18816 90TH PL SW.PDFlill 11111111
8795
18816 90TH PL SW
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
V V-W
7 PERMIT Permit Number. 7- 0�e=,
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ue a e: -d
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A. Address or Vicinity of Construction: 18616 90th PI ace W
GTE to place,operate, and maintain a buried _s_e_r_v_1ce
9 9 B. Type of Work (be specific): wire from existing pedestal #6692 located at 18816 90th
Pl2ceuW6 the yest to a reside e at 13816 90tMluetWOKot
, N.PA?wf5otfeet,
an p s no Or veway or road. ffease see attac s e C ee
Marilyn Holmgren, Permit Coordinator
C. Contractor: GTE Northwest Incorporated Contact: Dennis Alexander 771-9036 mobile 388-1358
Mailing Address: 2312C W Casino Road Phone: Marilyn 206/710-0786 or 483-1628
State License #: Everett, WA 98204-1440 Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. [3 Commercial Subdivision El City Project Q Utility (PUD, GTE, WNG, CABLE, WATER)
E] Multi -Family Single Family Other 2100-9POOlDB 242310
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut 0 Yes E3No G. Size of CY x IL�;,'da�gej
Pl opae s-ee att4ched ;ketch..
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City ofEdmondg 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 ofany legalproceedings including defense costs, and attorney fees by reason ofgranting thi8permit.
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 THEAPPLICANT.
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.
Ihave read the abovestatements and understand thepermit requirements and thepink copyof thepermit willbe
available on s *t t aT1E*es no*nspLection purposes.
Signature: FOR David Squires Date: 3/18/97
iatingtowWr or Agent)" Mgr -Access Design
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER V20 — DAYS
SPECIAL CONDITIONS: I UA
COMMENTS:
DATE:
DISRUPTION FEE/FUND 111;
RESTORATION FEE:
PERMIT FEE.
TOTAL FEE:
RECEIPT FEE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
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
I
1:?
p"a'
PERMIT SUBMITTED BY
GTE
ly
sov
LJ
%�9 P2- A/
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V)
LEGEND
PEDS a i
POLES 0
1ROAD BORES
OVERHEAD LINES
J.D.urILITY POTHOLE
UG TRENC14ING ----UGT—
R.O.w.
EOP
� :1 THE FOLLOWINC INFO TO BE PRQVII)ED
CD ;
RIGHT OF WAY LINES.EOP OR FACE OF CURB, EXISTING SIDEWALK, PCLES, ROAD CUTS AND THE UTJLfTY UNDER ROAD- CUTS,
Co ABOVE GROUND FACILITIES.(Ie:) PEDS,eoXES,CABINETS. F-TC..UNDERCROUND TRENCHING AND, O'VERHEAD LINES. R
FOOTACE OF WORK IN R.O.W. (D
a)
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RECEIVED
AUG 10 1988
PROFESSIONAL PROMPT MULTIPLE LINE
August 9, 1988
Washington Cities Insurance Authority
15215 52nd Ave. S.
Tukwila, WA 98188
RE: Insured
Date of Loss
Claimant
Our File No.
Gentlemen:
A C C T rATUVATT -
This loss was received in our office July 14, 1988.
I'T ATIA A XTrrO .
/Zt; /0/�
WASHINGTON OREGON
CLAIM SERVICE
APPRAISALS
8,6ce/ve,q
Atl,g 10 1
C0/77/771#7/ty 988
Se%ces oir
: City of Edmonds
: 6-19-88
: Kathryn Hawkins
& Mary Whittaker
: 8-9491
Kathryn Hawkins and Mary Whittaker, 18816 90th Pl. W., Edmonds, WA 98020.
FACTS OF LOSS:
A city sewer line was clogged causing a sewer backup into the claimant's residence.
The resulting bills from the Carpet Exchange, Rainbow Cleaning Co., and Roto-
Rooter, total $952.55.
DRAFT REQUEST:
Please issue your settlement check in the amount of $952.55 payable to Mary B.
Whittaker and Kathryn J. Hawkins. Please forward this check to them at 18816
90th Pl. W., Edmonds, WA 98020. A release of all claims is attached. This
report closes our file.
Sincerely,
/Br e Vaughn
WASHINGTON OREG CLAIM SERVICE
Seattle Office
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Encs.
CC: City of Edmonds
P.O. &,% 25144
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Spuk.tic, WA WIN-�490 P,Wilwij. OA 1)72-'5
24 hr. (21X) 367-358.1
t.") na-11151 24 hi. 003) 297-7'A)5
NOTICE:
rr a n
ur-am-c-u-
The Jnform ation'shown on the attached
map(s) was com ' piled for use by the City of
Edmonds/ its Employees and Consultants.
Th,..e City ofEcIm.onds does. not. warrant the
f anything set forth on these -
accuracy 0
rnap(�). An . y person or entity -requesting a
copy should conduct an independent
inquiry regarding th*e info'rmation shown or
-.--t-Fe -map(s)l including, but not limited to,
-er stub shown. Suc
the lociation of any sew
sewer stubs may or may* not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
tomp-1-o-yee-s o-r office-rs -sha-H be 11a-b-'Fe for the
information given on this map(5), nor for
any one representation provided based
upon said Map(s).
'7 CITY OF EDMONDS - SIDE SEWER PERMIT
2 A _L WATER -SEWER DEPARTMENT
—7 PERMIT
Call 776-1107 for side wer inspections BEFORE covering any portion of the construction.)
e'
(Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections.
ADDRESSLOCATION OF CONSTRUCTION .......................................................................................................................................................................
PROPERTYLEGAL DESCRIPTION .......................................................................................................................................................................................
.................................................. . ...................... . ................................................................................................. ........................... ..................................................
................................................................ OWNER AND/OR BUILDER ............................................................................ . .......................................................
CONTRACTOWS NAME & ADDRESS ----------------------------------------------------------------------
Permission is granted ------------------------------------------------------------ 19 ......... for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
—E No. I —The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been inspected.
irE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade
sharper than % will be permitted.
NOTE No. 5—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the main sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVEDF1 Date --- - ----------------------------------- BY ---------------- Date .................................... By ---------------- Date .................................... By ................
APPROVED',Z?f ------------------------------- BY -------------------------------------------------------
VIC
Remarks: ........................................................................................................................................................................................................................
..................................................................... ................... I., -------------- ................................................................................................................................. .........
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
hereby certify that the side sewer installation constructed under this permit
c�o.t;r�,.*�in�g�_'Fnl;i� P� - ing onstruction)'
was installed in accordance with all gVerning ordinances of the City of Edmonds.
Datedthis ............................ day of ................................................................. 19 .........
Check BEFORE you dig for: Water F], Gas [-], Telephone E], Power E], Sewer E], Other
APPLICATION
for
Me City of Edmonds
P
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS
OWNER ... I-S.A.Al
.. �T .........
. ...................
ADDRESS
........ ....... /V
No. —7:�, ................................
I
L 5
6
CONTRACTOR 4 ..... j ....
j 7PERMIT Nc(
LEGAL DESCRIPTION: LOT No . ..... 4 ..................................... BL4DCK No . ............................................
NAME OF ADDITION...' -e/V ........ &- /a
.... ... c .... Z.. --. ..Z.'�
— x . . ..... ..............................
4
Approved:
.1� A