ENG2021-0275 APPROVED SEWER PERMITPERMIT
PERMIT NUMBER
City of Edmonds
AveSEWER
N, Edmonds WA 98020ENG2021-0275
www.cityofedmonds.gov
Description: INSTALL 103' OF 4" PERMALINER ISSUED: 07/27/2021
Address: 7900 200TH ST SW EDMONDS WA 98026-6835
EXPIRES: 10/27/2021
Permit Subtype: PARTIAL LINE
Permit Type: SEWER Parcel Number: 00407700400802
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT AIRS RESCUE ROOTER 175 ROY ROAD, PACIFIC WA 98047 (253)872-6944
CONTRACTOR ARS RESCUE ROOTER 175 ROY ROAD, PACIFIC WA 98047 (253)872-6944
OWNER KAISER -BROWN LANE J 7900 200TH ST SW, EDMONDS WA 98026-6835
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00
SIDE SEWER PERMIT - PARTIAL REPLACEMENT $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
07/27/2021
RELEASED BY
DATE
Printed: Tuesday, July 27, 2021 7:56:41 AM 1 of 2
SEWER PERMIT
PERMIT NUMBER
City of • • •
•:• •ENG2021-0275
www.cityofedmonds.gov• •
CONDITIONS
CONDITION TYPE
The subject permit does not provide authorization to perform work within the City ROW. All work
under this permit is limited to private property.
DAMAGE TO FRONTAGE
IMPROVEMENTS
It is the owner's responsibility to repair/replace all damage of utilities or frontage improvements in
City right of Ways or Easements to City Standards caused by or occurring during the permitted
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.
Call for all required inspections. All work shall be inspected prior to backfill.
INSP PRIOR TO BACKFILL
If open trench occurs at property line, a 6" sewer cleanout shall be installed consistent with City of
Edmonds standard details.
Owner/Contractor to provide Side Sewer asbuilt at final inspection. See City Handout E71 for
SEWER ASBUILT
requirements.
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.
WATER AND SEWER
Maintain 10' of separation between the sanitary side sewer and the water service line.
SEPARATION
•
PECTION TYPE
7SIDE
DATE
RESULT
NOTES
r ir
COMPLETE
R
X-2 ENGINEERING FINAL"
E-2 TV AND WATER TEST
E-9 SEWER ASBUILT
Printed: Tuesday, July 27, 2021 7:56:41 AM 2 of 2
SIDE SEWER
PERMIT APPLICATION
CONTRACTOR INFORMATION:
Company Name:Ale'�' �0-eSWe, )CDL>r k2- Site Contact: j��Oh k�>e#-&\/O
Company Address: 11 1/> S C Phone #: C2 �c,� Z (Do[
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City: YRCA G Zap: Email #: C,3 No�ZV @ a r F. CO m
State License # NAGS �� o--1Q- l City Business License #
Expiration Date: I I 1 12 O-Z 2-
PROPERTY INFORMATION:
Address: —I q 00 2-0U*-1 St S�IJ eolrv) OnAls, VV Pr 9bo2 (.p
Owner's Name:
Phone #: /2-0(,0)
❑ FULL LINE REPLACEMENT ❑ SPOT REPAIR ❑ PIPE BURST RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific):
W %Vnv �, e C ontc er,� tv v S t un SUS, 03 ' o 14"
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 THE CITY OF EDMONDS, IF REPAIR OF EXISTING SEWER EXTENDS TO AN
ADJACENT PROPERTY, I HAVE OWNERS EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY.
SIGNATURE bbtrA/kfljDATE
Contractor or gent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE