19721 88TH AVE W.PDFIIIIIIIIIIII
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19721 88TH AVE W
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City.. of,EdmopOs
RIGHT-OF-WAYtONS*TRUCTION
PERMIT Pennit Nu . mber.' q5- /71
Issue Date: 5_7 9 1
A. Address or Vicinity of Construction: 19701 ('9521593
B. Type of Work (be specific): Install a 1-1/,q�__Piamtic Gas Main in 88
Av V at +— 5351 N c/l Maplewood Rd from +— 11'V to E ROW Line
C. Contractor: Washington Natural Gas
Mailing Address: 1122275 St SW Everett
State License #: 98203
D. Building Permit # (if applicable):
Contact: Frank Swan'.
Phone: 447-3284
Liability Insurance:
Bond: $
Side �ewer Permit # (if applicable):
E. Commercial EJ Subdivision C] City Project R] Utility (PUD, GTE, WNG, CABLE, WATER)
Multi -Family [] Single Family n Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: [E Yes ONo G. Size of Cut: 2' x,/41 H. Chargq_$
APPLICANT TO READ AND S
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds 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 bf it.�,#partments or
employees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgranting thi8permit.
'_D J C� - --� dv� ]�� "
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS F64R A PIERIOD OF ONE YEAR-FOLL I GSTHE 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.
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 e;nd of the working day;
NO EXCEPTIONS.
Ihaue read the above statements and understand thepermit requirements and thepink copy of thepermit will be
available on site at 01 ;,imesfoP#Rspecttoyt 4urposes. ?__-
Signature: &/�, A—zil Date: 8-22-95
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR'CITY USE ONLY,
APPROVEDBY: RIGHT OF WAY* DEPOSIT
TIME AUTHORIZED: VOID AFTER %J I Q —'DAYS DISRU I M-'O'N FEEAFUND, Ill:
SPECIAL CONDITIONS: Wk RESTORATION FEE:.
PERMIT FEE -
COMMENTS:
DATE --
TOTAL FEE.' 3 jo 1 40c)
RECEIPT�,�'FEE:
ISSUED BY:
J T_�
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES
I Comments:
I Diagram.:
8
(Fund I 11 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION 0 YES NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Tic im
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CITY OF EDMONDS
El NEW
El ADDITION
1:1 RETIREMENT
�ASSET INFORMATION SHEET
FILE
ASSET NO. 5�3 -,2
ADDITION TO ASSET NO.
DESCRIPTION
Lej'a 7A a ST/g
SERIAL NO.
LOCATION
DEPT. NO.
1`5 -2 2 1
6 510
"PURCHASE ORDER NO. -
PURCHASE ORDER DATE
COST
*PROJECT NUMBER
PROJECT COMPLETION DATE 6 310
COST ? 5/ eb
B.A.R.S. ACCOUNT NO. e> 0 C>
ESTIMATED LIFE
INITIATED BY DATE APPROVED BY
"SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT -
0 G.L. ENTRY
REFERENCE
DATE
VERIFIED BY
PROCESSED
BATCH NO. -
INITIAL
Mp)
DEPARTMENT FILE
CITY OF EDMONDS
FOONSPECTION CALL
PUBLIC WORKS DEPARIONT Permi
SIDE SEWER PERMIT 775-2525 Ext. JZ,2.0,2S� Issue Date
PEP -MIT MUST BE POSTED ON JOB s I 9M If 1W [77_17-77
1. Address of . Construction �. � , , - rl,-,,,
2. Property Legal Description (include all easements)
7:�
3.
Single Family
Residence Multi -Family
No. o ':040NSS
Commercial -
-
TREATMENT PLANT
4.
Owner and/or
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 No>e, Easement required -
attach legal description and county easement number.
READ THE FOLLOWT,.NG 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% (45'). 0
f. No -turn in side sSwer greater than 45 (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 1001 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 onVlj��,. Z�Twb (�21) working
days notice required.
DATE:
rtity,ma-t I nave reaa 7
shall/comply With the above
PERMIT FEE: DISAPPROVED BY: Date:
B YA 4 1 Date:
CONNECTION FEE:
P4 APPROVED By:d.,v�A' go Date:
0 V#C><-
P4 PERMIT MUST BE POSTED ON JOB SITE *
.1,
The City of Edmonds
Side Sewer Drawing
EASEMENT NO. -,
— ----------------------------- 0
NEW CONSTRUCTION Z REPAIRS F�
LID NO. --- ------------- ASMT. NO . ..................
OWNER --- R-O-M-F—LANO ----
H.0 M E— IS -------------------------------
CONTRACTOR ... ------
I 401M E-S ------ IN-C- ---- PERMIT NO. -G-9-IX ...
JOB ADDRESS .... t-9-r.7-2-1 --------
S-B----r-?4 -----------------
.................. LEGAL DESCRIPTION: LOT No. D ---------
....................... BLOCK NO - -------------------------------- —,
----------------------------------------- $lP ..... ! - - I A
.5 ----- 3-(0 ... 74 -------------------- --------------------- ---------- Evvro-N'D& --- I ---
TREATMEENT PLANT
NAMEOF ADDITION ..................................................................................
2.9 197 9-1 - SS -rv4
Lo-r 1D
- 5,
VtXF-P
cl:
Z5#
VWBEND
a C)l
' D E EP
is
C.0 Approved:
7
P -0001-11175 (REV.11/78) ---
WW DATE ........................ ------------ By _ ...................
a)
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co
OD
20
289.79
I , E. 5 2! 87.80'/
126.9�'
7 5.00'
3? 40 L. F. 12
1.00%
.0011'
3 1
YPE I a:)
E ju t
ol
v I C) F) J\l -F
1 4 Atb
82L.F 12'ct
0.80%
18.00 C.O.
WATER DRAINAGE _0
BERM TYR) 0.
e-40L. 6 "RV.C. AT 9.66% 2" ASPHALT LIP 10
75.00' r 106.99, 4— ro
42-20- Lc-o\ \ 69�78'
ZUU-ILF. p. V.C. AT 9.66 CONS . C.O.
C.O.
%CONST C-0- B -
CE .1 121 L.F. HIEL. AT 7.15%
TY:E I Wm
1% LE 372.00' 100.00 82,00, ot
Pp 15'
18.00,
0 _0
.P. z c�
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CA�%4 o4
0
AO,
NOTICE:
a r-r a n ty ... ol-
-N'o W 'shown on the attached
The informatiOrl
map(s) was compiled for use by the GtY Of
rnployees and Consultants.
Edmonds/ its E the
Th,.�e City of Edmonds does. not. warrant
accuracyof anything set for.th on these
Map(s�. An . y person or entity -requesting a
copy should conduct an independent
inform-ation shown on
inquiry regarding th*e
tFe -map(s)/ including., but not limited to,
er stub shown. Su&
the lociation of any sew
sewer stubs may or may- not exist. and may
at the location shown.
or may not exist
Neither the Cityof Edmonds nor its
empl-o-yee*s o*r offi-ce-rs -shal-1 be 1--jable for the
information giVen on this map(5), nor for
any one representation provided based
upon said. map(s),
---own a a rw
PERMIT
ro-
CITY OF EDMONDS
NUMBER
CONSTRUCTION PERMIT APPLICATION
joe
NAME (OR NAME OF BUSINESS)
AUL)Ht:Z)S Lb
jum=r A"'P't, h'o., L, 4.1
IPTION CHECKISUBDIVISION NO. LID 0.
Uj
MAILING ADDRESS
/,C- -,
A"d
& e_�I�)
CITY TELEPHONE NUMBER
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
.2
ea) y1le
NAME
EXISTING 0�6' REQUIRED DEDICATION
PROPOSED ---"—
h.,
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED
ir
L)
W
ADDRESS
STREET USE PERMIT REQUIRED 0
_m__ VW
7-C AP&
14
SEE ENGINEERING MEMO DATED
z
CC
<
ZITY TELEPHONE NUMBE
R`3V7
SEE PIW DEPT. REVIEW CHECK LIST DATED
NAME
REMARKS /
cr
ADDRESS
0
METER SIZE SUPPLY SIZE IXTURE UNITS
Cr
CITY TELEPHONE NUMBER
7BUILDING
7
Cc
z
0
REMARKS
LU
0
STATE LICENSE NUMBER CITY LICENSE NUMBER
Legal Description of Property - Inchude all easements
SIGN AREA ENV. REVIEW
ALLOWED PROPOSED COMPLET] EXEMPT
ADS NO.
(show below or attach four copies)
z
SHORELINE 0
92?
CL
Cc
U
4 7V
VARIANCE OR CU PLA *INYAE E Y
TDATE
(0
LU
....Ia-� .,
Y
-I Y-Rf
YARDS
0
LOT COVERAG z
0
W
15' FRONT SIDE REAR
Z!�=
z
c3s-6 z
7,-
.
REMARKS
NEW RESIDENTIAL PLUMBING
ADD/ALTER NON-RESIDENTIAL MECHANICAL
REPAIR RETAINING WALL SIGN
EXCAVATE FENCE
El
CHECKED BY OF CONSTRUCTION Cc E
HEIGHT
DEMOLISH OR FILL I- x FT)
7 1
PRE -MOVE INSP.1 swim
COMPLIANC F-1 POOL
SPECIAL INSPECTOR OCCUPANCY
OCCUPANT
REQUIRED GROUP
LOAD
SIDE SEWER EJ WATER LINE
13 YES I!NO
REMARKS
z
2
M
EJ 1:1
0
z
0
a:
U
NUMBER R 7ES UM BER OF
0::�
U0
FDELLING
W
In
UN 17 S
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
I 4e f-22,
-
VALUATION
FEE
PLAN CHECK FEE
BUILDING
PLUMBING
This Permit covers work to be done on private property ONLY.
MECHANICAL
GRADINGIFILL
Any construction on the public domain (curbs, sidewalks,
driveways, marquees, etc.) will require separate permission.
Permit Application: 180 Days
Permit Limit: 1 Year - Provided Work Is Started Within 180 Days
"Applicant, on behalf of his or her spouse, heirs, assigns and
U)
wi
successors in interest, agrees to Indemnify, defend and hold
W
harmless the City of Edmonds, Washington, its officials,
m
employees, and agents from any and all claims for damages of
5
whatpvpr nAturp. qriqinn HirartIv nr intlir—tN, fr #K^ ;
L-�
F—I
L -A
MEMO TO:
FROM:
SUBJECT:
Building Division
Planning Department
Engineering Division
Public Works Department
After review of the subject Building Permit application, we have the following
comments:
1. Connection to City water system required.
2. Connection to City sanitary sewer system required.
3. Right-of-way permit required for any work on City property.
4. Driveway slope not to exceed 14%
5. Backwater valve required if downstairs plumbing is below elevation of
upstream manhole.
6. . Water and sewer lines to be separated by 10 foot minimum.
BD 6/82
4.
PUBLIC WORKS DEPARTIM CHECKLIST
BUILDING PM1IT REVIEV
2_4
(address) (dat-0—
Street -Rig�it-of-`Way Existing_.�
Z
��_REQP__
Access Easements Existing REQD
Utility Easement Existing REQEL
W
Lot Per Subdivision Plat Assessor Map
W
Site Plan Checked for Accuracy, ele_-
Z
Underground 14iring Reqd.
H
0
Check Accuracy of �,egal Descr'�p�ion
Z
, �7
Review by Date
Existing Water Main Size
Water Main Re ed
Service Line Required
Hydrant Size Existing,
o4
Hydrant Reqd Per -Fire Code Size-
W
Detector Check Meter Reqd.
Cross Connection Inspection
Fire Department Conments
. e, c
'dater Meter Reqd. D��n L.)"-)
Ae
Review by , L Date,/4�0 I?, 1�f3
Septic Tank Design Approved Date __/—/3 -if',3
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availability Proj".
Drmqjmg No. File No.
Side Sewer Availability W-K
Sanitary Sewe ection Fee Reqd.
:3:
Review by Date
Open Ditch Existing. Reqd.
Culvert Reqd. A/ 0 Size
94
Catch Basin Reqd. AZO Indicate on Site Plan
0
Shoulder drainage maintain collection on swale open runoff
Ln
Manhole reqd. Indicate an Site Plan
Soil Conditi and Ground Water Field Checked
Raview b"ZIN,�, .,,e I—IL_,�L_3 I
y Date
1977
-0
DEC 1082
CAT" BA31X:
&M ols-jo(o& TRgNCW LVENGTH
WSUAL)
fit
tw.,
............................. . ...........
6* MG. LLA bwa car L1rvff'L TPtKiyC.N
V PFSLF Pom CAP
6"TEE W/ (-" LONG LEGS
SYSTEM CROSS-SECTION
COVER-
wAs w r- D
GRAVEL
01AM FURF P1
L 2,-e -
TRENCH CROSS-SECTION
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2
for AOV4-t--
location-,Zur -7
plan by
phone - I
date - 6 %G,-
DESIGN
Trench Perc
Number Rate
2. ic-- a--
DATA
LF per
1000 sq.ft.
\ % ,
Imperm Trench
Area Req.
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at re?ular intervals (at least
twice per year
CITY OF EDMONDS
irk
9
�j
JOD
00
co
zu
rh
1131TE ILAN, SCALE'
�;OTE:. DO NOT USE INFILTRATI . ON SYSTEM
lN SLOPES OVER 15 . PER -CENT (15 -
RISE PER 100 F N
STANDARD DRAINAG LAN
INFILTRATION SYSTEM
DEC ' 11982
CATCM SASIM:
Ans *is-30(00.
IftUAL
TIMMCW L-orNrarH
a
3
,r1kKMCH COVIM-A
M--Iv -- 6
......................... ....
