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21126 78TH AVE W.PDFIIIIIIIIIIII 6658 21126 78TH AVE W CITY OF EDMONDS PUBLIC ORKS DEPARTMENTj ENGINEERIP DIVISION MFFLiUM I I U14 FUR Rion i-uF-imi wioi iww wn rr-r\17! 1 1 TME TU PFLEMUST BE AVAILABLE At TH . E JOB . SITE FOR INSPECTION . PURPOSES Applicant to Complete Parts A and B A. Permit to be issued t o For Work at: .(address or vicinity) Type of Work to be done: A --k (attach drawing when applicable) Time Required -- Start: Owner: 9 .9 ot r- 4 1 19-p t �41y,7, Name Mailing Address ulty State Zip Finish: Telephone Number Contractor: 11 -D3 - 0tyL4P1C- /V 3 J�) S - 6 S1 71 Name State License Number Mailing Address City State Zip Telephone Number B. INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from -any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the applicant or the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal�proceedings including defense costs, court costs, and attorney fees by reason of granting this permit. Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year following the final inspection and acceptance of the restoration by the Engineering Division. Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at which time a debit or credit will be processed for issuance to the applicant. Work is subject to inspection and restoration in' accordance with City Code. A 24-ho�uir notice is required for inspection by E . nginee . ring. Call 775-2525, ext. 220. I understand that this permit must be available at the job site for inspection purposes at all times. Si g n a t u r e Date: O�ner oi7 Ag�-nt I TO BE COMPLETED BY ISSUING AGENCY: Date Issued:t--) -7 Security Bond: ;�Ii Time Authorized: R Permit No.:7A Fee:) 0 V -S. APPROVED BY Date: 70 --s-1-j1r174r - I 1-4 'o—,ow.- / - /, 414- aj�c- 41 �- -00,-Ae�k -� 40 __ry . NOTICE ST FILEERMITTEE ANI)/OR OWNER PARTIAL APPROVAL VIOLATION CORRECTIONS REQUIRED PERMIT NUMBER DRESS NO PERMIT STOP WORK — REMOVE CONSTRUCTION OR OBTAIN PERMIT AND MAKE WORK COMPLY WITH BUILDING LAWS. CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS El AND PERMIT — STOP WORK. MAKE EXISTING WORK COMPLY WITH APPROVED PLANS AND PERMIT OR REMOVE IT. STOP WORK — UNTIL AUTHORIZED TO CONTINUE BY INSPECTOR. CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN BE APPROVED. El �WORK DESCRIBED BELOW HAS BEEN INSPECTED AND IS "PROVED. ECONTACT INSPECTOR AND ARRANGE FOR APPOINTMENT. F RECALL FOR INSPECTION. THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN ......... DAYS OR PENALTIES IMPOSED BY LAW MAY BE APPLIED. FOR INSPECTIONS CALL: 775-2525. F] BUILDING DIV. INWECT011.- 9PUBLIC WORKS CITY OF FIRE DEPT. D"ru EDMONDS-- 0 0 The City of Edmonddss APPLICATION STFIEET FILE for S11DE SEWER PERNaT OUTSIDE K INSIDE [:] REPAIRS Fl CARDNo . ...................................... EASEMENT No . ...................................... .... ............................................... ... CONTRACTOR ........ .. .. ..... . ..... llt."4 ......................................... * PERMIT No. OWNER ...... ..... STREET o' . ................. HOUSE N -------- ............ ............... ....... AVENUE, LOT No . ............. ------- ---- BLOCK No . ............................... NAMEADD . ..................... ......... ........................................................... 2 -Z 4. 79 rm Wile ..... ...... #l: ........ . . t -a f A* 'c 4 dp ry t APPR0VFp FE 7 1964 '70 Date Approved: BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .................. ............ ------- DATE Y SEWER WORK ORDER ISSUED ............................. ............ L2 B ................ :�� ------------ ............. �� 4--� � NOTICE: No warranty of accuracy. The information shown on the attached map(s) was compiled for use by the City of Edmonds, its Employees and Consultants. The City ofEdmonds does not warrant the accuracy of anything set forth on these map(s). Any person or entity requesting a copy should conduct an independent inquiry regarding the information shown on the -map(s), in I cluding, but not limited to, the location of any sewer stub shown. Such sewer stubs may or may not exist and may or may not exist at the location shown,. Neither the City of Edmonds nor its employees or officers shall be lia-b-le for the information given on this map(s), nor for any one representation provided based upon said map(s). Call PRospect 6-1107 24 hours (plus CITY OF EDMONDS Saturday, Sunday and Holidays) be- 937 CITY HALL — WATER -SEWER DEPARTMENT fore work is ready for inspection. SIDE SEWER PERMIT .................................................. I ADDRESS ........... . ....... ....................................................................... 45q OWNER ......... ...... Auntoo.. ................................ ............ CONTRACTO i R ........ A1.=r!­05-0--: ............................. I Permission is granted ............. F'bbii ... 1Y ...................... 9 19..,6k for ..* ....................... days, to REPAIR or CONNECT a side . sewer with City Sewers in accord. application on fRE-5nd governing orilinances. 7: I ATTENTION IS CALLED TO THY FOLLOWING: I ' a perm struct sewer inside property line. A licensed Side Sewer Contractor NOTE No. 1—The owners of the property may obtain it to con must be employed to construct side sewer in street area. Do not cover any portion of sewer before it has been inspected. NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations gov'erning side sewers when you get permit. NOTE No. 3—Top of side sewer must have at least 30 inches coverage at property line and' 12 inches inside property line; minimum grade of 2%. No bends in grade sharper than % will be permitted. NOTE No. 4—Trenches in street must be water settled and surface of street restored it. r`i0inal condition. Contractors shall be responsible for failure due to improper work which may develop within one year of completion. NOTE No. 5—It is unlawful to alter or do any other work than is provided for in the pernilt, or to do any work on the main sewer or its ap- purtenances except to insert the pipe into the wye.