20621 88TH AVE W.PDFIIIIIIIIIIII
8479
20621 88TH AVE W
.4i
W
lesse
Go.
Co.
Ir
LOT AREA CALCUD7T10—N—S-1
EXISTING HOUSE 1300 SQ. FT.
LOT AREA 9800 SQ. FT.
ADDITION 558 SQ. FT.
TOTAL HOUSE SIZE 1858 SQ FT
ALLOWANCE BUILDING AREA
.(35% OF LOT SIZE)
DECKS & PORCHES 542 SQ. FT.
19949 LOT COVERAGE
a 9=
LLJ
>
C=
Ves,
U-
14 LU
LLJ
GENERAL CONTRACTORS LICENSE NUMBER - BY-SE-TE�221LR WASHINGTON STATE CONTRACTOWS LICENSE
VERIFICATION
PLOT PLAN VV"71E*D 7AX Lar M. - 30.2701/-.� - 063
JLEGAL'-' DESCRIPTION]
SCALE: 1,11=201-011 All that portion of the Southeast quarter of the Northwest quarter of Section 30,
Township 27 North, Rangi 4 last. W.H.,-de a cribed a. follow-
ULMA MTESWASUMAMWMS THE kAW4. . Beginning at the Northwest corher of Lot 6 OlyepiC H.1ght. Diwi.1— No. 2.
TK PLOT FLM WAS MWN FKM WG& SUE WOM ac,ca ding to Plot thereof recorded in Volune'17 of plats. page 64, in Snohooi.h
AND IS NDT TG BE CMMM AS A FRMUWK SIM. C—Ity, W-hingtonj
IMPE-P-WOUS SURF,46E' )+ZE,
HOOSE ROOF-:
2216 6IF'
D5CX5 j PORLm--s :
5yz 5F
W,+I-KS � 57--PS
/JON Sip'.
,PRIV-GWAY
6 .0.0 -11 F
7_07AL
3&56 5F'
377.
1-07- COVEXI�150(
TMSNC3 South 99'35'30' East 140 feet;
TMs"Cz North 0035;10 a. t 70 fast$
THSM3 N.rth 0 9*3 .' ;. 11:9t 140 fast;
THENCE South 0035#10- West 70 feet to the true point of beginning.
SITE PLAN
Chris and Eric Thorkildsen
21621 88 Ave West*
Edmonds, We 98026
# 771 - 6490 Bvset
'Remodeling
10-0-4
A
>
w
EI
id
>
ILU
cr)
LIJ
C= C-t
).0
LLI
A
PLOT PLAN
Height Calculation '. - /
'p-S - 8 z5- IVAY, HT
L. A N N N!, ra
13 108. 5*
08. G7
ft"4 eeq
101'.0
AVEFAiGt9-- GRAVF— iOG-5 ITE PLAN
Chds aifid Edc Thorkildsen
ACTQAI- 128-57 21621 88 Avb Wes(
M"= 131-5 Edmonds, Wa_9=6 Byset
# 771. - �490 'Rernodeling
Boa
PROJECT REVIEW CHECKLIST
DEP r -
A fi 5FI� 5*o1n1r e- PLAN CHECK#:
ME:
PROJECT ADDRESS: 20& Z-/ 1,4v-t A) -3 RECEIPT DATE: 19-17-96
REVIE E I I e)
PLAN. WATER
COMMENTS FIRE BLDG. � SEWER STREET ENG.
Setbacks/Variance/Setback Adjustment
. . .........
Conditional Use Permit
2
ADB Requirements
Other Zoning R quirements;
4
Underground Wiring Required
Lot Slope 15% e 3 ,1
. . . . . . . . . . . . . . . .
. . . . . . . . . . . .
.. ....... -)141-
J5
6
SEPA Environmental Checklist/Hydraulics Permit
m
M
7
Tree Cutting Plan
-- -
-
Plat/Subdivision Requirements
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .......
--------
.
Legal Description Verification SL4Lj 95- 1,9-)
........ . ..
10
Quit Claim/Street Dedications
. . . . . . . . . . . . . .
Easements - Public/Private
............ ...
A -
Engineering Storm Drain Review Fee 30
............ . . . . . . . . . .
Engineering 2.2 Inspection Fee 30
Drainage Plan (On -Site)
Setback - Top of Bank, Stream, Water Courses
Setback - Storm Drain Line
Open Ditch - Existing
................ ......
"N
-------
M."MISIA—M.2
-
Culvert Required
Culvert Size
Shoulder Drainage/Shale Open Runoff
21
Catch Basin Required
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Driveway Slope & Vehicle Access
Sidewalk Required
.......... . . . . . . ........
24:1
Curb & Gutter Required
)12
Curb Cut For Driveway Required
M.,
Street Paving Required
Al
Right -Of -Way Construction Permit Required
2 . 8
Street Name Sign Required
291,
Other Signing Required
::�30
Bond Required For Public Improvements
. . . . . . . . . . .
FEMA Map Check/Water Table
Side Sewer Availability
. . . . . . . . . . . .
Calculate Sewer Connection Fee If No LID #
----
Create Street File
---- --
?
--- --
1 �11 I d
Existing Water Main Size
Water Meter Size
Service Line Size
='A '42
. . . . . . . . . . . .
. .. .. . . . .
U.
Water Meter Charge Required
126:
Hydrant Required
.................. W.-O, - -----
............. .....
40::::
Hydrant Size Existing
S yx
41
Fire Line Charge Required - Sprinkler
*/A
42...
IStreet Cut
IMiscellaneous
Reviewed By:
FIRE
PLANNING ENGINEEftrN—G PUBLIC WORKS
R E C 0 R D OF C 0 N T A C T S
21
2
22
3
23
4
24
5
25
6
26
7
27
8
28
1 RW PERMIT # DATE ISSUED #
9
29
---RECEIPT
10
30
11
31
12
32
13
PAID $ RECEIPT # DATE
33
SS PERMIT # DATE ISSUE D RECEIPT #
14
PAID $ RECEIPT # DATE
34
1�
35
16
36
37
M§JER SIZE3/y PAID $ DATE RECEIPT
18
38
zx� 62�i
19
39
34. rtw 4m
26
40
#7 -
CITY OF EDMONDS
'9 9 0 19 ct
Address of Construction
;Woig- >) / ,
Property Legal Description (Include all easements):
/0 74- -3 077C S_1:S_ le9,
'�A
D10,VS
SIDE, SEWER PERMIT
PERMIT N2 8846
E
P, 2 8 1997
Ito .1pim
Owner and/or Contractor:
State License No. 67 AV--* a3Vj�2-_-( Building Permit No. F,�5-6 7 e
9- ringle Family Invasion into I City Right-of-WaX/No El Yes
El Multi -Family (No. of Units—) RW Construction Permit No
El Commercial Cross other Private PropertA..) � �No El Yes
0 Public Attach legal description and copy of recorded easement
r)2
I ceri(Ly�at I have read and shall comply with all city r���nts Date
as indicated on the back of the Permit Card.
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICEIUSE ONLY,
FOR INSPECTION CALL M-12ft, PUBLIC WORKS DEPT.
160. 0 0 -7-7/-OA35'
Permit Fee: Issued By
Trunk Charge. ZS'. 00 Date Issued:—Z-- 2- 6 -q 7-
Assessment Fee: & Receipt No.: 7, Z,,S 0
Lid No.: —
Partial Inspection: Date—Initial—
Comme6ts
Reason Rejected: Date —Initial
Final Inspection Approved: Dati�___��8_lnitiacf_�?
PERMIT MUST BE POSTED ON JOB SITE
White Copy: File Green Copy: Inspector Buff Copy: Applicant Re,sed 3190
The City of Edmonds Side Sewer Drawing EASEMENT NO . ... ............ ...........................
NEW CONSTRUCTION REPAIRS n LID NO . .................. ASMT. NO . ..................
OWNER--- ......................................................... .............. . ............... CONTRACTOR .................................................................................... PERMIT NO.
JOB ADDRESS ...... .. ..
........ 4 . .... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
..................................................................................................................................................................
NAMEOF ADDITION .......................................................................................................................
L'IEA�I�viENT PLAN-r
T9
9
viv*
A
4 Approved.
PWW-0001 -11175 (R EV. 11/78) DATE07.7.2-.k7f.7 ............... B y (l:
.............................................
NOTICE:
-N'0...W . a -r-ra nty ... o T., -du�, U J - -0 -y-
The -inforrnation'shown on the attached
map(s) was cOmpiied for use by the CitY Of
Edmonds/ its Employees and Consultants.
Th,�e City of Edmonds does. not. warrant the
t these
accuracy of anything set for. h on . '
map(s�. An . y person or entity -requesting a
copy should conduct an independent
inquiry regarding th-e inform-ation shown on
d to,
fffi�� -map(s)., including, but not limite
-er stub shown. Sucl-
the lotation of any sew
sewer stubs may or may- not e.xist. and may
at the location shown
or may not exist
Neither the City of Edmonds nor its
empl*o*yee's 0-r offi-ce-rs -shall be 11a-ble for the
information given' on this rnap(s), nor for
e representation provided based
any on
upon said- map(s)
LAYOUT LEGEND:
PADMOUNT TRANSFORMER
SECONDARY PEDESTAL
PRIMARY UNDERGROUND CABLE
-----------SECONDARY UNDERGROUND CABLE
AND'OVERHEAD LINE
PROPERTY LINE
RIGHT—OF—WAY LINE
—FUTURE DUCT
_U—EXISTING UNDERGROUND CABLE
SCHEMATIC LEGEND:
El i—BOX
0 10 TRANSFORMER
FUSE
PRIMARY UNDERGROUND CABLE
OVHD EXISTING OVERHEAD
FEED THRU BUSHING ON TRANSFORMER
L-4704-X
205TH PL SW L-21406—
I
REMOVE THE SECONDARY CABLE
FROM THE POLE TO THE
EXISTING PEDESTAL ON LOT 6.
UTILIZE THIS EXISTING PVC
FOR PRIMARY UNDERGROUND
TRANSFORMER
A-26145
DIST N-
SER
MAKE
25 KVA 7200-120/240V
_X
A-261-44
rEXISTING PEDESTAL
125'
DRIVEWAY
BORE
@)
0
A-26145
x
20511
Ld
7—
F_
00
DO
LAYOUT
1" = 50 1
4
5
1.1
7
VAULTS BY PUD
A-26144
42" x 42" x 30" OPEN BOTTOM
W/A 11" x 25" ACCESS HOLE
A-26145
42" x 42" x 30" OPEN BOTTOM
W/A 21" x 25" ACCESS HOLE
4
imm
CABLE
310' OF (1) 1/0 AL CNCTRC NEUT DB JCKTD PRI IN 2" PVC
MAKE Po REEL
140' OF 350 AL TRX DB SEC
DUCT
25' OF 2" PVC BY PUD
125' OF (2) 3" PVC BY PUD
110' OF 3 so PVC BY PUD (FUTURE)
I VAULT LIST
VAULT SHEET
A-26144 AND A-26145 1
A-27712 2
SCHEMATIC
NTS
L-
26144
VAY
53597
IS NO H 0 MIS H C 0 U N I Y
F= Li =
I PUBLIC UTILITY DISTRICT No:fl
LOCATION 2051188TH AVE WEST
AREA
SO COUNTY
POLE NO SW 1/4S 19 T27 R4
DATE 10/24/95 _W0 No
34
REASON FOR WORK PROVIDE PRIMARY UNDERGROUND.
ENGINEER OENS
DWG NO
112907
SERVICE TO
DRAFTER RB
UGND NO
8752-1
DALE KATHOL
APPROVED DH
SCALE
NOTED
GAS HEAT
PRINTED
DATE WORK COMPLETED FOREMAN-
ENVIRONMENTAL ANALYSIS
SUBSTATION -MAPLEWOOD —
FEES REQ'D
R EXEMPT
PARA. 18
ONOTEXEMPT
C
CIRCUIT NO 12-346 PHASE 1
N YES 0 NO
ITEM—
-
ROAD CROSSINGS ONLY
PRIMARY OVERHEAD
OVHD CONDUCTOR
KV
El RESIDENTIAL
ADD
CKT FT PH
APPR
DATE DESCRIPTION
0 COMMERCIAL
REM
CKT FT PH
LEO#
REVISIONS
APPR NO. DATE DESC IPTION
JE 1 12/96 ADD SHT —2 AN
�f A' I' T I 1-j I
AS -BUILT
APPR I NO. I DATE'
DESCRIPTION
114 L I %. r\ 1 r I
S_ S
UGND CONDUCTOR 7.2 KV
SECONDARY OVERHEAD
ADD 235 CKT FT 1 PH
BASIC FEE S
REM CKT FT PH
L3 S
NET 235 CKTFT
METER/CONV POLE s
PERMITS (DATE GRANTED)
PRIMARY UNDERGROUND
0 TREE TRIM
N RESIDENTIAL
11 STATE
0 COMMERCIAL
0 COUNTY
BASIC FEE S 975.00
0 ClTY(EDMONDS) 10/6/95
LEU* 6363
143' s 6.10 = s 872.30
0
EASEMENTS 0 REQUIRED
SECONDARY UNDERGROUND
E# 30305 0 NOT REQUIRED
BASIC FEE S
Ig� S = s
DATE SENT TO R/W 10/2/95
DATE APPROVED
—
UNDERGROUND PLAT
BASIC FEE S
FOREIGN CONTACTS
t FT @ S = s
0 GTNW JPN*
STREET LIGHTING
0 CATV JPN*
t FT Q S = s
0 JOINT TRENCH GTNW & CATV
1:1 JOINT BORE GTNW & CATV
WORK IN RIGHT OF WAY
0 PRIMARY
a PACIFIC CA BORE D/W
POLE STENCILING
0 SECONADARY
t FT 0 S s
FROM TO
TAKE OFF POLE
MISCELLANEOUS FEES
VAULT S
PRE-CONSTR REQUIREMENTS
PERMIT S 30.00
0 TREE TRIM 11 PUDLOCATOR
s
0 BACKHOE 0
s
11 ONE CALL DATE
s
TOTAL DUE S 1,877.30
DATE PAID-11/9/95
RECEIPT# 23150
NEW SVCE APPLICATION#, 244137 —
INDEX
POLES
PLAT
LOGS
U-MAP
XFMR
C-MA
LOCATION
MAP PAGE_454,J5
ENGINEER
PHONE—
BEEPER/
CELLULAR
MARK OENS CUSTOMER DALE KATHOL
(206)670-3214 PHONE 775-0232
BEEPER/
356-8546 CELLULAR
PRINTED
11/15/95 22
FERRY
DOCK
SNOHOMISH
COUNTY
PAnK
PUGET
SOUND
Ln
ix
00
196TH ST SWk
Apii w
wo
Goc
41LLL
L 00
pmac
00
...... ........ 202
ST S
JOB SITE
EDMONDS T�
/ I L ...... i� ------ 2 57H i
VICINITY MAP
TAGS
VAULT: A-26144 AND A-26145
CABLE: 53596 AND 53597
c
_R
L0 Y
00 00 i�4
0 to
0 0,
co
0
LAYOUT LEGEND:
PADMOUNT TRANSFORMER
SECONDARY PEDESTAL
PRIMARY UNDERGROUND CABLE
— — — — —
— — — 4/0 SECONDARY UNDERGROUND CABLE
STREET LIGHT CABLE
PROPERTY LINE
RIGHT-OF-WAY LINE
EXISTING UNDERGROUND CABLE
—U—
EXISTING DUCT
FUTURE DUCT
------- S ------
0 SANITARY SEWER/MANHOLE
------- D ------
0 STORM DRAIN/CATCH BASIN
------- W ------
0 WATER MAIN/METER
10,
FIRE HYDRANT
@
STREET LIGHT
SCHEMATIC:
REFER TO SHEET -1
205TH PL SW
SKOGERSON LN
D
TRANSFORMER
A-27712
DIST L-
SER
MAKE
15 KVA 7200-120/240V
_x
VAULT BY PUD
A-27712
42" x 42" x 30" OPEN BOTTOM
W/A 21" x 25" ACCESS HOLE
SECONDARY PEDESTALS
2 SEC PEDS/INSTALL PER DIST ASSY* 1U801
A-26145
EXISTING
20511
ROCKERY
- -------------- -------- r ------
- — — — — — — — — — --- 4
A-277
0\\
LOT 2 LOT 3 LOT 4 (EXCLUDED)
DRAINAGE\-\"
SWALE
0
j
LOT 1
_L�j
SNOHOMISH
IR lom
CABLE
VF;U �IC UTILITY DISTRICT NO 1/
255' OF (1) 02
AL CNCTRC NEUT DB JCKTD PRI IN 3" PVC
LOCATION 20621 88TH AVE W. EDMONDS 98206
AREA SO COUNTY
MAKE
PO REEL
POLE NO SW 1/4S 19 T27 R4 DATE 12/4/96
WO No 29159B
REASON FOR WORK PROVIDE 10 PRIMARY
UNDERGROUND ENGINEER McLAURY DWG NO 118153
250' OF 4/0 AL
TRX DB SEC IN 3" Pvc
DISTRIBUTION SYSTEM FOR DRAFTER JCL
UGND NO 8752-2
140' OF 08 AL
DUP DB ST LT IN 1" PVC
THE 3 LOTS IN THE
APPROVED JE
SCALE NOTED
HOFFMAN SHORT PLAT PRINTED
DATE WORK COMPLETED FOREMAN
ENVIRONMENTAL ANALYSIS
-DUCT BY PUD
SUBSTATION MAPLEWOOD
EES REQ'D
INEXEMPT 0 NOT EXEMPT
PARA. 18 C
CIRCUIT NO 12-346 PHASE 1
M YES 0 NO
ITEM
110' OF
3" PVC (EXISTING)
ROAD CROSSINGS ONLY
PRIMARY OVERHEAD
OVHD CONDUCTOR KV
0 RESIDENTIAL
ADD CKT FT PH
140' OF
3" PVC
APPR DATE DESCRIPTION
0 COMMERCIAL
REM CKT FT PH
40' OF
3" PVC (FUTURE)
LEO#
NET CKT FT
185' OF
2" PVC (FUTURE)
REVISIONS
@ s
UGND CONDUCTOR 7.2 KV
SECONDARY OVERHEAD
ADD 225 CKT FT 1 PH
APPR NO. DATE DESCRIPTION
BASIC FEE S
REM CKT FT PH
- Q S_ S
NET 225--- CKT FT
STREET
LIGHTS
METER/CONV POLE
PERMITS (DATE GRANTED)
PRIMARY UNDERGROUND
0 TREE TRIM
1 ST LTS/SOURCE VOLTAGE 120V
N RESIDENTIAL
0 STATE
ALL ST LT CA
TO BE IN 1" PVC
0 COMMERCIAL
0 COUNTY
INSTALL PER DIST ASSY# 1L902
BASIC FEE S 700.00
N EDMONDS
LEU*
0
EASEMENTS 0 REQUIRED
SECONDARY UNDERGROUND
E* 0 NOT REQUIRED
BASIC FEE (3 x S500.003 1,500.00
.1901 @ S-6—'7--5-J'= S 128-2-50
DATE SENT TO R/W
UNDERGROUND PLAT
DATE APPROVED
BASIC FEE S
FOREIGN CONTACTS
t FT 0 S = s
0 GTNW JPN#.
STREET LIGHTING
0 CATV JPN*
t FT 0 S — = s
M JOINT TRENCH GTNW & CATV
I
WORK IN RIGHT OF WAY
0 JOINT BORE GTNW & CATV
AS -BUILT
0 PRIMARY
0
0 SECONADARY
POLE STENCILING
APPR NO.1 DATE DESCRIPTION
225 t FT Q s 6.10 = s _ 1,372.50
FROM TO
MISCELLANEOUS FEES
TAKE OFF POLE
VAULT S
PRE-CONSTR REQUIREMENTS
PERMIT S 30.00
0 TREE TRIM 0 PUD LOCATOR
(1) ST LT COST EST s 1,006.00
N BACKHOE 0
1/2 OF LEU# 6363 s 436.15
0 ONE CALL DATE
.s
#
TOTAL DUE s 6,327.15
POLES IPLAT
DATE PAID
U-MAP
RECEIPT#
C-MAP
NEW SVCE APPLICATION#
LOCATION MAP PAGE 454,J5
ENGINEER GARY McLAURY
CUSTOMER PAUL STROMME
XING PRINTED
PHONE— (206)514-5628
PHONE (206)524-6821
PRINTED NnV lb'96
BEEPER/
,CELLULAR 290-0208/239-5294
BEEPER/
CELLULAR
4-POS/5-PO�
SET SCREW
TERMINALS
SECONDARY —
TRIPLEX CABLES
SMALL/LARGE
SECONDARY
PEDESTAL
3" PVC DUCT------_'_?�
TO FEED IN/OUT
OFCORNERS OF
PEDESTAL
3" PVC W/900
24"R BEND AND)
BELL END FROM
TRANSFORMER/
PEDESTAL
TYPICAL PEDESTAL DETAIL
NTS
(I
PUGET
SOUND
14
WO AY'
a0m7*s. P,,
VICINITY MAP
TAGS
VAULT: A-27712
CABLE: 53891
I
51
co
co
0
0 LO
If) CD
LAYOUT
V = 40'
00
E
uj
LAYOUT LEGEND:
PADMOUNT TRANSFORMER
SECONDARY PEDESTAL
PRIMARY UNDERGROUND CABLE
-----------SECONDARY UNDERGROUND CABLE
--O—POLE AND -OVERHEAD LINE
PROPERTY LINE
RIGHT—OF—WAY LINE
FUTURE DUCT
—U— EXISTING UNDERGROUND CABLE
SCHEMATIC LEGEND:
1:1 i-BOX
0 10 TRANSFORMER
FUSE
PRIMARY UNDERGROUND CABLE
OVHD EXISTING OVERHEAD
FEED THRU BUSHING ON TRANSFORMER
L-4704—X
205TH PL SW L-21406-XI
I
REMOVE THE SECONDARY CABLE
FROM THE POLE TO THE
EXISTING PEDESTAL ON LOT 6.
UTILIZE THIS EXISTING PVC
FOR PRIMARY UNDERGROUND
TRANSFORMER
A-26145 25 KVA 7200-120/240V
DIST
SER
MAKE
N— _X
4
5
A-26144
ol
EXISTING PEDESTAL
25'
DRIVEWAY
BORE
m
F_
V)
Ld
00
00
LAYOUT
1" = 50 1
I A-26145
1 7
x
20511
VAULTS BY PUD
A-26144
42" x 42" x 30" OPEN BOTTOM
W/A 11" x 25" ACCESS HOLE
A-26145
42" x 42" x 30" OPEN BOTTOM
W/A 21" x 25" ACCESS HOLE
1
CABLE
,310' OF (1) 1/0 AL CNCTRC NEUT DB JCKTD PRI IN 2" PVC
MAKE PO REEL
140' OF 350 AL TRX DB SEC
DUCT
25' OF 2" PVC BY PUD
125' OF (2) 3" PVC BY PUD
110' OF S' PVC BY PUD (FUTURE)
I VAULT LIST I
VAULT SHEET
A-26144 AND A-26145 1
A-27712 2
SCHEMATIC
NTS
26144
VAY
53597
—26145
_X
53891
—27712
L- _X
IS N 0 H 0 M IS
F_—D L__j
I PUBLIC UTILITY DISTRICT No
LOCATION 20511 88TH AVE WEST
AREA SO COUNTY
POLE NO SW 1/4S 19 T27 R4 DATE 10/24/95 WO No 34
REASON FOR WORK PROVIDE PRIMARY
UNDERGROUND ENGINEER OENS
DWG NO 112907
SERVICE TO
DRAFTER RB
UGND NO 8752-1
DALE KATHOL
APPROVED DH
SCALE NOTED
GAS HEAT_
PRINTED
DATE WORK COMPLETED FOREMAN
ENVIRONMENTAL ANALYSIS
SUBSTATION -MAPLEWOOD
FEES REQ'D
n EXEMPT ONOT EXEMPT
PARA. 18 C
CIRCUIT NO 12-346 PHASE 1
IN YES 0 NO
ITEM—
ROAD CROSSINGS ONLY
PRIMARY OVERHEAD
OVHD CONDUCTOR KV
1:1 RESIDENTIAL
ADD CKT FT PH
APPR DATE DESCRIPTION
0 COMMERCIAL
REM CKT FT PH
LEO#
NET CKT FT
REVISIONS
--p S_ S
UGND CONDUCTOR 7.2 KV
SECONDARY OVERHEAD
ADD 235 CKT FT 1 PH
APPR NO. DATE DESCRIPTION
BASIC FEE S
JE 1 12/96 ADD SHT -2 AND-- Q s = s
REM CKT FT PH
VAULT LIST
NET 235 CKT FT
METER/CONV POLE s
PERMITS (DATE GRANTED)
PRIMARY UNDERGROUND
0 TREE TRIM
M RESIDENTIAL
0 STATE
0 COMMERCIAL
0 COUNTY
BASIC FEE S 975.00
0 CITY(EDMONDS) 10/6/95
LEU# 6363
s 6.10 = s 872.30
.143'
EASEMENTS 0 REQUIRED
SECONDARY UNDERGROUND
E* 30305 0 NOT REQUIRED
BASIC FEE S
$_ = S —
DATE SENT TO R/W 10/2/95
UNDERGROUND PLAT
DATE APPROVED
BASIC FEE S
FOREIGN CONTACTS
It FT @ S = s
0 GTNW JPN*
STREET LIGHTING
0 CATV JPN*
It FT Q S = s
0 JOINT TRENCH GTNW & CATV
WORK IN RIGHT OF WAY
0 JOINT BORE GTNW & CATV
AS -BUILT
0 PRIMARY
PACIFIC CA BORE D/W
0 SECONADARY
POLE STENCILING
APPR NO. DATE DESCRIPTION
FT @ S s
FROM -TO
MISCELLANEOUS FEES
TAKE OFF POLE
VAULT S
PRE-CONSTR REQUIREMENTS
PERMIT S 30.00
E3 TREE TRIM 12 PUD LOCATOR
s
M BACKHOE 0
s
M ONE CALL DATE
s
#
TOTAL DUE S 1,877.30
POLES I IPLAT
DATE PAID-11/9/95
U-MAP
RECEIPT# 23150
C-MAP
NEW SVCE APPLICATION* 244137
LOCATION MAP PAGE 454,J5
ENGINEER MARK OENS
CUSTOMER DALE KATHOL
PRINTED 11/15/95 22
PHONE— (206)670-3214
PHONE 775-0232
BEEPER/
CELLULAR 356-8546
BEEPER/
CELLULAR
FERRY
DOCK
S140HOMISH
COUNTY
PMK.
PUGET
SOUND
co i i
w
196TH ST SIN
AN WO I,_
HILL 00,
CO
i - ------ ...... 202
....... JOB Sk
EDmoNbs
I � ...... I ....... I T�
VICINITY MAP
TAGS
VAULT: A-26144 AND A-26145
CABLE: 53596 AND 53597
CN
L0
00 co
oto
0 cn
CIO t,
." to
0
: D ;u:
LAYOUT LEGEND:
PADMOUNT TRANSFORMER
SECONDARY PEDESTAL
PRIMARY UNDERGROUND CABLE
— — — — —
— — — 4/0 SECONDARY UNDERGROUND CABLE
STREET LIGHT CABLE
PROPERTY LINE
RIGHT-OF-WAY LINE
EXISTING UNDERGROUND CABLE
U
N EXISTING DUCT
FUTURE DUCT
------- S ------
0 SANITARY SEWER/MANHOLE
------- D ------
0 STORM DRAIN/CATCH BASIN
------- W ------
0 WATER MAIN/METER
FIRE HYDRANT
STREET LIGHT
SCHEMATIC:
REFER TO SHEET -1
205TH PL SW
SKOGERSON LN
D
TRANSFORMER
A-27712 15 KVA 7200-120/240V
DIST L- _X
SER
MAKE
VAULT 13Y PUD
A-27712
42" x 42" x 30" OPEN BOTTOM
W/A 21" x 25" ACCESS HOLE
SECONDARY PEDESTALS
2 SEC PEDS/INSTALL PER DIST ASSY# lUB01
A-26145
EXISTING
20511
[Z ��l
0
rd WAR I WN
255' OF (1) 02 AL CNCTRC NEUT DB JCKTD PRI IN 3" PVC
MAKE PO REEL
250' OF 4/0 AL TRX DB SEC IN 3" PVC
140' OF 08 AL DUP DB ST LT IN 1" PVC
DUCT
BY
PUD
110'
OF
3" PVC (EXISTING)
140'
OF
3" PVC
40'
OF
3" PVC (FUTURE)
185'
OF
2" PVC (FUTURE)
STREET LIGHTS
1 ST LTS/SOURCE VOLTAGE 120V
ALL ST LT CA TO BE IN 1" PVC
INSTALL PER DIST ASSY# 1L902
4-POS/5-PO�
SET SCREW
TERMINALS
SECONDARY —
TRIPLEX CABLES
SMALL/LARGE
SECONDARY
PEDESTAL
3" PVC DUCT —
TO FEED IN/OUT
OF CORNERS OF
PEDESTAL
3" PVC W/900 —
24"R BEND AND
BELL END FROM
TRANSFORMER/
PEDESTAL
TYPICAL PEDESTAL DETAIL
NTS
SNOHOMISH
F—D--) F-1 F__l
Lf— L-ui
V PUBLIC UTILITY DISTRICT NO I
LOCATION 20621 88TH AVE
W, EDMONDS 98206
AREA
SO COUNTY
POLE NO
SW 1AS19 T27 R4
DATE 12/4/96
WO No
29159B
REASON FOR WORK PROVIDE
10 PRIMARY UNDERGROUND
ENGINEER McLAURY DWG NO
118153
DISTRIBUTION SYSTEM FOR
DRAFTER JCL
UGND NO
8752-2
THE 3 LOTS IN THE
APPROVED JE
SCALE
NOTED
HOFFMAN
SHORT PLAT
PRINTED
DATE WORK COMPLETED
FOREMAN—
ENVIRONMENTAL ANALYSIS
SUBSTATION MAPLEWOOD
IFEES REQ'D
0 EXEMPT
PARA. 18
0 NOT EXEMPT
ITEM C
CIRCUIT NO 12-346
PHASE 1
M YES 13 NO'
ROAD CROSSINGS ONLY
HNIMARY UVERHEAL)
0 RESIDENTIAL
UVHU CUNDUCIUR KV
ADD CKT FT PH
APPR
DATE
D-ESCRIPTION
0 COMMERCIAL
REM CKT FT PH
LEO#
NET CKT FT
_@2 S s
UGND CONDUCTOR 7.2 KV
REVISIONS
SECONDARY OVERHEAD
BASIC FEE S
C2 S_ = S
ADD 225 CKT FT 1 PH
REM CKT FT PH
NET 225 CKT FT
APPR
NO.
DATE
ITESCRIPTION
METER/CONV POLE s -
PERMITS (DATE GRANTED)
PRIMARY UNDERGROUND
0 TREE TRIM
M RESIDENTIAL
OSTATE
0 COMMERCIAL
LEU* BAS . IC FEE S 700.00
0 COUNTY
0 EDMONDS
S-----/,= --
0
EASEMENTS 0 REQUIRED
EO 0 NOT REQUIRED
SECONDARY UNDERGROUND
BASIC FEE (3 x S500.00)S 1,500.00
1900 @ s 6.75 /,= s 1,282.50
DATE SENT TO R/W
UNDERGROUND PLAT
DATE APPROVED
BASIC FEE S
t FT @ S = s
FOREIGN CONTACTS
0 GTNW JPN#.
STREET LIGHTING
0 CATV JPN#
t FT Q S = s
0 JOINT TRENCH GTNW & CATV
WORK IN RIGHT OF WAY
0JOINT BORE GTNW & CATV
0 PRIMARY
0 SECONADARY
0
AS -BUILT
POLE STENCILING
APPR
I NO.
DATE
DESCRIPTION
225 tFT@s 6.10 = s _ 1,372.50
FROM TO
MISCELLANEOUS FEES
TAKE OFF POLE
VAULT S
PRE-CONSTR REQUIREMENTS
PERMIT S 30.00
0 TREE TRIM 0 PUD LOCATOR
-0) ST LT COST EST s 1,006.00
NBACKHOE 0
-1/2 OF LEU# 6363 s 436.15
0 ONE CALL DATE
INDEX
POLES
PLAT
TOTAL DUEs 6,327.15
DATE PAID
RECEIPT*
NEW SVCE APPLICATION#
_
LOGS
j
U-MAP
XFMR
E
C-MAP
LOCATION MAP PAGE- 454,J5
ENGINEER.
PHONE
BEEPER/
CELLULAR
GARY McLAURY CUSTOMER PAUL STROMME
(206)514-5628 PHONE (206)524-6821
BEEPER/
290-0208/239-5294 CELLULAR
XING PRINTED
PRINTED NnV lb'96
VICINITY MAP
TAGS
VAULT: A-27712
CABLE: 53891
IN
Lo
00
cr)
LAYOUT
Vf = 40 1
C)
E..
w
"I
C5
v
J-A"v' "V
C.ity of E onds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number.
Issue Date:
A. Address or Vicinity of Construction: '621 88th Ave W
B. Type of Work (be specific): Trench 140' in R/W and install 1 street
C. Contractor: -SnohoMish County PUD No. 1
Mailing Address: po'gnx 1107 Fvprptt, Wash
State License #:
D. Building Permit # (if applicable):
light
Contact:Jerry Elkington0ary McLaury
Phone: 347-441 - 4 ' �51 - 4-5628
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. E] Commercial 0 Subdivision El City Project J5)kJtility_(PUD, GTE, WNG, CABLE, WATER)
E] Multi -Family El Single Family E) Other
INSPECTOR: I14SPECTOR:
F. Pavement or Concrete Cut: [I Yes XMo
G. Size of Cut: �J x
APPL - ICAN - TT . 0 - READ A:N'-b SIGN
H. Chargq_$ _
12-IL-10
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 of its departments or
employees, including or not limitedto the defense ofany legalproceedings including dpfens! costs, and attorney fees Py reason ofgranting thispermit.
z 1 12 6
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOIWNG THE FINAL
INSPECTIONAND ACCEPTANCE OF THE -WORK. 'ESi'lkATED,RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED B YCITY FORCES, AT WHICH TIMEA 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 requir�A 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 WN4 0jty4reg*ation's as requIrpd-py ity;E
V. - ' — #gineer.
All street cut ditches shall be patched with asphalt or City approved matehal prior to tde end of thew'6rking day;
NO EXCEPTIONS.
Ihave read the abovestatements and understand the permit requirements and thepink copyof thepermit willbe
available I e at all tim��for :ec
'jnsp
�ti 4purposes.
SignaturCe. 4:! k� �' I Date: - December 9, 1996
I(ContractQp,'o'r Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY.
TIME AUTHORIZED: VOID AFTER 7 1- DAYS
SPECIAL CONDITIONS: __�Ivee, V —
S�10&!U �P' kwae'a. aveal(A(!� J.
IQ G AJ S Of "d ot 11.4—t -
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND III:
RESTORATION FEE:
PERMIT FEE- 30,00
TOTAL FEE:
COMMENTS: RECEIPT FEE:
ISSUED BY:
—,DATE:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES (Fund Ill - Route copy to Street,De.pt.)
Comments:
Diagram.:
CONTRACTOR CALLED FOR INSPECTION El YES E] NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
k _-7
City of Edmonds
8 9 0 - 1 9 C� -
RIGHT-O&WAY CONSTRUCTION
PERMIT
Permit Number.
'.Cl Issue Date: '_,J
A. Address or Vicinity of Construction: - 20621 88 Av V (9705547)
B. Type of Work (be specific): lke;=subait for permit 1 97-011 per
request
C. Contractor: Va- Natural Gas now Puget Sound Yftexjr Doug Usitilo
Mailing Address: 1122 75 St SW Everett Phone: 356-7520
98203
State License #: Liability Insurance: Bond: $
D. Building Permit # (if applicable):
E. E] -Commercial E] Subdivision
0-Mfilfi-Family, 0 SingleFamily
INSPECTOR:
Side Sewer Permi t # (if applicable):
El City Project [2 Utility (PUD, GTE, VVNG, CABLE, WATER)
F] Other
INSPECTOR: RW
F. Pavement or Concrete Cut 0 Yes 0No G. Size of CuVf x 14' Charge:,$
APPLICANT TO READAND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City ofEdmondg,harmle88froniinjurie8, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City o� Ednumds, Or any Of its departments or
Jee8 by reason ofgranting thi8permit.
employees, including or not limited to the defense ofany legalproceedings including defense Costs, and at ey
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECT ION 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 THEAPPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call thb Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codeg.
Street shall be kept clean at all times. K 11 : ",
Traffic Control and Public Safety shall be indccordance 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 above statements and understand thepermit requirements and thepink copy of thepermit will be
available on site at all times for inspection purposes.
Signature: 4495ze y7h'd&J. Date: 2��
___U _(Condactor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BYAW
TIME A UTHORIZED: VOID AFTER DAYS
SPECIAL CONDITIONS:',
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND III:
RESTORATION. FEE:_
PERMIT FEE: 0(9
TOTAL FEE:
COMMENTS: RECEIPT FEE -
DATE: -ISSUED BY;, ZZ W_e4 d'4_'Q_
V I f I .r
NO WORK SHALL BEGIN PRIOR TO PERMIT ISAUANCE E I ng. Div. 1994 f
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
11 NO
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number -
Issue Date:
2U6 2 1 88 Av W (9/05�40
4
1, - A. Address or Vicinity of Construction:
-4-Anamoo, Q�
- C� -
�' . q s t z...L
B.. Type of Work (be specific): -1. *2" milh
IP tcou, 14'.W to 20''i"
9 0 . 1 9
88 A v
W �_d 2 �01' c'
Z06 1"L M4 t
zsuu 1. 11 t o
E tow
I fh'�
C. Contractor: Wast'l-LOAtoll
kat-ucdA
%2 a
Contact:
Kiagiiblucy
MailingAddress: 1122 71-A
St. S61--
Flverett'
Phone: 3561500
ext Z�96
State License #:
Liability Insurance!
Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. [I Commercial E] Subdivision E] CityProject r ility (PUD, GTE, WNG, CABLE, WATER)
] U6
0 Multi -Family EJ Single Family E] Other
INSPECTOR: INSPECTOR:
x
F. Pavement or Concrete Cut El Yes 0No G. Size of Cut: 4 .,1' H. Chargq_$
s�ver cx1st.Ai*- pal-ch
APPLICANT TO READ AND SIGN
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 of its departments or
employees, includingor not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgr;anting 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 TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work req uired 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.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on site at all times for inspection purposes.
Signaturel 22?
(Contractor or Ageni)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY:
TIME A . UTHORIZED: VOID . AFTER bffi4UA_30`DA'YS
SPECIAL CONDITIONS:
COMMENTS:
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND1.11:
RESTORATION FEE:
PERMIT FEE. -
TOTAL FEE:
RECEIPT FEE:
DATE:
ISSUED BY:
xYd-% Vi7niDW QTJ A T T. TIPP-TV 13V InR T(I 13F.lR.MTT I
1�
ANCE
1-1n, Ow 1994
I
Notes: The City of Edinonds
1) Field locate all utilities.
Call 1-800-424-5555
24 hours before digging.
2) Survey is not required
3) Maintain a minimum of 5'
horizontal and 3' vertical
clearance from all city
utilities and appurtenances.
I
Notes: The City of Edinonds
1 ) Field locate all utilities.
Call 1-800-424-5555
24 hours before digging.
2) Survey is not required
3) Maintain a minimum of 5'
horizontal and 3' vertical
clearance from all city
utilities and appurtenances.
I
Notes: Tbe City of Edmonds
1) Field locate all utilities.
Call 1-800-424-5555
24 hours before digging.
2) Survey is not required
3) Maintain a minimum of 5'
horizontal and 3' vertical
clearance from all city
utilities and appurtenances.
0
City of Ediiionds
RIGHT-OF-WAY CONSTRUCTION 038
PERMIT Permit Number. q 17-011
k, 4 -7
Issue Date':
A. Address or Vic . inity of Construction: 20'621 88 AV V_ (9705547)
-%WNNNNP- C) Q5
B. Type of Work (be specific): Install 2" MPE
IP from 14'W to 26E C/L
9 0 - 19
88 AV
W @ 230'S
C/L 206 Pl, SW then
south to 239'S then east
E low
line
C. Contractor: Washington
Nature&
Gas
Contact: — Mariamne
Kingsbury
Mailing Address: "'l 122 75
St SW
Everett
Phone: 356-7500
ext 7596
State License
98203
Liability Insum"ince:
Bond:$
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. C] Commercial El Subdivision El City Project g] Utility (PUD, GTE, WNG, CABLE, WATER)
FJ Multi -Family 0 Single Family E] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: ID Yes []No G. Size of Put: 4 x 2 H. Char
over exist atch c
APPLICANT TO READ AN44DN
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 of its departments or
employees, including or not limited to the defense ofany legalproceeding8 including defense costs, and attorney fees by reason ofgranting 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 TIMEA DEBIT OR CREDIT WILL BE PROCESSED 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 ditc ' hes shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTION S.
Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit will be
available on site at all times for inspection purposes. I
�1-17-97
NING WORK
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY DEPOSIT
3r
TIME AUTHORIZED: VQID AFTER MA46 j'�AYS DISRUPTION FEE/FUND I 11:
SPECIALZONDITIONSt
RESTORATION FEE:
9d IV
PERMIT FEE:
0 TOTAL FEE:,.
COMMENTS: RECEIPT FEE:
�_7 ,
DATE: 'ISSUED, BY- -
to*
NO WORK SHALL BEGIN PRIOR TO PERMIT IAUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund Ill - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION 11 YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
El NO
I
C)
Notes: The City of Edinonds
1) Field locate all utilities.
Call 1-800-424-5555
24 hours before digging.
2) Survey is not required
3) Maintain a minimum of 5'
horizontal and 3' vertical
clearance from all city
utilities and appurtenances.
4) Cuts In paving are shown as E3
5) 1 cuts In paving anticipated. —
0 E�-
1
— -- ---- RILL OF MATERIAL
c;, B
A Y
VWW-rx- Owl
Natural Gas
10 1) 1; P 2- — C— — S) -7-
-rc) <2,r--= I
b, v \,k4
T
0
C riti ca'ItA
r e a!
� A�Nl A tflo, " r i n". -a t i o n lsoilsftooi) �",
grap y&ydna
Nnor
4
C FILE NO. r6
A
Ch6tkfist
AV,
_g y!�
gda,tion ,
3 And.
s�l--Short,,,,,P at:! No—
"7�7,.��'port j�%ot, Aots,,. 9& 170 7d-tW,—Md.,EP
_U ..5
'Tax Account. Numbei.M.)AINDWRIU., 446-000 "01
r1t1yo
. "W"ASOMWOO
5446-000-009 2000--:t
3. :Approximate Site Size (aires or squar6166i).`,i-, ac. -
te 'X'
'11416
.21 , g&
4. Is this si currently developed?
K yes; how is site developed?,_-O 1 '401'
-5. Describe the general �ite topography. Check all that apply..
Jlhit 'V.W__,�FUE .-4.,'less *than 51fikd&iti(in oi&ehtir'e--s_it,�.42 U-173"
oarkee. -
Rolling. dopes on sia�keikhllj less -than 15% ver a
:, .1 . '1 (a' 6.0f .1046d o
466-feet).
horizontal d�iafi�e-
slopes present,on' site.of more than i5 i�� les"s'than' '3'0%' a vertical rise;
of 10-feet over a horizontal distance of 33 to 66-feet).
fSteep:.�,l grajes qfgn��ter,thait.30% present on site (a vertical rise of 10-feet over a
%,%
h9rizontal-Aistance,of less"dian. 33-feet).,
vit—
Other (pleasedescrib
--v
'Jac
p f �q.!i, 4'.., " -
6. Site bontains ar'e'as'of'vear,-i6ii�a'itinding �iater:' -No ;Appr6k.,,Dep.th: NI
A
_7'
7.. Site -contains areas ofseai6nal.stabding,wat I er. No
;-Apprqx, Depth:- t-,ir —
j
What seasoi(s) of the yearl..
" 8 Sitd is in'the flood N flood0ain. of a water course.
way 6,
9
Site contains a�creek or an.area where,water flows across the grounds surface? Flows are year-
-round? No Flowi are sea"sonail? '. No .(�&Fhat timepf year?. N/A
10. Site is primarily: forested
urban landscaped (lawn,shrubs X meadow ;'shrubs mixed _T�
11. Obvious wetland is present on site: No
or City Staff Use Only
?
i is Zoned
xnapped soil ty !�_,�Iew
Pe(s)?
C
.-W-etlafid inventory or A., map indicates-w d present on site?
Ctitical Areas inventory or C.A.- map indicit 'Crifical Amon site?
�----Sitja;�rithin designated earthsubsid6nc61indslj&h��M-j=?*:
-S46*designated on -the En'viiroiime�tall'y*S6ii�tfi've'A�e.0 Map;? AIV
J Ej�El
L �AMATION,
CONDMOMAL WAIVER
...STUDY REQUIRED
WAIVER
z _err
Re vi i 6*`W'e`d' b
Planner
Date
RCV01/004
T",
Jik
� � MIMI ` IN,
A R
q_ low. Ma I
TF
0, .1 op 41" f
City of Edmold
e
.,,.Areas,-Ch c
Critical e klist*
-tanda6mit-it to e-
The Critical Areas Checklist contained one, tn
di City. 1heCi
this form is to be filled out by any person review the ched hs make a precursory si
preparing a D6velo&eht Permit #,,;.V,.;visit,_and malm determination ofthd—
Application for the City of Edmonds prior subsequent steps necessary to complete a
3
to his/her submittal a!"cleveA10"'p''ment, A . 4t .
deirdoptntritTernut applidation.
i ia Jelli." s%.; �W M17k) 10 i lo
permit to the City.
0� 4DII& fv�, ZX 'W'i&-a�sipedtopy:oftliisfoiin;.the..,,
The purpose of the Checklist is to enable,,,*.-,' iwdi &vplicant,sh6uld also'submit a vicinity -
City staff to determine whether any or plot vlanfiqrj4dividual.lots,of the parceti.,n�;;,r, 4�.,77, f:.
potential cfidlc�
or
-withenough detail that City staff can fi d4 t, �P
In
present on the subject pro rty. The and identilly. the subject.pgxrl
-46
"Te, (Sh�
information- needed to tomplete the--7.. "t'i ad -the app cant shall indude�'.
Lst. should bi�hiily>airailable frorii eroeffikiiitlififi) o n (i 6. g; i Vk i k-4
Checkli
observations of the site or data available at phyima netc�)forfstudies W
ps,
CAty Hall (Critical Areas inventories, maps conjunction with this Checklist to assist
J2
lirnin'aryhi�,'A 44_�
'staff Mconi�leting'their "re_'l e%
or sodi surveys). P
of gii ati�
Anapplicant'!'orhisih'e*'ri4ii6sefititiv"e',,.--(3!':,'��,.,"el�,t;4yj
must fill out. -the checklist, sign and. date it,.j
I have completed the attached Critical Area Checklist and attest that the answers provided are.:,-,
&cU.W, to the best.of.Iny, I (fill out.the appro lumn below),
know. edge.
priate PQ
Owner Applicant:
Applicant Representative:
Robert Hoffman I,,,..Triad,. Associates /Phil. Kitzes
Nam Name.
2525 186th Place..Sdutheast_ 1'1'81,-4 1115t'h -'�"Av eiiriue' 'Northea's t -1: 4
Street Addrem .j.. StredAddr=,,vU%,'#;
and WA-.98034
.13othe114 WA.98012- (206)488-2727,'�-.'.-,.,.---..�,-.Kirk1
V,i�j�t,,xrw fho
Ci tate, ZIP ne�_.' City. State. ZIP
,kloorl -1
Signiture.( —Date S
L.F %X%lj� jr. jl
k % 10 4t/
ORAWACE
2
rrpE, w771
— — — — — — — — — — -
5,—z'
ALL '2',r5o'!
DETAX
ON SHEF T 2
S TREE T FILE
TOP
-WS TRUC 77ON 20'- rop 150
4" & 12' 350.04
3 73.
CB 5 r
Y I -op 3512
.0
j5.
24
� 1: , , \ \ W
SEV
cd !2' !C
Q)
ni
. ao
t
-zq
2
----------- . ............... ............ E
L4j 4
C3
i&S
RIPRAP PAO W1
5�,
CUARRY
E P. S 0 N L A hIE'
TO
rOR
'E CA sEvEm r
27- —7 1 -NANcE sy Lor i,
7E
AND J.
t
Ali
J.5j. 5
M. W S. 35 39,
2. NO TE.
LO
R
18 4� IE J.50.56 PIPE LENG7HS ARE CENTE
Or CB TO CENTER OF CB
Z-sTmyl
;6
WITU 17"
tj
ro EX J-54.
DAnIGHT
�:CN rO UP
Ca ok.
t_A
T
crj
3seL
A 7"-R
ZCE A NO ME 7ER
2 1 J. -34.'
USE
'TY OF D MO N D
CITY OF EDMONDS ZONEjq.6_/2.
R M IT A P PL'CATION
CONSTRUCTION PERMIT APPLICA1111011.4 -
U C T N P
ADDRESS
JOB
Sq
PERMIT
NUMBER 9r.0781
2-/ 6b"Ame,
W su ITE/APT 0
OF U SINE S S
OWNER NAME NAME OF
S_
V
N�E
TKI
-3
SUBDIVISION .0,
LID No
MAILI EBB Zor
4V PUBLIC
A
7
RIGHT OF WAY PER OFFICIAL STREET MAP,
6!" REQUIRED DEDICATION
T SCP ApprMed 0
REW Pe -it Roq..Ied 43-
St,"t Use-Pamit R*q-d 13
Inspection Required -8-
Sid"alk Required
CITY I
EXISTING
PROPOSED
NAM�� ea"a Ale
ZE
[RED
ADDRESS
REIIIIARKS
is V`-4 U - ug
CITY ZI
PHONE NUMBER
TEL, Lim.
MEMO DATED
- +- -7. 9 6
ADDFI��rg:3 (��Ahjt_ A�F — ENGINEERING
NUMBER
?6) - 16 1� ;_�5
- include all easements
DATE
Er.
lall `RE.IDE IAL
PLUMB11401110111CH
ADDITION
COMMERCIAL
COMPLLANC OR
CHANGE OFEUCSE
REMODEL
APT. BLDG.
SIGN
0 REPAIR
CVDS.
0
PENCE
1 x
DEMOLISH
WOODSTOVE
INSERT
SWIM POOL
HOT TUB/SPA
Er
RETAINING WALLY
13 ROCKERY
RENEWAL
NUMBER OF CRITICAL r&/y1F-VA- 11111
AREAS
NUMBER :;Z
OF �eq
DWELLING L�-,/ I
STORIES UNITS NUMBER
11 DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
SIGN AREA
SEPAREVIEW
ADS
ALLOWED
ROPOSED
COMPLETE
I
1EXEMPT
ORELINE 0
EXP
VARIANCE OR CU
P LANNINGoPIE)VEW BY
DATE
r,.:t V4
SETBACKS - FEET
HEIGHT
COVERAGE
FRONT -T:C SIDE I D
REAR'E�r I
ILOT
—5�
A?. %/02,52-50-07
-75�11EI IPOV
REQUIRED 1 �6;6
I 'F
rkrA KS
PROGRESS INSPECTIONS PER UBC 108
FINAL INSPECTION REOUIRED
PLAN CHECK FEE
T,
-T
BUILDING
7t,; 44 3
HEAT SOURCE:
GLAZING 3 -,7- %
PLUMBING
Plan Check No. 9&-2-06
MECHANICAL
- 711
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, sidewpike,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
STORM DRAJNAGE FEE
Permit Limit: I Year - Provided Work Is Started Within 180 Days
3 0
"Applicant. on behalf of his or her spouse. heirs, assigns and
ENO. INSPECTION FEE
successors in interest, agrees to indemnify. defend and ho d
2 harmless the City of Edmonds, Washington. its official.,
2 employees, and agents from any and all claims for damages of
from Issuance
I whatever nature, arising directly or Indirectly the
I of this permit. issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
0
- modify. waive or reduce any requirement of any city ordinance
nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
provision."
I hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
Information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and
THIS PERMIT
This application is not a permit until
5 tate laws regulating construction; and In doing the work authoriz.
AUTHORIZES
ONLY THE
signed by the Building Official or his/her
ed thereby. no person will be employed In violation of the Labor
Code of the State of Washington relating to Workmen's Compensa.
WORK NOTED
Deputy; and fees are paid. and receipt is
acknowledged In space provided.
tion Insurance and RCW 18.27.
INSPECTION
SIG
DEPARTMENT
OFFICIA E
CITY OF
zokl
W./.
EDMONDS
CALL FOR
RELEASED BY:
ATTENTION,
INSPECTION
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UN71L A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220 ORIGINAL - File YELLOW - Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
SECTION 109
PINK - Owner GOLD - Assessor
.71V
10/�6/96 08: 13 FAX
lei UU2
October 16,1996 RECEIVED
0 C T .2 8 1996
PERMIT COUNTER
Mr. Paul Stromme
Stromme Construction
9623 - 8th Avenue N.E.
Seattle, WA 98115
CO
RE: Hoffman Short Plat, S.9S-197. C
Dear Mr. Stromme:
You intend to construct homes on three contiguous lots in Edmonds. The site is in the
vicinity of 20618 - 88th Avenue West Two of the lots are on a shared moderate slope and
the third -is below the slope and relatively flat Attached as page 3-of this letter is a partial,
scale -altered site and topo plan prepared by Dean Read,- architect.
'You have a long farnilimity with the combined properties And were aware that foundation
conditions were unfavorable for conventional shallow foundation support on Lot 3. For this
reason and to head off any future questions about slope or foundation support for Lots 1
and 2, you asked me to inspect and prepare this letter.
At my suggestion, you arranged for the services of a backhoe at the time of my inspection
last week. Three test holes were dug; their locations are shown on page 3. A summary of
conditions -found is presented on page 4,
The stratigraphically deepest soil type is glacial till, found at location three. Locations one
and two are'i an ancient swale which first collected sandy sediment then organic silt and
peat- Grade has been raised about 5 feet with fill. You can expect that there might be
intermittent groundwater presence at 2 to 3 yards depth at Lot3,.though none was observed
during test digging.
Soil conditions are highly favorable for developing Lots 1 and 2- The glacial till there is a
hardpan at a depth of roughly one yard. I recommend that all parts of your foundation
system be dug sufficiently deep to bear on the hardpan. Because of the unusually hjcrh
0
strength of the till, slope stability is not an Jssue.
Conditions are not favorable for conventional foundation support on Lot 3. 1 recommend
thit.the bouse there be supported on small -diameter steel piles. The piles would be
between 2 and 4 inch diameter and of length� determined by driving perf6rinance. The
piles would be driven to 'practical refusal as defined by the procedure and equipment
employed. Below is a summary of size -capacity options. Higher capacities or different sizes
might be allowed subject to load testing or other justification.
JAMES EATON, PE Q GEOTECHNICAL SERVICES
A
(206)682-6942 IV Box 126 * Ho'bart, WA 98025
101/18/96 08:13 FAX
0003
Mr. Paul Sttomme
October 16, 1996
Page 2
Pile Type
2" Schedule 80
3" Schedule 40
4" Schedule 40
Driven By
90 psi pneumatic
hammer
350 Ib. hydraulic
hanuner
350 1b. hydraulic
hammer h " *
Nominal Allowable
Capacity
4 to 5 K
12 K
16+ K
Tle substance of this information was verbally passed to. Clark 'Johnson Assoc., your
structural engineers, At that time ihe garage floor options were briefly discussed. With less
than a full structural slab there is some risk of slab settlement. You can minimize the
effects of settlement in ways short of pile support. The choice may reduce to a practical
and economic one and will be discussed with you and your design team.
Conditions beneath Lot 3 are not so adverse as t*o require special recommendations for
utilities or for incidental improvements such as the driveway or sidewalks.
Please see that I am provided with copies of the foundation plans when available.
Yours very truly,
owl'
INA
off. INA
-El ... ...
James Eaton, PE 17
62-8791
cc:
Dean Read, Architect .............
=D(PIRES 17 42 Y—C,
Clark Johnson, Structural Engme, -- Z�
ss N89' 6 $ 50"W
'do
—sl
El 2 -3 4!- . .....
9716 O'w
8- CONC Ou
ro
\�SjTB A CK
LINE
sq
ft.
vLow.
to# Y..
ce
W71,4V
18,418. -sq. f
�'a 0_"WT-- MIDPOI
_I . 4
Na -1 w
9 50"'
140. IA
A
3 Irp
-.- ft&,.o
S% f t
904
ss
ell
uj Oz
A
Q
Cp
C>
go
10/16/96 08:13 FAX
16005
#1
#2
TEST PIT LOGS
0 1
Variable silty sand and sandy silt Ell (sofOoose)
5.0'-5.3'
Medium to dark brown organic silt with peat (soft)
7X-7.4' (Var.)
Gray firm sand with some coarse (medium to dense)
10.3t Completed and backfilled 10-8-96;-no groundwater encountered
5.49 Variable silty sand and sandy silt fli I (sofOoose)
Medium to dark brown organic silt with peat (soft)
7.2'-7.4'
Gray firm sand (medium to dense)
9.5' Completed and backfilled 10-8-96; no groundwater encountered
#3
01
Medium brown silty sand with gravel (glacial till, gradational
3.4� weathered and with 1600tS)
Ught to medium brown silty sand with gravel (glacial till
hardpan)
6.5' Completed. and backMe.d 10-8-96; no grou n*dwater encountered
PLANNING DATA
NAME:- 54y, D e
SITE ADDRESS: *206 DATE:
ZONING. PLAN CHK#: Lva
PROJECT DESCRIPTION.
A/O
CORNER.LOT (Yes/No)
SETBACKS:
Required Setbacks:
Front: 7-c-Left Side:— 10 RightSide: 10 Rear: Z-55-
Actual Setbacks: -
Front:, Y 7 Left Side: ) 0 Right Side: 10 Rear I (Z
Street map checked for additional setback required? AN (Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE:
07
Maximum Allowed: 41 —Actual:
BUILDING HEIGHT:
Maximum Allowed: 7,5- —Actual Height: ----
Datum . PointA44 144e AWOW Datum Elevation: 3
SUBDIVISION: t'77
CRITICAL AREAS #:
SEPA DETERMINATION:
LOT AREA:
OTHER:
Plan Review By: � CP- Ic V rv'f
890 - 199-
City of E&mon&
Critical Areas Checklist
The Critical Areas Checklist contained on
this form is to be filled out by any person
preparing a Development Permit
Application for the City of Edmonds prior
to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable
City staff to determine whether any
potential Critical Areas are or may be
present on the subject property. The
information needed to complete the
Checklist should be easily available from
observations of the site or data available at
City Hall (Critical Areas inventories, maps,
or soil surveys). -
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
RECItivea
AUG 2 9 1W
FMIT C&jft
and submit it to the City. The City will
review the checklist, make a precursory site
visit, and make a determination of the
subsequent steps necessary to complete a
development permit application.
With a signed copy of this form, the
applicant should also submit a vicinity map
or plot plan for individual lots of the parcel
with enough detail that City staff can find
and identify the subject parcel(s). In
addition, the applicant shall include
other pertinent information (e.g. site
plan, topography map, etc.) or studies in
conjunction with this Checklist to assist
staff in completing their preliminary
assessment of the site.
