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308 FIR PL.PDF11111111111111 11262 308 FIR ST TUWAY MESSAGE #TO FRO SUBJECT: DATE 2" 2: �i m Li, Y-� E s s A G E RETURN TO SIGNED R E p L y L DATE: SIGNED CASCADEO Ll-C2375 PRINTED IN U.S.A. go gol CITY OF EDMONDS 250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221 COMMUNITY SERVICES DEPARTMENT Public Works a Planning * Parks and Recreation # Engineering August 25, 1994 Mr. & Mrs. Robert Andre 308 Fir Place Edmonds, WA 98020 Dear Mr. & Mrs. Andre LAURA M. HALL MAYOR In response to your request for an adjustment to your water line that was broken on August 14, 1994 by the lawn more. The following criteria must be met: 1. You must submit repair bills or statement requesting a leak credit between the billing dates you feel are affected. 2. You must show proof leak is fixed when city crews check site. 3. You must -be a higher consumption that the previous year at the same time of year. 4. Only one credit will be granted every three (3) years. Please feel free to contact me at 771-0235, extension 349, if you have any further questions Sincerely, Ron Holland Water/Sewer Supervisor RH/lk 308FIRPL/TXTWATER * Incorpproted August 11, 1890 * Sister Cities International — Hekinan, Japan 1 8 9 0 . 1913 - CITY OF EDMONDS 250 - 5th AVE N. 9 EDMONDS, WA 98020 * (206) 771-3202 COMMUNITY SERVICES: Public Works 0 Planning 9 Parks and Recreation e Engineering June 13, 1989 Mr. & Mrs. Robert Andre 308 Fir Place Edmonds, WA 98020 Dear Mr. & Mrs. Andre: LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR Upon receipt of your letter, I have checked with the following cities and the results are as follows regarding cross connections: gity_9f_�y9gwood 1. Inspection upon installation. 2. No program of follow-up. 3. No annual inspection. City_2f_M2ynjlake Terrace 1. Inspection upon installation. 2. No program of follow-up. 3. No annual inspection. Alderwood-Water-Distr,ict 1. Inspection upon installation. 2. Requires annual inspection (completed by outside contractor). City_9f_EqTq2ds 1. Inspection upon installation. 2. Requires annual inspection (completed by outside contractor). After talking with the City of Lynnwood and Mountlake Terrace, both cities will be establishing a program of annual inspections to be completed by an outside contractor. The State Board of Health requires a certified inspector and not all local plumbers are certified. To become a certified inspector requires a three (3) day training period and an exam upon compleiion. 0 Incorporoled August 11, 1890 0 Sister Cities International — Hekinan, Japan k% Page Two Hose bibs are a concern with our water department and any place where water is drawn could effect our water system such as filling of swimming pools, hot tubs, etc. Enclosed are the regulations and ordinances which the City of Edmonds is adopting. Should you have additional questions, please call Archie Brena at 771-3202, extension 317. Sincerely, 0 Bobby Mills Public Works Superintendent BM/lk cc: Larry Naughten Mayor Enclosures ANDRE/TXTWATER FA RULES REGULATIONS OR of the STATE BOARD OF HEALTH REGARDING PUBLIC WATER SYST5M.S., Revised August 1983 0 UPARIMENT Of .9 SOCIAt & ITALM SERVICES DIVISION OF HEALTH Water Supply & Waste Section LD-11 Olympia, WA 98504 0 00 oo 0 o CD On 0 0 0 CD fb cr — r C) (D 0 3 cy. D, Cl. 00 L 0 5 < t-j n I = CD ao = 0' 0 0 0 cr 0 ca n 41 3 00 < n .a. 1 LA F), cr CD n 00 n n n n CL Iwo Public Water Supplies (c) The water purveyor shall notify the department within thirty days of any change in name, ownership, or responsibility for management of the public water system. (d) Water facilities inventory and report (WFI). (i) Every purveyor of a class I and 2 water system shall submit to the department an updated WFI report annually. (ii) Purveyors of class 3 and 4 water systems shall submit a WFI report to the department every three years. (c) Public water systems using an unfiltered surface water source shall submit an annual report summarizing the watershed control program and activities within the watershed during the previous year pursuant to WAC 248-54-225. [Statutory Authority: RCW 43.20.050. 83-19-002 (Order 266), 248-54-265, filed 9/8/83.] 248-54-275 Sanitary survey. The department or the local health officer, as determined by the joint plan of oper- ation developed in accordance with WAC 248-54-025, shall periodically conduct a sanitary survey with the cooperation of the management of those public water sys- tems surveyed. Q Facilities inspection — The sanitary survey shall include an inspection of all physical facilities of the public water system. (2) Operations and management inspection — The sanitary survey shall include - an inspection of any procedures, records, and data compiled or used by the purveyor relating to the operation and management of the water system. The inspection may include, but not be limited to, the review of water qual- ity monitoring data, performance data for water treatment processes, and the operations report. [Statutory Authority: RCW 43.20.050. 83-19-002 (Order 266), § 248-54-275, filed 9/8/83.] 248-54-285 Cross —connection control. (1) Administration. (a) A cross —connection control program is required as part of the opera- tions program outlined in WAC 248-54-195. (b) The purpose of a cross —connection control program is to protect the health of water consumers by: (i) The inspection and regulation of plumbing in existing and pro- posed piping networks; and (i i) The proper installation and surveillance of backflow prevention devices when actual or potential cross —con ncct ions exist and cannot be eliminated. Public Water Supp5es (c) It shall be the primary responsibility of the water purveyor to work cooperatively with local authorities to eliminate or control potential cross —connections. (d) The water purveyor shall develop and document enforcement author- ity and operating policies in a manner acceptable to the department. The current edition of The Accepted Procedure and Practice in Cross—Conncction Control Manual — Pacific Northwest Section — American Waterworks Association, shall be used as a resource to es- tablish minimum cross —connection control operating policies. Water purveyors and local authorities shall have the option of establishing more stringent requirements. (e) If an immediate hazard to health is caused by a cross —connection, then the water purveyor shall discontinue water service to the prem- ises impacted by the cross —connection, until it is verified the cross — connection has �cen eliminated or controlled. (2) Backflow prevention device installation and testing. (a) If a cross —connection cannot be eliminated, then a backflow device shall be required: (i) An air —gap separation or reduced pressure principle device shall be installed if the cross —connection creates an actual or poten- tial health or system hazard. (ii) An air —gap separation, reduced pressure principle backflow pEe- vcntion device or double—check valve assembly shall be installed if the cross —connection is objectionable, but not hazardous to health. (iii) Backnow prevention devices shall be installed at the service connection or within the following facilities, unless in the judg- ment of the water purveyor and the department. no hazard exists: Hospitals. mortu�rics, clinics, laboratories, piers and docks, sewage treatment plants, food and beverage processing plants, chemical plants using water process, metal plating in- dustries, petroleum processing or storage plants, radioactive ma- terial processing plants or nuclear reactors, car washes, facilities having an auxiliary water supply, and others specified by the department. (b) All reduced pressure principle backflow prevention devices and dou- ble—check valve assemblies installed shall be a model approved by the department. The department shall publish and maintain a list of ap- proved devices. (c) All reduced pressure principle backnow prevention devices and dou- ble—check valve assemblies shall be inspected and tested by a certified backflow device tester or cross —connection control specialist. Tests shall be conducted: (i) At the time of initial installation, and (ii) After the device is repaired, and [381 [391 7.20 Chapter 7.20 Backflow Prevention Sections: 7.20.010 Definitions 7.20.020 Cross -connections declared unlawful 7.20.030 Backflow prevention devices to be installed 7.20.040 Reputation of private water supplies 7.20.050 Adoption of state regulations 7.20.060 Abatement of unlawful cross -connections and installation of backflow prevention devices Procedures 7.20.070 Penalties 7.20.010 DEFINITIONS A. "Backflow" means a flow, other than the intended di- rection of flow, of any foreign liquids, gases or sub- stances into the distribution system of a public water supply. B. "Backflow prevention device" means a device approved by the State of Washington, Department of Social and 40 Health Services or such other state department as has jurisdiction over the subject matter and by the American* Water Works Association, used to counteract back pressure or prevent back siphonage into the distribution system of a public water supply. C. "Cross -connection" means any physical arrangement whereby a public water supply is connected, directly or indirectly, with any other water supply system, sewer, drain, conduit, pool, storage reservoir, plumbing fixture or other device which contains or may contain contaminated water, sewage or other wastes or liquids of unknown or unsafe quality, which may be capable of imparting contamination to a public water supply as a result of backflow. [Ord. 1711. §1 (part), 19741. 7.20.020 CROSS -CONNECTIONS DECLARED UNLAWFUL The installation or maintenance of a cross -connection, ...,.which, in the opinion of the director of public works or his designee, will endanger the water quality of the potable water supply of the city of Edmonds, is unlawful. [Ord. 1711 51 (part), 19741. 7.20.030 BACKFLOW PREVENTION..DEVICES TO BE INSTALLED Backflow prevention devices, when required to be installed. 341 . 7.20.040 in the opinion of the director of public works or his desig- nated representative, shall be installed and -maintained by the service customer on any service connection to the city of Edmonds water supply system where the backflow prevention devices are necessary for the protection of the city of Edmonds' water supply. [Ord. 1711 §1 (part), 19741. 7.20.040y' REPUTATION OF PRIVATE WATER SUPPLIES Use or operation of a private water supply system, contrary to the provisions of the ordinances of the city of Edmonds, or the laws of the State Of Washington or the rules and re- gulations of the State Board of Health regarding public water supplies where the private system is served by the city public water supply is unlawful. [Ord. 3.711 91 (part), 1974). 7.20.050 ADOPTION OF STATE REGULATIONS Rules and regulations of the State Board of Health regarding public -water supplies, entitled "Cross -Connection Control Regulations in Washington State", WAC 248-54-250 through WAC 248-54-500, and the American water Works Association, Pacific Northwest Section's Second Edition of "Accepted Pro- cedure and Practice in Cross -Connection Manual" as they pre- sently exist, and as they may from time to time, be amended in the future, are adopted by this reference as if set forth in full. [Ord. 1711 §1 (part), 19741. 7.20.060 ABATEMENT Or UNLAWFUL CROSS -CONNECTIONS AND IN� STALLATION OF BA CKFLOW PREVENTION DEVICES - PROCEDURES Cross -connections declared in this chapter to be unlawful whether presently existing or hereinafter installed and/or services requiring backflow prevention devices and/or uh- lawful use or operation of a private water supply system served by the city public water supply are public nuisances, and, in addition to any other provisions of this code or the ordinances of the city of Edmonds on abatement of public nuisances, shall be subject to abatement in accordance with the following procedure: A. In the event that the director of public works or his designee determines that a nuisance as herein provided does exist, written notice shall. be sent to the person in whose name the water service is established under the ' -records of the city of Edmonds water division, or al ' t*ernatively,a copy of such written notice shall be posted on the premises served. 342 1% 7.20.070 BJ131 B. The notice shall provide that the nuisance described herein shall be corrected within thirty days of the date the notice is mailed*or posted on the premises. C. In the event the nuisance is not abated within the, pre- scribed time, water service to the premises shall be,. discontinued. D. In the event that the nuisance, in the opinion of the director of public works, or his designated representa- tive, presents an immediate danger of contamination to. the public water supply, service from the city water supply system to the premises may be terminated without prior notice, provided, however, notice will be posted on the premises in the manner heretofore pr'ovided at the time the service is terminated. [Ord. 011 §1-(part), 1974). 7.20.070 PENALTIES In -addition to the remedies set forth herein, any person found guilty of violating any of the provisions of this chap- ter shall be subject to the penalties as set forth in Section 5'.50.020 of this code. [Ord. 1711 Sl (part), 1974]. (6/20/86) 343 CITY OF EDMONDS ASSEAFORMATION SHEET F/ IN61 ADDITION RETIREME NT ASSET NO. 2- 6 0 ADDITION TO ASSET NO. DESCRIPTION L-J A Tild --If? /2 u tc 1.7 L SERIAL NO. LOCATION DEPT. NO. F s-0 *PURCHASE ORDER NO. - PURCHASE ORDER DATE COST *PROJECT NUMBER co, PROJECT COMPLETION DATE 3o - 6'0 COST ./(-, B.A.R.S. ACCOUNT NO. q o 3 V �5- 6:3 is ESTIMATED LIFE g INITIATED BY DATE APPROVED BY "SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY El DEPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT G.L. ENTRY REFERENCE VERIFIED BY PROCESSED BATCH NO. DATE INITIAL (�np ' The City of Edmonds Side Sewer Drawing EASEMENT NO - -------------------------------------------- NEW coNSTRUCTION [R REPAIRS El LID NO.4 '-' - -ASMWT. NO. --------------- =z. IM -=is - OWNER ---- ....... C:i�, � --- �L-kc=j(�:>tXONTRACTOR --------- --- - -------------- ...... PERMIT NO. -4g �L JOB ADDRESS ... .................................. LEGAL DESCRIPTION: LOT NO - -------------- �-5 ------------------- BLOCK NO - ----------------------------------- ..................................................................... I ................................................................................... 44C a PWW-0Wl-11/75jRF-V.11jjM Approved: DATE.... ----------- ............... CITY OF EDMONDS PUBLIC WORKS bEPA04ENT FOR INSPECTION CAL46 Permit SIDE SEWER PERMIT 775-2525 Ext. 220 Issue Date PERMIT MUST BE -POSTED ON JOB SITE 1, Address of 7onstruction _qQ8 Firs' S I - 'CIT07-0 2. Property Legal Description (include all, easements') X M N PA4C 4 '-* a PLN �1 - L OT -S 3. Single Family Residence Multi -Family No. of Units Commercial 4. Owner -a-nd-/or­Bui.lder UM i 5. Contractor & License No. at-IrMIQ C_94�Tt_ R_9_�_�Zo 6. Invasion into City Right -of -Way : Nol­'� Yes (If Yes Right-of- way Construction Permit Required - Call Dial Dig (342-5344) before excavation). 0 E-i 7. Cross other private property: Yes No L��,��'Easem v4t� red - U attach legal description and county easement number. H P/z �4 READ THE FOLLOWI.NG AND SIGN: P4 a4 K4 a. Property owners must obtain a permit to install side sewers on >-I their property. A licensed side sewer contractor must be employed to CQ construct side sewers in the public right-of-way. 0 b. The side sewer contractor assumes full reponsibility for each installation for one year. C. Commercial establishment requires a minimum of a six inch (6") P4 z side sewer line. 0 d. Side sewers may not be in ser than thirty inches (30") to any structure. e. Side sewer lines must be aid m' i tollWaNOD 2% (1.15') 0 and maximum grade of 100% (450). 0 48 HOURS f. No turn in side sgwer gre ter 4 14yj': s 0 lowed between cleanout. All 90u turns ust tr CC% 5 (1/8 bend) and wye with removable cap. g. No down spouts, footing lo�r drai s can,i� onnected to side sewer system. h. Pea gravel is required f er lines through other than granular soil 4 i. Cleanouts are required a xit line and at minimum intervals of 1001 along -sewer 'line run. j. Trenches within City right-of-way must be restored to original conditions. Contractors shall be responsible for right-of-way failure due to poor compaction of fill. k. Side sewer must be left uncovered until inspected and approved by the City. 1. Inspection during normal working hours only. Two (2) working days notice required. -? /* DATE: I certify"that I have read 'rVV and shall comply with the above PPERMIT FEE: 10.00 DISAPPROVED BY: Date: L) By: Date: CONNECTION FEE: APPROVED By: Date:M,_ 0 PERMIT MUST BE POSTED ON JOB SITE DATE: I :,_ -:, 7:, t2-Q , i 14EMO TO: Building Division. Community Development Department FROM; Engineering Division Public Works Department SUBJECT: After review of the subject building permit application, we have the following comments: Ma :In Ag- PIO U TIM I)GnAh 0k) NEW 91RESIDENTIAL ID GAS LINE FRONT FIR FIRE ZONE TV ADD ALTER REPAIR NON-RESIDENTIAL SIGN RETAINING WALL FENCE I— X—" POOL G " swim IREMARKS I DEMOLISH EXCAVATE OR FILL PRE-MOV E INSP. 1:1 I SPECIAL INSPECTOR REQUIRED 0 VIES 0 No PL A N CHECKED BY Z NUMBER OF STORIES NUMBER OF 0 DWELLING I I- I UNITS NATURE OF WORK TO BE DO ,u, 0 PLAN CHECK FEE BUILDING PLUMBING MECHANICAL FENCE SIGN 0 "Applicant, on behalf of his or her spouse, heirs, assigns and 0 W J successors in interest, agrees to indemnify, defend and hold harmless I the City of Edmonds, Washington, its officials, employees. and RETAINING WALL M agents from any and all claims for damages of whatever nature, .( x arising directly or indirectly from the issuance of this permit. Issu- SWIMMING POOL 0 ance of this permit shall not be deemed to modify, waive or reduce qnv rertidrerne�t of inv ritv ord;nqnre nnr limit in ;inv wav the BUILDING DIVISIM Applicant Fill P USE E IT ZONE N U MeEn PERMIT APPLICATION Inside Heavy Lines JOB M R �nll m I . . MA71E JOR ri M a F, INgSS) U S ADDRESS --w,3 F,(2, L LEGAL DESCRIPTION SUBDIVISION SHORT SUB NO. W MAILING ADDRESS z 31: 9 ell Is" 0 C I Tv y PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP _,,rELEP.ON. NUMBER IF�e� et—L EXISTING_ WA M —E e-,-- C—) I I- U 71::� E- '-; A"5 DEFICIENCY OF RIGHT OF WAY — W t x TADDRESS -' 11�89 2- 9 A/,p - PUBLIC IMPROVEMENTS REQUIRED U _ _7 DRAINAGE IMPROVEMENTS REQUIRED 0 Ir CITY TELEPHONE NUMBER y/0 v000 Z4 —07L% DRAINAGE PLAN REQUIRED UNDERGROUND WIRING REQUIRED C1 -T:r --L NAME CONNECTION TO ry4ZARY SEWER nVA)ER, SEPTIC TAN K PE 11 NO. "'TW7 0 F. U RESS ELEVATION OF PRO E S & FOOTINGS REQ CITY TELEPHONE NUMBER SEE ENGINEERING MEMO DATED 0 U STAT4 LIC E NUMBER 7 CITY LICENSE NUMBER CHECKED BY VSL*,22 Legal Description of Property (Show Below or Attach Foup Cooies) METER SIZE BUILDING SUPPLY SIZE z er--.% 0 ;- IL SIGN AREA ENV. REVIEW ZDE It Al I WED I PROPOSED COMPLETE EXEMPT U IA SHORE W 0 REMARKS W Ili I I VARIANCE OR CU PLANNING REVIEW BY DATE YARDS LOT COVERAGE SIDE REA OF CONSTRUCTION icor)E IHFIG� k OCCUPANCY OCCUPA I GROUP I LOAD THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. VALUATION I FEE 0 0 3: U 5 M D IL M1W 3: I­ z W L Id z W I L 0 J W W 3 0 —luz PUBLIC VORKS DEPAR CHECKLISr BUILDING PER41T REVIEW 0 4Z"4-1 P:g , 7­0, (addres-s�— (date) 0 Street Right -of -Way Exist Z Access Easements Exist H jn4 Utility Easement Existing_­,,.�F�,Lj�. �REQD Lot Per Subdivision Plat P, Assessor 94 Site Plan Checked for Accuracy, 4 Z Underground Wiring Reqd. :a 0 Check Accuracy of Legal Description_ Z Review by Existing Water Main Size Water Main Required Service Line Required Hydrant Size Existing 94 Hydrant Reqd Per Fire Code Size 94 Detector Check �hter Reqd. Cross Connection Inspection Fire Department ComTients 'Water Meter e Reqd. Y:�= �s �--7 Review b ' 0 Date Septic Tank Design Approved Date Septic Tank Permit Reqd. Permit No. Sanitary Sewer Availability Proi - y-, Drawing No. File No. 'E- rZ Z %,A > Side Sewer Availability Sanitary Sewer Connection Fee Reqd. K�e) :3: Review by_ Date W Open Ditch Existing___ZVO,4�� 111,6�— Culvert Reqd. Size P4 Catch Basin Reqd. A/0 41 4F- -Indicate on Site Plan. 0 Shoulder drainage maintain collection on swale open runoff Manhole reqd. Ive C/ , C-- Indicate on Site Plan Soil Conditions and Ground Water Field Checked Review by . 1,2 Z4 �-, /-Z MO Revised: MO-1977 Page 2 Street Paving Reqd. 9 Curb and Gutter Reqd. /k Sidewalk Reqd. Curb Cut for Driveway Reqd. r4 Right -of -Way Construction Permit Reqd. Bond Reqd. for Public Inpravements 5 M Street Name Sign Reqd. -5� Other Signing Reqd. vz/ * Pre Permit Site Inspection made on z 0 F-4 BY: S94ER WATER P-4 V) z STREET �X4 ENGINEERING Special Requirements listed in merm to Commmity Development Department, Building Division BY - Date c> All item filled in on Building Permit Application BY Date Drawings Starrped and Notations Made BY Date Approved by Public Works Department Revised: lv 10-1977 2529 189th S.E. Bothell, Wa. 98011 485-0080 ,52. q0 40-15" PPROVED— DATE— AvE: S. ITY OF EDMONDS . BLDG. DEPT INSPECTOR f�'11 RECFIVED 0[c 0 3'79 CIT'( OF MMONDS DATE: 14EMO TO: Building Division. Community Development Department FROM; Engineering Division Public Works Department SUBJECT: (2, L-[-\, After review of the subject building permit application, we have the following comments: 0 * I --I I A 0 F=R 0 " I H P IFA CIFS . ... .. . ...... . .... . .......... P'Q U IM-0 q)'§nWT'-M (A) SYSM911 0 r IL 0 PRINT KEY FROM-Y4 13Y USER---j,JL25O.. 09/22/94 16.224412. 7 'Lo z 8/22/94 CITY EDMONDS Ur-.4201. I 2!� 4,o'200,'04 PM Disipl.ay Customers 1�1 3� 4 Customer No4 1.078W.5 0000 l3ort Cocle 0000 Type ISEA ER Mun ic i pa L? N Ownt.-n- Acldrei---�s Service Address 16 Name ANDRE RoBFR*r I v I C. Addre�ss 1 308 FIR PL es, ic, Add) 2 -ee C, i I. y S-t EDMONDS WA 2�Z 2310 0 Zip C"Ode 98020-4152 98020-4152 .0 Ph o ne 0000000000 0000000000 -- - - --. - - —.- . - . - - - - --.. -- .- I- I- - . . , - Sery i ce Loc SE:: P/L 1\1 MTF� 2 /Vc- 26 stalt? 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