15907 70TH AVE W.PDFIIIIIIIIIIII
5511
15907 70TH AVE W
CITY OF EDMONDS
ASSET INFORMATION SHEET
LJ NEW
❑ ADDITION
❑ RETIREMENT
ASSET NO. sleq
ADDITION TO ASSET NO.
DESCRIPTION
SERIAL NO.
LOCATION Q ^
DEPT. NO.
* PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
* PROJECT NUMBER W l -5 07 s q
PROJECT COMPLETION DATE I 30-�T
COST !(0►X7
B.A.R.S. ACCOUNT NO. _ i dO0 ` O�y-- 3YS 'UdCp3
! ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
`SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
LJ DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
0 G.L. E
REFERENCE DATE
�YERIFIED BY
PROCESSED
BATCH NO.
b P INITIA
CITY of EDMONDS
SEWER PERMIT,
For Inspection Call 771-3202
STREET FILE s i o E
Address of Construction: 1�5
r
Property Legal Description (Include all easements):
PERMIT NO. 08010
Owner and/or Builder: , hI /4DAVS Ai C .
Contractor & License No: /9
Single Family Residence.}
Multi -Family (No. of Units )
ELyN WOOD IADIII�
Commercial (No. of fixture Units )
Invasion into City Right -of -Way: No Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LIST ON THE BACK
rtify that I have read nd shall comply J UN 91989 Date
wi h the items listed on the back.
PUBLIC WORKS
Permit Fee:?
Trunk Charge: Z -
Assessment Fee:
Issued By:
:Date Issued:.]
Receipt No.. ��'_ `7
Partial Inspection:
Comments Date Initial
Final Inspection Approved:
Date nitia1
00 o Rejected:
Reason Date nitia
b
a,
(n** PERMIT MUST BE POSTED ON JOB SITE **
°G White Copy - File Green Copy - Inspector Buff Copy - Applicant
The City of Edmonds
f
Side Sewer Drawing
EASEMENT NO. ............................................
NEW CONSTRUCTION REPAIRS ❑ LID NO- ------------------ ASMT. NO - ------------------
OWNER ------------------------------------------------------------------------------------------------ CONTRACTOR ...... ...... ---- PERMIT NO. Q-%PJ-0
1�
JOB ADDRESS A-S41-D-77 -------- ........ 4-! ------- LEGAL DESCRIPTION: LOT NO- -------------------------------------- BLOCK NO.------------------------------------
CA t) 0— 0, -3 To I
---------------------------------------------------------------------------------------------------------------------------------------------------------------- -
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
LLY N =NW OO D =Ll LINE
E
Az %
Lplpue- 6-10 'RIT),ce-M
F
N4.
SIT
NO, alp t+' io'e't o ;L, IL
3
bile- elo 13 Del
Approved: IN
1\1
PWW-0001 -11/75 (REVA 1/78) — DATE `�{0..=-C ....... .. ( -------------- By (,-I/! ---------- ....................... ..............
3 V
• 4,J
.l;i •,�.. o ,P 'B .;Aye �
y. f,y Y
x
u
N
bl6 I -
3�0
I
375�2 GESCkJI��I
R� W CF LOT V7 Mruolraus
r ekm i r+e me V4 sw
• , � ---- - I I poi -to Tic Ave 4.
SA; ibi
�-
_di �z
Wau1r Cau i
L\ \ I 0 37si37[c3tz;;7c:1495= 4s 3T3.1S
� .L laup;:ri
r-7 Aerurr 59B.7s'
! De 7VITAJ A r� vAJ,�
3To' .�i
i �o •
bv
4i.
r
.. .'! �, r, � rl 9i,gJ Pi"C cca«w �' irA'_�•1�i6•
IlD -lorAavrll.
Ill -' ' DETEN 1
Ij PPEI>,
CATCH
i3TLS I N
� r )1 CETENTION Pt
N WORKSHEET
' I 1' MIN 2' M4X COvER I
LI 1%t SLOPE.
SYSTEM CROSS SECTION
CON-11l CATCH
BASIN 7
OUTI-Il
CONTR;51
TO OUTLET
�N PRAP OR
RUNOFF
SPREADER) ..
T'll TW cam- P►Pfi. 'l 'ff" . �"c.4 6",l 1
7 T
r.
2' a 2' a (D" DE=P. Alt & S;l (oa roue)
7,N 7'• 2' 3" DEEP, '_ CRUS14ED ROCK
OL
RIPRAP OUTLET
WASHED GRAVEL OUTFLOW TRENCH, MIN 10' LONG,
TOP 4 4" PERF P' PE Tp BE LEVEL
FROM , 'I
OUTSET
CONTROL
4" PERF PIPE WITH CAPS
RUNOFF SPREADER OUTLET
STANDARD DRAINAGE PLAN
DETENTION SYSTEM
for
location_
plan by
phone. o
date
DESIGN DATA
System Imperm Pipe Pipe Orifice
Number Area g Diam Length Diameter
/0
0
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Material
accumulated in the storage pipe must
be flushed out and removed from catch
basins to allow proper operation. The
outlet control orifice must be kept
open at all times.
Page 9 of
CITY OF EDMONDS
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
I )8 N (_ �A
MAILING ADDRESS
19 22
CITY TELEPHONE NUMBER
U
USE n
ZONE
PERMIT
NUMBER
JOB
ADDRESS -1-2
_EGAL DESCRIPT N CHECK SUBDIVISION NO. LID NO. y
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP
APPROVED BY
EXISTING .__ REQUIRED DEDICATION
PROPOSED-c-6? _
(�. �♦ (j 6 _ .. Qc.{ / RIGHT OF WAY CONSTRUCTION PERMIT REQUIRE
w ADDRESS STREET USE PERMIT REQUIRED,
IC1(,0 t 3f ��
= SEE ENGINEERING MEMO DATED
U
a CITY / TELEPHONE NUMBERy
�Y6 Z2 0 q REMARIjS
NA
,_ A
ADDRESS
CITY I TELEPHONE NUMBER
STATE LICENSE NUMBER
Legal Description of Property - include all easements
(show below or attach two copies)
LtJ 31 mea&
CNEW ® RESIDENTIAL
PLUMBING
ADD/ALTER
COMMERCIAL
MECHANICAL
REPAIR
11 APT. BLDG.
El SIGN /
El DEMOLISH
REMODEL
EXCAVATE
OR FILL
CARPORT
GARAGE
FENCE
( x FT)
SWIM
POOL
❑ WOO STOVE/
INSERT
ROCKERY WALL/
RENEWAL
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
NATURES OF WORK TO BE DONE (ATTACH PLOT PLAN)
G
METER SIZE IBUILDING SUPPLY SIZE IFIXTURE UNITS
REMARKS
SIGN AREA ENV. REVIEW ADB NO.
ALLOWED I PROPOSED COMPLETE I EXEMPT
SHORELINE p
VARIANCE OR CU IPLANNING REVIEW BY I DATE
O
Z
w
Z
Z
w
SETBACKS — FEET LHEIGH LOT COVERAGE _z
FRONT pS SIDE d r REA m� , Z
REMARKS g
CHECKED BY TYPE ONST RUCTION CODE HEIGHT
� _� lq5 S '
SPECIAL INSPECTOR AREA OCCUPANCY OCCUPANT
REQUIRED GROUP LOAD
0 YES C NO
REMARKS
PROGRESS INSPECTIONS PER UBC 305
70/YRPZ��
VALUATION 1 FEE Im
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
STATE SURCHARGE
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year • Provided Work is Started Within 180 Days
ENERGY CODE
"Applicant, on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
J harmless the City of Edmonds, Washington, its officials,
2 employees, and agents from any and all claims for damages of
iwhatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
omodify, waive or reduce any requirement of any city ordinance
TOTAL AMOUNT DUE
x nor limit in any way the City's ability to enforce any ordinance
provision."
I hereby acknowledge that 1 have read this application; that the
information given is correct; and that I am the owner, or the duly
ATTENTION
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and in doing the work authoriz•
THIS PERMIT
AUTHORIZES
ed thereby, no person will be employed in violation of the Labor
ONLY THE
Code the State of Washington relating to Workmen's Compensa•
WORK NOTED
tionlrisIlirance.
INSPECTION
DEPARTMENT
IGNATU E (OWNER OR AGENT)
DATE SIGNED
{hu-1-t. fil V_ /_,/
CITY OF
EDMONDS
AT ENTION 771-3202
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
102.87
aov. ao ldd93
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his
Deputy; and fees are paid, and receipt is
acknowledged in space provided.
OFFICIAL'S SIGNATURE DATE
RELEASED BY:
DATE
ORIGINAL — File YELLOW — Inspector
PINK — Owner GOLD — Assessor
0
Z
s
m
PRO,= REVIEW CIMMIST
S PRQTDCT ADDRESS:
Reviewed by: (initial/date)
COMMQm
PLANNING
WTR/SWR ISTREET M- Iw C,
FIRE
13UIIDING
/%///
///j/%%
1/////////
Sn=Z FAMILY/MULTIPLE/CoMMERCIAL - (Circle One)
SETl3AC1CS CROCKED - Planning
11111171
7T/-///777-7
vARLmCE/SFTRACK AW.
/////////
////////
//////////
1
111111177
Cf)NDITIONAL USE. PERMIT
//////
/////////
//_//////
//////////
---
/ // /
ADB REQWIREMEWS CHECKED
//////
/////////
////////
//////////11
/
1/ / T
7T7/ //l/
OTHER ZONING REQUIROTS
ENVIRONM¢MAL FEMURES
//////
/////////
////////`
ACCESS SLOPE & VEHICLE ACCESS
�5
/
/1/1//
PBBt
C
DRAINAGE
_GE PLAN (On Site)
Yr Y-77TR77TI771111
SILE -�-'
STREET F
_
//////
/////////
/////////
////////
8
//
_
LJr.AL DF5C7t MON VERIFICATION
//////
/////////
/////////
////////
9
/t //
///// /10
QUIT CLAIM/DEDICATIONS
��1
//// 77
EASEMENT - PUBLIC/PRIVATE
/////////
/////////
////////
11
W-
CAMRATE SER CONNECTION IF NO LID# /0
//////
/////////
/////////
////////
12
FIAT/SUBDIVISION REXIUIREMSEKt'S --'^
//////
/////////
////////
13
RTGIfT-OF-WAY CONSTRUCTION PERMIT READ
//////
/////////
/////////
�G�
14
77777T//
/
/ / /
/ //
M) I< READ mi PUBLIC IMPROVEMENTS �
//////
/////////
/////////
////////
15
:AIIS CONDITTONS & GROUND
111%17/-`%j`
/
WATER FIEID CHOCiCM
//////
/////////
/////////
////////
16
S'PREEP PAVING REQUIRED
/////////
/////////
17
_//////
CURB AND GI1PI'ER RDQUTR®
//////
/////////
/////////
/////// //
18
STDE.WALK REX,KJIRED
//////
/////////
/////////
19
o
/
��'(1
/
CURB CUT M-11 DRIVEWAY READ
//////
/////////
/////////
//////////
20
RIP
STREETSIGN REQD
/////////
/////////
//////1///
21
111177111
/ /
'
MER_T( ING READ
//
// //
/////////
//////////
22
AR SIDE SEWER AVAIIIL.I'TY
//////
23
TfflffEXISTING
_
��
WrER MATN SIZE
'// /
/////////
////////
/%%%%T%f%%%
24
'
/ /
/ 7777
////
// /
WATER METER SIZE f' 1
/7
25
:!
7 rf/7
J%R1
SERVICE LTNE SIZE
//////
/////////
////////
//////////
26
HYDRANT REOUIRID
/////////
///////////
////////
//////////
27
//
HYDRANT SIZE EXISTING
//////
//////////'T
////////
///////I//
28
1/
-17777
CROSS CONNECTION INSPECTION REQD
//////
/////////
////////
//////////
29
777T/7WATER
//
METER CHARGE REM
//////
/////////
30
—
/ /
/ /
FIRE LINE CHAME READ - SPRINKLER
11111141,//////////
31
STREET CVT
//////
/////////
t
//////////
32
OPEN DITCH EXISTING
777777
//////
/////////
/////////
33
111117
/
—
RD4D
l/////
/////////
/////////
34
/ ///
/ /////
_
CULVERT READ
//////
/////////
/////////
35
/ // /
SIZE
//////
/////////
/////////
36
171111
/
/ /
CATCH BASIN REM//////
/////////
/////////
37
/
/
INDICATED ON SITE PLAN
//////
/////////
/////////
38
SHOULDER DRAINAGE MAINTAIN
/
/// -F17:*
SHALE OPEN RUNOFF
//////
/////////
/////////
39
77T/-/-/T/77////////
MISC:
/////////
1////////
40
_ 1989
7INORKS
REVIEWED BY:
PLANNING MGR. ENGINEERING MGR.
PUBLIC RK)RKS MGR.
S 1A L.> a iv is loin
omen
ortion 0
in the NE
Lee
37, Meadowdale Beach
SWI/4, Sec. 5 (27N-4E)
Tax Title__� I
Slaughter
370
NOTE: Site is
uniformly wooded
with approximately
35-40 trees 8" to
24" diameter.
—...—Building Setback Li
1L
I
390
Scale.: I"=40'
Nov. 11, 1988
Thorsteinson I Zone: RS-12
re Hyd 2
228.s
Li- I 11—W ',7107.37
43'. 59"1
ci
324 01
SS.
'7
C
0-61 �Ss
Orl ginai Lot Line
L:
X
fl
.iz
11-t! Line I Rn
West Line Lot 37
Ca SSM
Wittmann %%
Mulf ord NE L S.
10— WO
8
6
CD
U V4tLAN4Sv
SOUND sunvr_YTNO TNC
22727 Highway 99, Suite 110, Edmonds, WA 98020 (206) 778-1556
C3
P
,• f , i7
City of Edmond Permit No•
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date:
A. Address or Vicinity of Construction: ® � � - �� "�� �- LA-1
Type of Work (be specific):,
State License #: " ' - 79 'S -
City Business License #:
D. Building Permit # (if applicable):
Contact: A e/✓"n
Phone: YZ5 1
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable
E. ❑ Commercial ❑ Subdivision ❑ City Project EUC (PUD, VERIZON, PSE, COMCAST, OVWSD)
❑ Multi -Family ❑ Single F�n;iily P I Other
INSPECTOR:
F. PAVEMENT CUT: ❑ YES ' ❑ NO G. SIZE OF CUT X
CONCRETE CUT: ❑ YES ❑ NO
G. V Mail Approved Permit ❑ 'Call for Pickup
APPLICANT TO READ AND SIGN
INDEMNITY. • Applicant understands by .hislher 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 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. 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 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 OR INSPECTIONS
Signature: - s Date: 0 15
ontractor or
Approved by: f a le
Time Authorized , � oid After
Conditions:
W
REQUIRED INSPECTIONS:
FOR CITY USE ONLY
Right-of-way Fee � jt, ✓
Disruption Fee/Fund 111:
Inspection Fee:
Total Fee: . (0 „
Receipt No:
.— Issued by:. -
Call 425-771-0220, Ext. 1326 for a 24- ou vo' c �d+o
FINAL APPROVAL OF PERMITTED WOR c c`
Inspector's Sig
request line.
DATE: 5/4�
CADocuments and Settings\CunisNy Documents\Forms\Engnmg\ROWpermit_doc Revised 10/01/03
40
w
W)
15907
MM
00
RIGHT-OF-WAY CONSTRUCTION PERM
AND INSPECTION REQUIRED KW
00
70t" Ave W
Comcast of Bellevue, Inc. pole
1525 75th Street SW
Suite 200
Everett, WA 98203
Contact: Kermit Benson 425-263-5362
North Drop
Node: EM 05A
15907 70TH Ave W - City of Edmonds
Open trench in shoulder
of ROW of approx 20 ft,
bore roadway 24 ft, and
set carson to extend and
bury CAN service drop
A
AWT
BY ENGINEERING
Work Details
Open trench in shoulder of ROW for approx 20 feet (m/I) and bore roadway approx 24 feet (m/1) feet and set carson to
extend and bury CAN service drop to 15907 70th Ave W. Install cable at 36" depth.:
All disturbed areas will be restored to existing or better conditions.
Backfill material will be mechanically compacted to 95% of maximum density as specified by the City of Edmonds. In tight
corridors hand trenching will be utilized to ensure protection of other utilities. Contractor must locate all existing utilities
impacted by this project.
Please see attached plans for restoration, erosion control and traffic control. Erosion control will consist of placing filter
fabric fence and/or sandbags along curbs and catch basins where necessary. Keep.drainage system clean and
functioning. Remove all debris from the work site. Streets and roads will be cleaned both during and after installation of
work.
Ccomcast
PROJECT'S TIMELINE AND PROPOSED HOURS OF OPERATION:
• Timeline — Up to 30-days past the issue date.
• Work Hours —The entire project area will be conducted from 7:00 AM to 7:00 PM or
as specified by the Inspector.
Traffic Control Plans
1. The standards and guides of the latest version of the MUTCD or as set-up per
Code shall be followed at all times.
2. A copy of the Permit and Traffic Control Plan shall be on -site with all
contractors during the project.
3. All contractors will avoid parking on sidewalks and shoulders and will take the
lane and follow the proper traffic control set-up for the given situation.
4. Pedestrian access shall be maintained through or detoured around all work
sites.
5. Please find attached the traffic control plans for the various types of work
sites that will be encountered during our project.
6. Flaggers will be used only when all other methods of traffic control are
inadequate to warn and direct drivers. Only licensed flaggers will be used on
the project.
7. If situations occur when questions arise about proper traffic control set-up the
solution will be determined in the field with the Comcast Construction Rep.
and the Inspector.
Erosion Control:Rules
If curb and gutters in project area:
• Filter bags will be placed in catchbasins downstream of work site, and
• Small check dams of pea gravel filled sandbags will placed within the
gutter upstream of the catchbasin.
Traffic control set-up for minor encroachment
.001
JJeurnlOoJ
Traffic control set-up for lane closure
ftAGGEa STATION
Depth, Cleaning, Containment,
Compaction, and Restoration
7 4 1
Depth =
♦ 36-inch minimum
♦ Compatible w/
other utilities
♦ Shoring required
at 4-ft +
Pavement Cuts =
♦ T-cut 1-ft wider
than trench
♦ Neat -line saw -cut
or jack hammered
edge
♦ All trench backfill shall be mechanically
compacted to 95 percent of maximum density
using 1-ft loose lifts with whacker or 2-ft loose
lift with a hoe pack.
♦ If proper compaction cannot be achieved with the
native material, new import material is required at
the 95 percent rate.
♦ As an alternative, CDF can be used in a design
mixture approved by the Engineer.
ccomcast
CLEANING: All Streets and roads are required to
be cleaned and swept both during and after the
installation work.
♦ Mechanical Vacuum is preferred method
CONTAINMENT: All un-restored shoulders or
material storage areas are required to be contained
with reflective barricades.
All disturbed areas shall be restored to
existing or better conditions ! ! ! t t t t
Trench parallel to road:
♦ Shoulder - Match existing surface conditions
♦ Pavement - 6 1/2 inches of crushed surfacing material
and asphalt concrete Class B at 2- inches minimum or
same thickness if greater..
Trench across road (immediate cold mix patch):
♦ Asphalt - Permanent hot mix patch at same thickness
or 2-inches and sealed within 30 days.
♦ Concrete - saw cut and pored with mastic joints, eight -
sack mix, either type II of III cement, within 30 days.
z
V--
tACT,
370
lo I
37 8 -
I
SF /J.g�� �/�r/�s
1s9o� , o `� 141
MAR 15 P'E%'n
PERMIT rOUNTER