20190325104957.pdfCITY OF E,DMONDS
121 5TH AVENUENORTH . EDMONDS, WA 98020
PHONE: (425)771-0220 - FAX: (425)771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSIIED 8NG20190107
SIDE SEWER PERMIT
Fermit Number; ENG20 1 90i 07
Job Address:9429 l90TH PL S'W, EDMONDS
E.,^:-^r:^- Tì^+^. Â(/,)2//)Al OrJÀpl¡ crll\Jil ualv. vJt LJt -w t /
CONTRACTORAPPLIC,{NT
ROTO-ROOTER
20508 56TH AVE W SUITE C
ROTO.ROOTER
20508 56TH AVE W SUITE C
LYNNWOOD, WA 98036 LYNNWOOD, WA 98036
(206) 633-5500
LICENSE #; ROTORSCI22BR EXP : 04/03/2020
PROPOSE TO RzuSE LATERAL
PROPOSE TO RzuSE SIDE SEV/ER
LIDNUMBER:
DRAINACE
PROJECT CROSSES OTHER PRIVA TE PROPERTY
VERIFICATION OF RECORDED EASEMENTS COMPLETE
INDEMMTY: The Applicant has signed an applicaÍion vhich states he/she holds the City of Edmonds harmlessfom injuries,
damages or claims of any kind or description whatsoeyer,foreseen or unþreseen, lhal may be made againsÍ the City of Edntonds or
any ofits deparfments or employees, including but not limited lo the defense ofany legal proceedings including defense costs and
afÍorneyfees by reason ofgranlirtg Íhis perntil.
CALL DrALA-DIG (1 -800 -424-5555) BH'ORE ANIY Ð<CAVATION
CALL FOR INSPECTION (425) 7 7 | -0220 Ð(T. I 326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTTON REQUESTS
Y N
NNN
REPAIR
CRINDERPUMP
I58 ST OF PIPEBTJRSTINGV/ITH HTPE4''
N
N
JOB DESCRIPTION
EASEMU{T INFORMATION
THIS APPLICATION IS NOT A PERMITUNTIL SIGNED BY THE CIry ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PRO\4DED.
Printed: Mon March 201
APPLICATION APPROVAL
f rnncorv I nvsrncroRcoPY APPLICANTCOPY
SIDB SEWER PBRMIT (l-Single Family)
CONDfTIONS
STATUS: ISSUED 8NG20190107
¡ Refer to City of Rlmonds 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 l0'separation between the sanitary side sewer 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 verified by the City's Public \ù/ork Dept. to obtain approval for reuse. Contact Edmonds
Sewer Division af 425-771-0235.
¡ Condition of the existing sanitary s ide sewer to be verified prior to obtaining approval for reus e. TV ins pection required. Video
to be submitted to City for review.
Eascrenl andlorpetmssion û:onradjacent property orvneris required priorlo entry/workwithin adjacent pr:opefty.
Applicant shall repair/replace all damage to utilities or frontage improvements in City right-oÊway per Cify standards that is
caused by or occurs during the permitted project.
Owner/Contractorto provide Side Sewer asbuilt at final inspection. See Cify Standads forrequirements.
Sound/Noise originating Íiomtemporary construction sites as a result of construction activity are exempt fromthe noise limits
of ECC Chapter 5.30 only during the hours of 7:00arn to 6:00pm on weekdays and l0:00am 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.
Appiicant, on -behaif 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 clairns for darnages of
whatevernature, arising directþ or indirectþ fromthe issuance ofthis permit. Issuance ofthis pennit shall not be deemed to
modifi, waive or reduce any requirements of any Cify ordinance not limit in any way the City's abilþ to enforce any ordinance
provision.
a E-Sanitary Side Sewer Inspection
a
PARTIALINSPECTION
PARTIALINSPECTION
FINA L INSPECTION A PPROVED
DATE:-
DATE:
INITIAL:
INITIAL:
INITIAL:
NOTES
NOTES
DATE:-
INSPECTIONS
of
¡
>*
CONTRACTOR INFORMATION:
Company Name:
Company Address:
SIDE SE\MER
PERMIT APPLICATIOI{
Site Contact:
#
9
Email #:
State License #City Business License # I A'Tn e ç/ t27 ßR
Expiration Date:
PROPERTY INFORMATION:
Address
Owner's Name:
3 c:_A (,U t\ 49oZ¿:
Phone #:
n rur-r, LrNE REpLACEMENT n spor REPAIR Snn BURST ! NNITNN GERMALINE ONLY)
, DESCRIPTION OF PROPOSED WORK (Be Specific):'r ¿"T
ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE PERMISSION TO WORK ON ANY PROPERTY OTHER
THAN THAT O\A/NED BY THE SUBJECT PROPERTY OV/NER.
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
DATE ô4 - f'f-tSIGNATURE
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
?