ENG20170401-APPROVED PERMIT.pdf�y01E')4,°
CITY OF EDMONDS
�N
121 5THAVENUE NORTH -EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20170401
Permit Number: ENG20170401 Expiration Date: 10/19/2018
Job Address: 303 EDMONDS ST, EDMONDS Location:
APPLICANT CONTRACTOR
BEACH WALK APARTMENTS RYAN GENERAL CONTRACTORS INC
GO HOLDINGS LLC GBH C/O DONALD MCINTOSH
PO BOX 1509 PO BOX 751
LANGLEY, WA 98260 WOODINVILLE, WA 98072
(425)488-9249
LICENSE 4: RYANGC1930PC EXP: 05/23/2019
JOB DLSCRIPTION
CONSTRUCT IMPROVEMENTS PER CIVIL PLANS APPROVED UNDER BLD20161366. ADDED UTILITIES AND PAVEMENT
RESTORATION
DISRUPTION INFORMATION
ASSESSED VALUE: $623,000.00 PROPERTY AREA: 6970
SIDEWALK: ( 165X6) DURATION IN MONTHS: l FEE: $1,094.89 STREET DISRUPTION TRENCH CUT: ( 0 X 0 )
PARKING: (100X10) DURATION IN MONTHS: I FEE: $1,093.83 YEAR OF OVERLAY: 0 FEE: $0.00
ALLEY: ( OXO ) DURATION IN MONTHS: 0 FEE: $0.00
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 N,hatsoever, 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 ofany legal proceedings including defense costs and
attorney fees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONEYEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OFTHEWORK
• 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
possesion.
• 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.
• Three sets of construction drawings of proposed work are required with the permit application.
CALL DIALrA-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT.1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQ LIEN -IN
APPLICATION
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: Thursday, October 19, 2017
RELEASED BY
DATE
`t� F. II .E. COPY INSPECTOR COPY ❑ APPLICANT COPY
STATUS: ISSUED
• None
INSPECTIONS
• E-Pre-Con
• E-Erosion Control/Mobilization
• E-Traffic Control
• E-Curb/GutterPre-Pour
• E-Sidewalk Pre -Pour
• E-Pavement Subgrade & Paving Limits
• ErPavement Compaction Test Report
• E Pavement Striping
• E Sewer Tap on City Main
• E Sewer Lateral Installation
• E-Sewer Lateral Pressure Test
• &Engineering Final
• E-Storm Main Installation
• E-Storm Stub to Property Line
• E-Garb/Gutter Post -Pour
• E-Sidewalk Post -Pour
PARTIAL INSPECTION DATE: INITIAL:
PARTIAL INSPECTION DATE: INITIAL:
FINAL INSPECTION APPROVED DATE: INITIAL:
r
NOTES:
NOTES:
ENG20170401
Of EDA4(-).
fNc. 1390
ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: $24 / vrlS CONTACT: .iafsGf Uf4t4rir h k
CONTRACTOR: a� �[ Phone #: 77g. OEM
Mailing Address: mmo Ny' NjrIX 4z ,�/{ a Fax #: &�O 7
70
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State License #: �, W�e,/jh✓il/� Email #: Jur�(%� CC7 e�9,n re�ivti .,rot"
City Business License #: ❑ Liability Insurance Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: ;3 / A 67o6w,4 S��r
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
Commercial
10- Multi -Family
Subdivision
❑ Single Family
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
City Project
❑ Other
2 Yes ❑ No
P
ENG#
Traffic Control (Only)
DESCRIPTION OF PROPOSED WORK (Be Specific) : /11,eW 5yc4 22& ///� can/
Jcl�(Ies cor^,^ec bN.s % rrr-s'�� _-1 t2 l6ts
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5) YEARS? YES ❑ NO Year:
PAVEMENT CUT: 2� Yes ❑ No If yes, indicate size of cut: 5 x 3U'
CONCRETE CUT: ❑ Yes ❑ No If yes, indicate size of cut: x
RIGHT-OF-WAY
CLOSURE AREA
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
6 LF
7 q d SF
- f-
Alley 72 Hrs + LF
Parking 72 Hrs + (DO LF
X
X
LF
LF
SF
pop SF
ys
APPLICANT TO READ AND SIGN
*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 possession.
*Restoration is to be in accordance with City codes and Standards. All street -cut trench work shall be
patched with asphalt or City approved material prior to the end of the workday — NO EXCEPTIONS.
Indemnity: The Applicant has signed an application which states he/she hold 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 defense costs and attorney fees by reason
of granting this permit.
I have read the above st tements and understand the permit requirements and acknowledge that I must
follow all require74n
for the it t be v id.
SIGNATURE DATE 1017116
Contracto r Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE