740364.pdfBUILDING DEPARTMENT ZON
Appursnt Flu E
PERMIT APPLICATION Inside Heavy Linos Toa
ADDS
NAME (OR NAME OF BUSINESS)
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Belt Homes LOT
MAILING ADDRESS FRRM
9808 - 215th S.W. _
C I•rC
CITY TELEPHONE NUMBER A
Edmonds. Washington 1776-2829 —4
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owner
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Lot 3 - Elm View Addition
Division B
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PERMIT
.6 NUMBER 740364
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AOTUAL �(7� LOT COVESYAOE�
CISTAfG STREET R/Wr:.:: .Fft• DEFICIENCYy THIS PROPERTY
COMP. PLAN ST. R/RVpff.t. spIl'. •.Q..FT.
7MARK8 Driveway slopes not to exceed thos
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REMARKS
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LINE
SIGN
WALL NII NG
FIRE ZONE TYPE OF CONSTRU ION BTREE IMPROVED
THIS SITE IS LOCATED IN THE CITY
SHOULD 3I BE CODED 04.SALES TAX
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BUILDING
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
El REPAIR ❑
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X® NEWLd RESIDENTIAL
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ADD ❑ DEbSOL18H
ALTER EXCAVATE
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LINE
SIGN
WALL NII NG
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PL HE ED Y
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THIS SITE IS LOCATED IN THE CITY
SHOULD 3I BE CODED 04.SALES TAX
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POOL
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70"
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1UMBER OF STORIES
NUMBER OF
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAS LINE
I 8 basement
DWELLING
UNITS
i
MATURE OF WORK TO
BE DONE
Valuation
Fee Receipt r
New Residence
I
tRETAINING
WALL
Plan Check No .....................
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BUILDING
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EE PROPOSED USE
PLUMBING
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PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAS LINE
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9
FENCE
SIGN
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tRETAINING
WALL
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BWIMMlNG POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
1
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TOTAL AMOUNT DUE
I hereby acknowledge thaI have read this application; that the In-
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formntlon given iscorrect; and that I = the owner, or the duly author-
Ized agent of the owner. I agree to comply with City and elate laws regu-
ATTENTION
APPLICATION APPROVAL--/
Iag construction; and In doing the work authorized thereby, no person
willUnbe employed In violation of the Labor Code of the State of Washington
TINS PERMIT
This application is not a permit until
rslotmg to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
i
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 shall be coin-
knowledged in space provided.
PNted In six months.)
I
SIGNATURE (OWNER OR AGENT) DATE "TONED
INSPECTION
Epppggq'''OW SI ATU
DEPARTMENT
CITY OF
EDAIONDS
DATE
NOTE:/ Applicant Subject to Pian Check Fee
— 1 7-
775-2525
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