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Ciety of Edmonds PERMIT NO: 9339,
PERMIT EXPIRE
SIDE SEWER PERMIT
Address.o LED #
f Construction: "114"
Property Tax Account Parcel No. 1 -7 2ZZ 0�4 00-3: ocp
Attach copies of all access and utility easements Verified and Approved b
Owner and/Q1 !LycewrA 4t,\Q 6
,Ct6ntracto
0 -17sq
Contractor License Building Permit#: 2-60
Single Family Invasion into City *Right -of Way: ElYes No r
F-1 Multi -Family (No. of Units *RW Construction Permit #
F� Commercial (No. of Units, Cross other "Private Property: Yes No
F-1 Public "Attach legal description and copy of recorded e*asement.
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Ownr- �Contractor � '-/ .. . . 1 -.1
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er or contract6r signAirvekorn"d acknowledgement statement: Date
,��,qBv i 6ing for this permit I certify that I have read the City's public� handout entitled
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1p7idSewer Specifications, and shall comply with all City requirements outlined therein.
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9 CALL DIAL -A -DIG (1-800-425-5555) BEFORE ANY EXCAVATION 2
2 FOR INSPECTIONCALL 425-771-0220 extension'3- .,131UN
24 HOUR NOTICE REOUIRED FOR AL�L INSPECTION REQUESTS
NOTE: IF JOB SITE IS-NOTREADY FOR INSPECTION WHEN -
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED...
JobSiteReadyYES NO,* Date:' Ihitial,*
Partial Inspection: Date: Initial:
Partial Inspection: Date:, Initial:
1Y. FINAL INSPECTION APPROVED.' Date: Initial: As -built to Street File:
f,�. PERMIT MUST-BEPOSTED -ON JOB SITE t�
White Copy: File Green,Co: :-lnspe�tor Buff Copy: Applicant
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CITY
OF EDMONDS SIDE
SEWER AS -BUILT
ADDRESS
18027
72ND AVE W
PERMIT
NUMBER 9339
HOMEOWNER xxxxxxx
CONTRACTOR JAMES
NEWTON
DATE 04/05/01
DRAWN ISMAEL ABILA
BY
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