20181004115727.pdfof E D&
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 ENG20180450
SIDE SEWER PERMIT (I -Single Family)
Permit Number: ENG20180450 Expiration Date: 01/04/2019
Job Address: 710 7TH AVE S, EDMONDS
APPLICANT CONTRACTOR
All County Sewer All County Sewer
1509 143rd P1 SW 1509 143rd PI SW
Lynnwood, WA 98087
Lynnwood, WA 98087
(206) 554-9992
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JOB DESCRIPTION
-_Y�REPAIR LNJPROPOSE TO REUSE LATERAL LID NUMBER:
N I GRINDER PUMP N I PROPOSE TO REUSE SIDE SEWER F N 1 DRAINAGE
Sewer repair along south side of house to edge of easement. Cleanouts to be installed out of house and by kitchen
EASEMENT INFORMATION
N I PROJECT CROSSES OTHER PRIVATE PROPERTY
N ]VERIFICATION OF RECORDED EASEMENTS COMPLETE
SS easement along western easement
IADEMATTY- The Applicant has signed an application which states helshe holds the City ofEdmonds harmlessfrom injuries,
damages or claims ofany kind or description ivhalsoever, foreseen or unforeseen, that may be made against the City ofEdmonds or
any ofits departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
afforneyfees by reason ofgranting this permit.
CALL DIALA-DIG (1 -800-424-5555) BEFDRE ANY EXCAVATION
CALL F)OR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOT A PER%4IT UNTIL SIGNED BY THE CITY ENGINEER OR HISMER DEPUTY AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed: Thursdav, October 04, 201
<7
RFM&,� ED BY DATE
F FILE COPY F—] INSPECTOR COPY F APPLICANT COPY
STATUS: ISSUED
ENG20180450
• Refer to City of Edmonds Side Sewer Inforination h an dout for approved pipe materials, inspections and other requirements.
• A 6" clearrout 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 pen -nit 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 sewerto 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/rcplace 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
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 inderrmify 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 firomthe 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- As Built
E,San itary Side Sewer Inspection
E-Erigineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPEC71ON DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
Of EVAjo 411-
C. IS90
SIDE SEWER
PERMIT APPLICATION
CONTRACTOR INFORMATION:
CompanyName: ALC- 00"4
Company Address:
Site Contact:
Phone N:
77
City: Ll Aj Aj 07) Zip: Q0,1V 7 Email#: -1 76P
State License # 6) Y Lf City BusinessLicense# IVU—
Expiration Date: ZZ V 12—
PROPERTY INFORMATION:
Address:
Owner's Name:
ly eqge4v
Phone#:
?�Ke- ZZ--e y
F� FULL LINE REPLACEMENT 0 SPOT REPAIR EIPIPE BURST RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific):
ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE PERMISSION TO WORK ON ANY PROPERTY OTHER
THAN THAT OWNED BY THE SUBJECT PROPERTY OWNER.
CERTIFICATIONS NECESSARY FOR INSTALLATION METHODS ARE THE RESPONSIBILITY OF THE
CONTRACTOR PERFORMING SAID WORK.
I REPRESENT AND WARRANT TO THE CITY OF EDMONDS, IF REPAIR OF EXISTING SEWER EXTENDS TO AN
ADJACENT PROPERTY, I HAVE OWNERS EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY.
SIGNATURE DATE/l!�/7&///X'-
Contractor or Agent f 7
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE