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640 ALDER ST.PDFiiiiiiiiiiiiii 10061 640 ALDER ST ADDRESS: TAX ACCOUNT/PARCEL NUMBER:Wq3<UQ9Yb/-:3n0 BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) FOR: CRITICAL AREAS: q�-/7(j 7fi4jq f - DETERMINATION: [:] Conditional Waiver E] Study Required �Waiver DISCRETIONARY PERMIT #'S:. 65. 191 DRAINAGE PLAN DATED: PARKING AGREEMENTS DA EASEMENT(S) RECORDED FOR: PLANNING DATA CHECKLIS' SCALED PLOT PLAN DATED: SEWER LID FEE $: SHORT PLAT FILE: SIDE SEWER AS BUILT DA SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR WATER METER TAP CARD DATED: LID #: LOT: BLOCK: I ��, -, AQ - 0; 9/ - 0 b" � 72 LATEMP\DSrs\Fomis\Street File Checklist.doc 4* PLANNING DATA SINGLE FAMILY RESIDENTIAL STREET FILE Name: O'er— Date: :t q1 �1,o Site Address: qo Plan Check RZ-,() 200 7 OF7 Project Description: ja/-aq e- < Reduced Site Plan Provided: NO) Zoning: Map Page: -Lo 3 Corner Lot: (YES A Flag Lot: (YES Critical Areas Determiriation ff: Mq&7 6 El Study Required aiver SEPA Determination: El Exempt El Needed (for over 500 cubic yards of grading) 0 Fee F-1 Checklist El APO List with notarized form Required S?tbacks Street: Side: Rear: IV Actual Setbacks Street: Side: Rear: 5— Detached Structures: caA/c,5 - Rockeries: JC9 1 - 5- Fences/Trellises: t,91. �C-- Bay Windows/Projecting Modulation: El Stairs/Deck: 116.,S /wok i Height Datum Point: Cale_ — /. ) Datum Elevation: Maximum Height Allowed: Actual Height: S-- Other Parking Required: Parking Provided: Lot Area: 0 Maximum Lot Cove rage: 35% Proposed: Lot Coverage Calculations: A z- ADU Created: (YES Subdivision: 10q— Legal Nonconforming Land Use Determination tssued: (YES Cornatents 6-,Vd-,� �e IOtA - - , (/ oofto( Plan Review By: �7/ Ptannog Data form 04-11-06.cloc y CA". 0 c I Areas Checklist a -Site inforinition (soils/to o&aphy/h' rology/vegetation) p yd 1. Site Address/Location- -De Lt _'. 5 r Al 2.-. -Propeav Tax Acoou'nt Number�, 4� 4 2 - 0 3 4 - blS - 00 0 7 3. Approxin�ate* Site Size (acres or square feet):' JUL .0.7 1995 .4. Is this site.�urrently`dev*eloped? yes; no. is site developed? 49144; FAmmy��, If yes; how -5..,. Describe.the gen" site topography. Check all that apply. if jeg_,;hap,_,5-fee6elevation change over entire-eite.:,/,ibtoa,5rD �­ OW iiij; slopes,on sttd en&ally less than rise of 1046a over a '66 -feet). bj44Mjth6i6n6d 6f t T,1� I 'ZO 54 IN; - .116bes, i iresent on Ake 6f more than 15% and less dm 169� i.avaftlml ricP fV. . 0 �­ J� 33 to 66466Q. a-Wrii6ntaldistanceoei hah,30% present on site (a vertical rise -f C1 Aktt,� of 10 �d over a," h iontal diftinkiiof I oh ess than 33-fp�)' 4f oi,y ink ihviv, L'! -1, 2�_­ er- feai��esci(ibe):,r,�,*,�,,',,,�",�t o 4... ,.Site,,contains�,-areas-bUyear-round, standing water:.-_ Approx. De pth: iiih .`4 .,A iffli-IL 0, 7. Site'coniains keai of siai�n'all stah'ding water: Ajd .;,�pprox. Depd�:. "What- te"(s)jpf,�e. y5�q .0 N V`f' of ��Siw is:M e - bw a water 9.. Site toftwins'al.. =or an area flows across the grounds surface? Flows are year-- �4 al roundT,,­-:­.-",:, PO (W _Oat time of year?. gA f -shrubC, i m i ied f 10. Sf orested'', meadowl i nt OL, urban I 11. Obvioils and.'is,,pres on,Mte:'. NV;., bvi sli"si 4 soil i)? de4� inventory'or C.A. map indicates �vetland :3.-. ­W. ;I.,- Obiadi :Dresent an site? Aln t A-1 S� -P 890-19 Ednion' �-Cit Y ''I , VPS r c C al Ar.easi, h e�� C­`kH:§tzq q'A l." V44A�T3 .40 5 The Critical Areas Checkristoontaini�d,,,6�k��0�&,,riand.,siibmit,it'aykht�-at�, cl), is this form is -to be filled - opt.by ..,W*rson, - w- fW, r. Yrn L & kh ! t L -dp inadoinino q eterm 4 uen �s sma essar .g,, y Mittel d(gi to till, kpplication - for the',,C .Wof Edmonds" R. t Omplete.t', ment pxmit i 1 0 n..,`!*��, th permit to. e av With gn copy o e Ii h6bId'9WsubMit iv—kinit k*.'Map '7" The purpose'of 'the'' Chec'.1kItst is'to enib �. ,-, :,­ 0'1�01�� :N, ap City staff to determine whether any or Plot plawfor -individual,:Iots of the parcel potential Critical Areas are or may be.., ...... *0 enough detail that City staff can find present on the subject prop". The t4e su4ject,pap identifif, d -needed to'conioleteft 7 the applicant s all Ind u e, informati6fi Checldist should bd iiasily availible from-M-4.," (e. 4� . 4, iite� 1 9 obwmtions.of the site, or data available at,_.� plan.."pography. ` -,4c.,)'-,otstudiesin.'.,".,.,- mao City Hall (Critical Areas.mventones,,Maps;;)A,.-,'. yfigon nction'with this, hecldist,tw assist W. or soil surveysY0.-, staff in compt Jpg, eir prelunina 3'C,+ S" An aipplican orhi dr iorc�dntatft;i�,-�,* -A must fill'outAhe,,diecklist,.sighl�hd dateIt �r- '4�­�heckl d" Ad" ed I have completed the.*&taqh0.iQritiWAj, istan a�� answers4provi___,stre,,.A4- i to th wledge.(fi# qutoe -a— pf-my-kno- a In &POO ppropri tebolu ft Owner 1. Applicant- ApplicancRepresen tivet 'T V-1 h�,qq"6­ V-) Un TAfj, 1z. A �";Zr VIAI Name 1� 4�4 ALP StreetAddress;.,,�.-­- "A N M W �Fr is 4SW4�21W-" I � wa, ty recurs - It"ItI, ty A A6 L !kl;* Any request for modification, variance or other administrative deviation (hereinafter "variance") _CMa O[Fout must be speciflually d ide ed. Ap- proval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been specifically identified, re- quested and considered by the appropriate city official in accordance with the appropriate provision of city code or state law does not approve any items not to code specification. r A W6 Nit :D T to cd k alae 9-- Fe- r% c (o Li 0 q I 114 ale ZOAP-1 Rs -to CJ- 3 c4e'llj�e� 0 RECEIVEID JUL 3 1 1995 ZG: L FEWITCOUNIM o rzm E: rz iz, 71 m E-)( T iN6 S t- A E) T APPROVED�PY PLANPING SCALG I - 20/ PLo-r PLAd G 4 0 A L D F,-zz, S -r, I POO r- ok 3,� L i: UE L if J,- -r1ope- xe ix �e / r e-47 . To P Vi tv) a -zo I TO I rl (11 LLIC'ml r:)ra-cl<e-tsz,, V—,Vj 4 T 015 - A —711 I TIT Fl 1910C q if I . Y,?--2 k !K CLC x t ro� -L L F,3 C-\ k 46 *All LC4 to —be. Pressve-,e- Tre-ate-4 LJ A 980.10 zaae" Rs -to 6' jW114AWIK- I 10, Of A. I& p---� BY N' IG -Vs D r' PLAf NIN 7 04 uy * CALL FOR 'ATTENTION INSPECTION IT 10 le-Irl toe ,I IMI AWPI It Tn I M 1140 bep&w LJ A 0.10 TRS-(, [a 40 lot wcdk Fe, n r- je J�, Of MING SY PLAf N 19 Cw uy I CA FILE NO. Critical Areas Checklist Site Information (soilsftv . ographAydrology/vegetation) 1. Site AddressALocatton:640 4-1 d v- 0-- 2. Property Tax Account Number: V,3q;j__0,jy-o13_000-7 3. Approximate Site Size (acres or square feet): '5- 10 0 ZV V U 4. Is this site currently developed? --k—yes; no. if yes; how is site developed?. H p Lks 5. Describe the general site topograph y. Check all that apply. X Flat:* less than 5-feet elevation change over -entire site. RECEIVED -AUG 17 1994 F E R I �, I ii T1. G I, VIN T E RI Rolling: slopes on site generally less than 15% (a vertical rise of 10-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 10-feet over a horizontal distance of 33 to 66-fed). Steep: grades of gricater than 30% present on site (a vertical rise of -10-feet over a horizontal distance of less than 33-fed). Other (please describe): 6. Site contains areas of year-round standing,�rater: 116 Approx- Depth: 7. Site contains areas of seasonal standing water: Approx. Depth: What season(s) of the year? S. Site is in the floodway /1) V floodplain of a vrjw course. 9. Site contains a creek or an area where water flows. across the grounds surface? Flows are year- round?. jLj C) Flows are seasonal? (What time of year?. 10. Site is primarily: forested meadow shrubs mixed urban landscaped (lawn,shrubs etc) 11. Obvious wedand is present on site:, -A C.Ai-nnoittdicatesCritical -Area on sitid? reaj; inventory or thiii&§h: ted' rthsubsidmice'*Iandslidt:�hazard-2real. a 'gn iea -CM, RCYO.W-19M 0 40 ,ff go -199- City of Edmon& Critical Areas Checklist 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 - Ile 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. IMe information needed to complete the Checklist sh6uld 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. Ile City win review the checklist, malm a precursory site visit, �and make a determination of the subse.quent steps necessary to complete a development permit application. With a signed copy of this form, the applicant should also submit a vicinity map - or plot plan for individual lots of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant shall include other pertinent information (eg. site plan, topography map,. etc.) or studies in conjunction with this Checklist to assist staff in completing their.preliminary aspessment of the site. - - I have completed the attached Critical Area Checklist and attest dW' the answers provided are factual, to the best of my knowledge (fill. out the appropriate column 'below). Owner Applicant- Applicant Representative: Name' Nam 0. Street Addrez q 60A0 d-< City, State. ZIP Phone &t 212f- z Signature I (13 Pt A)F—. Stred Addrem 9 ox-I � -amry 5, 0411L W --QM ge-ko d(y-. StAe. ZIP Phone 9// Signature I Date APPLICATION The City of Edmonds for EASEMENT NO. — ----------------------------------------- SIDE SEWER PERMIT 105-02500 NEW CONSTRUCTION [] REPAIRS 0 LID NO - ------------------ - ASMT. NO - ------------------ OWNER ............... Cbe-ste.r..Dep.ew --------------------------------------------------- CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO . .................... . .... ...... .. ..... .... JOB ADDRESS ..... 640 ... A-1-de.r --- Stree.t ............................. ------- -- - ---- -- ------ ---- - LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------ NAMEOF ADDITION ------------------------------ ........................................................................................ DYE TESTED ON SEIVER - March 1,, 1976 By Jim Jensen Approved: DATE............................................ By ............................................................ 11/75 �- �J�tt� 5- WE shop Azar &PP vow Eons, T-4 ik MDR 1 k IAQ -'z -7: 45 Sol T- 1.4 -lz 0 -TK r_ 1 V r_ P.0 City of MmFondtgVt om Permit No: .709' L6 ENT SERVICES ­1 3-622�3 RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Dat.:fluy�W_3 A. Address or Vicinity of Construction: B. Type of Work (be sp�cific): .-Xp 1444�n .- - fit A- Z_L r.-L-L '1 41 ­11 __L__ a < W 0 1'- / 0 7 0 / ( - _1,JA C. Contractor: F�5E- ZP" 1--h Lte.-k- Mailing Add,ss:—/ 3 3 _3o _Sfoe) e., State License #:-?/z C I-IC41: 101 M 1!�= D. Building Permit # (if applicable): Contact: . '51uc_ 0 4MALOALL Phone: Liability Insurance:— Bond: $ Side Sewer Permit # (if applicable): E. E] Commercial E.] Subdivision City Project' EUC (PUD, VERIZO�OAT& T, OVWD) Multi -Family, E] Single Family El Other INSPECTOR: F. PAVEMENT CUT: [I VES RNO G. SIZE OF CUT _ X CONCRETE CUT: [I VES ONO IND EMNITY. 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 hut not limited to the defense of any legal proceedings including defense costs and attorneyfees by reason ofgranting this permit. THE CONTRACTOR IS "SPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECT70N AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL HE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BYCITYFORCES, AT WHICH TIMEA DEBITOR CREDIT WILL BEPROCESSED FOR ISSUANCE TO THEAPPLICANT, * 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) ?RIOR TO BEGINNING WORK IHAVERF,4D THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE THATIMUSTMAKE THE PINK COPY OF THE PERMITA VAILABLE ONSITE A TALL TIMES FOR INSPECTIONS, Signature: is�� Date: dla to /0,-� (Coii-tractor or Agent) FOR CITY USE ONLY. Righi-*of4viy Fee:1 dr� + isr ortz bi'siupti6n. 06e'/F�ndl 14: 1111 tIO s: '.i'i6ri6o6 fee; T dt IF o a ect tas""R eiptNo:,� issue . I ­V. 1114_wz� 32mm d b fl& Is., �fo�, 7 jl�, e -z - I ., u w.k. UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS COMMUNITY DEVELOPMENT CODE (Phone 425-771-0220, Ext. 1326) FINAL APPROVAL OF PERMITTED WORK.- DATE: Inspector's Signature For inspection requirements see Engineering Inspection Information handout. No \VORK SIIIALL 14JAN I'MORTO VERNI]ITISMIANCF, DAMy D­—fflAF.—\E.g—S\R0Wp..it_.d. I I a** TIME 15:46 *** P.01 -COMM. AL- DATE SEP-16-200 MODE = MEMORY TRANSMISSION I FILE NO.= 0131 STN NO. A BR NO 001 STATION NAME/TEL.NO 92064184260 START=SEP-16 15:47 PAGES DURATION 001/001 00:00'43" END=SEP-16 15:46 Ain 7 4 inn City of EdrnondtEVELOPMEU SERVICES Permit No:41923 -02 3-3 RIGHT-OF-WAY CONSTRUCTION PERMIT vu-- Datalw—w-e-3 A. Address or Vicinity ofConmction: 6,kj R. Type of Work (be specific): J?S*Ar_6*'!1Q P ernM,',- 40 _T17tL4_M1 I a " AlPa '-XP 424AIn w o 4" /070/ -i�m& P�es 2-,C Ji 'I,- C. Contracto"_PSE /P"ACA4441-k Contact: -'5uc- 1 mailing Address: 13 3240 -5f0flf-I AVC,_� Al Phone: (.;) C& ) -//,k -42-3 1 SmteLicemeO:-Plt-r-J-IC(-X-7)tlI Mla: — Uability Insurance:_ Bond; S D. Building Permit #(if applicable): Side Sewer Permit 0 (if applicable):— E. C3 Commercial C1 Subdivision C] City Project 0 EUC (PUD, VERIZOtOAT& T. OVWD) C3 Multi -Family C] Single Family C3 Other I'NSPFC-TOP: AKrh 11, 1:�,t i— 115Q,1, X,7� 0 F, PAVEMENT CU`F! 0 YES ffNo G. SIZE or CUT — X CONCRETLCUT: CIYCS NNO INDEMNITY, Applicant understands by his1her signature to this application helshe holds the Clot of Edmonds harmless from injuries, damages 0, claims of any kind or description whatsoever, foreseen or unli7reseen, that may be made against the City of Edmond.r or any of its departments or employees, including but not limited to the defente of any legal proceedings including defeate costs and anarneyfecs by reason ofgronting this permit. rHiE COWA4C7'OR IS AE.5POxS78U FOR WORKMANSHIP AND MATERIALS FOR A PERJOD OF ONE FEAR FOLLOWING THE FINAL INSPECTION AND ACCLPYANCE OF THE WORK WTIMATED RrJTOJlAT1ON POW WML BE HELD UNTIL THE FINAL STREET PATCH is COMPLETED J9YCIrYFaRCE9. AT WNICH TIMEA DEBtrOR CREDIT*= SEPROCESSW FORISSUANCEro TAISAPITIC41VT 9 Traffic tontrol and public safety shall be in accordance with City replations as required by the City Engineer. Every flagger most be trained as required by (WAC) 296-iSS-305 and must have certification verifying completion of the required training in their possession. s Restoration is to be in accordnace with City codes. All street-toit trench work shall be patched with asphalt or City - approved material prior to the end of The workday - NO EXCEPTIONS. 9 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 ABOVE STA TEVENTS AND VNDEASTAND TRE PERMIT REQUIREMENTS AND ACXNOWLED45E THA T I MUST MAKE THE PINK COPY OF THE PEAMITA VAILABLE ON SITE ATALL TIMES FOR INSPECTIONS Signature:_ Date. (Coffractor or Agent) FORCrrY. USE OnY.. Appr9Ve4i6yg_ ay Feet; ILQ2 o' OF., Time Autbotized;.V0 dAl6ir 1k. pill nFe und.11.1: Fee: Total Fee:'' b UAL 'AaIaL�� z4o: kA5' elpt _VJL0,L-CU Rf�]IV4 bsued br. UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS COMMUNITY DEVELOPMENT CODE (Phone 425-771-0220, Ext. 1326) FINAL APPROVAL OFPERHITTED WORK: DATE: Inspector's Signature For inspection requirements see Engineering Inspection Informntion handout I ' 11 �A Z 0 U 0 Z V) ZD 0 CIT Y OF EDMONDS S lenw 0. PUBLIC WORKS DEPARTMENT STREET FUE Issue Date RIGHT - OF - WAY CONSTRUCTION PERMIT A. *Address or vicinity of Construction Owner: Name Mailing Address. City, S ta te, Zip Code Contractor: Name Mailing Addres's C1 ty Star e, p Code * Permit Issued To: Type of Work to be Done: • Work n Connection With: El Sub or Plat El Single Family 0 Comm]. / Ind. 0 Apt. Condo. • Pavement Cut: - El Yes El No State License Number ? e-i % 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 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. 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. Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at which time a debit or credit will be processed for issuance to the applicant. Work is to be inspected. Restoration to be in accordance with City Code. T raffic 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 must be available at the job site for inspection purposes at all times. Signature: ate Owner or Agent THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES CALL DIAL - DIG PRIOR TO BEGINNING WORK C. Issued By: 1-f7 6 a rh Time Authorized: Void after N:'/) —days Special Conditions: Ammendments: 4 Permit Fee: Security Deposit: Receipt No.: . Fund III Fee: Street Cut Dimensions M t--! F_ C, �_z 0-11 E D * * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * -tjr. cj Pubiic works Eng. Div. December 1978 FIELD INSPECTI 0 NbTES Fund 111 0oute . cor)v to'Street Dept] Comments: Diagram: ,a Contractor called for inspection Ye's No T Date: Bv: Date: Nork Disa.pproved By: Work Approved By: Date : &hAk Inspector:. Eng. Div. December 1978 STREET FILE-` HARVE H. HARRISON CITY OP 200 DAYTON ST. ED1M0NDS_WASf . flNGTON 98020 (206) 175-25�15 MAY0 DEPARTMENT OF PUBLIC WORKS March 16, 1981 Dear Resident: On February 17, 1981, the E-dmonds City Council passed Resolution 488 for construction, reconstruction and repair of deteriorated sidewalks. A public hearinq will be held in the Council Chambers at the -Civic Center on April 21,1981 at 7:30 P.M.._Yqu are invited to- a.t.tend_:.,,.t.his hqarJng__Eor. discussing r&p'a'ir of portions :o'f .ciet,6t:ioratbd,,�*,��.i,(i�i,.���i..k,-.,,'-.,,�/ abutting your -property impr*ovem(---H-t of 9"' 'i n need of repair at the expense of the abutting property owner is provided by City Ordinance, Chapter 7.20 and� Revised Code of Washington, Chapter 35.68. The areas needing repair have heen marked in pai'nt,on the sidewalk adjoining your property. Reconstru'ction-and repair of these sidewalks Must be completed on or, before September li 1981. In the event improvements are no� completed within the above specified time, the'Gity��ill perform and complete the improvements, at the;: (',�xp`�e;nse 'of 'the abutting property owner. This action is' in response to many citizen�requests and pedestrian falling accidents which have been incr , easing in recent years as a result of sidewalk deterio'r­ation� and increased pedestrian traffic. Sincerely, FRED F. HERZBERG Director of, Public Works V, rPermit No: 3 -02 ��3 S City of Edmond'� CONSTRUCTIONTERMIT IssueDate: JUIW03 RIGHT-.OF_WAY,, icinity of ConstriicU6 Z e* A. Address or V B.. Ty0e of Work (be An gP6,;. TO, nt 4t5- 4 1 Q C. Contractor: C 0 act* P ne: Mailing Address: lio Liability' j i1surance "Bond: $ State License #: D. BuildingPermit (if apfilkiible): Side Sew'er Permit:# (if.applitable): OVWD)� ivisioln 'City P�oject (PUi), VEkIZOOAT& T E. El Commercial,. r_1* Multi -Family '.'E] Single I'dinil Other - INSPECTOR: r_� A F. PAVEMENT CUT: YES 9�0 G. SIZE OF CUT X, CONCRETE CUT: YES 19 NO A131"LICANT'ro IZI`�IAV ANI) SIGN 771- INDEMNITY. Applicant understandi by hi�lhqr signqture'� to this applicaiion`42yh� holds the City. of gdm�hds,haimless ftom injuries,. damages or.claims of any kind'br 'description whatsoever, -foreseen or unforeseen, ithat may be made against the Cit� of Edmonds oi any of its departments 'or eMployqes, including but. not limited to the, defense of any legal proceedings including defense c 'ts and aitorneyJees by reason of 6s anting thispermit. THE CONTRACTOR� IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD -OF ONE YEAR FOLLOWING THE FINA L INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES 07LL BE HELD UNTIL THE FINAL STREET PATCH is COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR, CREDIT 47LL BE PROCESSED FORlSSUANCE TO THE APPLICANT Traffic control and'public S*af6ty shall be in accordance with City regulations as. required by the City Engineer. Every, flagg6r must be trained.as required by (WAC) 296-155-30.5'and must have. certification. verifying completion of -the. required training in their possession. Rest'oraiion' 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 drawingsof 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 ABOVE STA TEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE ` TffA T I MUSTMAKE THE PINKCOPY OF THE PERMITA VAILABLE ON SITE A TALL TIMES FORINSPECTIONS, Signal'ul e Date: 03 (Coii-tractor 6ii'�Age,nt) ]POR 0TYUSE ONLY Right-of-wayfpe': 66* + 2�_� �vppro,�ed by: J6� Time Authorize4.,Void, After I 12AI:J Disruption Fcc/F'pnd''1-11:" Jr Special Conditions: M%krrm 01. S� -R-estorationfee: Total bNk Fee: AQN L __C :8-ft !a ,-Reccipt'No: mu6 &bv: UPON COMPLETION Of PERMITTED WORK9 AN ENGINEERING FINAL INSPECTION IS REQUIRED% PER. CHAPTER 18.00- OF THE- EDMONDS COMMUNITY DEVELOPMENT- CODE (Ph'O nie 425-771-0220, Ext. 1326) FINAL APPROVAL OF PERMITTED WORK. DATE: Inspector's Signature For'insnectio'n reaunrements see Engineeringinsnection In'formation handout. It ALL -TO EXPOSED SURFACE$, BE COVERED WITHIN 2 DAYS ki" A We� fig b ovTot o tA o r- -feu5. 100 Le 0- 0 00 L -\J yr APPROVED AS NOTED CovyLik+ R5 d/at A BY ENGINEERING 31,K.3' -3�ry(W A- \9 1 1 vll�- l"QA nnt. 24 HR. NOTICE REQ. w JA Ll (;kle4 L%y*qll Date: IQ 0 -z FOR INSPECTION 0 pu sVvd v6M HEIGHT CALCULATWNS: DATUM POINT: BOTTOM OF TELE POLE AT SW CORNER. DATUM; 100.01 A: 101.5 B. 101.5 C. 101.5 D. 101.5 406 --.:, 4 = 101.51 AVER. HGT. uqo PROPOSED RIDGE: 115.59 MAX- RIDGE: 101.5 + 151 = 116.59 —4 (00-01 . ....................... C-VFE4> --Z0,0 PROJECT ADDRESS / OWNERS: KEN & BETH COOPER 640 ALDER STREET EDMONDS 98020 425-774-1557 TAX No: 00434209401300 LEGAL: CITY OF EDMONDS BLK 94 LOT 13 & 14. T27RO3 S24SW SCOPE OF PROJECT: NEW DETACHED GARAGE 22'-0" x 20'— 0" = 440 SQ. FT. GRAVEL DRIVE 450 SQ. FT. ZONE: RS-6 LOT SIZE: 60'x 110'= 6,600 SQ FT LOT COVERAGE: EXISTING HOUSE 1042 SQ FT. EXISTING DECK: 308 SQ FT. EX. WAW STAIRS, PORCH(-AJ)9P SO FT 4449 SQ FT. 14t4 PROPOSED GARAGE: 440 SO. FT. TOTAL: H09, SQ FT HOUSE BUILT: 1910 Ns�\ IMPERVIOUS: APPROVED BY PL�N G 6. 7 Zone Lo�-6 Comer Flag A2glired —Actual Front .20 Z-0 + Sides /3 Rear Other E�aht I 2> 2 8. W16 PRE-1977 HOUSE, WALKS 1350 SQ FT. POST-1977 DECK 308 SQ FT GARAGE: DRIVE 440 450 1198 SQ FT. GRADING: LESS THAN 20 CU YDS PLUMB : NONE STREET FILE RECEIVED AUG 2 3.2007 BUILDING DEPARTMENT CITY OF EDMONDS PROPOSED 2" MPE—IP MAIN 22-S CA E.O.M. 2* MPE CAP 229-W, 22-S C/L M., W04 V W-w-w-w-w- I W_ 20' PAVING 60 20' PAVING [FR/W —FUSE TIE—IN 169'W, 22'S CA ST EX. 2' MPE—IP 22'S 3' GRASS 1070UB755-00 to 4 1 S/W 8 0 C4 Ot,9 9*9 STANDARD GAS CONSTRUCTION NOTES: 1. FIELD LOCATE ALL UNDERGROUND UTILITIES. CALL NONE—CALLN TWO WORKING DAYS PRIOR TO CONSTRUCTION, IN WESTERN WASHINGTON CALL: 1-800-424-5555. IN KITTITAS COUNTY CALL: 1-800-553-4344 2. ALL CONSTRUCTION IS TO CONFORM TO PSE GAS OPERATING STANDARDS AND GAS FIELD PROCEDURES. 3. EROSION AND SEDIMENTCONTROL SHALL BE PER PSE STANDARD PRACTICE 0150.3200 TECHNIQUES FOR TEMPORARY EROSION AND SEDIMENT CONTROL AND ANY ADDITIONAL LOCAL JURISDICTION REQUIREMENTS. 4. 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 LARGEO 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 ISNTALLED OR REPLACED PER GAS OPERATING STANDARD 2550.1600. ALLOW ADEQUATE TIME FOR. CUSTOMER DECISION AND RESPONSE. 5. ANY CHANGE IN ROUTE, TIE—IN METHOD OR ADDITIONAL'MAIN FOOTAGE MUST BE APPROVED BYPSEGAS ENGINEERING SERVICES. 6. COMPLETE "PIPE CONDITION REPORTmON ALL EXPOSED EXISTING PSE FACILITIES. CHECK BOX ON REPORT FOR WIRE BOX( TESTLEAD )INSTALLATION. T. ACTIVE SERVICES DENOTED BY: 8. PIPELINE MARKERS AND WARNING SIGNS SHALL BE INSTALLED AND RECORDED BY THE CONTRACTOR PER PSE GAS OPERATING STANDARD 2525.2500. 9. VALVE MARKERS SHALL BE INSTALLED AND RECORDED BY THE CONTRACTORPER PSE GAS OPERATING STANDARD 2525.2600 FOR ALL HP VALVES IF THE LOCATION IS NOT REDILY ACCESSIBLE, AND FOR ALL VALVES WHERE PERSISTANT SNOWFALL MAY OBSCURE THE VALVE BOX . : 110. TO PREVENT ACCIDENTAL OVERPRESSURE OF ADJOINING SYSTEMS9 NO TWO MAINS SHALL BE CONNECTED EXCEPT AS SHOWN ON THIS DESIGN UNLESS APPROVED BY PSE GAS ENGINEERING SERVICES. 1111. SYSTEM MAOP DENOTED BY:ISYSTEM MAOP = 45 PSIG I I 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. GAUGE AND MONITOR USE OF ALL STOPPERS AND SQUEEZES TO ENSURE ADEQUATE FEED. (USE MANOMETER FOR LPSYSTEMS) 115. RESTORE ALL DRIVEWAYS SUBJECT TO OPEN CUT TO ORIOINAL OR BETTER CONDITION. PURGEPOINTS ANDPRESSURE TAPS TOBE INSTALLED PER PSE GAS OPERATING STANDARDS 2525.3400, AND 2525.1200. r—SITE I � I J FITTER (Check Box if Complete) • WORK AREA LEFT IN CLEANISAFE CONDITION. 1:1 • COMPLETE ALL PIPE TABLES AND GAS PRESSURE STAMP 11 • FIELD CHANGES RED —LINED ON AS—BUILTS. 1:1 o MATERIAL VERIFIED AND CHANGES NOTED ON PAPERWORK. 1:1 • ALL VALVE AND TIE—IN LOCA11016 NOTED ON AS —BUILT. 171 • NOTE BEGINNING OF MAIN, EOM,& LINE OF MAIN LOCATIONS. El • SHOW ROPE LOCA77ONS & CUL—DE—SAC RADIUS El Fitter's Signature Company Employee ID# GAS MAIN INSTALLATION/RETIREMENT Type/Work Pipe size Type Estimated Length Actual Length Manufacturer INSTALL 211 MPE W GAS MAIN PRESSURE & TESTING TYPE TEST PRESSURE TESTED BY DATE ON TIME ON DATE OFF TIME OFF TYPE TEST PRESSURE TESTED BY DATE ON TIME ON DATE OFF TIME OFF IDes i gn Press 60 SYS MAOP 45 PROJECT PHASE NOTIF# ORDER# V) 0 L SAP Superior Service/Meter Service/Meter Service/Meter Service/Meter Ind. Service Ind. MSA Dis. Reg./FT HP Svc/MSA Relocate Ret i rernent X517644856 107017526 X118415693 106113164 Contractor: CONSTRUCTION COST CODES: 031-103-1 1 1 7 Project Manager Contact Information: PATTINESS CELL: 425-327-2783 Vicinity Map WORK SITE 0 U11 V/////; i a liffiar/0 r/W/m/ Owner If Developer Contact Info KEN COOPER 640 ALDER ST EDMOND,WA 98020 ATTN: WPN r.nnPF:P office 0.2 �_l \0 CALL (800) 424-5555 r4I 0 D"CTMCCC nkVC D=n= Vn" n7f' t— THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF FACILITIES r-( REAL ESTATE/EASEMENT PERMIT N/A EDMONDS REV# DATE BY DESCRIPTION FUNCTION CONTACT PHONE DATE 3 PROJECT MGRI PATTINESS 206418-4237 2 ENGR — GAS I DRAWN BY COUNTY EMER SECT SNOHOMISH 5 114 SEC OP MAP SW-24-27-05 160-062 UTILITIES CONTACT PHONE# PUGET SOUND ENERGY DESIGNED BY PILCHUCK CONTRACTORS INC. CHECKED BY GAS WK CTR APPROVED BY MNSNIHIG ITTER #1 PLAT MAP FITTER #2 163-066 IMAPPING JOINT FACILITIES ARRANGEMENTS PHUONG DAO PATTINESS PATTI NESS 2064184218 8/17/03 2064184237 2064184237 2" MPE-IP MAIN EXT. 107017526 Dra%ving Number 640 ALDER ST EDMONDS, WA 98020 N/A rA CQ 91.4 t- (COOPER) SCALE: AGE: 41:� ".4 TO = 50' IP 1/1 k