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luting conetructloa; and In doing the work authorised thereby, no person
will be employed In vlolatlnn or the Labor Code of the State of Washington
NAME (OR NAME OF BUSINESS)
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FENCE
ONLY TILE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be Com-
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I hereby acknowledge that I have read this application; that the in.
BUILDING
formntlon Riven Is correct; and that I nm the owner, or the duly authur-
IrMI agent of the owner. I agree to Comply with Illy and elate law. tutu-
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luting conetructloa; and In doing the work authorised thereby, no person
will be employed In vlolatlnn or the Labor Code of the State of Washington
HEAT d: GAS LINE
relating to Workmen's Compensation Insurance.
F) TYPE OF CONBTRUCT2 STREET IMPROVE
IYE9 NO
FENCE
ONLY TILE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be Com-
SIGN �jZ
SPECIAL INSPECTORREQUIRED
❑PLANYES
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CNECXED dY THIS SITE IS LOCATED IN THE CITY
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I hereby acknowledge that I have read this application; that the in.
BUILDING
formntlon Riven Is correct; and that I nm the owner, or the duly authur-
IrMI agent of the owner. I agree to Comply with Illy and elate law. tutu-
PLUMBING
luting conetructloa; and In doing the work authorised thereby, no person
will be employed In vlolatlnn or the Labor Code of the State of Washington
HEAT d: GAS LINE
relating to Workmen's Compensation Insurance.
AUTHORIZES
FENCE
ONLY TILE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be Com-
SIGN �jZ
31GNATUIiE ON A DATESNED
INBPECTfON
RETAINING WALL
DEPARTMENT
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SWIMMING POOL
CITY Or
EDhIOND$
DEMOLITION
775-2525
PRE -MOVE INSPECTION
Any constructiun on ibe public domain (curbs, ddewalks, drlvewan,
EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the in.
TOTAL AMOUNT DUE
formntlon Riven Is correct; and that I nm the owner, or the duly authur-
IrMI agent of the owner. I agree to Comply with Illy and elate law. tutu-
ATTENTION
luting conetructloa; and In doing the work authorised thereby, no person
will be employed In vlolatlnn or the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be Com-
pleted In .Iz months.)
31GNATUIiE ON A DATESNED
INBPECTfON
DEPARTMENT
CITY Or
EDhIOND$
NOTE: AHNlicant Subject to Plan Check Fee
775-2525
This Penult cover. work to be done an prly to property ONLY.
Any constructiun on ibe public domain (curbs, ddewalks, drlvewan,
mrtraueee. etc.) will rcgalre ..past. permledon.
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APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILE
- 6 ORB BIO
DEPARTMENT URE
1
(�' ( 4 :.'�(/.�
CITY OF
EDIVIONDS DATE
NOTE: Applicant Subject to Plan Check Fee 775-2525
This Permit cnvers work to be done on private property ONLY.
Any wnstructlon on the public domain (curb., sidewalks, drlveways,
mINSPECTOR
marquees, etc.) will require separate permission.
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I `q YES [I NO
'P CIA ECTI REQUIRED OCCUPANCif' GROUP
BUILDING DEPARTMENT
USE PERMIT i;•� �'
ZONE 3- NUMBER 1,50
RESIDENTIAL
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Applicant Fill
NEW
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THIS SITE IS LOCATED IN THE CITY
PERMIT APPLICATION Insido Heavy Lines
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OF EDMONDS. LOCAL SALES TAX
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REMARKS -
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NAME (OR NAME OF HUBINE88)
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LOT COVERAGEo �� LOT COVESYAGE
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PER61188IBLE HEIGHT � PItOPUBED RETORT t AonrQ,c .,'J_ci
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DWELLING
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TELEPHONE N7UMBER
A UAL LOT AREA `\ TO DLDG. AREA
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YARDS PROPOSED YARDH
Valuation
Fee Receipt No.
