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G ILDING DEPARTMENT AppileantFILLSc A
Inside heavy Lines ERMIT APPLICATIONJoB
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ADDRESS
N M' (OH NAME OF DUBINE88) / Or L/L J
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iV JJ�y��p r� /! / L.�[ 1 N✓ (: LOT COVERAOEe
LOT COVERAGE 1 .
/ a IM�AlLIN6 ADDRESS l� PERMISSIBLE HEIGHT PROPOSED HEIGHT O ;
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O C TY TELPHONE NUMBER ACTUALOT AREA TOTAL
EL SLDO. AREA z
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REQUIRED YARDS PROPOSED YARDS w S
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NAFRNID
OT tlE REAR FRONT BIDE REAR
ME I e
LECAL LOT VARIANCE OR CO D TIONAL UeE
H DIIE88 YE9 ❑ NO PERMIT NUMBER �V� �1� '
.� PLAN DE . APPR VAL O 7�DATE:
U CITY TELEPHONE NUMBER J '
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STREET RlY
EXIBTINC STREET R/W ............F'T. DEFICIENCY THIS PROPERTY
AME
COMP, PLAN BT. RJW ............FT. ............FT. i -
REMARKS
C 1,13DRES. 'z
CHECKED BY
Sd ITY I TELEPHONE NUMBER M
p METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED BY I
O TATE LICENSE NUMBER CITY LICENSE NUMBER
REMARKS N ?
I.egai Deeerlpllan o[ Property (Show Below or Attach Four Copies)
TYPE CONNECTION VERIFIED BY
A ;
i. PERT. TEST I PERMIT NUMBER � 1
nM
W
REMARKS 'n
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FIRE E I TYP�CONSTI/CTTgN(/ I STREET IMPROVED
/Z YE8 NO
SPECIAL INSPECTOR REQUIRED OCCUVAA'NCY OHOUP
CAS ❑ Y69 N NO I % — 2
RESIDENTIAL I NE PLAN CHECKED BY(y�/7/ THIS SITE IS LOCATED IN THE CITY
El NEW NON-RESIDENTIAL ❑ SIGN ) `I jI{Q1JLD BE CODED 31.D4.
�{ OF EDMONDS. LOCAL SALES TAX
ADD RET❑ DEMOLISH WALL VINO REMARKS
ALTER ❑ EXCAVATE FENCE
OR I. LL (.......... z .......... Ft.)
SWIT
❑ REPAIR ❑ PRE-INSP. El POOL
NUMBER OF STORIES I NUMBER Oil
DWELLING
UNITS
/NyATURE OF WORK TOREDONE J Valuntlon Fee Receipt No.
!ll £ (� /' Plon Check N. ..................... /')^
o i1 /_ POSED /_.' C %[, tip -- �i BUILDING ,';,
PROUSE
q PLUMBING
W1
O PLOT PLAN (Indlcnte Building eMbnoka, abutting Stents) HEAT &CAB LINE
FENCE (fl
SIGN
RETAINING WALL �
8W1aSMIN6 POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have reed this application; that the In- v '
formation given In correct; and that I am the owner, or the duly author- '
Ired agent of the owner. I agree to comply with ally and slate lawn regu- ATTENTION APPLICATION APPROVAL
lating construction; and in doing the work authorlred thereby, no person
will. employed In violation of the Labor Code of the Slate of Washington TINS PERMIT This application is not a permit until
nlntlag to Workmen's Compensation Insurance. AUTHORIZES Signed by the Building Official or his Dep -
ONLY THE
NOTE: Permit Limit One Year (Egeept DEMOLITIONS which WORK NOTED Uty; and fees are paid, and receipt is ac
.hall be completed to ninety days; MOVED -IN BUILDINGS shall be win- knowledged in space provided,
Pleted In f month..) ,
INSPECTION
IGN It ( SVNER RAC NT) DATE SIGNED DIRECTOWS'SIONATUFIIiiiTW- ��-
% 1 DEPARTMENT }/J�. -�
- CITY OF / I J
EDMOND3 DwTE
NOTE: Ahh nt Subject to Plan Cbeck Fee 77 OND �G
Tlds Pennit corer, t,.,k to be done an private property ONLY.
Any construction on the public domain (curb., sidewalks, drhe,"s, FILE
marquee., etc.) will require .epouaie permis.1m.
