20170126123754.pdf0
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CITY O�F EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
°rI PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PE MIT,MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20170032
SIDESEWER PERMIT (]-Single Family)
Permit Number: ENG20170032 Expiration Date: 03/27/2017
Job Address: 1061 9TH!AVE S, EDMONDS
APPLICANT CONTRACTOR
Mountlake Terrace, WA 98043 Mountlake Terrace, WA 98043
(206) 305-0345
LICENSE'#P irh11ds879b3 EXP:01/23/2019
.JOB DESCRIPTION
Y, REPAIR N PROPOSE TO REUSE LATERAL LID NUMBER:
N GRINDER PUMP N PROPOSE TO REUSE SIDE SEWER N' DRAINAGE
Repair a section ofside sewer just outside ofhome also installing cleanout.
LASEMENT INFORMATION
N; PROJECT CROSSES OTHER PRIVATE PROPERTY
N' VERWICnATION OF RECORDED EASEMENTS COMPLETE
INDEMNITY.• The Applicant has signed an application which states he/she holds the City of Edmonds harmless from injuries,
damages or claims ofany kind or description whatsoever, foreseen or unforeseen, that maybe made against the City ofEdmonds or
anyiofits departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
attorney fees by reason ofgranting this permit.
CALL DIAIrA-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NOTTCEREQUIRED FOR ALL INSPECTION REQUESTS i
THIS APPLICATION IS NOT PERMIT UNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY. AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED,
Printed: Thursd2 r, Janga1, . §, 2017
116LEA r,D JATE
FILE COPYINSPECTOR COPY APPLICANT COPY
• Refer to City of Edmonds Side Sewer Information handout for approved pipe materials, ins
• A 6" cleanout with 12" locking cast iron lamphole cover is required at the property line.
• Maintain 10' separation between the sanitary side sewer and the water service line.
• A separate, right-of-way construction permit is required for work within the City right-of-w,
• Condition of the a)dsting lateral to be verified by the City's Public Works Dept. to obtain al
Sewer Division at 425-771-0235.
• Condition of the existing sanitary side sewer to be verified, prior to obtaining approval for i
to be submitted to City for review.
and other requirements.
)r reuse. Contact Edmonds
'inspection required. Video'
• vwnernwntractor to proviae ame hewer asouin at nnai inspection. gee uaty mantraras tor requirements.
• Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
of Chapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all other times the noise, originating from construction sites/activities must comply with the
noise limits of Chapter 5.30, unless a variance has been granted pursuant to;ECC 5.30.120.,
• 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 issuance of this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance not limit in any way the City's ability to enforce any ordinance
provision.
• 11SanitaryrSide Sewer Inspection
• E-Engineering Final
PARTIAL INSPECTIONDATE: INITIAL: NOTES::
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL: