Engineering Permit FormSTREET USE PERMIT
PERMIT NLII�IBE
City of Edmonds
:0• •
www.edmondswa.gov i
Description: STREET USE - CROW SIGN ISSUED: 04/30/2024
Address: 105 5TH AVE S EDMONDS WA 98020-3148
EXPIRES: 04/30/2025
PS mit Subtype: COMMERCIAL STREET
Permit Type: STREET USE parcel Number: 00434212000102
CONTACTS
NAME TYPE NAME ADDRESS PHONE
APPLICANT
SHARI RUST
4549 125TH AVE SE, BELLEVUE WA 98006
(206)406-3437
CONTACT
NEW IMAGE CREATIVE SIGN INC.
4549 125TH AVE SE, BELLEVUE WA 98006
(206)406-3437
CONTRACTOR
NEW IMAGE CREATIVE SIGN INC
4549 125TH AVE SE, BELLEVUE WA 98006
(206)909-6996
OWNER THIRD AVENUE SOUTH PROPERTIES
229 3RD AVE S STE 301, EDMONDS WA 98020
LLC
DESCRIPTION
AMOUNT PAID
CITY TECHNOLOGY FEE - PER PERMIT $45.00 $45.00
STREET USE - 4.1.24 $132.00 $132.00
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: 04/30/2024
Printed: Tuesday, April 30, 2024 1:36:05 PM 1 of 2
STREET USE PERMIT
PERMIT NUMBER
City of • • .
Edmonds•:0• •
www.edmondswa.gov i
CONDITIONS
CONDITION TYPE
NOTES
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.
Exterior light fixtures, banners, signs and flags must provide for a minimum clear zone of 7 ft above
HEIGHT CLEAR ZONE
City right of way.
INSPECTIONS
INSPECTION TYPE
DATE
RESULT
NOTES
COMPLETE
X-2 ENGINEERING FINAL
Printed: Tuesday, April 30, 2024 1:36:05 PM 2 of 2