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Fee Receipt No.
FIRE ZONE I TYPE
OF CONSTRUCTION STREET IMPROVED
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I
BUILDING
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REQUIRED
YES 0 NO
BUILDING DEPARTMENT
AppLcant FIII
USE PERMIT 75�,�� I
ZONE NUMBER
PLUMBING
GAS ❑ YES ❑ NO
RESIDENTIAL LINE PLAN CHECKED BY
EjNEN
NON-RESIDENTIAL ❑ SIGN
-
U
PERMIT APPLICATION
Inside Heavy Lines
I
TOB
❑
RETAINING
WALL
FEN
REMARKS
ADDRESS 23611 Highway 99
FENCE
❑ ORFILL
NAME (Oft NAME OF BUSINESS)
Sunset Realty, Inc..
ACTUAL
LOT COVERAGE AGE
N
MAILING ADDRESS
❑ PIRB MOVE
PERMISSIBLE HEIGHT PROPOSED HEIGHT
O
N
i
23601 Highway 99
SWIMMING POOL
NUMBER OF STORIES NUMBER OF
O
CITY
TELEPpHONE NUMBER
ACTUAL LOT AREA TOTAL BLDG. AREA
e
PRE -MOVE INSPECTION
Edmonds
778 0163
REQUIRED YARDS PROPOSED YARDS
-`SIDE
N
EXCAVATION OR FILL
NAME
FRONT 8IDE REAR FRONT REAR
2.00
TOTAL AMOUNT DUE
I hereby acknowledge that I have rend this application; that the In-
L❑EYESL LOT❑ VARIANCE R CONDITIONAL USE
ADDRESS
NO PERMIT NUMBER
ATTENTION
APPLICATION APPROVAL
lating construction; and to doing the work authorised thereby, no Person
Fy
w•111 be employed In violation of the Labor Cade of the Slate of Washington
PLANNING DEPT. APPROVAL DATE:
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
aS
4
CITY
TELEPHONE NUMBER
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com.
knowledged in space provided.
pleled in six months.)
I
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
O
INSPECTION
�✓�DEPARTMENTC�.qIke „
NAME
COMP. PLAN e'r. R/W ............FT. ............ FT.
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CITY OF
EDMONDS
Center Dozing
RDMARXB
775-2525
tC
ADDRESS
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2117 SW 114thw
BY
cc
F
CITYTELEPHONE
NUMBER
(CHECKED
Seattle 98146 I
243 5550
METER SIZE
SERVICE SIZE
CLEARANCE
CHECKED BY
O
STATE LICENSE NUMBERI
CITY LICENSE NUMBER
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REMARKS
Legal Description of Property (Show Below
or Attach Four Copies)
23611 Highway 99
TYPE CONNECTION
VERIFIED BY
p
Odmonds, Was 98020
m
PERO. TEST
PERMIT NUMBER
Fruitland Acres to
bake Ballinge
w
w
Blk �Ol' D 03 N 100 it of 0 200
REMARKS
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Fee Receipt No.
FIRE ZONE I TYPE
OF CONSTRUCTION STREET IMPROVED
l
I
BUILDING
SPECIAL INSPECTOR
REQUIRED
YES 0 NO
OCCUPANCY GROUP
a
PROPOSED USE
PLUMBING
GAS ❑ YES ❑ NO
RESIDENTIAL LINE PLAN CHECKED BY
EjNEN
NON-RESIDENTIAL ❑ SIGN
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
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❑
ADD
ALTER
DEMOLiBH
CE
❑
RETAINING
WALL
FEN
REMARKS
FENCE
❑ ORFILL
. .........)
SIGN
REPAIR
❑ PIRB MOVE
❑
SWIM
POOL
N
SWIMMING POOL
NUMBER OF STORIES NUMBER OF
1
XX±XXX DWELLING
UNITS
]
PRE -MOVE INSPECTION
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Fee Receipt No.
demolish
Plan Check N........._...........
BUILDING
ry
Y
a
PROPOSED USE
PLUMBING
U
PLOT PLAN (Indicate Building setbacks: abutting streets)
HEAT h GAS LINE
»
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
2.00
PRE -MOVE INSPECTION
EXCAVATION OR FILL
2.00
TOTAL AMOUNT DUE
I hereby acknowledge that I have rend this application; that the In-
formation given Is correct; and that I am the owner, or the duly author.
Ixed agent of the owner. I agree to cmP1Y with city and elate laws regu.
ATTENTION
APPLICATION APPROVAL
lating construction; and to doing the work authorised thereby, no Person
w•111 be employed In violation of the Labor Cade of the Slate 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
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com.
knowledged in space provided.
pleled in six months.)
B14�1H (Q_WNFR �4D AGENT) I
I
DATE BfONED
INSPECTION
�✓�DEPARTMENTC�.qIke „
4/25/75
., r
FZATR
CITY OF
EDMONDS
NOTE: ApQ resat Subject to Plan Check Fee
S%
775-2525
This Permit toren work to be done on Drlvole Property ONLY.
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