Engineering Permit FormSEWER NEW RESIDENTIAL PERMIT
PERMIT E3
City
of Edmonds'
ENG2022-0579
www.edmondswa.gov .911106 AL
Description: SEWER - RELOCATE SIDE SEWER FOR ADDITION AND ADD CLEAN OUT
ISSUED: 01/26/2023
Address: 20224 83RD AVE W EDMONDS WA 98026-6728
EXPIRES: 07/25/2023
Permit Type: SEWER NEW RESIDENTIAL Permit Subtype: Parcel Number: 00431200000603
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT PEIK LI PANG 6331 NE 129TH ST., KIRKLAND WA 98034 (425)287-1567
CONTACT 5FT2 STUDIO ARCHITECTS 6331 NE 129TH ST., KIRKLAND WA 98034 (425)287-1567
CONTRACTOR CONTRACTOR UNKNOWN
OWNER JAMIE & TENURE STEVEN KAHN 20224 83RD AVE W, EDMONDS WA 98026
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00
SIDE SEWER PERMIT - NEW RESIDENTIAL $110.00 $110.00
REQUIREMENTS
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
I
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: BAC DATE: 01/26/2023
Printed: Thursday, January 26, 2023 12:01:45 PM 1 of 2
SEWER NEW RESIDENTIAL PERMIT
j City of Edmonds
PERMIT NUMBE
121 5th Ave N, Edmonds WA 98020 ENG2022-0579
www.edmondswa.gov / 425.771.0220
CONDITIONS
INSPECTIONS
INSPECTION DATECOMPLETE®- 1
E-2 SIDE SEWER
Printed: Thursday, January 26, 2023 12:01:45 PM 2 of 2