Engineering Permit Form ENG2019-0541OF WAY PERMIT
PERMITNUMBER,
City of Edmonds
EdmondsRIGHT
98020 1 1Li
www.cityofedmonds.gov
Description: Right Of Way - 1-Single Family ISSUED: 06/08/2022
Address: 541 12TH AVE N EDMONDS WA 98020-2932
EXPIRES: 06/03/2023
it Type: RIGHT OF WAY Permit Subtype: RESIDENTIAL Parcel Number: 00535600000200
W
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
$100.00 $100.00
ENGINEERING INSPECTION FEE
$400.00 $400.00
RIGHT OF WAY STANDARD PERMIT FEE
$300.00 $300.00
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
6/8/2022
RELEASED BY
DAT.-
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KIRRMF WAY PERMIT
City of • • •
•:• •ENG2019-0541
www.cityofedmonds.gov• •
CONDITIONS
CONDITION TYPE
AlertAffected Properties
Alert affected residents and/or businesses prior to work start.
Bore Crossings
Verify clear bore crossings
Conform to approved plans
Conform to approved working drawings and Traffic Control plan.
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.
ESC Required
Maintain erosion & sedimentation control. Keep street clean.
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.
Inspections
Call for required inspections as noted.
Landscape Restoration
Restore Landscape to like or better conditions.
Public Utility Separation
Public utilities maintain 5' separation from City Utilities.
ROW Restoration
Restore ROW to City standards
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 7:00am to 6:00pm on
Sounds/Noise
weekdays and 10:00am and 6:00pm 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 Handout
Traffic Control per approved plan and MUTCD. Refer to City of Edmonds traffic control requirements.
Underground Utility Locates
Call for locates of underground utilities prior to any excavation.
Utility Patch Restoration
Utility patch restoration to be in accordance with approved plans and Edmonds Standard detail E2.3
INSPECTION TYPE
DATE
RESULT
NOTES
COMPLETE
A-1 TESC AND MOBILIZE
E-7 CURB GUTTER
E-7 DWY APPROACH
E-7 MAILBOX LOCATION
E-7 PAVEMENT COMPACTION TEST
REPORT
E-7 PVMT SUBGRADE
E-7 RESTOR LIMITS
E-7 SEWER LATERAL
E-7 TRAFFIC CTRL
X-2 ENGINEERING FINAL"
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