ENG2021-0500 SEWER PERMITPERMIT
PERMIT NUMBER
City of Edmonds
AveSEWER
9801 1 11
www.cityofedmonds.gov
Description: SPOT REPAIR ON PRIVATE PROPERTY ISSUED: 12/08/2021
Address: 21110 80TH PL W EDMONDS WA 98026-7015
EXPIRES: 03/08/2022
Permit Type: SEWER Permit Subtype: PARTIAL LINE Parcel Number: 00500800000200
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT MIKE'S PLUMBING PO BOX 1535, EDMONDS WA 98020 (425)775-0201
CONTACT MIKE'S PLUMBING PO BOX 1535, EDMONDS WA 98020 (425)775-0201
CONTRACTOR MIKES PLUMBING/DRAIN CLEANING PO BOX 1535, EDMONDS WA 98020-1535 (425)775-0201
OWNER BEN HOLT INDUSTRIES INC 22508 76TH AVE W, EDMONDS WA 98026
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00
SIDE SEWER PERMIT - PARTIAL REPLACEMENT $110.00 $110.00
•
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
MY W44� 12/08/2021
VAI!A[►9:1•]
DATE
Printed: Wednesday, December 08, 2021 9:20:33 AM 1 of 2
SEWER PERMIT
PERMIT NUMBIER,
City of Edmonds
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.
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.
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.
INSPECTIONS
INSPECTION TYPE DATE
RESULT
COMPLETE
E-2 SIDE SEWER
X-2 ENGINEERING FINAL"
Printed: Wednesday, December 08, 2021 9:20:33 AM 2 of 2
CITY OF EDMONDS M BuildingPermit.com
Utilities Application #1060875 - SALISH APARTMENTS- sewer repair
Applicant
First Name Last Name Company Name
MIKE'S PLUMBING MIKE'S PLUMBING
Number Street Apartment or Suite Number E-mail Address
PO Box 1535 info@mikesplumbinganddrain.com
City State Zip Phone Number Extension
EDMONDS WA 98020 4257750201
Contractor
Company Name
MIKES PLUMBING/DRAIN CLEANING
Number Street Apartment or Suite Number
PO Box 1535
City State Zip Phone Number Extension
Edmonds WA 98020-1535 (425) 775-0201
State License Number License Expiration Date UBI # E-mail Address
mikespc990km 5/12/2023 FD9114:3DR info@mikespiumbinganddrain.com
Project Location
Number Street Floor Number Suite or Room Number
21110 80TH PL W
City Zip Code County Parcel Number
EDMONDS 98026 00500800000200
Associated Building Permit Number Tenant Name
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
BEN HOLT INDUSTRIES INC
Number Street Apartment or Suite Number
22508 76TH AVE W
City State Zip
EDMONDS WA 98026
Certification Statement - The applicant states:
I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and
authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I
have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work
requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
Date Submitted: 12/7/2021 Submitted By: MIKE'S PLUMBING
Page 1 of 2
CITY OF EDMONDS M BuildingPermit.com
Utilities Application #1060875 - SALISH APARTMENTS- sewer repair
Project Contact
Company Name: Mike's Plumbing
Name: Sandra Stokes Email: office@mikesplumbinganddrain.com
Address: PO Box 1535 Phone #: (425) 775-0201
Edmonds WA 98020
Project Type Activity Type Scope of Work
Multifamily Residential Utility Modification Side Sewer Repair Only
Project Name: SALISH APARTMENTS- sewer repair
Description of Work: Side sewer repair on property.
Project Details
Project Information
Repair
Page 2 of 2