ENG20170154-SS.pdfDtt 4
CITY OF EDMONDS
121 5TH AVENUENORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBS TE*
STATUS: ISSUED ENG20170154
SIDE SEWER PERMIT (]-Single Family)
Permit Number: ENG20170154 Expiration Date: 05110/2018
Job Address: 21230 80TH AVE W, EDMONDS
APPLIC�.�NNT CONTRACTOR
PRIDE VENTURES PRIDE VENTURES
320 DAYTON ST SUITE 108 320 DAYTON ST SUITE 108
EDMONDS, WA 98020 EDMONDS, WA '98020
(425)422-0053
LICENSE #: PRIDEVL890R2 EXP` 01/15/2018
JOB DLS(-Rw,rION
Y REPAIR N PROPOSE TO REUSE LATERAL LID NUMBER:
N GRINDER PUMP N PROPOSE TO REUSE SIDE SEWER N DRAINAGE
INS"1''ALL SIDE SEWER
FASEMENT INFORMATION
N' PROJECT CROSSES` OTHER PRIVATE PROPERTY
N VI RIFI(, TION OF RECORDED EASEMENTS COMPLETE
IADEMATTY The Applicant has signed an application which slates he/she holds the City of Edmonds harmless from injuries,
damages or claims ofany kind or description whalsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any ofits departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
attorney fees by reason ofgranting this permil.
CALL DIAL -A-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
APPLICATION APPROVAL
THIS APPLICATION IS NOTA PERMIT UNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY- AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED,
Printed: Wednes'(l Mei' � I ) 2017
X, FILE COPY r_� INSPECTOR COPY [:] APPLICANT COPY
• 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' separationbetween the sanitary side sewer and the water service line.
• 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 fi•omthe 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 Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf ofhis 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 fi•omthe'issuance ofthis pen -nit. Issuance ofthis 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'
PARTIAL INSPECTION DATE: INITIAL: NOTES:_
PARTIAL INSPECTION DATE: II�IITIAL: NOTES:
FINAL INSPECTION APPROVED DATE:W INITIAL: