Issued permit.pdfOF CY'o 0
° CITY OF EDMON _DS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20170342
SIDE SEWER PERMIT (]-Single Family)
Permit Number: ENG20170342 Expiration Date: 10/30/2017
Job Address: 19325 83RD PL W, EDMONDS
APPLICANT CONTRACTOR
SPOSARI INC, DBA MR ROOTER SPOSARI INC, DBA MR ROOTER
2000 S 116TH ST 2000 S I I6TH ST
SEATTLE, WA 98168
SEATTLE, WA 98168
(206)651-2917
LICENSE #: MRROOP'022NE EXP: 08/19/2018
Y
N
REPAIR N PROPOSE TO REUSE LATERAL LID NUMBER:
GRINDER PUMP N I PROPOSE TO REUSE SIDE SEWER F N 1 DRAINAGE
Make an approx 34 spot repair on sewer and install clean out near the home.
1
N PROJECT CROSSES OTHER PRIVATE PROPERTY
N VERIFICATION OF RECORDED EASEMENTS COMPLETE
INDEMNITY The Applicant has signed an application which stales 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 ofils 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 0-800-424-5555 BEFORE ANY EXCAVATION
MCA ECTION (425) 771-0220 26 toy 7q
24 HOUR NOTICEREQUIRED FOR ALL INSPE(:TI TS
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.
BY
Printed: Wednesday, August 30, 2017
DATE
❑ FILE COPY ❑ INSPECTOR COPY ❑ APPLICANT COPY
STATUS: ISSUED
ENG20170342
• 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 as built at final inspection. See City Standards for requirements.
• Sound/Noise originating fromtemporary construction sites as a result of construction activity are exempt fromthe noise limits
of ECC Chapter 5.30 only during the hours of 7:00amto 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
PARTIAL INSPECTION DATE: INITIAL: _ _ _ NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
Of EOM04 r
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SIDE SEWER
PERMIT APPLICATION
CONTRACTOR INFORMATION:
Company Name:�ri i
Site Contact: �1 ha, Hen -c-
Mailing Address: 2 O()Mailiing���-01 55-r
State License #: M P-P 00P� 022
Expiration Date: ej - 10( - \1r1,,5
City Business License #: aR.O -7b7
PROPERTY INFORMATION:
Phone#: (9S(_20�
Fax #: � 26 "2 2 CG 3 %
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iabilihInsurance Bonded
Address: 1 2 2 5 ►� pj �'%�
Owner's Name: Lra MdrcL4
Phone #:
❑ Full Line Replacement E5/slpot Repair ❑ Pipe Burst
DESCRIPTION OF PROPOSED WORK (Be Specific) :
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Contractor 0 Ageitt
❑ Reline (PermaLine Only)
NO WORK SI kL- 4EGIN PRIOR TO PERMIT ISSUANCE