ENG2022-0031 SIDE SEWER PERMITPERMIT
PERMIT NUMBER
City of Edmonds
AveSEWER
••01 11
www.cityofedmonds.gov
Description: REPLACE 4 IN FROM HOUSE TO PL INSTALL 6 IN CO ISSUED: 01/28/2022
Address: 548 6TH AVE S EDMONDS WA 98020-3407
EXPIRES: 04/28/2022
Permit Type: SEWER Permit Subtype: TOTAL LINE Parcel Number: 27032500209100
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT SAM TEDDY 9228 GOBLIN LN, EVERETT WA 98208 (425)241-5544
CONTACT SJ TEDDY PLUMBING CNTRTRS LLC 9228 GOBLIN LN, EVERETT WA 98208 (425)241-5544
CONTRACTOR SJ TEDDY PLUMBING CNTRTRS LLC 9228 GOBLIN LN, EVERETT WA 98208 (425)241-5544
OWNER ERLENE K STEVENSON 548 6TH AVE S, EDMONDS WA 98020
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00
ENGINEERING INSPECTION FEE $110.00 $110.00
SIDE SEWER PERMIT - FULL 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
ENGINEERING DIVISION
,..,7TED
RELEASED E
11 /28/2022 DATE
Printed: Friday, January 28, 2022 2:43:25 PM 1 of 2
SEWER PERMIT
City of Edmonds
Ave N, Edmonds WA •:• •ENG2022-0031
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 SEWER PRESSURE
E-9 SEWER ASBUILT
Printed: Friday, January 28, 2022 2:43:25 PM 2 of 2
CITY OF EDMONDS M BuildingPermit.com
Utilities Application #1084018 - Stevenson Side Sewer
Applicant
First Name Last Name Company Name
Sam Teddy SJ TEDDY PLUMBING CNTRTRS LLC
Number Street Apartment or Suite Number E-mail Address
9228 Goblin Ln sam@sjteddy.com
City State Zip Phone Number Extension
Everett WA 98208 (425)241-5544
Contractor
Company Name
SJ TEDDY PLUMBING CNTRTRS LLC
Number Street Apartment or Suite Number
9228 Goblin Ln
City State Zip Phone Number Extension
Everett WA 98208 (425)241-5544
State License Number License Expiration Date UBI # E-mail Address
SJTEDTP79OMN 7/13/2023 BD47514R.'I sam@sjteddy.com
Project Location
Number Street Floor Number Suite or Room Number
548 6TH AVE S
City Zip Code County Parcel Number
EDMONDS 98020 27032500209100
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
Erlene K Stevenson
Number Street Apartment or Suite Number
548 6th Ave S
City State Zip
EDMONDS WA 98020
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: 1/28/2022 Submitted By: Sam Teddy
Page 1 of 2
CITY OF EDMONDS M BuildingPermit.com
Utilities Application #1084018 - Stevenson Side Sewer
Project Contact
Company Name: SJ TEDDY PLUMBING CNTRTRS LLC
Name: Sam Teddy Email: sam@sjteddy.com
Address: 9228 Goblin Ln Phone #: (425)241-5544
Everett WA 98208
Project Type Activity Type Scope of Work
Single Family Residential Utility Modification Side Sewer Repair Only
Project Name: Stevenson Side Sewer
Description of Work: Dig up and replace broken existing 4" Concrete side sewer from house to 6" on
property. Bring 6" cleanout to Easement/Property line.
Project Details
Project Information
Replace
Page 2 of 2