ENG20170008-SS.pdflG' %' OF EDMONDS
121 5TH AVENUE NORTH -EDMONDS, WA 98020
PHONE: (425) 771-0220'- FAX: (425) 771-0221
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*PERMIT MUST BE POSTED ON JOBSI'1TE*
STATUS: ISSUED ENG20170008
SIDE SEWER PERMIT (]-Single Fandly)
Permit Number: ENG20170008 Expiration Date: 03/09/2017
Job Address: 20314 77TH AVE W, EDMONDS
APPLICANT CONTRACTOR
FISCHER PLUMBING FISCHER PLUMBING
6608 220TH SW 6608 220TH SW'
MOUNTLAKE TERRACE, WA 98043 MOUNTLAKE TERRACE, WA 98043
(206)510-6337
LICENSE #: FISCHPCI31RI EXP: 02/22/2018
JOB DESCRIPTION
Y REPAIR N PROPOSE TO REUSE LATERAL LID NUMBER:
N GRINDER PUMP N (PROPOSE TO REUSE SIDE SEWER N DRAINAGE `
ReplacIti 4" side sewer to shared: 6" side sewer,
N]VERIFICATION OF RECORDED EASEMENTS COMPLETE
INDEMNITY The Applicant has signed an application which states he/she holds the City of Edmonds harmless from injuries,
damages or claims ofany kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any, ofits departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
attorney fees by reason ofgranting this permit.
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
APPLICATION APPROVAL
THIS APPLICATION IS NOTA PERMIT UNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.,
Printed:. Mupdaj1miwar 09,201'
, , l,L S'ED BY DATE
�LE COPY r INSPECTOR COPY
APPLICANT COPY