20826 80TH AVE W.PDF111111111111
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20826 80TH AVE W
41
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City of Edmohds'. Permit No:
RIGHT-OF-WAY CONSTRUCTION PERMIT, Issue Date: (oil 1490,
A. Address or. Vicinity of Const . ructi . on: Z-0132 60 5�mA,,& alem 7- Al
B. Type of Work (be specific): cc ggeza&ks�-
x" Poo
C.-
C4 Cg
C. eerAr-actur C
lVallAIM. ontact:
Mailing Add'ress:Vn 7 Phone: L4c5_2>47—Yq13',
rance
State Eicense #: Liability Insu :IyBo/d-. S7
C;1
D. Building Permit'# (if'dpplicaible): Side Sewer Permit # (if applicaVI-p,):"
V_4pUp,
6)o08115q,3 k
E. F-1 Commercial E] Subdivision City Pr ect P'O'EtUp (PUD, GTE, PSE, CHAMBERS, OVWD
Oi
F� Multi -Family E] Single Family Other
INSPECTOR-
F. PAVEMENT: YES No G. SIZE OF CUT x H..Charge:
CONCRETE CUT: YES ANO
APPLICANT TO READ AND SIGN
IDEMNITY. Applicant understands by his/her signature to this application helshe holds the City of Edmondkharmless from inju es,'t
damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City 'bf Edmonds or
any of its departments or employees, including but not limited to the defense of any'legal proceedings including �de��_��e d
an
attorneyfees by reason of gran ting this pe i rmit.
THE CONTRACTOR IS "SPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR, FOLLOWING THE FINAL
INSPECTION AND ACC . EPTANCE 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.
Traffic control and public safety shall be in accordance with City,regulationi as required . by th!�City Engineer.f,* Every
flagger must be trained as required by (WAC) 296-155-305 and must have certification verifying completion of the
required, training in their possession. 1*
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. J,
Three sets of construction drawings of proposed work are required with t e permit appliciiion—
IHA.VE READ -THE ABOVE STATEMENTS,AND QNDEB�$TAAD. THE PER -MIT REQUIREMENTs AND ACKI�QWLEDGE
THA TI MUST MAKE THE IFINk COkY THEPERS11TA VAILABLE ON SITE ATALL-TIMES TdR ANSPECTIONS-
P 0
Signature: Date
.,.e A )PA .4
(Contractor or Agent)
Joe CAL
L DI L-A-DIG (1-:800 424-5555) PRIOR TO BEGINNI 61iK
Wi
FOR CITY USE ONLY'
'A bE Rig4t-of-wa ee:
pproved Ir
-9 V idA C) 0,
'-TimeAuthoriz Disrupti ee/Fund I I 1'-.�
��,,,,Aands(ap Res to tio
''SpPcialConditions 'ap,�zfw >a Fee
N tal Fe
e:
Receipt Noi
AAYMAR, -Aii)Y t .0
nor
UPON COMPLETION OF PERMITTED�WORK, AN ENGINEERING FINAL
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT CODE.
FINAL APPROVAL OF.PERMITTED WORK.
INSPECTOR'�'VGAIA R[RE DATE:
"'For inspecilon requirements see Engineering Information Handout.
NO WORK SHALL BEGIN I"RIOR TO PERMIT ISSUANCE
PUBLIC UTILITY DISTRICT NO.l. OF SNOHOMISH COUNTY
LOCATION 20826 80TH AV W. EDMONDS ZIP CODE 98020 SOUTH COUNTY AREA
POLE NO. SE 1/4S 19 T27 R04 DATE 8-2-99 W.O. NO. 311543
REASON FOR WORK TO SET A SERVICE POLE TO ENGINEER RASHELL TASK 3 Ai R "4, Yl
CLEAR UP PUD CLEARANCE DRAFTER LRR U.G. NO. If
SCALE it 100,
DATE WORK COMPLETED APPROVED_j D . ATE PRI . NTED
FORMAN ENVTRONMFNTAl ANAI YqT'Z
,FEES REQ'D 11 YES
RIMARY OVERHEAD
'M'
ESIDENTIAL
M�
�O MMERCIAL
0
L 0
E \00. P s
SEC OVERHEAD
B931C FEE/
IPS S_
METER/CO\V. POLE / s
PRIMARY I YERGR ND
L
* RESIDENTIA
* COMMERCIAL
8 C FEEE S_
LEU NO.
La
SECONDARY /UNDENROUND
BASIC NCE S
2 EXEMPT 0 NOT EXEMPT
0 NO PARA. 18 ITEM * C
U.G. COND.
ADD CKT. FT. PH
R M T I
/ EM CKT. F PH
NET
CK T.
O.H. U. G. C Or.
KV
ADD
CKT_ IFN PH
R Z
EM
T. I
CKT. PH
FT.��
KT. FT.
C C T. I
PERMITS
(DATE GRANTED)
0 TREE TRIM
0,STATE
0 COUNTY
X CITYEDMONDS (BLANKET)
0
EASEMENTS
X REQUIRED
0 NOT REQUIRED
. IDS A=$
UND PLAT
DATE RELEASED
BASIC FEE
FOREIGN CONTRACTS
JUNDERG
q FT.@$
V
GTNW JPN NO. 1809 E99
S ST T Lj
TR T LIGHTING
CATV JPN NO. 1809 E99
q- FT.9S =s
o JOINT TRENCH GTNW & CATV
W K IN RIGHT OF WAY
0 JOINT BORE GTNW & CATV
0 RIMARY
/
0
POLE STENCILING
SECONDARY
rL FT.@$ 7s
FROM TO
MISCELLANEOUS FEES
TAKE OFF POLE
VAULT S
PRE—CONST. REQUIRMENTS
PERMIT S
0 TREE TRIM 0 PUD -LOCATOR
$_
0 BACKHOE 0 FLAGGING
XONE CALL DATE
S
s
No.
INDEX
POLES
PLAT
TOTAL DUE S
LOGS
JU-MAP
DATE PAID
RECEPT NO.
)�FMR
C-MAP
LOCATION MAP PAGE455 A6
NEW SVCE APPLICATION NO.
LEGEND.
0 EXISTING POLE
9 EXISTING PO.LE-TO BE REMOVED
0 NEW POLE
)K NEW POLE TO REPLACE EXISTING POLE
SUBSTATION PERRINVILLE
CIRCUIT NO. 19-196 PHASE 321
E NGR'S TEL. # I
1425-347-4413
ENGR.S PAGER #
F425-290-0180'1
F1,1100
208TH ST SW
N
C'REW TO HANDLE NOTIFACTION
OF CUSTOMERS OF ANY OUTAGE
2 SET 35'POLE AS STAKED
INST 10103
208TH PL SW INST T0102
rFN REMOVE Y-GUY FROM THE NORTH
AND REROUTE SERVICE TO
ADDRESS 20826
020:
III - 1
31' 211TH PL SW
SCHEMATIC
NTS
BMP PRACTICE WILL BE
FOLLOWED. 2" INCHES OF
STRAW ON EXPOSED SOIL
7:::
208TH S� SW FU100
P-3734-X
4\20818
20902
I \A(A
4 �O7 40'
-50
<I:
20918
4-5005
RECEIVED
tl AY If - 21000
ENGINEFERING
20825
7
20829
08TH PL SW
'SL-1883-0 SL-11871-0
0 N-2993-X
4-64 1 7920
0 N-15701
4-65
SL-6�
4-6
'FAN
211TH PL SW
c:
c
0
3)
L)
CL
V)
04
F-
CENTER OF ROAD
EDGE OF ROAD
I GAS--
208TH ST SW
SOFT SHOULDER
ZUbZb
3
t-�Zv")
20.902
LC�
91
14
<E
03
F SEWER
EDGE OF ROAD
WATER
20825
c
7
)FT SHOULDER
F- 41' 208TH PL SW
7920
4---�0901
. \ 38'
-33'
31 1
8 9 0 - 1 9 9 -
City of.Edinonds
OF -WAY CONSTRUCT
RIGHT- ION
PERMIT Permit Number-
Issue Date:.. fo
A. Address or Vicinity of Construction: - 20826 80 Av V (9614890)
B. Type of Work (be specific): Insta1l Service
C. Contractor: Washington NaigralL GaS
Mailing Address: 1122 75 St Sw Everett
State License #: 98203
D. Building Permit # (if applicable):
Contact: Harime KingsbuKI
P��k'd�ne: 366-9500 X 7596
Liability Insurance: I Bond:$
Side Sewee-Permit # (if applicable):
E. EJ Commercial Subdivision 0 City Project K] Utility (PUD, GTE, WNG, CABLE, WATER)
-Family Single Family
Multi Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut Yes ONo G. Size of Cut: J x H. �harg
APPLICANT TO READ AND'SIGN
Applicant understands and by his signature to this application, agre& to hold the City ofE&nondg haj�Aless from injfiri-es, damages, or
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 legalproceedings including defense costs, and attorney fees by reason ofgranting thi8permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTA&vCE 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 THE APPLICANT.
Construction drawing of proposed work required with,permit application.
A 24 hour notice is required f6r inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
RestoriLtion 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 thepink copy of thepermit will be
available on site at all tim s for inspection poses.
2
Signature:'—d-e I Date:
ractor or(Agent)
C'rLL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: k N4, Ac A -AA RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER DAYS DISRUPTION FEE/FUND III:
SPECIAL CONDITIONS: RESTORATION FEE:
COMMENTS:
DATE:
PERMIT FEE::
TOTAL FEE:
RECEIPT FEE:,.
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
DiaLrram.:
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
(Fund 111 - Route copy to Street Dept.)
El YES
Date:
Date:
El NO
Poe A M
A VAYI*Xfzn EreWCO"T"N
Q
Vatermain depth 0 / As
W gas main
Addendum to: City of Edmonds
Right of V8Y -oo
Permit Applicatlon�
Submitted by: Mariamne Kingsbury.
Engineering Aide
Vaphington, Natq�pl Gas
0356-7500 X7596
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Water hydrant
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Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
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AV&ftxfiDnEfOWCOrMFV Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Marianne Kingsbury
Engineering Aide
Vq#hingtot T-
k,, Natq 1
ra Gar
1356-7500 X75§9
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gas main
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1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
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CITY OF EDMONDS
r'-gloor FILE ENGINEERING DEPARTMENO
sulta: I
APPLICATION FOR RIGHT—OF—WAY CONSTRUCTION PERMIT
(Applicant to Ca-molete A & B and Submt in Duplicate)
A. Permit to be issued to:
For work at: (address or vicinity) ','Z OF 15 S� 7—
Type of work to be done: c- A V4 rX a X 4 C c-,Els' S" -r-o
(Attach Drawing When Ap
,plicable)
Time Required -- Start: c? Q 0 A-w
Owner: (�� Y---62 C/-
Name
Mailing Address
City State
Contractor:?--3-f 7),
Name
?0
Mailing Address
ciey State
Finish:
Telephone Number
State License 'Number
-2 ';� e - o 7
Telephone Number
B. INDEHNITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including but not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
S
Upon issuance*of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Department.
'Work subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by the Engineering Department.
Call 775-2525.
Signature:
Owner or Agent Date Signed
C DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit Issued (Date)__Z�Zz�z Permit Numb er--�7_7,
Fe/1 Bond:
Time Authorized:
CITY OF ElDtlolms
InsP Dat iNGINEEBING DEPARTMENT'
4 �---.-.Remarks.
............
,Izlsp D,).te ........... ..... By_...
;7 ------------ Remarks
- ---------
........... ...........
Ina!) //, -
-.Romarks,z�o - ------
ffnr- rw
P Date ........ Re -friar z;w-elle't
......... By . ..........
'UM1 . ....... ............ By .........
........................
I .............................. . ...... .......
NOTICE:
No warranty of accuracy.
The -information 'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edmonds does not warrant the
accuracy of anything set for ' th on these
map(�_). Any person or entity-reque sting a
copy should conduct an independent
inquiry regarding the information shown on
-map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
ernp-1-o-yees or offiCer's shall be Iiabil-e-for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION LYNN PLANT
ds' 'o-STREET FILE for
The City of Edmon SIDE SEWER PERMIT t±M)ENT No . .......... ...............................
NEW CONSTRUCTION B--- REPAIRS
�, I - '--\ - g -, i i r - -, u- -)
OWNER------ i ............................................... .............
ADDRESS( '/0 ........................................... ........... . . .............. .................
2 661 io - go r,4 .4 ua - LJ.
0
-:71 0
10
CONTRACTOR ....... 2"Z4 ... / . . 7 .. ............... PERMIT No.
LEGAL DESCRIPTION: LOT No . .......... Y ............................... BLOCK No . ......................... ..... ...........
NAME OF ADDITION...,./ ......... ........ .......... D. .... 0 ...........
APPROVED--
I&OR 10
nr
—,I
Approved:
DATE6--..)) .............. ; ................ By
................. 1) ....... I ..........................
�T7
MY �OFEDMONDS
CIVIUCENTER—WATER-SEWER DEPARTMENT Call PllOsPeCt� 6-1107 wheii 'Work
1i ready.for lns�cctjo ifispec
n.
(No '1982
wSaWrday,:-Stmday. or-lioiiii�js-) TV,
.:'SIDE -SEWER PERMIT -
ADDRESS'; .................... 210 .21st Aven' Sou*th
..................................... . ......................... ......
................................................ .........................................................
Hollis 8toddar.d
OWNER........ E ........... ....................................................... Olympic View- Pl
...........
.................... CONTRACTOR... ............................................................... uM -b.i n g:
Per April 10, 67
nlission-Is granted ..................
..... "M .................... )19 ........ I.. for ...................... days, to RE
with -City Sewers In accordance with ' plicat TAIR or CON I NECTa side sewer
ap. Ion 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 property line. A licensed Side Sewer Contractor must
be employe * d to construct.st . de sewer in street area. Do not cover' any portion of sewer before it has beerf Inspected,
-NOTE No. 2—Obtain full Information regarding Ordinance 11.16.030 and Regulations gove
NOTE- No. 3—Top- of- Ming side sewers when you get permit.
side sewer must have at least 30 inches coverage at property line and -12 Inches inside property line; rainimurn grade . of 2%.
No -bends In grade sharper than % will be Permitted
\—,,TE No. 4 Trenches In street must be water -settled and surface of street restored to original condition. Contractors shall be r'
failure due to. improper work which may develop within 'one year of completion. esponsible for
NOTE No. 5---It Is unlawful to alter or do any other work than is pr ovided for 16 the permit, or to do any work on the main
p�yr�enances except to Insert the pipe -into the wye. sewer -or Its ap-