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7517 OLYMPIC
VIEW DR
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CityOf Edn1OI1C�.SPERMITNO•.g9T: � •. • ,PERMIT EXPIRES
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.SIDESEWER PERMIT.. l
Address of Construction- CO)y A 4�'c Vis hJ Do-i ✓A LID #
Property Tax Account Parcel No.�%��
Attach copies of all access and utility easementsVerified and Approved.by -- -�--�-.
Owner and/or (Eacto : A �
Contractor License #: 6 Ak' d a S. ilding Permit #:
® Single Family Invasion into City *Right of Way: Yes �No.
/❑ Multi -Family (No. of -Units ) *RW Construction Permit #
❑ Commercial (No. of Units ) Cross other "Private Property-: ❑-Yes ..2 No
❑ -Public **Attach legal description and copy of.recorded easement..,
Owner/ ontractor
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
' ide Sewer Specifications, and shall comply with ill City requirements outlined therein. `
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2 CALL DIAL -A -DIG. (1-80041545555) BEFORE ANY EXCAVATION .
9 FOR INSPECTION -CALL 425-771-0220 extension =� ►���,
24 HOUR NOTICE REOUIRED.FOR ALL"'INSPECTION Rt-OUSTS t
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Permit Fee $ Repaic,Fee $ . -- Issued By:. --�
Trunk Charge $C Date Issued: '! �'a.•
Assessment Fee $ Receipt No:
City Permit Surcharge Fee $5.00 Total Fees Paid $
NOTE: IF JOB SITE IS NOTREADY 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-
Initial.,FINAL INSPECTION APPROVED: Date: /AS -built File:.•
PERMIT MUST BE POSTED ON, JOB SITE
White Copy: File Green Copy: Inspedtor. - Buff Copy: Applicant, ,
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❑LYMPIC VIEW DR,
CITY OF EDM❑NDS SIDE SEWER
AS -BUILT
ADDRESS
7517 ❑LYMPIC
VIEW DR,
PERMIT
NUMBER 9407
HOMEOWNER
CONTRACTOR
E A R T H W❑ R K ENT
DATE
05/15/01
BRAWN ISMAEL ABILA