17914 73RD AVE W.PDF111111111111
5746
17914 73RD AVE W
Cit of Edmonds
"Y
-OF-WAY CONSTRUCTION
RIGHT
PERMIT Permit Number. '?6"
Issue Date:
A. Address or Vicinity of Construction: 17QJ 4 7.1rd Ayp. W
8 9 0 _'J C� B. Type of Work (bespecific): Replace depreciated pole
C. Contractor: Snohomish County PUD No. 1 Contact:
Mailing Address: pf) Rny 11Q7 Fvprptt, Wash Phone:
State License #: 98206' Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. F1 Commercial E] Subdivision 0 City Project )0 Utility (PUD, GTE, WNG, CABLE, WATER),.,,
Multi -Family EJ Single Family r] Other
INSPECTOR: I INSPECTOR: V,.Vt'tQ-4r,\
F. Pavement or Concrete Cut 0 Yese'E]No_) G. Size of x H.—Charge $1
Cu
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agreed to hold the City ofEdmonds harmless fywk &Jui-ies,'damageB, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be ma_de against the City of Edmonds, or any Of its departments or
offrantingthispermit.
employees, including or not limited to the def6nse of any legalproceedings including' defe '�osft' and attorney fees
1 6y. —.2.
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 TIMEA DEBIT OR CREDIT WILL BEPROCESSED 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 is to be inspected during progress and at completion.
Restoration is to be in a&ordaii��. with,,City Codes.
Street shall be kept clean iUt �11 time's.t, AI I -
Traffic Control and Public Safety shalibe iii accordance with City regulations as required by the City Engineer.
All street cut ditches shall be pitched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and unders tand.the permit requirements and the pink copy of thepermit will be
available ons - e t all times for inspection pur-v?ses.
Signatur��11.0'. Date: 1111 Y 16, 1996
ntractor or A6")
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY U SE ONLY
APPROVED BY: _1,& 111VIACA4 RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER OW6 30—DAY S DISRUPTION FEE/FUND 111:
SPECIAL CONDITIONS: BU -QA _M HAV4, �_,RESTORATION, FEE.:
PERMIT FEE:
A A" 3 6 f
TOTAL FEE:
COMMENTS: RECEIPT FEE:
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments:
I Diagram.:
CONTRACTOR CALLED FOR INSPECTION El YES NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
DZD
. COF D
1476 - " ' "' Rev. I ?J94
IOc,�T'6� -1 -7 j / :f
SNOHOMISH COLDM PUBLICUTILITY DISTRICr No. I
kE IM
-73PO Au j", Ry 9�3 0 -26
�f 0 AREA
POLE #
1/4
S 8 T-�-? R!!�
DATE -7- ] 0
W.O. # -Z '�
REASON FOR WORK
ENGINEER,—). rV),pek
DWG. # 3 6 1
Pf- yo L f�'4
V,- ),4 Cow
Lis C f
a,*),vT
DRAFTER
U.G. #
DATE WORK COMPLETED
FOREMAN
SCALE
DATE PRINTED
I APPROV
FEES REQUIRED: ENVIRONMENTAL ANALYSIS
Z EXEMPT 0 NOT EXEMPT
Q YES �NO I PARA. 18 ITEM C
PRIMARY OVERHEAD
"'M "y "JV
O.H. U.G. COND.
KV
0 RESIDENTIAL 0 COM CIAL
ADD -C !9�_
PH
LEO
REM C�KT. FT. -PH
NET Fr.
CKT.
SECONDARY PVERHE�J�--_'-_
O.H. U.G. COND. -
. - KV
BASIC F $
$
ADD_CKT
REM Fr.
PH
PH
METtil/CONV. POLE, s
NET CKT. FT.
PRIMARY UNDERGROUND
0 RESIDENTIAL -0 COMM IAL
PR
RE
MA
S D
R
E_
Y
I _UN_DER9R
I
OUND
NTI �� _'3 Co'� IAL
BASIC F $
L U #
EU#--_
$
$
SECONDARY UNDERGROUND
6�SIC FEE - $
UNDERG.ROUND PLAT
-- 'N,,,BASIC FEE $
s
STREET-LIGHTI G,'
$
*dFtk'k_RIGHT-o�-wA*
• PRIMARY
• SECONDARY
oft @ $ $
MISCELLANEOUIFEES
ULT $
P RMIT $
$
T(#AL DUE: $
DATE PAID
RECEIPT #
NEW SVC AALIC.
PERMITS
0 TREE TRIM
0 STATE
0 COUNTY.
)�CITY
(DATE GRANTED)
EASEMENTS-
0 REQ . UIRED -ANOT REQUIRED
DATE RELEASED
SUBSTATION 1:'kKpl I'v L.,l 1E
CIRCUIT NO. Z_ PHASE
�&4F_Mj,4 71',r.,
FOREIGN CONTACTS
NW JPN #
CATV JPN J
• INT TRENCH GTNW & CATV-,'-
• jOINT BORE GTNW &-CATV--,-
POLE STENCILING
FROM
TAKE OFF-POICE-
PRE-CONSTR. REQUIREMENTS
• TREE TRIM 0 PUD LOCATOR
• BACKHOE AFLAGGING
�ONE CALL -DATE
a
LOCATION MAP PAGE -9 5 5 - 11 -
31 3 -1 5�
3e&--
2-90 -
N- 2 503 --K
IY-J 70oz-
M
7- Fo
—TAI s r- �7oP) IZ F 2-0 r—,O 16 z
2-5 Kvg /Y- -?O�5g-x
xr)R 5-7 k;T-E 307-2
5-rpl,IQ To' -5,4eqri>ojv Pvj-a
N
F*I-
SNOHOMISH COUNTY PUBLIC UTILITY DISTRICr No. I
E -q:D
j �10EU
1476 .Rev. 12/94
PREL!MlNARY._.-._
LOCATIO� ):2 j J:f
? 3,90 AUC �v
AREA
POLE #
1/4 Sp T�L-? Rn
DATE
W.O. #
REASON FOR WORK
-
ENGINEER rV),pck
DWG. # 3 6 1
_akdLgo
nC M ('o W a,4 1,,v
DRAFTER
U.G. #
SCALE
DATE WORK COMPLETED
FOREMAN
FEES REQUIRED: ENVIRONMENTAL ANALYSIS
U YES NO 0 EXEMPT 0 NOT EXEMPT
I PARA. 18 ITEM C
PRIMARY OVERHEAD O.H. U.G. COND. — KV
0 RESIDENTIAL U COM CIAL ADD CKT._ET�,_ PH
LEO RE C. D. FT. PH
NET�_ CKT. Fr.
SECONDARY _0VERHENX,-__'
BASIC F $
$
METER/CONV. POLE. _- s
PRIMARY UNDERGROU�Ng,,,"
0- AE*SIDE-NTI-A,L---,U,"--C*-OM-�---�IAL
. ZBASIC F $
LEU #
@
SECONDARY UNDERGROUND
B�SIC FEE - $
$ $
UNDEIkC-
offt. @
IUND PLAT -
BASIC FEE $
s
STREET-LIGHTIO
-As
WbRk IN RIG AT
Cl PRIMARY
USECONDARY
oft @ $_
$
MISCELLANEOUS FEES
V, ULT s
P $
MIT
T(#AL DUE: $
DATE PAID I
RECEIPT #
NEW SVC
O.H.U.G.COND.—KV
ADD PH
_CKT -
REM:::;;��� . FT. PH
NET CKT. FT
PERMITS
• TREE TRIM
• STATE
• COUNTY.
*ITY
0-
EASEMENTS
0 REGUIRED
DATE RELEASED
(DATE GRANTED)
ANOT REQUIRED
FOREIGN CONTACTS
2 TNW JPN
N
u JbINT TRENCH GTNW & CATV
UJOINT BORE GTNW & CATV_____
APPROVED I DATE PRINTED
SUBSTATION jg:_i-jf9)lv L"OlE
CIRCUIT NO. I-,) - 4) Z_ PHASE ):) 2-
/Y H
a T
z I
-rd v
6&4 9
�4F_M 4 -ri'C,
0 __ 1 '317 --�3 IS'
POLE STENCILING
FROM
TAKE c)FF_POCE_
PRE-CONSTR. REQUIREMENTS
0 TREE TRIM 0 PUD LOCATOR
UBACKHOE AFLAGGING
ONE CALL DATE
LOCATION MAP PAGE !fl 'i 5 - 11 -
3eg- 1/67 C,5ki-
z go - 0 1 n. t2'9'r" F
- 7(� ! 9 -1�1
503
CT
36"111 15-t 5, \W
M
I
Z F
2-5 KV4 /Y- -?65g-x
xr,R 5-7 k;TE
1,10 To 46>14 PL-D a IV P67LF- /0
7
' 1
, 3-89
0 0`76PREDEOFI FILE
CITY OF EDMONDS
200 DAYTON ST. - EDMONDS, WASHINGTON 98020 - (206) 775-2525
DEPARTMENT OF PUBLIC WORKS
July 29, 1980
Mr. Ron Harper, Manager
Snohomish County P.U.D. District #1
21018 Highway 99 South
Lynnwood, Washington 98036
COPY
HARVE H. HARRISON
MAYOR
Dear Ron:
SUBJECT: STREET LIGHT VICINITY OF---1791-4 -73RD AVENUE WEST
The City of Edmonds hereby authorizes the light in front of
the following address to be turned on:
1791-4 73rd Avenue West
If you have any questions regarding this matter, please contact
me at 775-2525, extension 220.
Sincerely
�J S E. ADAM P.E.
a I
�C'*iyvSEngineer
JEA:jky
STREET LIGHT REPAIR REOUEST
TO: Service Department
Snohomish County P.U.D.
21018 U.S. Hwy 99
Lynnwood, Washington 98036
FROM: (City)
(Dept.)
Street Light Location:
1 -1 - i ') 7 1! — -, � �17-- �- —
Date
ROUTING PROCEDURES
1. City keep pink copy and send remaining two
copies to PUD.
2. PUD Service Department "log" order and give
order to crew.
3. Crew return completed form to Service Department
who will keep white copy and return yellow copy
to the city involved.
Apparent Problem:.
Lamp Out El Broken Glassware El Damaged Fixture F-1 Lamp Burning Continuously El
Remarks:
1980
Conditions Found:
Lamp OutEl Broken Glassware Damaged Fixture 0 Faulty Ballast El Faulty Photo ControlEl
Lamp Size:
Fixture Cleaned: Yes— No
Action Taken:
W
234-1 Worked by: Date F
V., I ... ..
V.
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X-IM ...... ...........
CITY OF EDMONDS
PUBLIC WORKS DEPAR9;No FOR INSPECTION CALL* Ormit N? -.6282
775-2525 Ext. 220 Issue Date
SIDE SEWER PERMIT
PERMIT MUST BE POSTED ON JOB SITE
077 71r
1. Address onstruction 1-7c714— 23 LA) 9 S'O ?_6
2. Property Legal Description (include all easements) L611y'lew Frnt
3. Single Family Residence Multi -Family No. of Units
Commercial
4. Qwae*—afHWor Builder
5. Contractor& License No.
6. Invasion into City Right -of -Way: No Yes (If Yes Right-of-
way Construction Permit Required - Call Dial -Dig (342-5344) before
excavation).
7. Cross other private property: Yes NoLZEasement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain a permit to install side sewers on
their property. A licensed side sewer contractor must be employed to
construct side sewers in the public' right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year *
c. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
d. Side sewers may not be installed closer than thirty inches ('30")
to any structure. 0
e. Side sewer lines must be laid at a minimum grade of 2% (1.15
and maximum grade of 100% (450).
f. No turn in side s8wer greater than.450 (1/8;bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. T6q� (2) working
days notice required.
I M
L21-7
)ATE:
-1 hat I halv-e read
and sha N 11 comply/laith the above
L j Cs;� V
PERMIT FEE: Z_IPS�� � , DISAPPROVED BY: Date:
�4 Nz�� I I
UW By: -Date:
In CONNECTION FEE: )CAAR APPROVED By-.. Date:
04
0
Pk - * PERMIT MUST BE POSTED ON JOB SITE
Th,d -Cityof Edmonds
Side Sewer Drawing I
EASEMENT NO . .......................... ..............
NEW CONSTRUCTION REPAIRS Fj LID NO . ............. .... ASMT. NO . ..................
OWN,xk -------- 5-VL-�-Kl-C - — -------------------------------
JOB ADDRESS --- -------------------
PWW-0001-11175 (REV.11/78)
CONTRACTOR ---- ....................... PERMIT NO.
LEGAL DESCRIPTION: LOT NO. ---- 4 ----------------------- BLOCK NO - -------------------------------
..................................... ............................................................................................................................
NAME OF ADDITION ------- ....... Lt�?ul.:.K.T.V:at-4 .............................................
0
0
Approved:
I/ \� V "', ;
DATE... ................ B y ................ 1) --------------
'DR E, - DMONDS.—II..-
CITY FTX
N_�PECTION:-CA
TPIEN
a
T C. t
_'Vermi
��qwgalc LWI,
775-2525 E x
Issue Date 7 1
low
--JOB SITE
O.S.T-ED-..ON,
_XA
Pv-e--- 1A)
7n �7j-lil �7
Des.crip lo* men 4111 %]'I-CUJ
't' n Unclude'4d.&,�, s,!:-"-". t J
S),
s M
1--No.of- Un i ts�
e Family �e idence.
CO3mmerc.3:a
Qwmer— . a.nd-/or* Builder' R did ok
5. Con -tractor & License No. R U P S Z 9
6. Invasion int6 City Right-of"Way: ..'No� V,: - Yes (If Yes Right-of-
way Construction Permit.Requiried Call -Dial Dig,(342-5344) before
excavation),.
E-1 .7'. Cross other private property: Yes Noz.,#.�'Easement' required'_.
attach legal description and county easemdht-number.�
READ.-tHE POLLOW-T,.NG AND SIGN:
P4
.4 a.'. Property owners must obtain a -permit 'to' install' side'sewers on
>4 their proper,ty A licensed.side 'sewer�contractor must be emplo' edc''to'
Y.
construct.side sewers in the public'.right-of-way.
bi. The side sewer contractor assumes full reponsibility for each'
installation for*one year..
��-4 c., Commercial establishment requires a minimum of a six inch W!)
P4 side'.sewer line.
.0 d. '-Side sewers may not be -installed closer than thirty inches 00")
to any structure.
0
e. Side sewer lines must be laid a.t.a minimum grade of 2% '*(-1 15
and maximum grade of 100,% (450).
0 0
E-1 f. No turn in side s8wer greater than 45, (1/8.1bend) is 0 alloWd
between,cleanout. All 90 turns must be constructed of a 45 (1/8
bend) -and wye,with removable cap.
... -g. No'down spouts,'f oating drains or floor drains can be, connected
to. -side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than -granular soil.
il. Cleanouts are required at 30"-60" from',each plumbing exit line
an - d at*.minimum.intervalls of 100' along sewer.l.ine.r.un.
j. Trenches -within Qityltright-of!--way must be restored to original
-for right-of-way failure
conditions., Contractors shaft -'be responsible.
due.7-to poor compaction of fili%-.
k�-_ Side sewer must be left -uncovered' until inspected and approved
by the City.
Inspection during normal working- hours only. T� (2) working
days notice req.uired
�7 4)
J;,4
ead
rr,'_-_��T-7t!�Frtify//that I h,ave r
".: 'and shall comply -With the above
-PERMIT FEE: DISAPPROVED BY: Date:
By: Date:
CONNECTION FEE: kA-9. APPROVED By: Date:
.0
PEPM IT MUST-, BE, PQSTED� ON JOB TE