ENG2021-0159 ROW PERMITOF WAY MINOR PERMIT
PERMITNUMBER,
City of Edmonds
EdmondsRIGHT
98020
1 1 '
www.cityofedmonds.gov
Description: REPLACE ASPHALT DRIVEWAY STORMWATER MANAGEMENT NOT REQD
ISSUED: 05/07/2021
Address: 21714 97TH AVE W EDMONDS WA 98020-3955
EXPIRES: 11/05/2021
rmit Type: RIGHTOF WAY MINOR Permit Subtype: RESIDENTIAL Parcel Number: 00559700201300
i
NAME TYPE NAME ADDRESS
PHONE
APPLICANT JB ASPHALT PAVING INC 22228 95TH PLW, EDMONDS WA 98026
(425)774-6537
CONTRACTOR JB ASPHALT PAVING INC 22228 95TH PLW, EDMONDS WA 98026
(425)774-6537
OWNER WOELFLE KAMERON 21714 97TH AVE W, EDMONDS WA 98020
FEE INFORMATION
DESCRIPTION AMOUNT
PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00
$40.00
RIGHT OF WAY MINOR PERMIT FEE $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.
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
05/7/2021
RELEASED BY DATE
Printed: Friday, May 07, 2021 4:12:08 PM 1 of 2
WAY MINOR .UM PERMIT
City of • • •
Edmonds•:• • ENG2021-0159
www.cityofedmonds. ov/425.771.0220
CONDITIONS
CONDITION TYPE
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.
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.
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
X-2 ENGINEERING FINAL"
Printed: Friday, May 07, 2021 4:12:08 PM 2 of 2
it f
ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: Private
CONTRACTOR: JB Asphalt Paving- �
Mailing Address: 22228 95th P1 W, Edmonds 98020
State License #:
City Business License #:
CONTACT: Gage Henry
Phone #: 509-860-4213
Fax #:
Email #: gage@jbasphalt.com
-�Liability Insurance --�Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 4-1 1� -) !I- 4.�; r_ I
[_.ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:---�
Commercial
0 Multi -Family
Subdivision
0 Single Family
0 EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
I- ANY ASSOCIATED PERMITS? I
City Project
F-1 Other
0 Yes 7 No
BLD# ENG#
Traffic Control (Only)
A
DESCRIPTION OF PROPOSED WORK (Be Specific): &
4;'
I WAS STREET OVERLAYED WITHIN THE LAST FIVE (5) YEARS? YES ❑ NO X Year:_ I
PAVEMENT CUT:
CONCRETE CUT:
El Yes E No If yes, indicate size of cut: x
F-1 Yes E] No If yes, indicate size of cut: x
RIGHT-OF-WAY
CLOSURE AREA
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
SF
Alley 72 Hrs + LF
X
LF
SF
Parking 72 Hrs + LF
X
LF
SF
APPLICANT TO READ AND SIGN
*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 possession.
*Restoration is to be in accordance with City codes and Standards. All street -cut trench work shall be
patched with asphalt or City approved material prior to the end of the workday — NO EXCEPTIONS.
Indemnity: The Applicant has signed an application which states he/she hold 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 defense costs and attorney fees by reason
of granting this permit.
I have read the above statements and understand the permit requirements and acknowledge that I must
follow all requirements in order for the permit to be valid.
SIGNATURE Gage Henry DATE 4/10/2021
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
ENGINEERING DIVISION
APPROVED AS NOTED
, 05/07/2021
MEETING OR EXCEEDING 2,000 SF
OR NEW/REPLACED IMPERVIOUS
SURFACES SHALL REQUIRE
STORMWATER MANAGEMENT.
Applicant shall repair/replace all
damage to utilities or frontage
improvements in City right-of-way
per city standards that is caused or
occurs during the permitted project.
MAXIMUM DRIVEWAY SLOPE
ALLOWED 14%
OWNER/CONTRACTOR IS RESPONSIBLE FOR
EROSION CONTROL AND DRAINAGE
OWNER/CONTRACTOR RESPONSIBLE FOR LOCATING
ALL ON SITE UTILITIES. RELOCATION/REVISION TO ANY
UTILITIES MAY REQUIRE A SEPERATE PERMIT.
21714 97th AVE W
42'
TACK COAT GLUE @ EASMENT TO
DRIVEWAY APPROACH AT
STREET SHALL NOT
EXCEED 24' IN WIDTH.
HOUSE
existing driveway
l 18.5
------------
power pole
10
La dscaped
-.----- 151 51,
20.5
new driveway width mail boxes
97th AVE W REQUIRED
LANDSCAPED AREA
�-- 51
ROW
5'
i E:-