Engineering Permit FormNEW RESIDENTIAL PERMIT
PERMIT ER
City •EdmondsSEWER
121 Sth Ave N, Edmonds WA :� • i
www.edmondswa.gov i
Description: SEWER NEW RESIDENTIAL FOR NEW SFR ISSUED: 09/13/2023
Address: 840 DALEY ST EDMONDS WA 98020-3951
EXPIRES: 09/07/2024
rmit Type: SEWER NEW RESIDENTIAL Permit Subtype: Parcel Number: 00434208101000
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NAME TYPE NAME ADDRESS PHONE
APPLICANT PETER TANG 5603 230TH ST SW, MOUNTLAKE TERRACE WA 98043 (206)372-2584
CONTACT PNT GROUP 5603 230TH ST SW, MOUNTLAKE TERRACE WA 98043 (206)372-2584
CONTRACTOR CAREY BROTHERS ROCKERIES LLC 19622 SR 9 SE, SNOHOMISH WA 98296 (425)481-0788
OWNER PETER & JIA TANG 840 DALEY ST, EDMONDS WA 98020 (206)372-2584
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE - PER PERMIT
$45.00 $45.00
ENG - INSPECTIONS
$252.00 $252.00
SIDE SEWER PERMIT - NEW SFR RESIDENTIAL $126.00 $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
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: 09/13/2023
Printed: Wednesday, September 13, 2023 11:52:17 AM 1 of 2
SEWER
NEW RESIDENTIAL PERMIT
PERMIT
City of Edmonds
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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.
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
COMPLETE
E-2 SIDE SEW ER27SIER
X-2 ENGINEERING FINAL"
Printed: Wednesday, September 13, 2023 11:52:17 AM 2 of 2