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714 10TH PL S.PDF1111111111 565 714 10TH PL S Notes: 1. All signs and spacing shall conform to the MUTCD and City of Edmonds specs 2. Alert affected residents 3. Channelizing devices are 28" < traffic cones. 4. Maintain a 10' driving lane on pavement for vehicles. 5. All signs are 48" x 48" B/O C\j unless otherwise specified. • 6. Work zone is 13'w/o c/I 10 PL S & 16's/o c/I Spruce ST OOW 6001, IOU Spruce ST A Pilchuck Contractors, Inc. Job #107018380 1 Dec 03 Sheet 1 / 1 J. Buss National Barricade Co • 0 • • • A, 6 nmn— CHANNELIZING DEVICE SPACING (FEET) TAPER TANGENT 20 20 Spruce ST C Of I'l-I NOT TO SCALE ROAD WORK AHEAD HEAD , X � W20-1 LEGEND WORKAREA • 28" TRAFFIC CONE -4- EXISTING TRAFFIC FLOW YZ SIGN LOCATION PROTECTIVE VEHICLE OR WORK VEHICLE +7C. l g9v 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. The 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. The information needed to complete the Checklist should 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 Ci ..The Ci city....The tiY. will review the checklist, make a �. precursory site visit, and make a determination of the subsequent 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 (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assist staff in completing their preliminary assessment of the site... I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate. column below). Owner/ Applicant: = Mid a/�� Name 214 19J. S. Street Address �on�s 'V� q' 29 City, State, ZIP �76�Qgene • i e Date Applicant Representative: Name Street Address City, State, ZIP Phone Signature Date <' CA FILE IVO. Critical ,Areas Checklist Site Information (soils/topography/.hydrology/v(egetation), 5' 1. Site Address/Location: �� /n�y PlaC:° 2. Property Tax Account Number: o'25a� 031 0 005 `'C.0 , 3. Approximate Site Size (acres or square feet): /� ' ScI "T' ' �'" 66�J 4. Is this site currently developed? Yyes; no. If yes; how is site developed? Ye5I a &Y/T1a 5. Describe the general site topography. Check all that apply: f _Flat: less than 5-feet elevation e change over entire sit.:, g 4A Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet ove>Y* VIP. 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-feet). Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: Q_ ; Approx. Depth: 7. Site contains areas of seasonal standing water: 0 Approx. Depth: What season(s) of the year? 8. Site is in the floodway_ jao_ floodplain140 of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round? lop Flows are seasonal? (What time of year? ). 10. Site is primarily: forested ; meadow ; shrubs ; mixed ; urban landscaped (lawn,shrubs etc) 11. Obvious wetland is present on site: 140 ^rA_chkdoq Rev02/11/97 • a • APPLICATION The City of Edmondfor EASEMENT NO_ ____________________________________________ STREET FlLfw SIDE SEWER PERMIT CONSTRUCTION REPAIRS ❑ LID NO.el-SMT. NO. OWNER 1--11�_l_ERE=N----•-----•--•------ CONTRACTOR E?S LIKLIN - c8�1 v ------•------_----- PERMIT NO. - JOB ADDRESS -?-14- -1---------P1---��'T"1--� LEGAL DESCRIPTION: LOT NO. ------- c= ............... _-------- BLOCK NO. -------------------------------- NAME OF ADDITION ___.RoI EST E- T'�-lG> MSS Approved: / DATE ,40,9,'/.l.__-/;,1 . G CITOP �IS�EaWER� WATER'-SEWER•'DEPARTMENT t ca -• (/Call 77b" 628 for side sewer \...inspectios MFOLcovering any. pon got the -construct -nstrucUon %Inspections -will bey providedwithin 24'•hours (after: requst NO Sal 1Sun.for holiday -inspections .. .. ADDRESS�LOGATION(OF, CONSTRUCTION+.. tt�r�~\ ... .-.. c?...:.. l?RQPERTxY LEGAL(+DESCRIP,TION :.- r ? C . ;?' ;...., .:.,.. ?., n,.a'-f-.........:..,-- ......A'AoY as. ..... . r .. tl art . fix- �bA .. .................. s OR•B BUILDER "71'`��....... --�5- kC'r�= OWNEIR. AND/ UI ER .._ ) .. ��. �JTR�ICTORaSNAMEir&`,ADDRESS'......:. ;:„, .i-�.._.-.�\....-, ................................................................... :-.....:. -vA , - ', IP�ermission is granted �1�:� ► :.� ..:..:.......�..... `. , for repair !and%or �conneetionl of a.alde- sewer to; the cltiy, sanitary lsewer' n' 19`�"► . +sv�tem�in"`�accordance�,wlth�SClty,.�of�.Edmonds'•ordinances \��_. 'fin - -� : _- .. •. .. +'vA'i-rn.NdTION I8'>iCA�L'LED�`TO�THE •FOLLOWING: -•� - - s; r�; ! �. l `- - - ��_,k -•, - SNOTE�No:"43 The owners),of•+the',property-may {obtain a permit to, construct sewer Inside Property line. i A• �'llcense&'Side Sewer -Contractor -must -bedemployed. to'construct, sidebsewer in street area*.,:•Do not'cover.an portion, of sewer before it - has been,inspectedt ]VOTE\ IVo xy2 Ali[workatperf6rmedrin� city,,right-of-way.requires� any,Invasion, of Right -of -Way Permit,olitainable; from• the.City Engineer's':office 1VOTE No:.3 , Obtains;fullfinformation:.regarding,Ord inance,-1P.16;030 and Regulations, governing alde;:sewers. when yous,get permit., y = � n+.. . NOTEt1No:,i4 Top t;fsideasewerr must ,have• at•tleast 30` Inches, coverage ate.property, line and, 42 .inches' inside_ property. line; minimum graderof '2 % , :Not ibendss In. grade 'sharP.er than '/e"wilil.be�permitted'..' �. t : .,: • , - `; NOTE.sNo}�1g—Trenchesjin,streetamust be,wate.r,settIed,.arid! surf&& ot,street restored ,to_,original' condition., Contractors shall ,be responsible.:for failurej.due, to; improper C' - work"tiwhiclifmay,deyelopiwlthln,oneyear.of completion, 1 TE�No!16—It+ ish'iunlawfulv;Coi-altec�o'r; do;•any other" work .than is provided for in, the. -permit,- or, toy do"any, work on the main -,sewer its appurfenances,.except to, in,.._ •T-aerfyfhe-tpipe'into�tfie wye: •'..1. . DIS�A`PPROVEDI': Date ...... By.-•• -- -Date::.:, / s. B Date:... B , ❑� Y Y. vj�'fi(1 �.a!f..�{ .:.. •• .. y +Remarks i Y ..........Shf - . - .... •.... ............. •.... ....... .............................. . V f' BOTHPer�I' nit C p�esF MUST Be Signed' By Owner ,of';Firm' P-,erfor-ming (Construction PRIOR To, Request For Insgectioni ....................... ....... hereby certify. 'that.the. side. se_wer;insiallat1on-constructed,under�this3Permit, of�C`onfracfing.'Firm�'Performing-Construction) w� rinstalledvin�iaccordalice,with(:alL;governing' ordinaiices(of A -lid City:uof-Edmonds Dated'this �d clay^:of .......... ...... ,/� . Cheeki,BEFORE, you, dig for: Water 0 Gas ❑ , Telephone f© Power ❑ Sewer 0, Other ❑, d . aAPPLICATION 41 The City of Edmonds for EASEMENT NO_ ..... _______________________________________ SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS ❑ LID NO___________________ _ASMT. NO. __-_____-_- OWNER ._...1!�r�....17.���i�w CONTRACTOR 1--------------- . PERMIT NO. JOB ADDRESS -__; ........ d ��-___-/__S_----------------------- LEGAL DESCRIPTION: LOT NO_ ................. ..................... BLOCK NO.------------------------------------ ,fx ST 4g> NAMEOF ADDITION -------------------------- --..................................................................... ---------------------- ryr�r ►ti a 7XI Approved: DATE............................................ By-------------------- STREET FILE %3%» CITY of EDMONDS --- PUBLIC WORKS DEPARTMENT Routing of Building Permit Applications Proposed Property Address of Application: 714 - 10th Place South DEPARTMENT COMMENTS DATE WATER STREET rC �j-5 74 r ZL S E W E R NOTES G� - BUILDING DEPARTMENT COMMENTS q��90 - : i j BUILDING D E P A R T M E N Applicant Fill USE PERMIT ZONE • NUMBER ' 7 1976 PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS 7/ ­ /`� NAME' (OR NAME OF BUSINESS) 14e'L C. r1 LEGAL LOT LOT AREA SUBDIVISION NO. YES ❑ NO W MAILING ADDRESS 3 L 1 y/ +� j^ / C1 VARIANCE OR COND. USE NO. ADB NO. .�j U' CITY NUMBER PROPOSED YARDS HEIGHT = ]TELEPHONE 1 �� CYS ^�'') J 6 ' '� FRONT 'SIDE REAR Z Q NAME r U ALLOWABLE. SIGN AREA PROPOSED SIGN AREA -� a W r ADDRESS OTHER I U REQUIREMENTS (t CITY TELEPHONE NUMBER PLANNING DEPT. APPROVAL DATE Q. �' NAMESTREET jj ,� c c" l•e LL C, i! I�� EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY 0 I- U ADDRESS l_-1 3 7 COMP. PLAN ST. R/W FT. FT. o ,� Ir r 7EITY � TELEPHONE NUMBER REMARKS Z o .11 -10 -*)l ?� - > z �. it W U STATE LICENSE NUMBER CITY LICENSE NUMBER _ CHECKED BY W Z c; I 19; Z Legal Description of Property (Show Below or Attach Four Copies) STREET AND/OR_ UTILITY ❑ YES W WORK REQ'D ❑ NO UNDERGROUND ❑ YES Z 0 WIRING REQ'D' ❑ NO F 'CONNECTION TYPE VERIFIED'BY a _ U ❑ YE PERMIT NUMBER W[A W SEPTIC SYSTEM ❑ APPVD BY CITY ENG. ❑ NO W 0 .J REMARKS Q W �I Z r IL_ U to W m 0 METER SIZE SERVICE SIZE CLEARANCE CHECKED BY E W r REMARKS Q 3 © NEW RESIDENTIAL GAS L NE FIRE ZONE TYPE OF CONSTRUCTION CODE ❑ NON-RESIDENTIAL []SIGN El❑ ADD DEMOLISH RETAINING SPECIAL INSPECTOR.AREA REQUIRED OCCUPANCY GROUP OCCUPANT LOAD ❑ ALTER ❑ EXCAVATE WALL FENCE ❑ YES ❑ NO I r OR FILL ( X FT). PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY w ❑PRE REPAIR -MOVE SWIM OF EDMONDS. LOCAL SALES TAX ❑ INSP, POOL SHOULD BE CODED 1 t7 _� REMARKS Z NUMBER OF STORIES NUMBER OF _ ❑ • DWELLING J ' UNITS m NATURE OF WORK TO BE DONE PROPOSED USE ' VALUATION FEE - - PLAN CHECK NO. PLOT PLAN INDICATE BUILDING SETBACKS, ABUTTING STREETS) BUILDING ' PLUMBING - HEAT & GAS LINE FENCE - SIGN • RETAINING WALL SWIMMING POOL - ' PARCEL C The west 120 feet of that portion of thenorthwest: quarter of the northeast quarter of Section 2.5, T.ownship 21 North, Range 3 East, W.M., described as follows: Beginning at a point 388.00 feet south and S88005.'00"E, 360 feet from the northwest corner of said northwest quarter of northeast: quarter; thence continuing W W5'00"E, 240.00 feet to an existing fence; thence . S1016'00"W, 248.00 feet; thence N88005'00"W, 240 feet; .thence .N.I°16'00"E, 248 feet.to the point of beginning. EXCEPT the north 164.80.feet thereof and. EXCEPT that portion deeded to the City of Edmonds for street .righl-of-way. a d LESLIE C. HALVERSON I REID, MI'.DDLETON & ASSOC.IATES; CONSUTIN'G L' ENGINEERS a LAND SURVEYORS INC.c, DESIGN DRAWNCHECHED EDMpN'DS 1? EVERET"T. WASHINGION STREET FILE i)Al'f- Sentemher^ln_, 19.7F_. _T NFM, TO: 11arry +'►ii t:ciitt; Gui1dinn Official FRM1: Richard I!, Anon Assista.►it,f,ity Fnnineer SI11',,l(-1;T:. f.,LIILDIfIG RF_1?fIIT. I1RRL.IC/ITIOiI FOR SVFiI flfLI.FREP! 714 lntfi fl. S. After review of the .,►ihject huil.dinn nermit am)]icationhive the fol 1 m,!i nci comments 1. Connection to. sanitary sewer renuired. 2. Lot drainage to he -contained on site.. 3. Underground %qi ri ng rectui red. ` kj 1. llsnhalt paving required per.S-13-7r, c•!ith turn-armind also. paved Bond to be posted before release of Building Permit. llJf1:MIA.:mjr L O�j s P. , 0 F,-- vv OA.1 spmv T-!9 -114 OAT PERMIT ADDRF I Oft 1-1 �.. LEGAL DESCRI WN • �� /� 'lam Ir BUILDING PERMIT RF.VIE14 - ENGINEERING DEPARTMENT CHECK LIST Instruction: Check Accuracy of Legal Description Check Against Assessor's Map for Legal Subdivision Does it conform to City Approved Subdivision? Reviewer's Initials s1. This lot included in Subdivision/Pl No. t 2. Site Inspection made on: Q) 1 t,6 (in 3. l!hat are ground ,water and soil conditions? Pik' l' u4t 4. Site Drainage Checked? � 5. Storm Sewer Availabilitv: Roadside Ditch kk-r^i-L :_of Gwq. No. Projec 6. Grading & Final Contours: Mcm 7. Septic Tank System Design Approved: •� 8.. Sanitary Sewer Availability Sht. __of Owg. NojfgZl Project' Side sewer availability: a L 9. Sanitary Sewer Connection Fees? 10. tdater Mains & Fire Hydrants (Indicate Size Main) IihA ? Check Fire Dept. s Comments 11. Sidewalks: (Site jnspection shows conditions of sidewalks as follows) 12. Curbs:_ grade and width): Curb Cuts/Driveways (Check driveways for safety, lncation, 13. Underground I!iring: Street Lights: 14. Street Right-of-way A Bldg. setbacks:91 iSht. ( f official Street Map. 15. Existing Utility Easements? 16. Access Easements: 17. 18. 19. 20. 21. Site Plan checked for accuracy? Special Requirements listed in Memo to Bldg. Dept. M,WO Commercial & Apt. Requirements form completed? 1 Drawings stamped & notation All Items filled in on Bldg 22. Bonds posted for site work? 23. Right-of-way Invasion Permi COMMENTS: Rev. 7/1/76 Z(.9 4'ls'h�y )^^•7 �1 ie*Z, i° f,a Y K:iy,7 4s , .X.r A'ra ;j.>.3 �.' S � �.c�Y -.4 �Y`i 0 .�, +X:�ga ,rz•� s@c '4r �'�SW � y •h sp • s i .') y�'>.t��+P/fY1r •�1 1r 5 - - . r >n� 1■^J■ C 'J'�- y •'K "'• f. 4 F a ^' .iti 4 G S 2� t' . �i k •, YMa V-a�g.��y y+,rVSi�".t �X O ro+ MOl4MVi�;F�t..\`'i;{�. =dr: flt'xw"�.+� ?'+•,ca. a?te-Yr�e�'i s "'v� °"� wPiti`q' °' \ a - yr �- •fy. .,.�+ ..• �'r Ay�+,r�, �'�, 'Y•c7Fsji .. "'+'_y, it"`,% Or '9P«" _ �.� °_r 0 a1 .#;+St Y '$' 4` '4iA Z' 9'k'y��{/'1`_1y.e*'!�Y• \C+�� jr"w:-l�'•4.�.J lr,Qygj�-� ,•y.,��g'',`�1s ,�C,�i�° aar }„/` r y� +o�(•� Is/gK ts%VIt"', + + ! �.-..... •3� 44. +SF•n `4 ! , • .le£�. ;Si - .'i°' "�s'4 's^x' a\ T`�- j �.. ,�tA �["i.,n•S.,•y�i 'f3ii!l Z. / F.e sa � ' a,' "� �s"t4: o.t� �p ``a� by���,,,t' '�•3'eg',p�;�S�'���rsb'���y� �,+Y�;s ' e - .. ....-.' ...... ..-, ..a.... 9;. s - ` x ,/, y,.,.•.....�,Y,,..'..:.-. t•.iy The Critical Areas Checklist contained it, and submit- itto the,Ci sThe Ci�� J i} . ., l• , l r .> . r:>'••`a �t.< . 1}. J,J ur4 4 .�'1-.'x....' J �r �d i`�+t�i. on this form is to be filled out by any will revie-Ar the checklist; make a • � + �� ` ,� s � �, ,. person preparing a Development Penmiv',i * `precursory -site visit; Application for the City of Edmonds > > determination of the subsequent steps ``_ prior to his/her submittal of a necessary to complete a development development permit to the City. permit application. r, The 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. The information needed to complete the Checklist should 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 With a signed copy of this form, the applicant should also`submita 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 (e.g. site plan, topography ` map, etc.) or studies in conjunction with this Clecklist to assiststaff in completing their preliminary .: ' assessment of the site,-' I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner/ Applicant: v­ L MMIM4-5- Name Street Address City, State, zrn ,776 • q gene t L. i re Date Applicant Representative: Name Street Address City, State, ZIP ,. Phone _4 r. Signature ` - Date ,=s d.."..�%' K.�s.i�ntk• R r�va •�:1s,♦:W, ipt'h•N1N,+N•?!!v,''!'�i6k(^• °%��•"W '9dF' r � c`4 ^Mo!-.'^'+m'M"n. wr '�+�' ; CA FILE IVO �,.,• �� s qq a :r CriticaI Areas--th Mist ` +; t y• v� .xa }y.'• �. si•*af 't6 % �°'re'2 `ti •I/F :w.#4yrt,'.�•4.{o.�'v *"ip �.1,i•^f•i•'Yir'+.'A'SSGk,.�,Y%8t•1�.•'t ,,. �. yw}. `y'�•I!*z'� .9e �5 _.••83�k'�y�7:,— t •i,�..t.�. r` Safe Information (sods/topography/hydrology/vegetation) �� �.•. 1 Site Address/.Location e�= . . - - n r .. - - ~a,••y. e: ,. . i.',i yWi'tF ';Y �"4+ * t; F' i� �•• 2. Property TaxAccountNumbero��03 �¢06 3. Approximate Site Size (acres or square feet)* 4. Is this site currently developed? ✓Y ` n° If yes; how is site developed? y • �-3.a 'yf r. `'*F -: Ad'' 1'3a at E4 4'.•�7 �iGstita''�`,k��ifrY 's+� ,�-?' . Describe the general site topogra' phy."Of ck all that 5. apply: Ly :� 'PYB _ 1�Flat: , „ less than 5-feet elevation change over entire site.; ; ;;,, 4" �r, ,,644 1 ra;) f �fT. Rolling: slopes on site generally less than 15°k (a vertical rise of 10-fe6f4ef ) 0 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-feet). Steep: grades of greater than 30% present on site (a, vertical rise of 10-feet over - a horizontal distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: Ij 0 Approx. Depth: 7. Site contains areas of seasonal standing water:_; Approx. Depth: What season(s) of the year? 8. Site is in the floodway__Jao�_ floodplain4Q of a water course. 9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round? J0Q Flows are seasonal? (What time of year? ). 10. Site is primarily: forested ; meadow ; shrubs ; mixed ; urban landscaped (lawn,shrubs etc) L�= 11. Obvious wetland is present on site: 140 For l.: Site is Zoned? y Staff Use y 2 SCSmapped.soil.type(s)?. CtRd✓L-'L�`C Srtrt�Y LoAnS •.B �� S ipe 3. Wetland inventory or C.A. map indicates wetland present on site? 4 Critical Areas inventory or C.A. map indicates Critical Area on site?, o 5 Site within designated earth. subsidence. landslide hazard. area? 6. Site designated on the Environmentally. Sensitive Areas Map?. `Q 'DETERMINATION STUDY REQUIRED CONDITIONAL WAIVER 0�• WAIVER < r Reviewed by:.. �. L L o LJb 1 Planner f ate 4ca—chkdoq Rev 02/11/97 77F'S: ALe Zr AFi% AESIDENT-"S, CON1:004 T.'O. Mari r 9AVC Z E4.46, icy , City Of Edmond5 I? t:No RIGHT-OF-WAiY CONSTRUCTION PERMIT Issne Date:�3 A. Address or, V icmity of Construction: -. j 16 76193 � v B. Type of Work be specific): � ` ( C14 v'l 1 ti'1 i 0 L YP ( \fit 0 C. Contractor: i , C.���_�c 1 z Contact: !PSw kd Mailing Address: j _:2N:--,iA0 a � titp Phone: 9 1G io -1,(1 '4 as 7 State License #: 1• �'A or I (:U i Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project ❑ EUC (PUD, VERIZON, PSE, AT& T, OVWD) ❑ Multi -Family Single Family - ❑ . Other INSPECTOR: F. PAVEMENT CUT: kES ❑ NO G. SIZE OF CUT X �- CONCRETE CUT: ❑ YES ❑ NO AN'LICANT TO IZEAI) AN[) SIGN INDEMNITY. • Applicant understands by his/her signature to this application he/she holds the City of Edmonds harmless from .t 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 attorney fees by'reason of granting this permit. a 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 TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. 'j...:.. •tom t �♦ 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 HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE THAT I MUST MAKE THE PINK COPY OF THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS Signature: Date: 3/5,3 (Contractor or Agent) FOR CITY USE ONLY Approved by: Right-of-way Fee: Time Authoriz �d: Void After MoWe'-t-1 /S 4A.120e • 'Disruption Fee/Fund 1114 Special Conditions INTAiN S�S�'T= d4CK FI+zom ALL. Restoration Fee: 'f�i°�. ' -Total Fee: A6 7 'e.- R'ec,!pt No. ; Issued by: /LL y°(.. Tt` K CJIMLJ/ 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.OFPERMITTED WORK., DATE: ns ector's Signature For -inspection requirements see Engineering Inspection Information handout. NO WORK SHALL BEGIN NZIOIZ TO I'EIZMIT ISSUANCE DAMy STANDARD GAS CONSTRUCTION NOTES: I I I 1 I "I b SPRUCE ST 2�1:A__ — v�a EX. 2" PE IP 16'S 03 IPa Ft°w 107015858-99 �. �. �. �—• -- -- -- '� i "L I o ay C44 IN i aN TIE-IN FUSE 19 -S CIL & 13'W CIL 2" X 900 PE ELL ( ')S CIL (Y-')W CIL PROP. 1-114" PE IP MIIN 13-W CIL ( ')W CIL. J END MAIN 269 -S CIL 13'W CIL END OF R/Ir (--')W CIL (--')S CIL 1. FIELD LOCATE ALL UNDERGROUND UTILITIES. CALL "ONE —CALL" 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 SEDIMENT CONTROL 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 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 2550.1600. ALLOW ADEQUATE TIME FOR CUSTOMER -DECISION- AND RESPONSE. 5. ANY CHANGE IN ROUTE, TIE—IN METHOD OR ADDITIONAL MAIN FOOTAGE MUST BE APPROVED BY PSE GAS ENGINEERING SERVICES. 6. COMPLETE "PIPE CONDITION REPORT" ON ALL EXPOSED EXISTING PSE FACILITIES. CHECK BOX ON REPORT FOR WIRE BOX (TEST LEAD) INSTALLATION. 7. ACTIVE SERVICES DENOTED BY: XXXX 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 CONTRACTOR PER 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 _ 10. TO PREVENT ACCIDENTAL OVERPRESSURE OF ADJOINING SYSTEMS, �JO TWO MAINS SHALL BE CONNECTED EXCEPT AS SHOWN ON THIS DESIGN UNLESS APPROVED BY PSE GAS ENGINEERING SERVICES. 11. SYSTEM MAOP DENOTED BY: I SYSTEM MAOP = —45— PSIG 12. RESTORE ALL DRIVEWAYS SUBJECT TO OPEN CUT TO ORIGINAL OR BETTER CONDITION. 13. GAUGE AND MONITOR USE OF ALL STOPPERS AND SQUEEZES TO ENSURE ADEQUATE FEED. (USE MANOMETER FOR LP SYSTEMS) 14. PURGE POINTS AND PRESSURE TAPS TO BE INSTALLED PER PSE GAS OPERATING STANDARDS 2525.3400, AND 2525:1200. FITTER (CHECK BOX IF COMPLETE) Work area left in Clean 11c Safe condition ❑ Complete all Pipe Tables and Gas Pres lure Stamp ❑ Field changes Red -Lined on as -built ❑ Material verified -and Changes noted on paperwork ❑ All Valve & Tie-in Locations noted on as -built ❑ Note beginning of Main; EOM & . Line of Main locations ❑ Show Rope Locations & Cul-de-sac Rad;us ❑ Foreman's Signature Company Employee ID# GAS MAIN INSTALLATIONIRETIREMENT Type/Work Pipe Size Type Estimated Length Actual Length Manufacturer INSTALL 1-1/4" PE IP 250' GAS MAIN PRESSURE 8, TESTING TYPE TEST 1PRESSURE TESTED BY DA"i E ON TIME ON - - - DATE OFF DATE _I TIME OFF TYPE TEST PRESSURE TESTED BY DATE ON TIME ON DATE OFF TIME OFF Desi n Press 60 SYS MAOP 45 PROJECT PHASE NOTIF# ORDER# d 0 SAP Superior Service/Meter Service/Meter Service/Meter Service/Meter Ind. Service Ind. MSA Dis. Reg. / FT HP Svc/MSA Relocate Retirement X459686232 107018380 X658663282 106118882 Contractor. CONSTRUCTION COST CODES: . 0314034 Project Manager Contact Information: PATTI NESS CELL-425-327-2783 REV# DATE BY - DESCRIPTION Vicinity Map WORK Edrhan Owner / Developer Contact Info CHRIS ROGSTAD 71410 PL S EDMONDS, WA 98020 ATTN: CHRIS ROGSTAD 206-285-5820 office CALL (800) 424-5555 2 BUSINESS DAYS BEFORE YOU DIG THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF FACILITIES REAL ESTATE/EASEMENT PERMIT N/A EDMONDS FUNCTION I ONTACT PHONE- DATE 3 PROJECT MGR I PATTI NESS 425-327-2too 111111luo 2 ENGR-GAS 1 DRAWN BY COUNTY EMER SECT SNOHOMISH 5 1/4 SEC OP MAP NE-25-27-03 164.062 CHECKED BY GAS WK CTR APPROVED BY MCNSEG FITTER #1 PLAT MAP FITTER #2 164.047 MAPPING JOINT FACILITIES ARRANGEMENTS . R.CONNER PATTINESS PATTI NESS UTILITIES CONTACT PHONE# PUGET CHRIS ROCSTAD ESOUND NERGY 1-114 PE IP MAIN EXTENSION 714 10 PL S. EDMONDS, WA 98020 DESIGNED BY PILCHUCK CONTRACTORS INC. 206-853-2277 11120/03 425-327-2783 425-327-2783 lk- 2R'D- 107018380 )rawi�/AmbE SCALE: AC 1"=50'1 1