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NAME
FRONT SIDE REAR FRONT BIDE REAR
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Plan Check No ..................._
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DEMOLITION
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REMARKS
PRE -MOVE INSPECTION
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ADDRESS
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EXCAVATION OR FILL
CHECKED BY
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CITY
NUMBER
TOTAL AMOUNT DUE
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forms
orm Hon given 1s correct; and that I aot the owner, or the duly author-
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(TELEPHONE
METER SIZE SERVICE SIZE'
CLEARANCE
CHECKED BY
latlnIf construction; and In doing the work authorized thereby, no person
STATE LICENBII NUMBER
CITY LICENSE NUMBER
I
THIS PERMIT
I
relatlgg to Workmen's Compensation Imucanw.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
raW
shall be completed In likely days; MOVED -IN BUILDINGS shall be was-
knowledged in space provided.
REMARKS
t
SIGNATURE (OWNEED
Legal Description of Property (Show Below or Attach Four Copies)
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✓!1-�t)<
TYPE CONNECTION
VERIFIED BY
PERC. TEeTPERMIT
NUMBER
04
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REMARKS
to
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a
Z N Y F ONBTRUCTIO STREET IMPROVED
- 6 ORB BIO
DEPARTMENT URE
1
(�' ( 4 :.'�(/.�
CITY OF
EDIVIONDS DATE
NOTE: Applicant Subject to Plan Check Fee 775-2525
This Permit cnvers work to be done on private property ONLY.
Any wnstructlon on the public domain (curb., sidewalks, drlveways,
mINSPECTOR
marquees, etc.) will require separate permission.
t
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C.-
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I `q YES [I NO
'P CIA ECTI REQUIRED OCCUPANCif' GROUP
RESIDENTIAL
YO
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NEW
N
LAN CHECKED❑
P
THIS SITE IS LOCATED IN THE CITY
Q NON-RESIDENTIAL
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OF EDMONDS. LOCAL SALES TAX
ADD
AINING
REMARKS -
SHOULD BE CODED 31.04.
DEMOLISH
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El ALTER EXCAVATE EJ
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On FILL I..........X..........1".)
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REPAIR ❑ IRE -MOVE O PSWIMOOL
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NUMBER OF eTOR1E9 NUMBER OF
DWELLING
UNI1B
NATURE OF WORK TO BE DON StC' '� ` �' �jtJ7 �-!J
Valuation
Fee Receipt No.
/T'2F /2
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Plan Check No ..................._
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S.Pr r (r.G rl � r' N."
BUILDING
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PROPOSED USE
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PLUMBING
aPLOT
PLAN (Indicate Building set`ba, gtt,rng streets)
HEAT & GAS LINE
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FENCE
I
SIGN
v
RETAINING WALL
-
N
SWIMMING POOL
1
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the In.
TOTAL AMOUNT DUE
L7 s
forms
orm Hon given 1s correct; and that I aot the owner, or the duly author-
Ized agent of the owner. I agree to comply with Illy and elate law, rag'-
ATTENTION
APPLICATION APPROVAL
latlnIf construction; and In doing the work authorized thereby, no person
;
Will be employed In violation of the Labor Code at the State of Washington
THIS PERMIT
This application is not a permit until
relatlgg to Workmen's Compensation Imucanw.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
i
shall be completed In likely days; MOVED -IN BUILDINGS shall be was-
knowledged in space provided.
Dleted in ,Ix months.)
SIGNATURE (OWNEED
INSPECTION
DlR'
- 6 ORB BIO
DEPARTMENT URE
1
(�' ( 4 :.'�(/.�
CITY OF
EDIVIONDS DATE
NOTE: Applicant Subject to Plan Check Fee 775-2525
This Permit cnvers work to be done on private property ONLY.
Any wnstructlon on the public domain (curb., sidewalks, drlveways,
mINSPECTOR
marquees, etc.) will require separate permission.