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18423 73RD AVE W
,PERMIT NO: 92.31
City of Edmonds
PERMIT EXF RES
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AddressofConstructiow /0�/Za- ;J'�3td JU�E ttJ LUD Q
Property Tax Account Parcel No. 4qql�5 z)bn c2o a2== Nov n R 2non
Attach copies of all access and utility easements Verified and Approved by
IjUbLIU WORKS DEM
Owner and/or Contractor: d,LEyE_LA&Sn j I
Contractor License#: eW-Ca — _4�20�4 —NQ -Building Permit #:
E�rSingle Family
Multi -Family (No. of Units
Commercial (No. of Units
Fj Public
.Invasio.n into City *Right -of Way: F� Yes �o
*RW- Construction Permit#
-Cross other "Private Property: El Yes 2-90
"Attach legal description and copy of recorded easement.
Owner/Contractor 1/Z /49 6
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
9
Side' Sewer Specifications, and shall comply with all City requirements outlined therein.
LYNNWWOOO'
LINE
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W CALL DIAL -A -DIG (1-800.-425-.5555) BEFOREANY EXCAVAT
R FOR INSPECTION CALL 425-771-0220. extension 329 W
24 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:
Partial lnsp'ecflon: -Date: Initial:
Partial Inspection: Date: Initial:
FINAL INSPECTION APPROVED: Date:' Initial: As -built to Street File:
t� PERMIT MUST'BE POSTED ON JOB SITE t�
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Side Sewer Drawing EASENtENT NO - ----------------------------- ------------
The City of Edmonds LID NO . .................. ASMT. NO.
NEW CONsTpLjCTION REPAIRS X
- CTOR ... ................. .... PERMIT NO.
OWNER ..... -CJ.V��tqAj ... . ...... .. ......................... .. CONTRA BLOCK NO . .......... ... I ..... ............
rj LEGAL DESCRIPTION: LOT NO - --------- --------------------- ------
..).4ve,M ................... ................................
JOB ADDRESS ..... I.V03 ......... �7-3 ...... ............................................. ...................
............................................................
........................... ... . ............
NAME OF ADDITION ---------------------------- ------------------------------------ Q-
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Approved:
DATE................ By ---- -------------- c�
pWW.0001-1 1175 (REV-1 V78)