1488_001.pdfCITY OF EDMOI.{DS
¿c. l8
STATUS: ISSUED
I2I 5TH A\ÆNUENORTH. EDMONDS, WA 98020
PHONE: (425)771-0220 - FAX: (425) 77t-0221
*PERMIT MUST BE POSTED ON JOBSITE*
ENG20190131
RIGHT OF WAY PERMIT (l-Single Family)
Permit Number: ENG20 I 901 3 I
Job Address:715 SPRUCE ST, EDMONDS
Exp iration Date: 0 6 I 20 /2020
Location:
APPLICANT CONTRACTOR
SELECT HOMES INC.
CYOKAYI-A CLARK
16531 13TH AVEV/ ST-IITEA1O7
LYNNWOOD, WA 98036-
SELECT HOMES INC.
C/O GARY CLICK
I6531 13TH AVE V/ SUITE A107
LYNNWOOD, WA 98036-
(425) 742-6044
LICENSE #: SELECHIl IOKN EXP 12/3112019
.IOB DESCRIPTION
ASSESSED VALUE:
SIDEWALK: ( 0X0 )
PARKING; ( 0X0 )ALLEY: ( 0X0 )
$O.OO PROPERTY AREA
DURATION IN MONTHS: O
DURATION IN MONTHS: O
DURATION IN MONTHS: O
0
FEE: $0.00
FEE: $0.00
FEE: $0.00
STREET DISRUPTIONTRENCHCUT: ( O XO )
YEAR OF OVERLAY: 0 FEE: $0.00
DIS RIJPTION INFORMATION
Dzu\tsWAYAPPROACFI AND UTILITY CONNECTIONS
INDEMMTY: The Applicant has signed an applìcafion which states he/she holds the City of Edmonds harmlessfom injuries,
damages ot' claims of any kind or description whalsoeyer, foreseen ot' unþr'eseen, thaf may be made against the City of Edmonds or
any ofits deparÍments or employees, including but nol limited to the defense ofany legal proceedings including defense costs and
aÍlorneyfees by reason ofgranÍing lhis permit.
TTIECONTRACTOR IS RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FOR A PERIOD OFONEYEAR FOLLOWING T}TEFINAL
INSPEC TIO N AND AC C FPTANC E O F THE W O RK
Traffic Contlol 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 ofthe required training in their
possesion.
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 EXCEPTIONS.
Three sets of construction drawings of proposed work are required with the permit application.
CALL DIALA-DrG (1 -8 0 0-4 2 4-5 5 55) BEFORE ANY D(CAVATION
CALL FOR INSPECTION (425) 7 7 I -0220 D(T. 1 326
24 HOUR NOTICEREQUIRH) FOR ALL INSPECTION REQUESTS
2o)/¿)¿. ,t/nâ.*6120119
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THIS APPLICATION IS NOTA PERMITUNTIL SIGNED BY TI]E CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID. AND RECEIPTIS ACKNOV'/LEDGED fN
SPACEPROVIDED.
Printed: Wednesday. June 19. 2019
,{PPLIC,{TION APPROVAL
DATERELEASED BY
! ru.ncorv f nvsrncroRcoPY f] lrruclwr coPY
STATUS: ISSTIED 8NG20190131
¡ Restore ROV/ to City standards. Call for locates ofunderground utilities priorto any e><cavation.¡ Public utilities maintain 5' separation from City Utilities.¡ Verify clear bore crossings. Utilrty patch restoration to be in accordance with Edmonds Standard detailE2.3¡ Maintain erosion & sedimentation control. Keep street clean.¡ Traffic Control per approved plan and MUTCD. Referto Cþ of Rlmonds traffic control requirements.. The proposal will not adversely impact public space open to vehicular or pedestrian travel.¡ Three feet of clearance around fire hydrants, standpipes, P.I.V.'s, manholes, water nìeters, blowoffs, cleanouts and valves shall
be maintained.
. A 6" cleanout with 12" locking cast iron lamphole cover is required at the property line.. Maintain 10'separation between the sanitary side sewer and the water service line.¡ Easenrent and/or permiss ion from adjacent property owner is required prior to entry/work within adjacent property.. Applicant shall repair/replace all danrage to utilities or fiontage improvements in City right-oÊway per Cþ standards that is
caused by or occurs during the permitted project.. Applicant, on behalf ofhis or her spouse, heirs, assigns, and successors in interests, agrees to indenmify defend and hold
harmless the City of Edmonds, Vy'ashington, its officials, employees, and agents fiom any and all clairns for damages of
lvhatever nature, arising directþ or indirectþ fi'om the issuance of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance not limit in any way the City's ability to enforce any ordinance
provision.
¡ E-Driveway Approach¡ E-Sewer l¿teral Installation
¡ ÞSewer lateral Pressure Testo E-ROW Restoration
¡ ËEngineering Final
PARTIALINSPECTION
PARTIALINSPECTION
FINAL INSPECTION APPROVED
DATE.-
DATE:-
DATE:-
INITIAL:NOTES:
INITIAL:NOTES:
INITIAL:
lllGt{T ()F WAY PEIÌM tT (l-Singlc Family)
coNDlTloNS
¡NSPII"I'IONS
ls9
PROJECT NAME:
ROW PERMIT NO. : ENG A,dq ôI3I
ISSUE DATE:
RIGHT-OF-\MAY C ONS TRUC TIONI
PERMIT APPLICATION
CONTACT:
Phone #:óCONTRACTOR:
Mailing dflfl¡ss5¡ rø6ãt ßF (P .frlo1. Fax #:4Zç,TIZ .Çc>(Z
State License #:
SÚ H-f 14ek¿L)
City Business License #:ñ?-. Õ'7-b3"Il
Email #:
Liability Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION:
ROW \ryORK ASSOCIATED WITH THE FOLLO\ryING TYPE OF PROJECT:
Commercial Subdivision City Project
Other
Traffic Control (Only)
I Multi-Family ffi singte Family tl
n EUC (PUD, vnRrzoNo PSE,
COMCAST, OVWSD):
Is this permit paft of ablanket permit?fl Yes n No
ANY ASSOCIATED PERMITS?BLD#ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) :
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES NO Year:
PAVEMENT CUT:
CONCRETE CUT:
n Yes
I Yes
No
No
If yes, indicate size of cut:
If yes, indicate size of eut:
x
x
RIGHT-OF.\MAY
CLOSURE
AREA TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs +LF x LF'SF
Alley 72Hrs+LF'X LF'SF
Parking 72 Hrs +LF X LF SF'
APPLICAIIT TO READ AND SIGN
*Traffic 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
veriffing completion of the required training in their possession.
*Restoration 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 cosús 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 requirements in order for to be valid.
SIGNATURE DATE
ontractor or Agent
I
NO WORI( SHALL BEGIN PRIOR TO PERMIT ISSUANCE