20180906124959.pdf01;
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CITY OF EDMONDS
PHONE: (425) 771-0220 - FAX: (425) 771-0221
121 5TH AVENUE NORTH - EDMONDS, WA 98020
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20180387
RIGHT OF WAY PERMIT (I -Single Family)
Pen -nit Number: ENG20180387 Expiration Date: 11/06/2018
Job Address: 95 10 EDMONDS WAY, EDMONDS
Plumbing & Drain Co. Plumbing& Drain Co.
926 96th St E 926 96th St E
Tacoma, WA 98445 Tacoma, WA 98445
(2 5 3) 98 7-79 80
LICENSE 4 PLUMBDC991JF EXP:04/22/2019
JOB DESCRIPTION
Removing asphalt around water meter boxto gain access to meter and service lines.
Location:
DISRUPTION INFORMATION
ASSESSED VALUE $0.00 PROPERTY AREA 0
SIDEWALK: (OXO DURATION IN MONTHS: 0 FEE; $0.00 STREET DISRUPTION TRENCH CUT: 0 x 0
PARKING: OXO DURATION IN MONTHS: 0 FEE: $0.00 YEAR OF OVERLAY: 0 FEE: $0.00
ALLEY: OX0 DURATION IN MONTHS 0 FEE: $0.00
INDEMNITY- TheApplicant has signed an application ivhich states helshe holds the City ofEdmonds harmlessftom injuries,
damages or claims ofany kind or description whatsoever, foreseen 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
atiorneyfees by reason ofgranting this permit.
TUECONTRACTOR IS RESPONSIBLEFOR WORKMANSHIP AND MATERIALS FOR A PERIOD OFONEYEAR FOLLOWING THEFINAL
INSPECTION AND ACCEPTANCE OF THEWORK
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 verifying completion of the 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-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 NOTAPERMITUNTIL SIGNED 13Y THE CITY ENGINEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED
Printed: Thursday. Sewernber 06. 201
BY
F FILE COPY F] INSPECTOR COPY F APPLICANT COPY
STATUS: ISSUED
ENG20180387
• Restore ROW to City standards
• Restore Landscape to like or better conditions.
• Call for locates of underground utilities prior to any excavation.
• Alert affected residents and/or businesses prior to work start.
• Conforrn to approved working drawings and Traffic Control plan.
• Verify clear bore crossings
• Utility patch restoration to be in accordance with Edmonds Standard detail E2.3
• Maintain erosion & sedimentation control. Keep street clean,
• Call for required inspections as noted.
• Traffic Control per approved plan and MUTCD. Refer to City of Edmonds traffic control requirements.
• Applicant shall repair/rep lace 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.
• Sound/Noise originating from temporary construction s ites as a result of construction activity are exempt from tile noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:00pni oil weekdays and I 0:00arn and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all other times the noise originating fi-om 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.
• A pplicant, on behalf ofhis or her spouse, lheirs, assigns, and --- ---- - ---- :._ interests, agrees to indeninif- deknd and hold
I % I I U I I I I U bu"Cbbulb 111 11 1 U iiy U 1c; U U il U
han-nless 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 of this 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 ally ordinance
provision.
• E-Traffic Control
• E-Engincering Final
• E- As built
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: fMTIAI-:
ROW PERMIT NO.: ENG
ISSUE DATE:
'kLm=wXF- RIGHT-OF-WAY CONSTRUCTION
41C. 1 SC30 PERMIT APPLICATION
PROJECT NAME: CONTACT:
CONTRACTOR: twa�vx ro,
Mailing Address:
!3��
State License #- P) LA 6k s z) C'SZ-9 / _S
City Business License #: U 9 - oqs"�'3';�
Phone #: ';)_r_-T- 9J--7 &-V
Fax #:
Email #: _3<_n-V Ckiet, if 6, C-6 , C'0
0 Liability Insuran—ce 0 Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: to E��O"'J�s
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
H Commercial Subdivision Ll City Project 0 Traffic Control (Only)
F� Multi -Family Ej Single Family
F� EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
F� Other
F� Yes F� No Job Number
I ANY ASSOCIATED PERMITS? BLD# ENG# I
DESCRIPTION OF PROPOSED WORK (Be Specific): V�evk\Q-V�VA Af-RV,�kl
CX-c"_vs -An
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES 0 NO 0 Year:
PAVEMIENT CUT: 9 Yes No If yes, indicate size of cut: - Ll x
CONCRETE CUT: El Yes No If yes, indicate size of cut: - x
RIGHT-OF-WAY
AREA
CLOSURE I
TOTAL
DURATION
(NUMEBER OF MONTHS)
Sidewalk 48 Hrs + LF
I X
LF
SF1
Alley 72 Hrs + LF
X
LF
SF
Parking 72 Hrs + LF
X
LF
SF
APPLICANT 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
verifying 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.
INDEMITY: The Applicam has sigped aii application wilicli states lie/she liold tile City of Edmonds
lianniess fi-oni iii4iries, damages or claigis of arty kind or description \vliatsoever. foreseen or 1111foreseeli,
fliat inav be imide against the City of Edgionds or any of its departtilents or employees. iliclLiding defense
costs aii(l attonley fees by reasog of, grallfilig this perillit.
I have read the above statements and understand the permit requirements and acknowledge that I must
follow all requirements in order for the permit to be valid.
SIGNATURE DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
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