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ENG20140302 (2).PDFllll jjlll �y oC E 1) CITY OF EDMONDS 121 5TH A VENUE NORTH - EDMONDS, WA 98020 PHONE: (425) 771-0220 - FAX: (425) 771-0221 *PERMIT MUST BE POSTED ON JOBSITE* STATUS: ISSUED ENG20140302 SIDE SEWER PERMIT (I -Single Family) Permit Number: ENG20140302 Expiration Date: 08/18/2014 Job Address: 18812 OLYMPIC VIEW DR, EDMONDS ATWOOD FABRICATING PO BOX 12765 MILL CREEK, WA 98082 ATWOOD FABRICATING PO BOX 12765 MILL CREEK, WA 98082 (454)481-5388 LICENSE #: EXP: Y REPAIR N PROPOSE TO REUSE LATERAL LID NUMBER N GRINDER PUMP N I PROPOSE TO REUSE SIDE SEWER N DRAINAGE REPAIR PERMIT TO ADJUST 6" SIDE SEWER TO EXISTING HOME NEAR SW CORNER OF PROPERTY. W ILL ALSO PROVIDE A SEWER STUB FOR FUTURE LOT 2. STUB WILL COMPLY WITH CONDITIONS OF APPROVAL FOR SHORT PLAT PLN20130043 N I PROJECT CROSSES OTHER PRIVATE PROPERTY N VERIFICATION OF RECORDED EASEMENTS COMPLETE INDEMA7TY The Applicant has signed an application which states he/she holds the City of Edmonds harmless from injuries, damages or claims ofany kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or anv of its departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and attorney fees by reason ofgranting this permit. CALL DIAL -A -DIG (1-800424-5555) BEFORE ANY EXCAVATION CALL FOR INSPECTION (425) 771-0220 EXT. 1326 24 HOUR NOTICE REQ UIRED FOR ALL INSPECTION REQUESTS THIS APPLICATION IS NOTA PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN SPACE PROVIDED. RELEASED BY 14-- , COPY INSPECTOR COPY Printed: Wednesday, June 18, 20 C.-I/'C // r--1 DATE APPLICANT COPY STATUS: ISSUED ENG20140302 • Refer to City of Edmonds Side Sewer Infomration 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 existing 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 pemussion 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 asbuilt at final inspection. See City Standards for requirements. • 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 10:00am 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. • 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 limit in any way the City's ability to enforce any ordinance provision. • E-Sanitary Side Sewer Inspection • E-Engineering Final PARTIAL INSPECTION DATE: IMTIAL: NOTES: PARTIAL INSPECTION DATE: INITIAL: NOTES: FINAL INSPECTION APPROVED DATE: INITIAL: OF E041NIP _ ° CITY OF EDMONDS 121 5THAVENUENORTH-EDMONDS, WA 98020 PHONE: (425) 771-0220 - FAX: (425) 771-0221 waft — ENGINEERING APPLICATION ACCEPTANCE Monday, Your Application has been accepted by the City of Edmonds and we will start the review process with the information you provided. More information and changes may be required during this process. Application Number: ENG20140302 Project Address: 18812 OLYMPIC VIEW DR, EDMONDS Permit Type: Side Sewer Intersection: ATWOOD FABRICATING PO BOX 12765 MILL CREEK, WA 98082 (454)481-5388 ATWOOD FABRICATING PO BOX 12765 MILL CREEK, WA 98082 (454)481-5388 Work Description: REPAIR PERMIT TO ADJUST 6" SIDE SEWER TO EXISTING HOME NEAR SW CORNER OF PROPERTY. WILL ALSO PROVIDE A SEWER STUB FOR FUTURE LOT 2. STUB WILL COMPLY WITH CONDITIONS OF APPROVAL FOR SHORT PLAT PLN20130043 Outstanding Items at 1nme of Submittal: NEED CITY BUSINESS LICENSE To view up to date information about your permit please visit the City of Edmonds Development Services website at http://"www.ei.edmonds.wa.us. ���gU30Z SIDE SEWER PERMIT APPLICATION CONTRACTOR INFORMATION: . CompanyName: Site Cont-act:. Phone#: M r ICE p' ; Sao Mailing Address: .b fox i Z'11p5 ��, Fax #: 4Zs _ q$kp _ State License#: Expuntion Date: �GT, ( 2 Email#: � � City Business License #: Liability LLsurince Bonded H 1— U-000yS3 1053 - OC.r 1 Z PROPERTY INFORMATION: Ad(lress: �7QJ Z (�� M PI C, VC-1 L� Owner'.s Name: L �COSC.� Phone #: Full Line Replaceinent ❑ SpotRepan• ❑ Pipe Burst Reline (PermaLine Only) DESCRIPTION OF PROPOSED WORK (Be Specific) : SIGNATURE DATE e A�-1,11v Conhnctor or Agent NO `'VORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE STATE .OF . )ss COUNTY OF S no I certify.:that`I know or have satisfactory evidence that t' (`G n YP. r is the person who appeared before:me;:and said person aclrnowled ed that` this insttvmentand acknowledged it to. be free purposes mentioned in the.inshvrnent:. and:voluntary act for the uses -and 17ated. 0 6- / =' �7rll Jy- . (Signritttte} Notary. Public . State of Washington ' �t04�piZ;SfCzD MANDON MEZISTRANOPrintNory My. Appointment Expires May 10, 2016 . Title: iVn{�y:. iubl�c 1W appointment. expires: It) -- Xn/Z Title: _MY appointment expires: STATE OF �ctiS lz,h3or ) )ss _ COUNTY,OF . I cert6that I know or have satisfactory evidence that is:the person who appeared before h* and said n acknowl dged that ` daw. signed instrumentant ----.free purposes mentioned in the instrument. and voluntary act.for the uses and Dated:,.©� - l 3 - dolt' Notary Public (Signature) State.of Washin on. . BRANDON MEBS RANo .: Print.NoyNam: . � My AppointeExpireMay 10; 2016 Title: My appointment expires:.. 5 — �.:� - Hof: Title: My appointment expires: Page 3 O: O Q o 0 cam. . o � Q v) o C w . Q LJ w r- O. o co �-- 00 oo �- z ec r z � w co. .: W..J.. . lia \ . " .:" n F-- Q. N Qi-- Ln ,N w do O [� O t.tW�. /z�� `J -- - ... - J U. ._ w O /�yy�� LL ry ' N. `,, - o n - W PAGE .4