ENG2022-0534 SIDE SEWER PERMITSEWER PERMIT
PERMIT IM
City •Edmonds'
:01 1
San
www.edmondswa.gov i
Description: SPOT REPAIR ON PRIVATE PROPERTY ISSUED: 11/01/2022
Address: 19811 88TH AVE W EDMONDS WA 98026-6308
EXPIRES: 01/30/2023
Permit Subtype: PARTIAL LINE
Permit Type: SEWER Parcel Number: 27041900209800
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT DEVON PAFFORD 6202 214TH STREET SW, MOUNTLAKE TERRACE WA 98043 (206)960-3200
CONTACT JIM DANDY SEWER AND PLUMBING 6202 214TH STREET SW, MOUNTLAKE TERRACE WA 98043 (206)960-3200
CONTRACTOR JIM DANDY SEWER &PLUMBING 6202 214TH ST SW, MOUNTLAKE TERRACE WA 98043 (206)960-3200
OWNER WENDY B SHAW 19811 88TH AVE W, EDMONDS WA 98026
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
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.
RELEASED BY: GRN DATE: 11/01/2022
ENGINEERING DIVISION
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Printed: Tuesday, November 01, 2022 2:09:35 PM 1 of 2
SEWER PERMIT
PERMIT NUMBER
City of Edmonds
www.edmondswa.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.
SEWER AND WATER
MAINTAIN 10 FEET OF SEPARATION BETWEEN THE SANITARY SIDE SEWER AND THE WATER SERVICE
SEPARATION
LINE.
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.
TRAFFIC CONTROLS
Traffic Control per approved plan and MUTCD. All Flaggers shall be certified.
UNDERGROUND WIRING
All new, extended, rebuilt, or relocated electrical utility and/or service shall be placed underground.
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: Tuesday, November 01, 2022 2:09:35 PM 2 of 2
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CONTRACTOR INFORMATION:
SIDE SEWER
PERMIT APPLICATIOl'eTT
Company Name: JIM DANDY SEWER & PLUM91 Site Contact: DEVON PAFFORD
%-ompany Aaaress: 6202 214TH ST SW
6202 214TH ST SW
City: MOUNTLAKE TERRACE Zip:98043
State License # JIMDADS879133
Expiration Date: 12/23/23
PROPERTY INFORMATION:
Phone #: (206) 960-3200
Email #: dispatch@jimdandysewer.com
City Business License # #NR-026724
Address: 19811 88TH AVE W I EDMONDS 198026
Owner's Name: WENDY SHAW
rune ff:
FULL LINE REPLACEMENT POT REPAIR ❑PIPE BURST ❑RELINE (PERMALINE ONLY)
DESCRIPTION OF PROPOSED WORK (Be Specific): SIDE SEWER SPOT REPAIR. APPRX 10' IN LENGTH
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 -XPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT
PROPERTY.
SIGNATURE b% DATE
Con r ctor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
CITY OF EDMONDS M BuildingPermit.com
Utilities Application #1223608 - SHAW - SIDE SEWER SPOT REPAIR
Applicant
First Name Last Name Company Name
DEVON PAFFORD Jim Dandy sewer and plumbing
Number Street Apartment or Suite Number E-mail Address
6202 214th street sw dispatch@jimdandysewer.com
City State Zip Phone Number Extension
mountlake terrace WA 98043 (206) 960-3200
Contractor
Company Name
Jim Dandy Sewer & Plumbing
Number Street Apartment or Suite Number
6202 214th ST SW
City State Zip Phone Number Extension
MOUNTLAKE WA 98043 2069603200
State License Number License Expiration Date UBI # E-mail Address
JIMDADS879133 1/23/2023 BDigri74:3.'l dispatch@jimdandysewer.com
Project Location
Number Street Floor Number Suite or Room Number
19811 88TH AVE W
City Zip Code County Parcel Number
EDMONDS 98026 27041900209800
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
Wendy B Shaw
Number Street Apartment or Suite Number
19811 88TH AVE 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: 11/1/2022 Submitted By: DEVON PAFFORD
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i
CITY OF EDMONDS MyBuildingPermit.com
Utilities Application #1223608 - SHAW - SIDE SEWER SPOT REPAIR
Project Contact
Company Name: Jim Dandy sewer and
plumbing
Name: DEVON PAFFORD
Address: 6202 214th street sw
mountlake terrace WA
98043
Email: dispatch@jimdandysewer.com
Phone #: (206) 960-3200
Project Type Activity Type
Single Family Residential Utility Modification
Project Name: SHAW - SIDE SEWER SPOT REPAIR
Description of Work: Side sewer spot repair, apprx. 10' in length
Project Details
Structure Type
Single Family Dwelling
Project Information
Repair
Scope of Work
Partial Line Replacement
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