ENG2024-0331+Supplementals_Authorization_and_Acknowledgment_-_Utilities+7.1.2024_12.13.32_PM+4352435Og FDAI
OM
MyBuildingPermit.com
Jurisdiction: Edmonds
Project Name: Hopper - SFR Sewer
Application ID: 1511703
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.
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.
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 196-23 WAC and chapter 196-33 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/engineersiandsurveyors/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.
John Murphy