750305.pdfBUILDING DEPARTMENT Applicant Fill �"� �5 -� NUMBER/1 750305
PERMIT APPLICATION Inside Heavy L(nos JoB
ADDRESS
NAME (OR NAME OF BUSINESS) 7� PERMISSIBLE ACTUAL �/� O '• i
G4A� � �� A LOT COVERAGE 3 O AC RAGE
fC MAILING 111111 , PERMISSIBLE HEIGHT PROPOSE. I _' 10 1 A
O CITY Tr]CLEPHONE NUMBER ,I rQl A'L) /}p, piA�i yTOTAL BLDG. AREA 7.
M N Y lZ SCJ �`I- /C�Do'•�(JT` I RE4^^h i
REQVIRED YARDS PROPOSED YARDS '
NAME FRONT BIDE REA71 FRONT BIDE REAR
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(7 L AL I- VARIANCE OR C NDITIONAL
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ADDRESS ( YES ONO PERMIT NUMBER !/r .L�� ;
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STREET R/ O i
EXISTING EET R/ W ....... _... FT. DEFICIENCY THIS PROPERTY
NAME I AN ST. R/ W ............Fr. F
REMARKeT.
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METER SIZE I SERVICE SIZE I CLEARANCE ICH ED BY I I
STATE LICENSE NUMBER CITY LICENSE NUMBER [�kyr7 i
REMARKS
Legal Description of Properly (Show Below or Attach Four Copies)
L Ci G�L \ • / 1� 7 TYPE CONNECTION VERIFIED BY i
Co PERC. TEST I PERMIT NUMBEIV
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THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
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NUMBER OF STORIES NUMBER OF
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NATURE OF WORK TO BE DONE
Valuation Fee Receipt No.
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PROPOSED UBE
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PLUMBING
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PLAN (Indicate Building setbacks, abutting streets)
I;EAT A CAH LINE
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PENCE
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BION
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RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given I. correct; and that I nm the owner, or the duly author,
Izrtl ageat of the owr. I agree to comply with city and state Iowa regu•
ATTENTION
APPLICATION APPROVAL
Iating construction; and In doing the work authorized thereby, no person
will be employed In violation or the Labor Code of the Slate of Waahington
THIS PERMIT
This application Is not a permit until
relatl.g to Workmen'. Comp....U.. Imuran.
AUTIIOIUZE13
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-
.hell be completed hl ninety d.y.; IILOVEDdN BUILDINGS shall be coni
ledge n space provided.
plated In six months.)
tl ATUItE (OWNER R GENT)
DATE HIONED
INSPECTION
Dl T '8 HI TU
DEPARTMENT
CITY OF
EDhfONDB
DA E
NO E: Applicant Subject to Plan Check Fce
775-2525
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This Pe unit col- .retic to be done on private Properly ONLY.
Any md—tin. on the public domain (curb., sidewalks, drlvn.vay°'
FILE
marquees, ele.) will require eeparwle perml.alen.
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Legal of Property (Show BBelow or Allson lour a:aptee)
AlIg-
6 -16-76 'L L,
/Description
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USE PERMIT - -).- .. •,.,�
BUILDING DEPARTMENT Appucant-Fill ZONE NUMBER
I hereby acknowledge that I have rend this application; that the In.
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PERMIT APPLICATION Inside Heavy L1nes Joe
ADDRESS
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Ized agent of the owner. I agree to comply with city and slate law. ratio.
NAME (UR NAME OF BUBINE88)
tJy-1"•�.��.�I \ GIC ,( V l-' ` t-'� LOT COVERAGE/ 3 O LOT �C� AGE _ 4
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MAILING ADDREBB --
-.f- PER61I8BIBLE HEIG}iT / ?file EIGHT
tg�•� moo- w���--� oc 10
TOTAL BLDG.I. AR
Will be employed In viol atof the be, Code of the Slate of Washington
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C CITY`
TELEPHONE NUMSER AFf VftLOT AREA , „ 4
elgned by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
REQUIRED YARDS PROPOSED YAR -DS-
REAR
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NAME FRONT BIDE REAR FRONT BIDE
((rr --t-or-� �-�rr �'t't-�t✓�-X% i�'S i o' aX_Ir.R OR ir ` 227'
LOT0
NV_.2,/71V
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pleled In circ months.)
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HHINATURE (OWNER OR AGENT)I DATE SIGNED
INSPECTION
hUl ADDR11 211NO PERMIT NUMBER
DA -
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CITY OF
M_
CITTELEPHONENUMBER
^ STREET R/19
/ EXISTING �'PREF.T A/W ............FT. DEFICIENCY THIS PROPERTY
p
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1CONSTRUCTION
ES 0 NO
NAME
COMP. PLAN BT. R/W ............FT. ............FT.
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
775-2525
O W �' C �- - REMARKS
0 YES 0x0
This Permit coven work to be done an private properly ONLY.
NEN
M ADDRESS
62
❑ NON.RESIDENTIAL amx
S. LOCAL SALES TAX
yJ/ �/
tL CHECKED BY
ILI nDD RETAINING
SH ULD BEEDMON
.« ='rSHOULD BE CODED 31.04.
REMA
CITY
TELEPHONE NUMBER /- / ( 1_J., /
'-
EXCAVATE FENCE
❑
O _-. __. _ _.._...... ............
...,,... , ,,.�..,,... we,rvn,..., aIETER SIZE I SERVICE SIZE I CLEARANCE
I CHEPBED, BY /i
Y
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Legal of Property (Show BBelow or Allson lour a:aptee)
AlIg-
I-
/Description
�+r✓�C�- 1 l / 1^'t �_C 4A C;l
TYPE CONNECTION VERIFIED BY
I hereby acknowledge that I have rend this application; that the In.
I
r
Ized agent of the owner. I agree to comply with city and slate law. ratio.
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lating construction; and In doing the work authorized thereby, no person
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Will be employed In viol atof the be, Code of the Slate of Washington
b � c--) c. k-
41vu
relatlhg to Workmen's Compensation Insurance.
elgned by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
W
kl
B
I
pleled In circ months.)
LEJ
on
HHINATURE (OWNER OR AGENT)I DATE SIGNED
INSPECTION
DIREOTOR'S SIGNATURE
DA -
1
/
.: • ;' -, , .,
CITY OF
FIRE Z�O�N_ETYPE OF BTREE -IMPROVED
,DATE
.E7
1CONSTRUCTION
ES 0 NO
EDMONDS
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
775-2525
GAS
® RESIDENTIAL LINE
0 YES 0x0
This Permit coven work to be done an private properly ONLY.
NEN
PLAN CHECI{ED�IIY THIS SITE IS LOCATED IN THE CITY
INSPECTOR
❑ NON.RESIDENTIAL amx
S. LOCAL SALES TAX
yJ/ �/
ILI nDD RETAINING
SH ULD BEEDMON
.« ='rSHOULD BE CODED 31.04.
REMA
DEMOLISH HALL
❑ ❑
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EXCAVATE FENCE
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ALTER
❑ OA FILL (.... ..... Y .......... F[.)
REPAIR PRE-b[OVE Stmt
INSP. POOL
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NUMBER OF STORIES NUMBER OF
DWELLING
(.
UNITS"
l/' n._\ 1 L� �../ % {'7 �/ /••� .S % i '-�.. //✓,j%ll /✓/i
NATURE OF WORK TO BE DONE
Vuluntlon
Fee
Receipt No,
T>OVI �c.P.0 YOC' ���,tc�tta
-
/
Plan Check Na .....................
BUILDING
L PROPOSED USE
PLUMBING
U
aPLOT PLAN (Indicate Building setbacks, abutting circa.)
HEAT A GAS LINE
^ 7
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have rend this application; that the In.
formation given le correct; and that I am, the owner, or the duty author.
Ized agent of the owner. I agree to comply with city and slate law. ratio.
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
Will be employed In viol atof the be, Code of the Slate of Washington
TIHB PERMIT
This application is not a permit until
relatlhg to Workmen's Compensation Insurance.
AUTHORIZES
elgned 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 no
shall be completed In ninety day.; MOVEDAN BUILDINGS shall be cam-
lmowledged in space provided.
pleled In circ months.)
��
HHINATURE (OWNER OR AGENT)I DATE SIGNED
INSPECTION
DIREOTOR'S SIGNATURE
DA -
DEPARTMENT
/
.: • ;' -, , .,
CITY OF
,DATE
NOTE: Applicant Subject to Plan Check Fee
EDMONDS
775-2525
This Permit coven work to be done an private properly ONLY.
Any eon tinfellan on the public domain (curbs, sidewalk., drivew.ys,
ntsequec., ate.) will require separate permission.
INSPECTOR
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