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CA FILE NO. qq- Ilf-7
Critical Areas Checklist
--------------------------------------------------------------
Site Inform'. ation (soils/top.ographyl�hy4rology/vegetation)
1. Site Address/Location: f �0*— Clue- Ulf's4- AA1Akj-0,,,q36ZZ
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet):
4.' Is this site currently developed? 'K yes; no'
1, 16 1 . I
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.
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-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
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year? \A AW q
8. Site is in the floodway N1 0 floodplain of a water course.
9. Site contains �creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? (What time of year?
. shrubs mixed
10. Site is primarily: forested meadow
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site:
DEURMINATION
%a_chk.doc; Rev 10/03/97
2
19 - M-)
City of Edmonds
RECEIVED
MAY 2 � 1999
CRITICAL AREAS CHECKLIST PERMIT COUNTER
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
inforination 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, and submit it to the
City. The City will review the checklist, make a
precursory site visit, and make a deten-nination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
locating the specific piece of property described on
this form. 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 Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
CQLA&'S SOJACedD
Name
Street Address
I mapt'T',vd rp, W A -- — 1011r, HOW-4 01
city State Zip
15�5s—
T
Signature.
Date
Applicant Representative:
Name
Street Address
City State Zip
Telephone
Signature
Date
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NOTL
This is not a survey. it is a parcel map PA.M., Aj
used for location of property only
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4',r? C. 1 Sq\3
CITY OF EDMONDS
121 5TH AVENUE NORTH . EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
May 27, 1999
Carlos Saucedo
23318 96h Avenue West
Edmonds, WA 98020
Subject: Determination regarding Critical Areas Checklist # 99-147
Dear Applicant:
BARBARA FAHEY
MAYOR
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATIONIP reached by,the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of thi . S Critical Areas Checklist "DETERMINATION" for your records.
PLEASE EXAMINE THIS" DETERMINATION" FOR ADDITIONAL REQUIREMENTS. yoU MAy NEED To SUBMIT.
ADDITIONAL INFORMATION SUCH AS AN MAMMAL CH CKLIST OR CA"REAS
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
wo, You must submit a copy of the CRITICAL AREAS CHEcKLIST and DETERMINATION KITH ALL
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCES 1.
Permit applications include the following:
Enc: Determination
* Architectural Design Board
C:ReceptionUanakCRLTR.doc
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Thank you.
Planning Secretary
Incorporated August 11, 1890
Sister City - Hekinan, Japan
NOTIC�.
VA I
The Jnform ation'shown on the attached
Hed for use by the City 01
Map(s) was compi
Edmonds/ its Empl-oyees and Consultants.
Th,e City ofEdrn.onds does ' n ot. warrant the
accuracy of anything set.for.th on t. ' hese
m a p (S"). A n . y person or entity -requesting a
COPY.should conduct an.independent
-ation shown-c
inquiry regarding the 'nf' rm
_ffi_�� -maP(S),, including, but not limited to,
the lotation of any sewer stub shown. Su(
sewer stubs may or may- not exist and ma�,
or may not exist at the location shown.
,ty of Edmoinai-s/ nor its
Neither t1he U rcers -sh-a-1.1 be lIa-b-11--e for th
emp`o-yee-s O-f offi
information given on this map(5), nor for
ion pr 'ded based
any one represe.ntat' ovi
upon'sald map(_5).
PERMIT EXPIRES
USE PERMIT
ZONE
CITY OF EDMONDS 9 9 10 (6
C NUMBER
JOB SUITE/APT#
.'CONSTRUCTION PERMIT APPLICATION ADDRES . S
SIN
F07WNERNnNAME OF BU I� ESS five, V�
LEGAL DE ION CHECK S UBDIVISION NO. LID NO.
w MAILING ADDRESS
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0 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved
RW Per. R:q.�;eo
CITY ZIP TELEPHONE EXISTING REQUIRED DEDICATION Street U.: p rn p � 0
Inspection Required
PROPO SED sidewalk RequiredV. 0
NAME METER SIZE: LINE SIZE NO. OF FIXTURES PRV REQUIRED
.. . .1.. : - - . — . - - NO 0'
YES 0
W Uj
t ADDRESb z
:C REMARKS z
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NAME
ENGINE . ERIN E MID DATED�� REVIEWED BY
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cc ADDRESS ? q A/
0
FIRE MEMO DATED REVIEWED BY w
LL
ZIP TELEPHONE
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0
VARIANCE OR CU ADB# SHORELINE #
STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EXEMPT ALLOWED PROPOSED. ALLOWED".' PROPOSED
Z LEGAL DESCRIPTION OF PROPERTY - INCCubEALL EASEMENTS
EXP
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ALLOWED PROPOSED FRONT SIDE REAR FRONT UPSIDE REAR
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CHANGE OF USE
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REMODEL APARTMENT SIGN
RE
GRADING FENCE
REPAIR CYDS X FT)_,;� -*CHECKED BY TYPE OF CONSTFJUCTIO�Nc( OCCUPANT
60DE GROUP
OTHER
DEMOLISH 0 TANK I ''. :
SPECIAL INSPECTOR" AREA OCCUPANT
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U
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U -NUMBER
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a OF AREAS
M -10
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DESCRIBE WORK TO BE DONE
u c, al�
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VALUATION FEE
PLAN CHECK FEE
GLAZING % LOTS OP % BUILDING -7
L
PLAN CHECK NCI- VESTED DATE' PLUMBING
C
MECHANICAL". -'.'7
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC GRADING/FILL
DOMAIN (CURBS,SIDEWALKS, DRIVEWAYS, MARQUEES,ETC.) WILL REQUIRE
SEPARATE PERMISSION.
2 STATE SURCHARGE
a: 40
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT: I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS STORM DRAINAGE FEES
cn
CA -APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS ENG. INSPECTION FEE
W
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
. NOS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
x AIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
D PLAN CHECK DEPOSIT
0 EEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
x NOR LI MIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION."
I — - TOTAL AMOUNT DUE 7'7
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT;AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CO�STRUC- CALL This application is not a permit until signed by the
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building Official or his/her Deputy: and Fees are paid.�and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27.
' RAG OFFI A I G �Np
,SYN QW! N �ER IENT) DATE SIGNW (425) RE. ZDA 1�1: Z
0
(411Q 4z�ct-p 771-022 __ T lt�
RELEAST DATE
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
N'OINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR
�OF, OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK -OWNER GOLD - ASSESSOR
11111111111111
15553
23318 96TH AVE W
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DA
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED: I
SCALED PLOT PLAN DATED:
DETERMINATION: 0 Conditional Waiver E] Study Required F1 Waiver
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
BLOCK:
L-\TEMP\DSrs\Fonns\Street File Checklist.doc
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R E:c E I VE D
JUL 2 1 1999
DEVELOPMENT SERVICES
CITY OF EDMONDS
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11 STRJ I
SINGLE FAMILY RESIDENTIAL
Name: 50wc-e&
Date: -2�02
Site Address: 'Z 3 3 V
Plan Check# 200 -7- 0 �'3q
Project Description: V(0 (J((�, JOK �(--J I od/o -kf (h L
Reduced Site Plan Provided 6�/ NO) ning:
F—zo
Map Page:
Corner Lot: (YES Flag Lot: (YES
Critical Areas Determination ff: L( -7
Study Required
waiver
SEPA Determination:
VExempt
El Needed (for over 500 cubic yards of grading)
0 Fee 11 Checklist 0 APO List with notarized form
Required
Street:
Side: 7,5-
1 Side. 57 J
Rear:
Actual Setbacks
Street: q Side: 3 Side: (6 Rear:
El Detached Structures:
El Rockeries:
0 FencesiTrellises:
El Bay Windows/Projecting Modulation:
El Stairs/Deck:
Bquildin Height
Datum Point:
(0 )
Datum Elevation: /,go t
Maximum Height Allowed:
Actual Height: V
Other
Parking Required:
Parking Provided:
Lot Area: 135-0
Maximum Lot Coverage: 35% Proposed: -Zo
Lot Coverage Calculations: 0 0 4 2-6 q6 .4- E,,r 6 c) 0� 7 —7 (x 4
ADU Created: (YES / NQ)
Subdivision: ^/0
Legal Nonconforming Land Use Determination Issued: (YES
goLuCnts
via�, 6u On TS
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4�c. /cc st 5-5
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Plan Review By:
Ptd,t,*x) Data fo� 04 -11 -0640C
. 41,g( E RECEIVED
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PERMIT EXPIRES
i�
CITY OF EDMONDS
/JSE PERMIT
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NUMBER 6qw
CONSTRUCTION PERMIT APPLICATION
JOB SUfTEIAPTo
ADDRESS o
9
OWNnNAME/NAME OF BUSINESS
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PLAT NAM&SUBDIVISION NO.
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LID FEE 6
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OWNER/CONTRACTOR RESPONSIBLE FOR,EROSION CONTROLORAINAGE
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PLAN CHECK NO: VESTED DATE
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t BE DONE ON PRIVATE PROPERTY ONLY. AMY CONSTRUCT110#4 ON THE PUBLIC
DOMAIN (CUPAS. SIDEWALKS. DAIVIEWAM MARQUEES, ETC.1 WILL REQUIRE GRADINGJFILL
SEPARATE PEPJdrSK)PL
STATE SURCHARGE
PERMIT APPUCATIOW. 1 *0 DAYS
PERIk9T LnffT. I YEAR - PROVIDED WORK IS STARTED WITHIN ISO DAYS
ENG. REVIEW FEES
SEE 13ACK OF PO4K PERMIT FOR MORE INFORMATION
-APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS'AND SUCCESORS ENG. INSPECTION FEE
IN INTEREST. AGFI.EES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAPING
2 EDMONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND AGENTS FROM ANY AND INSPECTION FEE
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE RECEIPT
UEEMEDTOMODIF CITYORDR�ANC �L�N'.CHECK DEPOSIT,
Y, WAIVE OR REDUCE ANY'AEOU NTOFANY Ei
0 NOR LIMIT IN ANY WAY THE CITY'S ABILITY.XO ENFORCE ANYORDINANCE PROW SION.-
x R CEIT6
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAYE"READ THIS APPUCATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS RECAAASMG CONSTRUC- T"n* amucaton a not a Pe�t until s&Vw by me
CALL
TION: AND IN DO NG THE WORK AUTHORIZED THEREBY. NO PEACSION YAULL SE EMPLOYM &ak*"% OMOQA or r-&Flw Devuty &nd F*" &-o
IN VIOLATION OF THE LABOR CODE OF THE STATE OF VKASNVWGT(X AeL4r4jjQ 1,0 FM --of b ---cw6m*pd min soace p:D-ood.
WORKMEN'S COMPENSATION INSURANCE AND RCW �A27-
con
;DVW.%F.q OR AGEMT) iiiiiiiiiiiii
Zil
Permit No: .200Z -CIA53
City of Edmonds
RIGHT-OF-WAY CONSTRUCTIONTERMIT Issue Date: ILO
A. Address or Vicinity of Construction: 23318 96 AV W
B. Zge of Work re ic): PERMISSION I IS REQUESTED TO INSTALL NEW GAS SERVICE 2" PE IP
JOTecif
EXTEN FROM 57N OF 234 ST SW NORTH TO 157' N
C. Contractor: PSE/PILCRUCK(WNT /I Contact:* SUE SIDICK"".
Mailing'Address: STONE AV N Phone: 206-418-4239
State License #: PiLCHCI101MA Liabi Bond: $
I --lity Insurance:
t" -
D., Buildiu, Permit # (if applicable): Side Se.wer Permit # (if applicable):
E. F� Commercial F1 Subdivision City Project F] EUC (PUD, VERIZON, PSE, AT& T, OVWD)
Multi -Family E] Single Family r_1 Other
INSPECTOR:
F. PAVEMENT
,�CUT: El YES El NO G. SIZE OF CUT _X
CONCRETE CUT: El YES El NO
AN'LICANT TO IZEAI) ANI) SICN
INDEMNITY. Applicant understands by his/her signature to this application helshe holds the Citybf, Edmonds h-armless from
injuries', damages or claims of any kiA4 or description whatsoever, foreseen � ..unforeseen, 'that may beim"ade a&nst the City of
Edmonds Wainy- 6 is departments'or emplo�ees, including but nof'limited to t& defense of any legal proceedings !ncluding defense
costs and attorneyfees by reason ofgranting this permit.
"74 T
THE CONTRACTOR IS RESPONSIBLE "FOR eWORKMANS��IPMXD -MI'ATERIALS -FOR !A -PERIOD -6F--ONE- YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE FiiORK. ESTIMATED RESTORATION FEES W1LL BE HELD UNTIL THE FINAL STREET PATCH IS
COMPLETED BYCITYFORCES, AT WHICH TIMEA DEBITOR CREDIT W1LL BEPROCESSEDFOR ISSUANCE TO THEAPPLIC4NT.
Traffic co ' ntrol and public safety shall be in accordance with City regulations as required by the City Engineer. Every
flagger must be trained as required by (WAC) 296-155-305 and must have. certification verifying completion of the
required train ing.in-t1reir 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
IHAVEREAD THE ABOVE STATEMENTS AND UNDERSTAND TIIE PERMIT REQUIREMENTS AND.ACKNOWLEDGE
THATIMUSTMAKE THE PINK COPY OF THE PERMITA VAILABLE ON SITE A TALL TIMES FOR INSPECTIONS
Sign' re: Date:"
(Contractor or Agent)
FOR CITY USE ONLY
Approved by: D. rntu%ml-
Time Authorized: Void After /ot.
Special Conditions: REe;MW., IZOW MIZ 60 S'A030AP-Do
�v 'I
Right-of-way Fee:-, 40 +
Disruption Fee/Fund 11-1:
Re's4oration Fee:
Total Fee:
Receipt No:
1 Issued /--,/044�
Q,�
UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL
INS PECTION IS REQUIRE D PER CHAPTER 18.00 OF THE EDMONDS
COMMV,NITY DEVELOPMENT CODE (Phone 425-771-0220, Ext 1326)
FINAL APPRO VAL OF PERMITTED WORK. Pt,4_ &I �r n - pv, (I i 14 W I* R I( k_,O� DATE: i o/7_401
Inspector's Si-anature 12-4/0 L X01V as
For inspection requirements see Engineerifig Inspection Infdrmation handout."
NO WO11K SHALL IMCIN 11MOIZ TO nizmrr ISSIjANCE
DAMy Documents\Forms\Engrum'g\ROWpermit—.doc
W
STANDARD NCC GAS
CONSTRUCTION NOTES:
EOM
2" PE CAP
157'N CL & 20'W CL
(--,)N CL,
W CL
cz
60'
R/W
t.Au - tru - I f
00
63
TRANS FIT. & TEST LEAD
It-.
C0
CO3
59'N CL & 20'W CL
ITO
CAD
-A,
CYI
(--")N CL
W CL
PROPOSED 100
2" PE IP MAIN
20'W CL
TIE—IN
- - - 1)w CL
IV
r14
2" SHORT
NvTOPPER
S
57'N CL &
20'W CL
9 CO'S
--- P)N CL
W CL
fic'67
234 ST SW
;0
"UMMMMMM
0
FITTER (CHECK BOX IF COMPLETE)
Work area left in Clean & Safe ondition
Complete all Pipe Tables and Gas Pressure Stamp
Field changes Red -Limed on as -built
Material verified and Changes noted on paperwork
All Valve & Tie-in Locations oted on as -built
Note beginning of Main, EOM & Lime of Main locations
Show Rope Locations & Cul-de-sac Radius
Foreman's Signature
Company
Employee ID#
1. FIELD LOCATE AH UNDERGROUND UTILITIES. CALL "ONE— CALL' TWO WORKING
DAYS PRIOR TO CONSTRUCTION, 1-800-424-5555.
2. ALL CONSTRUCTION IS TO CONFORM TO PSE GAS OPERATING STANDARDS
AND GAS STANDARDS PROCEDURES MANUAL
3. INSTALL MAIN VALVES OUT OF TRAFFIC WERE POSSIBLE.
4. ANY CHANGE IN ROUTE, TIE—IN METHOD OR ADDITIONAL MAIN FOOTAGE MUST BE
APPROVED BY PROJECT MANAGER.
5. COMPLETE "PIPE CONDITION REPORT' ON ALL EXPOSED EXISTING PSE
FACILITIES. CHECK BOX ON REPORT FOR WIRE BOX (TEST LEAD)
INSTALLATION.
6. INSTALL ONE POUND ANODE FOR EVERY 1000' OF LOCATING WIRE. INSTALL
ANODE AND TEST LEAD WIRES PER PSE GAS OPERATING STANDARDS 14.2 AND
14.5.
7. MAINTAIN CATHODIC PROTECTION FOR STEEL MAINS BY THE USE OF
CONTINUITY BONDS OR OTHER MEANS DETERMINED BY THE PSE CORROSION
ENGINEER PER PSE GAS OPERATING STANDARDS 10.3
8. INSTALL ANODES AND TEST LEAD WIRES AS REQUIRED PER PSE GAS
STANDARDS PROCEDURES P0201 AND P0303 AND PSE GAS OPERATING STANDARD
10.2. TEST LEAD 'ORES ARE REQUIRED ON ALL TRANSITION FITTINGS.
9. REFER TO PSE GAS OPERATING STANDARD 6.8 FOR MAIN AND SERVICE COVER
REQUIREMENTS.
10. MAINS AND SERVICES SHALL BE TESTED AND PURGED PER PSE GAS
OPERATING STANDARDS 6.14, 6.17 AND 14.2 AND PSE GAS FIELD PROCEDURE
P0816.
11. CUSTOMER PROVIDED TRENCHES ON PRIVATE PROPERTY SHALL CONFORM TO PSE
STANDARDS.
12. EROSION AND SEDIMENT CONTROL SHALL BE PER PSE STANDARD PRACTICE
0150.3200 TECHNIQUES FOR TEMPORARY EROSION AND SEDIMENT CONTROL AND
ANY ADDITIONAL LOCAL JURISDICTION REQUIREMENTS.
13. TO PREVENT ACCIDENTAL OVERPRESSURE OF ADJOINING SYSTEM. NO TWO MAINS
SHALL BE CONNECTED EXCEPT AS SHOWN ON THIS DESIGN UNLESS APPROVED BY
A PSE REPRESENTATIVE.
14. SYSTEM MAOP DENOTED BA SYSTEM MAOP - 45 PSI�]
15. COORDINATE INSTMAATION NTH CORROSION CONTROL:- ED VOOGT 206-396-2799-6313.
GAS MAIN INSTALLATIONIRETIREMENT Vicinity Map
Estimated Actual
TypetWork Pipe Size Type Length Length Manufacturer
INSTALL 2" PE 100'
GAS MAIN PRESSURE & TESTING
TYPE TEST RE _TESTED 13Y
DATE R�_ :FIMP OFF
i :12: "' — --- i - I
I TYPE TEST I IPRESSURE I -iESTED BY
IDesign Press 60 1 SYS MAOP 45
PROJECT PHASE
NOTIF#
ORDEFZ#
U)
SAP Superior
Service/Meter
Service/Meter
Service/Meter
Service/Meter
Ind. Service
Ind. MSA
Dis. Reg. / FT
HP SvctMSA
Relocate
Retirement
X767104901
107014199
X353521613
106091252
X546244242
Contractor CONSTRUCTION COST CODES:
021-103.1 1 1 1
Project Manager Contact Information:
DOUG USITALO
CELL: 425-327-Mi
REV# DATE BY DESCRIPTION
WORK SITE
01,
2 3210,
C:1 --...231ST
232ND SST SW
x 7
<C ST SW
1176
23011 SW
970
CL
23 TH
Pl. SW
sl, ir
CM3)
23 1, 235TH ST SW
FL S�
ST SW
238111 ST
0 2M THOMAS BROS. MAM
rn ST
Owner/ Developer Contact Info
DEBBIE SAUCEDO
318 96 AV W
EDMONDS, WA 98020
ATTN:DEBBIE SAUCEDO 206-533-2004 office
CALL (800) 424-5555
2 BUSINESS DAYS BEFORE YOU DIG
THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF FACILITIES
ESTATE/EASEMENT PERMIT
NIA CITY OF EDMONDS
TION CONTACT PHONE DATE
3
PROJECT MGR
D. USITALO
206-418-4236
8/26/02
2
ENGR-GAS
1
DRAWN BY
P. MCGHUEY
206-418-4214
8/30/02
CHECKED BY
D. USITALO
206-418-4236
COUNTY
EMER SECT
GAS WK CTR
APPROVED BY
D. USITALO
206-418-4236
11
SNOHOMISH
5
MCNSEG
FITTER #1
1/4 SEC
NW-36-27-03
OP MAP
164.062
PLATMAP
166.067
FITTER #2
n
0
MAPPING
JOINT FACILITIES ARRANGEMENTS
n
UTILITIES
1:1
n
E]
CONTACT
PHONE#
PUGET
SOUND DEBBIE SAUCEDO
EMGY 211 PE IP MAIN EXTENSION
23318 96 " W, EDMONDS, WA 98020
DESIGNED BY PILCHUCK CONTRACTORS INC.
0-7-0 14
SCALE:
11"= 50'