18327 73RD AVE W.PDF111111111111
5780
18327 73RD AVE W
—c
. IS91)
RMIT NO: 9235,
City of Edmonds. PE
PERMIT EXPIRES
SIDE SEWER PERMIT
Address of Construction: 15a��29 ];;�d Aye7 W L11D* gag &T 0
Property Tax Account, Parcel No. 44gs- OL�0033 4=.�2 NUV 0 6 2009
Attach copies of all access and utility easements Verified and Approved
Owner and/or Contractor:
Contractor Licensek -Building Permit
.21S'i'trigle, Family Invasiolli int . o City *.Right -of WAy:'E:l Yes [3'go
Multi -Family (No. of Units *RW Construction Permit
E] Commercial (No. of Units Cross other "Private Property: Yes 0
E]Public **,Attach legal description and copy of recorded easement.-
Owner/Contractor
Owner or contractor signature and acknowledgement statement: Date
By signing for this permit I certify that I have read the City's public handout entitled
Side Sew I er Specification s, and shall comply with all City requirements outlined therein.
2 CALL DIAL -A -DIG (1-800-425-5555) 4EFORE ANY EXCAVATION 9
9 FOR INSPECTION CALL 4215,771-0226 ext�nsion 329 9
24 HOUR NOTICE REQUIRED FOR ALL 1,NSPECTION, REOUE,-STS
.:FOR OFFICE USE ONLY
Repair Fee $ Issued By.
Permit Fee
Trunk Charge $ Date Issued: 00
Assessment Fee $
City Permit Surcharge Fee $5.00
Receipt No:
Total Fees Paid $
NOTE: IF JOB SITE IS NOT READY FOR INSPECTIONWHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED.
Job'Site Ready YES NO Date: Initial:
Partial Inspection: k— + t'!;: Date: Initial:
Partial Inspection: Date: Initial:
FINAL INSPECTION APPROVED: Date:. Initial: As -built to Street File:
f� PERMIT MUST BE POSTED ON JOB SITE 15,
White Copy: File Green Copy: lnsl�ector Buff Copy- Applicant
L;tevnp;bldg;forvns,sspernnitjlg41
Side Sewer Drawing
EASEMENT NO .
................................ .......
The City of
Edmonds
REPAIRSb< LID NO . ..................
ASMT. NO . . ...............
NEW CONSTRUCTION El
ct7 -3�5
-------- c
PERMIT NO . ......... I ..........
CONTRACTOR
......... .....
...... .......... ...... ................... ..
BLOCK
NO - -------------- ----- ---------------
OWNER . .........................
.......... .............
) LEGAL DESCRIPTION -. LOT NO - --------------------------------------
.......
............
JOBADDRESS
- ....
................................................
................ ..........
NAME OF ADDITION ------------------------------------
...............
----------------
b3zj
cl
L3
E
L2
V
c
�j
Approved:
DATE............................................ By----------------------------------------
pWW.00oi-i
1175 (REV-1 1178)