19219 88TH AVE W.PDFIIIIIIIIIIII
8388
19219 88TH AVE W
NOTICE:
--7:- �- o T -amc-(-- u �-Y.
-No-w-arran.
The information shown on the attached
iled for use by the City of
map(s) was cOMP
Edmondsi its Employees and Consultants.
Th,.e City of �Edm.onds does not. wa rra nt the
cy of anything set forth on these
accura
M a p (�-). A n . y person or e.n.tity,requesting a
copy should conduct an independent
m-ation shown on
Inquiry regarding the infor
-t-Fe -map(s), Including, but not i'mited to -h
th . e location of any sew-er stub shown, Suc
exist and may
sewer stubs may or may
or may not exist at the location shown.
Neither the ,-ity of Edmoindls nor its
k-.1
empl-o-yee-s o-r offi-ce-rs -sh-al'l be I-Jab]--e for the
information given on this map(s), nor for
any one representation provided based
upon'said map(s),
FILE APPLICATION CARD No . ................................
for
The City of Edmonds 1 ritt-T SEDE SEWER PERMIT EASEMENT No . ......................................
OUTSIDE E] INSIDE -E] REPAIRS
OWNER...... ....... ...... .............. CONTRACTOR ..................................................................................................... PERMIT No.
STREET
HOUSENo. ----- . ..... ....... 4� ............ -- .................. AVENUE LOT No . ...................................................................... BLOCK No . ...............................................
NAMEADD . .............................................................................................................................................................
'Far
APPROVED
A N 8 196
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
SEWER WORK ORDER ISSUED .......................................... DA ---- 13Y . ..... .... ------- ---------------------
'CITY OF EDMONDS Cill PRospect 6-1107 24'. hours, (�lus
Saturday, Sunday and Holidays) be. 9-
CITY HALL WATER -SEWER DEPARTMENT fore work is ready for Inspecti
on 905.
SIDE "SEWERPEMIt'
I ADDRESS.-
U OWNER
melw,- a? ers, n.
CONTRACTOR ............
L Permission is.-grAfited... im - U
...... � a - ary .. Za. 19...'64 for days, to REPAIR or CONNECT'a side sewer
with City. Seweis in ace6rdince with -a�'
plication on file and governing ordinances
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—The owners of the Property may obtain a Permit to construct sewer inside prop
ingst be employed to construct side sewer in, street area. Do not cover any per
,,erty line. A licensed Side Sewer Coritraator
tion sewer before it has been inspected.
ain . . t " I .
NOTE No. 2—Obt � full in -formation regarding Ordinancb 11.16.030 and Regulations governing side sewers when you get permit.'
I NOTE No. 3=,Top of side. sewer. must have at least 30 inches coverage t Property line and 12 inches inside property line; mi'
2 Old. No behils in grade sharper than % will be permittedn nimum grade of
NOTE No. 4—Trenches in street must be water settled and surface of street restored Ao original 'condition. Contractors shall be responsible for
failure due to improper work which may develop within one year of 'complotion.
NOTE No. fi—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work an the main sev�dr'or its'aii-
mirtenan
ces excep 1,0 nsert the pipe into the wye.
07
8 9 0 1 9 C) Q5
City of Edmonds
W
RIGHT-Oli�- 'w CONSTRUCTION
PERMIT Permit Number.
41�_Ole Issue Date:
A. Address or Vicinity of Construction: 19219 88 Ave W ( 9425955
B. Type of Work (be specific)
C. Contractor: Washington Natural Gas Company
Mailing Address: 815 Mercer Street.Seattle
State License #: WA 98111
D. Building Permit # (if applicable):
Install New Service
Contact: Frank Swan
Phone: 224-2278
Liability Insurance:
Bond: $ AV
Side Sewer Permit # (if applicable):
E. E] Commercial 0 Subdivision n City Project [?q Utility (PUD, GTE, WNG, CABLE, WATER)
E] Multi -Family [J Single Family F] Other
INSPECTqR: INSPECTOR:
F. Pavement or Concrete Cut: Yes []No G. Size of Cut: 4 H. Chargq�,$
J,
APPLICANT TO READ AN N
e e
' D
D
INDEMNITY.- Applicant understands and by his signature to this �pjqliCqtion, agrees to h 4 eCityofEdm ridsharmless niurieR, 11ges, or
claims of any kind or �ies'rz . ption whatsoever, foreseen or unfores,66n, that may �e mad ihot !§VlCity of Edmonds, �or a
(tl of its'departments or
f.e.
employees, including or not limited to the defense of an3, legal proceedings including e4f..q. t�s ttorney fees by reasqrr4fgrAr1i0
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR-O)PE ''0 OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATIO$,Frf: I �')�L BE HELD UNTIL Tff&F1 S TRE E T PA TCH
IS COMPLETED BY CITYFORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BEPROCESSED FOR ISS rO-1 ' An NT.
