SEWER PERMIT.pdfE1fU IT"' EDM"N'T'S
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121 5TH AVENUE NORTH -EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20180494
SIDE SEWER PERMIT (]-,Single Family)
Permit Number: ENG20180494 Expiration Date: 01 /25/2019
Job Address: 7115 OLYMPIC VIEW DR, EDMONDS
APPLICANT CONTRACTOR
REVIVE PROJECT PROS REVIVE, PROJECT PROS
8317 188TH ST SW 8317 188TH ST SW
EDMONDS, WA 98026 EDMONDS, WA 98026
(206)488-6557
LICENSE 4: REVIVPP821 C3 EXP: 02/23/2020
.JOB DESCRIPTION
N IREPAIR N PROPOSE TO REUSE LATERAL LID NUMBER:
N GRINDER PUMP N PROPOSE TO REUSE SIDE SEWER F_N7 DRAINAGE
INSTALLNEW SANITARY SIDE SEWER - OPEN TRENCH FROM STUB AT PROPERTY LINE TO HOUSE. 6" CLEANOUT TO BE
AT GRADE AT PROPERTY LINE WITH 12" CI LAMPHOLE COVER PER CITY STANDARDS. EXISTING SEPTIC SYSTEM TO BE
PROPERLY ABATED.
PROJECT CROSSES OTHER PRIVATE PROPERTY
VERIFICATION OF RECORDED EASEMENTS COMPLETE
INDEMAVTY 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 ofits 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 DIALrA-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS
T'FIIS APPLICA"ITON IS NOT A PF.,RMITUNTIL SIGNED BY'HJF,, CITY ENGINEER OR HIS(MER DEPUTY: AND FEES ARE PAID, AND RECE.IPTIS ACKNOWLEDGED IN
SPACE: PROVIDED.
SED BY
Printed: Thursday, October 25, 201
IA Z 5 [ze I
DATE
FILE COPY INSPECTOR COPY F APPLICANT COPY
STATUS: ISSUED
ENG2O18O494
• 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 ebsting lateral to be verified by the City's Public Works Dept. to obtain approval for reuse. Contact Edmonds
Sewer Division at425-771-0235.
• Condition ofthe a)dsting sanitary side sewerto be verified priorto obtaining approval for reuse. TV inspection required. Video
to be submitted to City for review.
• li .scnint andls, r permission Ii-om adjacent propetly owner is required prior to entry/vvorla within adjacent prope0y:
• 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 fromtemporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00amto 6:OOpm on weekdays and 10:00am and 6:OOpm 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 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 from the issuance ofthis permit. 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
• B-Engineering Final
E-Contractor to Provide Asbuilt
• E-Septic Abatement
PARTIAL INSPECTION DATE: INITIAL:
PARTIAL INSPECTION DATE: INITIAL:
FINAL INSPECTION APPROVED DATE: INITIAL:
NOTES:
NOTES:
CONTRACTO11 INF ORNIATION:
Company Name:
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Company Address: �'�� hone #: ZC>"
City zips Email #:
State License #" City Business License #,r
Expiration Date: 2-0 i)
PROPERTY INFORMATION:
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Address:
Owner's Name:
Phone # 702 j�r,7e7 2 2 &1-4
LL LINE REPLACEMENT ❑ SPOT REPAIR ❑ PIPE BURST ❑ RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific)
V
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 "II' w CFI-Y OF EDMONDS, IF REPAIR OF EXISTING SEWER EXTENDS TO AN
ADJACENT PROPERTY, I II'A 6EXPRESS Pam' N TO PERFORM WORK ON THAT ADJACENT
PROPERTY.""
SIGNATURE DATE
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE