750247.pdfI
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PERMIT
BUILDING DEPARTMENT AZ
Applicant]EM OONE NUMBER 75`�247
ADDRESS
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PERMIT APPLICATION Inside Heavy Linea
PERMISSIBLE
LOT COVERAGE
ACTUA
LOT COVELGE
NAME' 0 NAME BBUUSIN011111
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
OiOil
03 r^ /
ACTUAL LOT AREA
TOTAL BLDG. AREA
MAILING ADDRESS
//)// `SCC /T f/�/ /•Y �/7
REQUIRED YARDS
FRONT SIDE REAR
PROPOSED YARDS
FRONT BIDE REAR
TELEPHONE NUMBER
CITY//�''
C] YES C3 NO
COMP. PLAN BT. R/W ............ FT.............FT.
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All
REMARKS
NAME
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yADDRESS
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ADDRESS
JOB //�/
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t/�•wGY
PERMISSIBLE
LOT COVERAGE
ACTUA
LOT COVELGE
CITY
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
c
ACTUAL LOT AREA
TOTAL BLDG. AREA
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REQUIRED YARDS
FRONT SIDE REAR
PROPOSED YARDS
FRONT BIDE REAR
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C] YES C3 NO
COMP. PLAN BT. R/W ............ FT.............FT.
LEGAL LT VARIANCE OR CONDITIONAL USE
0 YES O NO PERMIT NUMBER
REMARKS
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PLANNING DEPT. APPROVAL DATE:
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CITY
TELEPHONE NUMBER
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CONSTRUCTION STREET IMPROVED
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STREET R/{V
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
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C] YES C3 NO
COMP. PLAN BT. R/W ............ FT.............FT.
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REMARKS
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CHECKED BY
RESIDENTIAL
AS
INE
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TELEPHONE NUMBER
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STATE LICENSE •tNUAIBER
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CITY LICENSE NUMBER
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METER BILL
I SERVICE SIZE CLEARANCE
CHECKED BY
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Legal Description of Property (Show Below or Attach Four Copies)
REMARKS
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FIRE ZONE TYPE OF
CONSTRUCTION STREET IMPROVED
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C] YES C3 NO
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SPECIAL INSPECTOR REQUIRED
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RESIDENTIAL
AS
INE
❑ YES NO
(OCCUPANCY
NEW
PLAN CHECKED BY
THIS SITE 15 LOCATED IN THE CITY
ADD
NON-RESIDENTIAL
E] SION
OF EDMONDS. LOCAL SALES TAX
cH0 1 D B ODED 31,04,!
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❑RETAINING
DEMOLISH WAIS
REMARKS
ALTER EXCAVATE FENCE
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OR FILL (........_r..........Vt.)
,
REPAIR ❑ PRE-INSPAIOVE ED awl
POOL
NUMBER OF STORIES NUMBER OF
DWELLING
I
UNITS
NAT U E OF WORK TO HEDONE
Valuation
Fee Receipt No.
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Plan Check No .....................
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ROPOBE USE
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PLUMBING
PLOT PLAN (Irld-10 Building setback., nb.ttlaa .treat.)
HEAT A OAS LINE
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FENCE
SION
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
hereby aeknowiedge that I have rend this application; that the
In•
formation given In correct; and that I am Ne owner, or the duly author-
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I:ea agent of the owner. I agree to eomplY with etly and stale laws raga•
lating conelructloq; and In doing the
and
ATTENTION
ATTENTION
APPLICATION APPROVAL
work authorised thereby, no parson
will be employed In of the Labor Code of the State of Washington
relating to Workmen's
TIHB PERMIT
This application !s not a pelTnit until
Compensation Insurance,AUTHORIZES
NOTE: Permit Limit One Year
ONLY THE
eigned by the Building Official or his Dep -
(Except DEMOLITIONS which
.hall b
WORK NOTED
uty; and fees are paid, and receipt is ac -
completed In ninety days; MOVED -IN BUILDINGS shall be man.Imowledged
in apace provided.
SIGNATURE (OWNER OR AGENT) DATE STONED
INSPECTION
Di TOR'S
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DEPARTMENT
JTNAT
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CITY OF
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EDMONDSL24
DA E 1
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NOTE: Applicant Subject to Plan Check Fee
S_ 75 -
Thla Permit cuters to be done on private DraPartY ONLY.
PR a-Ilor
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Any conntrnetlon an theI'. public d....1. (curb., nldrwNks, drlvew'aye,
,ril,ircr, rlc.l „Ill r','urn ,rpurutr prrn,lrnlnn,
]'ILP•.