1369_001.pdfCITY OF EDMONIDS
4c. I
12I 5TH AVENUENORTH - EDMONDS, WA 98020
PHONE: (425)771-0220 - FAX: (425)771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSIIED ENG2019 0222
RIGHT OF WAY PBRMIT (r
Permit Number: ENG20 1 9 0222
Job Address: 115 EDMONDS ST, EDMONDS
E4piration Date : 06/09 /2020
Location:
APPLIC.{NT CONTRACTOR
CRITCH1¡W HOMES
CYO JEF'FREYCRITCHLOW
PO BOX 13400
MILLCREEK, WA 98082-
CRITCHLOW HOMES
C/O JEFFREY CRITCHLOW
PO BOX 13400
MILL CREEK, WA 98082-
(42s) 743-4447
LICENSE #: CRITCHIO55JP EXP: 02/0112019
INSTALLATION OF WATER METER, SEWER CONNECTION, OTHER CONSTRUCTION RELATED TO THE SFR PERMIT
8LD20190124
INDEMMTY The Applicant has signed an applicaÍionvhich states he/she holds the City of Edmonds harmlessfrominjuries,
damages or claims of any kind or description v,hatsoet,er,foreseen or unforeseen, thaÍ may be made againsÍ the City of Edmonds or
any ofits departments or employees, including but not limited lo the defense ofany legal proceedings including defense costs and
afÍorneyfees by reason ofgranfing this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATM,IALS FOR A PERIOD OF ONEYEAR FOLLO}VING TTIEFINAL
INSPECTION AND AC CNTANCE O F TIIEW ORK
Traffìc Control and public safety shall be in accordance with City regulations as required by the City Engineer. Every flagger must
be trained as required by (WAQ 296-155-305 and must have certification verifying completion ofthe required training in their
possesiolì.
Restoration is to be in accordance with City codes. All street-cut trench work shall be patched with asphalt or City approved
material prior to the end of the workday- NO Ð(CEPTIONS.
Three sets of construction drawings of proposed work are required with the permit application.
CALL DIALA-DIG (1 -800 -424:5555) BFORE ANY Ð(CAVATION
CALL FOR INSPECTION (425) 7 7 l-0220 D(T. 1326
24 HOfiR NOTICEREQTIIRD FOR ALL INSPECTION REQTTESTS
a
TE
JOB DıiCRTPTION
ASSESSED VALUE,
SIDEWALK: ( 0X0 )
PARKING: ( 0X0 )
ALLEY: ( 0X0 )
$O.OO PROPERTY AREA
DURATION IN MONTHS: O
DURATION IN MONTHS: 0
DURATION IN MONTHS: O
$0.00
$0 00
$0 00
FEE
FEE
FEE
STREET DISRUPTIONTRENCH CUT: ( O XO )
YEAROFOVERLAY: 0 FEE: $0.00
DIS RT]PTION INFOIIMATION
TT]IS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CIry ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED ]N
SPACE PROVIDED.
June I 20
{PPLIC,{TION APPROVAL
! rn rconv INSPFCTORCOPY ! arrlrcaNTcoPY
lll(ìHT OF WAY I'BIIM IT (l-Single Farnilv)
CONDT'l'tONS
STATUS: ISSUED 8NG20190222
. Restore ROV/ to City standards. Call for locates ofunderground utilities priorto any e><cavation.o Conformto approved working drawings and Traffic C-ontrol plan.
