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Engineering Permit FormNEW RESIDENTIAL PERMIT PERMIT NUMBER City of Edmonds AveSEWER N, Edmonds WA 98020 ENG2021-0229 www.cityofedmonds.gov Description: NEW SEWER FOR NEW SFR 323 DALEY ST ISSUED: 06/29/2021 Address: 323 DALEY ST EDMONDS WA 98020-3123 EXPIRES: 06/29/2022 Permit Type: SEWER NEW RESIDENTIAL Permit Subtype: Parcel Number: 00434211903000 Isle] NAME TYPE NAME ADDRESS PHONE APPLICANT BRIAN CLOWARD 630 NW 81ST STREET, SEATTLE WA 98117 (206)755-0759 CONTACT CLOWARD SUSTAINABLE DESIGN 630 NW 81ST STREET, SEATTLE WA 98117 (206)755-0759 CONTRACTOR DENNIS PARKER-DALEY STREET 528 PINE ST#1, EDMONDS WA 98020 (425)359-9189 BUILDERS LLC OWNER DENNIS PARKER-DALEY STREET 528 PINE ST #1, EDMONDS WA 98020 (425)359-9189 BUILDERS LLC FEE INFORMATION DESCRIPTION AMOUNT PAID CITY TECHNOLOGY FEE CHARGED PER PERMIT $40.00 $40.00 ENGINEERING INSPECTION FEE $110.00 $110.00 SIDE SEWER PERMIT - NEW RESIDENTIAL $110.00 $110.00 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 INDEMNITY 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 THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW DATE Printed: Tuesday, June 29, 2021 8:01:15 AM 1 of 2 NEW RESIDENTIAL PERMIT PERMIT NUMBER City of Edmonds AveSEWER 98020 ENG2021-0229 www.cityofedmonds.gov• 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. ESC REQ Maintain erosion and sedimentation control per City and SWMMW standard requirements. INSP PRIOR TO BACKFILL Call for all required inspections. All work shall be inspected prior to backfill. All utilities shall be located prior to any excavation. New locates shall be called for if at time of UTILITY LOCATES excavation, original locates are no longer identifiable. INSPECTIONS INSPECTION TYPE DATE RESULT NOTES COMPLETE X-2 ENGINEERING FINAL" E-2 SEWER PRESSURE E-2 SIDE SEWER Printed: Tuesday, June 29, 2021 8:01:15 AM 2 of 2