-n &Wt U N K -�'
V PrILY PIPF
&",rlm W/ 4" LON6 LEGS
LCVB-L TRW Ncif
CAP
SYSTEM CROSS—SECTION
KENCH COVER -
WASWEID
GRAV U L
C DIAIA FURF P1
L- 2'. Cr
TRENCH CROSS—SECTION
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE I OF 2
for
location
plan by
phone 11G-L!��"-
date ts V!— I ,,Q—
DESIGN DATA
Trench Perc LF per Trench
Number Rate 1000 sq.ft. Area Req.
M
M1
IMMM
MM
ME3
NOTES
1. Call Engineering Division (771-3202)
for prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
priv . ate property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floating material and
sediment at regular intervals (at least
twice per year).
CITY OF ED ONDS
t
SITE LA
it
E
SCALE0
ZONE Rs-,�
S E T C
REA
0TK_
PEIGHT
J.
got
I f
STANDARD DRAINAGIi-4LAN.
NOTE: DO NOT USE INFILTRATION SYSTEM
INFILTRATION SYSTEM
ON SLOPES OVER 15 PERCENT (15
PAGE 0. 09
P05T RISE PER 100 FEET HORIZONTAL) -7 -
a,
r-Aniuit 4667
F
s-'e-7V Biorback
LEGAL DESCRIPTION FOR OLLIE A..BJORBACK
PARCEL A
Al I that portion of the northeast- YA of the northwest 1/4, of Section 19,
Township 27 North, Range 4 East, 14.14. , described as jol lows: Beginning at
a point on the west I ine of said subdivision that is 569.91 feet south of
the northwest corner thereof; thence * N88*27'36"E, a distance of 232-00 feet;
thence northerly paral lei with the west I ine of said subdivision a distance of
20.00 feet; thence N8827176"E, a distance of 212.79 feet; thence NI'32'22"W
to an intersection with a line drawn parallel with and lying 98.00 feet south-
erly of the north I ine of the south' 1/2 of the northwest 1/4 of the northeast
1/4 of the northwest 1/4 of said Section 19; thence west parallel to said
north line 444.80 feet to an intersection with the west line of said subdivi-
sion; thence southerly along the west line of said subdivision to the Point
of Beginning.
EXCEPT the east 125.00 feet and
EXCEPT the west 30-00 feet thereof.
PARCEL B
The south 80.00 feet of the east 100.00 feet of the west 130-00 feet of
that portion of the northeast 1/4 of the northwest 1/4 of Section i9,
Township 27 North, Range 4 East, W.M., described as follows: Beginning at
a point on the west line of said subdivision that is 649.91 feet south of
the northwes t co rne r the reof ; then cc north a 1 ong s a i d wes t I i ne t o a pol n t
wh i ch i s 98. 00 f cc t south o f the no rth I i ne of the sou th 1 /2 of the nor thwes t
1/4 of the northeast 1/4 of the northwest 1/4 of said Section 19; thence
east parallel to said north line 444.80 feet; thence SI*32122"E, to a point
that is N88*27'36"E, 444-78 feet from the Point of Beginning; thence S88'27'
3611W, 444-78 feet to the Point of Beginning.
PARCEL C
The south 80.00 feet of- the east 102.00 feet of the west 232.00 feet of
that portion of the northeast 1/4 of the northwest 1/4 of Section 19,
Township 27 North, Range 4 East, W.M., described as follows: Beginning at
a point on the west line of said subdivision that is 649.91 feet south of
the northwest corner thereof; thence north along said west line to a point
which is 98.00 feet south of the north line of the south 1/2 of the northwest
1/4 of the northeast 1/4 of the northwest 1/4 of said Section 19; thence
east parallel to said north line 444.80 feet; thence S 1*32122"E, to a
point that is N88'27'36"E, 444-78 feet from the Point of Beginning; thence
S88027'36,v, 444-78 feet to the Point of Beginning.
PARCEL D
The south 100.00 feet of that portion of the northeast 1/4 of the northwest
1/4 of Section 19, Township 27 North, Range 4 East, W.M., described as follo�as:
Beginning at a point on the %..,est line of s.aid subdivision that is 649.91 feet
south of the northwest corner. thereof; thence north along said west line to
a point which is 98.00 feet south of the north line of the south 1/2 of the
northwest 1/4 of the norEheast 1/4 of the northwest 1/4 of 'said Section' '19;
thence east paraliel to said north line 444.80 feet; thence Sl*32'22"E,-- to a
point that is 148802736"E, 444.78 feet from the Point of Beginning; thence
S88027'36"W, 444-78 feet to the Point of Beginn.ing. OFFIC1AL RECOMS
EXCEPT the cast 125.00 feet and
EXCEPT the west 232.00 feet thereof. .)I
VOL 852 PAcE'157
77