501 2ND AVE N.PDFIIIIIIIIIIII
4804
501 2ND AVE N
Z
ow
0
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r ,
CITY, OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
Aid /V
r
Owner: &�) h
Name ' Aacl
Mailing Address
E,41AA^A44_( P70
city, " �t��e, Zip Code
0 Contractor:- _T_n14 P1 (-)nail=
f
Name
P. t3A
Mailing A res,
�=,� 4A CPA 1� 9 90 -2-6
City, State, Zip Code
ermit-No.
Issue Date .0ol)
0 Permit Issued To: Rr-ri k r i/
0 Type of Work to be Done:
0 Work in Connection With:
El Sub or Plat Single Family
El Comml. / Ind. El Apt. Condo.
0 Pavement Cut: El Yes 'O"No
C_ 4-ci Lq c �J o
C 0 - 1UL E.,T- W
State License Numb"
7 -7 �, - / �-/) / ),
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or em oyees, including or not limited toiliai3ciome 91 any legal
proceedings including defense, costs, court costs, and attorney s OK reason of gr tin L
D1 L DIG
Upon issuance of this permit, the contractor is responsible r wor d aterigs V9PIpe d of one year
following the final inspection and acceptance of the restoration y the I g ivi onBEFOR
YOU DIG
Funds held from the Security Deposit (estimated restoration fe will the c is com )Ieted, at
which time a debit or credit will be processed for issuance to the p,
Work is to be inspected. Restoration to be in accordance with ic COS NUMMULY i h Traffic
Section of City Code. Street to be kept clean at all times. A 24 - uirmluyim ing. Call
775-2525, extension 220.
I understand that this permit must be available at the job site for inspection purposes at all times.
Signature: Date Ai a,)
Own�r W�gent
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Vold after 0-1 —days
Special Conditions: ag-
r C..Wl C.7tV
I Ae W n r r n 6-A 4., M
i r
.A in m. e, n d, m e- n ts: C.*114a,40�1_ad_s �e
CC - - /-- A— I--- v
/ -_ ov
Permit Fee:
Security Deposit: IL 6?
ReceiptNo.: amcqia.
Fund III Fee: & ) .12-,
Street Cut Dimensions NOA—z-
��; �X
NO TO PERMIT ISSUANCE
Eng. Div., December 1978
FIELD INSPECTION NOS
(Fund 111 - Rofe conv to Street Dent.
rnmme.-An+- Q -
Diagram:
Contractor called for inspection Yes No
work Disar3proved By: Date: By: Date:
Work Anproved By: —Date:
Inspector: _- 7T
Ena. Div. December 197S
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMI
A. *Address or vicinity of Construction
'-7h t 4 'Ell �') V.
Owner: LA %k
Name A
I -A J 1.) 4
Mailing Address
City, S ta te, Zip Code
Contractor? V - Q
Name
—,IS 1) S \,A
Mailing Address
z
-< City, State, Zip Code Telephone Number
U
.4
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, Of claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
0
U
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
0
Issue Date
0 Permit Issued T.:P. ?A,(.)
Type of Work to be Done: TZL*N C- A 0 �AJ
• Work in Connection With:
0 Sub or Plat El Single Family
El Comiml. / Ind. El Apt. Condo.
• Pavement.Cut: El Yes El No
z
0
LU
V)
—D
State License Number
Funds held from the Security Deposit (estimate8 restoration fee) will be held until the final street patch is completed, at
which time a d6it or credit will be processed for issuance to the applicant.
Work is, to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit
Signature;.�.A'
Ownei
be 4-vailable�atl the job site for inspection purposes at all times
or Agent
te
I I
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: A A
Time Authon'zccl: Vold after days
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit:
Receipt No.:
Fund Ill Fee:
Street Cut Dimensions
X —
4,1 1// .
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
� I
FIELD INSPECTION OTES (Fund 111 - 197vite conv to Street Dent.
O^Mm�� +- � -
Diagram:
Contractor called for inspection . Yes CNo)
Work Disanproved Bv: Date: Bv: Date:
Work Anproved By: SCS71 Date: Y,
Inspector:
Ena. Div. December 1978
kjw.10177
'I-,
C UTILITY DISTRICT N9.1 of So AREA
oh!* County -
1P
Location
V. Q10
owe
3 q
S
it
Scale k"- k0o,
Reason for work
�C- Engineer
A" A C- As &At
U& file Me.
A"revals
'ED
PERMIT REQUIRED
-F"
R IGN CONTACTS
-f ASEMENT
ENVIRONMENTAL ANALYSIS
Type
CCo
00
m pany-
Exempt under District SEPA
A14
LRN. No.
j
procedures, Section III -A
Date Granted
—JE,
Fees required Yesm _14'
.s
. f joo
Grantor—
Paragraph
Log Past
Log Posted
I n 'or
ventory
T. C.
T yp.
yp
Date Granted
Date k
hTransf.Cardj
L
Pole D
)* t.
Date 'k Amounl—'111
Interpretation Referred To:
M a poste4
t Ma
I Circuit MO
Date Released For Construction
Date —BY
Date Wcork Completed
Foremian
Circuit Number--
3' —Substation 11A A 1'-_)'-Ji 'v\t 12 V
O.H. U.6. Cond KV
Add—Ckt Ft —PH
Remv_Ckt F t------PH
Net—Ckt Ft
R - -2 (Q 4
('y
Sewer
Gas
Backhoo
DtF T A
0711 1 KkS T A L-L S �3
R
A L U Q0
��- - \ V-k �' -V r) �__ t_ . P c- o �: S' �_ t' _� ��—N P)� I,-- -D
5
W.O. No.-
wa-tev sew -vice -
Drawing
The city of Edmonds
EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS LID NO. � ----------------- ASMT. NO - ------------------
OWNER --- 13 6 ... Crwml ----------------------------------------------------- CONTRACTOR --- ------------------------------------ I ------------- - PERMIT NO - --------------------
JOB ADDRESS ---- 561 - 2- 0 Ave. K. LEGAL DESCRIPTION: LOT NO - -------------
----------------------------------------------------- ---------------------- ----- ------------------- BLOCK NO - -------------------
-n
4-6 ww.+,c- cx , ��gcle- Eeuw-y- Pe-Y*Lit
---- ----------------------- ---------------- r--a ... 2qF ------------ ...................................................
NAME OF ADDITION --------------------------------------------------------------------------------------------------- tk 4 3 (0 3
(0, C-0. pippt-,--�
ApPrOved:
I " A-11-S - Water Service UtAe-
Ito P-S r. C sch. 40)
owe-ixr Service Meve-r.
PWW-0001-1 1/75 (REV. 11/78) DATE By t
.......................
6igle,Sewer Drawing EDMONDS
The City of Edmonds I TREATMENT PLANT I EASEMENT NO - -------- --------- -------------------------
NEW CONSTRUCTION REPAIRS 0 LID NO - ------------------ - ASMT. NO
OWNER ---------- 5-o-.6 ..... cry r-) ------------------------------------------ CONTRACTOP - ----- R-4--R ----- pl-OML V1
01--- 6 1309 e - �J - -- - ----- k ----- a ---------------------- .. PERMIT NO. -(075k)-Z
JOB ADDRESS ---------- 501 ---- ---------- ---------- --------------- ---------------- LEGAL DESCRIPTION: LOT NO - -------------- ----------------------- BLOCK NO - ------------------------------------
--- ------------ ---
a kovlcx-� ----- .... Rzoy&.-
E—DM0`NDS--"-1
TREATMENT PLANT
NAME OF ADDITION -------------- --------------------------- ----------------------------
Q)
Siv6 g , d ec
2" Ave. NO
C .0 .(:3'c(ecp)
46' be-1,Ld Wowrt)
4" F-V-C - Siae- %.�.Lve-r-.
�nspec.tiort-Tre- C, 41ciee-p) (Rise-r)
W�e- (VACC-p)
cn,
ft-A
Z
---------------
Approwd:
PWW-0001-11/75 (REV-11/78) DATE B, ------- — ...........
C CITY OF EDMONDS
I
FOR INSPECTION C 6363
PUBLIC WORKS DE 4 TMENT Permit
PU
775-2525 Ext. 220 Issue Date 10 -7
S, DE SEWER PERMIT
J* PEP -MIT MUST BE POSTED ON JOB SITE
1. Address of Construction
&i
("' �zt"�
2. Pro erty Legal De cription (include all easements)
Ee 1�ac lic-d �
3. Single Family Residence Multi -Family No. of Units
Commercial
4. owner LaL CyLzkup
5. Contractor & License No. owrier Lvi Coslckli sj�
6. Invasion into City Right -of -Way: No 1," Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
7. Cross other private property: Yes No L-"Eas.ement required -
attach legal description and county easement number.
READ THE FOLLOWTNG AND SIGN:
F*14 a. Property owners must obtain a permit to install side sewers on
>4 their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
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")
side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
e. Side sewer lines must be lai at in un Lj(G 2 % ( .150)
0 and maximum grade of 100% (45'). UAVL
E-1 f. No turn in side sSwer greatf t 1/8 s C all1wed
between cleanout. All 90 turns must be t cte 5 (lj8
bend) and Wye with removable cap. 41tulti
g. No down spouts, footing drains ins an coinected
to side sewer system.
h. Pea gravel is required for b nes
through other than granular soil.
i. Cleanouts are required at 30ba 402,05-M-M-Wi-M-21 line
and at minimum intervals of 100' 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 6__
I certify that I have Vead
and shall comply With the above
F4 PERMIT FEE: DISAPPROVED BY: Date:
L) W I . ) Date -. A
"I CONNECTION FEE: APPROVED By:L_BK�_ Date:fj"_3
0
'.. PERMIT MUST BE POSTED ON JOB S14
N
USE �ERMIT
U MBER
BUILDING DIVISION
Applicant Fill
ZONE
.
0
IERMIT APPLICATION
Inside Heavy Lines
J013 _n
ADDRESS I ?mV
NAME (OR NAM� UF' 67 SINESS)
DESCRIPTION
BDIVii::ii: ��I
SHORT SUB NO.
yj
LEGAL
m -
W MAIL G ADDRESS
z
r\ ch
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
0 CITY
EXISTING_,,�
ce
(0
PROPOSED_
-NAME
DEFICIENCY OF RIGHT OF WAY
0
I-
U
PUBLIC IM PROVEMENTS REQUIRED
0
W ADDRESS
It
DRAINAGE IMPROVEMENTS REG UIRED El
3:
I
U TELEPHON� NBER
DRAINAGE PLAN REQUIRED EJ
U
M CITY
UNDERGROUND WIRING REQUI RED
CONNECTION TO SANITARY SEWER
IL
NAME
SEPTIC TANK PERMIT REQ'D 0 NO.
0
0:
ELEVATION OF PROPERTY CORNERS
0 ADDRESS
& FOOTINGS REQ'D
U
<
M CITY
I ELEPHONE NUMBER
SEE ENGINEERING MEMO DAT ED 'a< 26,
z
'Fla
(0 - I So
0
U STATE LICE E NUMBER
CITY
C'�'
-N czs
-b (--) � :� --,�
SIZE
L 3Z el'
—
or Attach Four Copies)
- ERAIZE BUILDING SUPPLY
Ir
W
Legal D scription of Property (Show Below
3-AZ
I
REMARKS
z
ENV. REVI W ADB 0.
SIGN AREA�,'_,�' /
ALLOWED
- COMPLETE
PROPOSjDj
EXEMPT
SHORELINE
U
W
REMARKS
VARIANCE OR CU
PL-ANNING REVIEW By
DATE
J
LOT COVERAGE
YARDS
1; REAR
SIDE /I
FRONT
0
NEW
El RESIDENTIAL
LAS
G
INF
FIRE ZONE
IYPE OF C NSTRUCTION
ODE
Rf
El S, GN
AREA OCCUPANCY
F1ADD RETAINING
SPECIAL INSPECTOR
REQUIRED
GROUP
DEMOLISH WALL
[I YES [3 NO
EXCAVATE FENCE
ALTER OR FILL I— X—FT)
El
PLAN CHECKED BY THIS SITE 15 LUL;Alr-UII-4 1—
EDMONDS. LOCAL SALES TAX
OF
SHOULD BE CODED 31.04.
pkE-MOVE swim
M REPAIR EIINSP. El POOL
REMARKS
z
NUMBER OF STORIES
NUMBER OF
z
DWELLING
UNITS
-j;—ATURE OF WORK TO BE DONE
L
U -VQr\Q o
1A
W
---------
AN CHECK FEE VALUATION FEE
m
0
z
PLOT PLAN
L
BUILDING
0
J
W
PLUMBING
>
W
MECHANICAL
FENCE
t
z
SIGN
".XI)PIiC3IIt, oil behalf of his or her spouse, heir s, as,.,igns and
defend and hold harmless
0
W successors in interest, agrees to ilideninify,
its officials, el-111110yees,
and RETAINING WALL
U
-j
1 he City of EdIllunds. Washington, f whateVer natkirC,
3: fr,,lll and all claillIs for dainages 0
POOL
iny
SWIMMING
Issil-
0
PUBLIC WORKS DEPARMvENT CHECKLISr
BUI1DING PEF,&aT REVIEW :��>ok LAJ
(address) (date)
C3
Street Right -of -Way Existing
Z
H
Access Easenients Existing 1,_% CIN REQD
C4
Utility Easement Existing__hkp _4,r, 6al- ftiz REQD
Lot Per Subdivision Plat / Assessor 19p__
Site Plan Checked for Accuracy
-Underground 14iring Reqd.
Check Accuracy of Legal Description C__ - -7-1 - -7
Z
Review by
Existing Water Main Size
Water Main Required A11A
Service Line Required
Hydrant Size Existing
r4
Hydrant Reqd Per Fire Code - CA —Size
Detector Check Meter Reqd. AUA
Cross Connection Inspection
Fire Department ConTnents
Water Meter Char Reqd._
Review by. Date
Septic Tank Design Approved Date
Septic Tank Permit Reqd. Permit No. �Jjk
Sanitary Sewer Availability Proj.
Drawing No. File No.
Side Sewer Availability,
Sanitary Sewer Connection Fee Reqd. 4 70 e V A,;
�ate
:3:
Review by
Open Ditch Existing.. Reqd.
Culvert Reqd. Size
P4
Catch Basin Reqd. Indicate on Site Plan
0
Shoulder drainage maintain collection on swale open runoff
U)
Manhole reqd. Indicate on Site Plan
Soil Conditions and Ground Water Field Checked
Review by Date
Revised: MO-1977
Page 2
0
Street Paving Reqd. IYA2,z-
Curb and Gutter Reqd. ",&
Sidewalk Reqd.
Curb Cut, for Driveway Reqd. /7 ".a
p4 Right -of -Way Construction Permit Reqd.
Bond Reqd. for Public Inprovenents
Street Name Sign Reqd. 4
Other Signing Reqd.
Pre Permit Site Inspection made on
0
,4 F4 BY: SEWER
WATER
P4
En
z STREET
F4
ENGINEERING
14 Special Requirerwnts listed in memo to ComTunity Developnient Departrrent,
Building Division
BY Date
o All iten-s filled in an Building PernrLt Application
P4 BY Date
P4 Drawings Stanped and Notations Made
P4 BY Date
-`4
Approved by Public Works Department
Kevised: 1v 10-1977
a
DATE:
If
14EMO TO: Building Division
Community Development Department
FROM; Engineering Division
Public Works Department
SUBJECT: —f!>(:f) I — !2�o - k I -
After review of the subject building permit application, we have
the following comments:
I w- W,
W— ill 11111
0,
LI
AV
fAq
,4V tev
Ilk
4P- (::�L
VI
IC)
TYLEYRING ASSOC, INITr
�4 I-,
VA. 9cf,19'
W.,.� 981,
7 7`
REAL ESTATE SAL.m TAX
AMOUNT PAIO't,.�
1-01 A Y
14*
VOL. 0 F,
RECORDED
..... ......
KIRKE
REAL ESTATE CONTRACT
13Y —1 —"—
Llep,.Ity
THIS AGREEMENT, made and entered into this day of
April, 1977, b�Nlnd between EDITH WICKER, hereinafter entitled
SELLER" , and RnBERT WILLIAM CRUMP and TRISHA �-,IINNIFRED CRUMP,
y-4
husband and wife, hereinafter entitled "PUPCHASER".
W I T N E S S E T 1-1
That the seller agrees to sell to the purchaser and the
I
purchaser agrees to purchase of the seller the following described
real estate with the appurtenances, situate in the County of Snohomish,
State of ',6117ashington:
All that portion of Government Lot 2, Section 24 and Govern-
ment lot 1, Section 23, in Township 27 North, Range 3 East,
11. 1
.1. , described cis follows:
Beginning at a point on the Easterly margin of Sunset Ave.
(1.1'ront St.) N 32'12' E, 826.32 ft. from the Northeast corner
of Edmonds St. and said Sunset Ave.; thence S 57048' E, a
distance of 260.0 ft. more or less to the 1.1esterly margin of
2nd Ave. as fixed and established by City of Edmonds Ordinance
710; thence N 30'48' E along said marQin, a distance of
55.0 ft.; thence N 57148' W, a distance of- 260.43 ft. more
or less to thelEasterly margin of Sunset Ave.; thence S 32'12'
W along said margin, a distancc of 55.0 ft. to the Point of
Beginning.
EXCEPT the Westerly 132.0 ft. as measured along the Northerly
and Southerly lines.
Tho t('rills arld condi-tio), ; Of thi�; col�tr,-ict ;ir,, is fnl
0 0
-CITY OF EDMONDS
PUBLIC WORKS
DEPARTMENT
TO:
SUSPENSE DATE:
0
DIRECTOR
Investigate
and Report
ADMINISTRATIVE SECRETARY
Take Appropriate
BUILDING & GROUNDS SUPT.
Action
Prepare
letterimemo
for my signature
CITY ENGINEER
EQUIPMENT RENTAL SUPT.
For Information
STREET DIVISION SUPT.
Previously Ref'd
WATERISEWER SUPT.
11fq
Status of Action?
Return to:
TREATMENT PLANT SUPT.
COMMENTS:
C_-
QWL_�r-_�
C-:.� 0
Lk) (L,1� 1!:,
eF�,j
FROM:
PWA-Ml-11-78
0
0
BILL'S HARDWARE/MARINE
186 SUNSET AVE. i EDMONDS. WA 98020 / TEL. 775-2001
SENTRY.
F"-� ure-l- Z- L",
DIKAL-"�- C� 300);c k,�3
�-k w4h
C�oe. N..
CIO
6�
�J&oc CI
w�m CAAQ�l C�-x C��-
I'hi,;- "A
4, Q)e-ka3xl sm v i 6n
ljj��
IATT
I
w6A �3.
(09�)9
BILL'S HARDWARE/MARINE
186 SUNSET AVE. / EDMONDS. WA 98020 / TEL. 775-2001
SENTRY.
------ -----
9 c� cA
tO
"41
M AK
L-oT DQA-Wkbr- F�--m ow> M4
CITY CLERK
Cdm Civic C"ter
01,
U T I L I T Y E A S E M E N T
12
IN CONSIDERATION of benefits to accrue to the grantors herein,
the undersigned, ALAN W. MORRIS and JOYCE A. MORRIS, his wife,
hereby grant to the CITY OF EDMONDS, a Municipal Corporation, a
permanent easement for the installation, operation and maintenance
of Utilities over, across, through and below the following described
property, and the further right to remove trees, bushes, undergrowth
and other obstructions interfering with the location, construction
and maintenance of said utility or utilities, together with the
right of access to the easement at any time for the stated purposes.
The easement and right-of-way hereby granted is located in the
County of Snohomish, State of Washington, and is more particularly
described as follows:
A 10 ft. wide easement, when measured perpendicular to the easterly
boundary of the following described property, is conveyed to the
City of Edmonds for utilities.
C 0
Part of Government Lot 2, Section 24, Township 27 North, Range 3 Ea;:!�f,
W.M., described as follows:
Commencing at a point on the Westerly line of Third Avenue, 854.90
feet North 29018'00" East as measured along the said Westerly line
from the Northwesterly corner of Third Avenue and Edmonds Street
(said point being the Northeast corner of Sunset Addition to the
City of Edmonds as recorded in Volume 15 of Plats, page 41, records
of Snohomish County, Washington); thence North 89056'50" West for
125.52 feet to the true point of beginning; thence continuing North
89056150" West for 125.52 feet, more or less, to the Easterly margin
of Second Avenue; thence along said margin North 30048148" East.for
188.00 feet; thence East 125.33 feet; thence South 3004Q'00" for
187.87 feet to the true point of beginning; EXCEPT theNorth 80,00
feet thereof;
Situate in Snohomish County, Washington
The CITY agrees to restore to si�bstantially the original condition
such improvements as are disturbed during the construction, maintenance
and repair of said utility or utilities; provided, the grantors, their
heirs or assigns shall not construct any permanent structures over,
upon or within the permanent easement.
DATED This -/-7 day of
STATE OF WASHINGTON)
)ss
COUNTY OF SNOHOMISH
19
-&1f - e ±1:12zL-1zk-
On this day
personnally appeared before me ALAN
W. MORRIS
and-JOYCE
A. MORRIS, his wife, to me known to be the
IndIvIclual (S)
described
in and
who executed the within and foregoing
instrument,
and
acknowledge
that ALAN W. MORRIS signed the same
as JOYCE A. MORRIS
.
his
wife,
free
voluntary act and deed, for the uses
A� -
and pur 68 .. .
therein..mentio
N.V..
" - � V" M
Cn
NOTA11Y PU8LI-C/In
<-ndikoro.Z,
C3
State f W a.5hingto
--n1n .:�o F
Lij
NO SALES TAX at 5��
0
>:
REQUIReD
C;
0
DEC 3 -1981
Ld
cm
KINE I V SPA ''M1
Deputy
8112020149
VOL17031PAR
APPUCATION
The City of Edmonds for EASEMENT No - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION [-] REPAIRS LID NO - ------------------ - ASMT. No - ------------------
OWNERhk* -------- �E ------------------------------------------ CONTRACTOR -------------------- _ ------------------------------------------------------------- PERMIT NO. — -----------------
JOB ADDRESS A�Zj --- — --- c..? - ---------------------- LEGAL DESCRIPTION: LOT NO - ------------ — ----------------------- BLOCK NO - ------------------------------------
------------------- -------------------------------------------------------------- ----------------------------------------------------------- ----------
NAME OF ADDITION ------------------------------------------------
q -14-
Approved:
DATE............................................ By ---------------
0
REGARDING: 501 Second Avenue North
(address)
R E C
0 R D 0
F C 0 N T A
C T S
DATE
NAME,
PHONE NO., &
COMMENTS
ADDRESS of CALLER
5/l/74
Edith
Wicker
Certified
Letter No. 406436 sent
901 Curtis St.
requiring
hook-up within 60 days.
5/10/74
Sedro
Wooley 98284
Was never
notified that connection
should have been made.
5/74
D.T.O.S.
6/5/74
Certified
Letter No. 406471 sent
rescinding letter.
ACTION TAKEN INITIALS
Letter received. TE
TE
TE
Letter received. TE
I
0
kn
xo�
Pilchuck Contractpirs,
C 2&
Date IL 7 NOT
TO
Sheet of W174 SCALE
Job # 6)
SIGN SPACING
MPH
W
45+
5001
35
350'
30
200'
25
100,
lil 5(r Seaftle)
CL
4 t
1 - All signs and spaci t f
to MUTCD & City of M=
Traffic Control specs.
2. Channelizing devices are 28"
traffic cones.
3. All signs are 48" x 48" B/O unless
otherwise specified.
4. Alert affected residents.
5. Work to take place between 9 a.m.
And 4 p.m.
6. Maintain two 11' lanes.
7. Work agra will be 6 1 of C/L of
,2 Av - & 629� 5 of C/L of
APPROVED R3 NOTED
BY ENGINEERiNG
LEGEND
28" TRAFFIC CONE
WORK AREA
0010-
TRAFFIC FLOW
WORK VEHICLE
SIGN LOCATION
SCALES IN - 50'
FUSE TIE—IN
686-S, 15-W CA
PS, V CA
40'
R/V
CASPER ST.
--i&T
R/Wl
C*�
V,> S�
AP)
S�
PROPOSED 2" MPE—IP MAIN
15V CA
- , W C/L
E.O.M. — 2" MPE CAP
736'S, WIN CA
PS, _'W CA
STANDARD GAS CONSTRUCTION NOTES:
11. FIELD LOCATE ALL UNDERGROUND UTILITIES. EXCAVATOR TO CALL "ONE-CALLm TWO WORKING DAYS PRIOR TO:
TO CONSTRUCTIONs 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.
41. EROSION.'AND SEDIMENT CONTROL SHALL BE PER PSE STANDARD PRACTICE 0150-3200 TECHNIQUES FOR TEMPORARY
N
EROSI N AND,%DIMENT 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 2550.11600. 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 "PIPE CONDITION REPORTm 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 ACCESSIBLE9 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:1SYSTEM MAOP = 45- PSIGI
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.
------------------------ PHONE_fL/A -----------
17- NOTE ALL ACTUAL FOOTAGE, LOCATION AND MATERIAL CHANGES ON THE AS -BUILT IN RED. DENOTES
FOOTAGE BETWEEN FITTINGS.
FITTER (Check Box if Complete)
WORK AREA LEFT IN CLEANISAFE.-ONDITION.
1711
COMPLETE ALL PIPE TABLES AND GAS PRESSURE STAMP
El
FIELD CHANGES RED—LINEDN AS—BUILTS.
EJ
MATERIAL VERIFIED AND CHANGOTED ON PAPERWORK.
El
ALL VALVE AND TIE—IN LOCAJIONMTED ON AS —BUILT.
El
NOTE BEGINNING OF MAIN,EOM,& LINE OF MAIN LOCATIONS.
11
SHOW ROPE LOCATIONS & CUL—DE—SAC RADIUS
El
Fitter's Signature
Company PILCHUCK DATE
GAS MAIN INSTALLATION/RETIREMENT
Type/Work
Pipe
Size
Type
Estimated
Length
Actual
Length
Aanuf acturei
INSTALL
Z.
MPE
50'
GAS
MAIN PRESSURE & TESTING
TYPE TES
PRESSURE
TESTED BY
DATE ON
TIME ON
DATE OFF
TIME OFF
TYPE TEST
PRESSURE
TESTED BY
DATE ON
TIME ON
DATE OFF
TIME OFF
Design Press 60
SYS MAOP 45
PROJECT PHASE NOTIF# ORDER#
SAP Superior X213030343 107025397
Service/Meter— X213031131 106164412
Service/Meter
Service/Meter
Ln Service/Meter
0 Ind. Service
Ind. MSA
Dis. Reg./FT
HP Svc/MSA
Relocate
Retirement
I Contractor CONSTRUCTION COST CODES:
1051-103-11 1
,�,�j?ctMana er Contact Infdrmation:
KIM GRAY
CELL: 425-290-2878
Kim-graympse. com
Vicinity Map
Owner / Developer Contact Info
ROBERT W. CRUMP
501 2 AVE N.
EDMONDS, WA 98020 office
ATTN: ROBERT W. CRUMP 425—T76-0839
CALL (800) 424-55?8
2 BUSINESS DAYS BEFORE YOU D
THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF FACILITIE-Sl
I
r—
rn
LO
C\1
0
Ln
0
Ln
0
C\l
Cityof Edmonds Permit No: C,&/2 26
RIGHT-OF-WAY CONSTRUCTION PERMIT IssueDate: 1-6-660
U (L.—
A. Address or Vicinity of Construction:
B. Type of ' Work (be specific
10 �- LP ";'-' � C� -I
I C. Contractor:
I
�A --,� _.�, \ t
Mailing Address: �t>_�)Q
State License �0 I 1'� � VA
� ACA % �' A O�) C� A ') J k 'Itri � 1,
I rkC,1,��__ T-1 C�r
Contact:
Phone: r )LOL9 - Ll t ?J 4?_�)
Liability Insurance: Bond:
City Business License #:
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. Commercial 0 Subdivision El City Project F] EUC (PUD, VERIZON, PSE, COMCAST, OVWSD)
Multi -Family Single Family M Other
PaLt) 44--j-'s/ & I
INSPECTOR:
F. PAVEMENT CUT: YES El NO G. SIZE OF CUT x
CONCRETE CUT: Ll YES El NO
G. E] Mail Approved Permit Call for Pickup
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands by his/her signature to this application helshe holds the City of Edmonds harmless from
injuries, 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
costs and attorneyfees by, reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP ' AND MATERMLS 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 TIMEA DEBITOR CREDIT WILL BEPROCESSED FORISSUANCE TO THEAPPLICANT.
a
* Traffic control 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 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 ABO VE STA TEMENTS AND UNDERSTAND THE PERMIT REQ UIREMENTS AND A CKNO RIED GE
THA T I MUST MAKE THE PINK COPY OF THE PERMIT A VAILABLE ON SITE A T ALL TIMES FOR INSPECTIONS
Signature: r&) �k A- Date: Ic
(Contractor or Agent)
REQUIRED INSPECTIONS:
Call 425-771-0220, Ext. 1326for a 24-hour
FINAL APPROVAL OF PERMITTED WORK:
inspection request line.
DATE: b + ffo
s
J
CADocurnents and SettingsTurtisNy Documents\Fomis\Engnrng\ROWpermit_.doc Revised 10/01/03