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01
PERMIT —7P 'f:,,ti
ZONE NUMBER
BUILDING DEPARTMENT Applicant Ftll
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Inside Heavy Linos
PERMIT APPLICATION I
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ADDRESS )67 �1
NAME to NAME OF BUSINESS)
pp;RMLtlS1BLE �" ACTUAL
LOT COVEAGE
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MAIWNO ADD iEee ,
ILEPHONE
LAT COVERAOI.r
pE1tal ltltllHLE HEIOIIT PROPOSED HEIGHT
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A 4 SLUG. AREA
ACTUAL LOT AREA TUTA
NUMBER
CITY T
REQUIRED YARDS PROPOSED YARDS
REAR
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FRONT SIGN REAR FRONT SIDE
NAME
(.,
LEGAL LOT AItIANCE OR CO[i}) TIO NAL USa �O
YES PERMIT PEMIT NUMBER ltJ\
I,Uj ADDRESS
PLAN BE . APPR VAL DATE:
117 �
3
O TELEPHONE NUMBER
C CITY
I
STIWET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
-S
NAME
COMP. PLAN ST. R/W ............FT. ............FT.
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REMARKS
,
C ADDRESS
M 333
Q
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CHECKED BY
1
CITY
TELEPHO E NUMBER
F
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METER S1ZE SERVICE SIZE CLEARANCE
CHECKED BY
o
V STATE LICENSE NUMBER
CITY LICENSE NUMBER
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REMARKS /A
Legal Description of Property (Snow Below
or Attach Four Copies)
TYPE CONNECTION I VERIFIED HY
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PERC. TEST PERMIT NUMBER
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FERE NE TYP£ OE CONSTRUCTS N STREET IMPROVED
t2�YES [03 NO
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SPECIAL INSPECTOR REQUIRED(OCCUPANCY GROUP -�
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0 NEW
❑ RESIDENTIAL
GAS
❑ LINE
C]YES NO
PLAN CDY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
NON-RESIDENTIAL
SIGN
SHOULD BE CODED 31.04.
ADDRETAINING
L]DEMOLISH WALLtZ
REMARKS
FENCE
❑ EXCAVATE
ALTER X ..........
OR FILL
'
REPAIR swim
PRE -MOVE ❑ POOL
❑
i
INSP.
NUMBER OF STORIES NUMBER OF
`�-
DWELLING
I
UN1T8
NATURE OF WORK TO BE DONE
Vnum"an Fee RccclpV No. .
�{
)JY , `Af ): -r .0 V tll�
•II
clan Check Na ....................
CC
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o IC Ir
BUILDING(20
1.� /�/L •l./�;r
a, PROPOSED USE
PLUM33ING
PLOT PLAN (Intllcnta DLLIIdln6 setbacks, abutting e\rUcete)
HEAT 6c GAS LINE
--
i
,�
0 �J 1
s �I371
FENCE
I
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
i I�
PRE -MOVE INSPECTION
'
EXCAVATION OR FILL
i
TOTAL AMOUNT DDE
I hereby acknowledge that I have tend this application; that the fn-
I
formation given Is correct; and that I am the owner, or the duly author-
add elate laws regu-
APPLICATION APPROV�L
Ized agent of the owner. I agree to Comply with city ATTENTION
latidg construction;and In doing the work authorized thereby, no Berson
the Labor Code of the State of Washington THIS PERMIT
application is not a permit
This app
ntil �I
will be employed In violation of
relating to Workmen's Compensation lasuradce.
AUTHORIZES
signed by the Building Official or his
Dep -
ONLY THE
uty; and fees are paid, and receipt I so -
NOTE: Permit Limit One Year (Except DE31OLITIONS Which WORK NOTED
be cam•
knowledged In space provided.
.hall be completed In ninety days; MOVED -IN BUILDINGS .hail
plated In .ix;m 1113.)
N INSPECTIOTURE
DEPARTMENT
DIRECTOR'S, 016NATURE „ I-
`(
SIGNATURE (O{VNER OR AGENT) DATE BiGNEll
+/
CITY OF
I'll. (/ j�Z1.\"�L
EDMONDS
DATE %
NOTE: Applicant Subject to Plan Check Fee
775-2525
This Permit coven work to be done an private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
INSPECTOR
marquee., etc.) will require separate permission.
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