ENG2021-0404 SEWER PERMITSEWER PERMIT
PERMIT NUMBIER,
City of Edmonds
www.cityofedmonds.gov
Description: NEW SIDE SEWER FOR ADDITION CONNECTED TO EXISTING
ISSUED: 10/18/2021
Address: 8415 TALBOT RD EDMONDS WA 98026-5044
EXPIRES: 01/16/2022
Permit Subtype: PARTIAL LINE
Permit Type: SEWER Parcel Number: 00594400001600
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT NOBUL PLUMBING LLC 2918 127th Ave NE, LAKE STEVENS WA 98258-8053 (425)280-3878
OWNER FELTON SAMUEL PAGE & LIN CHEN 2612 NW 201ST ST, SHORELINE WA 98177
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.
BY
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
10/18/2021
DATE
Printed: Monday, October 18, 2021 10:27:59 AM 1 of 2
Printed: Monday, October 18, 2021 10:27:59 AM 2 of 2
CONTRACTOR INFORMATION:
Company Name:
Company Address:
SIDE SEWER
PERMIT APPLICATION
LL Site Contact: wg�
City: Labe. S*Nen% Zip: 9 5S
State License # 664 _ 751 _ (o-7q
Expiration Date: 05131 / 2=21
PROPERTY INFORMATION:
Address: H j JC T,16 ,-(- ,�
Phone #: Y 2-5 — S a( —z.-o�; r z
Email #: h 0btkl blurn be CS @a Mal I • Co m
City Business License# L1 _751_ 47y
Owner's Name:
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hone #:
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❑ FULL LINE REPLACEMENT ❑ SPOT REPAIR ❑ PIPE BURST ❑ RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific): j
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ISSO' ANCE 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 OW'_ TRS EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY.
SIGNATURE z2it DATE
Contractor or Agent
NO WORK SfLYLL. BEGIN PRIOR TO PERMIT ISSUANCE