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ENG2024-0072 SEWER PERMITSEWER PERMIT PERMIT of EdmondsNUMBER City Edmonds WA 980201 11 www.edmondswa.gov i Description: SEWER - SPOT REPAIR WITH A LINER ON PRIVATE PROPERTY ISSUED: 02/23/2024 Address: 17115 TALBOT RD EDMONDS WA 98026-5057 EXPIRES: 05/23/2024 Permit Subtype: PARTIAL LINE Permit Type: SEWER Parcel Number: 27040700103800 REPLACEMENT CONTACTS NAME TYPE NAME ADDRESS PHONE APPLICANT ZACHARY HEAD 20907 HIGHWAY 99 STE C, LYNNWOOD WA 98036 (206)348-8138 CONTACT PRICE BUSTERS PLUMBING 20907 HIGHWAY 99 STE C, LYNNWOOD WA 98036 (206)348-8138 CONTRACTOR PRICE BUSTERS PLUMBING 3212 NE 167TH ST, LAKE FOREST PARK WA 98155 (206)348-8138 OWNER HAL LELAND 17115 TALBOT RD, EDMONDS WA 98026-5057 (425)361-7351 FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE - PER PERMIT $45.00 $45.00 SIDE SEWER PERMIT - PARTIAL REPLACEMENT $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: MAJ DATE: 02/23/2024 Printed: Friday, February 23, 2024 9:09:45 AM 1 of 2 SEWER PERMIT PERMIT NU M�IBE City of Edmonds 121 Sth Ave N, Edmonds WA 98020 ENG2024-007A 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. 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 7S111DE RESULT NOTES COMPLETE R X-2 ENGINEERING FINAL" Printed: Friday, February 23, 2024 9:09:45 AM 2 of 2 of ED, 4(0) `V INC. 1 S90 CONTRACTOR INFORMATION: SIDE SEWER PERMIT APPLICATION Company Name: Price Busters Plumbing Site Contact: John Morrow Company Address: City: Lynnwood Zip:98036 State License # PRICEBP869MA Expiration Date: 07/01 /2024 PROPERTY INFORMATION: Phone #: 206-348-8138 Email #: PriceBustersePlumbing@gmail.com City Business License # 603-388-617 Address: 17115 Talbot Road Edmonds, WA 98026 Owner's Name: Hal Eland Phone #: FULL LINE REPLACEMENT VkPOT REPAIR []PIPE BURST RELINE (PERMALINE ONLY) .............................................. .:<........................................ DESCRIPTION OF PROPOSED WORK (Be Specific): Spot repair on main sewer line as well as Permaliner installation EMERGENCY SIDE SEWER REPAIR 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 EXPRESS PERMISSION TO PERFORM WORK ON THAT ADJACENT PROPERTY. SIGNATURE At " `��Q��' 8 arr DATE 02/21 /24 Contractor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE CITY OF EDMONDS M BuildingPermit.com Utilities Application #1445631 - Hal Leland Applicant First Name Last Name Company Name Zachary Head Price Busters Plumbing Number Street Apartment or Suite Number E-mail Address 20907 Highway 99 STE C pricebustersplumbing@gmail.com City State Zip Phone Number Extension Lynnwood WA 98036 (206) 348-8138 Contractor Company Name PRICE BUSTERS PLUMBING Number Street Apartment or Suite Number 20907 Hwy 99 Suite C City State Zip Phone Number Extension Lynnwood WA 98036 (206) 348-8138 State License Number License Expiration Date UBI # E-mail Address PRICEBP869MA 7/1/2024 F i iFt B17 pricebustersplumbing@gmail.com Project Location Number Street Floor Number Suite or Room Number 17115 TALBOT RD City Zip Code County Parcel Number EDMONDS 98026 27040700103800 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 Hal Leland Number Street Apartment or Suite Number 17115 TALBOT RD City State Zip EDMONDS WA 98026-5057 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: 2/21/2024 Submitted By: Zachary Head Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Utilities Application #1445631 - Hal Leland Project Contact Company Name: Price Busters Plumbing Name: John Morrow Email: pricebustersplumbing@gmail.com Address: C 907 Highway 99 STE Phone #: (206) 348-8138 Lynnwood WA 98036 Project Type Activity Type Scope of Work Single Family Residential Utility Modification Partial Line Replacement Project Name: Hal Leland Description of Work: EMERGENCY SIDE SEWER SPOT REPAIR AND PERMALINER INSTALLATION Project Details Structure Type Single Family Dwelling Project Information Repair Page 2 of 2 r / MyBuildingPermitxom Jurisdiction: Edmonds Project Name: Hal Leland Application ID: 1445631 Supplemental Name: Authorization and Acknowledgment - Utilities Please Note: If the work is not being performed by a homeowner, a licensed and bonded General Contractor or Plumbing Contractor is required to perform sewer installation and repair. An individually Licensed Plumber license will not be accepted for sewer work. Please contact WA State Labor & Industries for more information. Yes, I acknowledge All provisions of laws and ordinances governing this type of work will be complied with. I further agree to hold harmless the City of Edmonds as to any claim (including costs, expenses, and attorney's fees incurred in investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of Edmonds, but only where such claim arises out of the reliance of the City, including its officers and employees, upon the accuracy of the information supplied to the City as part of this application. I hereby authorize the City representatives to inspect the property Monday -Friday between the hours of 8:00 a.m. and 5:00 p.m. during this permit application process for verifying site conditions. I certify, under the penalty of perjury under the laws of the State of Washington, that the information and exhibits herewith submitted are true and correct to the best of my knowledge and that I am the owner or am authorized by the owner of the subject property to file this application on their behalf. Yes, I authorize. Electronic documents submitted to the City of Edmonds for plan review and permit issuance must be provided in a format that does not prevent the City from making code comments on the documents during review or from making the documents ready for permit issuance. Documents submitted in any manner that prevents the City from completing the review and permit issuance process, including but not limited to submitting documents that are locked, may result in additional review time, permitting delays, and/or cancellation of the permit application if the problem is not resolved by the applicant in a timely manner. Please refer to chapter 18.43 RCW, chapter 18.210 RCW, chapter 1 96-23 WAC and chapter 1 96-33 WAC for Washington State laws governing electronic documents. An interpretative guideline from the Board of Registration for Professional Engineers and Land Surveyors can be found at http://www.dol.wa.gov/business/engineerslandsurveyors/docs/eDocslnterpretiveGuideline.pdf. These laws and requirements are subject to change and the submitting parties are responsible for keeping apprised of any such changes. Please acknowledge that you understand these requirements and have verified the electronic documents being submitted meet the City of Edmonds submittal requirements by checking the box below. If you have questions, contact the Engineering Division at engineeringpermits@edmondswa.gov or 425-771 -0220. Yes, I acknowledge. The City of Edmonds makes permit applications available to the public in an effort to make its processes as transparent as possible. By signing or initialing this document, I acknowledge that any and all information submitted as part of this application, is public information. I further acknowledge and agree that this permit application, and any and all documents related thereto, may be disclosed by the City of Edmonds to the public without redaction. Please sign below to acknowledge. Alex Borromeo