ENG2021-0395 SEWER PERMITPERMIT
PERMIT NUMBER
City of Edmonds
EdmondsSEWER
98020 1 1 '
www.cityofedmonds.gov
Description: INSTALL A CLEAN OUT ON PRIVATE PROPERTY ISSUED: 10/06/2021
Address: 20025 82ND AVE W EDMONDS WA 98026-6720
EXPIRES: 01/04/2022
Permit Subtype: PARTIAL LINE
Permit Type: SEWER Parcel Number: 00569400000900
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT MIKE'S PLUMBING AND DRAIN PO Box 1535, EDMONDS WA 98020 (206)794-7518
CONTRACTOR MIKE'S PLUMBING AND DRAIN PO Box 1535, EDMONDS WA 98020 (206)794-7518
OWNER INGHAM ROBYN & ALI HAMID S 709 DRIFTWOOD PL, EDMONDS WA 98020-2663
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.
RELEAS
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
10/06/2021
DATE
Printed: Wednesday, October 06, 2021 9:52:55 AM 1 of 2
SEWER PERMIT
City of Edmonds
Edmonds•:• • 1 1 '
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.
PLEASE REFER TO STANDARD DETAILS SS-200, SS-201 AND, SS-202. STANDARD DETAILS CAN BE
FOUND ON THE CITY OF EDMONDS WEBSITE. SDR35 WITH GASKETED FITTINGS IS REQUIRED FOR ALL
SEWER REPAIRS. FOR ANY REPAIRS WHERE THERE IS MORE THAN ONE STICK OF PIPE, A PRESSURE
SEWER REQUIREMENTS
TEST IS REQUIRED. WHERE LINING OR PIPE BURSTING WATER AND TV TEST IS REQUIRED. IF THE 4-6
TRANSITION IS ENCOUNTERED, A 6" CLEANOUT IS REQUIRED AT THE PROPERTY LINE. THE 6"
CLEANOUT SHALL HAVE A 12" CAST IRON LAMPHOLE COVER WITH 1/2 HEX BOLTS, GRIPPER TWIST
PLUG, AND A 24" CONCRETE COLLAR. AN AS BUILT IS REQUIRED PRIOR TO FINAL OF THE PERMIT.
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.
INSPECTIONSM
INSPECTION TYPE DATE
RESULT
COMPLETE
E-2 SIDE SEWER
X-2 ENGINEERING FINAL"
Printed: Wednesday, October 06, 2021 9:52:55 AM 2 of 2
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CONTRACTOR INFORMATION:
SIDE SEWER
PERMIT APPLICATION
Company Name: M l
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Site Contact: PV N
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Phone #: 2D�t 79 477S I S
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City: D M at�t t�s Zip: q So20
State License # M I PG�q c) iLM
Expiration Date: DtJ , 2 2023
PROPERTY INFORMATION:
Email #•fl E • (n •CAM
City Business License ## O2#
Address:
2cv025 7 r d p Ave W E7PmcNl DS
Owner's Name:
Phone #:
❑ FULL LINE REPLACEMENT XSPOT REPAIR ❑ PIPE BURST
DESCRIPTION OF PROPOSED WORK (Be Specific):
91112r I s IM—arlawwwwom
❑ RELINE (PERMALINE ONLY)
ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE PERMISSION TO WORK ON ANY PROPERTY OTHER
THAN THATOWNED BY THE SUBJECT PROPERTY OWNER.
CERTIFICATIONS NECESSARY FOR INSTALLATION METHODS ARE THE RESPONSIBILITY OF THE.
CONTRACTOR PERFORMING SAID WORK.
I REPRESENT AND 'V O E CITY OF EDMONDS. IF REPAIR OF EXISTING SEWER EXTENDS TO AN
ADJACENT PROP Y, I E ERS EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY.
SIGNATURE
DATE l Q•
or Agent
NO WORK SHALT, BEGIN PRIOR TO PERMIT ISSUANCE