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18424 72ND AVE W
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City of Edmonds, PERMIT -NO: 9323-
PERMIT EXPIRE
SIDE SEWER PER)4IT
Address of Construction: ls4a�f 17 7- 4 0 W #
Property Tax Account Parcel No. QC) C) ()Z Z CDC)
t ' A h copies of all access and utility pasements Verified and'Approved b
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Owner and/or Contractor: g-=zVm"s
Contractor License#:. 1�_"DtmA-445
Single Family
Multi -Family (No. of Units
Commercial (N(o..of Units
F] Public
0
ilding Permit
Invasion into City *Right -of Way: Yes No
*RW Construction Permit
Cross other "Private Property: El Yes No
"Attach legal.description.and copy of recorded easement.
Owner or contractor signature and acknowledgement statement:
B signing for this,permit I certify that I have read the City's public hando'ut.entit ed
y
ide Sewer Specifications, and shall comply with all City requirements outlined therein.
DTte
-DIG (1-800-425-5555) BEFORE ANY EXCAVATION 2
CALL DIAL -A.
W FOR INSPECTION CALL 425-771-0220 extension�Wr���,,'
24. HOUR NOTICE REOUIRED FOR ALL INSPECTION REQUESTS
T.� PERMIT MUST -BE POSTED ON JOB'SITE r�.
White Copy::. File.' Green.Copy: Inspector Buff Copy: Applicant
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HOUSE
21
41/
C11
EDGE OF PAVEMENT
72nd Ave, West
CITY OF
EDMONDS
SIDE SEWER AS -BUILT
ADDRESS
18424 72nd Ave West
PERMIT
NUMBER 9323
HOMEOWNER R i c e
CONTRACTOR K & S Const,Inc,
DATE 4/3/01
DRAWN
I
Danietle Gilbert
BY