ENG2022-0514 SEWER PERMITSEWER PERMIT
PERMIT NUMBER
City of • • •
...0iENG2022-0514
www.cityofedmonds.gov
Description: SEWER - SPOT REPAIR ON PRIVATE PROPERTY ISSUED: 10/19/2022
Address: 1218 OLYMPIC AVE EDMONDS WA 98020-2515
EXPIRES: 01/17/2023
Permit Subtype: PARTIAL LINE
Permit Type: SEWER Parcel Number: 00606600000501
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT ALICE ANDERSON 5400 152ND AVE SE, SNOHOMISH WA 98090 (425)985-0521
CONTACT BROOKSIDE PLBG & PIPEWORKS LTD 5400 152ND AVE SE, SNOHOMISH WA 98090 (425)985-0521
CONTRACTOR BROOKSIDE PLUMBING 5400 152ND AVE SE, SNOHOMISH WA 98290 (425)985-0521
OWNER DAVID SHNEIDMAN 17356 BEACH DR NE, LAKE FOREST PARK WA 98155
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.
BY
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
10/19/2022
DATE
Printed: Wednesday, October 19, 2022 3:27:39 PM 1 of 2
SEWER PERMIT
City of Edmonds
•:• •ENG2022-051
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.
MAINTAIN EROSION AND SEDIMENTATION CONTROL PER CITY AND SWMMW STANDARD
ESC REQUIREMENTS
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 or 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
SOUND AND 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 and activities must comply with the noise
limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
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.
•
PECTION TYPE DATE
7SIDE
RESULT
NOTES
COMPLETE
R
X-2 ENGINEERING FINAL"
Printed: Wednesday, October 19, 2022 3:27:39 PM 2 of 2
of EOA10<
C. 1 s90
CONTRACTOR INFORMATION:
o x"-1 T C -U, ! TT 7l
;3 Jt lJ 12' ►J Ili r V L' 1\
Company Name: Brookside Plumbing & Pipework
Company Address: 5400 152nd Ave SE
5400 152nd Ave SE
City: Snohomish Z►p:98290
State License # BROOKPP791 R1
Expiration Date: 1 /3/2024
PROPERTY INFORMATION:
Address: 1218 Olympic Ave, Edmonds
Site Contact: Marvin Andeson
Phone #:425-418-5357
Email #: brooksideplum@yahoo.com
City Business License #
DTI / aoa%.3
Owner's Name:
David Shneidman
�
Phone n:
I LULL LINE. REPLACEMENT POT REPAIR PIPE. BURST RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specifc):Repair leaking sewer line right outside back of house
ISSUANCE OF THIS PERMIT DOES NOT CONSTITUTE PERMISSION TO WORK ON ANY PROPERTY OTHER
THAN THAT OWNED BY THE SUBJECT PROPERTY OWNER.
CERTIFICATIONS NECESSARY FOR INSTALLATION METHODS ARE THE RESPONSIBILITY OF THE
CONTRACTOR PERFORMING SAID WORK,
I REPRESENT AND WARRANT TO THE CITY OF EDMONDS, IF REPAIR OF EXISTING SEWER EXTENDS TO AN
ADJACENT PROPERTY, I HAVE OWNERS EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY.
SIGNATURE—rVDATE 1 o�
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
CITY OF EDMONDS M BuildingPermit.com
Utilities Application #1217625 - Danita
Applicant
First Name Last Name Company Name
Alice Anderson BROOKSIDE PLBG & PIPEWORKS LTD
Number Street Apartment or Suite Number E-mail Address
5400 152nd Ave SE brooksideplum@yahoo.com
City State Zip Phone Number Extension
Snohomish WA 98090 (425) 985-0521
Contractor
Company Name
BROOKSIDE PLBG & PIPEWORKS LTD
Number Street Apartment or Suite Number
5400 152ND AVE SE
City State Zip Phone Number Extension
SNOHOMISH WA 98290 (425)985-0521
State License Number License Expiration Date UBI # E-mail Address
BROOKPP791 R1 1 /3/2024 FD414in74 brooksideplum@yahoo.com
Project Location
Number Street Floor Number Suite or Room Number
1218 OLYMPIC AVE
City Zip Code County Parcel Number
EDMONDS 98020 00606600000501
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
David Shneidman
Number Street Apartment or Suite Number
17356 BEACH DR NE
City State Zip
LAKE FOREST PARK WA 98155
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: 10/18/2022 Submitted By: Alice Anderson
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Utilities Application #1217625 - Danita
Project Contact
Company Name: BROOKSIDE PLBG &
PIPEWORKS LTD
Name: Alice Anderson Email: brooksideplum@yahoo.com
Address: 5400 152nd Ave SE Phone #: (425) 985-0521
Snohomish WA 98090
Project Type Activity Type
Single Family Residential Utility Modification
Project Name: Danita
Description of Work: replace leaking sewer line
Project Details
Structure Type
Single Family Dwelling
Project Information
Repair
Scope of Work
Partial Line Replacement
Page 2 of 2