7.24.18 - Issued Permit.pdf-1 0 V. E D &
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
I rs'), PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20180318
RIGHT OF WAY PERMIT (1-Single Family)
Permit Number: ENG20180318 Expiration Date: 09/24/2018
Job Address: 21709 97TH AVE W, EDMONDS Location:
APPLICANT CONTRACTOR
Down Right Concrete Down Right Concrete
1401 237th PI SW 1401 237th PI SW
Bothell, WA 98021 Bothell, WA 99021
(425) 412-0455
LICENSE#: DOWNRRC88IMT EXP�08/12/2018
JOB DESCRIPTION
Replace driveway and walkway. Widen driveway
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
INDEMNITY- The Applicant has signed an application which states helshe holds the City ofEdmonds harmlessftom injuries,
damages or claims ofany kind or description ii,halsoever, 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
afforneyfees by reason ofgranting thispermil.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THEW 0 RIC
• Traffic Control and public safety shall be in accordance with City regulations as required by the City Engineer. Every flaggcr must
be trained as required by (WAC) 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 pennit application.
CALL DIALA-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOnCEREQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOTA PERMITUNTTL SIGNED BY THE CITY ENGINEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIPTIS ACKNOWLEDGED IN
SPACE PROIADED.
Tuesday. July 24.201
ZA
TE
F-] FILE COPY F-] INSPECTOR COPY F-1 APPLICANT COPY
STATUS: ISSUED
ENG20180318
• Restore ROW to City standards
• Restore Landscape to like or better conditions.
• Call for locates ofunderground utilities prior to any excavation.
• Alert affected residents and/or businesses prior to work start.
• Conforrn to approved working drawings and Traffic Control plan.
• Public utilities maintain 5'separation from City Utilities.
• 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 fi-ontage 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 from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:00pm on weekdays and 10:00arn 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.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
lian-niess 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 ofthis permit. Issuance of this 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.
INSPECTIONS
• E-Driveway Form & Slope Ver.
• E-Engineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPEC710N DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
OWN E,"VOONTRAG'TOR IS RE"';nFONSIBLE FOR
EROSION CONTROL NNE, DRAINAGE
LA
cw,
Pw.
7T
X
9D
W,
5AO-� C*--or A-,`,$4�'r APf
-M�EL)��O j�rjp-ef-,-
"fAO Z(91AI-f
c7 rrA
x
< C^
(b
Q6�
Q>
INGINEM9*41 ON"" Applicant shag repair/replace all damage to
APPRff AS NOTED Utilities or fmntage improvements in City
kit right-of-way per City standards that is caused
or occurs during the permitted pv�',ect.
__'� of EVAi,-,,
/ik/(:. i. S90
ROW PERMIT NO.: ENG U19�05iS
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME:,,5- CONTACT: VA\\U--
%1_1p C_V�V_�S;
CONTRACTOR: _r C[)ACgT;�' Phone#:
Mailing Address: Lk\b L_ -Tt-� '? L 9 I/V Fax #:
C)96
V_' w Pf
State License#: 't)DVJM �ZV_C., Email 10 0 w t) V I C-1 C-0 �_f
City Business License #: pkRr- lity Insurance Fq Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 7-1 _+ 0 Ci q -=f T4 kv 10 � �-oiQ_s
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
F� Commercial El Subdivision El City Project El Traffic Control (Only)
F� Multi -Family 1� Single Family F1' Other
F] EUC (PUD, VEI;�ZJON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit? F-1 Yes VNo
I ANY ASSOCIATED PERMITS? BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific): TA2\vl�tor*9
WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES LJ NO L/J Year:
PAVEMENT CUT: El Yes F� No If yes, indicate size of cut: x
CONCRETE CUT: E] Yes F-1 No If yes, indicate size of cut: x
RIGHT-OF-WAY AREA
CLOSURE
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
Alley 72 Hrs + LF
Parking 72 Hrs + LF
- -
X
LF
SF
I
X
LF
SF
I X
LF
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 requirements in order fo ri-nit to be valid.
SIGNATURE k I DATE
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE