Engineering Permit FormSEWER PERMIT
PERMIT E3
City of • • .
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www.edmondswa.gov i
Description: SEWER SPOT REPAIR UP TO 4' IN LENGTH ISSUED: 07/28/2023
Address: 1028 CASCADE LN EDMONDS WA 98020-2912
EXPIRES: 10/26/2023
Permit Subtype: PARTIAL LINE
Permit Type: SEWER Parcel Number: 00548900001405
REPLACEMENT
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT AARON PALMEN 6321 7TH AVE S., SEATTLE WA 98108 (253)405-7765
CONTACT ROTO ROOTER SERVICE COMPANY 6321 7TH AVE S., SEATTLE WA 98108 (253)405-7765
CONTRACTOR ROTO ROOTER SERVICES CO 6321 7TH AVE S, SEATTLE WA 98108 (253)405-7765
OWNER SUSAN DELSIGNORE 1028 CASCADE LN, EDMONDS WA 98020
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE - PER PERMIT $45.00 $45.00
ENG - INSPECTIONS $126.00 $126.00
SIDE SEWER PERMIT - PARTIAL REPLACEMENT 1 $126.00 1 $126.00
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
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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: JOK DATE: 07/28/2023
Printed: Friday, July 28, 2023 1:24:32 PM 1 of 2
SEWER PERMIT
PERMIT NUMBE3
City of Edmonds
www.edmondswa.gov • •
CONDITIONS
CONDITION TYPE
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.
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:OOam to 6:OOpm on
SOUND AND NOISE
weekdays and 10:OOam and 6:OOpm 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.
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INSPECTION TYPE DATE
RESULT
NOTES
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COMPLETE
E-2 SIDE SEWER
X-2 ENGINEERING FINAL"
Printed: Friday, July 28, 2023 1:24:32 PM 2 of 2