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CA FILE No.
Critical Areas Checklist
Site Information (soiisftopoT�al�y/hy4r �Io V/ve etf
gy
1. Site Address/Location:
2 P' 3-7-2)(c> ODS
rdperty Tax Account Number: 00(0 to
3. Approximate Site Size (acres or squ feet) 4X 9 190
4. Is this site currently developed?. 7yes; no j� -I
If yes; how is site developed?--,
5. Des the general site topography. Check all that apply.
Flat: less than 5-feet-elevation change over entire site.�;:'.';'.",
Y61 nei i.*1
'vertical- rite
"Rolling:- s1opesoi.i-sit,6`j6ii ly less than 15%. a; 6f 1046et o'ver;i
i t. I -,r,.'horizontal distance of 66-feet).
t'iteof more than 15% and
Hilly. slopes present o;: nr' Iiii'thiW, 30% a.vertical rise
of 10-feet ovei� horizontal distance of 33 to 66-feet)'."
Steep:., grades of greater than 130% present on site (a vertical rise of 10-feet over a
horizontal distance,of less than 33-f
Oth'e'r"'(Ple'ase describe
6. Site contains areas of year-round standing -water. Approx. Depth:
7. Site contains areas of seasonal standing water: App rox. Depth:
What season(s) of the year?
8. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? _ (What time of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc)
A0 11. Obvious wetland is present on site:
For City Staff Use Only
A. Site is Zoned?
9
'-2'.*:.'--.-- -SCS mapped soil type(s)? 414 e,,,,.g
-3.'. Wetland inventory or C.A. map indicates wetland present on site?
4. Critical Areas inventory or C.A. map indicates Critical Area on site? Al 0
.5... Site within designated earth subsidence landslide hazard area? A,10
gc , 9,
'Site designated on the Environmentally Sensitive Areas MapP
"Ocsoes Jo Aoet 010'Ve-4,6-
DETERMWATION Jleo
-STUDY REQUIRED CONDITIONAL WAIVER
WAIVER
Reviewed by:_
Plaffner Date
Rev 01/04/94
890.194-
City of Edmonds
Critical Areas.,,\ Checklist
The Critical Areas Checklist contained on, and submit itto the City. TheCitywill
this form is.,tD filled out by, paq.,pqrso
review, the: checidist. - make aprecursory site
preparing a Development Permit
i -:� - . .Yisitan malke a determination of the
Application for the City of Edmondspriq�_.,,-, st�bseqpqnt steps necessary to complete a
to his/her su6mitial of a dev�lopm6nt d mient ljoermli applica6n.
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,
WIth a signed copy of this form, the
:11'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:
1—f �g�- ;,A &�/
Nam
Street Address
Applicant Representative:
Name
Street Address
Phone City, State, ZIP Phone
Date Signature Date
ly,
do'%
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CA FILE NO.
Critical Areas Checklist
Site Information (soils/topo ra7�y/hy4rqlogy/ve tfp�)
It t, W JAM
1 Site Address/Location: 0 7/
# _ , 7e
2. Broperty Tax Account Number: 3�72)(o OpS -Qo& to
I 2� 9
3. Approximate Site Size (acres or sq feet):
4. this gite currently developed? 7,
I yes; no
if, yes; how is site developed? T
5. Drc�r' e the general site topography. Check all that apply -
I— Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
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).
I — Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
.4 t
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year?
I
8. Silte is in the floodway floodplain of a water course.
.1
A 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
01 t
rord? Flows are seasonal? (What time of year?
10. SRe is primarily: forested eadow shrubs mixed
P, ; in
urban landscaped (lawn,shrubs etc) V
A11P I I. Jbvious wetland is present on site:
S
S1
4. C
5. Si
Si
ROVOIM04
For City.Staff Use Only
is Zoned?
3 mapped s.oi I type(s)? 414 ervct — Lj;- 6
Uanu inventory or %_.A. map indicates wetland Oresent on site? Z—IVU
tical Areas inventory or C.A. map indicates Critical Area on site? /_/0
Within designated earth subsidence landslide hazard area? A-10
designated on the Environmentally Sensitive Areas Map?
12LATION:-.: 1ew 6100C.S 4 A"et 019,0d"'t- �bo 6e� Ift"ON; +..d, .
STUDY REQUIRED CONDITIONAL WAIVER
71'*_�.
WAIVER,
by:
Plafter Date
9 9
Cit-4of Edmonds
Critical Areas Checklist
The C I tical Areas Checklist contained on and submit it to the City. The City "I
this fonn is to be filled out by any person review the checklist, make a precursory site
preparIg a Development Permit visit, and make a determination of the
ApplicLon for the City of Edmonds prior subsequent steps necessary to complete a
to his/ter submittal of a development development permit application.
permit the City.
With a signed copy of this form, the
The pur
.pose of the Checklist is to enable applicant should also submit a vicinity map
City staf to determine whether any or plot plan for individual lots of the parcel
. 1.
potentiM Critical Areas are or may be
V- with enough detail that City staff can find
presention the subject property. The and identify the subject parcel(s). In
info"on needed to complete the addition, the applicant shall include
Checklist should be easily available from other pertinent information (e -g. site'
observLons of the site or data available at plan, topography map, etc.) or*1 studies in
City H I (Critical Areas inventories, maps, conjunction with this Checklist to assist
or soil surveys). staff in completing their preliminary
Iassessment of the site.
An applicant, or his/her representative,
must fill out the checklist, sign and date it,
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). 41 ft4, N
Owne Applicant: Applicant Representative:
Nam Nam
Jz,
Address
Street Address
I Vi
'S ZIP
Ph
City, State, ZIP Phone
i"L Date Signature Date
A V
ERA
M
0
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0
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CITY of EDMONDS S I D E S E W E R P E R M I T
For Inspection Call 771-3202 Sypi'EET PERMIT NO. 07999
Address of Construction: C2 /0// /Z e S_
Property Legal Description (Include all easements): O/V 1414 EDMONDS
TREATMENT PL
Owner and/or Builder: 0 t14 �k_g "ie-
Contractor & License No: C /,P I
Single Family Residence t�c
Multi -Family .(No. of Units _)
Commercial* (No. of fixture Units
Invasion into City Right -of -Way: No Yes (If.Ye,s, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No ,k Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE'READ THE ITEMS LISTED ON THE BACK
37
1 ce?tify that 1, have rea�rand shall comply Date
with the items listed on the back.
Permit Fee:
Issued By:
Trunk Charge: 2506) Date Issued:
Assessment Fee: Receipt No.:
Partial Inspection:
Comments Date Initial
Final Inspection Approved: 9-12-8a '49
Date Initial
Rejected:
eason
** PERMIT MUST BE POSTED ON JOB SITE
Wh.ite Copy - File Green Copy - Inspector
Date Initial
Buff Copy - Applicant
, k
Side Sewer Drawing
0,
The City of Edmonds
EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS LID NO. 16.1 ------- - ASMT. NO - ------------------
OWNER -DOM ..... HO-Wf — ------------------- ------------------ ------------- CONTRACTOR R-IC,.VA'
..S ---- BF<X!A0-C -- ---------------- PERMIT NO. 7-55-9
JOB ADDRESS -2,101-1 --------- " -1 - L - L C,- R,0� .... 1PL, LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO. EDMONDS
I TREATMEWT-PLANT
---------------------- ........ ...... ---------------------------------------------------------------------------------------- ----------------------------------
NAME OF ADDITION ------------------
2.1011 H I L LC PF-!S-TPL-
N=
emus—/, -Wl
PWW-OW1 -11/75 (REV. 11/78)
0
0
Vim
Approved:
DATJ�-. By,,.-O&-- C --- ----- ---------- ---------------------
7
Notes:
1. All signs and spacing shall conform
to the MUTCD and City of Edmonds specs
2. Alert affected residents
(k
F-
x
3. Channelizing devices are 28"
0
traffic cones.
Z
4. Maintain a 20'driving lane on
NOT TO
pavement for vehicles.
SCALE
5. All signs are 48" x 48" B/O
unless otherwise specified.
6. Work zone is 11'e/o ell Hillcrest PL
& 507's/o cA Main ST
Main ST
1-02
M<*>-
Main ST
ay3HY
MOM
ALM
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Moll
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1A
-PAMN(;-
Pilchuck Contractors, Inc.
Job #107017294
27 Aug 03
Sheet I / 1
J. Buss
National Barricade Co
CHANNUIZJNG DIWICE SPACING (FEET)
TAPER ::
AfANGENT
20
1 20
LEGEND
WORK AREA
28" TRAFFIC CONE
A-0- EXISTING TRAFFIC FLOW
3Z SIGN LOCATION
PROTECTIVE VEHICLE
3 ORWORKVEHICLE
City of :Edmonds Permit No: 2063— 02-
i - ";'. - .. -.1 . q-,Qq-L)3
RIGHT-OF-WAY CON.ST.RU.CTION PERMIT issue Date:
T
A. Address or Vicinity of Construction: 6), 1
B. Type . of . Work (be specific).TY114CO I J001 ry, cl; n Ct CIL C�_
11 1 F_ oq CIL 0'�_ QI 6Lv W 7� Ug.
30v)
C. Contractor: V1 L�UA C_. 00 in Contact: ISU.0, &C1, C
Mailing Address: �7��Ako 10 Phone", 0? q(:) 3 Cl
State License #:-.P I L L Liability Insurance: Bond: $
D. B'ui'lding Permit # (if applicable): Side Sewer Permit # (if applicable):
E., F1 Commercial El Subdivision El City Project El EUC (PUD, VERIZON, PSE, AT& T, OVWD)
r-1 Multi-I�amily Single Family Other
INSPECTOR:
F. PAVEMENT CUT: 10 YES El NO G. SIZE OF CUT 0- x
CONCRETE CUT: 0 YES El NO
Al"I'LICAN'r i'o 11EAl) ANI) SIGN
INDEMNITY. Applicant understands by his/her signature to this application helshe holds the City, 6f1dm6hds h , aFt�les�,Jrom
rh C i ty of
injuries, damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made agains t e
Edmonds or any of its departmenits or employees, including but not limited to the defense of any legal proceedinj�'idcl'�ding defense
costs and attorneyfees by reason ofgranting this permit.
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 BYCITYFORCES, AT WHICH TIMEA DEBITOR CREDIT W!LL BEPROCESSED FOR ISSUANCE TO THEAPPLIC4NT
* Traffic control and public safety shall be in accordance with City regulations as required by the City Engineer. Every
flagger must 6i trained as required by (WAC) 296-155-305 and must, have certification verifying completion of the
required training in their possession.
* 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 o(construction drawings of proposed workare required with the permit application.
CALL DIAL -A -DIG (1-800-424-5555) PRIOR, TO BEGINNING WORK
I HA VE READ THE ABOVE STA TEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THA T I MUST MAKE THE PINK COPY OF THE PERMIT A VAILABLE ON SITE A TALL TIMES FOR INSPECTIONS
Signature: Date:
(Contractor or Agent)
FOR CITY USE ONLY
Approved by: b. &L90Xr
Time Authorized: Void After Z4 / 0:3�
Special Conditions: Rg�S PoW fM O-ffU _e2WARD5,
I
-VAWIC, 0_Q0TF_QL- AffLOWD X AM19MMfZ&1 D_qMa.
Wb-cureTb Lw-EoL geam coop mm�; WMvP-5cu trzFs
AEPEIVA-Irkl k1khY1110 62W C(TV SEWELMA-10
Right-of-way Fee: "160 +Ic-f Cd/ffiv
Disruption Fee/Fund 111:
Restoration Fee:
TotalFee: Da4;7u-
ReceiptNo- ,i
Issued
--!-!I . A #1 ii 144117
UPON COMPLETION OF.PERMITTED'WORK, AN ENGINEERING FINAL
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT CODE (Phone 425-771-0220, Ext. 1326)
FINAL APPROVAL OF PERMITTED WORK. DATE:
Inspector's Signature
For inspection requirements see Engineering Inspection Information handout.
I I ... ..... .. .. I,., a
NO W011K SHALL IIEGIN 141101Z TO I'EIZMI'F ISSIJANCE
DAMy Documents\Forms\Engnmg\ROWpermit_.doc
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it NUM
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P'PLICATION
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"Zip PUBLIC RIGHT 9F WAi( P�E,9 PFMI�I, �Tflt�T TgSPP ApPrWed C3
TELEPHONE NUMBE MAr
W,'Permit Required 0
d!:;.- EXISTINP R40_141RIED Opq!S�.TION 77-7� Street Use Permit Req'd [1
79"('r —0 9-7 1 1 rispection Required 0
P"OPOSEP
Sidewalk Required [3
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071F-FI1T11E1 I W
-�Irqp PRV REQUIRED 1-
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YES 0 NO 0
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ENGINEERING MEMO DATED
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REVIEWED BY
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REVIEWED BY
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STATE LICENSE NUMBER EXP RATION E
EPS i 0`9.9 LA 2 IX
SIGN AREA
SEPA
Legal Description of Property - include all easements Z-A
PROPOSED
REVIEW
COM PLETE
EXEMPT
ADB NO.
Z
SHORELINE
2
EXP
ARIANCE OR cu
�LANNING REVIEW BY
DATE
SETBACKS - FEET
HEIGHT
LOT COVERAGE
Property
Tax Account
00-1� OD4,
FRONT SIDE
REAR
REMARKS
Parcel No.
i
NEW
RESIDENTIAL
EJ PLUMBING
ADDITION
COMMERCIAL
ECHANICAL
El APT. BLDG.
El
REMODEL
SIGN
DING" FENCE
EIREPAIR E!" 1:1
'CHIECKED 6Y
TYPE OF CONSTRUCTION
CODE
OCCUPANT
GRO P
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—
2Z
WOODSTOVE SWIM POOL
DEMOLISH (NSERT r HOT TLIB/SPA
SPECIAL INSPECTOR
AREA
OCCUPANT
REQUIRED
YES
LOAD'
GARAGE 'RETAINING WALL/
CARPORT RENEWAL
7REMARKS
ROCKERY
(TYP_F QFUSE, BUSINESS OR ACTIVITY) EXPLAIN:
'PROGRESS INSPECTIONS
PER LIBC !105
NUMBER
UM
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NU BER OF
F CA
C 'IT'
CRITIC
OF
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:UN
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AREAS 4A2
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STORIES
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U B
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
FINAL INSPECTION REOUIRED
VALUATION
FEE
PLAN CHECK FEE
BUILDING
HEAT SOURCE�
ZING
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers.wprk to be done on private property ONLY.
GRADINGIFILL
Any construction 6.n- the public domain (curbs, sidewplks,
driveways, marquees,, etc.) will require separate permission.
STATE SURCHARGE
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is Started Within 180 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spci heirs, assigns and
�ENG. INSPECTION FEE
successors in interest, agrees to indemnify, defend and hold
2A
harmless the City of. Edmonds, Washington, its officials
�m
employees, and agents from any and all claims for damages cii
F,
whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
C3
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
3
3
provision."
I hereby acknowIpA_geLtt111a I have read this-ipplication; that the
information tuorrTs correct; and that I arrf the owner, or tho duly
ATTENTION
APPLICATION APPROVAL
IZ
aut-hori e t;he Owner. I agree to comply with city and
'legrinat--ofig
THIS PERMIT
.
sta =1 construction--aind in doing the work authoriz-
AUTHORIZES
This application is not a permit until
"I!.
thereb 1�6rson will be,,,em'ployed in violation of the Labor
ONLY THE
Sig ned by the Building Official or his/her
Did he St4ife of Washington relatin Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt is
suranCe d RCVV�j Yo
/an -8.27.