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�e* gtila'elons as required by th'e' Cd�-E'fig"lneer.
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 above statements and understand thepermit requirements and thepink copy of theperm it ivill be
available on site at a e for inspection purposes.
Signature: 4! Date: 08-12-1994
(Contractor o� Ag e-n'r)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: k; 4-Al RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER 0 — DAYS DISRUPTION FEE/FUND III:
SPECIAL CONDITIONS: SW 4-T QF- k-Ay RESTORATION FEE:
COMMENTS:
04011, eAviR4 eyV-7ot4C7v,,t. PERMIT FEE: 00
TOTAL FEE:
RECEIPT FEE:
47.V10A
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Fngrg. I)iv. 1991
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
AWF. 4-13, ,
Addendum -to City Of :dkonds'
Right -,.qg W
A,A
on
-PUka#ted bys IN
IX TAIMPLD
,TCHZLL.8i;
VashinotOn VitUrikl -Gas
-521-;-'5246
ASP> T-t
C>ve�-� VL( TrI>
4.
I
49np_�own�_'n 'epth
---------------
fit gas Imain
Key; .-w- water
-g- gar, ..
-ss- sewer
-e- watex hyclrant
C) watL,-.- vhlyc
?15 Merccr St. (1 0. )::,., low). scud, , WA S U 11 1206) 6,22- -767
V
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"'Addend,
IMIA
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SubmAtted
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a . a
1 -52 a 246
-2- t
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.14'.i:.. I 'All
,--A .
a
ITNG to window
Key:
Watp-r 3main depth- --w- water
CVano�wn ?Qcn- �9_ gas
-A, gas nain -as- sewer
water hycirw
watt.;:
(206) 6_12--767
el
All"
Add* hduii
Mir or'
mama
cliat
bt �10
on
15246
I 521J
td-)
(,N-T AST> T.�j
V4
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Mae;
Alen
A
I 'No to window
1�1
Water 2pain depth Key: --w- water
CVano'Gn� -9- gas
gas Immin -sa- newer
-e- Watex hydrac�-
0 . wat("z
'�\A S S) J 1 (206) 622.-767
We J4
it
umidto. I
,v!jtjgjjt 0 fw
at WE on
,OF MUM.,
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71
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Key:
Watom main depth- --w- water
(Irnkn6wii_�) mcrr cttG4c
------------------ -g- gar,
to gas main -ss- sewer
water hydr&r
C>
?JS )AMC" St. 0 0. "VA S q) I 1 6-22-767
City of Edmonds
RIGHT -OF -WAY. -CONSTRUCTION
18 9 0 C) C)Q5
PEJRMIT Permit Number -
Issue Date:
A. Address or Vicinity of Construction: 21510 92 Av W
B. Type of Work (be specific)- Emergency Leak Repair
C. Contractor: -Washington Natural Gas CompaAy Contact: Frank Swan
Mailing Address: 815 Mercer Street Seattle, WAPhone: 224-2278
State License #: 98111 Liability Insurance:
D. Building Permit # (if applicable):
E. E] Commercial E] Subdivision
n Multi -Family M SingleFamily
INSPECTOR:
Bond: $
Side Sewer Permit # (if applicable):
0 City Project n Utility (PUD, GTE, WNG, CABLE, WATER)
[] Other
INSPECTOR: f<vj
F. Pavement or Concrete Cut: [N Yes 0 G. Size of Cut: x H. Chargq�,$
APPLICANT TO READ AN40 IGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to h e City ofEdmonds harmll HfTin%ju, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made 4�i 't,the City of Edmonds, or any of its,departments or
employees, including or not limited to the defense of any legal proceedings including defens�e 8 8, �nd attorney fees by reason of
gra tin�tlWspermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS F PERIOD OF ONE YEAR F�LLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FE_S11jk1 BE HELD UNTIL THEWNALSTAR�T 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.
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 site at all times for inspection purposes.
Signature: A-61- L P Date: November 14, 1994,
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: t?%l
TIME AUTHORIZED': VOID AFTER DAYS
SPECIAL CONDITIONS: N 0 A.C. P.
Cc, -r S //V 1e,0 A P WA
COMMENTS:
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND Ill:
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE:
RECEIPT FEE:
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE, Engrg. I)iv. 1991
FIELD INSPECTION NOTES
Comments:
Diagram:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES 11 NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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