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18021 HOMEVIEW
DR
�r 12 C. 10"
PERMIT NO: 9369
of Edhi-onds.
.ity PERMIT EXPIRES - (o i o I
SIDE SEWER PERMIT
Address of Constructi
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Property Tax Account Parcel No. 1-4_7_7h'CQ0'Q:7b,0(_-) 0::Z�7
Attach copies*1,0f all access and utility easements Verified and Approved b
Owner and/or Contractor:44 14�� Z 4ft�
Contractor License #: ZJ )4-(- 0 Q 9- 4c. )4j,3 Building Permit #:
C2LSingle Family
Fj Multi -Family (No. of Units
F-1 Commercial (No. of Units
F-1 Public
Invasion into City.*Right-of Way: El Yes $4.Nq
*RW Construction Permit #
Cross other **Private Property: Yes -$&NO
"Attach legal description and copy of recorded easement.
Owne ontiactoDr. Cf--fl-V
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06-eror contractor.signature and 4tknowledgement statement:
By signing for this permit I certify that I have read the City's.public handout entitled
S ide Sewer Specifications, and shall comply with all City requirement's outlined therein�.
9 CALL DIAL -A -DIG (1-800-425-5555) BEFORE ANY EXCAVATION 2
9 FOR INSPECTION CALL 425-771-0220 extension 329 9
HOUR NOTICE
FOR OFFICE USE ONLY
Permit Fee $ An. -Repair Fee Issued By:'
Trunk Charge $ Date Issued:__�q r) i
Assessment Fee $ Receipt No:
City Permit Surcharge Fee $5.00 Total Fees Paid $
NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED..
JobSite Ready YES NO Date.: Initial:
Partial Inspection: Date: Initial:
Partial Inspection: Date: Initial:
q 7IT16r, 1.
FINAL INSPECTION APPROVED: Date: _jnitial:—DO( As -built to Street File:
T_� PERMIT MUST BE POSTED ON JOB SITE t�
White Copy: F.ile Green Copy: Inspector Buff Copy: Applicant
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CITY OF
EDMONDS SIDE
SEWER
AS-13UILT
ADDRESS
18021 HOMEVIEW DR,
PERMIT
NUMBER 9 3 5 9
HOMEOWNER HAYES
CONTRACTOR
AAA
DATE
04/12/02
DRAWN ISMAEL ABILA
BY
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