. Utilrty patch restoration to be in accordance with Ednnnds Standard detatlE2.3. Maintain erosion & sedimentation control. Keep street clean.. Traffic Control per approved plan and MUTCD. Referto City of Edmonds traffic control requirements.¡ Maintain l0' separation between the sanitary side sewer and the water service line.. Condition ofthe existing latelal to be verified by the City's Public V/orls Dept. to obtain approval for reuse. Contact Ednnnds
Sewer Division at 425-771-0235.¡ Easernent and/or permission from adjacent property owner is required prior to entry/work within adjacent properfy.¡ Install mailboxin location approved by post ofüce.. Applicant shall repair/replace all darnge to utilities or fiontage inprovements in City right-oÊway per Cþ standards that is
caused by or occurs during the permitted project.. Sound/l'Joise originating fromtemporary construction sites as a result ofconstruction activity are exempt fromthe noise limits
of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, e><cluding
SundaysandFederalHolidays. Atallothertimesthenoiseoriginatingfromconstructionsites/activitiesmustcomplywiththe
noise limits of Chapter 5.3Q unless a variance has been granted pursuant to ECC 5.30.120.. Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indenmifl defend and hold
harnrless the City of Blmonds, Washington, its officials, enployees, and agents fiom any and all clairns for damages of
whatevernature, arising directþ or indirectþ fromthe issuance ofthis permit. lssuance of this permit shall not be deemed to
nrcdi$, waive or reduce any requirements of any City ordinance not limit in any way the City's abilþ to enforce any ordinance
provision.
¡ BF¡osionControVMobilization¡ ÞDriveway Form& Slope Ver.o BPavement Compaction Test Report. BEngineering Final
PARTIALINSPECTION
PARTIALINSPECTION
FINAL INSPECTION APPROVED
DATE INITIAL:
IMTIAL'_
INITIAL:
NOTES:_
DATE:
DATE:
INS PtI-T'IONS
of EF
90
PROJECT NAME:
ISSUE DATE:
RIGHT.OF-WAY CONSTRUC TION
PERMIT APPLICATION
CONTACT
Row pERMrr No. : ENG b\q o?.ZL
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JÊFF C"tqtT<4 ua)
CONTRACTOR: r- f2 tt!,1\ t ¿ ¡ Ì, ---. \ ¡-I- . - r < Phone #: bl.q €.\-V'tL-¿)l-/) û'1L)/tay¿ ) t ^'¿a -, ì7'2a¿., t a ll4
Mailing Address: po ,ô'< I oz2 F0 nø Fax #: 'f zs T rfL^ 3 3 3,
Srate License #, eß l TCA f o Sf¡ p Email #'¿Q-€ç g ¡¿ltr<4c auù Hon t{s, avh,
City Business License #:2 ffi r,ialitity Insurance ffi BondedL6
ADDRESS OR INTERSECTION OF CONSTRUCTION, I I 5 f4 4 c>aø lT
ROW WORI( ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial Subdivision Traffic Control (Only)
I Multi-Family El, Singte Family
T EUC (PUD, VERIZON, PSE'
coMcAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
City Project
Other
f ves INo
BLD# 7ÐI ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) :
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES NO Year:
PAVEMENT CUT:
CONCRETE CUT:
Yes
Yes
A,ñ No
No
If yes, indicate size of cut:
If yes, indicate size of cut:
x
x
RIGHT.OF.WAY
CLOSURE
AREA TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs +LF x LF SF
Alley 72IIrs+LF x LF SF
Parking 72IJrs +LF x LF SF
APPLICANT TO READ AND SIGN
xTraff,rc control and public safety shall be in accordance with City regulations as required by the City
Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and must have certification
verifying completion of the required training in their possession.
xRestoration is to be in accordance with City codes and Standards. All street-cut trench work shall be
patched with asphalt or City approved material prior to the end of the workday - NO EXCEPTIONS.
lndemnity: The Applicant has signed an application which sfafes he/she hold the City of
Edmonds harmless from injuries, damages or claims of any kind or description
whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any of its departments or employees, including defense cosfs and attorney fees by reason
of granting this permit.
I have read the above statements and understand the permit requirements and acknowledge that I must
follow all req order for the permit to be valid.
SIGNATURE,DATE ,5 -zo - t 1
Contractor or Agent
NO WORI( SHALL BEGIN PRIOR TO PERMIT ISSUANCE