20500 85TH PL W (2).PDF111111111111
8079
20500 85TH PL W
NOTICE:
rra nt .. ....
N'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 Edrn.onds does not warrant the
on these
accuracy of anything set for.th
rnap(�_). Any person or entity -requesting a
copy should conduct an independent
-ation shown on
inquiry regarding the inform
Imited to
tF�e -m a p (s) . including, but not H
th'e lociation of any sewer stub shown. Such
exist and may
sewer stubs may or may
t the location shown.
or may not exist a
�ity of Edmo'nd'c, nor its
Neither the
h-a-1.1 be Viab-'F-e for the
empl-o-yee-s o-r office-rs -s
information given o.n this map(s), nor for
any one representation provided based
upon said map(s).
0
The City of Edmoav Fu
APPLICATION
for
SIDE SEWMR PEILBUT
NEW CONSTRUCTION Pt REPAIRS 0
EASMIENT No.
�1�t) lf,::?f l(i"-,
0
OWNER ....... m . ......................... CONTRACTOR ................ ............... --- W. g
ADDRESS ........ t-5-'rfq 1�*, 4t)4, LEGAL DESCRrPTION: LOT No . ...........
....... ......... .......................... . ...... ...............................
NAME OF ADDITION ..........
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ANK
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PROPERV IUMF—)�
Approved:
BLOCK No . ..........................
34; / I
APPRO�ED
�AY 12 1970
DATE
BY
CITY OVEDMONDS -hiin
Call PRospect 64�07 'w work
sl. 'Inpec-
C CENTER WATER -SEWER DEPARTMENT I ready -'for, ifispectioli. (N.:
Clv� ay, Sundav or holldmis.) N2 37,14
tlons.Saturd
sIM-. SEWER," PERMIT
20500 - 85th Place West ----- .................................................................................................
ADDRESS--------------------------------------------------- -------- ......
............... CONTRACTOR ........... ....................................................
OWNER .................................... P'aymond lia gen
19-79., for ........................ days to REPArR or CONNECT a side sewer
pern-lission is granted �Y' ....... ..........
with City Sewers in accordance . with application oil file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING: rmit to construct sewer inside Property line. A licensed Side Sewer ContraP-tor must
NOTE No. 1—The owners of the property may obtain a Pe a. Do not cover any portion of sewer before it has been inspected.
be employed to construct side sewer in street axe
NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 3—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 1/h will be permitted.
NOTE No. 4—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 appur-
tenances except to insert the pipe into the wye.
7
City,of Edmonds Permit No:=
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date:
A. Address or Vicinity of Construction: 20500� 85 PL W
B. Type of Work (be specific): pjwms5S6f) ta
U
C:2 0 5-0 0 U'l
C. Contractor: PSE/PILCRUCK CONT
033USTONE AV N
Mailing Address:
StateLicense#: PILCIMI 101MA
D. Building Permit # (if applicable
10-76 11-4 -71 -7
Contact: SUE SIDICK
Phone: 206-418-4239
Liability Insurance: Bond:$
Side Sewer Permit # (if applicable):
E. Commercial Subdivision F1 City Project EUC (PUD, VERIZON, PSE, AT& T, OVWD)
-1 Other
Mu"Iti-Family Single Family r
INSPECTOR:'
F. PAVEMENT CUT: YES NO G. SIZE OF CUT X
I CONCRETE CUT: �YES El NO
Al"I'LICANT TO M,Al) ANI) SIGN
INDEMNITY. Applicanfunderstands by his/her. signature -to thiso application h�ljhe holds� the 06� of Edmonds harmless from
injuries, damagqs or 'claims of dhy kind or description whatsoever, foreseen,�r unforeseen,; that may be made against the City of
-Edmonds or an5�. f loyq f f any legal proceedings including defense
,9,,Iits � departments or- emp esJncluding but not limited to the de ense o
costs and attorn �es by reason of�g�anti�g this permit�
'i� ASHIP A'ND'MA&Ri�LS POk,A -PERIOD OF ONE YEAR FOLLOWlNG THE FINAL
THE CONTRACTOR IS RESPI.ONSIBLi-FOR ORKMA
INSPECTION AND A CCEPTANqE OF THE WORK. EST[AiA TED RESTORA TION'FEES W1LL BE HELD UNTIL THE FINAL STREET PA TCH IS
COMPLETED B Y CITY FORCESJA T WHICH TIME A DEBIT OR CREDIT HILL BE PROCESSED FOR ISSUANCE TO THE A PPLIC4NT.
Traffic cofitrol ' and public safety shall be in accordance with City regulations as required by the City Engineer, �: Every
flagger must be'trained as required by (WAC) 296-155-305 and must have certification verifying completion of the
required training in theirpossession.
Restoration is to be in. accordance,with City codes. . All street -cut trench work shall be,, -patched with asphalt or City -
approved material prior to the end of the workday - NO., EXCEPTIONS.
Three sets of construction drawings of proposed work are required with the permit application.
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
IHAVEREAD THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THATIMUSTMAKE THE PINK COPY OF THE PERMITA VAILABLE ON SITE A TALL TIMES FOR INSPECTIONS
Signatu Date: 0
re: _'xli �1? -
(Contractor or,�Vgent)
IEOR CITY USE ONLY
Approved by: wc(mlftw
Time Auth�rized: Void After . 01 / j" '16-6
Special Conditions: -*?fMC 60JIMOL -Pl7e�
JML-TO.D -, fA*1W*W S' M01A eTTQ Xkkl",
VYPA,_'V_ A4 i-- iAArrvv %kirrny,:U
Right-of-way Fee -1010f
_5
Disruption Fee/Fund 1'11.:,j
Restoration F_ ee:
Total Fee:
Receipt No.
Issued by:
7.
UPON COMPLETION OF PERMITTED WORK", AN ENGINE'tRI N.G FINAL'
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT CODE (Phone 425-771-0220, Ext. 1326)
FINAL APPROVAL OFPERMITTED WORK. �-7*,,� 2Lcglie�a DATE: /0 /8-/07
hispector's Signature
For inspection requirements see Engineering Inspection Information handout.
NO WOIZK SUIALL 11l,(;1N 11MOIZ TO ]UMIT ISSUANC17.
DAMy Documents\Forms\Engning\ROWpermit_.doc
STANDARD NCC GAS
CONSTRUCTION NOTES:
P,
4t4 ------ At4l ------
Q�
14-4 ------
13�4
CD 5/8*688'N
a
CIS! 1999
207 ST SW
-----------
�t
ko
CO
60'
R/14
1�21
0
1: 0
M
ILLJ
0
5/8 so 778N
C3
IMININION
EOM
Z' PE CAP
1098'N CL & 13'E CL
(--')N CL
(—')E CL
PROPOSED 250'
Z' PE IP MA IN
13'E CL
( --- *P? CL
TIE—IN
FUSE
848'N CL & WE CL
( --- *)Y CL
(-,)E CL
(CHECK BOX IF COMPLETE)
Work area left in Clean & Safe ondition
Complete all Pipe Tables and Gas Pressure Stamp
Field changes Red —Limed on as —built
Material verified and Changes oted on paperwork
All Valve & Tie—in -Locations noted on as —built
Note beginning of Main, EOM & Une of Main locations
Show Rope Locations & Cul—de—sac Radius
Foreman's Signature
Company Employee ID#
1. FIELD LOCATE ALL UNDERGROUND UTILITIES. CALL "ONE— CALL" TWO WORKING
DAYS PRIOR TO CONSTRUCTION, 1-800-424-5555.
2. ALL CONSTRUCTION IS TO CONFORM TO PSE GAS OPERATING STANDARDS
AND GAS STANDARDS PROCEDURES MANUAL
3. INSTALL MAIN VALVES OUT OF TRAFFIC WERE POSSIBLE.
4. ANY CHANGE IN ROUTE, TIE—IN METHOD OR ADDITIONAL MAIN FOOTAGE MUST BE
APPROVED BY PROJECT MANAGER.
5. COMPLETE "PIPE CONDITION REPORT' ON ALL EXPOSED EXISTING PSE
FACILITIES. CHECK BOX ON REPORT FOR WIRE BOX (TEST LEAD)
INSTALLATION. -
6. INSTALL ONE POUND ANODE FOR EVERY 1000' OF LOCATING WIRE. INSTALL
ANODE AND TEST LEAD WIRES PER PSE GAS OPERATING STANDARDS 14.2 AND
14.5.
7. MAINTAIN CATHODIC PROTECTION FOR STEEL MAINS BY THE USE OF
CONTINUITY BONDS OR OTHER MEANS DETERMINED BY THE PSE CORROSION
ENGINEER PER PSE GAS OPERATING STANDARDS 10.3
8. INSTALL ANODES AND TEST LEAD WIRES AS REQUIRED PER PSE GAS
STANDARDS PROCEDURES P0201 AND P0303 AND PSE GAS OPERATING STANDARD
10.2. TEST LEAD WIRES ARE REQUIRED ON ALL TRANSITION FITTINGS.
9. REFER TO PSE GAS OPERATING STANDARD 6.8 FOR MAIN AND SERVICE COVER
REQUIREMENTS.
10. MAINS AND SERVICES SHALL BE TESTED AND PURGED PER PSE GAS
OPERATING STANDARDS 6.14, 6.17 AND 14.2 AND PSE GAS FIELD PROCEDURE
P0816.
11. CUSTOMER PROVIDED TRENCHES ON PRIVATE PROPERTY SHALL CONFORM TO PSE
STANDARDS.
12. EROSION AND SEDIMENT CONTROL SHALL BE PER PSE STANDARD PRACTICE
0150.3200 TECHNIQUES FOR TEMPORARY EROSION AND SEDIMENT CONTROL AND
ANY ADDITIONAL LOCAL JURISDICTION REQUIREMENTS.
13. TO PREVENT ACCIDENTAL OVERPRESSURE OF ADJOINING SYSTEM, NO TWO MAINS
SHALL BE CONNECTED EXCEPT AS SHOWN ON THIS DESIGN UNI ESS APPROVED BY
A PSE REPRESENTATIVE.
14. SYSTEM MAOP DENOTED B� SYSTEM MAOP = 45 PSIG.]
GAS MAIN INSTALLATIONIRETIREMENT
Type/Work
Pipe Size
I
I Type
Estimated
Length
Actual
Length
Manufacturer
INSTALL
2-
PE
250'
J
GAE' AIN PRESSURE-& TES TING
W-P—ETEST -'RESSURE-
DATE ON r1ME ON
TESTED BY
DATE OFF
';-IME OFF
TYPE TEST
PRESSURE
TESTED BY
DATE ON
I !ME ON
DATE OFF
OFF
Design Press 60
-'T!ME
SYS MAOP 45
PROJECT PHASE
NOTIF#
ORDER#
SAP Superior
Service/Meter
Service/Meter
Service/Meter
ServicelMeter
Ind. Service
Ind. MSA
Dis. Reg. / FT
HP Svc/MSA
Relocate
R tirement
X758909623
107014717
X353167942
106095082
Contractor CONSTRUCTION COST CODES:
021-103-1 1 1 1
Project Manager Contact Information:
PATTI NESS
CELL: 425-327-2783
Vicinity Map
WORK SITE
Ownerl Developer Contact Info
NORTHCREST DEVELOPMENT CORP
20500 85 PIL W
EDMONDS, WA 98026
ATTN: RICK KLEM 206-550-4245 office
CALL (800) 424-5555
2 BUSINESS DAYS BEFORE YOU DIG
THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF FACILITIES
REAL ESTATE/EASEMENT PERMIT
N/A EDMONDS
REV# DATE BY DESCRIPTION FUNCTION CONTACT -PHONE I DATE I
3 PROJECT MGR P.NESS 206-418-4237 110/16/02 1
2 ENGR-GAS
I DRAWN BY
COUNTY
SNOHOMISH
1/4 SEC
SW-19-27-04
UTILITIES
CONTACT
PHONE#
EMER SECT
4
OP MAP
160.068
CHECKED BY
GAS WK CTR APPROVED BY
MNSNHG FITTER #1
PLAT MAP FITTER #2
163.068 PAPPING
JOINT FACILITIES ARRANGEMENTS
P.MCGHUEY
P. NESS
P.NIESS
141. %�
,Pllg�,'i�
PUGET
SOUND NORTHCREST DEVELOPMENT CORP
EMGY 21' PE IP MAIN EXTENSION
20500 85 PL W, EDMONDS, WA 98026
DESIGNED BY PILCHUCK CONTRACTORS INC.
206-418-4214 10/16102 1
206-418-4237
206-418-4237
107014717
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