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102 BELL ST.PDFiiiiiiiiiiiiii 10294 102 BELL ST 0 •- ADDRESS: l O� !/C l/ TAX ACCOUNT/PARCEL NUMBER: BUILDING PERMIT (NEW STRUCTURE): L { qi� COVENANTS (RECORDED) CRITICAL AREAS:. 0— 6) 7 Z DETERMINATIONS: ❑ Conditional Waiver ❑ Study Required x Waiver DISCRETIONARY PERMIT #'S:&Q•�O'g°tC eu "ix, q�•p-1Nt..) DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PLANNING DATA CHECKLIST DATED: !,�i) 2-Rj q - SCALED PLOT PLAN DATED: 116M 0 SEWER LID FEE $: LID #: .; . SHORT PLAT FILE: CJ' I L1 LOT: BLOCK: I2. SIDE SEWER AS BUILT DATED: -�e-51' 1 SIDE SEWER PERMITS) #: �I GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR:4�D wP1 ,c5tn WATER METER TAP CARD DATED: OTHEd-.4�O I t Dq �c 4 , r �CtI1�� 1 LATEMP\DSTs\Forms\,Street File Checklist.doc • o` o 0 o aTo>zM g P- o s � o Gu vwe" 0 S` TFEE T. or u, lrXlo�f l•I6uD* �tSc Spir�o�i �. 7e Dtr �levmv 1 '• t• to °,ETCAG� LIWE— ( _ r y t a W. _N Ij RO 1 LE � .� i a •..-• - ' ` -�: 0' ,. d� e T y-VO _t WEB -W 0 0. o Ito{yGe. o - 0 9ETDAG�� 9ET �Gj�- j-t13E(IaailUGl . Iir l�►r�f Tt�ll�ll . � ELE-eTFH GAL 2e' OM G�£TbRGI�'_ i=U" eCO.(pM s i rii,u_ ��. nu IrAA ACCEPTABLE TIGHTLINE MATERIAL a_, N-1 ?ADS ►� .w �- a' "' SCh 40 PVC ai co 7 o SDR 35 (ASTM D3034) 44 N 'frr 'fit ' � r!: e- �'! FILL {_� E STREET i- RECEIVED Critical, Areas Checklist MAY 2 6 1993 Site Information PERMIT COUNTER ProjectName: 5�0 Permit Number. Site Location: wr � f- Property Tax Account Number. -0/ i Approximate Site Size (acres or square feet): �� x /?,Q/ A/ Have you filled out a Critical Areas Checklist for a project on this site before? General Site Conditions 1_ Has the site been cleared or toggod? Date of most recfent action: l9L�J Soils / Topography CAW Y 2. In the Snohomish County Soil Survey, what is the mapped soil type(s)? Z 8 SG�fS 3. . Describe the general site topography. Check all that apply. y Flat: less than 5 feet elevation change over entire site. Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a horizontal distance of 66 feet) Hilly: slopes present on site of more than 15% and less than 30Yp ( a vertical rise of 10 feet of horizontal distance.) 1 Steep: grades of greater than 30% present on site. Comments .WAIVER Critical areas study:is not required. 'Oetermi�ation .Number. h.A -.q3 " 1 Review r Planner -Date Rev 3127/92 Q 1e9� 199 City of Edmonds Critical Areas Checklist The Qtitical Areas Checklist contained on this form is _to be filled out by any person preparing a. Development Permit Application for the City of Edmonds prior to his/her submittal of a development permit to the City_ The purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are or may be present on the subject property. The information,needed to complete the Cheddist should be easily available from observations of the site or data available at City Hall (Critical Areas inventories, maps, or soil surveys). An applicant, or his/her representative, ,= fill out the cheddist, sign and date k and submit it to the City_ The City will review the the ddist, make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development Permit application. With a signed copy of this form, the applicant should also submit a vicinity map of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant is encouraged to include anyother pertinent information or stddics in conjunction with' this Checklist to assist staff in completing their preliminary assessment of the site - I have completed the attached Critical Area Checklist and attest that the answers provided -are factual, to the best of my knowledge (fill out the appropriate column below). Owner/ Applicant: Applicant Representative: t: 4A2W pt, Name S Name Title 1606 /0 Street Address Crty, State, ZIP one Signature Date Aw*ri/ 5d�2ru n�yos ,,fS Title /i()s M Street Address Cte,.Z Phone Signature Date . CITY OF EDMOND nECEIVEID SIDFIEWEA PERMIT APR 2 9 1994 1890 19PUBLIC WORK PERMIT N2 ,857-9. 1'i s I)Ep7 Address of Construction: I EDMONDS -rF.I Property Legal Description (Include all easements): anj n4FNT PLANT J Owner and/or Contractor: �"� l N �T N C State License No. A LK (C c ,/� /�� Building Permit No. / 3d tqQ X"S"ingle Family Invasion into City Right -of -Way: ❑ No �( Yes ❑ Multi -Family (No. of Units ) RW Construction Permit No. 410Ath'AD rcR ❑ Commercial Cross other Private Property: KNo ❑ Yes ❑ Public Attach legal description and copy of recorded easement I certify that It have read and shall comply with all city requirements; as indicated on the back of the Permit Card. �f12- elN Date N 1 * CALL DIAL -A -DIG (1-800-424-5555)` BEFORE ANY EXCAVATION OFFICE USE ONLY * FOR INSPECTION CALL M Permit Fee: 30,00 771� Trunk Charge: C� s• Assessment Fee: Lid No.: Partial Inspection: Comments PUBLICIWORKS DEPT. ssu d By s:;A �di'7 Date Issued: Receipt No.: A :�;i 4-1 3 Reason Rejected: Final Inspection Approved: Da#e--��=��'nitialN•��`"�`�� by Date Initial Date Initial— ** PERMIT MUST BE POSTED ON JOB SITE ** ? White Copy: File - Green Copy: Inspector Buff Copy: Applicant Revised 3190 Th C' f CA A Side Sewer Drawing E Ity o mon S EASEMENT NO. NEW CONSTRUCTION REPAIRS ❑ LID NO___________________ ASMT. NO. ------------------ 'OWNER---------------------•-•----••------.-----------------------•--•---•-----•---------.- CONTRACTOR-----•-------------•----------------------------•-----------------------•----------- PERMIT NO.(���._�__-L_ JOB ADDRESS _�_ __-.5 ................ LEGAL DESCRIPTION: LOT NO. -------------------------------------- BLOCK NO. _____--____--___-___-_________--_-_. PWW-0001-11/75 (REV.11/78) f. NAMEOF ADDITION..............................•---•----------------------•-•-••-----•------•---......------........._--•-•--•-------_� { `E1)11l0;\ � "ah•�K �a✓� TREAiN;Ei+. p AN"1', C6•C Ds�. t 3� i ►n rj-LK I = q c Approved: C DATE..-/ Z-. _ 1; ..-------------- B �Z-�.------- ---------------- The City of Edmonds WATER SERV ►Ce yawing EASEMENT NO - -------------- ----------------------------- NEW CONSTRUCTION REPAIRS ❑ LID NO_ .................. _ASMT. NO. _--____-__-_._.-._ OWNER .................................................... CONTRACTOR------__---------------------------------------------------------------------------- PERMIT N0' 33PSOI JOB ADDRESS --- .-- B_ t• L------ ��--------------------------------- LEGAL DESCRIPTION: LOT NO. -------------------------------------- BLOCK NO. ----------------------------------- C PWW-0001-11/75 (REV.11/78) --------------------------------------------------------------------------------- ---------------------------------- NAMEOF ADDITION------------------------------------------------------------------------ I ALL V/4' caPP6R Approved: 1 Q SU N SET AV . DATE J.' R`J-1..1 J,I9BY .44.&T. w --------------------------- APPLICATION The Cityof Edmonds for SIDE SEWER PERMIT NEW CONSTRUCTION ❑ REPAIRS ❑ EASEMENT No ........................................... 112-04700 OWNER.------...H...H.....H-alb.e.Ct................................................................... CONTRACTOR..------------................----...................------.....------------......------.......... PERMIT No....................... ADDRESS ....... 1.36... Sunset ... Ave .------------------------------------------------------------ LEGAL DESCRIPTION: LOT No............................................... BLOCK No............................................. NAME OF ADDITION ......................................... ............ - - • IL-1 Dye Tested On Sewer 1972 Approved: DATE................................................ By.---....................-----......------............................. 4; JUN 14 '94 09:57. SKA-WASH. CO. 206 762-2451 d"we" "re DCV"owRnrr ca�t� �OMh�lla?IOM I DATE: a► �' Camweaeaoa Company SCATTL[. WASIjiLUMMM 'M OS REC81VED 1 4 1994 i�:i* 'iNEEMNG Ull-asoa , 4731 TWEL►7M AVENUE N.I. To: ATM Lyc e G� Fit IC Iit1.11G� �:Y1'1 SU=CT: Total numb r of pages being transmitted including this'covei' $beets 'there Le -s problem with the tianamission of you done t ra�eiwe all the poses please call 762-5922. Comment$: -�~ -7IL3 Q��a -rt JUN 14 '94 09:57 SKA-WASH.CO. 206 762-2451 v PREVt P.2 CASCADE TESTING LASOMA AV. lRKf.L 7E91'in� 6 tN�PgCTWN /;►re3rNL;L1Q/Qrt�1.04�rf Rt POR A k CERT. NU.�•"� Kr���. �..f�..,.tMo.., ��. ao�a�i•avo c, Cv[Attr 1sO�f�sra•V0�7 �( t"Qr� ' � T Loc R N th --.-. . . L 11 PERMIT N0. QwNCA - hG WEATHER MAP Af— rf At ARCHITECT R'rTN; AS REOUESTED BY:-(.:,QI'L�_ � # b r THE CON'TftACTCFJ I FOLLCWING WA9. NOTED:' r . 04 f • !: _Tl�i4y8tIOA 4 ....... �.4� . .. . , .... ....... Q Wet 0Cn9;ty PCF . Moisture Centant .r.4 .... Dry Density PCP :proatCr Value . I�.•,.. 13i ....... . Cr�mp�C11Rn -- % 415 9' 5 "Location .:Elevation ..... .. .V , ... �. ...... ..... ... pry ~Wei Density PCF ........ ... - ... I' FJr �}�•n� .. Moisture Content lc►Gt Ufa jr Pry Density • 9CF .... • ....... ..... PrOCIor Value, . • t,;4mpaCtiAn % aRAOV90 SY: INSPECFA%R�; �i r 'r. FIEREPORT f aL001 ,�ma.f.anP.Ln..Kona.Wt. COPIES TO-p �.--- Ran C. E r. City of Edn&ds RIGHT-OF-WAY CONSTRUCTION PERMIT Permit Number- Issue Date: A. Address or Vicinity of Construction: )ra k � - ` o 8 9 0 199 - B. Type of Work (be specific): A 1 �i l.� �0A \ �. ��1.� CS luSe C 1P_LLAi- rkru�►11 Contractor: SKVAGM �Sl-1 (C)u m1� `( T �Q• U �ntact: 2 \ C "P�PZ Q CA +C i'1-1 Mailing Address: A k R kAC1 1 Phone: 6.7 State License #: Liability Insurance: Bond: $ BuildingPermit # if a livable - ks'i-"�'�"�y Side Sewer Permit # if applicable): c PP ) c PP � ): E. ❑ Commercial ❑ Subdivision ❑ Multi -Family 9 Single Family INSPECTOR: ❑ City Project Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Other INSPECTOR: F. Pavement or Concrete Cut: ,Yes ❑No G. Size of Cut: x H. Charge $ APPLICANT TO READ AN6SIGN INDEMNITY: Applicant understanlatsoever, his signature to this application, agrees to he City of Edmonde.harm 4 4%'"!'Y"ries, damages, or z claims of any kind or description w foreseen or unforeseen, that may be ina a a--gainst the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal proceedings including.defer e�costs, and attorney fees by reason o%,gra ting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION; F$E*ILL BE HELD UNTIL THE FINAL STREET PATCH 1S COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCEIO•TNFRAP#L(CANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and material is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. /1 I have read the above statements and understand the permit requirements and the pink copy of the permit will be available on site at -a times fQr inspect�bWurposes. Date: S141 -9 y or CALL DIAL -A -DIG PRIOR TO BEGINNING WORK -FOR CITY USE ONLY { APPROVED BY:, RIGHT OF WAY DEP.OSIT,_ TIME. AUTHORIZED: VOID AFTER T DAYS DISRUPTION FEE/FUND 111: SPECIAL CONDITIONS: RESTORATION:FEE:.. PERMIT FEE: TOTAL FEE: COMMENTS: RECEIPT FEE: DATE: ISSUED, BY: NO WORK SHALL BEGIN PRIOR TO PERMIT UANCE Engrg. Div.' 1991 a..-.P',f'j�.k�i �`r�,ar+f�� � ��' � ,I{�t :. si' +'`� �''" y74T�t+{w,t *�'�.s.+ ,�ti�.i �.^;�',,:•H=e".'�nUPt• a ` •` .� � t r� { City. of Edn&ds RIGHT-OF-WAY CONSTRUCTION PERMIT Q / / i Permit Number. ' *** . REVISED PERMIT.'*** .. Issue Date: I - K'; A. Address or Vicinity of Construction: 136 Suns8e Ave j 8 B. Type of Work (be specific): Install 2" Plastic IP Main Ext. in Sunset 9 0-19 Ave from 276' N to 347' N centerline of Main St. Pera ace drawing TAB #9324015 C. Contractor: Washington Natural Gas Co. Contact: Frank Swan Mailing Address: 815 M&rcer St., Seattle,WA Phone: 224-2278 State License #: Liability Insurance: Bond: $ r_. D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): u E. ❑ Commercial ❑Subdivision ❑ City Project ❑ Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut: El Yes []No G. Size of Cut: 1 (2 x 4) H. Charge $ APPLICANT TO READ A SIGN _� `` &r� . INDEMNITY: Applicant understands and by his signature to this application, agrees to ho ��e City ofEdmonds har s9 f j , damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made.a ai t the City of Edmonds, or any of its epartments or employees, including or not limited to the defense of any legal proceedings including defense cos, and attorney fees by reason bf grlanting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET•PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL?k_PjR4CESSEO FOR ISSUANCEPZO-T#4 A14,VL CANT. Construction drawing of proposed work required with permit application. 7 A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and material is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior -to the end of the working day; NO EXCEPTIONS. I have read the above statements and understand the permit requirements and the pink copy of the permit will be available on site at all times for inspection purposes. Signature: Date: (Contractor or Agent)".' CALL DIAL -A -DIG PIUOR TO BEGINNING WORK E6 CITY USE ONLY APPROVEDBY; �� `r� l RIGHT OF WAY DEPOSIT pn TIME AUTHORIZED: VOID AFTER _ f .,ham AYS DISRUPTION FEE/FUND.-111 . r SPECIAL CONDITIONS: G Vr t1A C¢P RESTORATION FEE: r - S F k PERMIT FEE: V eO fAS TOTAL PEE: COMMENTS: _,151, SS ove F . RECEIPT FEE: eAS7 kVA9( DATE: ISSUED, BY:' NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.) Comments . Diagram CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: CITY' of EDMONDS Telephone Conversation Record Project J G'��/ �lF�rd/ �3� / a--� 4L Project Na Time zs Date CaR to e17,4094-16 1/,1S L Call from Zzf GE-G�ZlBN+�� Phone No. Phone No, Discussion. Agreement and/�orActionQ A1,05 � C .�C C�G`o� � 1�t _�-.� /.mod /� �' viu-�z.•t-� ,e a..�►•.-�� CC: 0 04/94 1,2s09 E 206 545 4416 SORTUN VOS P.01 S 0 R T N OpV 0 S Sortun-Vog Amhitwtc, P.S. 1105 Norlh Mh Street Smile wathlnipoa palm R F: C Fr 1 V E Q C") S4S-9100 Pnn (2") 5/5•{416 V 1994 Pate: } ENGINEERING . - .. .... . ... . .. . . ..' . MAO .54)w� byi- .51�Qa.e9. ?jgf#,f2 4.01F (All &C. u- rwYa awrr� F�. yap Q►, p¢r vf�.tp war �w W � . r y .moo , �u� W��f; 7f��. � ��. • . . ' , . .......... .... ....... f 4r9412,10 E 296 545 4416 SORTUN VOS P.92 STADAR^ DRAINAGE DETE W V SYSTEM WORKSHEET t owm ADDRESS - W CALC BY: Pj' v PHONE; 5R 2166 DATE; '"DESIGN DATA***** IMPERVIOUS AREA PIPE DIA PIPE LG ORIFICE N /� W.1 0 PIPETO t LEVEL o,wCC2'MAK QW49 AlmtlEV_. ..__ PROMCONTaO�.eUTLLej��jtJ*' /GJ3I j 0 /sPf IMm irry fLEJ.- &"ro? CATCH CAK4'Oi CAM" MV [lE� O.IJMY _ fYPmb IG ��3 i� SYSTEM CROSS SECTION i RUNOFF $PREADER' OUTLET i 4'. 57 (KJA tRY SPA L L 4 'P, 1/4• CRUSb,EO 7pi:u TOOTING DRAINS SMALL NOT BE CONNECTED 2^0 DETENTION SYSTEM N0,T8S. 1. Call Engineering Division (17a-0220) for a tightlino and datcativa systenn LMecttOn before backfilling and for i'mal inspections. 2, Responsibility for opmtioo and rnaintceha= of drainage systems on private property is. the responsibility of the Prope[ty own". Material aocu=lated in the storage pipe must be flusiv out and removed from the catch basins to allow Proper opcsation. Ths outlet control orifice must bo kept open at all times. R�.v I4 Page 6 ❑ f 6 T� APP IZOVT.D BY I D14TE, ABSEVIATIONS Mdtior Bdt Ad vslatle K 4male(t BvildInCone m Conhol.Idnl - [A Otnmeler 1M Otmonslon ON Down DS Dowm d Ell Each ELLC Elburie 1 EO faum EXIST E)dstt FIN Finish FS Flush Beam GALV Galvanize GL Grass GLB Gburn]Bnm GWB G wn wait Board HB Naga 8tbb HOAZ HarkonW ISO site Glass MAX Maid num Mir+! Minimum NIG Nol In Contract Oyer OC On Center PL.YWO pinmd R RaaivalRiser REIRF Raleio REC O MaXOred so Rauah •n SF: . m Foo4 SPEC Specification T q Taryus and Groevo TUC Todd Concale T. il Treads TW TVDIrAl VERT VaAfcal V13 Valeg Grah WI With - : 0�U�L 60tit C Ice.I i fJ I N -J. " ! f � (241 floor. � f�I��` 11 15 m CO 12''OG 1 Q. 4 4 i 5 ?L EzEM t4i rat #IR AML FL 1 i� �-I D � x ,, 85,,94,,94 12111 It 206 545 4416 SORTUM UDS P. 03 w al 0 40. Tlo ,- � I 1 .I_— rLA9 • 1 �l Tl�-1 TL �4ai� fiV . J, Yi�Ot1ECi' m R N IbETCA4 r- 1�ep FvprcE MOW, ..5p JtFJX4 W, qOO 31b 6 0 pave, Iv P,F,e � �' IN tn 0 a N m I d a c d x w _ K -il Q Irlty-t Wail S 14, ik-3fl MIY44 ar o �nsM aµ wile. d► 0 4 - �� �huil� _� - , jp :.1 " lax- ®r VIA l7A6tr,-V WK ?W 20'. �F� �ErTU►�+Glt--._.. 1=0` m x R _m .Q L i w . � •. .. ....rnr; 4^"Y� .�, �,� ,;l...k -..ti YL. ,.. �. r. �., ,yn;, n.c-.i ��, ���: te. .._i ��er:�--.� :,..,- � .. - , ., , .. . ,. •S•. 4•n ., ry- • f},�:_tn. v,.�n'4,--4,-fa,{��.>w .�y.f,�y„+l;n,n ,.fa. ds City of E �•�• X RIGHT-OF-WAY CONSTRUCTION PERMIT Permit Number: / 7tl-��L/,Z Issue Date: A. Address or Vicinity of Construction: 10 7-1,3 6 LL ST• 8 B. Type of Work (be spec ��1 T-�i L=#i ��/� 90 - 19( C. Contractor: K ( ST Mailing Address: �ra'c141 0-\Jt= Sc� State License #: D. Building Permit # (if applicable): tfic). Contact: Phone: �li0�j� i0�51OU Liability Insurance: iIES Bond: $ Side Sewer Permit # (if applicable): E. E] Commercial E) Subdivision ❑ City Project ❑ Utility (PUD, GTE, WNG;•CABLE, WATER) ❑ Multi -Family �' Single Family ❑ Other INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut: I/�npST l-1 <_z_ti ��I Crr NnVey p15�e_b SEe_-r .- l OF sk0EwA�u. ❑ Yes G. Size of Cut: x APPLICANT TO READ AND SIGN H. Charge:$ +ti INDEMNITY: Applicant understands and by his signature to this application, agrees to 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 or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT. WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Construction drawing of proposed work required. with permit application. A 24 hour notice is required for inspection- Please call the Engineering Division, 771-0220. Work and material id to be ir1's'pecte'�d2during'progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of,the working day; NO EXCEPTIONS. I have read the above tate ents nd ur#qrsta the permit requirements and the ink cop of th permit will be available on sime l ti es for sp ion p r oses. �j Signature: / Date: ..42— (Contractor or Agent) A. CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY APPROVED BY: TIME.AUTHORIZED: VOID AFTER DAYS SPECIAL CONDITIONS: COMMENTS: USE ONLY....::::,r'- RIGHT.OF WAY,IAEPOSIT, Y DISRUPTION FEE/FUND III: - RESTORATION FEE: PERMIT FEE: t TOTAL FEE: / RECEIPT FEE: :25/�2 4Z yy DATE: ISSUED. BY: - NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 - PEEC FILE • STREET E US PERMIT APPLICATION NAME OF APPLICANT: NAME OF BUSINESS:L MAILING ADDRESS: k, CONTACT, PERSON AND PHONE NUMBER: gOJo "2 3 Z" %,6% { ADDRESS OF PUBLIC USE: 6 3 fa 4N4grr 4oKZ a Describe the public place or onion of public space to be utilized: Attach a plot plan. Specify the type of use • desired: Specify the length of time for use NOTE. The issuance of this permit is understood by the applicant to be of a temporary nature and that no vested right is granted INDEMNITY.- The applicant understands and by his/her signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the applicant or the City of Edmonds, or any of its departments or employees, including but not limited to. the defense or any legal proceedings including defense costs, court costs, and attorney fees by reason ofgranting this permit. In addition, the application understands that the City shall be provided a Certificate oflnsurance to indemnity and hold harmless the City of Edinondsfrom all claims and/or property damage, and naming the City of Edmonds as an additional insured. CODE APPLICATION.• By signing the application below the applicant warrants that s/he has read or had the opportunity to read Chapter 18 of the Edmonds Community Development Code and s/he understands that all terms of the adopted ordinance are incorporated herein as if set forth in full and this application and permits therefore are subject to the terms of that Chapter. • SIGNATURE DATE 3 23 ..Ill u. •• ' ng!APl!'JE8!ili e5iti!t .u::y w:rmcL•x.:! RIMp ;:u!r•�:cr�!i: SIGNATURE OF APPROVAL FROM ABUTTING PROPERTY OWNERS When applicable, if the street use proposal directly impacts any adjacent business or private property owner the applicant must obtain written approval from the affected parties. This requirement is evaluated by City Staff after the initial submittal of the application. Signature ' Address Signature Signature. Address. 'Address Signature Address ,DO NOT WRITE BELOW THIS LINE ... FOR CITY USE ONLY Planning Division Review: ADB# Approved B Date '5 Public Works Review: Fire Department Review: Approved By, Approved By Police Department Review: Approved By Date S - -Z3�5 Permit Coordinator Review:. Certificate of Insu'ance-Verified s � � Engineering Division Review: Bond Required g: . Amount $ Approved By DatedIt _ZU19 Remarks or Comments: ✓lbe 48Fg- 4.y /ficCc�,r.� d�f r/ lzd.9�c,f. 6 V/ I PERMIT # GZ5" DATE OF ISSUANCE RELEASED BY ;�� RECEIPT # -941 .• PRODUCER Stanley T. Scott & Co., Inc. �312 EastLake Avenue, East eattle,--WA 98102 (206) 32'3" 3931 INSURED MRAZ & COMPANY.RENOVATION & CONSTRUCTION 4005 80TH AVE. S.E. MERCER ISLAND, WA. 98040 SUE DATE (IAAIDD/YY) 3/24/1994 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY D LETTER ........................... COMPANY E LETTER :C RAQ�S...::....... .... THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . .................. ... ... . ................................................................................................. ... ... . ............. CO : TYPE OF INSURANCE POLICY NUIDIER :POLICY EFFECTIVE :POLICY EXPUiAT10N LDS LTR: DATE (MMI)DNY) DATE(MMIDDIM .........................................................................i................................................. ....... ;............................................................................................................ A GENERAL LIABLLITY i GENERAL AGGREGATE s 210 0 0, O O Q i X COMMERCIAL GENERAL LIABILITY 081MP0023394619 TWF ' PRODUCTS-COMPNP AGO...... s . 2....... .000.f..00Q ........ .......... CLAIMS MADE X occuR. 0 6 /O 1 /9 3 0 6/ 01 / 9 4 PERSONAL 8 ADV.INJURY., 000,00C X OWNER'S & CONTRACTOR'S PROT. EACH OCCURRENCE i 1, 000, O O a X . WA STOP GAP v FIRE DAMAGE can one fire) a 300, 000 ....................................................... AUT04M E LIABILITY $ : ANY AUTO 061FJ0OMN619 TWF ALL OWNED AUTOS SCHEDULED AUTOS, g...X HIRED AUTOS ,...X . NON -OWNED AUTOS GARAGE LtABIUTY ...:.......................................................:. EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION - AND - EJIPLOYERS' LIABILITY OTHER MED. EXPENSE (Any one person); i 5, 0 0 0 . ............. ............................... COMBINED SINGLE Ij O O O O O LIMIT i 0 6/ 01 /9 3 0 6/ 01 / 9 4 BODILY INJURY E (Per Person) s BODILY INJURY (Per accident) i PROPERTY DAMAGE i ............................... .................. .... ......... >... .. ........... ........ :EACH OCCURRENCE .......... S E AGGREGATE a DESCRIPTION OF OPERATIONSAACATIONSNEHICLES/SPECIAL REYB EVIDENCE OF INSURANCE FOR STREET USE PERMIT . ...... STATUTORY LIMITS . ... - - :-EACH ACCIDENT - '3 DISEASE - POLICY LIMB i ............. E DISEASE - EACH EMPLOYEE i THE CITY OF EDMONDS IS ADDITIONAL INSURED PER ISO FORM CG2010. 250 5TH AVE. N. EDMONDS, WA. 98020 It,, f 1�,,•��UH f�v.-rl.. 1-Ii`c/-19 7«' �,,..r— f.e.l.- iPI Tilwo 10#2 511S .: (� • :j �l0• a' - _ . � � . ticsP�hw~� o�•c.�ev+IK..K,e �? � �c�. — �r .ts � � � - � �� 1"m���lavt �'� - �>-'- -• : --- �- - •---_ 1 Rig,. _ �. __ -� • 15fz- I� i use A'l _ i • • 1+ t It AL - it .. V �� ,' i� � • ''F - �=�.�� "�>;-�`��'. j �"�;�` ��� � � �'� - Spl/��.lolec�s O"Tod r1- q-- 1 j-•�{.•. j'�Fl f� �i.*1 .,i`.I PSt. t,7' a 1' I -oil 7ff�ya: ry L+T ' 7Aa /G11t Api _ jA\ O- � 7 � Z S .T.: � ?` t S '7S•. F i it `` •4 .tl ( t �- � � 1 � a>t l ,�-li'� _ .'.tj M JA.' a �•�«r•�{ yw�; � 1 OI! ..rY a<y�5h. }?• •� •r,�.�,1 i _� "a?41'S:ti`+y, + .d ` � �':b�'q` •ci byw�d 4..4�)�, s. aL s, ' _� � v ••1 - i�.�?�" :i2h :.'�` .j�,j`• ,7��1 ��J i !., o a 'k.. �I :�K`,�. I, S 1 1 i I ( 7 � O . - '\ ^ A'1./ �. — .. .• 1 � � .Y. Z� \1 OJ - .Z �. .'i•.IS Y J1 :i �•L S d r 1. i 'j -� � � s . ,. _.., ••fkt t• � ' 4 c•-� i a :rfi•;• •.aei,n; l7 "f� �Q .!� i .. ,i ' =I I J-� �.y �.'1 •s �} 6 1..4 v' 1 1 _ R, l -\\ � t aL�ia•�- ••' YS.,K, `•y�.A` •,k•�"q• y,�: r Tt' ,l i::; 5.: .y. art:!:. ♦; .�Jn�t'�� � _ O Q� _'G�#�IpaG _ �' r: t } n.l •''+- ., __' .r++.•�•%f' _�1 'i _ .. _ _.-- __- '- --.` "Y-`,`t?Y,. �7j .. . _ t�. -Q i. yl+t��}�.�L, 47 �� a--t�'•r� t 1� :c'Y .,• _ __ .-- -•'-- ---'- - - �' �� '•\. . � _. . fit` • . .-�}y�'�'r' � 1� ��;h=.� . , ��s ,;���. -�� � '�: - 4�f E��� � - ��• l OF - • � - _ i i . " , '�� .. �{ � �� � j� '�.• (,,;R;,�,jtip. ':• • _�. �_ -` _ ! _ - -�� � D/1 ...... ! ... � • I OJT. C11�K a5 •_A+rl r.a• .l ,.n ,' ''• + �: ,0..�� /„j.'.:` .�.�,^�. -r: .� •�.'- .�;�4 :.4•. ;�-!i• ..� - J�.��r� V Cl` �r•.+.K'-e; wn.`r y7Y`^w ��!- '� ,�•; S•l:-a.«.';rN•i .i�sa ir-r-,.4.•:•.S•i-•'•- �•t •a ..,'4•. 1• Cw• •�'LL•. . �7 III .t1 �, ,�(q '•r•`• ,.r, r,� »I.,C,.y a�,yC .S.a a,•.-�M.. �i.r:yp _.agwb 4.: ,.,}` , u�'"Y��•' ,;; .•�•IC,: i •+ •? �tA /}-r .f°G'!:':...77;'i'_- .d.:.::T,.���l.Lid'1.��.?,�. ��}}�:w•: ".Y rkA4X '�` :kri •�i' '"S a .f+' tr',-?•'fd' .a� ("l .1.�� .r- ;�r`•,)y.. Lam"-��-74::+u•µ .':P'.. Y��.•.a.-..' - ' i�.�. l,.i `•O:x�r: �U � 4 //�� PROJECT REVIEW CHE LIST, plglC7E:. S T8EfiTK F q MM-VqoftK%5 D CIT ADDRESS:- LOZ/3-0/l/ ST. RECEIPT DATE: /0 EVIEW n a ate PLAN. WATER rt 'COMMENTS."' FIRE BLDG WER.STREE7 S:.-.:ENG.m: I Setbacks/Variance/Setback Adjustment Conditional Use Permit ............. A 3.. ADB Requirements Other Zoning Requirements ..... Underground Wiring Required ......... Lot Slope 1596 SEPA Environmental Checklist/Hydraulics Permit Tree Cutting Plan Plat/Subdivision Requirements ...... ..... Legal Description Verification Quit Claim/Street Dedications . . . . . . . Easements - Public/Private . . . . . 12- Engineering Storm Drain Review Fee -1 3 Engineering 2.2 Inspection Fee ............... -4 Drainage Plan (On -Site) . . . . . . . . . . . . . . . .......... 1-5 Setback -.To of Bank, Stream, Water Courses Setback - Storm Drain Line 10pen Ditch - Existing 18 Culvert Required -19 Culvert Size -- 20 ,Shoulder Drainage/Shale Open Runoff --a*!- .21 Catch Basin Required .22 Driveway Slope & Vehicle Access . . . . . . . . . . . . Sidewalk Required .e ICO L"�& -.24 Curb & Gutter Required 25-: Curb Cut For Driveway Required is ................. 26:: Street Paving Required .... . ...... . . . . . . . . . . . . :: ... 27 Right -Of -Way Construction Permit Required 28_�, Street Name Si Required -'29 Other Zigning Required V Bond Required For Public Improvements No . . . . FEMA Map Check/Water Table . . . . . . . 32 Side Sewer Availability 33 Calculate Sewer Connection Fee If No LID # Create Street File Existing Water Main Size4 . . . . . . . - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - $5 ' -3 Water Meter Size G.1" .16 1,L3a-uN . .. . -3A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Service Line Size -- ----- ---- ------- ... Water Meter Charge Required 7W -38-- Hydrant Required U. .40 Hydrant Size Existing ')Af Fire Line Charge Required - Sprinkler 0 42' ,Street Cut W% WO i yv% Imm 00 e.%, 4- . . . . . . . . . . . . ....... 43: [Miscellaneous 44 Reviewed By: FIRE 0- PLANNING ENGINEERING PUBLIC WOMM STREWT _71 -rD *'cisr 49zi PEMM APPLICATION REQUIREMENTS To: Permit Coordinator, Building Division STREET FILE FROM: Lyle Chrisman, Engineering Inspector OWNER: �✓�r-t- O�-C-So..� PLAN CK 1t ADDRESS: �yL DATE: l 6 �cJo u 93 After review of the subject permit application, the following requirements mustbe met. 1. Construction hours are: WEEKDAYS .......... 7:00 A.M.-10:00 P.M. WEEKENDS/HOLIDAYS ..... 10:00 A.M.-6:00 P.M. 2. A separate RIGHT-OF-WAY- Construction Permit is required for all work on Publicproperty. (ECDC 18.60) 3. Truck haul route plan must be submitted and -approved prior to permit issuance. 4. Builder/Owner is responsible for containing all temporary runoff and erosion control on site. (ECDC 18.30.030d) S. NO WORK SHALL BE DONE WITUIN 15 FEET OF STREAMS OR 10 FEET FROM ANY CLOSED DRAINAGE FACIL- ITY. BUILDERIOBWER IS REPSONSIBLE FOR IDENTIFYING CONDITIONS ON THE DRAWING. (ECDC 18.30.50G) 6. FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCY70N. (ECDC 18.30) 7. INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEMS, TIGHTLINES, FOUNDATION DRAINS, AND CATCH BASIN INSTALLATION. INSPECTIONS ARE REQUIRED PRIOR TO BACKFILLING. (ECDC 18.30) 8. Repair or replace all defective existing curb, gutter, and sidewalk adjacent to the property. If an intersection is involved a handicap ramp may be required. Contractor shall meet with the City Engineering Staff to determine the extent of repair prior to issuance of the permit. (ECDC 18.90) 9. Driveway slope shall not exceed 14 %. without a waiver. Every attempt should be made to keep the slope below 14 Waiver granted to __%. (ECDC 18.80.060D) 10. Driveways must be paved from property line to City RIGHT-OF-WAY. A separate perimit is required. (ECDC 18.80.060C) 11. INSPECTIONS ARE REQUIRED ON DRIVEWAYS AND SIDEWALKS PRIOR TO AND AFTER POURING. (ECDC 18.30) 12. No burning of construction refuse without a permit from the Fire Department. 13. Connection to City water system is required. There is a separate charge for the water meter. (ECDC 7.30) 14. A back water valve is required if downstairs plumbing is below the elevation of upstream manhole. (ECDC 7.20) 15. Water and sewer main lines should be separated by 10 feet minimum. (ECDC 18.10) 16. Connection to the City sanitary system is required. A separate permit.is required. LID# Fees paid: Yes No Charge 65 (ECDC 18.10) lz 17. Underground wiring is inquired on all new construction; and for additions, alterations, and repairs that exceed 50 % of the total assessed value of the structure. (ECDC 18.05.010) 18. A FINAL ENGINEERING INSPECTION IS REQUIRED PRIOR TO THE BUILDING DIVISION GRANTING OCCU- PANCY OF THE BUILDING OR STRUCTURE. (ECDC 18.90) 19. � c am d/i "Luf uq NC'u/ 20. Art zzwd �� v; GA � Lf } C 0 T Y OF � � � � J�N ..;. )�F,RVE H. )r�,r n;sor, _ 1...r rnn'rOFt 2W DAYTON ST • EDMONDS. WASHINGTON 98020 • (20) %r :1'Y1:, DEPARTMENT OF PUBLIC WORKS i-},)rch .16, 1981 STREET FILE Dear Resident: On February 17, 1981, the Edmonds City Council passed Resolution 488 for construction, reconstruction and repair of deteriorated sidewalks. A puhl.i.c hearing will be held in the Council Chambers at the Civic Center. on April 21,1981 at 7:30 P.M.-. rYou—are invited to attend_ this- hearing_ for discussing repair'df:,'portions 'of deteriorated: sidewalk abutting yours'property-: 'The improvement of 'sidew'alks in need of repair at the expense of the abutting property owner is provided by City Ordinance, Chapter. 7.20 and Revised Code of Washington, Chapter :35.68. The areas needing repair have heen rnarked in paint on the sidewalk adjoining your prover.t.y. Rnconstr.uction and repair of these sidewalks must be iced on or before September 1, 1981. In the event i(npr.nvements are not completed within the above specified time, the City will perform and complete the imp rove me nu; at the expense of the abutting property owner. This action is in response to many citizen requests and pedestrian falling accidents which have been increasing in recent years as a result of sidewalk deterioration and increased pedestrian traffic. Sincerely, PRI-:,I) F. IIC RZRI;:RG ' Di.rCCtnr of. Public Works .7Ywr:. ,r"4�' raw it�n.•' w/mew'.e1 �r a.r"'y,-, USE PERMIT CITY OF EDMONDS ZONE NUMBER -�' 3 CONSTRUCTION PERMIT APPLICATION . It ' 6. JOB SUITE/APT OWNER NAME/NAME OF BUSINESS ADDRESS T LEGAL DESCRIPTION CHECK SUBDIVISION -NO. LID NO. ZMAILING ADDRESS ,, 3 O r W l�TP 1 PUBLIC RICH OF WAY PER OFF ICI TESCP Approved ❑ CITY ZIP TELEPHONE NUMBER /J�, �,j� Pe mil Required EXISTING �"�' REQUIRED DE T N (J(�treat g rmi q'd O PROPOSED NAME Sidewalk e ❑ 0 � C5 ® TjI � REMARKS ` 1.1 ¢ w W ADDRESS fJ jl/ i z a CITY ZIP TELEPHONE NUMBER MQ / S Q w hh NAME t� t_ ENGINEERING MEMO DATED // �� q t yy�y ADDRESS �� i —G; METE SI BUILDING SUP LY SIZE NO. OF FI% ES ¢ CITY ZIP TELEPHONE N O REMARKS 3 U f d/ STATE I NUMEiEiT EX ICEN§E PIRATION OAT SIGN AREA SEPA REVIEW `+ ALL PROPOSED COMPLETE EXEMPT Legal Description of Property. - include all easements 77 O ' w 1 SHORELINE M I EXP (L — ¢ VARIANCE D AT (n tn �REVI - �{P / W aWCU SETBACK/i yFEEET HEIGHT LOT C VERAGE � 1 Property FRONT (/ C-) SIDE REAR ,2 © Q Tar Recount ®1 �/ /w��+ /�i a/� _ REMARKS a Parcel No. `.I VVC/(�/ �� NEW 1—/y RESIDENTIAL 2 PLUMBING n EIADDITION 1:1COMMERCIAL le „ .MECHANICAL APT. BLDG:+I O REMODEL SIGN /o ;CHECKED BY TYPE OF CONSTRUCTION CODE - HEIGHT REPAIR CYDS. (ENCE x "_FT) DEMOLISH WOODSTOVE SWIM POOL SPECIAL INSPECTOR OCCUPANCY OCCUPANT HOT TUB/SPA P. 2ONSERT REQUIRED / GROUP '� LOAD , ❑YES �GA RAGE: RETAINING WALL/ � RENEWAL REMARKS ROCKERY o (TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 305 z p to NUMBER NUMBER OF CRITICAL O m OF "//� DWELLING .�• AREAS , STORIES 1 INUMBE ' O 6. UNITS �G - DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) IC"2FINAL INSPECTION REQUIRED VALUATION FEE 'PLAN CHECK FEE BUILDING HEAT SOURCE: GLAZING PLUMBING ' Plan Check No. MECHANICAL This Permit covers work to be done on private property ONLY. GRADING/FILL ,,Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE -41 SO Permit Appllcation: 180 Days..,_,.. d /W Permit Limit: 1 Year - Provideork Is Started Within 180 Days STORM DRAINAGE FEE 3 "Applicant, on behalf of his or.her spouse, heirs, assigns and ENG. INSPECTION FEE 50 successors in interest, agrees to indemnify, defend and hold J harmless...the City- of . Edmonds, Washington, its . officials, z employees, and agents from anj:and all clairfis for damages of ) whatever nature, arising directly or indirectly from the issuance = of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT //—�J� 0 modify, waive or reduce any requirement of any city ordinance nor limit in any way the City's ability to enforce. any ordinance TOTAL AMOUNT DUE provision." I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL information given is correct; and that I am the owner, or the duly authorized agent of the owner. I agree to comply with city and THIS PERMIT J `' This application is not a permit until state laws regulating construction; and in doing the work authoriz• AUTHORIZES THE signed by the Building Official or his/her ed thereby, no person will be employed in violation of the Labor ONLY Code of the State of Washington relating to Workmen's Compensa• WORK NOTED Deputy; and fees are paid, and receipt is ti n Insuran INSPECTION acknowledged in space provided. SIGN E WNER OR AGE DATE SIGNED DEPARTMENT ' JT) CITY OF OFF S SI URE DATE i r r EDMONDS CALL FOR AELEASE4 DATE ATTENTICN INSPECTION IT- IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771-0220 UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW - inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. PINK - Owner GOLD - Assessor 111>11 roc f-c%m oono 17111 cnA _ 11 EDC 10 M81nl W%" REN41510 A I NI Amou t�l T OF 5/17"f I GU -CS I m PAV 1!NG `}4 I717�`I NO. DESCRIPi ION DATE BY i REVISIONS I L =91 10 NOTES: EDMONDS 2.) FIELD LOCATE ALL UTILITIES CALL 1-800-424-SSSS 48 HOURS BEFORE DIGGING 2.) INSTALL