ENG20160013.PDFOp E ID)
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
��c. 1890
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20160013
I SIDE SEWER PERM IT(I-Single Family)
Permit Nwnber: ENG20160013 Expiration Date: 04/11/2016
Job Address:18500 OLYMPIC VIEW DR EDMONDS
SOUTHWEST PLUMBING SOUTHWEST PLUMBING
2401 SW ALASKA ST 2401 SW ALASKA ST
SEATTLE, WA 98106 SEATTLE, WA 98106
(206)498-7344
LICENSE 4: SOUTHWP071C6 EXP:04/01/2017
1
"GRINDERPUMP
N PROPOSE TO REUSE LATERAL LID NUMBER
N IPROPOSETO REUSE SIDE SEWER F7DRAINAGE
SPOT REPAIR ON PRIVATE PROPERTY OF UP TO 4-FEEr. PIPE HAD MAJOR ROOT INSTUSION AND A BREAK IN THE LINE,
PIPE LOCATED 2-FEET UNDER BIG REDWOOD TREE NEAR BLUFF.
N PROJECT CROSSES OTHER PRIVATE PROPERTY
N VERIFICATION OF RECORDED EASEMENTS COMPLETE
INDEMNITY,- 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
any 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 REQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOT PERMITUNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED.
Printed:
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XF LECOPY INSPECTOR COPY ❑ APPLICANT COPY
11, 2016
STATUS: ISSUED.
ENG2O16OO13
• 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 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 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 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 of7:00amto 6:00pmon weekdays and 10:00amand 6:00pmon 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 fromthe issuance of this.pennit. 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.
• &CONTRACTOR TO PROVIDE ASBUILT
• E-Sanitary Side Sewer Inspection
PARTIAL INSPECTION DATE:
PARTIAL INSPECTION DATE:
FINAL INSPECTION APPROVED DATE:
INITIAL: NOTES:
INITIAL: NOTES:
INITIAL:
<4 of E DAl0tiO
INC. I S90
CONTRACTOR INFORMATION:
Company Name:
Company Address: ) N 0/ S Vy A
DIM WAYS IS
Site Contact: . R &Li
acheco
Phone #: lO 1 _ !199— 7 J? qq
City: 5 •ems CN Zip: °18 I a 6 Email # N R Q a O%
State License # , p D �'�r City Business License #
Expiration Date:
PROPERTY INFORMATION:
Address: 19500 Q � C ^ D�D
Owner's Name: Af
V`-£ PV �
Phone #: .
❑ FULL LINE REPLACEMENT SPOT REPAIR ❑ PIPE BURST ❑ RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific) :
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ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE PERMISSION TO WORK ON ANY PROPERTY OTHER
THAN THAT OWNED BY THE SUBJECT PROPERTY OWNER.
CERTIFICATIONS NECESSARY FOR INSTALLATION METHODS ARE THE RESPONSIBILITY OF THE
CONTRACTOR PERFORMING SAID WORK.
I REPRESENT AND WARRANT TO THE CITY OF EDMONDS, IF REPAIR OF EXISTING SEWER EXTENDS TO AN
ADJACENT PROPERTY, I HAVE OWNERS EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY. j
SIGNATURE DATE 0 1
Contractor or Agefd
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE