20190321110609.pdfOV LI)j,/
A
CITY OF EDMONDS
121 5TH AVHqUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERNUT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20190104
SIDE SEWER PERMIT (2-Multi-Family)
Permit Number: ENG20190104 Expiration Date: 04/25/2019
Job Address: 20622 76TH AVE W, EDMONDS
APPLICANT CONTRACTOR
JIM DANDY SEWER JIM DANDY SEWER
903 N 128TH ST
SEATTLE, WA 98020
903 N 128TH ST
SEATTLE, WA 98020
(425) 346-7332
ICENSE #jmdad5879b3 EXP: 05/09/2020
_Y�REPAIR
N
JOB DESCRIPTION
N PROPOSE TO REUSE LATERAL LID NUMBER.
I GRINDER PUMP "N PROPOSE TO REUSE SIDE SEWER E—N 1 DRAINAGE
3'deep spot repair approx 3'long
EAS FMENT INFORMATION
PROJECT CROSSES OTHER PRIVATE PROPERTY
N
I VERIFICATION OF RECORDED EASEMENTS COMPLETE
IADEMATTY- The Applicant has signed an application which 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 ofits departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
attorneyfees by reason ofgranting thispermit.
CALL DIAL -A -DIG (1-800424-5555) BEFDREANYEXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICE REQ UIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
11\
RELEA
SPACE PRONMED.
Printed: Thurs day. March 21, 201
DATE
E] FILE COPY F-] INSPECTOR COPY E] APPLICANT COPY
STATUS: ISSUED
ENG20190104
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 service line.
A separate right-of-way construction pernfit 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.
0 Condition of the existing sanitary side sewer to be verified prior to obtaining approval for reuse. TVinspection required. Video
to be submitted to City for review.
Easement and/or pennis s ion fromadjacent property owner is required prior to entry/work within adjacent property.
Applicant shall repair/replace 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.
Own er/Con tractor 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 fromthe noise limits
of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00am and 6:00pni on Saturdays, excluding
Sundays and Federal Holidays. At all other times then ois e originating from constructions ites /activities must comp ly with the
noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
0 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 from any and all claims for damages of
whatever nature, arising directly or indirectly fromthe issuance of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance not lirr6t in any way the City's ability to enforce any ordinance
provision.
I INSPECTIONS
0 E-Sanitary Side Sewer Inspection
PARTIAL INSPEC71ON DATE: INITIAL: NOTES;
PARTIAL INSPECTION DATE: INITIAL: NOTES;
FINAL INSPECTION APPROVED DATE: INITIAL:
SIDE SEWER
PERMIT APPLICATION
IA,C.
CONTRACTOR INFORMATION:
Company Nanie�� A �k
(/.��.Site Contact:
Company Address: /- f),A
) �& ) 111A X�,4- Phone#:
City: 211 p: Email #:
— /0 . � e "-4 6? ;� " Cv--k
State License # J97 City Business License # 4g
Expiration Date:
PROPERTY INFORMATION:
Address: 57
9 6P�
Owner's Name:
Phone #:
r-1 FULL LINE REPLACEMENT EISPOT REPAIR [-I PIPE BURST [:] RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific):
'Yriq,no --irr-2t4- Re-oc-t.-- cv, s—etj� /Y �,o C 9ANIKI - 2 / //9/7 C .
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
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
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