LOCATING WIRE OVER ALL PE DIRECT BURIAL PIPE 3.) INSTALL A ONE POUND ANODE FOR EVERY 2000' OF LOCATING WIRE 4.) SURVEY IS NOT REQUIRED S.) MAINTAIN A MINIMUM OF S' HORIZONTAL AND A 3' VERTICAL CLEARANCE FROM ALL CITY UTILITIES AND APPURTENANCES 6.) CUTS IN PAVING ARE SHOWN AS -�- .7.) b I CUTS ANTICIPATED 8.) COMPLETE EXPOSED PIPE CONDITION , REPORT WNG FORM #S63.13 (D-1) 10 s - g — 7 I 2" PE CAP sZ- C650 6 1 TEST LEAD WX ZNVIR.ES SD- 30-1 s 10' # 10 "TEST LEAD W IRE as 4 1 Z " TRA1V slTION F CITING -Mv BOO 3 z �7RVtL�STOP 2 Z 1' 1 IV ZT - I o- !TEM OUANT DESCRIPTION STOCK NO BILL OF MATERIAL PERMITS: EOMOMDS 1 /4 SEC: SE 23 • 2-T• ,3 PLAT: fro 3 • ray OP MAP: �. AREA: Z I l TAX CODE >r1 �„"® a �o.e'® SEO. NO: W 6 1 r TOG Awbgrg6onErr_,gyCcrr anv D.G.R: PROP. Z" SDR- II PE IP MAIN ENT. -To-. 13ro SUNSET AN E DWN: DI F,l 4- / 27 / 94 IR (oc)4.3.3 RR - — 4-015 ' Q 9324-015 DRAWING SCALE: I .. Sp I APP: `I 7��1-0 aQrnv cnA _ 11 oG 10 MOIfNI REV 15I ONA I NJ 7AMO0tl,l T OF 5/17/ "f I C•U'CS I !V DAV 11 NG `14 DI7ON NO. DESCRIPTION DATE BY APP'D REVISIONS NOTES: EDMONDS O - 1.) FIELD LOCATE ALL UTILITIES CALL 1-800-424-5555 48 HOURS BEFORE DIGGING 2.) INSTALL LOCATING WIRE OVER ALL PE DIRECT BURIAL PIPE 3.) INSTALL A ONE POUND ANODE FOR EVERY 1000' OF LOCATING WIRE 4.) SURVEY IS NOT REQUIRED 5.) MAINTAIN A MINIMUM OF 5' HORIZONTAL AND A 3' VERTICAL CLEARANCE FROM ALL CITY UTILITIES AND APPURTENANCES 6.) CUTS IN PAVING ARE SHOWN AS -e- 7.) ( CUTS ANTICIPATED �4 B.) COMPLETE EXPOSED PIPE CONDITION REPORT WNG FORM #563.13 (D-1) io 9 8 — 7 1 2" PE CAP 52- Gmb 6 1 TEST LEAD BOX ZNV IFES ffNa 30-1 s 1 O' # 10 -TEST LEAD W IRF. 85- "(5 4 1 Z" TRANSITION Fl-MTQC= - bF BOO 3 2 -7 V - 540 IV l.zl, 5 -1 F- PIPE- 0 !TEM QUANT DESCRIPTION I STOCK NO. BILL OF MATERIAL PERMITS: EDMOMOS 1 /4 SEC: SE 23 - 2-7- 3 PLAT: I6 3. 65 OP MAP: I GO - 6 2 ,�. Alslec,.® Amlmaw-® IMF '® ®® Gw A V bslw-cjbn Energy Cormany AREA: zit TAX CODE: SEO. NO: D.G. R: PROP. 2" SDR- -to.. 136 SUNSET DWN: DI KI i Q- CI -I j SCALE: I "Z 5O ' I APP. II PE IP MAIN ENT. ANE / 2-1/ 1:34 IR CC04"' - RR I 8� Q JOB4-015 � J � ORAWIN6 � ( ��-o 9324015 2" PE CAP 34i' N t- � 21 ' W 2O'a • PROP 2" SDFZ- I PE IP MAIN 21 ' W h ar Cu v � Al, v ,a �"J y N �h 7RANSI-T \ON R7 ING R� 277' N s I21' W (L w / I a- SHORT 3 REV 1510t-.1 I NA AapnoU t,.i T OF 5/17� 'f 1 CU-TS Iry DAV'INC-3 `14 r2 NO. DESCRIPTION DATE BY I REVISIONS NQIR TES: EDMONDS 1.) FIELD LOCATE ALL UTILITIES CALL 1-800-424-SSSS 48 HOURS BEFORE DIGGING 2.) INSTALL LOCATING WIRE OVER ALL PE DIRECT BURIAL PIPE 3.) INSTALL A ONE POUND ANODE FOR EVERY 1000' OF LOCATING WIRE 4.) SURVEY IS NOT REQUIRED 5.) MAINTAIN A MINIMUM OF 5' HORIZONTAL AND A 3' VERTICAL CLEARANCE FROM ALL CITY UTILITIES AND APPURTENANCES 6.) CUTS IN PAVING ARE SHOWN AS -e- 7.) „8.) I CUTS ANTICIPATED COMPLETE EXPOSED PIPE CONDITION , REPORT WNG FORM #563.13 (D-1) 10 — 9 — 8 — 7 1 2" PE. CAP s2-4650 6 1 TEST LEAD SOX ZNV 1RES Sa 30-1 s 10' # 10 TEST LEAD Vv1[Z1= asmo - 4 1 Z'• TIZANSITION I imt-aG 7BF a00 3 PE z Z 1' zt� z•� -i� p�P a ITEM OUANT DESCRIPTION STOCK NO. BILL OF MATERIAL PERMITS: E0M0N0S 1 /4 SEC: SE 23 - 2-r- ,3 PLAT: 1(o 3 - 65 OP MAP: I r00 - 6 Z ® AREA: Z I I TAX CODE. mmjrmAGm3;ffw == SEO. NO: Avvb9wx ton EnergyCon••pany D.G.R: PROP. Z" SDR- II PE IP MAIN ENT. to 13(o SUNSET ANE OWN: �� /�✓� 4- / 2-7 / 0 IR CCxl-3'3 -�-/-j— Q JOB CH `'}_ / �8/ 7 � DRAWING Z� 1 SCALE: I "� 5O' APP: �D/�-p 93240I5 F=l PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY LOCATION 1 CQ` POLE NO. S)F 1/4 S23 T 27 R REASON FOR WORK_���-� � - FEE F9 DATE WORK COMPLETED 1476 REV. 7/87 AREA DATE W.O. NO. OWG NO DRAFTER U. G. NO. SCALE" 'A C' I I % , =- I I t APPROVED DATE PRINTE D FOREMAN ENVIRONMENTAL ANALYSIS - I N EXEMPT 0 NOT EXEMPT SUBSTATION �4, p ua� 0 &C� FEES READ X-YES 0 NO PARA. 18 ITEM C KV CIRCUIT NO. PHASE PRIMARY OVERHEAD 0 w I I G COND. El RESIDENTIAL ADD CKT, FT. PH El COMMERCIAL PH LEO# REM CKT. FT. NET CKT. FT. O.H. U.G. COND. KV SECOND I ARY OVERHEAD ADD CKT. FT. PH BASIC FEE $ -_ REM CKT. FT. PH METER/CONV.. POLE $ NET CKT. FT. T PERMITS (DATE GRANTED) PRIMARY UNDERGROUND 0 TREE TRIM Jl 0 RESIDENTIAL' 0 STATE 0 COMMERCIAL 0 COUNTY BASIC FEE LEU# XCITYT_bMRb-S_ $ $ ❑ SECONDARY UNDERGROUND EASEMENTS 0 REQUIRED NOT REQUIRED BASIC FEE UNDERGROUND PLAT DATE RELEASED BASIC FEE FOREIGN CONTACTS /U�J t FT. 0 $_ / = 0 GTNW JPN# STREET LIGHTING F0 CATV JPN# T. @$ 0 JOINT TRENCH GTNW & CATV WORK IN RIGHT OF WAY 0 JOINT BORE GTNW & CATV 0 PRIMARY 0 0 SECONADARY POLE STENCILING - t-FT. @$_ FROM TO c MISCELLANEOUS FEES TAKE OFF POLE VAULT $ PRE-CONSTR. REQUIREMENTS PERMIT 0 TREE TRIM EIPUD LOCATOR BACKHOE 0 FLAGGING XONE CALL DATE TOTAL DUE INDEXPOLES PLAT DATE PAID LOGS U-MAP RECEIPT# XFMR -MAPl' NEW SVCE APPLICATION# LOCATION MAP PAGE � s� ppar-N .0 TIN IAT, kl C CP4 IT cc)�,�c 1.02 R� u=. �i L�aEI,J uu (Z, CO�riz;\ ZM.Ll, C:) 4-1 4-10 N-5 9- P_ (03) 60-X /F,(9 9 . 4-106C-,\ <:? 6' RSCEMIVED OCT 2 8 1993 PERMIT COUNTER 7Z�00 c/) rn rn I 471 I,-- rn