Engineering Permit FormNEW RESIDENTIAL PERMIT
PERMIT NUMBER
City of Edmonds
AveSEWER
N, Edmonds WA 98020 ENG2021-0229
www.cityofedmonds.gov
Description: NEW SEWER FOR NEW SFR 323 DALEY ST ISSUED: 06/29/2021
Address: 323 DALEY ST EDMONDS WA 98020-3123
EXPIRES: 06/29/2022
Permit Type: SEWER NEW RESIDENTIAL Permit Subtype: Parcel Number: 00434211903000
Isle]
NAME TYPE NAME ADDRESS PHONE
APPLICANT
BRIAN CLOWARD
630 NW 81ST STREET, SEATTLE WA 98117
(206)755-0759
CONTACT
CLOWARD SUSTAINABLE DESIGN
630 NW 81ST STREET, SEATTLE WA 98117
(206)755-0759
CONTRACTOR
DENNIS PARKER-DALEY STREET
528 PINE ST#1, EDMONDS WA 98020
(425)359-9189
BUILDERS LLC
OWNER DENNIS PARKER-DALEY STREET 528 PINE ST #1, EDMONDS WA 98020 (425)359-9189
BUILDERS LLC
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00
ENGINEERING INSPECTION FEE $110.00 $110.00
SIDE SEWER PERMIT - NEW RESIDENTIAL $110.00 $110.00
REQUIREMENTS
REQUIREMENT TYPE
NOTES
TRAFFIC CONTROL Traffic control and public safety shall be in accordance with City regulations as required by the City
Engineer. Every flagger must be trained as required by WAC 296-155-305 and must have certification
verifying completion of the required training in their posession.
RESTORATION Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with
asphalt or City approved material prior to the end of the workday - No Exceptions
WARRANTY The contractor is responsible for workmanship and materials for a period of one year following the final
inspection and acceptance of the work.
INSPECTION SCHEDULING: WWW.MYBUILDING PERMIT.COM
24 HR NOTICE REQUIRED
INDEMNITY
The Applicant has signed an application which states he/she holds the City of Edmonds harmless from injuries, damages or claims of
any 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 of any legal proceedings including defense costs and attorney fees by reason of
granting this permit.
RELEASED BY
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
DATE
Printed: Tuesday, June 29, 2021 8:01:15 AM 1 of 2
NEW RESIDENTIAL PERMIT
PERMIT NUMBER
City of Edmonds
AveSEWER
98020 ENG2021-0229
www.cityofedmonds.gov•
CONDITIONS
CONDITION TYPE
NOTES
It is the owner's responsibility to repair/replace all damage of utilities or frontage improvements in
DAMAGE TO FRONTAGE
City right of Ways or Easements to City Standards caused by or occurring during the permitted
IMPROVEMENTS
project.
ESC REQ
Maintain erosion and sedimentation control per City and SWMMW standard requirements.
INSP PRIOR TO BACKFILL
Call for all required inspections. All work shall be inspected prior to backfill.
All utilities shall be located prior to any excavation. New locates shall be called for if at time of
UTILITY LOCATES
excavation, original locates are no longer identifiable.
INSPECTIONS
INSPECTION TYPE
DATE RESULT NOTES
COMPLETE
X-2 ENGINEERING FINAL"
E-2 SEWER PRESSURE
E-2 SIDE SEWER
Printed: Tuesday, June 29, 2021 8:01:15 AM 2 of 2