3.2.18 - Issued sewer permit.pdfOV
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CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSTTE*
STATUS: ISSUED ENG20180095
I SIDE SEWER PERMIT (3-Commercial) 0
Permit Number: ENG20180095 Expiration Date: 04/02/2018
Job Address: 21431 72ND AVE W, EDMONDS
Best Plumbing
4129 Stone Way N
Seattle, WA 98103
Best Plw-nbing
4129 Stone Way N.
Seattle, WA 98103
(206) 930-0726
LICENSE 4: BESTPGL973CD EXP: 02/04/2019
YdREPAIR
N
JOB DESCRIPTION
N PROPOSE TO REUSE LATERAL LIDNUMBER:
GRINDER PUMP HN PROPOSE TO REUSE SIDE SEWER F—T� DRAINAGE
Approx 6'of4" repair. Install 4" cleanout nearbuilding.
LAS EMENT INFORMATION
• I PROIECT CROSSES OTHER PRIVA TE PROPERTY
• VERIFICATION OF RECORDED EASEMENTS COMPLETE
IADEMATTY- 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 inay 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
afforneyfees by reason ofgranting thispermil.
CALL DIAL-A-DIG(1-800-424-5555) BEFORE ANY EXCAVATION
CALL FIOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NO-nCEREQUIRED FOR ALL INSPEC-nON REQUESIN
THIS APPLICATION IS NOT A PERWTUNTTL SIGNED BY THE CITY ENGINEER OR HISMER DEPUTY AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
RELEA�
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Printed: Friday, March
F FILE COPY F-] INSPECTOR COPY F APPLICANT COPY
STATUS: ISSUED
ENG20180095
• 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 existing sanitary side sewer to be verified prior to obtaining approval for reuse. TV inspection required. Video
to be submitted to City for review.
• Easement and/or permission from adjacent property owner is required prior to entry/work with in 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 construction s ites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00arn to 6:00pm on weekdays and 10:00am and 6:00prn 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.
• 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 from the issuance of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance not litnit in any way the City's ability to enforce any ordinance
provision.
INSPECTIONS
E-Sanitary Side Sewer Inspection
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
If your project is SOUTH of 220th St.
and/or WEST of Hwy 99, it may be in
Olympic View Water & Sewer District
of 1DkfC,
C, SIDI�-J SEWER
PERMIT APPLICATION
CONTRACTOR INFORMATION:
Company Name:
Site Contact-
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Mailing Address- wA-1 A3
State License #: &55FIGL ql,;�Cb
Expiration Date:
City Business License #: N R 0a-f 14 2-
PROIIERTY INFORMA'I'ION:
Address! Qk 9,�,
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Phone #: SO-079(,,
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Fax #: ;�b6 6
Email #:A1)CC,k
iability Insur
Owner's Name: Z
Ph o n c #: (.670
El Full Line Replacement Afs-p"ot Repair Pipe Burst El Reline (PermaLine Only)
DESCRIPTION OF PROPOSED WORK (Be Specific):
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SIGNATURE
Contr�,rf`tr or Agent
DATE 3 �- � V
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE