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BUILDING DEPARTMENT Appncant F'iLL PERMIT
Z°r�rE NUMBER —150311
PERMIT APPLICATION I Inside Heavy Lines
/ NAME IOR NAME OF BUSINESS)
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MAILING ADDRESS
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FV. CITY (TELEPHONE NUMBER
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Plan Check No .....................
PERMI08I8LE
LOT COVERAGE
CTUAL rp
OT COVES XGE
PEMII13818LE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
TOTAL BLDG. AREA
REQUIRED YARDS
T E REAR
FRONBID
PROPOSED YARDS
FRONT SIDE REAR
LEGAL LOT VARIANCE OR CONDITIONAL USE
fl YES rl NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W ....... .... FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
S
ST
Plan Check No .....................
7.I
,Y' ice'
I Qf,YES
11 NO
BUILDING
PROPOSED USE
SPRCIAL INSPE1yC°l'TOR REQUIRED
OCCUPANCY GROUP
❑RESIDENTIAL
NEW
NON-RESIDENTIAL
nnn
DEMOLISH
ALTER EXCAVATE
❑
❑
LINE
SIGN
RETAINING
WALL
❑PLAN CHECKED DYO
REMARKS r
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THIS SITE IS LOCATED I THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD eE CODED 31.04.
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❑
REPAIR ❑
ORFILL
PN' -MOVE.
❑
(ENC............'.)
POOL
FUAIDER OF STORIES
NUMBER OF
O
FENCE'
SIGN
DWELLING
fRETAINING
WALL
UNITS
SWIMMING POOL
QATURE OF WOR1K. TO HE DONE %�
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Vnlunllon
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Receipt I•
Plan Check No .....................
7.I
BUILDING
PROPOSED USE
a
PLUMBING416
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PLOT PLAN (Indicate Hulldln6 setbacks, 86utling street.)
HEAT & GAS LINE
O
FENCE'
SIGN
fRETAINING
WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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1 hereby acknowledge that I have read this application; that the In.
TOTAL AMOUNT DUE
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formation given Is correct: and that I am the owner, or the duly author -
(red agent of the owner. I agree to comply with city and state )awe rest-
ATTENTION
APPLICATION APPROVAL
(ming con.lructlon; and In doing the worn 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 -ONLY
.I .
NOTE: Permit limit One Year (Except DEMOLITIONS which
TILE
uty; and fees are paid, and receipt is ac-
shall be comp) led In ninety days; MOVED -IN BUILDINGS shall be cons.
WORE[ NOTED
knowledged in space provided.
pleted In slz onth..)
tl16NAT'U (01VNER AGENT) DATE SIGNED
INSPECTION
DIRE ILT RE
DEPARTMENT
CITY OF
71
EDMONDS
DATE
NOTE: Applicant Subject to Plan CherFee
Z-7
775-2525
This I•ermit ,oven work to be don on private property ONLY.
Any epn.t O,cl bn on the public domain (cnrbn, nld,widk., driveways,
., r,�„r,•r, v1,.1 „Ill rrutlrr .eparelr I�rr„d ..len.
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RECORD OF INSPECTIONS
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Date Passed
Foundation
Plumbing (Partial)
(Rough)~
Frame
Furnace & Fuel Lines
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Final
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