20170227104340.pdfof Et)41
CITY OF EDMONDS
121 5TH A VBqUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
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*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20170070
SIDE SEWER PERMIT (I -Single Family)
Permit Number: ENG20170070 Expiration Date: 06/27/2017
Job Address: 8209 211 TH PL SW. EDMONDS
South County Plumbing
PO Box 6157
Edmonds, WA 98026
South County Plumbing
PO Box 6157
Edmonds, WA 98026
(425) 775-7377
LICENSE #- SOUTHCP19302 EXP 08/30/2018
.JOB DESCRIPTION
YJREPAIR N PROPOSE TO REUSE LATERAL LID NUMBER:
N I GRINDER PUMP "N PROPOSE TO REUSE SIDE SEWER F_N] DRAINAGE
PerPublic Works TImHarris, okto line approx 10'ofthe 6" lateral concrete in the right ofway, adjacentto property.Add cleanout of
6" if possible, possibly 4". Contractorto maintain 10 from back of water main blow -off.
EASENIENT INFORMATION
• I PROIECT CROSSES OTFIIR PRIVATE PROPERTY
• VERIFICATION OF RECORDED EASEMENTS COMPLETE
IADEMNITY- The Applicant has signed an application which states helshe holds the City ofEdmonds harmlessfrom injuries,
damages or claims ofany kind or description whalsoever, foreseen or unforeseen, that may he made against the City ofEdmonds or
any ofils departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
atiorneyfees by reason ofgranting this permit.
CALL DIAIA-DIG (1 -800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOTA PERMITUNTTL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED
Printed: Monday. February 27, 2017
F FILE COPY F-] INSPECTOR COPY F APPLICANT COPY
STATUS: ISSUED
ENG20170070
• Refer to City of Edmonds Side Sewer Information handout for approved pipe materials, inspections and other requirements.
• 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.
• A separate right-of-way construction permit is required forwork within the City right-of-way.
• Condition of the existing lateral to be verified by the City's Public Works Dept. to obtain approval for reuse. Contact Edmonds
Sewer Division at 425-771-0235.
• Condition ofthe existing sanitary side sewer to be verified prior to obtaining approval for reuse. TVinspection required. Video
to be submitted to City for review.
• Easement and/or permission fi-om adjacent 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 ternporary construction sites as a result of construction activity are exempt firomthe 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, 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 fi-om any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance ofthis permit. Issuance ofthis 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-TV and water test
• E-Sanitary Side Sewer Inspection
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
SIDE SEWER
PERMIT APPLICATION
CONTRACTOR INFORMATION:
Company Name:
Site Contact: Phone #: '
J-2<Z -7SA, Ctk-��O- 2,� — -7
Mailing Address: Fax
State License#:
Expiration Date:
City Business License #:
PROPERTY INFORMATION:
Address: 4--&P C) "1 1 4�- P �—
Owner's Name:
Phone#:
Email #:
'K Liability Insurance ,�R B-onded
F-1 Full Line Replacement 0 Spot Repair F1 Pipe Burst '&Rcline (Perma Line Only)
DESCRIPTION OF PROPOSED WORK (Be Specific)
r
SIGNATURE DATE '2 -Z-7 -1-7
Contractor or Agellf-
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE