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BUILDING DEPARTMENT Applicant Fill
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inside Heavy Linos
PERMIT APPLICATION
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ADDRESS f /
NAy261,E (Oft NAME BUBINE/BB)
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PERMISSIBLE o
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LOCOVERAGE � i �O LOT COVEItAOE
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MAILING ADDRESS
PERMISSIBLE IIEIGI azo PROPOSED HE ilT�
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TELEPHONE NUMBER
ACTUAL OT A
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REQ IRED YARDS YRO BED VARUS
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FRONT SIDE REAR NT SIDE REAR
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NAME
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LEGAL LOT VARIANCE OR DITIONAL USE
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ADDRESS
YES NO PERMIT NUMBER
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PLANNING �jT ,,,APPft VAL
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CITY
TEL PHONE NUMBER
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STREET R/W
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EXISTING STREET R/W ............Fr. DEFICIENCY THIS PROPERTY
NAME
COMP. PLAN 8T. R/W ............FT. ............FT.
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REMARKS
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CHECKED BY
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CITY
TELEPHONE NUMBER
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METER BILE SERVICE SIZE CLEARANCE
CHECKED BY
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
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REMARKS
Legal Description of Property (BhoW or Attach Four Copies)
[Below
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TYPE CONNECTION
VERIFIED BYAl
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PERC. TEST PERMIT NUMBER
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REMARKS
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FIRIP,�9NE TYPE OF CONSTRUCTION STREET IMPROVED,'
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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® RESIDENTIAL
GAS
LINE
Q YES NO '
FJ NEW
PLAN CHECI(El�i IIP THIS SITE IS LOCATED IN THE CITY
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❑ NON-RESIDENTIAL
❑
EDMONDS. LOCAL SALES TAX
SIGNOF
SHOULD BE CODED 31.04.
RETAINING
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N�{ES� �l
REPAIR ❑
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NUMBER OF STORIES NUMBER OF
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NATURE OF WORK TO BE DONE
Valuation
Fee Receipt Na.
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Finn Check No .....................
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BUILDING
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PROPOSED USE
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PLUMBING
PLOT PLAN Building
HEAT & GAS LINE
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Undlenle setbacks, abutting streets)
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FENCE
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SIGN
RETAINING WALL
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SWIMMING POOL
DEMOLITION
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PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL A51OUNT DUE
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1 hereby acknowledge that I have read this application: that the In.43
, given le correct: and that I sun the owner, or the duly author-
ized agent of tha owner. I agree to comply with city and elate law, regu-
ATTENTION
APPLICATION APPROVAL
,sting construction; and In doing the work authorlxed thereby, no person
will be employed In violation of the Labor Code of the Slate or Washington
TIUS PERMIT
This application is not a permit until
'
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
{YORK NOTED
uty; and fees are paid, and receipt is Be
shall be completed In ninety days; MOVED -IN BUILDINGS ,hall he com-
knowledged in space provided.
pieced In als month,.)
SIGNATURE (OWNER OR AGENT) DATE B1GNE
INSPECTION
DIRECTOR'
8•I(GNAT i./%
DEPARTMENT
CITY OF
NOTE: Applicant SBGject to Plan Cheek Fee"
EDMONDS
DATE
-
775 -2525
This 1'e Rult sayers work to be done on prh•ale property ONLY.
Any canstructlua an the public domain (curbs, sidewalks, driveways,
FILE
marquees, eteal will require separate permission.
11111
Plan Check N
•-
BUILDING DEPARTMENT Applicant Fln
ZOFNE
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nIDIETIt
PERMIT APPLICATION DIM. Heavy Linos
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ADDRESS /
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BUILDING
NAME (OR NAME OF BUSINESS)
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SPECIAL INSPECTOR REQUIRED
❑ YES VNO
OCCUPANCY GROUP
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PFR h11tleIB E ^
tAT COVERAGI?
ACTUAL
LOT COVERAGE 01 <
❑
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MAILl O ADDRESS
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PERMISSIBLE HEIO
/ PROPOSED HE
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NON-RESIDENTIAL
DEMOLISHE]RETUNING
EXCAVATE
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SIGN
FENCE
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REMARKS
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REPAIR
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CITY
CITY -
TELEPHONE NUMBER
ACTUAL LOT AREA
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TOTAL HLDO. RCS (
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NUMBER OF
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L UTAED YARU9
FRONT BIDE
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ISO OtlED VARDtl
REAR Flt NT BIDE REAR
NAME
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ADDRESS
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LEGAL VARIANCE
O BCONDSTIONAL U E
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Q] YES NO PERMIT
NUMBER
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Valumlon
PLA NNI 6 D,E T. API'
VAL DATE:
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�CITY
N
TELEPHONE NUMBER
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STREET X/{V
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DEMOLITION
EXISTING STREET R/W
............FT, DEFICIENCY THIS PROPERTY
C-
NAME
COMP. PLAN ST. R/W
............FT. ............FT.
IWW
____..-� •--"
REMARKS
PRE -MOVE INSPECTION
F
ADDRESS
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MAO
DEPARTMENT
CITY OF
EDDIONDS DwTE i
NOTE: Applicant Subject to Plan Check Fee
/ ^� • r
This I'ermll ro o b, re work tdo 775.2525
ue on "Vote property' ONLY. j
Any construction on 111, public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate perndeslon. 'INSPECTOR
Plan Check N
N/A U (. Ujl
FIRE((ONE TYPE OF CONSTRUCTION STREET IMPROVED
_. .Y I '� ❑ YES [3 NO
BUILDING
v
5r
SPECIAL INSPECTOR REQUIRED
❑ YES VNO
OCCUPANCY GROUP
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RESIDENTIAL
❑
LINE
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
ADD
ALTER
❑
NON-RESIDENTIAL
DEMOLISHE]RETUNING
EXCAVATE
❑
SIGN
FENCE
r
LOCAL
SOHOULD BE CODED 31.045ALE5 TAX
REMARKS
/�„ —rY,04— xX
n
t-C�/�' /3,e) / G%
REPAIR
❑PRE
On FILL
-MOVE
INSP
El
(.......... .......... r,.)
SWITIt
POOL
t
)006/! C/J —JL1k6%J YV/A .0 ~
NUMBER OF STORIES
NUMBER OF
�\!J
11�Y`
FENCE
DWELLING
`—
fF: i
UNITS
SIGN
NATURE OF WORK TO BE DONE
r, -t: ILS 1 L .1, ,
'
Valumlon
Fee
Receipt F
DEPARTMENT
CITY OF
EDDIONDS DwTE i
NOTE: Applicant Subject to Plan Check Fee
/ ^� • r
This I'ermll ro o b, re work tdo 775.2525
ue on "Vote property' ONLY. j
Any construction on 111, public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate perndeslon. 'INSPECTOR
Plan Check N
BUILDING
v
5r
a. PROPOSED USE���
lI'
PLUMBING
APLOT PLAN (Indicate BUlidln6 ecWorks. abutting street.)
HEAT & GAS LINE
32 \
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11�Y`
FENCE
`—
SIGN
'
RETAINING WALL
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N
{ i •... ., i
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SWIMMING POOL
DEMOLITION
C-
____..-� •--"
PRE -MOVE INSPECTION
1
EXCAVATION OR FILL
S D•CJ
///�
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In•
formation given iscorrect; and that I am the owner, or tho duly author-
j
Ized agent of the owner. I agree to comply wltlt city and .tote lows resu
toting construction; and In doing the work authorised thereby, no person
ATTENTION
APPLICATION APPROVAL
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
c '
relating to Workmen's Compensation Insurance,
AUTHORIZER
signed by the Building Official OT his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
µ•ORI{ NOTED
utyj and fees are paid, and receipt is ac -
,hall be completed In ninety days; MOVED -IN BUILDINGS shall be cem•
knowledged in apace provided,
picted In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIRECTOR'S SIGNATURE
DEPARTMENT
CITY OF
EDDIONDS DwTE i
NOTE: Applicant Subject to Plan Check Fee
/ ^� • r
This I'ermll ro o b, re work tdo 775.2525
ue on "Vote property' ONLY. j
Any construction on 111, public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate perndeslon. 'INSPECTOR