ENG2022-0167 SIDE SEWER PERMITPERMIT
PERMIT NUMBER
City of Edmonds
EdmondsSEWER
98020 1 1
www.cityofedmonds.gov
Description: SPOT REPAIR ON PRIVATE PROPERTY ISSUED: 04/18/2022
Address: 601 DAYTON ST EDMONDS WA 98020
EXPIRES: 07/17/2022
Permit Type: SEWER Permit Subtype: PARTIAL LINE Parcel Number: 00434209703700
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT DONALD JACKSON 7306 210TH ST SW, EDMONDS WA 98026 (425)877-5601
CONTACT FRANCOIS CREPEAU 7306 210TH ST SW, EDMONDS WA 98026 (425)622-7741
CONTRACTOR ACTION JACKSON DRN CLN/PLB LLC 23814 84Th Ave W, Edmonds WA 98026 (425)877-5601
OWNER CECILIA 6TH AND DAYTON LLC 2117 NW 95TH ST, SEATTLE WA 98117
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
ENGINEERING DIVISION
...,7TED
RELEASED BY
14/18/2022 DATE
Printed: Monday, April 18, 2022 7:31:35 AM 1 of 2
CITY OF EDMONDS M BuildingPermit.com
Utilities Application #1125466 - Sewer spot Repair
Applicant
First Name Last Name Company Name
Donald Jackson ACTION JACKSON DRN CLN/PLB LLC
Number Street Apartment or Suite Number E-mail Address
7306 210th st sw actionjacksondcap@yahoo.com
City State Zip Phone Number Extension
Edmonds WA 98026 (425)877-5601
Contractor
Company Name
ACTION JACKSON DRN CLN/PLB LLC
Number Street Apartment or Suite Number
7306 210th st sw
City State Zip Phone Number Extension
EDMONDS WA 98026 (425)877-5601
State License Number License Expiration Date UBI # E-mail Address
ACTIOJD884M7 8/3/2022 F;nign1 BDD actionjacksondcap@yahoo.com
Project Location
Number Street Floor Number Suite or Room Number
601 DAYTON ST
City Zip Code County Parcel Number
EDMONDS 98020 00434209703700
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
Cecilia 6TH AND DAYTON LLC
Number Street Apartment or Suite Number
2117 NW 95TH ST
City State Zip
SEATTLE WA 98117
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: 4/15/2022 Submitted By: Donald Jackson
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CITY OF EDMONDS MyBuildingPermit.com
Utilities Application #1125466 - Sewer spot Repair
Project Contact
Company Name:
Name: Francois Crepeau Email: Francois@actionjacksonplumbing.com
Address: 7306 210th st sw Phone #: 4256227741
Edmonds Wa
98026
Project Type
Nonresidential
Activity Type
Utility Modification
Scope of Work
Partial Line Replacement
Project Name: Sewer spot Repair
Description of Digging down 7 feet where line exits the building. Repairing broken section of 4 inch
Work: existing line with sdr 35 pvc, make all proper connections, bed with appropriate gravel, test
for leaks, inspections, backfill native dirt
Project Details
Project Information
Repair
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