740600.pdf"y"
NAME
FRONT SIDE REAR FRONT 81DE REAR
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LEGAL LOT VARIANCE OR CONDITIONAL USE
WADDRESS
YES NO PERMIT NUMBER
BUILDING DEPARTMENT
Applicant Fill
NUMBER 740600
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PERMIT APPLICATION
Inside Heavy Lines
Joe L
TELEPHONE NUMBER
NAME (OR NAME OF BUSINESS)
Kr 13x0 LO
PERh1IeSIBI.E ' / LOT CO q
LOT COVERAGE LOT COVE1tA0E
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MAILING ADDRE8BO
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NAME
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PERMISSIBLE HEIGHT PROPOSED HEIGHT
COMP. PLAN ST. R/W ............FT. FT. W
RPI.1A1iH8 F
x
CITY TELEPHONE NUMBER
ACTUAL LOT AREA TOTAL BLDG. AREA
(off/� /tee !BZW
=
/ ri
REQUIRED YARDS PROPOSED YARDS p
NAME
FRONT SIDE REAR FRONT 81DE REAR
LEGAL LOT VARIANCE OR CONDITIONAL USE
WADDRESS
YES NO PERMIT NUMBER
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PLANNING DEPT. APPROVAL DATE:
C
CITY
TELEPHONE NUMBER
STREET R W p
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAME
O
COMP. PLAN ST. R/W ............FT. FT. W
RPI.1A1iH8 F
x
C
ADDRESS
(off/� /tee !BZW
CHECKED BY
94
CITY �d ice/ /
4_ � ` e
I TEJLE�PjHONO NUMBER
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METER SIZE BEIGVICE SIZE CLEARANCE CHECKED BY
STATE LICENSE NUMBER
CITY LICENSE NUMBER
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REMARKS
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Legal Description of Property (Show Below or Attach Four Copies)
TYPE CONNECTION VERIFIED BY
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PERC. TEST PERMIT NUMBER 0..
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REMARKS W
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
Q YES (3 NO
SPECIAL INSPECTOR REQUIRED GROUP
IOCCUPANCY
❑ YES 0 NO
(� ❑ GAB
RESIDENTIAL LINE
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NEW
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
NON•RESIDENTiAL1 11
OF EDMONDS. LOCAL SALES TAX
s1GN
SHOULD BE CODED 31.04. {
ADD RETAINING
El WALL
REMARKS
EX AV 18H
ALTER EXCAVATE FENCE
ALL- i)d /)�
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OR FILL 4.........x..........Ft.)
_
REPAIR SWIM
❑ INSPAIOVE El POOL
NUa1DER OF STORIES NUMBER OF
DWELLING
I
UNITS
NATURE OF WORK TO HE DONE
Valuation Fee Receipt No.
Plan Check Na .....................
BUILDING t
4
py,
PROPOSED USE
PLUMBING
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PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAB LINE 1
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FENCE I
SIGN
RETAINING WALL
N
SWIMMING POOL .
DEMOLITION
PRE -MOVE INSPECTION
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EXCAVATION OR FILL f 1)
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TOTAL AMOUNT DISE
I hereby acknowledge that I have read this application; that the In.
CCV I
'
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 elate laws regu•
ATTENTION APPLICATION APPROVAL
lating const Mellon: and In doing the work authorized thereby, no person
wlll be employed In violation of the Labor Code of the Stale of Washington
TIHB PERMIT This application is not a permit until -
relating to Workmen's Compensation Insurance.
AUTHORIZES elgned 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 -
.hall be completed In nloety days; MOVED -IN BUILDINGS shall be core.
lalowledged In space provided. 1
Fitted In elx month.,)
f
INSPECTION DIRECTO tl1ON
R AGENT) DATE SIGNED
DEPARTMENT
//- 18,- %
22a
CITY OF
EDMONDS DATE
NOTE: Applicant Subject to Plan Cheek Fee
775-2525
This Permit corers work to be done an private property ONLY.
Any I ... tnretlon
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