740060.pdfSTATE LICENSE NUMBER CITY LICENSE NUMBER
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Valuation
Fee Re.clpt No
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Legal Description of Property (Show Below or Attach Four
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DEPARTMENT
RMIT
USE rrE NUMBER 74iJ060
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BUILDING
Applicant FMz
TYPE CONNECTION VERIFIED BY
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PERC. TEST
PERMIT APPLICATION
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OREMARKS
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ADDRESS
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NAME (OR NAME OF BUSINESS)
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SIGN
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PEItaIIeBIHLE ACTUAL e
LOT COVERAGE. LOT COVERAGE
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MAILING ADDRESS
PERMISSIBLE HEIGHT PROPOSED HEIGHT
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SWIMMING POOL
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FIRE ZONE T111 OF CONSTRUCTION S�T_RE�ET 3MP111E1
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CITY
TIELEPRONE NU BER
ACTUAL LOT AREA TOTAL BLDG. AREA
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EXCAVATION OR FILL
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REQUIRED YARDS ROP0.9LDARD S
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NO
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N M FRONT REAR FRONT REAR
TOTAL AMOUNTDUE
8P OCCUPANCY GROUP
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1 hereby acknowledge that I have read this application; that the in.
formation given Is correct; and that I am the owner, or the duly author-
RESIDENTIAL
❑
LINE
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❑ YES -� �j
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APPLICATION APPROVAL
LEGAL LOT VARIANCE OR CONDITIONAL USE
YES NO PERMIT NUMBER
NON-REBIDENTIAL
PLA C�iECKE n� THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
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relatlug to Workmen's Compensation Insurance.
PLANNING DEPT. APPROVAL DATE:
signed by the Building Official or his Dep -
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CITY I TELEPHONE NUMBER
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shall be completed In ninety days: MOVED -IN BUILDINGS shall be cam•
STREET R/W
ADD
DEMOLISH
RETAINING
WALL
EXISTING STREET R/W ............FT, DEFICIENCY THIS PROPERTY.
DATE SIGNED
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TER
NAME
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COMP. PLAN BT. R/W ............F7'. ............FT.
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❑EXCAVATE
OR FILL
REMARKS
(.......... x .......... Ft.)
CITY OF
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ADDRESS
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PR 6.3307
CHEC D BY
This Permit coven work to be done on private property ONLY.
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TELEPHONE NUMBER
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DWELLING
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METER ER SIZE SERVICE SIZE CLEARANCE
UNITS
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STATE LICENSE NUMBER CITY LICENSE NUMBER
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Valuation
Fee Re.clpt No
ILL -/`1 �JiL� L /'�,I�l•1//Ll1/ C• 1.// <•
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Legal Description of Property (Show Below or Attach Four
Caples)
REMARKS ��
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TYPE CONNECTION VERIFIED BY
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PERC. TEST
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PERMIT HER
OREMARKS
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FENCE
SIGN
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RETAINING WALL
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SWIMMING POOL
FIRE ZONE T111 OF CONSTRUCTION S�T_RE�ET 3MP111E1
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
NO
TOTAL AMOUNTDUE
8P OCCUPANCY GROUP
G O �/ S9
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1 hereby acknowledge that I have read this application; that the in.
formation given Is correct; and that I am the owner, or the duly author-
RESIDENTIAL
❑
LINE
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D-416— --
❑ YES -� �j
ATTENTION
APPLICATION APPROVAL
NEW
NON-REBIDENTIAL
will be employed In of the Labor Code of the State of Wmhlegton
PLA C�iECKE n� THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
This application Is not a permit until
relatlug to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
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SIGN
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SHO
shall be completed In ninety days: MOVED -IN BUILDINGS shall be cam•
•
ADD
DEMOLISH
RETAINING
WALL
ARKS
DATE SIGNED
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TER
O
FENCE
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�L�JI•'.Cj(fGJ%Q/[/ �C:F/ (�/j (j/'.
❑EXCAVATE
OR FILL
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(.......... x .......... Ft.)
CITY OF
REPAIR ElPRE-MOVEswim
INSP.
EDMOND$
POOL
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PR 6.3307
NUMBER OF STORIES NUMBER OF
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (.orbs, sidewalks, driveways,
DWELLING
UNITS
Valuation
Fee Re.clpt No
ILL -/`1 �JiL� L /'�,I�l•1//Ll1/ C• 1.// <•
Plan Check No.. .............
BUILDING
A
[O
4 PROPOSED USE
PLUMBING
a PLOT PLAN indicate Hullmng eetDacke, abutting streets)
HEAT & GAS LINE
7
p
FENCE
SIGN
RETAINING WALL
--
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNTDUE
G O �/ S9
G
1 hereby acknowledge that I have read this application; that the in.
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 law. ngu-
ATTENTION
APPLICATION APPROVAL
and
lating constmctlon: and in doing the work authorised thereby, no person
will be employed In of the Labor Code of the State of Wmhlegton
THIS PERMIT
This application Is not a permit until
relatlug to Workmen's Compensation Insurance.
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 so -
shall be completed In ninety days: MOVED -IN BUILDINGS shall be cam•
Wledged in Space provided.
pleled In .Ix months,)
SIGNATURE (OWNER OR AGENT)
DATE SIGNED
INSPECTION
IRE
DEPARTMENT
/
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CITY OF
EDMOND$
ATE
NOTE: Applicant Subject to Plan Check Fee
PR 6.3307
_
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (.orbs, sidewalks, driveways,
marquees, etc.) will r".I. separate permlwan.
USE PERM
`++ ONE NUMBER
BUILDING DEPARTMENT AppllcantFill
PERMIT APPLICATION I Inside Heavy Lines
NAME (OR NAME OF BUBINNUO)
MAILING ADDREBB
C CITYI TELEPHONE NUMBER
aU
C
JOE
ADDRESS
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PERMISSIBLE T
LOT COVERAGE
YES
❑PLAN CHECICED�)BYO
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i l,.;; ,%i. =; !
ACOTq
T COVERAGE
PERMISSIBLE HEIGHT
❑RETAINING
❑
PROPOSED HEIGHT
ACTUAL LOT AREA
WAIT'
FENCE
(..........x .......... Ft.)
TOTAL BLDG. AREA ,
REQUIRED YARDS
FRONT BIDE REAR
PROPOSED YARDS
FRONT SIDE REAR
PRE -MOVE
INSP.
D
SWIM
POOL
LE(IAL LOT
•Elia n Nn
VARIANCE OR CONDITIONAL USE
PF,RMIT NUMBER
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
. COMP. PLAN ST. R/W ............FT.
REMARKS
CHECKED BY
TELEPHONE NUMBER : / j
METER SIZE, SERVICE SIZE CLEARANCECHECKED BY
:NSE NUMBER I CITY LICENSE NUMBER I I, I -.`-
s
VPE CONNECTION VERIFIED BY
E E PERMIT NUMBER
b. K
IRE ZONE TYPE OF CONSTRUCTION IMPROVI
'Nr ,'iR••^ I i' - / d'XEB C1 NO
❑ NEW
/RESIDENTIAL
NON-RESIDENTIAL
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LINE
elaN
YES
❑PLAN CHECICED�)BYO
I /,moi ) /r, I
i l,.;; ,%i. =; !
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
ADD
ALTER
❑RETAINING
❑
DEMOLISH
EXCAVATE
OR FILL
O
WAIT'
FENCE
(..........x .......... Ft.)
REMARKS r)
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/:ir ,r: �• ;"ice �I / r;:� _�(-�� 'J%.�' �.:-�%' (:`fJ i �l"
ID REPAIR
PRE -MOVE
INSP.
D
SWIM
POOL
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NUMBER OF STORIES
NUMBER OF
PLOT PLAN (Indicate Betiding aetb eke, aDutting streets )
O�05P
HEAT A GAS LINE
DWELLING
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it
FENCE
UNITS
SIGN.
NATURE OF WORK TO BE DONE
tRETAINING
WALL
Valuntlon
Fec RccclPt No.
SWIMMING POOL
+._, .. G.. ii, ` L. .._•%.,J
Plan Check N. .....................
BUILDING
(Oy
0, PROPOSED UBE
PLUMBING
PLOT PLAN (Indicate Betiding aetb eke, aDutting streets )
O�05P
HEAT A GAS LINE
/
it
FENCE
SIGN.
tRETAINING
WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
6A. S
TOTAL AMOUNT DUE
Iheresy acknowledge that I have road this application: that the In.
r-1
formation given le 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
'
leting construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
TIDE PERMIT
This application is not a permit until
relating to Workman's Compensation Insurance.
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 -
shall be completed In ninety days; MOVED -IN BUILDINGS .hall be cum-
knowledged in space provided.
pleted In six mouth-.)
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SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIRECTOR'. SIGNATURE +
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DEPARTMENT
i
o�t`rt1� It-LF•�'-`G.,:� i !J "7
CITY OF
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EDMONDS
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NOTE: Applicant Subject to Plan Check Fee
PR 6-1307
1
This Permit eovers work to be done on private property ONLY.
Any construction on the public domain (eurbs, sidewalks, drlveways,
INSPECTOR
maraueee, etc.) wIB reew. separate permlblan,
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RECORD OF INSPECTIONS
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Date Passed ,? ,
Foundation p�
Plumbing (Partial) u
(Rough)
:'Frame
:,Furnace & Fuel Lines ,
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