INSPECTION
acknowledged in space provided.
SIGNATURE t0i6%�R OR E' I F
DATE SIGNED
DEPARTMENT
Z�4Ae
I
CITY OF
OFrCI4(/S ATE
-e�
7,�>
EDMONDS
!4
A'TtENTION
CALL FOR
r
-7- #7
Z,466�
INSPECTION
(:�L r,
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEENMADE AND APPROVAL OR
771-0220
ORIGINAL - File YELLOW - Inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
CHAPTER 3.
PINK - 0,A/r.er GOLD - Assessor
00-
USE
D 8
FIT' IE- 0MON, ZONE PERMI1
1,00INSTRUCT11,94' Pififl APPLICATION Y) NUMBER
JOB
POWNER NAME NAME OPA
u2ftESS ADDRESS SUITE!APT
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A R
0 14L ST9EET M�p '-TesCP-Appro,ed 13
YMSER
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3ff E �W Alt Required 0
EXISTINV�_
9E UIPED DfP!P�PPN
re Use Permit Req*d C3
0
sPection Required
Sidewalk Required 0
tINE-SIZE- NO.OFFIXTU ES PRV REQUI
"V RED
;ADDRESS 0
t: YES 11 NO C1
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EN111TE71301101701"wO DATED REVIEWED BY
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AIJO DAT5
1 f 1 .1,9 BIG
N AREA SEPA REVIEW ADS Vo.
Legal Description of Property - include all easements LOWE� FROPOSE� COMPLETE EXEMPT
111,4
Z SHOR W14EN
EXP`
CL , / rr �_l
cr VARIANCE� _0 U W BY
Q bAiTE
Ui
Allil -711
SETBACK HEIGHT LOT/bVER E Z
'"j Propert FRONT f,..g�r QE REA Z
y <
Tax Accoun I REMARKS
Parcel No.
FINEW RESIDENTIAL El PLUMBING
EIADDIIION 1:1 COMMERCIAL El MECHANICAL
REMODEL 0 APT_ BLDG- El SIGN
GRADING FENCE 'CHECKED BY7TYP6 OF CONSTRUCTION CODE OCCUPANT
REPAIR CYDSr x _FT) 9/,. GROUP
WOOQSTOVE A!
DEMOLISH INSERT SWIM POOL SPECIAL INSPECTOR OCCUPANT
0 1:1 HOT TUB/SPA REQUIRED S LOAD
GARAGE 71 RETAINING WALL/ 0 YE
CARPORT ROCKERY RENEWAL !REMARKS
(TYPEOFUSE BUS$ I N E I S Y) EXPLAIN: �PROGRESS INSPECTIONS PER USC 305
OR ACTIVIT
M
NGMQ01' NUMBER OF CRITICAL
I"
OF DWELLING AREAS
:::co ST RIES 1UNITS__ INUMBER
0
- DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
ZL&2.,:� rALY-4 2:1Z, A.) C2-14:" FINAL INSPECTION REQUIRED
VALUATION FEE
7
PLAN CHECK FEE
pl, BUILDING
HE�T'SOURCE: GLAZING
PLUMBING
Plan Check No. MECHANICAL
This Permit covers -work to be done on private property ONLY. GRADING/FILL
Any construction on the public domain (curbs, sidewelks,
driveways, marquees, etc.) will require separate permission.. STATE SURCHARGE
Permit Application: 180 Day3
Permit Limit: I Year - Provided Work Is Started Within 180 Days STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and ENG. INSPECTION FEE
in _Wqiqessors in interest, agrees to indemnify, defend and hold
Ln
harmless the City of - Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
Cc
< whatever nature, arising directly or indirectly from the issuance
of this permit. Issuance of this permit shall not - be deemed to PLAN CHECK DEPOSIT
modify, waive or reduce any requjw"rit-bi anj �Ity ordinance
0
I nor limit in any way the C�&ility to enforce'any ordinance TOTAL AMOUNT DUE
provision." '. I L �- � 12
I hereby a5�r�edge that I have read this application; that the
informatilpWgiven is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL
authpFffed gent I the owner.,I'agree to comply with city"and THIS PERMIT
e laws r:guja r9g cohst�uction; and in doing the work authoriz- AUTHORIZES T . his application i's not a permit until
ed thereby, no'Arson w.ill'be employed In violation of the Labor ONLY THE signed by the Building Official or his/her
Code�o�ti�)Ae of relating to Workmen's'Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
/ , INSPECTION acknowledged in space provided.
.4iQ,ta-insura,ncOan(.tRCW18.27.
-9jGNATUR1;..kQ �,�OFI AGENTY DATE SIGNED DEPARTMENT
I L'S SIGNATURE DATE
CITY OF
4 EDMONDS
DATE
ATTENTION CALL FOR
IT IS UNLAWFUL TO USE OR OCCUPY A BUILD ING - OR STRUCTURE INSPECTION
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
UNTIL A FINAL INSPECTION HAS BEENvMADE AND APPROVAL OR 771-0220 ORIGINAL— Fi1P__.YELLOVJ Inspecto r
CHAPTER I
PINK — Owr.pr GOLD — Assessor
11
MAIN ST
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514'S CL A- 11 `E CL
S CL
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PROPOSED 200'
1-0114" PE IP MAIN
77 K UL
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52'
R/W
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IP G4S FLOW
PROPOSED
EASEMENT
ROPE PROPOSED—`
1-114" PE IP,MAIN
153PS CL & 11 E CL
--- 1)S CL
I)E CL
C)
Q-4
PROPOSED 200'
1-114" PE IP MAIN
153'S CL
0
PL
PL
91 AV W t4ty PL
(HILLCREST PQ
ASPHALT
S—bound Lone CL N—Bound Lane
4' go
MG LGM Se 10' GRAVEL
lop Io
PROP. 1-1/4- GASI
1 VE CL
52' ROW
ROADWAY CROSS—SECTION
N.T.S.
FITTER (CHECK BOX IF COMPLETE)
EOM " PE CAP
1-114
153'S CL & 78'E CL
r --- 1)S CL
(---')E CL
Work area left in Clean & Safe ondition El
Complete all Pipe Tables and Gas Pressure Stamp 1:1
Field changes Red —Lined on as —built El
Material verified and Changes noted on paperwork 0
All Valve & rie—in Locations oted on as —built 0
Note beginning of Main, EOM & Line of Main locations 1:1
Show Rope Locations & Cul—de—sac Radius El
Foreman's Signature
Company Employee ID#
STANDARD GAS CONSTRUCTION NOTES:
1. FIELD LOCATE ALL UNDERGROUND UTILITIES. CALL "ONE —CALL" TWO WORKING DAYS PRIOR TO CONSTRUCTION, IN
WESTERN WASHINGTON CALL:- 1-800-424-5555. IN KITTITAS COUNTY CALL: 1-800'-553-4344
2. ALL CONSTRUCTION IS TO CONFORM TO PSE GAS OPERATING STANDARDS AND GAS FIELD PROCEDURES.
3. 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.
TIVITIES A MINIMUM OF TWO WORKING DAYS
4. NOTIFY PROPERTY OWNERS ADJACENT TO PROPOSED CONSTRUCTION AC
PRIOR TO BEGINNING CONSTRUCTION. USE iSi TO DISTRIBUTE FLYERS IF JOB IS LARGE, OTHERWISE HAND
DELIVER FLYERS BE SURE TO INCLUDE THE LIST OF FREQUENTLY ASKED QUESTIONS AND INFORMATION ABOUT
THE OPPORTUNITY TO PURCHASE AN EXCESS FLOW VALVE WHEN THEIR SERVICE IS ISNTALLED OR REPLACED
PER GAS OPERATING STANDARD 2550.1600. ALLOW ADEQUATE TIME FOR CUSTOMER DECISION AND RESPONSE.
5. ANY CHANGE IN ROUTE, TIE—IN METHOD OR ADDITIONAL MAIN FOOTAGE MUST BE APPROVED BY PSE GAS ENGINEERING
SERVICES.
6. COMPLETE "PIPE CONDITION REPORT* ON ALL EXPOSED EXISTING PSE FACILITIES. CHECK BOX ON REPORT FOR WIRE
BOX (TEST LEAD) INSTALLATION.
7. ACTIVE SERVICES DENOTED BY.
8. PIPELINE MARKERS AND WARNING SIGNS SHALL BE INSTALLED AND RECORDED BY THE CONTRACTOR PER PSE GAS
OPERATING STANDARD 2525.2500.
9. VALVE MARKERS SHALL BE INSTALLED AND RECORDED BY THE CONTRACTOR PER PSE GAS OPERATING STANDARD
2525.2600 FOR ALL HP VALVES IF THE LOCATION IS NOT REDILY ACCESSIBLE, AND FOR ALL VALVES WHERE
PERSISTANT SNOWFALL MAY OBSCURE THE VALVE BOX .
10. TO PREVENT ACCIDENTAL OVERPRESSURE OF ADJOINING SYSTEMS, NO TWO MAINS SHALL BE CONNECTED EXCEPT AS
SHOWN ON THIS DESIGN UNLESS APPROVED BY PSE GAS ENGINEERING SERVICES.
11. SYSTEM MAOP DENOTED BY. ISYSTEM MAOP = A5— PSIG
12. RESTORE ALL DRIVEWAYS SUBJECT TO OPEN CUT TO ORIGINAL OR BETTER CONDITION.
13. GAUGE AND MONITOR USE OF ALL STOPPERS AND SQUEEZES TO ENSURE ADEQUATE FEED. (USE MANOMETER FOR
LP SYSTEMS)
14. PURGE POINTS AND PRESSURE TAPS TO BE INSTALLED PER PSE GAS OPERATING STANDARDS 2525.3400, AND 2525.1200.
GAS MAIN INSTALLATIONIRETIREMENT
Type/Work
Pipe Size
Type
Estimated
Length
Actual
Length
Manufacturer
INSTALL
1-1/4"
PE
200'
GAS MAIN PRESSURE & TESTING
TESTED BY_
TYPE TEST
PRESSURE
DATE ON
TIME ON
DATE OF
TIME OFF
TYPE TE
PRESSURE
TESTED BY
DATE ON
TIME ON
DATE OFF
TIME OFF
IDesign Press 60
SYS MAOP 45
PROJECT
PHASE
NOTIF#
ORDER#
0
SAP Superior
Service/Meter
Service/Meter
Service/Meter
Service/Meter
Ind. Service
Ind. MSA
Dis. Reg. / FT
HP Svc/MSA
Relocate
Retirement
X647555468
107017294
X543032478
106111717
X393826250
1106111111768
Contractor CONSTRUCTION COST CODES:
031-103-1 1 1 T- d
Vicinity Map
-F
iiarague St
�dman St
Bell S�-
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S!t im
WORK SITE
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Ownerl Developer Contact Info
BEV FRANKLIN
21 Oil HILLCREST PIL
EDMONDS, WA 98026
ATTN: BEV FRANKLIN 425-7764M 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
REQUIRED EDMONDS
Project Manager Contact Information:
PATTI NESS
CELL: 425-327-2783
REV#
DATE
BY
DESCRIPTION
FUNCTION
CONTACT
PHONE
DATE
3
PROJECT MGR
PATTI NESS
206-4184237
411103
2
ENGR-GAS;
I
DRAWN BY
JOHN MOSS
206-418-4253
il-21103
CHECKED BY
PATTI NESS
206-418-4237
COUNTY
SNOHOMISH
EMER SECT
4
GAS WK CTR
MCNSEG
APPROVED BY
PATTI NESS
206-418-4237
FITTER #1
1/4 SEC
SW-19-27-04
OP MAP
160.068
PLAT MAP
163.068
FITTER #2
MAPPING
JOINT FACILITIES ARRANGEMENTS
UTILITIES1
I
I
PHONE#1
SAP Superior Ordei
PUGET 107017294
SOUND BEV FMNKLIN Drawing Number.
iR�GY 1-1/4" PE IP MAIN EXTENSION N/A
21011 HILLCREST PL, EDMONDS, WA 98026 SCALE:
DESIGNED BY PILCHUCK CONTRACTORS INC. 100=
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DISHED CAST [RON GRATE
— REMOVABLE END CAP WITH
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L6' CONCRETE BOTTOM TO BE POURED
IN PLACE
YARD DRAIN DETAIL
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TYPICAL INFILTRATION TRENCH SECTION
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SUMP & INFILTRATION TRENCH
,pjw41t#4n 1069 1
i.
STORMWATER RETENTION PLAN
(Ifill
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GENERAL NOTES
I ALL CONSTRUCTION SHALL CONFORM TO THE "STANDARD SPECIFICATIONS FOR
MUNICIPAL PUBLIC WORKS CONSTRUCTION" AND STANDARD PLANS AS ADOPTED
BY THE CITY OF EDMONDS. AND ANY REQUIREMENTS ESTABLISHED AT CITY
HEARINGS ON THIS PROJECT.
2. THE CONTRACTOR SHALL NOTIFY THE.-CITY_OF- EDMONDS DEPARTMENT OF PUBLIC
WORKS Z4 HOURS''PRIOR TO AND DURING WORK AND OBTAIN ALL REQUIRED PERMITS
PRIOR TO CONSTRUCTION.
3. THE CONTRACTOR SHALL NOTIFY THE CITY OF EDMONDS DEPARTMENT OF. PUBLIC
WORKS PRIOR TO BACKFILLING UTILITIES.
4. EXISTING UNDERGROUND FACILITES HAVE BEEN SHOWN ON THESE DRAWINGS FOR THE
PURPOSE OF ASSISTING THE CONTRACTOR IN LOCATING SAID FACILITES IN THE FIELD.
THE CONTRACTOR SHALL BE RESPONSIBLE FOR CHECKING ACTUAL LOCATIONS IN THE
FIELD AND CHECKING WITH APPROPRIATE AGENCIES THAT MAY HAVE UNDERGROUND
FACILITIES WITHIN THE PROJECT LIMITS. THE CONTRACTOR SHALL BE SOLELY
RESPONSIBLE FOR ANY DAMAGE TO UNDERGROUND FACILITIES RESULTING FROM HIS
OPERATIONS.
5. A COPY OF THESE APPROVED PLANS MUST BE ON THE JOB SITE WHENEVER CONSTRUCTION
IS IN PROGRESS.
6.� IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO CLEAN, FLUSH, DISINFECT
WHERE APPLICABLE AND OBTAIN SATISFACTORY APPROVAL FROM THE CITY OF EDMONDS
REGARDING THE QUALITY AND INTEGRITY OF EXISTING WATER LINES, SANITARY SEWER.
LINE, STORM SEWER LINE, RETENTION SYSTEM ETC. WRITTEN ACCEPTANCE BY THE
CITY OF THESE PROCEDURES MUST BE TRANSMITTED TO THE DESIGN rfNGINEER.
STORMWATER RETENTION SYSTEM
PLAN AND DETAILS FOR
DON HOWE RESIDENCE
Ptn. Lot 6, 131k. 5,.Alderwood Manor No. 9
Edmonds, Washing -ton
Reid, Middleton & Associates, Inc.
0
X
Engineers* Surveyors* Planners
121 5th Ave. N., Suite 200, Edmonds, WA 98020
DRAWN CHECKED DATE FIELD BK. SCALE FILE NO.
A.R.M . J.0. MARCH R : 30' 02-86-027
86 L.L. SHEET OF
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