542 PINE ST.PDF11111111111111
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542 PINE ST
C,
City of Edmonds
STREET FILE
RIGHT-OF-WAY CONSTRUCTION
VERBAL OKAY FROM ROY WHITCUTT
A pEpMIT_.
Permit Number:
issue Date: -3o-�?.3
8 9 0 - 19 q -
A. Address or Vicuinity.of Construction: 542 Pine St (9319890
B. Type of Work (be specific): Install Now Service
C. Contractor: Washington Natural Gas Coi Contact: Fx�ank Swan
Mailing Address: 815 Mercer St.Seattle,Wri Phone: 224-2278
State License #: 98111 Liability Insurance: Bond:$
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. F
] �omrnercial 0 Subdivision El City Project )PgWtility (PUD, GTE, WNG, CABLE, WATER)
n Multi -Family F] Single Family E] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: 0 Yes 0No G. Size of Cut: x H. Chargq_$
APPLICANT TO READ AN,D) SIGN
the City ofEdmonds=1 s r i ii -5s
INDEMNITY. Applicant understands and by his signature to this application, agrecal
'J.� damages, or
0 'd��partments or
claims of any kind or description whatsoever, foreseen or unforeseen, that may to against the City of Ed W�gr!,,:�xo
employees, includingor�not limited to the defense of any legal proceedings includin�,,dZf6gqsts, and attorney fees byrc�asomo(granting,thispe*rmit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR/FOLLOWING THE FINAL
FEE- S4 WILL BE HELD UNTIL ThEIFINA
INSPECTRtN AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION i I: STkkET PA TCH
IS COMPLETED -BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BEPROCESSEDFOR ISSUANCE TO THEAPPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice isrequired 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 ditches shall be patched with asphalt or City approved material prior to the end ofthe working day;
NO EXCEPTIONS.
Ihave read the above statements and understand the permit requiremen ts and the pink copy of thepermit will be
available on site at all times for inspection
purposes.
Signature: Date: June 1 25, 1993
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
DATE.
X0
IMP
NO WORK SHALL BEGIN PRIOR TO -PERMIT ISSUANCE
EngTg. I)iv. 1991
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Proposed Paving at 542 Pine Street
rage
Property line:
Border of Street
Border of Proposed paving:
— 180 ft—
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RECEIVED
JUL 16 1999
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS
Stone retaining wall
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—20 ft—
PINE STEET
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Proposed Paving at 542 Pine Street
rage
Property line:
Border of Street
Border of Proposed paving:
— 180 ft —
JUL 6 19,on
DEVELOP %F%7
cl YE'VT S&R
ry OF Oaf V'CES 6TI
Stone retaining wall
PINE STEET
—20ft—
M-V ftehAr �ox
orabirw
��AIPPLICAXION
or
The ti nds
-#y-of Edmo SIODE SEWER PERNaT
OUTSIDE INSIDE E] REPAIRS
CARD No . ...........................
EASEMENT No.
OWNER........... M ..... Gr'--a.q .............................................................. CONTRACTOR ............... A4-� . ............................................ PERMIT No.
STREET
HOUSE No . ..... J.-/7/j;L ------- . ....... AVENUE LOT !No . ...................................................................... BLOCK No . ....................
.......................................
NAMEADD . ............................... * -------------------- —, ....... I'll ---------- --------- -------------- 11 --------
rn
11
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
SEWER WORK ORDER ISSUED .......................................... DATE
P"o VED
...... By
- vf,
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City of Edmonds Permit No:
RIGHT�:OF-WAAY 'CONSTRUCTION PERMIT Issue Date: 51q hq
A. Address or Vicinity of Construction: 617- KI AJ f_
B. Type of Work (be specific):_'�'��J*% AJ"�, 4,-Lc-4
Contact_i�n
C. Condactor:__�14 P, P4,J 10
MaitingAddress: PhonC �CI 4 4 3 Y'
State License Liability Insurance Bond: 1$
D. Building Permit # (if applicable): Side Sewelr Permit # (if applicable):
E. n, -Commercial Subdivision City Project E] EUC (PUD, GTE, PSE, CHAMBERS, OVWD)
Multi -Family Smigle Family F1 Other
fNSPECTOR-
F. PAVEMENT: YES 0 NO G. SIZE OF CUT x H. Charge: $
CONCRETE CUT: E] YES F� NO
APPI-ICANT TO READ AND SIGN
IDEMNIT.Y. Applicant underkrh6- by h6lher signature to this application helshe holds the City of Edmonds harmlessftom injuries,
damages o*r claims of any kind or description whatsoever, foreseen or unforeseen, th * at may be made against th� City of Edmonds or
any.4of its departments- or employees, including but not limited to the defense of any legal proceedings including defense -costs and
,. I
attorneyfees by'reason 6fgranting 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 FORCES, AT WHICH TIMEA DEBITOR CREDIT WILL BEPROCESSED FOR ISSUANCE TO THEAPPLICANT.
*1 'Traffic control and public safety shall be in accordance with City regulations as required by the City E�gineer. Every.
flagger must be trained as reiquiired 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 appli�ation.
I HAYE READ THE A S AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THAT,IMUST THE Y OP THE PERMIT A VAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS
114S ta Date:
Signa urp., ko�41 J
(Contractor or Agent)
CALL -DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK.
FOR CITY USE ONLY,
Right-of-way Fee� 1000,
-Approved-'by
'Time AuthorJze',.:..V, id After. Disruption Fee/Fund 111:
ti Ai� on 4 Sh-
pec a Cond
-�S itions: Vi &L Restoration Fee:
. . W-1- 00
'i 14 Zq- : -lo. - -
4 oakov W: a U, U, 1 103 1 ft Total Fee-
Receint No:
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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 re4uirements'see Engineering Information Handout.