7028 181ST PL SW.PDF1298
7028 181 ST PL SW
City6f Edmonds IERMIT NO: 9505'
PERMIT EXPIRES - 5YI,41111
SIDE SEWER PERMIT
4C. S9 / V, -
Address of Construction: LED it
Property Tax Account Parcel No. elTl�� 419
Attach copies of all access and utility easements tVAVerified and Approved b
Owner and/or Contractor: ;Cqa;rg- jx��vegs' Z's-c-
Contractor License#: E-49714.56052V3, OW,49 -Building Permit#:
EreSingle Family Invasion into City *Right -of Way: Ej Yes
Fj Multi -Family (No. of Units *RW Construction -Permit #
Commercial (No. of Units Cross other."Private Property: El Yes [P-N6-�_
E] Public
A tf-4 I Ct 5
"Attach legal description and copy of recorded easement.
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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 ' I .
ide Sewer Specifications, -and shall comply with all City requirements outlined therein.
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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 APPROV ED: Date- -1la, Ini t ial: As -bulllfto Street File:
1,� PERMIT MUST BE POSTED.ON JOB. SITE t,
White Copy: File Green Copy: Ins pector Buff Copy: Applicant
L;temp;bldg;forms;ssperinitjlg4/00
.1 () F ED,�,,_
181ST ST. S.W.
CITY OF EDMONDS SIDE SEWER AS- BUILT
ADDRESS:
7028 181ST PL SW
PERMIT
NO: 9505
ICONTRACTOR: lHOMEOWNER: SCALE:
EARTH SERVICES INC ERIC CUMBERLAND I NTS
JE INSPECTED INSPECTED BY: DATE DRAWN: DRAWN BY:
7/9/01 1 D.G. 1 7/2 8/ J. BRONDER