18820 88TH AVE W.PDF8368
18820 88TH AVE W
City 6f Edmonds
RIGHT-OF-WAY CONSTRUCTION
VX7
PERMIT
Permit Number-
Wue Date:
\SS20 `ASTIA A\/ L
A. Address or Vicinity of Construction:
9 9 B. Type of work (be specific): GTL TO G LA Q -,/� C A8L&- 120'
GTC: NORTHWF-Sr + PLACL QA)F- RE-01SID4L
aA L--F. R r
C. Contractor: I NC 0R PO Contact: FIE. L OTE C WC'n"m E- J LA--:zEJq
IL4 I -I_ %+rr- f-A-151 ev '�q Phone: (204p) 1 '-11 ZZ
-V f
Mailing Address: F_ F_ 12
State License #: Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. Commercial F] Subdivision 0 City Project 0] Utility (PUD,glo WNG, CABLE, WATER)
Multi -Family E] Single Family Ej Other Ck P00 1 0-'-)8 L�72-33C
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut 11 Yes PgNo G. Size of Cut: H., 4Mapgf�,$� -I
3
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understan�s and by his signature to this application, agrees to hold 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 or not limited to the defense of any legalproceedings including defense costs, and attorney fees by reason of granting thispermit.
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.
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.
Restoration4is 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.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on site,p*\all spection purposes.
A &;E -S GL
Signature: --I�i Date:
(,fdRtFy&WtVr Agent)SSC M6A, A wfiri Psr/iv
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY.
TIME AUTHORIZED: VOID AFTER' DAYS'
SPECIAL CONDITIONS: M 14rAN j>STAKX.4F-
OF
COMMENTS:
RIGHT OFWAY.DhPOSIT
DISRUPTION FEE/FUND III:,'
RESTORATION FEE:
PERMIT FEE:
0 0
TOTAL FEE
RECEIPT FEE:
DATE:
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:
0 NO
APPLICATION
for
The -City of Edmonds REa-Flal: SIDE SEWER PERMIT EASEMENT No . ................. ........................
NEW CONSTRUCTION 0 REPAIRS 0
OVVrNER............
......
I ...... .............. ........
z�t�
ADDRESS ..........
C., .......
?_1 .....................................
A I . .............
L
CONTRACTOR ...... PERMIT No._
....... .... I ... .. ........
LEGAL DESCRIPTION: LOT No. ........ ...................... BLOCK No . ............................................
NAME OF ADDITION__.��H/_/,'R.c) T .5
............. ......................... ......................
��qEIVED
2'D 17 W2
Approved:
............................
----_----- ....... ................ By . ....................
bp
PERM
E DM -.1NIDS Sibt' �!E'!. W
WATE E ,P ...... . ...
R-SEWk,.DEPA.T NT
.4088
:,VERMIT
onstructlon.�-
alP 176-1107 for 'side seNver inspections BEFORE, covering any portion of the c
hin. 247 hours, after, request. NO Sat., Sum, or -inspections.)
pection will be provided' wit �holiday
ADDREV9S` LOCATION �OYCONSTRUCT'ION_:...
.............................. ................................................................ ...............................................................
-PROPERTY LEGAL DESCRIPTION ........... .......... ... ............................... .......................................... ............. ......... ............. ........ 7, .................
ir
................ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . ... . . . . . . . . . . . . . . . . . . . :7 . . . . . . . . . . . . . . . . . . . . . . . . . . . -7, . . . . . . . . . . . .. . . . . . . . . . . . . ........... ................... 7-7 ............ ....... .......................... ....................
.....................................
)kNWOR BUILDER ................ .............................................. .........................................................
7
t U �t �)a. liaW i",-n
.............. ........
CONTRACTOWS NAME:-&: ADDRESS .........................
............... ...... * ......................... .............................
Penydssion 1§;grantbd'.;. .............. 19_:7 for,� repair� andVor; conne'e'tion �of 'a side sewer Wthe- efty'sanitary sewer
-------------------------
sys'�exnjii; - accordance. with'tity.,of Edmon& ordina'11ces.
ATTENTION, IS'C�LL"EiVTO)-THE! FOLLOWINq:"._�
�1— ITE No.'I—Th-e. owner,,,,of.�tife.,property..may'obtain-.a permit to. 'const-ruct,sewer, inside propertyllne� A licen�se&SIde Sewer Contractor. must be� employed1to-construct
Side sewer.,in street. area; -Do not cover any portion of sewer' �efoic it has QnAnspected.,
Cit y*.En
TE, No. 2—All, work -,performed, in city right-of-way-reqVires.an Invaslon.:oi RJght-bf-Way Permit obtainable from.the gineer!s. office..
NOITE,-No. 3—'Obtaln full information regarding'Ordinance fl.16:030 and 'Regulations, governing -,sldc�sew�is. when you get permit.
'must� ha
NOTE,No; 4—Top�,of sldeisewerl ve at -least �30_ inches coverage at property.'line and�12. inches Inside property line;., minimum. grade, of' 2'%. No 'bends in grade
sharper, than "A',willt,bc, pe �mltted�
NOTE' No. -:&-'-!.'Trenches, I , n Street must be water..settled . . and. surface of -street restored -to original, condition. C . ontractors �hall' be responsible for failure due� to, Improper
work which may, develop within one year of completion.
NOTE, No. &--:It Is uWal�lful'-to -alter or do. any 'other.,work than. i's provided for in the perm!t,�'or, to do,any work on the main sewer'or its appurt6nances except to- in-
'sert the pipe-jnto. the Wye;
DISAPPROVED
...........
j' Datei .................. .... By ..................
Date.... . ............. .. By ...... ......... Date .................. ................... By ................
'i, S I
APPROVED
Date.....
Y .... /,. ............................ ...................
....... ....
PWW&rks:%'�
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
..............................
. . . . . . . . . . . . . . . . . . . . .
.......................................................................................................................................
. . . . . . . . . . . M . . . . . . . . . . . . . . . . . . . . . . . . . M . . . . . . . . . . . . . . . . . . . . . .
................... ...............................
. . . . . . . . . . . .. .. . : . . . . . . . . . ... .......... .... .... . ......... .. .... ... . .... .. ... .... 7 . . . . . 7 . . . . . . . . . . . . . . . . . . . . . . . . .. .. ..... ............. ..
BOTH'Permit, Co�ie� MUST'Be.Sign I 'ed. By Owner',of'Firm. PerformingCon . stru6tio.ln PRIORi To R I equest Fo�'In'specti.on
-h
hereby, certify that -the side�sewe� installatfon c6nstrticted bnder _t isperinit.
wner o, Contracting Firm Pe
I W-S,
0 Mer A�
th 1,govf�
rf
al nin Ahe City of Edmonds.
mas; installed in accordande-wi g:ordinances* of
Y 0 . ......
f, .......................... ........ 19L .........
Dateff 'this .......... ..........
Cheek, BEFORE, yoli, dig'f or: . Water, Ey, - Gas Ej-, Teleph6ne �,Power,:[];. Sewer
NOTICE:
No"War-ran.-y ... o
The information on the attached
Map(s) was compiled for use by the City Of
Edmonds,; its Employees and Consultants.
Th,,e City of*Edm.onds does not. warrant the
accuracy of anything set for.th on these
M a p (�_). A n . y person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform . ation shown on
ffi�e -map(s), Including, but not limited to, -h
th . e location of any sew-er stub shown. Suc
stubs may or may, not exist and may
sewer
or may not exist at the location shown.
Neit-heir the �ity of Edmoind's nor its
emp-j-o-yee-s o-r office-rs -sha[l be Viab]e for the
information given' on this map(5), nor for
e representation provided based
any on
upon said map(s).
NOT -ICE
,,C�PERMmEE AND /OR OWNER
STREET PARTIAL APPROVAL
. 4 VIOLATION
CORRECTIONS REQUIRED
PERMIT
NUMBER
JOB ADDRESS
NO PERMIT - STOP WORK - REMOVE CONSTRUCTION OR OBTAIN
PERMIT AND MAKE WORK COMPLY WITH BUILDING LAWS.
FCONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS
AND PERMIT - STOP WORK. MAKE EXISTING WORK COMPLY WITH
APPROVED PLANS AND PERMIT OR REMOVE IT.
FJ STOP WORK - UNTIL AUTHORIZED TO CONTINUE BY INSPECTOR.
CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN
BE APPROVED.
WORK DESCRIBED BELOW HAS BEEN INSPECTED AND IS APPROVED.
CONTACT INSPECTOR AND
ARRANGE FOR APPOINTMENT. RECALL FOR INSPECTION.
1-7Xe>
4-P7 2!��x-,v-02- 7V
pay
Aj zj -
THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN
DAYS OR PENALTIES IMPOSED BY LAW MAY BE APPLIED.
F
A�4� OR INSPECTIONS CALL: 771-3202. BUILDING DIV.
INSPECTOR PUBLIC WORKS
,/'
CITY OF DATE FIRE DEPT.
EDMONDS ri e�/-wxo
NOTICE
/OR OWNER
El PARTIAL APPROVAL
STfjEET.m',lV'VA6_LATION
7
CORRECTIONS REQUIRED
PERMIT
NUMBER
I JOB ADDRES S e�5 yv" k) I
ENO PERMIT - STOP WORK - REMOVE CONSTRUCTION OR OBTAIN
] PERMIT AND MAKE WORK COMPLY WITH BUILDING LAWS.
CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS
AND PERMIT - STOP WORK. MAKE EXISTING WORK COMPLY WITH
APPROVED PLANS AND PERMIT'OR REMOVE IT.
STOP WORK - UNTIL AUTHORIZED TO CONTINUE BY INSPECTOR.
CORRECTIONS LISTED BELOW MUST BE MADE BEFORE WORK CAN
BE APPROVED.
El WORK DESCRIBED BELOW HAS BEEN INSPECTED AND IS APPROVED.
PECTOR AND-_
CONTACTINS
ARRANGE FOR APPOINTMENT:-- RECALL� F�O'R'INSPECTION.
El
I -
THE A IONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN
DAYS OR PENALTIES IMPOSED BY LAW
MAY BE APPLIED.
OR INSPECTIONS CALL: 771-3202.
BUILDING DIV.'
X/ci
INrPECTOIr
PUBLIC WORKS
CITY OF
DATE
FIRE DEPT.
EDMONDS
WO: 9POOlPF008 ENGINEER: CJB S C 0 R E C A R D - P L A C I N G EXCH 2100 ZONE nl FEB 1)
ESTIMATED UNITS EQUIV A C T U A L
UNIT DESCRIPTION ACCOUNT 2XXX XXXX 6XXX HOURS UNITS-C-HOURS UNITS-X-HOURS UNITS-M-HOURS
PSM
HAND DIG TRENCH
2423.10
1�5
0
0
191
PGIA
PLACE PEDESTAL
2423A
3
0
0
3.6
GTE EQUIV HOURS 22J 22.) PLACING SUPERVISOR:
S C 0 R E C A R D S P L I C I N G
S02A
STRAIGHT SPLICE i SO
2423.10
so
0
0
2.9
SO4A
BRANCH SPLICE 1 50 PR
2423.10
so
0
0
3.5
S14A
SVC WIRE TERM. TRANS
2423.10
5
0
0
2.2
S24A
SECTION TRANSFER
2423.10
25
25
0
5.8
1
GTE EQUIV HOURS 11.5 2.9 14.4 SPLICING SUPERVISOR:
WORK ORDER TOTALS 2XXX xxxx GXXX TOTAL
Ill.i)C ING 8]s 815
SPL [C ING �401 101 502
ENG I NEER I NG 28� 143 430
TOTAL 1523 244 1262
0
CONST.NOTE
PLEASE CONTACT CUSTOMERS
AT THESE ADDRESSES FOR
ACCESS.
18820/776-0444
18821/ 775-9960
18826/774-9251
18827/775-8009
--B-
0
DATE12/97
P
STA
29
R
29
c
29
G
10
T
I
CI ."NT
BEFORE
AFTER
WKR IVAC
DEF
WKR
VAC
DEF
CD:451-475
11
10
4
11
14
0
CD:476-500
1 18
5 1
2
18
7
0
I WREi
CABLE TYPE
MAT. CODE
FOOJAGE
YR. PL.
AKF:50-24
221450
141,
1968
>- I L2543
E -900
X:1
U —AKF9-26
1 0 m mcn
m<
I I
P17 4"-PVC-1 WAY P17-/2
149 40 FT 150
18 T F-1 S T.
148+16
) 767 P16-/2
CD:401-450- 0574
P16
156
0)
��cb
r�
j 16
,q-LQ
Q) C\j Q
Q) I (-)
Q) I,(-)
U)
U-)
B - A E -F;�S- �'j 1
21 -B]
USE FOR BULK WO ONLY
PRIORITY ECAS
IN SER\qCE DATE O�-17-97
DRIVERS FOR WORK ORDER
DOR
FP —MO]/ TRANS / SAFETY
PUBLIC REOUIREMENT
PLANT EXTENSION / COMMDEV / RCTA
PERMITS
El BLANKET
El STATE
El COUNTY
El NONE
CONSTRUCTION
M DIAL. A DIG
0 FLAGGING
.1 BRUSHING
F
SPLCIAL CIRCUITS El
CAUTION
POWER 12 UG IN All
OTHER 13 UG M AE
TELCO INUG MAE
CLI I S RLOUIRED
El YES 0 NO
JOINT POLE
0 PUD
F1 P5M
El CATV
El GTE
0 NONE
JOINT TR[NCI-i
F1 P 111)
El PSP&L
El CATV
0 GTE
FEES REO'S
El GOP 0 LEC
El SPEC. CONST.
IN NONE
POIHT OF COHTACT
TECH. Q.J.BUELER
PHONE NO. 206 710-4122
FIELDED BYRICH EDWARDS
MATFRIAL
CODE
MATERIAL
DESCRIPTION
ENGR
EST
CONST
ACT
280450
AKF:50-24
220'
THOMAS MAP
PAGE 454 J3
18820
88TH AVE W
EXCHANGE
COUNTY
HALLS LAKE
N 0 1 domilSI-I
TITLE: FAP PMO AT 18820
0
88TI-I AVE W
0
0
0
0 Q
m 0
to
z
APPROVED Bf— DAIE
co C)
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m
co
T. 27N R. IE SEC .18C-ISIIEET
NO.: I OF