18730 76TH AVE W11111111111111
15096
18730 76TH AVE W
CITY of EDMONERSIVE® ��-�-
For Inspection Call �7,t T
PUBLIC Wp
T Address of Construction: 3 o
SIDE SEWER PERMIT
PERMIT NO.
ILYNNW.00D LINE /
76 �-�- W
Property Legal Description (Include all easements): 0 AJ
Owner and/or Builder
Contractor & License No:
Single Family Residence
Multi -Family
Commercial
C�
C®I&ram
CCOLG--r
(No. of Units �)
(No. of fixture Units )
C 0A1 <,; r. - ma c .
/SJLNI
Invasion into City Right -of -Way: No Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No Yes (If Yes, easement required,
attach legal description and county easement number.) 0.0,J -F= rk—e-
PLE READ THE ITEMS LISTED ON THE BACK
9 (�
I certify that I have read and shall comply Da
with the items listed on the back.
Permit Fee: Issued By:
Trunk Charge: le) 0 Date Issued -
Receipt No.:49.
Partial Inspection:
Comments / Date Initial
Final Inspection Approved: ,
ate Ini ial
00 o Rejected:
Reason Date 7nitial
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy - File Green Copy - Inspector Buff Copy.- Applicant
The City of Edmonds
Side Sewer Drawing
EASEMENT NO- ............................................
NEW CONSTRUCTION lZ REPAIRS ❑ LID NO- ------------------ ASMT. NO. _.-.__._-_._-___._
OWNER P4 ------- CO.W-C-M ---- T.W . ..... CONTRACTOR -AA-.Rl0-VA,.R -------------------------------------------------- PERMIT NO. 7471 7
.............
-------- ... . .......... LEGAL DESCRIPTION: LOT NO. S ----------------------------------- BLOCK NO. .......
JOB ADDRESS .......
--------------------------------------------- ..................................................... --------------------------------------------------------------
NAMEOF ADDITION ------------------------------------------------------------------------------------ ..................................
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27
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4t'-,-V E- Approved:
UINHWOOD
PWW-0001-11175 (REV.11/78) D A T E a#'j. 16"g, 8.(, ......... B Y-410
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