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18325 72ND AVE W
PERMIT NO: 9472,
City of Edmonds
PERMIT EXPIRES <?I 1 0
SIDE SEWER PERMIT I j
Address of Construction: 18327 '-).2 ", v`� 1,/ LID #
Property Tax Account Parcel'No. D(4?-. 0 1 S ()'0
Attach copies of all access and u�t�ity easements Verified and Approved b
Owner and/c(rContractorr: VA I'PA -Te rok 5
Contractor License #:
ZISZ'ngle Family
F-1 Multi -Family (No. of Units
Commercial (No. of Units
F� Public
ilding Permit #:
Invasion into City *Right -of Way: El Yes �No
*RW Construction Permit #
Cross other"Privat I e Property: El Yes P�rNo
"Attach legal description and copy of recorded easement.
,-jwne nt, atLUI
Owner or contractor signature and acknowledgement statements
Date
By signing for this permit I certify that I have read the City's public handout entitled
ide Sewer Specifications, and shall comply with all City requirements outlined therein.
9 CALL DIAL -A -DIG (1 -800-425 '5555) BEFORE ANY EXCAVATION W
RFOR INSPECTION CALL 425-771-0220 extension 329 W
24 -HOUR NOTICE REOUIRED FOR ALL INSPECTION, REOUESTS
`7777' ....... .. ....
FO OFFICE USE ONLY
.. ........... . .... ..
Permit Fee Repair Fee $ Issued By:_
Trunk Charge $ Date Issued:
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.
Job Site Ready YES NO —Date: Initial:
Partial Inspection: Date: Initial:
Partial Inspection: —Date: Initial:
FINAL INSPECTION APPROVED: Date: bl�-/O[ Initial: —0-9--As-built to Street File:
1,� PERMIT MUST BE POSTED ON JOB SITE 1-
White Copy:. File Green Copy: Inspector Buff Copy: Applicant
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CITY [IF EDMONDS SIDE SEWER AS -BUILT
ADDRESS
18325 72ND AVE W
PERMIT
NUMBER 9472
HOMEOWNER xxxxxxxxxx
CONTRACTOR POINT' CONST,
05/04/01
DRAWN ISMAEL ABILA
BY
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