20190307103210.pdfCITY OF EDMONDS
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STATUS: ISSUED
I2I 5TH AVENUENORTH - EDMONDS, WA 98020
PHONE: (42s)771-0220 - FAX: (42s)771-022t
*PERMIT MUST BE POSTED ON JOBSITE*
ENG20190083
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Permit Number: ENG20 I 90083 E4piration Date : 05/l 6 120 19
Job Address:9001 OLYI\4PIC VIEW EDMONDS
PzuCOR TECHNOLOGIES
2825 S t54TH ST
PRICOR TECHNOLOGIES
2825 S I54TH ST
SEATTLE, WA 98I88 SEATTLE, WA 98I88
(206) 2s8-s2't0
LICENSE #: NR-020649
TO REUSEI..ATERAL
TO REUSE SIDE SEWER
LIDNUMBER
DRAINACE
PROJECT CROSSES OTHER PRTVATE PROPERTY
\iERIFICATION OF- RECORDED EA SEMENTS COMPTÆTE
INDEMMTY: The Applicant has sígned an applicafion which stqtes he/she holds the City of Edmonds harmlessfrom iniuries,
damages or clainß ofany kind or descriplionwhatsoever,þreseen or unþreseen, lhat may be made against the City of Edmonds or
any of its depqrtments or employees, including but not limited to the deþnse of ony legal proceedings including defense cosÍs qnd
altorneyfees by reason ofgranting this permil,
CALL DIALA-DIG (l -S00-424-s555) BEFORE AITY D(CAVATION
cAI r. FOR TNSPTTION (4?5) 77t-0220 D(T. 1326
24 HOUR NOTTCERFQUIRu) FOR ALL INSPECTION KEQUESTS
EXP
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THÍS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY, AND FEES ARE PAÍD, AND RECEIPTIS ACKI'IOWLEDGED IN
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SPACE PROVIDED.
Printed:Thurs
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RELEASEDBY DATE
! ru.nconv ! nrsnncroRcoPY APPLTCANTCOPY
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STATUS: ISSUED 8Nc20190083
o Referto City ofRlnnnds Side Sewerlnformation handout forapproved pipe rnaterials, inspections and otherrequirements.
o A 6" cleanout with 12" locking cast iron lamphole cover is required at the property line,
o Maintain l0' separation between the sanitary s ide sewer and the water service line,
o A separate righì-oÊway construction permii is required for work within the City right-of-way.
o Condition of the existing lateral to be verified by the City's Public Works Dept. to obtain apprrcval for reuse. C-ontact Eclnpnds
Sewer Division at 425-771-0235.
¡ C-ondition of the existing sanitary side sewer to be vcrified prior to obtaining approval for reuse. TV inspection required. Vdeo
to be submitted to City for review.
¡ Easement and/or permission from adjacent property owner is required priorto entry/work within adjacent property.
. Applicant shall repair/replace all danrage to utilities or frontage improvements in City right-oÊway per City standards that is
caused by oroccurs during the pennitted project.
o Owner/C-ontractor to provide Side Sewer asbuilt at fural inspection. See City Standards for requkements.
¡ Sound/l.Joise 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 l0:00am and ó:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all othertimes the noise originating fromconstruction sites/activities rrust conply with the
noise limits of Chapter 5.30. unless a variance has been granted pursuant to ECC 5.30,120.
. Applicant, on behalfofhis orher spouse, heirs, assigns, and successors in interests, agrees ttl inciemnlfy lefend and lrold
harnrless the City of Rlnronds, Washington, its offcials, employees, and agents fron'l any and all claims for darnages of
whatever nature, arising directly or indirectly fromthe issuance of this permit, Issuance of this pemút shall not be deemed to
nndi$, waive or reduce any requirernents of any City ordinance not limit in any *ay the City's ability to enforce any ordinance
provision.
a ÞSanitary Side Sewer Inspection
DATE:-IMTTAL:PARTIALINSPECTION
PARTIALINSPECTION
FINAL INSPECTION APPROVED
DATE:-IMTIAL:
DATE:
NOTES:_
NOTF]S:
INITIAL
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CONTRACTOR INFORMATION:
SIDE SEWER
PERMIT APPLICATIOI{
Company Name: ¡4..c"./..Site Contact: C,L. f
Phone#: LËj-Soh- t_t ç(, (?
lo
Company Address: Lrl, l(4 te+ort
CiE:5.,- ].,Zipz 11
State License #(o-f 4¿-
Email #:
City Business License # /V fL _ @OL o 6+q
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ExpirationDate: \ I rt / Lt¿
PROPERTY INFORMATION:
Address: clao I Olr¡*,7,i l/, ru /,
owner's Name: /l ,i. ¡, /lr_ ifr- r-*-ri
Phone #: 7o ¿-3 g'i -8" 52
tr rur,r, LINE REPLACEMENT F SPOT REPAIR N PITB BURST N NNT.TNN (PERMALINE ONLY)
.i DESCRIPTION OF PROPOSED WORK (Be SpecifÏc):
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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 OV/NERS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY i/r7t,tDATE
Contractor or Agent
SIGNATURE
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE