20190321105606.pdfCITY OF EDMO].{DS
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121 sTH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425)771-0220 - FAX: (425)771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED 8NG20190103
SIDE SEWER PERMIT I
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Job Address:21211 92ND PL W EDMONDS
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APPI,ICANT CONTRACTOR
ROTO-ROOTER
20508 56TH AVE W SUITE C
ROTO-ROOTER
20508 56TH AVE W SUITE C
LYNNWOOD, WA 98036 LYNNWOOD, WA 98036
(206) 633-ss00
LTCENSE #: ROTORSCI 22BR EXP:04/0312020
TORzuSELATERAL LIDNUMBER:
PROPOSE TO RzuSE SIDE SEWER DRAINAG
PROJECT CROSSES OTF{ER PRIVATE PROPERTY
\ERIFICATION OF RECORDED EASEMENTS COMPLETE
INDEMMTY The Applicant has signed an applicaÍion which sÍates he/she holds the City of Edmonds harmlessfrom inittries,
damages or claims ofany kind or descriplion v'halsoever,foreseen or unforeseen, fhal nmy be made againsl the City ofEdntonds or
any ofits departments or employees, including but not limited Ío the defense ofany legal proceedings including defense cosls and
atÍorneyfees by reason ofgranting this permit.
CALL DrALA-DIG (1 -80 0 -42 4-5555) BB'ORE ArW UCAVATION
CALL FOR INSPECTION (425) 7 1 l-0220 D(T. I 326
24 HOUR NOTICEREQUIRil) FOR ALL INSPECTION REQUESTS
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REPAIR
CRINDERPUMP
snrall repair, approximately 4 ft
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JOB DESCRIPTION
EASF"MÐ{T TNFORMATION
THIS APPLICATON IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ,ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PRO\4DED.
Printed: Thurs March2 201
,{PPLIC,{TION AP PROVAL
RELEASEDBY DATE
! nmcorv ! ntsercroRcoPY ! arnucANTCoPY
STATUS: ISSUED 8NG20190103
r Refer to City of Edmonds Side Sewer Information 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 seruice line.¡ A separate right-oÊway construction permit is required forworkwithin the Cify right-oÊway.. Condition of the existing lateral to be verified by the City's Public Worla Dept. to obtain approval for reuse. Contact Rlmonds
Sewer Division at 425-771-0235.
¡ Condition ofthe existing sanitary side sewerto be verified priorto obtaining approval forreuse. TVinspection required. Video
to be submitted to Citv fol review.
SIDB SBWER PERMIT (l-Single Family)
CONDITIONS
Applicant shall repair/replace all dannge to utilities or frontage improvements in Cify right-oÊway per Cþ standards that is
caused by or occurs during the permitted project.
Owner/Contractorto provide Side Sewer asbuilt at final inspection. See Cify Standards for requirements.
Sound/Noise originating fromtemporary construction sites as a result of construction activity are e)€mpt fromthe noise limits
of ECC Chapter 5.30 onþ during the hours of 7:00am to 6:00pm on weekdays and l0:00am and 6:00pm on Saturdays, excluding
SundaysandFederal Holidays. 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 indenmify defend and hold
harmless the City of klmonds, Vy'ashington, its officials, enployees, and agents ÍÌom any and all claims for damages of
whatever nature, arising directþ or indirectþ fi'om the issuance ofthis permit. Issuance of this perrnit shall not be deemed to
modify, waive or reduce any requitements of auy Cþ ordinance not limit in any way the City's ability to enforce any ordinance
provision.
E-Sanitary Side Sewer Inspection
PARTIALINSPECTION DATE:NOTES.-
NOTES:PARTIALINSPECTION DATE:
FINALTNSPECTIONAPPROVED DATE:INITIAL:
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INITIAL:
INITIAL:
INSPECTIONS
CONTRACTOR INFORMATION:
SIDE SE\ryER
PERMIT APPLICATIOI{
Site Contact:Krr 5company Name: R., fo ßoø,/<tf
Company Address. .&ta/7 l" Ht/,c 5 phone#: f zf _ j/( ^ÒoZ1
City:ee,zip: /'Email #:
State License # RO|O ftSC tz7 ßR City Business License # /j A ^()Zzl/l
Expiration Date:
PROPERTY INFORMATION:
Address:
.LILil
?z n¿ 0t ,-')
ownerosName: Ton ß/.cz-
Phone #:
E rurr Lyn SPOT REPAIR N PTPN BURST N NNT,TNN GERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specilic):
3r4//L lort 4'
ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE PERMISSION TO WORK ON ANY PROPERTY OTHER
THAN THAT OWNED BY THE SIIBJECT PROPERTY OWNER.
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
ADJACENT PROPERTY, IHAVE OWNERS SS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY
DATE s z/
Contractor or Agent
SIGNA
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE