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CITY EDMONDS <br />121 5TH AVENUE NORTH - EDMONDS, WA 98020 <br />PHONE: (425) 771-0220 - FAX: (425) 771-0221 <br />*PEIMIT MUST BE POSTED ON JOBSITE* <br />Job Address: 24014 79TH PL W, EDMONDS Location: 24014 79TH PL W <br />Burlington, WA 98233 <br />Bwlington, WA 198233 <br />(425)457-6353' <br />T 1('FN1,F.$-'i.f—IR71 r7 FXP n,)/77/?nI <br />Work area is approx 163'S c/1 of 240th St SW and ISE & T W c/I of 79th PL W to install gas service. 1 3x5 concrete cut anticipated <br />and 12x4 paving cut anticipated, <br />DISRIJPTION INFORMATION <br />ASSESSED VALUE. $0,00 PROPERTY AREA: 0 <br />SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE $0,00 STREET DISRUPTION TRENCH CUT: ( 3 X 5 ): <br />PARKING:` ( OX0) DURATION IN MONTHS: 0 FEE $0,00 YEAR OF OVERLAY: 0, FEE $0,00 <br />ALLEY ( OXO ',) DURATION IN MONTHS: 0 FEE $0 00 <br />INDEMNITY The Applicant has signed an application which states he/she holds the City of Edmonds harmless from injuries, <br />damages or claims of anykind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or <br />any of ils;departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and <br />attorney fees by reason ofgranting'this permit. <br />THE CONTRACTOR IS RESPO NSIBLE FO R WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL <br />INSPECTION AND AC CEPTANCE 0 F THEW ORK <br />• Traffic Control and public safety shall be in accordance with City regulations as required by the City Engineer. Every flagger must <br />be trained as required by (WAC) 296-155-305 and must have certification verifying completion of the required training in their <br />possesion. <br />• Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City approved <br />material prior to the end of the workday- NO,EXCEPTIONS. <br />r' Three sets of construction drawings of proposed work are required with the permit application. <br />CALL DIAL -A-DIG (1-800-424-5555) BEFORE ANY EXCAVATION <br />CALL FOR INSPECTION (425) 771-0220 EXT. 1326 <br />24 HOUR NOTICEREQUIRFD FOR ALL INSPECTION REQUESTS <br />APPROVALAPPLICATION � <br />A PERMITUNTIL SIGNED BY THE CITY ENGINEER OR'HIS/HERDEPUTYi'AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED' IN <br />SPACE PROVIDED,, <br />Printed: Tuesda , MaX 09,201 <br />RELEASED BY' DATE <br />❑ FILE COPY ❑ INS PECTOR'COPY <br />❑ APPLICANT COPY <br />