eng20140154-permit and application.pdf0
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20140154
Permit Number: ENG20140154 Expiration Da i4��/2014
Job Address: 612 7TH AVE S, EDMONDS
III NONE= jimlim glimill
FISCHER PLUMBING COMPANY INC FISCHER PLUMBING COMPANY INC
1 115 NW 51 ST ST 1115 NW 51 ST ST
SEATTLE, WA 98107 SFAT11.1', WA 98107
LICENSE4. FISCIIPC 13 1 It I EXII, 02/22/2016
Y REPAIR I N PROPOSE TO REUSE LATERAL LID NUMBER: —
N GRINDER PUMP F—NFIPROPOSE TO REUSE SIDE SEWER DRAINAGE
Expose and repair a section of side sewer where the side sewer has a hole in piping. Length will not exceed 3 -feet in length and a
depth of 3 -feet. Will install a cleanout access point to the SUrface,
PROJECT CROSSES OTHER PRIVATE PROPERTY
VERIFICATION OF RECORDED EASEMENTS COMPLETE
INDEMNITY. The ilpl)licant has signed an application which states helshe holds the Cit)) oj'Edmonds harnitessfi-oin injuries,
damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City ofEchnonds or
any of its departnients or employees, including but not limited to the defense q1'any legal proceedings including defense costs and
attorney fees by reason of granting this permit.
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS
THIS APPLICATION IS NOTA PERMIT UNTIL SIGNED EY THE CITY ENGINEER OR HIS/HER DFPUI*Y: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACE PROVIDED
Tuesdav, April 01, 2014
RELEASED 13%—` DATE
*,4FILE COPY [:] INSPECTOR COPY [:] APPLICANT COPY
• Maintain erosion & sedimentation control. Keep street clean.
• Refer to City of Edmonds Side Sewer Information handout for approved pipe materials, inspections and other requirements,
• 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-way.
• Condition of the existing lateral to be verified by the City's Public Works Dept, to obtain approval for reuse. Contact
Edmonds Sewer Division at 425-771-0235.
• Condition of the existing sanitary side sewer to be verified prior to obtaining approval for reuse. TV inspection required.
Video to be Submitted to City for review,
• Easement and/or permission fi-om adjacent property owner is required prior to entry/work within adjacent property,
• Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per City standards that is
caused by or occurs during the permitted project.
® Owner/Contractor to provide Side Sewer asbuilt at final inspection. See City Standards for requirements.
• Sound/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 6:00pin on weekdays and I OMarri 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.
0 E -Sanitary Side Sewer Inspection
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL:
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Company Name:
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Site Contact:
Phone #:
Mailing Address:Fax
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State License #:
Expiration Date:
Email th
City Business License #:
El Liability Insurance Bonded
PROPERTY INFORMATION:
Address:
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14,
Owner's Name:
Phone #:
❑ Full Line Replacement
Spot Repair
0 Pipe Burst
El Reline (PermaLine Only)
DESCRIPTION OF PROPOSED WORK (Be Specific):
SIGNATURE
DATE
L
Contractor or Agent
SITTAUER, RAYMOND
612 7" AVE. S.
EDMONDS, WA. 98020
Attn:
SPECIFICATIONS
Jobsite: I SAME
Phone: 1425-776-5009
Fax:
SIDE SEWER POINT REPAIR
We will EXPOSE & REPAIR a section of side sewer where the side sewer has a hole in piping. The length will not
exceed 3' and a depth of 3'. While piping is remove we will have Drain Tech. Scour Jet to remove rock debris down
stream.
We will INSTALL a cleanout access point to the surface of the ground.
We will EXCAVATE, BACKFILL, & COMPACT the trenchline. Upon completion, grade trench scar to rough raked
dirt finish.
We will REMOVE, DISPOSE, & PATCH approximately 3' of driveway with concrete.
Provide labor, materials, rentals, safety equipment, & services needed.
Notes:
Proposal price excludes all permits & inspection fees. All Drain cleaning efforts will be billed separately.
This may not be the entire repair necessary to restore side sewer line to complete functionality. However, this repair must be
made at a minimum to attempt to access the remaining portion of the side sewer. A Video Inspection will be performed after
this proposal is executed to determine if further repair is necessary.
The texture and color of the new concrete/asphalt repair may not match the surrounding concrete/asphalt.
Any interruptions, delays, or additional costs outside of our control, caused by regulatory authorities or suppliers will be billed
additionally.
PRICE AND PAYMENT METHOD
We hereby propose to furnish material and labor --complete according to the above specifications, for the sum of:
$2,550.00 + Permit + Sales Tax.
Payment to be made as follows:
$1,275.00 to start.
® The remainder as invoiced.
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