18504 73RD AVE W.PDF111111111111
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18504 73RD AVE W
PERM11 NO: 9427
Cit of Edmonds
y PERMIT EXPIRE
SIDE SEWER PERMIT
Address of Con . struction: LID # Z
MQq A Y'c 44
Property Tax Account Parcel No.
Attach copies of all access and utility easements Veri
Owner and/or Contrarto): PQ( � 4 If 60A S 717- 6; ,
Contractor Li cense P6 I vt
and
Building Permit
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A'-S-�ingle Family Invasion into City *Right -of Way: El Yes ,.J�o
F� Multi -Family (No. of Units *RW Construction Permit
Ej Commercial (No. of Units Cross other **Private Property: El Yes. 9+mo—
Fj -Public "Attach legal description and copy of recorded easement.
tlJ-0." < Ownerf'C"ont'racto) o
Owner or contractor signature and acknowledgement statement: Date
By sighing 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.
W. CALL DIAL*A-DIG (1-8007425-5555) BEFORE ANY EXCAVATION 9
2 FOR INSPECTION CALL 425-771-0220 extens.ion 329� 9
24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REOUESTS
... ..... . .... FOR OFFICE USE ONLY.
Permit Fee Repair Fee Issued By:
V
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: Initial: As -built to Street File: E]
1,� PERMIT MUST BE POSTED ON JOB SITE t�
WhiteCopy: File GreenCopy: Inspector Buff Copy: Applicant
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ay not exi mv
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118504-73rd Ave. W,
".7
Inspecilon Tee (8' Deep)
61 Riser to surface
-V
3'
4' Sch, 30315
(2) 1/8 Bendszl--- Mastic Pipe -32'
151 Deep
3'
CITY OF EDMONDS SIDE SEWER AS -BUILT
ADDRESS 18504-73rci Avenue West
PERMIT 9427
NUMBER
HOMEOWNER
CONTRACTOR Pointe Construction
DATE 5-11-01
DRAWN Jim Roberts'
BY