELEPHONE UMBER
ACTUAL LOT AREA
TOTAL BLDG. AREA-
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REQUIRED YARDS PROPOSED YARDS
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NAME
FRONT BIDE
REAR FRONT BIDE REAR
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ADDRESS
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LEGAL LOT _VA IANCE OR CONDITIONAL USE
PERMIT NUMBER
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C] YES[3NO
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PLANNING DEPT. APPROVAL DATE:
61
CITY
PHONE NUMBER.
STREET R/W
EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
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NAME
COTtP. PLAN ST. R/W ............FT.
............Fr.
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REMARKS
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f. ICT' N
0 V C C /t) A t.) AI t AIPRONE
CHECKED BY
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CITY TEL
ENUMBER
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METER 81LE BEAVICE SIZE
CLEARANCE
CHECKED BY
STATE NUMBER
—LICENSE
KS
Legal DescriPtlon al Properly (Show Below or Attach Four Copies)
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TYPE C L'T10N
VERIFIED BY
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PER •e
RMIT NUMIBE,
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REMARKSD
to
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a
FIRE ZONE TYPE OF CONSTRUCTION P OVEll
No
SPECIAL INSPECTOR REQUIRED GROUP
RESIDENTIAL
GAB
❑ LINE
C]YES 1] NIO
(OCCUPANCY
r"
NEN
PLAN CHECKED IIY
THIS SITE IS LOCATED IN THE CITY
NON-RESSDENTIAL
El sicx
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OF EDMONDS. LOCAL SALES TAX
ADD
-y> l,• ! -r
RE, Ks
SHOULD BE CODED 31.04.
E] DEMOLISH ❑ WARRETAINING
11
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ALTER XE FENCE
EJCAVAT
OR FILL (........_x .......... Ft.)
REPAIR ❑ INPMIOVE SWINI
❑ POOL
NUMBER OF 8TOR31:9 NUMBER OF
DWELLING
I
UNITS
NATURE OF WORK TO IIE DONE
Valuatlon
Fee
Receipt No.
—
e
Plan Chech No .....................
11
BUILDING
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6,
PROPOSED UB£
PLUMBING
M
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAS LINE
�
FENCE
SIGN
RETAINING WALL
I
SWIMMING POOL
I
DEMOLITION
PRE -MOVE INSPECTION
_
EXCAVATION OR FILL
I
TOTAL AMOUNT DUE
I hereby acknowledge that 1 have read this application; that the tn-
formntlon given Is correct; and that 1 am the owner, or the duly author-
ired agent of the owner. I agree to comply with city ane state laws reg"-
ATTENTION
APPLICATION APPROVAL
Iating construcllan; ¢ad In doing the worlt authorlred thereby, no paean
eyed
will be employed In violation of the Labor Cade of the State of Nanbington
TIDE PERMIT
This application is not a permit until
relating to Compensation Insurance.
AUTRONZEB
signed by the Building Official or his Dep-
I
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
uty; and fees are paid, and receipt is ac -
I
shalt be completed 1. nlnety days; MOVED -IN BUILDINGS shalt be tom-
WORK NOTED
knowledged in apace provided.
pitted to six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIR1C�OR'8 SIGNATU ^!
I
DEPARTMENT
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_
CITY OF
E D9
DATE 11
NOTE: Applicant Subject to Plan Check Fre'
7775-255-25 25
This Permit c cork"'Iw done on Private property ONLY,
i
Any Coast ructies oroor
the pill lc domain (curbs, sidewalks, driveways,
INSPECTOR
maraaeer, etc,) will reaulre separate permission.
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