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18812 89TH AVE W.PDFIIIIIIIIIIII 8562 18812 89TH AVE W AW4 Date: To: From: Subject: MEMORANDUM I October 3, 1997 CIA k Jeannine L. Graf, Building Official CIA 0 Ann Bullis, Plans Examiner 9_1� �O Alternate subfloor material for proposed deck at 18812 89th Ave W _�_ The applicant of the subject permit application is requesting approval (per UBC 104.2.8) of Trex Composite Lumber. a recycled wood -polymer product, to be used for their deck subfloor. Attached is the product test report by National Evaluation Service (NES). In section 7.0 of the test report, NES finds that this product complies with the requirements of the Uniform Building Code and provides Span Tables for the product for decking only. All structural members made of this product (e.g. joists, beams, posts, guardrail, etc.) require engineered load calculations. However, the subject applicant is requesting to use this product only for surface decking. Based on the above information, I recommend approval of the product for use as decking subfloor, following mfg. recommendations and NES installation requirements, placing the 5/4" x 6" decking on wood joists spaced minimum 16" o.c. for the above noted project. Alternative Material X Approved Denied Comments: lo-3-1-7- Date City of Edmonds czR Planning Division CITY.OF EiD,"VIONDS BUILDING D-PkiRUMZNT.�. WORK -j CM"AL P C I T N U Ll D E R I q 7 -50,5 *P A 0;& A to n 1993 v imu EFFECTIVE 7-1-93 ............... ZONE SETBACKS: SIDE REAR Z� OTHER HEiaH'r No POVIONM 11;4A VOW-4. *4toltrA ats 4=rr It St 'Any request. for Todification, var -adm* I istritive deviation (hereinaft must be specifically caBed out's L4 . V, I Approval of any - plat or, ple 4irovi I sions-.-w.hich do I ;nd for which a variance b specifically identified, requested 8 I by the appropriate city official with, the appropriate provision o state!,-I-a-*—,d—oe�—no—t.App.rpy� ��It� speckfication. T-LOT F SC� I-W 514 x (C)" NI (;ROV ,h 141 GeP-26-19? FRI 15:4e ID: TEL NO, #391 P02 STATE OF WASHINGTON DEPARTMENT OF FISH AND WILDLIFE isoio U11 Craak &alsvard P M4 Creek, Washft7gbn 99012 v (206) 775-1311 PAX (206) 336-706 SepEember 26, 1997 Jason Tourtellot City of ]Edmonds PlAtMWS Dept, 121511 Avc. N. ]Edmonds, WA 98020 RE; Dave Peterson's deck repWement project and pogsible impacts to a known Bald Eagle nest. Dear Jason, This is a follow up to a voice mail message I left for you today, Thank you for the opportunity to review the above application. I do not bclicyc the rcplac=cnt of an existing deck will have any significant impact to the eagles or their habitat. I have spolcen with Mr. Peterson and no trees will bc removed. The lot is > 500 feet away from the nest and the eagles have already started to head north for the winter. Therefore no management plan or conditions will be requestcd by my departmcnt. Please call we (425) 379-2301 If you have additional qucritions, Sinoersly, --6 Steve llq,� Wildlife BioloSW CA FILE NO. L__T I Critical Areas Checklist -------------------------------------------------------------- Site Information (soils/ topography/ hydrology/ vegetation) 1 . Site Addi�ss/Location: 18 12> 12- 7- 2. P overtv Tax Account Number: Aftt__;;MV 3. Approximate Site Size (acres or square feet): 4. Is this site currently developed? ; yes no. If yes; how is site developed? 5. Describe �.he general site, topography. Q�eqk all that a ply. AU10i 2 7: 19,97 Flat: less than 5- eet elevation change over entire site. Rolling: slopes on site generah � 1 th 15 % (a vertical rise oflo-folwyPhTy swid y ess an horizontal distance of 66rfeet). Hilly: slopes pT�§pnt on site.oi "more than 15% and less than:.30%..( a vertical nse of ': iO�.feet over a h6Azontal distance 'of 33 to 66,foet)- *�P�::. grAdes:,.'., 4 ueater -thar0'0% present on.,s.ite (a vetticaLlrise of 1 0-feet over 33-feet).. a horizontal distance.of less than Other-i'(Wease describe): 6. Site contains areas of y6 a r*7-round st*44pg w ater: ;A prox. Depth: p 7. Site contains Areas of season�d. standing W'Ater: A:p rok. D6pth:' p What season(s) of the year? F, 8. Site is in the floodwav-_&.0' floodplain' of �a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are %] i.. year-round? Flows are seasonal? (What *me ti of year? 10. Site is primarily: forested meadow ;shrubs mixed urban landscaped (IaWnshrubs , etc) 11. Obvious wetland is present on site: For City Staff Use Only— .7 l.. .'Site is Zofied? ::2. SCS ma ped so p il.type(s)? C,,,Avc 2- ::3. . We.tland inventory or C.A. map indicates wetland present on site? �Vo 4. Critical Areas inventory or C.A. map indicatesCritical Area on site? 5.' S ite within designated earth subsidence landslide hazard area? //9A 'Site design aitedon the Environmenf�'lly Sensitive Areas Map! IV* ::DETERMINATION STUDYREQU= CONDITIONAL WAIVER WAIVER Reviewqd by: 7�5 - I . Z Planner 6ate Aca_chk.doc; Rev 07/11/97 City of Edmonds Critical Areas Determination Applicant: John Cashman Determination #: CA-97-172 Project Name: I Permit Number: I Site Location: 18812 89th Ave W. Property Tax Acct #: 4229-000-011-0103 � Project Description Non -Project Specific Determination: Conditional Waiver Conditional Waiver Criteria (all criteria must be found to apply): XX There will be no alteration of the Critical Area or its required buffers; XX The development proposal will not impact the Critical Area in a manner contrary to the goals, purposes, objectives and requirements of the Critical Areas ordinance; XX The development proposal meets the minimum standards of the Critical Areas ordinance; XX The above findings are based on the following conditions of approval: I - You must either submit a completed SEPA Checklist or: 2. You must either submit and sign a habitat management plan which is also signed by the Department of Fish & Wildlife or; 3. You must submit a letter signed by the Department of Fish & Wildlife stating that the proposed project will not impact the wildlife habitat of concern. Your contact at the Department of Fish & Wildlife is: Steve Negri 16018 Mill Creek Blvd. Mill Creek, WA 98012 (425) 379-2301 Based on the above findings and conditions, the requirement of for a Critical Areas Study associated with this development permit hereby Waived, as authorized by Chapter 20.15B.040 (A)(1) of the Edmonds Community Development Code. If you have any questions, pleAsedon't hesj�ate to contact me at 771-0220. Name' /1111' Signature Date 2 City cof kamconds Commmurvivy. Serwfces Dopartrne"c Bulicilima-Planniimg-Ensineerinar 121-5th ^NrOlmudu Mc3,mh 0 .2ncl 'Fluiur F-clymoncia, WAk 508,020 (425) 771-022C) FAkX: (426) 771-022-1 Yc�: Date 7ransmItted: Nc'. off Pages: 4-0- Recipfent's Fax onciudinia caver I ;>aie-) Pacalmlla Equipment: Autc3matic4C33roup 11 mins.); cBroup m. If there gore army pr4mblamm cturl F! 9 t:= . I4W4wI4*r2 or d,=��mw-vtm are r0,=mlv4Dd lm=4�rnplmta, 'pleam3o CAM (206) 771-0220 ancl oak fc-r . M=..Q=Z:!::= __ ___v 8, �F R49.- TRANSMISSION REPORT THIS DOCUMENT WAS SENT ** COUNT # 6 *** SEND *** (REDUCED SAMPLE ABOVE) INOI REMOTE STATION I.D. START TIME DURATION #PAGES COMMENT 4257871115 9-12-97 3:49PM 4-30" 6 TOTAL 0:04'30" 6 XEROX TELECOPIER 7020 City of Edmonds Community Services Departmem Building- Planning- Engj need ng 121 -Sth Avenue North 0 2nd Floor Edmonds, WA 98020 To: '�I- 7 �� ---1- Date Transmitted: !FII�2,4F7 Recipient's Fax No: -7e�—Ills No. oF Pages.. 46- (Indudinggr cover page.) Facsimile Equipment: Automatic/.Group 11 (22,3 mins.); Group Ill. If there are any problems during transmission or documernts are received incomplete, 'please call (206) 771-0220 and ask for: V --:Z �- eq Re 'ecepdcnVana/faxsheet.doc The Critical Areas Checklist contained on this form is An applicant, or his/her representative, must fill out to be, filled out by any person preparing a the checklist, sign and date it, and submit it to the DevJ6p`:`mk 6nt',�5'Rdftftit;,' Application 'for the City of City"`- W, The' City ill review the checklist, make a Edmo.nds'pr.ior to hisiher submittal of a development precursory 'ite visit d 'ake a determination of the S an m permit -t 6 G, subsequent- ste s necessary to cbmplete a development ..p permit aDDlication bmit a vicinity map,, Along �wjth the signed The purpose of the Checklist is to enable City staff to su I'At is determine whether any potential C iti; ' ' sist n ica eas arp,..or qopy.�of thi f& to A s Cit §taff in finding and may be, present on the �s4 bj;ect 'the I U1. oc th — _4tirig q specir, c piece of property dq� n §c bed on informationi meeded 40 complete. the Checklist should thi In addition, the Applicant shall include be easily Available from observations of the -site �or 6thet`�pdftiiient ii ;' mation (,e.g., site plah,,tp.ppgraphy i.f6t data available at Cit i.y Aall (Critical Areas inventories, mapi: M.) or% studies. in. co ni ri t -:ffiis� Checklist .0 maps, or soil surveys). to a.s:s,,I,s.t staff in completing their:'�:':: preliminary assess'rn- e:nt of the site I have completed the attached Critical Areas Checklist and attest that.th& answe dd -,,...rs rovi, 0 ar-ef�dtual, to the best of in kn w edge (fill out:the appxpp�a�ecolumn below).,.. Y. :, 0, Owner/Applica,nt: Name Street Address ... ....... .. .. city S tate Z�p Telephone Signature Date c:receptioMjana\cac1.doc A Pplicaiit Representative`-- N AM i Aa 4 OF" T;" CITY OF EDMONDS BARBARA FAHEY MAYOR 121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 FAX (425) 771-0221 COMMUNITY SERVICES DEPARTMENT Public Works 9 Planning/ Building - Parks and Recreation Engineering - Wastewater Treatment Plant 9/12/97 John Cashman 15919 Highway 99 Lynnwood, WA 98037 Subject: Determination regarding Critical Areas Checklist # 97-172 Dear Applicant: Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City is located on the reverse side of the form (bottom of page). It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records. IMPORTANT INFORMATION TO BE NOTEDO PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. YOU MAY NEED TO SUBMIT ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTAL CH—ECKLIST OR CRITICAL AREAS STUDY. The 'DETERMINATION' fo r the Critical. Areas Checklist you submitted is a site -specific determination not a project -specific determination. 11111111111110- You mustsubmit a col2y of the CRITICAL AREAS CHECKLISTand DETERMINATION WITH ALL _4110111110 PERMIT APPLICA TIONS or YOUR APPLICATION WILL NOT BE PROCESSED. Permit applications include the following: Critical Areas Determination * Architectural Design Board C:ReceptionWana\CRLTR.doc Building Permits Conditional Use Permits Subdivisions Variances Applications to the ADB* Land Use Applications Any other development permit applications. Thank you. Diane Cunningham Planning Secretary e Incorporated August 11, 1890 0 Sister Cities International — Hekinan, Japan USE PERMIT ZONE�,,�_ CITY OF EDMONDS 7 OF; iQ CONSTRUCTION PERMIT APPLICATI N NUMBER -w JOB UITE/APT # OWNER NAME/NAME OF BUSINESS ADDRESS s Okkip— LEGAL DESCRIPT 0 C E K SUBDIVISION NO. LID NO, ui MAILING ADDRESS Z 0 5�t�- PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. TESCP Approved IT CITY ZIP TELEPHONE NUMBER RW Permit Required 0 EXISTING REQUIRED DEDICATION — Street Use Permit Req'd 0 1110022. -7 70 PROPOSED Inspection Required 0 NAME Sidewalk Required 0 METER SIZE NE SIZE NO. OF FIXTURES PRV REQUIRED LOU t= ADDRESS YES 0 NO 13 3: REMARKS 0 (r CITY ZIP TELEPHONE NUMBER Z NAME M ADDRESS 0 ENGINEERING MEMO DATED REVIEWED BY 1- 15 L) 4 cc CITY ZIP PHONE NUMBER ,z FIRE MEMO DATED R�EVIEWED By 1,< W)nxpn W 0 j,07- e. Lr STATE LICENSE NUMBER EXPIRATION DATE ez(��5c- -CU f VARIANCE 04 ADB# SHORELINE # Legal Description of Property - Ind all efisements SEPA REVIEW SIGN AREA HEIGHT Z I�M-r 0 AQ COMPLETE EXEMPT ALLOWED I PROPOSED ALLOWED 1PROPOSED loy ski ARDIIj Q. "k cc EXP 'I 0 (n LOT COVERAGE REQUIRED SETBACKS (FQ POSED SETBACKS (Fr.) W a ALLOWED PROPOSED FRONT SIDE REAR FRONT L/R SIDE REAR 0 -j Z 4e' Property Z Tax Account _LOTAR PLANNING REVIEW BY DATE Parcel No. �j -,V7r I .�J 1 '7�1 4 7 W1 FV-1 REMARKS LfJ4 NEW RESIDENTIAL E] PLUMBINGWECH COMPLIANCE OR ADDITION 6MMERCIAL 0 CHANGE OF USE 6�.-L 1:1 REMODEL E] APT. BLDG. SIGN GRADING FENCE CHECKED BY TYPE OF CONSTRUCTIO CODE OCC PA —7 GROUU REPAIR CYDS. I— x —.FT) DEMOLISH WOODSTOVE SWIM POOL SPECIAL INSPECTOR AREA INSERT OCCUPANT 11 HOT TUB/SPA REQUIRED YES_ � LOAD 1:1 GARAGE RETAINING WALL/ -�) L5 C-41. 1 4::z 1�2 CARPORT E] ROCKERY R&N&WAL REMARKS Z 2 (TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: PROGRESS INSPECTIONS PER UBC 108 Z i-X X -;Vc-r- A at 0 r V) NUMBER W NUMBER OF CRITICAL 04.0 WA -17*zv /A ]A j v-� 0 OF DWELLING AREAS ( 00 STORIES I UNITS INUMBER 17- 1-7' 0 DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) A -7(, SF per-K FINAL INSPECTION REQUIRED VALUATION FEE PLAN CHECK FEE -Z3 BUILDING HEAT SOURCE GLAZING AM % PLUMBING Plan Check No. q 7 3 0& MECHANICAL This Permit covers work to be done on private property ONL GRADINGIFILL Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE 4.,�o Permit Application: 180 Days STORM DRAINAGE FEE Permit Limit: 1 Year - Provided Work Is Started Within 180 Days "Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE ,n successors in interest, agrees to indemnify, defend and hold W harmless the City of Edmonds, Washington, its officials, 5 employees, and agents from any and all claims for damages of 4 whatever nature, arising directly or Indirectly from the Issuance of this permit. Issuance of this permit shall not be deemed to PLAN CHECK DEPOSIT modify, waive or reduce any requirement of any city ordinance 0 X 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 information given is�co`rrect; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL authorized agent of! I he owner. 1. agree to comply with city And THIS PERMIT state laws regulating.co'nstructloh; and in doing the work authdriz- AUTHORIZES This application is not a permit until ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her Code of the State oflWashington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is -tion Insurarice aria qCW 18.27. INSPECTION acknowledged in space provided. SIGNATURE I WNZERORZGENT DATE SIGNED DEPARTMENT OFFICI si VR DATE CITY OF �47 EDMONDS CALL FOR RELE I t C)AfE ATTtNtION lqf� IT IS UNLAWFUL TO USE OR OCCUPY A BUILDIN . G OR STRUCTURE INSPECTION UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC 771-0220 OAIGt�Al- — File YELLOW — Inspector S - ECTION 109 PINK — Owner GOLD — Assessor CITY.OF M%40NDS BUILDING DEP RTJV1Z7NT.�. WORK — _;c .. 12 1- ayl -'-"^V-D DATE: i� P, E r.] I T N U Ll D E R ZONE - SETBACKS: -...FRONT,__ 7� SIDE /0 REAR Z- OTHER HEIGHT '91 *-1 15, ......... . FD"ONM 11;4A 9002.4. 4 =9 ;5*%16r1W-A a=o sp 16F Any reque.stfor modification, var -admii istrative devii3tion (heminaft n I must I be specifically called out: i N N �1 I I . ME, 4 Approval of any plat or',. ph rovisions-mbich do ---wtt;q;qply., for which variance b g\, specifically identifiL, requested s by the appropriate city official N with, the appropriate provision -a a % o n rove any ite state s ctr pe ication. XD XV r) In ------ CITY COPY I I Vr-4 Y I% ,Fr�oc:r— iA City of Edmonds Critical Areas Determination Applicant: John Cashman Determination CA.97.172 Project Name: Permit Number: Site L=tion: 1 18812 89th Ave W. Property Tax Acct 0: 4229-000-011-0103 ------------- J I Project Description; Non -Project Specific Determination: Conditional Waiver Conditional Waiver Criteria (all criteria must be found to apply): XX - There wffl be no alteration of the Critical Area or its required buffers; XX - The development proposal wilIl not impact the Critical Area in a manner contrary to the goals, purposes, objectives and requirements of the Critical Areas ordinance; The development proposal meets the minimum standards of the Critical Areas ordinance; XX _ The above fludin.gs are based on the following conditions of approval: 1 - You must e4ther submit a completed SEPA Checklist or- 2. You must either submit and aign a habitat management plan which is also signed by the Department of Fisb & Wildlife or, 3. You must submit a letter signed by the Department of Fish & Wildlife stating that the proposed project will not impact the -wildlife habitat of concern. Your contact at the Department of Fish & Wildlife is: Steve Negri 16018 Mill Creek Blvd. Mill Creek, WA 98012 (425) 379.'2301 I Based on the above findings and conditions, the requirement of for a Critical Areas Study associated with this development permit hereby Waived, as authorized by Chapter 20.15B.040 (A)(1) of the Edmonds Community Development Code. If you have any questions, plejw.,,don't he 19ge to contact me at 771-0220. Name Signature Date 2 CA FILE N0 - CA -q I - I . Critical Areas Checklist - - - - - - - - - - - - - - - - - - - - - - - - - - -- -S-i-te-i;iO3;ation (soils/topography/hydrol6gy/veget I ation) I Site Addiiss/Locitpri; Z. Is' A&� 2. Troperty Tax A�co�mt Number:' AjIgM 4 22.1 95'W* 95P. � d2:01 j —Z.00 �'I I Approximate Site Size (acres or square feet): 4. Is Ws site cunemly developed ? _k�.qp; no. If yes; how is site developed? -izel& -- .. . . . I �.. . I. — ... X 5. Describe Ihe general vit�. ppopap�y- a ply� eck aU that ap Fiat--' less -than 5-feet elevation change over entire site. Rolling: slopes on site generall� less than 15% (a vertical rise of 10- hor4'onW distame -of 66-feet). Hilly: sjop�s p;"ent on sit� 6i.'�ore ftp 15 % a -4n�0%,:(�verti sLl;,. 14. less 6 rbiof,l(�feetoveia��,�"on*disWic.e f tq et), :00% pxesent oa� site (a verhcaNiPe of 10,feot,over ,ptrJdis,",9f less 0An33-fqeI,), Othoi(Ploase, degaribe)i =7;:- 6. Site conta�veasofyp` -fdu4d Stan Appxpx, Pepth; Site -contains,aresks-ofseuorAl,,stmnft-g ~4 'A�Pfoje."De'-p- What 4ewn(p)of th S. site is in the floodway., �-floodpl4i�: 9. Site co tains a creek or an area where water flows across the grqvr�ds surface? Flows are ye.ar-round? o �.jp (What. tigm of year? 10, Site is primarily: forested meadow shrubs mixed urban landscaped ARVW 008 etc) 11. Obvious wetland is present on site: 4% & , ;j-, *,� -,*��?X M.Yamp.t., M M -F.n C . is q%3 John Cashman 15919 Highway 99 Lynnwood, WA 98037 Subject: Dear Applicant: CITY OF EDMONDS BARBARA F;AI-,EY M.;kYOR 121 37H AVENUE NORTH - EDMONDS. WA 98020 * (425) 771-DZM 0 PAK �,425) 771-0221 COMMUNITY SERVICES (DEPARTMENT Public Works e Planning/Suilding 9 Parks and Recreation * Fngineering & Wastewaler 1�eatrnsnt Plani 9112/97 Determination regarding Ciritical Areas Checklist# 97-172 Enclosed please find a copy Of the Critical Areas Checklist you submilted. The "DETERMINATION" reached by the City Is located on the reverse side of the form (bottorn of page). It is very Important for you to retain a copy of this Critical Area* Checklist "DETERMINATION" for your records. PLEASE EXAMINE THIS" DErERMINATION- FOR ADDIT70MAL REQUIREMENrS. YOUMAYNEEOTOSUeMir ADDITIONAL INPORMATION SUCH AS AN ENMQ&MWAL Q=&JST OR CRInCAL ARMS STUDY, The 'DETERMINATION' for the Critical Areas Checklist you submitted Is a site-spec:111c determInation not a project-specifle dellarmination. You m&&L&UAMJA.My of ihe CRITICAL AREAS CHEQKLt&T and DETERMINAIMN WITH ALL PERMff APPIJCA77ONS or YOUR APPLICATION WILL NOT of! PROCESSF-D. Permit applications Include the following: i Critical Areas Determination * Architectural Design Board 0:"VonVanaNCRLTPLdoc- Building Permits Condklonsll Use Permits. SubdMalons variance$ Applicatiorm to the ADB' Land Use Applications Arry other development permit applications. Thank you. Diane Cunningham Planning Secretary 0 Incorporcted August 11, IM 9 SiSter Cities International — Kekinan, Japan PLANNING DATA NAME: 'g6_7aSO4,,1 g�yz_ SITE ADDRESS:- -DATE: ZONING: PLAN CHK#- PROJECT DESCRIPTION: Nen, z176 5F jDeUj� CORNER LOT //I' (Yes/No) FLAG LOT ^/ 6 (Yes/No) SETBACKS: 1'.4 Required Setbacks: Front: -Z5 Left Side: Al Right Side: 16 Rear: Actual Setbacks: Front: J'Z- Left Side: lo Right Side: 16 Rear: -7 Street map checked for additional setback required? f- (Yes/No) LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED - (Y/N) LOT COVERAGE: Maximum Allowed:— '3 ----.Actual: 2:5) BUILDING HEIGHT: Maximum Allowed: 7,5 —Actual Height: Datum Point: Datum Elevation: A.D.U. CREATED?: SUBDIVISION: 17 -7 Co' CRITICAL AREAS #. SEPA DETERMINATION: LOT AREA: OTHER: Plan Review By: c.\ft1es*nTflAAp1andaLdoc 8 9 0 - 1 9 '� - City of Edmonds RIGHT-OF-WAY CONSTRUCTION IT . " r".. rpm Permit Number. -3 -.2 STREET Fla. e7 Is -sue Date: A. Address or Vicinity of Construction: 18812 89 Av. W. (9325979) B. Type of Work (be specific): C. Contractor: Was)1thgton Nat'l. Gas Co. Mailing Address: q]5 Marcar SG;att3'--- StateLicense#: -§811f D., Building Permit # (if applicable): Contact: Install Nbw Service Frank Swan Phone: 224-2278 Liability Insurance: . Bond:$ Side Sewer Permit # (if applicable): E. 0 Commercial E] Subdivision 0 - City Project Jkb[Utility (PUD, GTE, WNG, CABLE, WATER) E] Multi -Family 0 Single Family E] Other INSPECTOR: INSPECTOR: k-A-kikA8, F. Pavement or Concrete Cut RYes []No G. Size of Cut: (2) 2 x 4__QUt.9 H- ChargE�-$_ W@ water (1) To cross street APPLICANT TO READ AND SIGN INDEMNITY. Applicant understands and by his signature to this application, agrees Wliold the City ofEdmonds harmles . s from inipoes, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds,�or, an'y`.flts� departments or employees, including or not limited to the defense ofany legal proceedings including defen'sie cosip, �nd attorney fees by reason offrantij;g thispermit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR 14 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 04e-iQr' -ia?phcation. A 24 hour notice is required for inspection; Please,call the Engineering Division, A1701YO. 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 en'd of the working day; NO EXCEPTIONS. Ihave read the above statements and understand t�,epermit requirements and thepink copyof thepermit will be available on site at all times for inspection p ,�,x ,, �mn d 'se s. Sept. 22, 1993 Signature: Date: (Con I tractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK N FOR CITY USE ONLY APPROVED BY: %-A-A IA., �c RIGHT OF WAY DEPOSI T TIME AUTHO)RI.ZED+: VOID AFTER 11-213-91DAYS SPECIAL CONDITIONS: to r"'— COMMENTS: DATE: DISRUPTION FEE/FUND III: RESTORATION FEE: PERMIT FEE: TOTAL FEE: t36— RECEIPT FEE: ISSUED BY: 41 NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 FIELD INSPECTION NOTES Comments: I Diagram.: CONTRACTOR CALLED FOR INSPECTION Partial Work Inspection by P.W.: Work Disapproved By: FINAL APPROVAL BY: (Fund 111 Route copy to Street Dept.) El YES Date: Date: El NO M WNG to wi ndow( Water main depth Unkne z&"cl 17- 11 gas main Adde 0 City of'Edmonds Right of Way Permit Application ... Submitted b Guyla Connors y Engineering Aide Washington Natural Gas 521-5248 2 (zxz4) CU-F-S -M Ce-Oss S7r-i� -w- water -9- gas - -ss- sewer -E)-- water hydrant 0 water valve 815 M=cr St. (PO. Box 1969), Sc4nic, WA 98111 (206) 622-6767 NOTICE: Y. '0 Wa r.r a in y..-O-r- The information shown on the attached map(s) was c0m piled for use by the City of Edmonds/ its Employees and Consultants. Th,e City ofEdm.onds does. not . warrant the anything set forth on these accuracy of Map(�). An . y person or entity -requesting a copy should conduct an independent inquiry regarding the inform . ation shown on th-�� -map(s), Including, but not limited to, th . e lociation of any sewer stub shown. Suc sewer stubs may or may* not e.xist. and may or may not exist at the location shown Neitheir the City of Edmonds nor its empl-o-yee-s o-r office-rs -sh-a-1-1 be 11a-b-[e for the this map(5), nor for information g ven on e representation provided based any on upon'said map(s), APPLICATION for The City of Edmonds SIDE SEWTA PERNE[T Eom STf*ff "I �j�.AEAd MENT No - ------------------ N19W MCO STRUCTION [0] REPAIMMS 0 TKAI 3c,q— b 1 4 ID ............................ OWNER --------- ----- ----------- ADDRESSF ..... -------- w ----------------------- CONTRACTOR 4y- AlA1..W.'.0Ad ..... ........ --- PERMIT NO- 1w LEGAL DESCRIPTION: LOT No..// --- BLOCK No . .............................. ......... . NAME OF ADDITION 5&&.R .. !!;;�87 -------------------------------------------- 8q Avic-. w OC 8 Approved: DATE ............... ByAA.�4�-z ..... lK 77 AGNID. S AF ER PERM E DM EP wwERDEPAMT-M-ENT WWAT V�SE "0 Al R PET .4043 20, covering any Portion, of the construction:) Gall! 7,76-1,107,' for- 'sidb. --sewer inspections BEFORE inspectiom Inspection will, be provlded'�Ithln hours! after request. No, Sat., Sun_ or holiday ................ ........... ....................................... .. ............... OYCONSTRUCTION._.'...'.... . ... ... I ................. ADDRES&,LOCXT11ON 0 t 17 ........................ .............. ................................................................................... �FROPERTV LEGA\L1DESCR1,P.T1,0,N ........................... ..................... 7 ....... I ........... .................. ................ .................... ...................... T ....................... .......... ....... I .............. . ......................................................................... ................................ . jf:I.i f ER AND/OR BUILDER. ................................................. ........ ...... ....... ............... w.N. ...... . ..... ........ ................................ 0 . ............ ................... T on Maple � `Rd L.Ybn Y ynti46orl,- SevId-r 8. C.; ,�tructibn, '4214.- 1 ............... ............ .................................................... . .................. ..................... ..................... .................................... 7 TRACT.OW,& NAME:,&, ADDRESS (�Ctnlh for, r pair ailldybr- coiiiiection,,of,a,.Sidi6-,SeNv.e'z tol4he�,,City sanitary -sewer Fennission-is4granted'... ..... r .. ................... W ........... !syst6Tfi,,�in�,acc6rditiLce'With,C�ty of'Edniond's, ..'r.di'pan, es.. ,-'--�ENTION.IS�(jA,LLED.,To�'THE.-F�OLLOWING.: r-.m , usftbe', effiploye&.to.tconstruct s'.of tl�e property may obtairr a, Permit i�� construci sewer' inside property line;, A,,:Iicehsed Side Sewer�66n�racto. E No., I The, �owner n' of - sewer before it has,,been Inspectedt.. sidel scwer� in street area. *.Do: not cover any,portJo NOTE: No., t-of-,way.requi�es; an, Invasion of Right -of -Way Permit obtainable, from the City 2—AllIt.,work perforrned,in, Cit ' yLrigh -11.16. , 00;;and, ,Regulations governlng� side, sewers -when you get,p - ermit. NOTE'�,No ��6bt-�iW-'i�ill��infoimi).tion- r e garding'Ordinance- grade,of No, -ben,ds'in grade 0 4 -at�property line and 12, inches inside Property line:: rhjfiimum� NOTk N . —Top of sidetsewer,must have at least 30;Anches coverage sharper than. 'A. will: be, -permitted'.. 'or . Iginal -conditiom Contrartors� shaW b . e responsiblelor� failure due, to Improper :NOTE No '&-�!Trenchcs� in,,street must be water settled, and; surf ace of- street. reAtorbd, to work which mak.develop, within one year of completion.� -sewer or its i I Lppu I r I tenance . s except to in- Io,alter or do any other work,than is Provided for In the. Permit, or to. do any work on the n�aln;: NOTE No. 6—It is unlawful sert the pipe into the wye. Y, M, Date ..................... ........ ......... Bk ........ ...... "Q ;e . ...... ... ......... .. .... .... ... . Date .................... ................ By ............ DISAXPROV 01-14 ............ .................... I .......... .......... ................. APPROVED Date'b2z.- ... I 'j ....................... .. ...................... ............................. Remarks: .......................... ..................... .................... .................................... .......... ................................... 7 ... ............. ...... : ........ ...... ....................... 7* .... .. ........................................ : .......................................................... . ...... ....................... n' f Firm, Perf-orming,,Cbnstrluction,PRIOR,-To�'Reqtii�st-.,F,6r Inspectibn�.__ BOTH, Permit Copfes.MUST Be Sig e& By,,Owner:o Da y ................................... hereby certify��that;�the-§Ide sewer -ins tiilla'f iorr,b onstructed. und'er this permit 'Kr �P, -in. �C .. I wner, o t ruction,), f ContrZcting�Flrmg,� 'iy -of Edmo.nd&. r.i.g O'�ai Qi .--g-lnsta-11ed�inaccordancp--,With,air-go rning ordinaiices'. of' -the; .... .. .... .............. ........ Dated thiS ........ ..... ............... ........... of.' V,!" ��Ufeek BkirORK,y0U!,digJ Oi.:. Water,.,'[n, Gas�,E],,' Telcphone,iM,. Fower Ej, Sewer IER. -,,qther' Eh Y"