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23715 84TH AVE W.PDF11 lill 111111 7975 23715 84TH AVE W 0 ADDRESS: �tj D-:3 111,5 cD— 3'� 1 —7 S (4 A TAX ACCOUNTIPARCEL NUM13ER: 4 0 C?-cr-D BUILDING PERMIT (NEW STRUCTURE). 0 1 COVENANTS (RECORDED) FOR: CRITICALAREAS: —DETERMINATION: [] Conditional Waiver 0 Study Required Waiver DISCRETIONARY PERMIT #'S: 466 cla-ol 7 DRAINAGE PLAN DATED:— 1 g. I ) (1.1 q q PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE S: SHORTPLAT SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S).#: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DATED: OTHER: LID ff: LOT: BLOCK: 9 9 5 �V h2> LIL',;-:�? -:9 3(L9--(f LATEMP\DS'rs\Fornis\Street File Checklist.doe C. o QJ City of Edinonds RIGHT-OF-WAY CONSTRUCTION PERMIT Permit Number. Wue Date: C1 A. Address or Vicinity of Construction: Z3171 3JZ-3-715- 13 4 11� Ale- tA)' B. Type of Work (be specific): PER- 14L�P_>APn&-,eD C. Contractor: Kjew��UoJL.P_., Lkh I th 1!,Scontact: q�)1-40 _UF Mailing Address-. C) 1276--4 1116011 Phone: * <, L4 S, I C� 2, 1 L State License #: Oor—KN" 01 Liability Insurance: Bond: $ D. Building Permit # (if applicable) E. El Commercial E] Subdivision D9 Multi -Family E] 'Single Family INSPECTOR: rrouqr— F. Pavement or Concrete Cut: Yes Side Sewer Permit,# (if applicable): 1, W, �,I�ity Project ''0' Utility (PUD', GTE, WNG, CABLE, WATER). F1 Other 114SPECTOR: []No G. Size of Cut: x H. Chargq�_$ APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessfrom injuries, damages, oi� claims ofany kind or description. whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, oranv bf its departments or employees, including �r not limited to the defense of any legal proceedings including defense costs and attorneyfees by reason of granting. this per M"It. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC- TION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR.CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT i Two sets of construction drawings 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. completiona Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffi6 Control and Public Safety shall be in accordance with City regplffions as required by the City Engineer. All street cut tretich work 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 siteat all times for inspection purposes. 4 ',Signature: Date: (Contractor or Agent) CALL DIAL. -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY. 6?C14 - TIME AUTHORIZED: VOID AFTER DAYS SPECIAL CONDITIONS: PC1Z.__APPo9o,1+'D RIGHT OF WAY FEE: DISRUPTION FEE/FUND I 11: RESTORATION FEE: T OTAL FEE: - RECEIPT NO.: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997 FIELD INSPECTION NOTES I Comments: I Diagram. (Fund 111 - Route copy to Street Dept.) CONTRACTOR CALLED FOR INSPECTION E] YES NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: LICENSE DETAIL INFORNWION Form Page I of I STATE OF WASHINGTON DEPARTMENT OF LABOR AND INDUSTRIES Specialty Compliance Services Division P. 0. Box 44000 Olympia, WA 98504-4000 TBE RESULT OF YOUR INQUIRY FOR LICENSE NUMBER SELECTED IS: LICENSE DETAIL INFORMATION Current Filter: None Registration# or License NORTHU*1 01 MZ Name NORTHLAKE UTILITIES Address PO BOX 1691 Address City WOODINVILLE State WA Zip 98072 Phone Number 4254819212 Effective Date 7/9/90 Expiration Date 7/19/99 Registration Status ACTIVE Type CONSTRUCTION CONTRACTOR Entity CORPORATION Specialty Code GENERAL Other Specialties LIBI Number 601245642 * * *VIEW PRINICPAL OWNER(S) FOR THIS LICENSE* * - * * *VIEW CONTRACTOR BOND/SAVINGS INFORMATION * * * * * THECK INQUIRY FOR SUMMONS AND COMPLAINTS* * * * * * VIEW CONTRACTOR INSURANCE INFORMATION * * * New inquiry by CITY, NAME, PRINCIPAL OWNER NAME, NUMBER, UBI NUMBER or return to the L&I Construction Compliance Home Pag http://www.Ini.wa.gov/contractors/TF2Form.asp?License=NORTHU*IOIMZ 3/5/99 4"i . in - -ocj C. I's -City of Edmonds RIGHT-OF-WAY CONSTRUCTION PERMIT Permit Number. Issue Date: C)q A. Address or Vicinity of Construction: Z--*' 7 111 Z-6-7 12; B SrM IOHQ_�� B. Type of Work (be specific)-7:6-P, ckzk�a�j C. Contractor: Contact: Mailing Address: q (9 S"� Phone: State License #: L RW 0 Liability Insurance: Bond:$ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. n Commercial El Subdivision El City Project EJ Utility (PUD, GTE, WNG, CABLE, WATER) Multi -Family EJ Single Family Other INSPECTOR: rCCA.&-1, INSPECTOR: F. Pavement or Concrete Cut: 0 Yes E]No G. Size of Cut: x H. Chargq�,$ APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessfrom.injuries, damages, or cl6i ; mi�of any kind or description whats oever, 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 of any legal proceedings including defense costs and atiorneyfees by reason of granting thi s permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC- TION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WffL`BE HELD -UNTIL THE FINAL STREETPATCHIS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT . . Two sets of construction drawings 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 trench work shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS: I have rea ' d the above statements and- understand the permit requirements and the pink copy of the permit will be available on site at all timesfor inspection purposes. Signature: Date: -9 9 or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: nvt'� !2 0J, TIME AUTHORIZED: VOID AFTER Ve 6�_� DAYS SPECIAL CONDITIONS: RIGHT OF WAY FEE: DISRUPTION FEEIFUND I I I RESTORATION FEE: T OTAL FEE: 5-C RECEIPT NO.: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997 FIELD INSPECTION NOTES Comments: Diagram CONTRACTOR CALLED FOR INSPECTION Partial Work Inspection by P.W.: Work Disapproved By: FINAL APPROVAL BY: (Fund 111 - Route copy to Street Dept.) 13 YES Date: Date: El NO 'b, Date: To: From: Subject: MEMORANDUM December 23, 1998 Don Fiene, Hydraulics Engineer Jamal Mahmoud, Traffic Engineer Gordy Hyde, Development Services Engineerl?��' Building Permit Application for Ofteson at 23713/5 — 84" Ave. W. (ADB-98-17) (Plan Check 98-323) The Building Division received the attached revised building permit application information today. I included your latest plan review mark-ups and/or notes for your information. If you need more information, please check with me, as I have the ADB file and earlier correspondence with the applicant. Please review and return your comments to me as soon as possible so I may prepare review correspondence no later than January 5. Your cooperation in initiating a prompt review and a rapid response is appreciated. Thank you. CITY OF EDMONDS ENGINEERING DIVISION b8323b.doc ft -0 MEMORANDUM Date: January 5, 1999 To: Gordy Hyde, Development Services Engineer From: Jamal Mahmoud, Traffic Engineer � M Subject: Building Permit Application for Otteson at 23713 — 84th Ave W. (ADB 98- 17) (Plan Check 98 — 323) In order to complete the review of your building permit application, the following traffic issues should be addressed: The school bus stop sign could be located to the north only. Please coordinate with Community Transit. City of Edmonds .................. Community Services Department Engineering Division City of Edmonds RIGHT-OF-WAY CONSTRUCTION PERMIT* A. Address or Vicinity of Construction:—` Permit No: Y7 Issue Date: B. Type of Work (be specific): PERMIT REQUEST TO INSTALL A 1-1/4". PLASTIC PIPE — GAS MAIN IN 84 AVE W TIE INTO EXISTING MAIN AT + 3001 N, 121 W OF THE CENTERLINE OF 84TH AVE W & 238TO ST SW AND EXTEND 50' EAST TO SERVE TARGET, C. Contractor: PUGET SOUND ENERGY Mailing Address: 1122 75TH SW EVERETT Contact: DOLJ4 USITALO Phone: 425-356-7520 State License #: -Liability Insurance: Bond- $ I/ — 9 * 9 D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. Commercial Subdivision EUC (PUD, GTE, PSE, CHAMBERS, OVWD) [—] City Project Multi -Family Single Family Other INSPECTOR. F. PAVEMENT: El YES Dfl NO G. SIZE OF CUT x H. Charge: $ CONCRETE CUT: YES' W NO APPLICANT TO READ AND SIGN IDEMNITY. Applicant uind&stands by his/her signature to this application helshe holds the City of Edmonds harmlessfrom injuries, damages or claims cfany 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 legabp�o'ceedi�gs including defense costs and attorneyfee§ by reasotfi5fgranting 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 BY CITY FOOCES, 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 regulations as required by the City Engineer. Every hagger must '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. IHAVEREAD 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 FELMA H LOPEZ—FUGUIAO Signature: Date. (Contractor or Agent) 8/31/99 CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK Approved by: Time Authorized: Void After 0 Special Conditions: C 044 o� fe, ve L,, � e 6 , 4— E ONLY Right-of-way Fee: Disruption Fee/Fund 111: Restoration. Fee: Total Fee: Receipt No: issued byl. 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'S SIGNATURE DATE: For inspection requirements see Engineering Information Handout. : I 236th ST. S.W. I . PAY. W ID C? co r- CD '0 Re 4" CONDUIT TIE-IN a + 300 ' N, 12' W (2 x 1-1/4" TAP TEE) 1-1/4" PE IP t 300'N CL 3 MTR MANIFOLD PROPOSED 1-1/8" SERVICES END MAIN i 38'E, t 300'N CL 23715 3 MTR MANIFOLD N cy) E- C� 10 01 t- ;0 oo 238th T. S.W. F NOTES: 1. CALL 2 DAYS BEFORE YOU DIG 1-800-424-5555 CITY OF EDMONDS: Maintain a minimum of Whorizontal and 3' vertical clearance from all city utilities and appurtenances. Cuts in paving are shown as _Aq_ cuts in paving anticipated. Notify Engineering Division 24 hrs prior to construction - 425-771-0220 PROJECT MANAGER: DOUG USITALO - 425-356-7520 4" CONDUIT TO BE INSTALLED 300' NORTH OF THE CENTERLINE OF 238 ST. S.W. GAS MAIN INSTALLATIONRETIREMENT I R SIZE L N.GTH TYPE JURER 11/ 4 /1 50' MPE CALL 1-800-424-5555 2 BUSINESS DAYS BEFORE YOU DIG THIC CVE"TrU NinT Tn Pi: Ppiipn iipnN FnR FXACT IOCATION OF FACILITIES 5 REAL ESTATE/EASEMENT ------------------------- PERMIT EDMONDS ----------------------- 4 -- -------- ---------------------- 3 FUNCTION NAME PHONE NO DATE 2 PROJECT MGR: D.USITALO (425 .) 356 -7520 08/30/99 ENGINEER: ----------- -------- -- REV# DATE BY DESCRIPTION DRAWN BY: C.S. -------- 08/30/99 COUNTY IMER SEC Work Center _NSNHG_ CHECKED B Y: T M W_ --- --- -------- F_ /V — -Iqq APPROVED BY: (J��) � 5 �- 7 5)0- (j / JO/ 1/4 SEC SE - 31 - 27 - 04 OP MAP 164.68 PLAT MAP 167.69 - - ------------- ----------- -------- -- ------------- ----------- -------- -- U-MAP# (POWER CIR MAP# CIRCUIT# ------------- ----------- -------- -- MAPPING: ------------ JOINT FACILITIES ARRANGEMENTS UTILITIES------------------- -------------------------------------- ------------------ CONTACT--------------------------------------------- ------------------ PHONE# ---------------------------------------------------------- ------------------ 1-1/4" PE IP- MAIN EXTENSION TO PUGET SERVE: 23713, 23715 64 AVE. W. SOUND ENERGY PRELIMINARY ONLY Nnt for Construction INCIDENT# - - - - - - - - - - DRAWING# 107006825 ---------- SAP SUPERIOR ORDER# 107006825 ---------- SCALE: 50 1