23110 HIGHWAY 99.PDFiiiiiiii iiiiii
11541
23110 H IG HWAY 99
City of Edmonds.
RIGHT-OF-WAY CONSTRUCTION PERMIT
Permit No;�2065-1) / 0 0
IssueDate: 15-5--05"
A. Address or Vicinity of Construction:33/io
B. Type of Work (be specific \.YV-
�A �� C) Ma %-h On W,-1 9 9 1Z 0 YVA
+ 0 -7 3,-� 'S L nl� c2 3 0
1076325JU3
C. . 0 ContractorPJ61LACV'\ 006A Contact: (A Q S ('di y 1/�'/
Mailing Address: J 33,50 ��)�Q nt- U /J Phone: a 6 1-
State License #:,Pl L-C H C-L 10 Liability Insurance: Bond: $
City Business License #:
D. Building Permit # (if applicable):. Af,4 Side Sewer Permit # (if appileable):
1^___ "4F1x_ 4/2,7/05,
E. F1 Commercial Subdivision F1 City Project EUG (R.UD, VERIZONI, PSE, COMCAST, OV-WSD)
J[J Qinlgre-Famil'y-' "'eOther"__
F� Multi -Family
INSPECTOR:
F. PAVEMENTCUT: [�IYES El NO G. SIZE OF CUT X
CONCRETE CUT: YES F NO
G. F-1 Mail Approved Permit F� Call for Pickup
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands by hislher signature to this application helshe holds the City of Edmonds harmless'from
i . nj . uri . es, 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 but not limited to the defense of any legal proceedings including defense
cos6 and attorneyfees by reason ofgrantinethis 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 BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Traffic I control and public safety shall be in accordance with City regulations as required by the City Engineer. Every
flagger I -mu.st be 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 of construction drawings of proposed work are required with the permit application.
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
I HA VE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THA T I MUST MAKE THE PINK COPY OF THE PERMIT A VAILABLE ON SITE A T ALL TIMES FOR INSPECTIONS
Signature: Date: 'C3�
(Contractor or Agent)
FQR,.CI
Approved by:. )a I I'
Tiine Authorized: Void After _�L,
Special Conditions: I LOk 'L4
Call 425- 771-022q, Ext. 1326for a 24-hour
FINAL APPROVAL OF PERMITTED WORK:
Is Signature
I
i request line.
DATE:
�1
W
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
CTocuments and SettingsTunisNy Documents\Fomis\Engnrng\ROWpermit_,doc Revised 10/01/03
Pilchuck Contractors, Inc.
Job # 107023323
April 19, 2005
Sheet 1/1 Rob Inglis
NOT
TO
SCALE
PEDESTRIANS TO BE
REROUTED VIA
CONE PATTERN
OWM89MON DEVICE SPACING
MPH MPER . IANGENT
SWO 40
35145 30 60
25/30 20 40
avoa
kA t It t
31 QYS07.7
019
0�
01
THREE WORK
AREAS OF
3'X 5' EACH
IN CONCRETE
SIDEWALK
SIDEWALIC 0.7
CLOSL,6 0
ROAD
tl t t 'Yo�
AMCRIT
Notes:
1. All signs and spacing to conform
to the MUTCD and City of Edmonds
Traffic Control specs.
2. Channelizing devices are 28"
traffic cones.
3. Al signs are 48" x 48" 8/0 unless
otherwise specified.
4. AJert affected residents and
businesses.
5. Wqrl�to take place betweenRa.m.
A n d,-A 'p. m.
6. Work area will be 450'S of CA of
230 St SW & 42'W of C/L of Hwy 99.
APPH0,vgj) AS NOTFD
IBI Y E -- N 2E
G
Date: -57— rl— C-�) C�-
28" TRAFFIC CONE
WORK AREA
TRAFFIC FLOW
WORKVEHCLE
SIGN LOCATION
I
City of Edmonds Permit NoZa2L__'n_P__.!10
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date:
Q
A. Address or Vicinity of Construction: o,3 I fi WA V q
ANZ
B. Type of Work (be specific): tl)-'ej —VAP 10 D__T_ M 4,
.<-,o Lo 1) 1 AX 7�) e
C. Contractor: z9 4 wi F_ U/
Mailing Address: 2_3 -7 a-5
State License #:
D. Building Permit # (if applicable
A(Ze,
Permit ftf apyKable):
E. Q( Commercial SubdIvision I City )r EJX (PLJD, GTE, PSE, CHAMBERS, OVWD)
Multi -Family Singl Family Othe
INSPECTOR:
F. PAVEMENT: \"'__�SIZE OF CUT x H. Charge: $
CONCRETECUT S El ZZ
IDEMNITY. Applicant understands by e si ature to this application helshe holds the City ofEdmonds harmlessfrom injuries,
b �he
]Pti 0
? ' a is'
damages or claims of any kind or descriptio alsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any of its departments or employees, inclu 0 g but not limited to the defense of any legal proceedings including defense costs and
p m
attorneyfees by reason ofgranting this m t.
