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00 ADD 8S
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8 &2 776-
8 STATE LICE )BE NUMB R CITY LICEh
223.02 - l ie6f>
Proeorty tallow Below or Attach Fo
FRONT HIDE REAR FRONT $IDE REAR
LEGL LUT VARIANCE Olt CONDITIONAL UHF.
❑ AYE8 ❑ NO PERMIT NUMBER ,
PLANNING EPT. APPROVAL DATE:
STREEXIST NG STREET R/W ............ Fr- DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
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CBECKED BY '
METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED By
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REMARKS � '-
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TYPE CONNECTION VERIFIED BY
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PERC. TEST I PERMIT NUMBER (d
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REMARKS
1
1 I.
FIRE ZONE I TYPE OF CONSTRUCTION STREET IMPROVED
❑ YES ❑ NO
SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
YES NO
RESIDENTIAL
❑
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11 ❑
BY SITE IS LOCATED IN THE CITY
DUILDING
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BUILDING DEPARTMENT
Applicant Flu
USE
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PERMIT %/�r'/j I }�
NUMBER 404 v
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PLAN CHECKED THIS
EDMONDS. LOCAL SALES TAX
PERMIT APPLICATION
Inside Heavy Lines
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NON-RESIDENTIAL
❑
NAME (OR NAME OF BUSINESS)
SHOULD BE CODED 31.04.
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IAT COVERAGE
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ACTUAL
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CTELEPHONE
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NAME
zA
00 ADD 8S
F CITY TELEPHONE
8 &2 776-
8 STATE LICE )BE NUMB R CITY LICEh
223.02 - l ie6f>
Proeorty tallow Below or Attach Fo
FRONT HIDE REAR FRONT $IDE REAR
LEGL LUT VARIANCE Olt CONDITIONAL UHF.
❑ AYE8 ❑ NO PERMIT NUMBER ,
PLANNING EPT. APPROVAL DATE:
STREEXIST NG STREET R/W ............ Fr- DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
O
� I
CBECKED BY '
METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED By
a
REMARKS � '-
I
TYPE CONNECTION VERIFIED BY
i
PERC. TEST I PERMIT NUMBER (d
W r
REMARKS
1
1 I.
FIRE ZONE I TYPE OF CONSTRUCTION STREET IMPROVED
❑ YES ❑ NO
SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
YES NO
zo,
Q� l�r�� ��.�•T
BWIMMIN6 POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
C
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In.
lormatlan given Is correct; and that I am the owner, or the duly nuther-
lud client of the owner. I agree to complY with ally and .tete taws regu- ATTENTION APPLICATION APPROVAL -
I..ting construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington THIS PERMIT This application is not a permit until
relating to Workman's Compensation Ine-ance. AUTHORIZES signed by the Building Official or his Dep -
ONLY TIE lily; gild fees are paid, and receipt Is ae-
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
.ball be completed In ninety day.; MOVED -IN BUILDINGS shall be coin- knowledged In apace provided.
pleted In six months.)
iIGNA I(E (Ol ER OR AGENT) �' DATE SIONEU INSPECTION DiR OR's @)ONATU�IE
L/ DEPARTMENT
/`/•/L �/ s1C 7 L• ° i1.F,'vr : r%�'lr iii: i L[,.-/.C1�•
CITY OF
EDMONDS
NOTE: Applicant Sn� ect to Plan Check Fce 775.2525
Title I'rrmlt coven work to be done on private properly ONLY.
Any construction on the public domain (curbs• sidewalk., driveways, FILE
marquees, etc.) will r,gmea .,parole I—ml.slon.
Plan Cheek No .....................
RESIDENTIAL
❑
O B
LIANE
11 ❑
BY SITE IS LOCATED IN THE CITY
DUILDING
NEWOF
HEAT @ GAB LINE
PLAN CHECKED THIS
EDMONDS. LOCAL SALES TAX
FENCE
Q Q
NON-RESIDENTIAL
❑
BION
SHOULD BE CODED 31.04.
F1ADD
ElDEMOLISH
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RETAINING
WAIT'
REMARKS
- 12.14.040
❑
ALTER ❑
EXCAVATE
OR FILL
-FENCE
t........_x_........ Ft.)
Fence requirements section
REPAIR
❑
POOli
attached.
❑
INIEPEfOVE
:UMBER OF 8TORIES NUMBER OF
DWELL No
UNITS
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Q� l�r�� ��.�•T
BWIMMIN6 POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
C
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In.
lormatlan given Is correct; and that I am the owner, or the duly nuther-
lud client of the owner. I agree to complY with ally and .tete taws regu- ATTENTION APPLICATION APPROVAL -
I..ting construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington THIS PERMIT This application is not a permit until
relating to Workman's Compensation Ine-ance. AUTHORIZES signed by the Building Official or his Dep -
ONLY TIE lily; gild fees are paid, and receipt Is ae-
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
.ball be completed In ninety day.; MOVED -IN BUILDINGS shall be coin- knowledged In apace provided.
pleted In six months.)
iIGNA I(E (Ol ER OR AGENT) �' DATE SIONEU INSPECTION DiR OR's @)ONATU�IE
L/ DEPARTMENT
/`/•/L �/ s1C 7 L• ° i1.F,'vr : r%�'lr iii: i L[,.-/.C1�•
CITY OF
EDMONDS
NOTE: Applicant Sn� ect to Plan Check Fce 775.2525
Title I'rrmlt coven work to be done on private properly ONLY.
Any construction on the public domain (curbs• sidewalk., driveways, FILE
marquees, etc.) will r,gmea .,parole I—ml.slon.
Plan Cheek No .....................
Valuation
Foe Receipt No.
DUILDING
PLUMBING
HEAT @ GAB LINE
FENCE
Q Q
81CN
RETAINING WALL
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RECORD OF INSPECTIONS
Date Passed
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Foundation
11
Plumbfng.(Partiai)
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•(Rough)
Frame
Furnace & Fuel •Lines
Final s,
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