Engineering Permit Form ENG2019-0540SEWER PERMIT
City of • • •
...0i ENG2019-0540
www.cityofedmonds.gov
Description: 4" side sewer north of the driveway ISSUED: 06/08/2022
Address: 541 12TH AVE N EDMONDS WA 98020-2932
EXPIRES: 09/06/2022
Permit Type: SEWER Permit Subtype: OTHER Parcel Number: 00535600000200
iiii I 11-14111 a
NAME TYPE NAME ADDRESS PHONE
APPLICANT ISLAMUDDIN & RABIA WARDAK 4703 219TH ST SW, MOUNTLAKE TERRACE WA 98043-3612
CONTRACTOR RMK CONSTRUCTION PO BOX 1283, FALL CITY WA 98024 (206)510-7832
OWNER ISLAMUDDIN & RABIA WARDAK 4703 219TH ST SW, MOUNTLAKE TERRACE WA 98043-3612
FEE INFORMATION
DESCRIPTION AMOUNT PAID
ENGINEERING INSPECTION FEE
$200.00 $200.00
SEWER GENERAL FACILITY CHARGE RESIDENTIAL
$4,417.00 $4,417.00
SIDE SEWER NEW
$100.00 $100.00
X-TECHNOLOGY FEE
$35.00 $35.00
•
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
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RELEASED BY
DATE
Printed: Wednesday, June 08, 2022 3:51:38 PM 1 of 2
SEWER PERMIT
PERMITNUMBER,
City of Edmonds
...• • 1 1
www.cityofedmonds. ov/425.771.0220
CONDITIONS
CONDITION TYPE
10' Separation- Water &
Maintain 10' separation between the sanitary side sewer and the water service line.
Sewer
Cleanout at Property Line
A 6" cleanout with 12" locking cast iron lamphole cover is required at the property line.
Damage to Frontage
Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per
Improvements
City standards that is caused by or occurs during the permitted project.
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
Hold Harmless
agents from any and all claims for damages of whatever nature, arising directly or indirectly from the
issuance of this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any
requirements of any City ordinance not limit in any way the City's ability to enforce any ordinance
provision.
ROW Permit Req'd
A separate right-of-way construction permit is required for work within the City right-of-way.
Side Sewer Asbuilt
Owner/Contractor to provide Side Sewer asbuilt at final inspection. See City Standards for
requirements.
Side Sewer Handout
Refer to City of Edmonds Side Sewer Information handout for approved pipe materials, inspections
and other requirements.
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
Sounds/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.
Work on Adjacent Property
Easement and/or permission from adjacent property owner is required prior to entry/work within
adjacent property.
INSPECTIONS
INSPECTION TYPE DATE
RESULT
COMPLETE
X-2 ENGINEERING FINAL"
E-2 SEWER PRESSURE
E-2 SIDE SEWER
E-9 SEWER ASBUILT
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