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18027 73RD AVE W
PERMIT NO:
-City of Edmo tds PERMIT EXPIRES. klkll
11C. SIDESEWERPERMIT
Address of Construction: WZ-'l 7�>CA L11D # k7
7 7 5- -e�W "&-I
Property Tax Account Parcel No. I / i/�_—
Attach copies of all access and utility easements Verified and Approved, by
Owner and/or Contractor:
Contractor License #:
V Single Family
F-1 Multi-Fam'ily (No. of Units
Commercial (No. of Units
F] Public
F.
1��
ding Permit #:
Invasion into City *Right -of Way: 0 Yes . IV, No
*RW Construction Permit #
Cross other "Private Property: El Yes No -
"Attach legal description and copy.of recorded easement.
64rC-A—A-A OwnCr/Contracto 41
r or C�j
:e
or contractor signature and acknowledgement statement: Dater
' B signing forthis permit I certify that I have read the City's public handout entitled
3
y
ide Sewer Specifications, and shall,comply with all City requirements outlined therein.
S
2 CALL DIAL -A -DIG (1-800-425-5555) BEFORE ANY EXCAVATION W.
iff FOR INSPECTION CALL 425-771-0220 extension 3%
HOUR NOTICE REOUIRED FOR ALL INSPECTION REOUESTS
NOTE: IF JOB SITE IS *NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL. BE- CHARGED.
Job Site Ready YES NO —Date: Initial:
PalrUal Inspection: Date:- Initial:
Partial Inspection: Date: Initial:
FINAL INSPECTION APPROVED: Date:, initial: As -built to Street File:
PERMIT MUST BE
....POSTED ON JOB SITE
WhiteCopy: File Green Copy: Inspector Buff -Copy: Applicant
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180TH ST, SW
CITY OF EDMONDS
SIDE SEWER AS
-BUILT
ADDRESS
18027 73RD
AVE, W.
PERMIT
NUMBER 9365
HOMEOWNER xxxxxxxxxx
CONTRACTOR JD
. NEWTON
DATE
04/17/01
DRAWN
ISMAEL ABILA
BY
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