18720 76TH AVE W11111111111111
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18720 76TH AVE W
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CITY -of EbMON DSRECEIVEZ?
'For Inspection.Call 771-32 R 14 19 8 6
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Address of Construction:
S I D E -SEWER PERMIT
PERMIT NO. 07670
FILEPYNNWOOD LINE
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Property Legal Description (Include all easements): 6 N F7 I L(_`
Owner and/or Builder: (em 4--V\j 0 AJ S -r C
Contractor & Lic ense No: L_ c' N
Single Family Residence
Multi -Family .)�
(No. of Units
Commercial (No. of fixture Units
Invasion into City Right -of -Way: No X Yes 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.)
PLEAff READ THE ITEMS LISTED,ON THE BACK
1. certify that I have*read and ' shall comply -Date
with the items listed on the back.
Permit Fee - Issued By
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T-runk Charge: Date Issued:
Assessment Fee: Receipt No.:
Partial Inspection:
Comments Date Initial
Final Inspection Approved:
a 4tR86 I rd t i Dial
Rejected: Reason —T—ni t —ia I
Date
PERMIT MUST BE POSTED ON JOB SITE
White Copy File Green Copy - Inspector Buff Copy Applicant
1# 1
The City of Edmonds Side Sewer;Drawing
EASEMENTNO . ...........................................
NEW CONSTRUCTION H REPAIRS E] LID NO . .................. . ASMT. NO . .................
OWNER R-C,---00.LE.M T-4 ...... CONTRACTOR JkAM)VA.,RK .................................................. PERMIT NO. ' .747C-p
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JOB ADDRESS A .... ....... — --- - --------- b ................................ 4. LEGAL DESCRIPTION: LOT NOA ................................... BLOCK NO . ....
............................ .......... ..........................................................................................................................
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NAME OF ADDITION
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