20180319142635.pdfCITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
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*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20180127
SIDE SEWER PERMIT (I -Sin -le Familv)
Permit Number: ENG20180127 Expiration Date: 03/19/2019
Job Address: 103 8TH AVE S, EDMONDS
'APPLICANT CONTRACTOR
ROTO-ROOTER ROTO-ROOTER
4630 1 6th St E, Ste 139 4630 16th St E, Ste 139
FIFE, WA 98036
FIFE, WA 98036
(253) 405-2657
LICENSE #: ROTORSCI 22BR EXP: 04/03/2018
NdREPAIR
N
JOB DESCRIPTION
N PROPOSE TO REUSE LATERAL LID N UMBER:
GRINDER PUMP N PROPOSE TO REUSE SIDE SEWER r-7N1 DRAINAGE
SPOT REPAIR, 30FT PIPE LINING
EASEMENT INFORMATION
Nd
PROJECT CROSSES OTHER PRIVATE PROPEI-' , I Y
N
VERIFICATION OF RECORDED EASEMENTS COMPLETE
IAIDEMNITY- The Applicant has signed an application which states helshe holds the City ofEdmonds harmlessfi-om injuries,
damages or claims ofany kind or description Whatsoever, foreseen or unforeseen, that may be made against the City ofEdnionds or
any ofils departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
atiorneyfees by reason ofgranting thispermil.
CALL DIALA-DIG (1-800-424-5555) BEFORE ANY EXCAVAT70N
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTTCEREQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOT A PERNHT UNTIL SIGNED BY THE CITY ENGINEER OR H ISMER DEPUTY AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
F] FILE COPY 7 INSPECTORCOPY
Printed: Monday. March 19.201
DATE
F-] APPLICANT COPY
STATUS: ISSUED
ENG20180127
• Refer to City of Edmonds Side Sewer In fori-nation 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 for work within the City right-of-way.
• Condition ofthe 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. 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 fi-ontage 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 as built 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
of ECC Chapter 5.30 only during the hours of 7:00am to 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 s ites/activities must comply with the
noise limits of Chapter 5.30, un less 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
harrnless 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 ofthis pen -nit. 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.
I
• E-TV AND H20 TEST
• ESanitary Side Sewer Inspection
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
of EDA40 4�
INC. I sqo
If your project is SOUTH of 220th St.
and/or WEST of Hwy 99, it may be in
Olympic View Water & Sewer District
SIDE SEWER
PERMIT APPLICATION
CONTRACTOR INFORMATION:
Company Name:
Site Contact:
Phone#:
Mailing Address- Fax
State License #: 'Z-14 3 0 1,14 .5-/ 62 1 A
eebl?s IZZOR2
Expiration Date: -7 -7 1 r-7-, Email #:
City Business License#: Fj Liability Insurance Bonded
PROPERTY INFORMATION:
Address: tle-. 6c�oi ond-s
Owner's Name:
Phone#:
F-1 Full Line Replacement [Z Spot Repair EJ Pipe Burst 0 Reline (PermaLine Only)
DESCRIPTION OF PROPOSED WORK (Be Specific):
F�151- 4? JQ V- /=(a
rid 2,- �p J-fneje I" 12� (2 Q
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SIGNATURE DATE
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NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE