ENG2021-0524 SIDE SEWER PERMITPERMIT
PERMIT NUMBER
City of Edmonds
EdmondsSEWER
98020 1 1 �
ww.cityofedmonds.gov
Description: GRINDER PUMP REPAIR ISSUED: 12/21/2021
Address: 15931 72ND AVE W EDMONDS WA 98026
EXPIRES: 03/21/2022
Permit Type: SEWER Permit Subtype: GRINDER PUMP Parcel Number: 00513300003616
NAME TYPE NAME ADDRESS PHONE
APPLICANT BEAU FABREGAS 3601 121ST ST SW, LYNNWOOD WA 98087 (425)423-0900
CONTACT COMMERCIAL INDUSTRIAL ROOFING 3601 121ST ST SW, LYNNWOOD WA 98087 (425)423-0900
INC.
CONTRACTOR COMMERCIAL INDSTRL ROOFING INC 3601 121ST ST SW SUITE A, LYNNWOOD WA 98087 (425)750-1212
OWNER BEAU & LINDA FABREGAS 15931 72ND AVE W, EDMONDS WA 98026 (425)750-1212
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00
SIDE SEWER PERMIT - GRINDER PUMP $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
ENGINEERING DIVISION
APPROVED AS NOTED
RELEASED BY %%f��o �12/21/2021 DATE
Printed: Tuesday, December 21, 2021 11:09:23 AM 1 of 2
SEWER PERMIT
City of Edmonds
•:• •ENG2021-052
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.
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.
TRAFFIC CONTROL
Traffic Control per approved plan and MUTCD. All Flaggers shall be certified.
UNDERGROUND WIRING
All new, extended, rebuilt, or relocated electrical utility and/or service shall be placed underground.
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"
E-2 GRINDER PUMP
Printed: Tuesday, December 21, 2021 11:09:23 AM 2 of 2
CITY OF EDMONDS M BuildingPermit.com
Utilities Application #1067195 - side sewer
Applicant
First Name Last Name Company Name
Beau Fabregas Commercial Industrial Roofing Inc.
Number Street Apartment or Suite Number E-mail Address
3601 121 st St SW beau@cir-roofing.com
City State Zip Phone Number Extension
Lynnwood WA 98087 (425)423-0900
Contractor
Company Name
COMMERCIAL INDSTRL ROOFING INC
Number Street Apartment or Suite Number
3601 121st St SW Suite A
City State Zip Phone Number Extension
Lynnwood WA 98087 4257501212
State License Number License Expiration Date UBI # E-mail Address
COMMEI*205JJ 5/16/2023 FDm4Rig9 beau@cir-roofing.com
Project Location
Number Street Floor Number Suite or Room Number
15931 72ND AVE W
City Zip Code County Parcel Number
EDMONDS 98026 00513300003616
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
Beau & Linda Fabregas
Number Street Apartment or Suite Number
15931 72ND 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: 12/20/2021 Submitted By: Beau Fabregas
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Utilities Application #1067195 - side sewer
Project Contact
Company Name: Commercial Industrial Roofing Inc.
Name: Beau Fabregas Email: beau@cir-roofing.com
Address: 3601 121st St SW Phone #: (425)423-0900
Lynnwood WA 98087
Project Type
Single Family Residential
Activity Type Scope of Work
Utility Modification Side Sewer Repair Only
Project Name: side sewer
Description of Work: Applicant to take over city grinder pump. controls to be inspected with side sewer
permit
Project Details
Project Information
Repair
Page 2 of 2