20170216150058.pdfCITY'OF EDMONDS
121 5TH A VENUE NORTH - EDMONDS, WA 98020
to c."l PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBS TE*
STATUS: ISSUED ENG20170057
-SingleSIDES EWER PERM IT (I
Permit Number: ENG20170057 Expiration Date: 04/16/2017
Job Address: 23904 80TH WAY W 0, EDMONDS
APPLICA,NT CONTRACTOR
Rozalley Starre Roto•Rooter
23904 80TH WAY W UNIT J 10655 Tukwilla Blvd:
EDMONDS, WA 98026-9203" Tukwilla, WA 98168
(206)757-2809 .:
LICENSE'#: ROTORSC122BR EXP: 04/03/2018
JOB DESCRIPTION
Y IREPAIR I NPROPOSE TO REUSE LATERAL`` IJID NUIGIBER:
N GRINDER PUMP FN�PROPOSE TO REUSE SIDE SEWER N DRAINAGE
Spot repair, install 4" cleanout at the home. Possible pipe burst.
LAS y _ FORMATION
N I PROJECT CROSSES' OTHERPRIVATE PROPERTY
N VERIFICATION OF RECORDED EASEMENTS COMPLETE'
INDEMATTY ,The Applicant has signed an application` which states he/she holds the City of Edmonds harmless from injuries,
damages: or claims ofany kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any ofits departments or employees, including but not limited to the defense of any legal proceedings including defense costs and
attorney fees by reason ofgranting this permit
CALL DIAL -A-DIG (1 -800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
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APPLICATION APPROVAL
THIS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEER OR,HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN ''
SPACEPROVIDED,
I
Printed: Thursda Februa! 162017,,if id�
1 SEB. A"E
El FILE COPY INSPECTOR COPY APPLICANT COPY
• Easement an d/orpermiss ion fiomadjacent property owner is required prior to entry/work within adjacent property.
• Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per City standards that is
caused by or occurs during the permitted project.
• Owner/Contractor to provide Side Sewer asbuilt at final inspection.See City Standards for requirements.
Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
ofECC Chapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding ,
Sundays and Federal Holidays. At all other times the noise "originating from construction sites/activities must comply with the
noise limits of Chapter 5.30 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 indemnify defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from 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.
INSPECTIONS
• E-Sanitary: Side Sewer Inspection
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES: ;
FINAL INSPECTION APPROVED DATE: INITIAL.