7024 179TH ST SW.PDF111111111111
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7024 179TH ST SW
PE111 NO: 94-84
"City of Edmonds
M F PERMIT EXPIRE
SIDE SEWER PERMIT
Address of Construction: LID #
Property Tax Account Parcel No. IWO -FG 0 t OT
Attach copies of all access and utility e asements Verified and Approved by
Owner and/qr`Contrac�t: Aleh4,0,11-e SFL,0,eL_S
Contractor License Rr o'S Building Permit"k
qc? 45 cpz_.�
4�!rS�in le Family Invasion into City *Right -of Way: E:1 Yes
Multi -Family (No. of Units
Commercial (No. of Units
El Public
*RW Construction Permit #
V1
Cross other.* *Private Property: El Yes.
"Attach legal description and copy of recorded easement.
I n I
VVII %, %J
Owner or contractor signature and acknowledgement statement: Date
By signing for this permit'I certify that I have rdad'tli�'Qty's public handout entitled
ide Sewer Specifications, and shall comply with all City requirements outlined therein.
W CALL DIAL -A -DIG (1-800-425-5.555) BEFORE ANY EXCAVATION -W
W FOR INSPECTIONUALL 42-5-771-02-10 extension 329 2
24 HOUR NOTICE REOUTRED FOR ALL INSPECTION RE0UFSTS
................... .........
. . . .. ..... .... . .... . FOR OFFICE USE ONLY
Permit Fee Repair Fe6 $ Issued
Trunk Charge $ Date Issued: [,—&,I o
Assessment Fee '60 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:
FINALI.NSPECTION APPROVED: Date: U1 In,itjaI:__PCr_As-buiIt to Streeffile:
t� PERMIT MUST BE POSTED ON JOB SITEv
-White Copy: File Green Copy- Inspector' Buff Copy: Applicant
L;temp;bldg;formssspen-nitjlg4/00
NOTICE:
No warranty of accuracy.
The information shown on the attached map(s)
was compiled for use by the City of Edmonds,
its Employees and Consultants. The City of
Edmonds does not warrant the accuracy of
anything set forth on these map(s). Any person
or entity requesting a copy should conduct an
independent inquiry regarding the information
shown on the map(s), including, but not limited
to, the location of any sewer stub shown. Such
sewer stubs may or may not exist and may or
may not exist at the location shown. Neither
the City of Edmonds nor its employees or
officers shall be liable for the information given
on map(s), nor for any one representation
provided based upon said map(s).
t
N
179TH
ST, SW
C/o
6" PIPE
WYE DRIVEWAY
22
771
Ld
>
46'.
41
4'
_
22*5
80
)2'
26'
2 22*
17'
27'
GARAGE
25'—�
CITY
OF EDMONDS
SIDE SEWER AS
-BUILT
ADDRESS
7024
179TH ST, S,W,
PERMIT
NUMBER 9494
HOMEOWNER xxxxxxxxxx
CONTRACTOR PERRINVILLE
DATE
06/15/01
DRAWN
BY
ISMAEL ABILA
iF
Z71
'7 119 4-11
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