I have completed the attached Critical Area Checklist and attest that the . answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Robert Hoffinan
Name
2525 186th Place Southeast
Street Address
hothell, WA.98012 (206)488-2727
Cit tate, ZIP Phone
te, ZIP
Signiture ( Date
Applicant Representative:
Triad Associates/Phil Kitzes
Name
11814 115th Avenue Northeast
Street Address
Kirkland,WA.98034 (206)821-8448
City, State, ZIP Phone
8. 2-4.5'5
9Situ5e �' �' Date
CA FILE NO..
Critical Areas Checklist 14 ";'�i
i "information (soils/topography/hydrology/vegetation) P4&�,
e
Lot 2, City of Edmonds Short Plat No.4 83 And
Address 2�
f [Ucation: 4
portl'o 0 ots 9&10 of the Pine*Ridge Short Plat.,
2. Xrty Tax Account Number: 5446-000-009-0101 / 5446-000-010-0009/
�A-
3. Approximate Site Size (acres or square feet): 1.46 ac 5446-000-009-2.000
4. Is this site currently developed? _yes; X no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
X Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
X Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise
of 10-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: No Approx. Depth: N/A
7. Site contains areas of seasonal standing water: No Approx. Depth:
What season(s) of the year?
8. Site is in the� floodway No _ floodplain No of a water course.
9. . Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? No Flows are seasonal? No (What time of year? N/A
10. Site is primarily: forested meadow _;shrubs
; mixed
urban landscaped (lawn,shrubs etc) X
11. Obvious wetland is present on site: No
--For City Staff Use Only --
'I. Site is Zoned?
2.,,: mapped soil type(s)?
3. Wetland inventory or C.A. map indicates wetland present on site? AI0
4. Critical Areas inventory or C.A. map indicates Critical Area on site? 4 A)
5. Site within designated earth subsidence landslide fi aizard area? A/C)
6— Site designated on the Environmentally Sensitive Areas Map*7 A4
DETERMINATION
STUDY REQUIRED CONDITIONAL WAIVER
Reviewed by: WAIVER Z
Planner Date
Rev 01/0494
PERAUT APPLICATION REQUIREMENTS
To: Applicant
From: Jamal Mahmoud, Engineering Inspector
Owner: V-0 M "R leavL
Address:. -2.,2 6 ?-1 — ss 47::� A �-v - W
S.-TR EET ILE
Plan' Check No: eg
Date: tt� f�� +-
After review of the subject permit application, the following requirements must be met:
1. Consiruction hours are: WEEKDAYS — 7:00 A.r*L-10:00 P.M.;WEEKENDS/HOLIDAYS — 10:00 A.M.-6:00 P.M.
2. A separate RIGHT-OF-WAY CONSTRUCTION PERAW is required for all work on public property. (ECDC 18.60)
3. Truck haul route plan must be submitted and approved prior to permit issuance.
4. Builder/owner is responsible for containing all temporary runoff and erosion control on site (ECDC 18.30.030d).
5. NO WORK SHALL BE DONE WITHIN 15 FEET OF STREAMS OR 10 FEET FROM ANY CLOSED DRAINAGE
FACILITY. BUILDER/OWNER IS RESPONSIBLE FOR IDENTIFYING CONDITIONS ON THE DRAWING.
(ECDC 18.30.50G)
6. FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCTION.
(ECDC 18.30�
7. INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEMS, TIGHTLINES AND CATCH BASIN
INSTALLATION. INSPECTIONS ARE REQUIRED PRIOR TO BACKFILLING. (ECDC 18.30)
8. Repair or replace all defective existing curb, gutter and sidewalk adjacent to the property. If an intersection is involved, a handicap ramp
may be required. Contractor shall meet with the City Engineering staff to determine the extent of repair prior to issuance of the permit.
(ECDC 18.90)
9. Driveway slope shall not exceed 14% without a waiver. Every attempt should be made to keep the slope below 14%. Waiver granted to
C—' %. (ECDC 18.80.060D)
10. Driveways must be paved from' property line to City RIGHT-OF-WAY. A separate permi t is required. �ECDC 18.80.060C)
I I - INSPECTIONS ARE REQUIRED ON DRIVEWAYS AND SIDEWALKS PRIOR TO AND AFTER POURING. (ECDC 18.30)
12. No burning of construction refuse without a permit from the Fire Department.
13. Connection to City water system is required. There is a separate charge for the water meter (ECDC 7.20).
14. A back water valve is required if.downstaiis plumbing is below the elevation of upstream manhole. (ECDC 7.20)
15. Water and sewer main lines should be separated by 10 feet minimum. (ECDC 18.10)
16. Connection to the City sanitary system is required. A separate permit is required.
LID# Fees paid: Yes— No— Charge (ECDC 18.10)
17. Underground wiringisrequired on all new construction, and for additions, alterations, and repairs that exceed 50% of the total assessed
value of the structure. (ECDC 18.90)
18. A FINAL ENGINEERING INSPECTION IS REQUIRED PRIOR TO THE BUILDING DIVISION GRANTING OCCUPANCY
OF THE BUILDING OR STRUCTURE. (ECDC 18.90)
Pnff"P.Doc
ENGINEERRIG,
ROUTE TO On_�4_Backjo/_Y Add? Total Days c? Mailed I DIV
RESUB #I ON TOM —B ackjo I I_Add? Total Days Mailed
RESUB #2 ON TO Back Add?
1. Site/Drainage Plan & Calcs OK
2. Grading Plan/Calcs/CYG —240 SEPA?&tr OK
3. Driveway Slope 0/._IL9- Profile.
4. Truck Route Plan
5. Street Dedication?
6. Easement9
OTHER COMMENTS:
Total Days_��Mailed
Corrections Required Received
I. j)r,k4nq_4..f Rbai4
OK 2. &YVLL"
N-j
_OK 0 [(-
TEET__.C)_L
3.
4.
5.
STREET FILE*,
PW REVIEW Date Sent Back FIRE REVIEW Date Sent Back
PLANNING REVIEW TIME TOTAL DAYS ENG REVIEW TIME TOTAL DAYS
FIRE DEPT REVIEW TINE
TOTAL DAYS *** PW REVIEW . TOTAL DAYS
BUILDING DEPT REVIEW TIME: In -House
ORDINANCE COMPLETION DATE.
PERMIT #
Outside
COMPLETION DATE
,TOTAL DAYS.
TOTAL REVIEW TIME DAYS
ISSUE DATE
*CONTACT PERSON STATEMENT*
BY SIGNING TMS FORM I UNDERSTAND THAT I AM THE ACKNOWLEDGED CONTACT PERSON FOR
TEEIS PROJECT. IT IS MY RESPONSIBILITY TO COORDINATE ALL SUBMITTALS WrM TBIE CITY
AND ONLY I CAN MAKE INQUIRIES ON THE STATUS OF THE PERMIT. I UNDERSTAND THAT IT IS
MY RESPONSIBILITY TO DETERMINE IN ADVANCE OF PERMIT SUBMITTAL ANY DIS 4CRETIONARY
PERMITS THAT MAY BE APPLICABLE TO THIS PROJECT. I ACKNOWLEDGE THAT TO THE BEST OF
MY ABILITY I HAVE SUBMITTED ALL NECESSARY DOCUMENTATION IN ORDER TO MAKE A
/C01M"T ETE AP LICATION.
Date q 6C t0_ c4g, Mailing Address
)06L�J (F6/Z3 ��Aljf_
Contact Person (Print Clearly)
,ZOLi,�'57D - - 6_82 / / Zlbl—
Phone Number FAX Number
ROUTE.DOC/L/Temp/Bldg/Forrns-5/96
1-00
tj
44
Mew~ &rAa�e
*376 s 4i�
ou"
s CK
06
C*q
Llq..E
sq'..
a
LAI
LLI,
- ab
r
t #A - L
irb-
ft ED Y
Mr,
.4�— --Alga" ftasb�
0
.0 -------
Water Service Draw-Ing
The City of Edmond's E-ASEMEN11' NO . ..... ...... — ...... ....... . —
NEW CONSTRUCTION REPAIRS El LID NO . ................ ,.ASMT. NO . .....
OWNER............................. ......................... ........................... I ........ .... CONTRACTOR ...................................................... ............................. PERMIT No. 10.71,
JOB ADDRESS .... '" AV,5...,.w LEGAL DESCRIPTION: LOT. NO . ..... ............................ ..., BLOCK NO . ................................
.............................. . .. ..............
............................................................. I ...........................................
PWW-0001 -11175 (REV. 11/78)
ON �
Approved: PORTC-,'Al Ll- '�- 47 7
17 DATE..�(-,"?-: ............................. By ..... .. & ......