Engineering Permit FormRIGHT OF WAY PERMIT
PERMIT ' ER
City of • • .
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www.edmondswa.gov i
Description: RIGHT OF WAY Connect new wsl to meter on 91st BLD2023-0168
ISSUED: 10/27/2023
Address: 18230 91ST AVE W EDMONDS WA 98026-5312
EXPIRES: 10/21/2024
rmit Type: RIGHT OF WAY Permit Subtype: RESIDENTIAL Parcel Number: 27041800200300
i
NAME TYPE NAME ADDRESS PHONE
APPLICANT SOFIA BOLOTIN 18230 91ST AVE W, EDMONDS WA 98026 (425)551-9193
CONTACT SOFIA BOLOTIN 18230 91ST AVE W, EDMONDS WA 98026 (425)551-9193
CONTRACTOR SPH CONSTRUCTION INC 2505 92ND PL SE, EVERETT WA 98208 (425)870-1292
OWNER SOFIA & VLADIMIR BOLOTIN 18230 91ST AVE W, EDMONDS WA 98026
FEE INFORMATION
DESCRIPTION AMOUNT PAID
CITY TECHNOLOGY FEE - PER PERMIT
$45.00 $45.00
ENG - INSPECTIONS
$126.00 $126.00
RIGHT-OF-WAY PERMIT - STANDARD $378.00 $378.00
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: NED DATE: 10/27/2023
Printed: Friday, October 27, 2023 11:01:25 AM 1 of 2
RIGHT OF WAY PERMIT
PERMIT NU �!B E
City of Edmonds
SID
www.edmondswa.gov • •
CONDITIONS
CONDITION TYPE
MAINTAIN EROSION AND SEDIMENTATION CONTROL PER CITY AND SWMMW STANDARD
ESC REQUIREMENTS
REQUIREMENTS.
INSP PRIOR TO BACKFILL
Call for all required inspections. All work shall be inspected prior to backfill.
RESTORE LANDSCAPE
Restore landscape to like or better conditions
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.
WATER LINE ASBUILT
Owner/Contractor to provide water service line asbuilt at final inspection.
INSPECTIONS
INSPECTION TYPE DATE RESULT
NOTES
COMPLETE
X-2 ENGINEERING FINAL"
E-4 WATER SERVICE LINE
Printed: Friday, October 27, 2023 11:01:25 AM 2 of 2