7027 179TH ST SW.PDFiiiiiiiiii ii.
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7027 179TH ST SW
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City of Edmof
SIDE SEWER PERMIT'
Address of Construction: LV.L-'- 1 1 /�T, I —
Property Tax Account Parcel No. f-14' ZZ
Attach copies of all access and utility easements
Owner and/or Contractor: &^ +
Contractor License#: W&L,-Z9126 --KQk3(2a Building Permit #:
4.Single F , amily
Fj Multi -Family (No. of Units
F� Commercial (No. of Units.
F-1 Public
Invasion into City *Right -of Way: Ej Yes 6�No
*RW Construction Permit #
Cross other "Private Property: El Yes L2;No
"Attach legal description and copy of recorded easement.
Owner or contractor signatureryid acknowledgement statement:
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By signing for this permit I ce y that I have read the City's public handout entitled
,Wide Sewer Specifications, and shall comply with all City requirements o . utli.ned therein.
Date
2 CALL DIAL -A -DIG (1-800-425-5555) BEFORE ANY EXCAVATIONM
WTOR INSPECTION CALL 425-771-*0220 eitension 329 W
24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REOUESTS
FOR OFFICE USE ONLY
... . ...... . . ......
Repair Fee $ Issued By: IT. IMAJ
Permit Fee
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: .1nitial:
Partial Inspection: Date: Initial:
Partial Inspection: - ----- Date: Initial -
FINAL INSPECTION APPR
OVED: Date: 01 Initial: As-bu'ilt to Street File:
t, PERMIT MUST BE POSTED ON JOB SJTE'�,
VVhite Copy: File Green Copy: Inspector, Buff Copy: Applicant
L;temp;bl d&,fbrrns;sspenrn itj I g4/00
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).
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2-1/2'
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3' 11
65'
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F E N C E
26'
SWR MAIN
179TH ST,
CITY OF EDMONDS SIDE SEWER AS
-BUILT
ADDRESS
7027 179th
PERMIT
NUMBER 9417
HOMEOWNER DON & PERRY WILLIAMS
CONTRACTOR
DATE 05/08/01
DRAWN
BY ISMAEL ABILA
3 OeoP
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