ENG2021-0312 APPROVED SEWER PERMITSEWER PERMIT
PERMITNUMBER,
City of Edmonds
98020ENG2021-031
www.cityofedmonds.gov
Description: Spot repair close to the house on private property. ISSUED: 08/10/2021
Address: 7510 176TH AVE SW EDMONDS WA 98020
EXPIRES: 11/10/2021
Permit Type: SEWER Permit Subtype: PARTIAL LINE Parcel Number: 00513600002302
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT PRICOR TECHNOLOGIES 2825 S 154TH ST, SEATTLE WA 98188 (206)258-5270
OWNER HOLMES CRAIG A/HALL MEGAN L 7510 176TH AVE SW, EDMONDS WA 98020
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FEE INFORMATION
-Ab&--
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.
ED BY
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
08/10/2021
DATE
Printed: Tuesday, August 10, 2021 1:34:16 PM 1 of 2
SEWER PERMIT
City of • • •
•:• •ENG2021-031
www.cityofedmonds.gov• •
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.
INSP PRIOR TO BACKFILL
Call for all required inspections. All work shall be inspected prior to backfill.
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
INSPECTIONS
INSPECTION TYPE DATE
RESULT
COMPLETE
E-2 SIDE SEWER
X-2 ENGINEERING FINAL"
Printed: Tuesday, August 10, 2021 1:34:16 PM 2 of 2
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CONTRACTOR INFORMATION:
Company Name:
SIDE SEWER
PERMIT APPLICATION
Site Contact: A 1
Company Address: ift,5 s 1-51+1 �4 - Phone #: A53 15 O V ,T
City: ic, Zip:
State License #� L�
Expiration Date:
PROPERTY INFORMATION:
Address: 45,—Io
Owner's Name: ., Nn
Phone #:
Email #: -
City Business Livensel
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❑ FULL LINE REPLACEMENT % SPOT REPAIR ❑ PIPE BURST ❑ RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific):
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 HA OWNERS EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY.
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SIGNATURE DATE i
Contractor or Ane t
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE