Engineering Permit FormOF WAY PERMIT
PERMIT NUMBER
City of Edmonds
AveRIGHT
9801 1 1
www.cityofedmonds.gov
Description: IMPROVEMENTS FOR NEW SFR 323 DALEY ST ISSUED: 06/29/2021
Address: 323 DALEY ST EDMONDS WA 98020-3123
EXPIRES: 06/29/2022
rmit Type: RIGHT OF WAY Permit Subtype: RESIDENTIAL Parcel Number: 00434211903000
i
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 PREMIERE HOMES LLC 528 PINE ST#1, EDMONDS WA 98020 (425)359-9189
OWNER MILHOLLAND JOHN L & JANET D 4100 E PROCESSION SHORES RD, WHIDBEY ISLAND WA
98236
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT
$40.00 $40.00
ENGINEERING INSPECTION FEE
$990.00 $990.00
RIGHT OF WAY STANDARD PERMIT FEE
$330.00 $330.00
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 8:05:13 AM 1 of 2
KIRRMF WAY PERMIT
City of • • •
Ave•:• • ENG2021-0230
www.cityofedmonds.gov• •
CONDITIONS
CONDITION TYPE
Easement and/or permission from adjacent property owner is required prior to entry or work within
ADJACENT PROPERTY
an adjacent property.
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.
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
HOLD HARMLESS
issuance for this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any
requirements of any City ordinance nor limit in any way the City's ability to enforce any ordinance
provision.
INSP PRIOR TO BACKFILL
Call for all required inspections. All work shall be inspected prior to backfill.
ROW COMPACTION TEST
Right of way compaction tests are required per City standards.
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 of 7:OOam to 6:OOpm on
SOUND OR NOISE
weekdays and 10:OOam 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.
A Special Inspection agreement is required for this project. It is the owner/contractors responsibility
SPECIAL INSPECTIONS
to ensure inspections take place and that reports are provided to the Engineering Division on a weekly
ENGINEERING
basis at Engineeringpermits@edmondswa.gov.
UNDERGROUND WIRING
All new, extended, rebuilt, or relocated electrical utility and/or service shall be placed underground.
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
COMPLETE
MAI
A-1 TESC AND MOBILIZE
E-7 CONCRETE SIDEWALK
E-7 CURB GUTTER
E-7 RESTOR LIMITS
E-7 SEWER LATERAL
E-7 STORM CB
E-7 TRAFFIC CTRL
X-2 ENGINEERING FINAL"
E-7 TREE GRATE
Printed: Tuesday, June 29, 2021 8:05:13 AM 2 of 2