2423_001.pdfov, EDAf
CITY OF EDMONDS
PHONE: (425) 771-0220 - FAX: (425) 771-0221
121 5TH AVENUE NORTH - EDMONDS, WA 98020
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20190380
S ID E S EWER PERM IT (I -Single Family)
Permit Number: ENG20190380 Expiration Date: 09/24/2020
Job Address: 21231 92ND PL W, EDMONDS
APPLICANT CONTRACTOR
SELECT HOMES INC SELECT HOMES INC.
16531 13TH AVE W SUITE A107 16531 13TH AVE W SUITE A107
LYNNWOOD, WA 98036-
LYNNWOOD, WA 98036-
(206) 963-3787
LICENSE #: SELECHI I I OKN EXP: 01/02/2021
-_y
N
JOB DESCRIPTION
]REPAIR N_J PROPOSE TO REUSE LATERAL LIDNUMBER:
I GRINDER PUMP N I PROPOSE TO REUSE SIDE SEWER F N 1 DRAINAGE
Side sewer for new SFR (e)dsting home dernoed).
LAS EMENT INFORMATION
PROJECT CROSSES OTHER PRIVATE PROPERTY
N IVERIFICATION OF RECORDED EASEMENTS COMPLETE
IADEMNITY- The Applicant has signed an application which states helshe holds the City ofEdmonds harmlessfrom 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 this permit.
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
APPLICATIONAPPROVAL
THIS APPLICATION IS NOTAPER"TUNTIL SIGNED BY THE CITY ENGINEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed: Tuesday, September 24, 2019
z:)aw'-�z 9/24/19
RELEA SED BY
DATE
D FILE COPY F—] INSPECTOR COPY F-] APPLICANT COPY
STATUS: ISSUED
ENG20190380
• 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 permit is required for work within the City right-of-way.
• Condition of the e)dsting lateral to be verified by the City's Public Works Dept. to obtain approval for reuse. Contact Edmonds
Sewer Division at 425-771-0235.
• Condition of the e)dsting sanitary side sewerto be verified priorto obtaining approval for reuse. TVinspection required. Video
to be submitted to City for review.
• Easement and/or permission from adjacent 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.
• Owner/Contractor to provide Side Sewer as built at final inspection. See City Standards for requirements.
• Sound/Noise originating from temporary constructions ites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pmon weekdays and 10:00am 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 FC(7 5.30.120.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
hanniess the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatevernature, arising directly or indirectly fromthe issuance ofthis permit. Issuance ofthis permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance not limit in any way the City's ability to enforce any ordinance
provision.
a E-Sanitary Side Sewer Inspection
PARTIAL INSPEC71ON DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL: