ENG2022-0331 SIDE SEWER PERMITSEWER PERMIT
PERMIT NUMBER
City of • • •
Edmonds98020ENG2022-03,131
www.cityofedmonds.gov
Description: SEWER CONNECTION FOR ADDITION ISSUED: 06/24/2022
Address: 18426 79TH PL W EDMONDS WA 98026-5848
EXPIRES: 09/22/2022
Permit Subtype: PARTIAL LINE
Permit Type: SEWER Parcel Number: 00471000000800
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT JASON DUNCOMBE 18426 79TH PL W, EDMONDS WA 98026
(206)225-0478
CONTACT JASON DUNCOMBE 18426 79TH PL W, EDMONDS WA 98026
(206)225-0478
CONTRACTOR OWNER
OWNER JASON & NASANZUU DUNCOMBE 18426 79TH PL W, EDMONDS WA 98026 (206)225-0478
FEE INFORMATIOt,&,_._
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00
SIDE SEWER PERMIT - PARTIAL REPLACEMENT $110.00 $110.00
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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
16/24/2022
DATE
Printed: Friday, June 24, 2022 4:18:53 PM 1 of 2
CITY OF EDMONDS M BuildingPermit.com
Utilities Application #1163815 - Connecting to Sewage
Applicant
First Name Last Name Company Name
Jason Duncombe
Number Street Apartment or Suite Number E-mail Address
18426 79th PI W jdduncombe@gmail.com
City State Zip Phone Number Extension
Edmonds WA 98026 (206) 225-0478
Contractor
Company Name
Owner
Number Street Apartment or Suite Number
City State Zip Phone Number Extension
State License Number License Expiration Date UBI # E-mail Address
Project Location
Number Street Floor Number Suite or Room Number
18426 79TH PL W
City Zip Code County Parcel Number
EDMONDS 98026 00471000000800
Associated Building Permit Number Tenant Name
BLD22-0334
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Jason & Nasanzuu Duncombe
Number Street Apartment or Suite Number
18426 79th PI 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: 6/23/2022 Submitted By: Jason Duncombe
Page 1 of 2
CITY OF EDMONDS M BuildingPermit.com
Utilities Application #1163815 - Connecting to Sewage
Project Contact
Company Name:
Name:
Address:
Jason Duncombe
18426 79th PI W
Edmonds WA 98026
Project Type
Single Family Residential
Email: jdduncombe@gmail.com
Phone #: (206) 225-0478
Activity Type Scope of Work
Utility Modification Partial Line Replacement
Project Name: Connecting to Sewage
Description of Work: Our connection for permit BLD22-0334 to the sewage line is just beyond 2 feet.
Project Details
Project Information
Replace
Page 2 of 2