it
THE CONTRACTOR IS RESPONSIBLE OR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTIONAND ACCEPTANCE OF�HE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS
COMPLETED BY CITY FORCES, AT WHICH TIME A DEBITOR CREDIT WILL BE_PP"--__ ISSUANCE TO THE APPLICANT.
* Traffic control and pub�lic_Q�-r--- cis as required by the City Engineer. Every
I �/' 101
flagger must be trained i ve certification verifying completion of the
01
required trainingin their P
* Restoration iyt'o be in acc, VOW ork shall be patched with asphalt or. City -
approved material prior to i
4 Three sets of construction d' pit application.
I HA VE READ THE ABO VE ST, ",E UIREMENTS AND ACKNOWLEDGE
THAT I MUST MAKE THE P11 T A T ALL TIMES FOR INSPECTIONS
(1p.
Signature: :2A- ocz_- F x I 'V Date:
(V (Oej :11/0 �d-
;qaF
CALL DIAL7 INNING WORK
I Twkr,
— -
�.Seje(
Approved by: Right-of-way Fee:
Time Authorized: Void After Disruption Fee/Fund Ill:
Special Conditions: Restoration Fee:
Total Fee:
Receipt No:
Issued by:
UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT CODE. I
FINAL APPROVAL OF PERMITTED
INSPECTOR'S SIGNATURE DATE
For inspection requirements see Engineering Information Handout.
6
0_1r_0
f
SCALE: I' - 50'
3/4-. 5/8- 448-S
1978--
U�
01
0
CURB IYP.
ASPHALT PAYING
ILL,
t-11' L11ILI11
EA11101
PROP. 1 1/4- SERVICE
230 ST SW
Q_ 60'
R/W
2" SHORT STOPPER
TA WRE & BOX
20# CP ANODE
450'S, 42'W CA
___'S, ---'W CA
2" TRANSITION FITTING
451'S. 42-W CA
---'s. ---'w CA
PROPOSED 2" MPE—IP MAIN
42-W CA
E.O.M. (ENDS AT PA)
2" MPE CAP
733-S, 42-W CA
__ , S, ___'w
FITTER (Check Box if Complete)
• WORK AREA LEFT IN CLEANIS'AFE CONDITION.
• COMPLETE ALL PIPE TABLES AND GAS PRESSURE STAMP
• FIELD CHANGES RED -LINED ON AS-BUILTS.
• MATERIAL VERIFIED AND CHANGES NOTED ON PAPERWORK.
ALL VALVE AND TIE-IN LOCA71ONS NOTED ON AS -BUILT.
NOTE BEGINNING OF MAIN, ECUA LINE OF MAIN LOCATIONS.
o SHOW ROPE LOCATIONS & CUL-DE-SAC RADIUS
Fitter's Signature
Company
DATE
STANDARD GAS CONSTRUCTION NOTES:
11. FIELD LOCATE ALL UNDERGROUND UTILITIES. EXCAVATOR TO CALL 'ONE-CALLm TWO WORKING DAYS PRIOR TO
TO CONSTRUCTION9 IN WESTERN WASHINGTON CALL: 1-800-424-5555. IN KITTITAS COUNTY CALL: 1-800-553-4344
2. NOTIFY APPROPRIATE PERMITTING AGENCY PRIOR TO JOB START (SEE PERMIT REQUIRMENTS).
3. ALL CONSTRUCTION IS TO CONFORM TO PSE GAS OPERATING STANDARDS AND GAS FIELD PROCEDURES.
4- 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.
5. NOTIFY PROPERTY OWNERS ADJACENT TO PROPOSED CONSTRUCTION ACTIVITIES A MINIMUM OF TWO WORKING DAYS
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 INSTALLED OR REPLACED
PER GAS OPERATING STANDARD 2550.1600. ALLOW ADEQUATE TIME FOR CUSTOMER DECISION AND RESPONSE.
6. ANY CHANGE IN ROUTE, PIPE SIZE/TYPE. TIE-IN METHOD OR ADDITIONAL MAIN FOOTAGE MUST BE APPROVED BY
THE APPROPRIATE PSE ENGINEER OR PSE REPRESENTATIVE.
7. COMPLETE OPIPE CONDITION REPORTO ON ALL METALIC PSE FACILITIES. CHECK BOX ON REPORT FOR WIRE
BOX (TEST LEAD) INSTALLATION.
8. PIPELINE MARKERS AND WARNING SIGNS SHALL BE INSTALLED AND RECORDED BY THE CONTRACTOR PER PSE GAS
OPERATING STANDARD 2525-2500.
9. INSTALL MAIN VALVES OUT OF TRAFFIC WHERE POSSIBLE. 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 READILY 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 APPROPRIATE PSE ENGINEER OR PSE REPRESENTATIVE.
11. SYSTEM MAOP DENOTED BY:ISYSTEM MAOP —la- P=SIG -
12- GAUGE AND MONITOR USE OF ALL STOPPERS TO ENSURE ADEQUATE FEED.
13- RESTORE ALL DRIVEWAYS SUBJECT TO OPEN CUT TO ORIGINAL OR BETTER CONDITION.
14. PURGE POINTS AND PRESSURE TAPS TO BE INSTALLED PER PSE GAS OPERATING STANDARDS 2525-3300, AND 2525-1200.
15- MAINS AND SERVICES SHALL BE TESTED AND PURGED PER PSE GAS OPERATING STANDARDS 2525.3300 AND 2525.3400.
16. IF METALLIC PIPE IS INVOLVED, COORDINATE INSTALLATION WITH CP TECH.
RICK KESSLER ------ PHONE. 206-571-7908 _.
IT- NOTE ALL ACTUAL FOOTAGE9 LOCATION AND MATERIAL CHANGES ON THE AS -BUILT IN RED.
FOOTAGE BETWEEN FITTINGS.
GAS MAIN INSTALLATION/RETIREMENT
Type/Work
pipe
size
Type
Estimated
Length
Actual
Length
Manufacturer
INSTALL
2"
MPE
283'
GAS
MAIN PRESSURE & TESTING
TYPE TESTI
PRESSURE
TESTED BY
DATE ON
TIME ON
DATE OFF
TIME OFF
TYPE TEST
PRESSURE
TESTED BY
DATE ON
TIME ON
DATE OFF
TIME OFF
IDesign Press 60
ISYS MAOP 45
PROJECT PHASE
NOTIF#
ORDER#
V)
I
SAP Superior
Service/Meter
Service/Meter
Service/Meter
Service/Meter
Ind. Service
Ind. MSA
Dis. Reg./FT
HP Svc/MSA
Re I'ocote
lRetirement
X190706422
107023323
X190707691
106150356
Contractor. CONSTRUCTION COST CODES:
051-103-1 1 1 1 1
Project Manager Contact Information:
KIM GRAY
CELL: 425-290-2678
kim-graympse.com
REV# DATE BY DESCRIPTION
3
2
1
COUNTY EMER SECT
SNOHO. 5
1/4 SEC CIP MAP
NE-31-27-04 164-068
UTILITIES
El
n CONTACT
El PHONE#
El PUGET
�vl SOUND
ENERGY
DESIGNED BY PILCHUCK CONTRACTORS INC.
GAS WK CTR
MCNSEG
') DENOTES
WORK SITE
Vicinity Map
F ---F-F—,x /
;W
00
T-1 I
. ) 4STWjillIIIIIIII� 2281H
Owner / Developer Contact Info
LGR, LLC
17754 15 AVE NE
SHORELINE WA 98165
ATTN: PETE GAFFNEY 425-388-2114 office
0
-4
0
ca
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
NOT REQUIRED I EDMONDS
FUNCTION
PROJECT MGR
ENGR - GAS
DRAWN BY
CHECKED
APPROVED B
CP APPROVAL
PLAT MAP I
166-069 IMAPPING
JOINT FACILITIES ARRANGEMENTS
CONTACT
KIM GRAY
PHUONG DAO
KIM GRAY
KIM GRAY
kICK KESSLER
(LES SCHWAB TIRE CENTER)
2" MPE-IP MAIN EXT.
23110 HIGHWAY 99. EDMONDS, WA 98026
PHONE I DATE
206-418-4234 13-22-05
206A18-4218
4-6-05
20BA18-4234
4-13-05
206-418A234
4-13-05
206-571-7908
4-14-05
SAP Superior Order
107023323
SCALE: AGE:
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