20170509095335.pdf0
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CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20170179
I SIDE SEWER PERMIT (I-Sing-le-Fanifly)
Permit Number: ENG20170179 Expiration Date: 08/08/2017
Job Address: 19709 86TH PL W, EDMONDS
APPLICANT CONTRACTOR
MIKES PLUMBING AND DRAIN CLEANING MIKES PLUMBING AND DRAIN CLEANING
PO BOX 1535 PO BOX 1535
EDMONDS, WA 980201535
EDMONDS, WA 980201535
(206) 472-5010
LICENSE 4: MIKESPC99OKM EXP: 05/11/2017
��181.111 U Will ILI I Idn"im
Y REPAIR N PROPOSE TO REUSE LATERAL LIDNUMBER:
GRINDER
7 PUMP N I PROPOSE TO REUSE SIDE SEWER FTNT� DRAINAGE
REPAIR APPROX. WFOR 4" SIDE SEWER AND RE -LINE DOWNSTREAM OF REPAIR UNDER ROCK RETAINING WALL
(APPROX. 10'). ALL WORK ON PRIVATE PROPERTY AND NOT NEAR PROPERTY LINE.
I
EASEMENT INFORMATION
• I PROIECT CROSSES OTHER PRIVATE PROPERTY
• VERIFICATION OF RECORDED EASEMENTS COMPLETE
I
IADEMA7ITY- The Applicant has signed an application which states helshe holds the City ofEdmonds harmlessfrom injuries,
damages or claims ofany kind or description 141halsoeverforeseen or unforeseen, that may be 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
altorneyfees by reason ofgranting thispermil.
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
THIS APPLICAT10N IS NOTA PERMITUN111- SIGNED BY THE CITY ENGINEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACEPROVIDED.
Printed: Tuesday. Mav 09.201
DAff
X�FILECOPY F� INSPECTOR COPY F� APPLICANT COPY
STATUS: ISSUED
ENG20170179
• Refer to City of Edmonds Side Sewer Information handout for approved pipe niaterials,inspectiODs and other requirements.
• A 6" cleanout with 12" locking cast iron lamphole cover is required at the property line.
• Maintain I O'separation between the sanitary side sewer and the water service line.
• A separate right-of-way construction permit is required for work 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 of the existing sanitary side sewer to be verified prior to obtaining approval for reuse. TV inspection 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 temporary construction sites as a result of construction activity are e)r-mpt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00arn 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 Cbapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf ofhis or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
harailess the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, aris ing directly or indirectly from the issuance ofthis 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-WATER TEST/TV
• E-Sanitary Side Sewer Inspection
• &CONTRACTOR TO PROVIDE ASBUILT
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
05 EDA,
SIDE SEWER
PERMIT APPLICATION
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CONTRACTOR INFORMATION:
Company Name: ff I-T- PLOMBY-A)b �, 09-hy-A) c,_L-E�WVf-_LV6
Site Contact* T R A) f,:: C Phone #: 7-610 L4 o
Mailing Address: ax N:
P0 (S-35 SD AOA) 95 WA
State License #: Mx K (:�, 5 P C, q q 0 j< M
Expiration Date:
City Business License#: bu6IG311,
PROPERTY INFORMATION:
Email #:
F� Liability Insurance F1 Bonded
Address: ()q kA M OODS VIAD,
Owner's Name:
Phone #:
F� Full Line Replacement Spot Repair El Pipe Burst J��eline (PermaLine Only)
DESCRIPTION OF PROPOSED WORK (Be Specific):
C--V A L R PP (ZOA 1 0' 6. 5EWL-A 1�6 afjE
Des,mio mc a E f'fl 1: 9, 10 0 (:�R R(sr-AL-
W A LL_ fAPP4z6,,,, I k� ')
SIGNATURE DATE
Coj4r_actor_ or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE