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PLAN CH E DY
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THIS SITE IS L
OF EDMONDS.
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'ormntlon given iscorrect; and that I sum the owner, or the duly author.
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axed agent of the owner. t agree to comply with Illy and elate Iowa raga-
ATTENTION
APPLICATION APPROVAL
lating eun.tmetton; and In doing the work authorized thereby, no person
REMARKS
!
.'ill be employed in violation or the Labor Code of the State or Washington
THIS PERMIT
Legal DCacrlPllon of Property (Show Below or Attach Four Coplee)
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY TH
WORK NOTED
uty; and fees are paid, and receipt is ac -
Lor iy T�.rR,,< 04e94 �/pSA ial� TYPE CONNECTION VERIFIED BY�
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plated In six months.).
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PERMIT NUMBERC
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DATE iiv
REMARKS
775-2325
7
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FIRE ZONE TYPE OF CONSTRUCT�N BTRE'PT IMPROVED
0 NO
NEW
RESIDENTIAL
NON-RESIDENTIAL
❑
GAS
LINE
BICN
❑ YES [ij.f 6
1•lon Check No .....................
PLAN CH E DY
/
THIS SITE IS L
OF EDMONDS.
SHOULD BE CC
ADD
ALTER
FDEMOLISH
EXCAVATE
❑
E]
RETAINING
FECzOn
[MAR
PLUMBING
(OLS
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FILL
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PLOT PLAN (Indicate Building eetb=kB, abutting streets)
HEAT @GAS LINE
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REPAIR
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;UMBER OF STORIES
NUMRER OF
SIGN
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UNITS
SWIMMING POOL
Valuation
Fee
Receipt No.
f�ewee'* is '9DCp
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1•lon Check No .....................
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BUILDING
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PLOT PLAN (Indicate Building eetb=kB, abutting streets)
HEAT @GAS LINE
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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I hereby ,knowledge that I have rend this application; that the In.
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'ormntlon given iscorrect; and that I sum the owner, or the duly author.
axed agent of the owner. t agree to comply with Illy and elate Iowa raga-
ATTENTION
APPLICATION APPROVAL
lating eun.tmetton; and In doing the work authorized thereby, no person
.'ill be employed in violation or the Labor Code of the State or 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 -
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY TH
WORK NOTED
uty; and fees are paid, and receipt is ac -
.hail be completed In nlmdy day.; MOVED -IN BUILDINGS shall be cam.
knowledged In space provided.
plated In six months.).
SIGNATURE (OWNER ORA NT)DATE
S16NED
INSPECTION
\
D1R O 'B dl NAT RE
DEPARTMENT
I /
CITY OF
EDMONDS
DATE iiv
NOTE: Applicant Subject to Plan Cbeck Fee
775-2325
7
This Permit r work to ba done an prlvate property ONLY.
Any a ustructlmt on the public domain (curbs, sidewalk., driveways.
marquees, eIc.) .111 reeulre eeParale permission.
FILE
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Valuation
Fee
Receipt No
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BUILDING DEPARTMENT Applicant Fill
USEPERMIT
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RESIDENTIAL
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PERMIT APPLICATION
Inside Heavy Lines
ADDRESS
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❑ NEW
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NAME (OR NAME OF BUSINESS)
1 O
PLAN CHEC EDfIIY
THIS SITE IS LOCATED IN THE CITY
TAX
❑NON-RESIDENTIAL
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❑
LOT C tlBIBLE ACTUAL
LOT COVERAGE LOT COVE, AGE
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OF EDMONDS. LOCAL SALES
SHOULD BE CODED 31.04.
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REQUIRED YARDS VS
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AME
c1 C' -rL�i_ J- /71-
FRONT SIDE REAR FRONT SIDE REAR
UMBER OF STORIES
11 911OR OF
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
F
ADDRESS
$hall be completed In ninety day.; MOVED -IN BUILDINGS shall be cam-
VARICE OR CONDITIONAL USE
LEGA LOT AN
lj YES [3 NO PERMIT NUMBER
knowledged In space provided.
pleted In .1. month..)
UNITS
SIGNATURE (OWNER OR AGENT)DATE B16NEll
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PLANNIN DEPT. PI'ROVA DA Et
DIRE TO '8 81 NATO E
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CITY
TELEPHONE NUMBER
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NOTE: Applicant Siibject to Plan Check Fee
EDIVIOND3
ATE 5 '
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7 -
STREET R/t
This Permit curare work W be done on private properly ONLY.
Any censlructlen on the public domain (curbs, sidewalks, drlreway.,
marquee., etc.) will require separate permlWan.
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
INSPECTOR
S
NAME
COMP. PLAN ST. R/W ............FT. ............FT.
W
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REMARKS
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CHECKED BY
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METER SIZE
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Valuation
Fee
Receipt No
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SPECIAL INSPECTOR REQUIRED GROUP
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IOCCUPANCY
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PLAN CHEC EDfIIY
THIS SITE IS LOCATED IN THE CITY
TAX
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FIRE ZONE � TYPE
flan Check No
Valuation
Fee
Receipt No
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—N 12rYEe ❑ NO
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.....................
BUILDING
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4 PROPOSED SE
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SPECIAL INSPECTOR REQUIRED GROUP
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RESIDENTIAL
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GAS
LINE
❑ YES M-10/
IOCCUPANCY
❑ NEW
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1 O
PLAN CHEC EDfIIY
THIS SITE IS LOCATED IN THE CITY
TAX
❑NON-RESIDENTIAL
❑
SIGN
�y/
OF EDMONDS. LOCAL SALES
SHOULD BE CODED 31.04.
x ADD
❑
DEMOLISH
❑
RETAINING
WALL
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DEMOLITION -
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FENCE
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1 hereby acknowledge that I have rend this application; that the In.
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formation given Is correct; and that I am the owner, or the duly author.
El REPAIR
❑
PRE -MOVE
INSP.
❑
SWIM
POOL
c1 C' -rL�i_ J- /71-
I
4,/ S/ 1?5'
UMBER OF STORIES
11 911OR OF
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
DWELLING
Sty; and fees are paid, and receipt is ae-
$hall be completed In ninety day.; MOVED -IN BUILDINGS shall be cam-
knowledged In space provided.
pleted In .1. month..)
UNITS
SIGNATURE (OWNER OR AGENT)DATE B16NEll
v\
INSPECTION
DEPARTMENT
DIRE TO '8 81 NATO E
^ l /b
flan Check No
Valuation
Fee
Receipt No
7 �� 1.���•
.....................
BUILDING
/ %//ri � �'j vU
4 PROPOSED SE
�
PLUMBING
lT (0 (l _2¢_
aPLOT
PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAB LINE
h
1 O
FENCE
9IGN
RETAINING WALL
BWIMMIN6 POOL
- -
DEMOLITION -
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1 hereby acknowledge that I have rend this application; that the In.
J6.71
formation given Is 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
lating construction; and In doing the work authorized 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 -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
WORK NOTED
Sty; and fees are paid, and receipt is ae-
$hall be completed In ninety day.; MOVED -IN BUILDINGS shall be cam-
knowledged In space provided.
pleted In .1. month..)
-.
\
SIGNATURE (OWNER OR AGENT)DATE B16NEll
v\
INSPECTION
DEPARTMENT
DIRE TO '8 81 NATO E
^ l /b
-? Yrr/y • / •://�r.<.� / l
CITY OF
NOTE: Applicant Siibject to Plan Check Fee
EDIVIOND3
ATE 5 '
'
�ffj L. -
7 -
775-2525
This Permit curare work W be done on private properly ONLY.
Any censlructlen on the public domain (curbs, sidewalks, drlreway.,
marquee., etc.) will require separate permlWan.
INSPECTOR
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(Rough) � l
Frame
Furnace & Fuel LinesCXv�B�
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RECORD OF INSPECTIONS
Date Passed
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Foundation�r-9-1,i-�
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(Rough) � l
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