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10229 244TH ST SW.PDF10229, 244TH ST SW ADDRESS: `'75r 540 TAX ACCOUNT/PARCEL NUM 3ER: 00 �71 IM ©D_���� BUILDING PERMIT (NEW STRUCTURE): COVENANTS(RECORDED)FOR: CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: SOILS REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DATED: OTHER: LATEMP\DST's\Forms\Street File Checklist.doc City of Edmonds Permit No: 60S - 0309 RIGHT-OF-Wxy/- CONSTRUCTION PERMIT Issue Date: A. Address or Vicinity of Construction: 10 11Z-Z-a/ ol <4 B. T e of Work (be specific): d 1 ty �'� 1 O r� 3 �L S IS 'A) I L c; aq 5!r S 1-e��� l U O 7 we) C �0 ZJ p 0� o3 51 S Le) fDo/f- `-` C. Contractor: P1 161 L� J/1\ COVI Contact: sS 0, S 1 D t C Mailing Address: I 3 3 �0 t/Lrz V N Phone: ram' State License #: 4 I L �'I L° rI I lip Liability Insurance: Bond: $ City Business .License #: � � D. Building Permii # (if applicable): Side Sewer Permit # (if applicable): r E. ❑ Commercial 1 '❑ Subdivision ❑ City Project ❑ EUC (PUD,-VERIZON, PSE, COMCAST, OVWSD) ❑ Multi -Family Single Family ❑ Other INSPECTOR: I&Sit F. PAVEMENT CUT: [0 YES ❑ NO G. SIZE OF CUT X S� CONCRETE CUT: ❑ YES ❑ NO 1 • G. ❑ Mail Approved Permit ❑ Call for Pickup APPLICANT TO READ AND SIGN INDEMNITY. Applicant understands by his/her signature to this application 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. 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. ♦ Traffic control and public safety shall be i�n 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. 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 prdposedfwork`are`regdieed'Whirthe permit application. CALL DIAL-A=DIG (1-800-424-5555) PRIOR TO BEGINNING WORK I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS'AND ACKNOWLEDGE THAT I MUST MAKE THE PINK COPY OF THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS Signature: (i� KJC.c�°�. Date: (Contractor or Agent) I ;� FOR CITY USE ONLY Approved by: Jaime Hawkins Right-of-way Fee: $160.00 + $15.00 Time Authorized: Void After Febru4 y / 3rd / 2006 Disruption Fee/Fund 111: $0.0 Special Conditions: Restore ROW to like and/or better condition. InspectionFee: 2 @ $50.0 = $100.0 Maintain 5' Min. setback from all City of Edmonds utilities. Verify Total Fee: $275.00 clear bore crossings. Call for locates of all U/G utilities prior to any Receipt No: excavation. Alert affected residents and businesses. Conform to Issued by: the approved working drawing and Traffic Control plan. Please refer to Edmonds Std. detail E2.3 for utility patch restoration requirements. Please call the number below to schedule the required inspection(s). 1, 1.- REQUIRED INSPECTIONS: Call 425-771-0220, Ext. 1326 for a 24-hour voice -recorded inspection request line. qI FINAL APPROVAL OF PERMITTED WORK:. DATE: `7A 0(- Inspector's Signature 1 WORK SHALL BEGIN PRIOR T1 PERMIT CADocuments and Settings\Curtis\My Documents\Forms\Engnrng\ROWpermit_ doc Revised 10/01/03 Pllchuck Contractors, Inc. Job # 107025382 Nov 15, 2005 Sheet 1 of 1 Rob Inglis "9 ALLOW ACCESS TO DRIVEWAYS 4 100, 100, 100' NOT TO SCALE r1 MIS rMN �X14 FX-4 1� 244th ST SW WORK AREA 3' x 15! 24 HR. NOTICE REQ. FOR INSPECTION APPROVED AS NOTED BY ENGIN ERING ni r Date: Az Z LEGEND • 26' TRAFFIC CONE ® WORKAREA TRAFFIC FLOW WORK VEHICLE N SIGN LOCATION Notes: 1. All signs and spacing to conform to the MIJTCD and City of Edmonds Traffic Control specs. 2. ChannellAng devices are 28' traffic cones. 3. Al signs are 48' x 48' B/O unless otherwise specified. 4. Alert affected residents. 5. Work to take place between 9 a.m. And 4 p.m. t f 0 o S b A p ONE LANE ROAD �IIEAD z ob eM WORK AHEAD z t- CHANNEIIIATION DEVICE SPACING MPH TAPER TANGENT 60,70 40 80 35146 SO 60 25M 20 40 SCALES 1" a 50' 10217 10209 N ^ N I 244 ST SW i R/W ( ') E.O.M. - 2" MPE CAP 16'N, 107-W C/L ON, 'W C/L PROPOSED 2" MPE-IP MAIN 16-N CA 'N CA FUSE TIE-IN 315-N CA do 35'R N, -'R ROPES 30'R TO 35'R MAIN ROPES 'N, 'W CA TO 'N. 'W CA I 244 ST SW SNOHOMISH CO. 60' R/W KING CO. (N 205 ST) FITTER ' rtheck Box if Complete) ® WORK AREA LEFT IN CLEAN/SAMGNDITION. ❑ o COMPLETE ALL PIPE TABLES AND GAS PRESSURE STAMP ❑ ® FIELD CHANGES RED-UNEDN AS-BUILTS. ❑ ® MATERIAL VERIFIED AND CHANGaIit;TED ON PAPERWORK. ❑ ® ALL VALVE AND TIE-IN LOCAi)OWTED ON AS -BUILT. ❑ s NOTE BEGINNING OF MAIN.EOM,3 LINE OF MAIN LOCATIONS. ❑ ® SHOW ROPE LOCAflUNS 8 CUL-DE-SAC . RADIUS ❑ Fitter's Signature Company PILCHUCK DATE STANDARD GAS CONSTRUCTION NOTES: I. FIELD LOCATE ALL UNDERGROUND UTILITIES. EXCAVATOR TO CALL "ONE -CALL" TWO WORKING DAYS PRIOR TO TO CONSTRUCTION. IN WESTERN WASHINGTON CALLS 1-800-424-5555. IN KITTITAS COUNTY CALLS 1-800-553-4344 2. NOTIFY APPROPRIATE PERMITTING AGENCY PRIOR TO JOB START (SEE PERMIT REOUIRMENTS). 3- ALL CONNSAATRRUC��T��IppOjN IS TO CONFF��O,,RM TO PSE GAS OPERATING STANDARDS AND GAS FIELD PROCEDURES. 4o ROS10N A SEDi NT CONTROL SAND ANYEADDITIOONN& LLOCALDJlJfi1SDlCYION REOUIREMENTSIQUES FOR TEMPORARY 5. NOTIFY PROPERTY OWNERS ADJACENT TO PROPOSED CONSTRUCTION ACTIVITIES A MINIMUM OF TWO WORKING DAYS PRIOR_TID BEGINNING CONSTRUCTION. Uu USE tsi Tn nteTDSnTe e,vree *r .— - w n...*rwwc• 6. ANY CHANGE IN ROUTE. PIPE SIZE/TYPE. TIE-IN METHOD OR ADDITIONAL MAIN FOOTAGE MUST BE APPROVED BY THE APPROPRIATE PSE ENGINEER OR PSE REPRESENTATIVE. 7- COMPLETE "PIPE CONDITION REPORT" ON ALL METALIC PSE FACILITIES. CHECK BOX ON REPORT FOR WIRE BOX (TEST LEAD) INSTALLATION. 8- PIPELINE MARKERS AND WARNING SIGNS SHALL BE INSTALLED AND RECORDED BY THE CONTRACTOR PER PSE GAS OPERATING STANDARD 2525.2500* W1.. INSTALL MAIN VALVES OUT OF TRAFFIC WHERE POSSIBLE. VALVE MARKERS SHALL BE INSTALLED AND RECORDED BY THE CONTRACTOR PER PSE GAS OPERATING STANDARD 2525.2600 FOR ALL HP VALVES IF THE LOCATION IS NOT READILY ACCESSIBLE• AND FOR ALL VALVES WHERE PERSISTANT SNOWFALL MAY OBSCURE THE VALVE 80:1. 10. TO PREVENT ACCIDENTAL OVERPRESSURE OF ADJOINING SYSTEMS. NO TWO MAINS SHALL BE CONNECTED EXCEPT AS SHOWN ON THIS DESIGN UNLESS APPROVED BY APPROPRIATE PSE ENGINEER OR PSE REPRESENTATIVE. 11. SYSTEM MAOP DENOTED SYs S STEM MAOP -,A- PS-1-al 12- GAUGE AND MONITOR USE OF ALL STOPPERS TO ENSURE ADEQUATE FEED. 13- RESTORE ALL DRIVEWAYS SUBJECT TO OPEN CUT TO ORIGINAL OR BETTER CONDITION- 14- PURGE POINTS AND PRESSURE TAPS TO BE INSTALLED PER PSE GAS OPERATING STANDARDS 2525.3300. AND 2525.1200. 15- MAINS AND SERVICES SHALL BE TESTED AND PURGED PER PSE GAS OPERATING STANDARDS 2525.3300 AND 2525.3400. 16. IF METALLIC PIPE IS INVOLVED- COORDINATE INSTALLATION WITH CP TECH. Ila-.--------------------- 9 1T- NOTE ALL ACTUAL FOOTAGE• LOCATION AND MATERIAL CHANGES ON THE AS -BUILT IN RED- ( ) DENOTES FOOTAGE BETWEEN FITTINGS. GAS MAIN INSTALLA71ONMETIREMENT Type/Work Pipe Size Type Estimated length Actual Length anufacture INSTALL 2" MPE 80 -- GAtS .IV4ASIN PRESSURE Ni TE3TiNG TYPE TEST DATE ON PRESSURE TIME ON TESTED BY DATE OFF TIME OFF TYPE TEST DATE ON PRESSURE TIME ON TESTED BY DATE OFF ITIME OFF 4 Design Press 60 ISYS MAOP 45 PROJECT PHASE NOT IFtt ORDER# a o SAP Super i or Service/Meter Service/Meter Service/Meter Service/Meter Ind. Service Ind. MSA Dis. Reg./FT HP SVC/MSA Relocate Retirement X 03 99 107025382 106163992 Vicinity Map WORK SITE C) 244 TiI IEO N 20 TH 'N V 1 t20dTH ;T I N IV Owner / Developer Contact Info ARNON SUGAR 10229 244 ST SW. EDMONDS• WA 98020 office ATM: ARNON SUGAR 206-542-6585 COnVactor: CONSTRUCTION COST CODES: 051-1 33-1 PMPd Manager Cwftd Information: CALL (8 0 0) 4 2 4- 5 5 5 5 KIM GRAY 2 BUSINESS DAYS BEFORE YOU DIG CELL: 425-290-2678 THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF FACILITIES kIm.Oroy(apse.Ocm REAL ESTATE/EASEMENT PERMIT N/A EDMONDS REV# DATE BY' DESCRIPTION FUNCTION CONTACT PHONE DATE 3 PROJECT MGR KIM GRAY 206-418-4236 U-04-05 2 ENGR - GAS 1 DRAWN BY PHUONG DAO 206-418-4218 II-06-05 CHECKED BY J- SNYOER 206-418-4220 II-OT-05 v COUNTY SNOHO EWER SECT ItGAS WK CTR APPROVED B GRAY v 206-418•-4236 MCNSEG CP APPROVAL 1/4 SEC OP MAP PLAT MAP SW-36-27-03 164-062 167-066 MAPPING JOINT FACILITIES ARRANGEMENTS UTILITIES CONTACT PHONE# I\ P U G ET SAP Superior Older. #' SOUND (ARNON SUGAR) 1070253B2 ENERGY 2" MPE-IP MAIN EXT. Dom' WA m be 10229 244 ST SW. EDMONDS, WA 98020 SCALE: DESIGNED BY PILCHUCK CONTRACTORS INC. N Ln N 0 to - o_ 01 0 O N :3 N, L 0 AGE: 0 1/1