MCGAUGH Side_Sewer_ApplicationSIDE SEWER
PERMIT APPLICATION
Z'�C.
CONTRACTOR INFORMATION:
Company Name: RICHARD G.C. Site Contact: E LOY DE PAZ
Company Address: 18557 NE 116TH ST Phone #: 425-518-8493
City: REDMOND Zip: 98052 Email #: jorgelimberg@gmail.com
State License # RICHAGC814BT City Business License #
Expiration Date: 01/3012023
PROPERTY INFORMATION:
Address: 880 SOMERSET LN EDMONDS, WA 98020
Owner's Name:
MCGAUGH DAVID & FRANCES
Phone #:
[Z FULL LINE REPLACEMENT ❑ SPOT REPAIR ❑ PIPE BURST ❑ RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific):
NEW SEWER LINE FROM GARAGE.
ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE PERMISSION TO WORK ON ANY PROPERTY OTHER
THAN THAT OWNED BY THE SUBJECT PROPERTY OWNER.
CERTIFICATIONS NECESSARY FOR INSTALLATION METHODS ARE THE RESPONSIBILITY OF THE
CONTRACTOR PERFORMING SAID WORK.
I REPRESENT AND WARRANT TO THE CITY OF EDMONDS, IF REPAIR OF EXISTING SEWER EXTENDS TO AN
ADJACENT PROPERTY, I HAVE OWNERS EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY.
SIGNATURE ELOY DE PAZ DATE 05/12/2021
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE