20190307121616.pdfCITY OF EDMOI{DS
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121 5TH AVENUENORTH - EDMONDS, WA 98020
PHONE: (425)771-0220 - FAX: (425)771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED Er{G20190084
SIDE SEWBR PERMIT l
Permit Number: ENG20 1 90084
Job Address:21700 96TH AVE W, EDMONDS
Expiration Date: 05/1 0 l20l 9
CONTRACTORAPPLICANT
SEWER FRIENDLY
23930 HIGHWAY 99
SEWER FRIENDLY
23930 HIGHWAY 99
EDMONDS, WA 98026 EDMONDS, WA 98026
(206) 93r-8161
LICENSE #: SEWERFL I 96MS EXP:07/1012019
PROPOSE TO REUSE LA TERAL
PROPOSE TO RzuSE SIDE SEWER
LIDNUMBER:
DRAINAG
PROJECT CROSSES OTHER PRIVATE PROPERTY
VERIFICATION OF RECORDED EASEMENTS COMPLETE
INDEMNITY: The Applicant has signed an applicaf ion which slaÍes he/she holds the City of Edmonds harmless f'om injuries,
damages or claims of any kind or description u,hatsoeyer,foreseen or unforeseen, Íha| ntay be nnde againsf the City of Edmonds or
any ofits departments or employees, including but not limited to the defense ofarry legal proceedings including defense costs ønd
aîtorneyfees by reason ofgranfing lhis perntit.
CALL DIALA-DIG (1 -80 0 -424-55 55) BB'ORE Ar.{Y D(CAVATION
CALL FOR INSPFCTION (425) 7 7 t -0220 D(T. I 326
24 ITOUR NOTICEREQUIRE]D FOR ALL INSPECTION REQUESTS
DATESED
N N
NNN
REPAIR
CRINDERPUMP
3 FT REPAIR
N
N
JOB DESCRIPTION
EAS FJ\.{E {T INFO RMATION
THIS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEEROR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PRO\,1DED,
Printed:Thurs 201March
APPLICATION APPROVAL
I rn-nconv INSPECTORCOPY ! lruucANTCoPY
STATUS: ISSUED 8NG20190084
¡ Referto City of klmonds Side Sewerlnformation handout forapproved pipe rnterials, inspections and otherrequirements.¡ A 6" cleanout with 12" locking cast iron lamphole cover is required at the propefty line.r Maintain l0' separation between the sanitary side sewel and the water seruice line.¡ A separate right-oÊway construction permit is required for work within the Cify right-oÊway.. Condition of the existing lateral to be verifìed by the City's Public Works Dept. to obtain approval for reuse. Contact Rlnronds
Sewer Division af 425-771-0235.
¡ Condition ofthe existing sanitary side sewer to be verified prior to obtaining approval for reuse. TV inspection required. Video
to be submitted to City for review.
SIDB SBWEIì PBRMIT (l-Single Family)
CONDTTIONS
. Applicant shall repair/replace all danrage to utilities or frontage irnprovements in Cþ right-oÊway per City standards that is
caused by or occurs during the permitted project.¡ Owner/Contractorto provide Side Sewer asbuilt at final inspection. See City Standards for requirements.. Sound/Noise originating fromtemporary construction sites as a result of construction activity are exempt fromthe noise limits
of ECC Clrapter 5.30 only during the hours of 7:00arnto 6:00pln on weekdays and 10:00am and 6:00pnr on Saturdays, excluding
SundaysandFederalHolidays. Atall othertimesthenoiseoriginatingfromconstructionsites/activitiesmustcomplywiththe
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 indemnify defend and hold
harmless the City of Edmonds,'Washington, its officials, employees, and agents fiom any and all clairns for damages of
whatevernature, arising directþ or indirectly û'omthe issuance ofthis permit. Issuance ofthis pemit shall not be deemed to
modi$t, waive or reduce any requirements of any Cify ordinance not limit in any way the Cify's ability to enforce any ordinance
provision.
E-Sanitary Side Sewer Inspectiona
PARTIALINSPECTION
PARTIALINSPECTION
FINAL INSPECTION APPRO\ED
DATE:-
DATE:
DATE:
INITIAL:
INITIAL:
NOTES:_
NOTES:
INSPITTrcNS
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CONTRACTOR INFORMATION:
SIDE SE\ryER
PERMIT APPLICATIOI{
Company Name: Sgrt¡
Company Address: L3q o ilr^)v qq
site contact: L1Z6 ^ 3þ\ -3
Phone #:lo- Ø1o-- -TLllQ
Citv
srateLicense# SELÐEt FLqluÍ.{l
Email #: B¡rlO
City Business License #
zip
Expiration Date:
PROPERTY INFORMATION:
Address:zt1 OD qbt" FilJË l.,J
Owner's Name
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Phone #:
X rur,r. LrNE REpLACEMENT Espor REpATR n prru BURST I nnl,rNn (PERMALINE oNLY)
DESCRIPTION OF PROPOSED WORK (Be Specific):
\VL
ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE PERMISSION TO WORK ON ANY PROPERTY OTHER
THAN THAT OWNED BY THE SUBJECT PROPERTY O\ryNER.
CERTIFICATIONS NECESSARY FOR INSTALLATION METHODS ARE THE RESPONSIBILITY OF THE
CONTRACTOR PERFORMING SAID V/ORK.
I REPRESENT AND WARRANT TO THE CITY OF EDMONDS, IF REPAIR OF EXISTING SEV/ER EXTENDS TO AN
TO PERTORM WORK ON TIIAT ADJACENTADJACENT
PROPERTY
PROPERTY, I
DATE 3^1"1qSIGNATURE
NO \ryORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE