5.2.19 - ISSUED PERMIT.pdfOv FbAf
CITY OF EDMONDS
1215THAVENUENORTH- EDMONDS, WA 98020
,4-"6 PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20190189
RIGHT OF WAY PERMIT (]-Single Family)
Permit Number: ENG20190189 Expiration Date: 07/03/2019
Job Address: 7320 164TH PL SW, EDMONDS
Location: 7320 164TH PL SW
FISCHER PLUMBING
FISCHER PLUMBING
C/O BRUCE ROBERTSON
CIO BRUCE ROBERTSON
6608 220TH ST SW
6608 220TH ST SW
MOUNTLAKE TERRACE, WA 98043
MOUNTLAKE TERRACE, WA 98043
(206) 783-4129
LICENSE#: FISCHPCI3IRI EXP:02/22/2020
REPLACE 1-2 PANELS OF SIDEWALK CONCRETE.
DISRUPTION INFORMATION
ASSESSED VALUE $0 00 PROPERTY AREA 0
SIDEWALK: (OXO) DURATION IN MONTHS: 0 FEE, $0 00 STREET DISRUPTION TRENCH CUT: 0 x 0
PARKING: OX0 DURATION IN MONTHS: 0 FEE $0 00 YEAR OF OVERLAY: 0 FEE: $0 00
ALLEY OX0 DURATION IN MONTHS 0 FEE $0 00
IADEMATTY- The Applicant has signed an application lvhich states helshe holds the City ofEdmonds harmlessfrom injuries,
damages or claims ofany kind or description ivIialsoever, foreseen or unforeseen, that may be made against the City ofEdmonds or
any ofils departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
atiorneyfees by reason ofgranting this permit.
TEE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THEWORK
• Traffic Control and public safety shall be in accordance with City regulations as required by the City Engineer. Every flagger must
be trained as required by (WAQ 296-155-305 and must have certification verifying completion of the required training in their
possesion.
• Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City approved
material prior to the end of the workday- NO EXCEPTIONS.
• Three sets of construction drawings of proposed work are required with the pen -nit application.
CALL DIALA-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTTCEREQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATTON IS NOTAPERMITUNTIL SIGNED BY THE CITY ENGINEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROVIDED
BY
Printed: Thursday. Mav 02. 2019
/ Z�
DAIA
E] FILE COPY F-] INSPECTOR COPY E] APPLICANT COPY
STATUS: ISSUED
ENG20190189
• Restore ROW to City standards
• Restore Landscape to like or better conditions.
• Call for locates of underground utilities prior to any excavation.
• Alert affected residents and/or businesses prior to work start.
• Confon-n to approved working drawings and Traffic Control plan.
• Verify clear bore crossings
• Utility patch restoration to be in accordance with Edmonds Standard detail E2.3
• Maintain erosion & sedimentation control. Keep street clean.
• Call for required inspections as noted.
• Traffic Control per approved plan and MUTCD. Refer to City of Edmonds traffic control requirements.
• 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.
• 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 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all othertimes the noise originating from construction sites /activities must comply with the
noise limits of Cbapter 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
whatevernature, arising directly or indirectly fromthe issuance ofthis; permit. Issuance of this perrnit 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.
• E-SidewalkPre-Pour
• E-Engineering Final
PARTIAL INSPECTION
PARTIAL INSPECTION
FINAL INSPECTION APPROVED
DATE: INITIAL:
DATE: INITIAL:
DATE: INITIAL:
NOTES:.
NOTES:
.-I of 1EVA,1n,
11vc. 1 S90
ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: , CONTACT:
L
CP, 9--o6vi,,oei
CONTRACTOR: Phone #: S,- L412A
Mailing Address: �60s�� ZZ 0A44t14 Fax #-
State License #: F -I mail #:
City Business License #: F� Liability Insurance F-1 Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 252:10 I(L4" L,
I ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT: I
Commercial
F� Multi -Family
Subdivision
D Single Family
F-1 EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
City Project
F-1 Other
El Yes El No
ANY ASSOCIATED PERMITS? BLD# _?,tJtiO3. - ENG#
91 �2
DESCRIPTION OF PROPOSED WORK (Be Specific):
Traffic Control (Only)
I WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YESE] NOE] Year:
PAVEMENT CUT: El Yes F-1 No If yes, indicate size of cut: X.
CONCRETE CUT: _�9 Yes F-1 No If yes, indicate size of cut: X.
FRISGHT-OF-WAY
T
AREA
LO
L : URE
C C OS
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
SF
Alley 72 Hrs + LF
X
LF
LF
SF
Parking 72 Hrs + LF
X
SF
APPLICANT TO READ AND SIGN
*Traffic control and public safety shall be in accordance with City regulations as required by the City
Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and must have certification
verifying completion of the required training in their possession.
*Restoration is to be in accordance with City codes and Standards. All street -cut trench work shall be
patched with asphalt or City approved material prior to the end of the workday — NO EXCEPTIONS.
Indemnity., The Applicant has signed an application which states helshe hold the City of
Edmonds harmless from injuries, damages or claims of any kind or description
whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any of its departments or employees, including defense costs and attorney fees by reason
of granting this permit
I have read the above statements and understand the permit requirements and acknowledge that I must
follow all requi rein entsJ&,16rder for th -i t to e valid.
'e
SIGNATURE D AT. Cf
'ractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE