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718 ALDER ST.PDFIIIIII IIIII IIIII IIIII IIIII IIII IIII10079 718 ALDER ST 0 10,5-- 0 305-3 y u Aso o7rD lip U 'P ....._.....:.District' ..4% L �'% n, .. ' ..... City of Edmonds ---Water Water Department TAP CARD cow Date........ ........ Meter No. 72.53 Tap I No ..... i . i ................................. . .1 Size........ SizeA ....... PM. .. Mfgrs. No.2.9_"._.=.7A'705n StyleP.,..W ..... C-9Z . ...... For l ......................... .......... / ....................... /V.;;Zo ............. ....................... LotNo------------------------------------------- Blk. No.------................:..::....................... Add-..................................................................................................... I ................ ....... Service Location .................................................................................... ....................................................................................................................................... MeterhLocation kh . ..... 441RM!) F.M... 6P ....... "I . - Vv MakeTap ..... * ............................................................ ....................................................................................................................................... Pressure ..... 1.1,5 .. . ........ lbs. Test .................................... 50 SendBills to .......................................................................................................... ...................................................... Date of Work !,73.. so . Foreman Guar. Voucher No ....................... ; ................... $ .......................................... Remarks: ......................................................... ..................................... . .................... ................................................................................................................. . ....... . ............ Zo... . ............................................................. . ....... . .............. OUTGOING Index ......... Reg ....... Route Bk ......... Stencil ...... Card ----- i INCOMING Index ------ --- Reg ....... Route Bk ......... Stencil- ..... Card-:_.. Material Chargeable to Installati eters .1 4r. NO. SIZE DESCRIP'r.'0N-" RATE AMOUNT --•----------• .......... Meter ..... -.............................. ......... --... ......._... .............. .......... Meter Box -------•------•--------- ............. .............................. .............. --.......... ............. ---•--•--- Check Valve ...... .... _.... _....... .............. ..... -... .......... .............. -----•--• Pipe, Galv. Screw .................. .............. .._......... .......... ------•---•-- ---------- Nipples .................................... ••--•--------• -- .... .... .......... ............... .......... Bushings .................................. .............. .._.... --... .......... ------------------------- Plana Ells -------------------------------• .............. ............ .......... .......... _. .......... St., Ells .................................... .............. .......... -- ..----------•- -----••••.............. ------••------ ....•-•--- -••--•-•-- . ---•---• Tees ------•-•--------------•------••--------- ..................................................... ......•.............................................. •-•--•--------------------•-...._......---•-•-----.....-•--•--•--•--- --••-------- .............. .............. •----------• •-•.............. ............ •-•-•------- .......... .... ---------- .......... Material Chargeable to Taps Connected NO. , SIZE ' DESCRIPTION &ATE AMOUNT = _ -------I • ........ Pipe, Black Screw ................... ------------• ............. --------- -----=--= ---- -----•---- Pipe,- Galv. Screw ................... .............. ............. ......... .............. ---------- Lead Connections .:................ -•--••----•- ....---•---. .......... ------••--- .......... Curb Cocks .--.--•----•----••....... ........... '..- ..... ... .............. ........... Corp. Cocks ........................... ............. ••----....._. ......... ----•••---•-.. .......... Unions ................. -................. ............... ............. ......... .............. .......... Saddles .................................... ----•-•------- ..... _....._._ Nipples ' ..---••------ --------- Bushings ............... =.................. .............. ... -----._ .......... •--•-•-----•. •-----•--• Plain Ells -------•••-----•--------••--... ............ •-----------• •---•----- .............. -----•---- Street Ells ..................... -- ... ... ............. .......... -• --•---•--• ............ .......... Tees .......................................... --•••------•--• ......... -- .......... .............. .......... Curb Boxes ------------ --------------- -----•-------- ............. .......... S. O. Extensions "' ---.----- Gates•---•--••---•-------------------------•-............ •-- _... ._......... .............. .......... Plugs ........................................ .............. ---•------•• •------•-• ............... -----_.... Couplings ............................... .......... --- ----- ------- ......... .............. ......... Gate Boxes ............................ •----•-------- ------------- .... ---- ----•--•------ .............. .............. --•--•--•-•--• --•---•••• •----•••• ---------• ---------- ---------------------------------•------------------. >. ..................................................... ........................................................... ........................................................... ............. --•-------- .. ............. ............. "-------•---- ............ ............ --......... ••-----•--• .......... .......... -- •----••---•--- .............. .............. ............... ---•---••...._ .............. .......... _........ -•------•- .......... _........ ---.----- •.....................•----•..............-----.........••• ......................................................... . -••...................•---.............•-••------........•• ........................................................... .......................................................... Hours Time —Day Men ------•. ............. ............... ............... .............. ............... ............... ............ •---------- ............ ------- ---- ....... _... ............ - ........ .......... .......... ----- ---- _.... .... -------•-- ..............• --------- Hours Time —Monthly Men -- ------------- ....... -... ........... -•----•-----•• ------... Hours' Time —Auto ............ ..........•-----• ....... -... ....... -- .............. -------•-- Superintendence---------------------- -------------- --......... .......... ---•-•-------- -------•-• , Total ....---•-••..... --------------• ------- _....- •••---- ROUTING SLIP r� NEW SERVICE INSTALLATION ADDRESS: DATE: ` DIAL A DIG# P.U.D. %11�1 TELEPHONE A: CABLE T.V..,, GAS FOREMAN ' STORM SEWER OTHER c, FUTURE SERVICE INSTL: 'YES NO BORE: CUT: i SURCHARGE: YES NO CREW DATE: INITIAL: UNLOC DATE: �� 'O 1 INITIAL•A J-1 ,- ACCOUNT NUMBER •3-•-$� METER SHOP /OS-(ia9flQ SUPPLIER: St=�`t TREATMENT PLANT FORII`M JSIDE-SEWER.PEMIT CE) B L T # FORFIM INITIAL: DATE: TAP CARD METER SHEET APPLICATION/ UTILITY DISPATCH BILLING o -720 Mtlocl� ADDRESS: '716 m . TAX ACCOUNT/PARCEL NUMBER: `7` 37� D'7 enD BUILDING PERMIT (NEW STRUCTURE): 1 COVENANTS (RECORDED) CRITICAL AREAS: DETERMINATION: []Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR:_ PERMITS (OTHER):19�(p PLANNING DATA CHECKLIST DATED: /' SCALED PLOT PLAN DATED: 42411l1��(/ SEWER LID FEE $: LID #: 5i SHORT PLAT FILE: j� LOT: BLOCK: SIDE SEWER AS BUILT DATED: �7/ZbI�S� SIDE SEWER PERMITS) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: S5u - YI &wk*az- FOR: WATER METER TAP CARD DATED: �I27IS 1 OTHER: (2 w q y -D)3 d 1 C ) LATEMPOSTs\ orms\Street File Checklist.doc tip 00 OWN -41 MON L N4 YAk -uam -7-7-7 1�2 -i%�7777 77 t ----------------- -7— Dvlc,%"P� W"Asn"y SAO iSY{OYr 0 WAY 00"A" , 00 OAK (71 d M. 1, L k�- L A 7 'nm;t Cgs ,54 MARK; >A 1 00010 am WWI& W WQUU,"o hol aNPQAIta' T ZA"A"! .2 Ing nu'jo;U;d t el ra ye.' , —0 'loft c 4, of �Simcor,:W.41 1 TTos~ nxbt�. P It lho 0 at' QW, v WON W 0 , Qm n j a r? stop". ;V —2 xmm wow �l 4 Rn OfPcompe-4, is 0 -11 SS Pro er S-�reet- STREET FILE cx,�y 144 w p14 `j ip 3o M&v zoor- F. a� a ®N® DEC 11 1160 t PLAT OF' SUP:`JEY \ t .... FOR PAN TERRA INC. Lots 13 and 14, Block 91; City of -Edmonds �r' PCAT? ,. rr. r • h- 59.95 OMCAs) 2v'9 , .; 0 (,t L 4T) Z10.Od �?) ' .. .. - . -' f,' , ■=,.5�'T r xL %ice, r _o a \ '.� IT vt ffigh LS :12 l..`,�In' ti i.{1r.�U» - �.. } 9 r •t is l ', F �JB�jD /-�99z ,'/ `.U�G►/�/IIC= �' .G�jll i /Ci 0-. .�5• .1 _, ,_ CITY OF EDMONDS PUBLIC WORKS DEPAR*"-- FOR INSPECTION CALL rmit N? 6670SIDE SEWER PERMIT 775-2525 Ext. 220 Issue Date ;&g/ � PERMIT MUST BE POSTED ON JOB SITE �r Address of Construction 7 1 Cr /4/dc . Property Legal Description (include all, easements) r3/oak 91 �; �� 6f ) k. 0 •.�(S Single Family Residence _X Multi -Family No. of Units Commercial Owner and/or Builder Contractor & License No. Z Z 3 - 0 1 /4 2 - Al C - S,) - D 3 v .3 r5 Invasion into City Right -of -Way: No�_ Yes (If Yes Right-of- way Construction Permit Required - Call Dial Dig (342-5344) before excavation). 7. Cross other private property: Yes No X Easement required - u attach legal description and county easement number. ' H w READ THE FOLLOWT,.NG AND SIGN: a. Property owners must obtain a permit to install side sewers on >-I their property. A licensed side sewer contractor must be employed to construct side sewers in the public right-of-way. w b. The side sewer contractor assumes full reponsibility for each H installation for one year. C. Commercial establishment requires a minimum of a six inch (6") side sewer line. u d. Side sewers may not be installed closer thaiNk (jolt) to any structure. �#QREOYQUQ�V15°) we. Side sewer lines must be laid at a minimum o g ° 1-800-5N_ak4�7 and maximum grade of 100� (45 ). H f. No turn in side sewer greater than 45 (1/8;bend) is°a o ed between cleanout. All 90 turns'must be constructed of a 45 (1/8 bend) and wye with removable cap. g. No down spouts, footing drains or floor drains can be connected to side sewer system. h. Pea gravel is required for bedding when installing sewer lines through other than granular soil. i. Cleanouts are required at 30"-60" from each plumbing exit 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: 7- S_ MAR 2 h 1981 I certify that I have read and shall comply with the above PERMIT FEE: S, �� DISAPPROVED By: Date: v W By: Date: CONNECTION FEE: APPROVED By: Date: * PERMIT MUST BE POSTED ON JOB SITE "CITY OF EDMONDS _ r"jPUBLIC WORKS DEPART. FOR INSPEC 'ION CALL eamit H? _ _ 6670 :_nLDE SEWER PERMIT 775=2525 Ext. 220 Issue Date PERMIT MUST BE.POSTED ON JOB SITE _Address of Construction 7e UJZ. Property Legal Description (include all, easements) 3y -6- / W3. Single Family Residence k' Multi -Family N . Commercial EDM TREATMENT PLANT cc F.. 4. Owner and/or Builder CO 5. Contractor & License No. �� _Q 1 i ? ' ,�� !' '- y i! 6. Invasion into City Right -of -Way: No Yes (If Yes Right-of- way Construction Permit Required - Call Dial Dig (342-5344) before excavation). 7. Cross other private property: Yes No X Easement required - attach legal description and county easement number. READ THE FOLLOWT.,NG AND SIGN: a. Property owners must obtain a permit to install side sewers on 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. ','DC c. Commercial establishment requires a minimULk 48 M®th (6") side sewer line. AFO 9U. d. Side sewers may not be installed closer [� �+`�!#i �! s (30") to any structure. j . $00 - 561-§4%g e. Side sewer lines must be laid at a minimum grade. o % 1.15°) and maximum grade of 100% (450). f. No turn in side sewer greater than 45° (1/8,bend) is0allowed between cleanout. All 90 turns must be constructed of a 45 (1/8 bend) and Wye with removable cap. g. No down spouts, footing drains or floor drains can be connected to side sewer system. h. Pea gravel is required for bedding when installing sewer lines through other than granular soil. i.• Cleanouts are required at 30"-60" from each plumbing exit 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 certify that I have read and shall comply with the above . PERMIT FEE: ,V S - U W CONNECTION FEE: w7 runh -ke : �,xs% �.. * PERMIT MI DISAPPROVED By: Date: By: Date: APPROVED By: Date: BE POSTED ON J T 4L 1�y L-f to U an er4ye 4qe �,.npr�6edaf,ons of cAnd,:sr"rZed'S,.-,4 e fer-ok 0' 7 J Ac- PLAT OF SURVEY FOR PAN TERRA INC. 'Lots 13 and 14, Block 91, City of Edmonds e ee zo PLAr) 15) N /VZW 045 14/0. z S 94 s Side Sewer Drawing The City of Edmonds EASEMENT NO . ............................................ NEW CONSTRUCTION REPAIRS❑ LID NO ................... . ASMT. NO . .................. R... ..................................... CONTRACTOR . . ............... OWNER ............................ ....................................... PERMIT NO. .................... JOB ADDRESS Z LOT NO . ..... 1Y/1.4 .............. BLOCK NO. ....... f/ ......................... . ...5-....77 ............................... LEGAL DESCRIPTION. ...... ......... ....................................................................................................................................................... NAME OF ADDITION ....... el1v .................... EDMONDS P*T-,- TrtEATMENTLA Approved: Pwwtooi-1 1/75 (REV. 11/78) DATE -- ............. Bm—��.. -------------- t (50- >0 r APPROVED BY 'PLANNING 01 -?)o + Zone .-2±---. corner 1 Front Ld cl Sides Rear ��OA- APPRO' D BY ENGlNE&gj,,jG 15 rko mew lmpmvKA-S --------- -- Ifei N oth In cJ Perm i-f fcct to ex4cncl CL100,je- f \N fflA V1 til-e 5c4-bobf-5 lb,lil"l k t" to p,% tat, IjAIP11 17 2014 DEVELOPMENT SERVICES CTR. CITY OF EDMONDS �r� :.�$'v�,Pw'7"�t �: ��' � v+..r •:��-'YtiY'rti �v4 .�..e/�...}n•.°'l'.r4�-y �...?•n'^'1 �ii Y.itivr�2Ll .. �yN .,• i -.. a � ...r L' lug.' rrc}��an'x+''.ri.•'q*fr� ;tfry�r;ybfLf•�-.rye}�}ny�+,T-' d A City of Edmore RI T-OF-WAY'-CONSTR - TION 890 Or-�o 19 PERMIT Permit Number. — VERBAL: ROY 1-5-94 Issue Date: T= A. Address or Vicinity of Construction: 71.8 ALDER STREF,T B. Type of Work (be specific): PLACE B-WIRE FROM TERM #7706 j USHING UNDER ALDER ST & PLOWING 80-FT. MEDICAL NEED. SEE ATTACHED SKETCH. C. Contractor: GTE NORTHWEST INCORPORATED Contact: BARBARA TOLLEFSON, PERMIT COORDINATOR Mailing Address: 22118 20TH AVE. SE SUITE 1311one: BARB 488=1642 State License #: BOTHELL, WA 98021 Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project ® Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ .Other W.O.#2100-9POOIDB 242310 INSPECTOR: INSPECTOR: (k; � F. Pavement or Concrete Cut: LN Yes LJNo G. Size of Cut: L x 4 H. Charge $ f/ APPLICANT TO READ AND, GN INDEMNITY: Applicant understands and by his signature to this application, agrees to ho the City of Edmonds,harmlpss frofri iriji t mages, 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 or not limited to the defense of any legal proceedings including- !,dee nVA ts, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FO`PERIOD OF ONE YEAR FOLLOWIN .THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL'1BE 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. s Construction drawing of proposed work required with permit application. A 24 hour notice is required 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 of the working day; NO EXCEPTIONS. I have read the above statements and understand the permit requirements and the pink copy of thepermit will be available on site at all times for inspection purposes. Signature: - Date: 1-4-94 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: RIGHT OF WAY DEPOSIT ' TIME` AUTHORIZED; VOID AFTER MUIC-4 DAYS DISRUPTION FEE/FUND.,111: SPECIAL CONDITIONS: RESTORATION FEE: PERMIT FEE: TOTALrFEE: COMMENTS: RECEIPT. FEE:, DATE: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 Aides ST STREETFILE July 10, 1981 MEMO. -TO: BUILDING DIVISION FROM: ENGINEERING DIVISION SUBJECT: DRAINAGE -AT 718 ALDER Prior to final approval,' we:require the following: .1. Tie..downspouts to tightline(s): a., At northeast corner of building. b. At south side of entry. 2. Outfall all downspout tightlines to'either: a. -Creek, using rip -rap at outlet, i creek is on subject property; or b. Rip -rap pile to act as energy dissipator and runoff spreader at low point on site An'southwest corner. 3.. Install"an ADS.1524'catch basin or equal, with oil separator tee .or 900 bend in line from driveway basin. We suggest installation at west :side of driveway. BF:gdl CITY OF EDMONDS ' w.AS INFORMATION SHEET ❑ NEW STREET FILE ASSET N0. ❑ ADDITION ADDITION TO ASSET NO. ❑ RETIREMENT DESCRIPTION SERIAL NO. LOCATION DEPT. NO. *PURCHASE ORDER NO. _ PURCHASE.ORDER DATE COST *PROJECT NUMBER cij PROJECT COMPLETION DATE COST o p B.A.R.S. ACCOUNT NO.�.- ESTIMATED LIFE a � INITIATED BY DATE APPROVED BY "SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST *SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT ACCOUNTING ONLY a DEPRECIATE MONTHLY DEPRECIATION AMOUNT ANNUAL DEPRECIATION AMOUNT _ G.L. ENTRY REFERENCE VERIFIED BY PROCESSED BATCH NO. I �.:•. DATE::=' 1�411 INITIAL by __ __ DEPARTMENT_ FILE ,! ♦M1 •FILE C0O STREET FILE May 5 ,'19 81 MEMO TO: Planning Division FROM: John B. Mitchell Acting.Public Works Director SUBJECT: APPLICATION FOR STREET USE PERMIT/718 ALDER ST. Prior to the issuance of this permit, the following is required: 1) Have applicant submit plan showing proposed location of dumpster and baricades. We will require lighted barricades on both sides of the dumpster and to in- dicate approximately 40 feet of No Parking on the opposite sides of the street; - 2) Approval of the Engineering Division of the location and barricade plan and receipt of the required in- surance documents. Upon compliance with the above, the application will be approved. JOHN B. MITCHELL JEA/jf J.E. Adams dt 01 CITY OF EDMONDS, PU$LIC WORKS DEPAR NT `t 200 DAYTON STREET , EDMONDS, WA • 98020 775-2525 APPLICATION FOR STREET USE PERMIT Name of Applicant: ,q, / E9RA Mailing Address: S/ �%E fr aYTOA/ ��y �D�� o�✓OS , �/f� ri f'o 2 D Telephone Number: 7r2/ - Date: 1-11 olg/ Description of Public Place or Portion thereof desired to be used: (exhibit may be attached) ET,`�FFT /N ff 0"7- OF NEIV C0NS7ieUC7-/0n) Siif '7/8 �LDE e Y7/?CC7— Type of Use desired to be made of Public Place: Z5- Y�4,?O To 6C Q,IACF NFx T TO CUFl/� F®R �EPos/T%yG o.5 �'o�yS7�G'�Ti�nJ wAST F If applicable, attach plans and specifications for any utility or structure to be erected and/or maintained on the Public Place: /v 0-vc= 1MPORARY PERMIT: Unless otherwise designated herein, this permit is understood by ,applicant to e wholly of a temporary nature, that it vests no permanent right whatsoever. If the permitted use becomes dangerous or such structure shall become insecure or unsafe, or shall not be constructed, maintained or used in accordance with the provisions of this title, the same may be revoked and the structure and obstructions ordered removed by order of the City Engineer. If this application is for a specified period of time, the terms of said application is: ?o, To 'o 0,4ys INDEMNITY: 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 descr'p- tion whatsoever, foreseen or unforeseen, that may be made against the applicant or the City .of Edmonds, or any of its departments or employees, includinq but not limited to the defense :of any legal proceedings including defense costs, court costs, and attorney fees by reason ,of granting this permit. In addition, applicant understands that the City shall be provided a certificate of insurance to indemnify and hold the City of Edmonds harmless from all claims and/or property damage, naming the City of Edmonds as an also insured. APPLICATION OF CHAPTER 6.40 OF THE EDMONDS CITY CODE: Applicant warrants that he has read, or had the opportunity to read, Chapter 6.40 o t e Edmonds City Code, attached herewith, and understands that all terms of that Ordinance are incorporated herein as if set forth in full and this application and permit therefore are subject to the terms of that Chapter of the Edmonds City Code. I 11/7/74 rev. � S ll�v. a r .yic.ri•�G Applicant s Signature y ,0If-?I Dt to City of Edmonds , pub 1 i c Wo Dept AP . APPLICATION FOR STREET USE PE� -- Page 2 Approval (and Agrepment, if applicable) of Abutting Property Owners: Signature Printed Name Address Date IPxy l r/ if,4 27 i N G S� l✓EST Y/A�7Un/ ��/�v/ !i� DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency) City Council Approval (Attach Minute Entry): Permit Fee: Annual Fee: due January 1, 19 Amenities Design Board Approval (if applicable) Attach Minute Entry: Building Official Approval (if applicable): Signature Date Provision for Indemnity: Terms and Provision of Performance Bond, if applicable: (Reference 6.40.050 of applicable Ordinance) PERMIT AUTHORIZATION BY P.W. DIRECTOR: Signature Date PERMIT NO. Remarks: 11/7/74 rev. DATE PUBLIC WORKS DEPARTMENT CHEamisT BUILDING PERMIT REVIEW 7/ b ,one S- A/ b (address) � to 0 Street Right -of -Way Existing REQD HAccess Easements Existing � Lev *4 REQD a Utility Easement : Exis.ting w ... Lot -Per. Subdivision„ `Plat Assessor Map w Site. Plan_ Checked . for,•.Acc-ura low _ .. z Underground Wiring Regd. H Check Accuracy of 'o.z Review by r,0Z,4V1 Date ' -, w Existing Water Main Size �C /, Water Main Required Service Line Required 3 '� Hydrant Size Existing � c� Hydrant Reqd Per Fire Code Size w Detector Check Meter Reqd. H Cross Connection Inspection Fire Department Comments �. Water Meter Charge Regd. 6 5'D,. °� "� ' 00� Review by Date Zvi Septic Tank Design Approved Date Septic Tank Permit Reqd. Permit No. Sanitary Sewer Availability WeS Proj . 11D Drawing No. File No. P4 Side Sewer Availability w Sanitary Sewer Co ctio e F .Regd. -�- 3 Review by ,gym, Date Open Ditch Existing Regd. Culvert Reqd.4;1- c4 Catch Basin Reqd. Indicate !1n Site Plan O Shoulder drainage maintain collection an swale open runoff H (n Wnhole`/reqd.� Indicate an Site Plan �---- Soil Conditions and Ground Water Field Checked Review by� Date / G Revised: 1v10-1977 Page,,2 Street Paving Regd.. H Curb and Gutter Reqd. W Sidewalk Reqd.elfta W Curb Cut for Driveway Regd. 9 w Right -of -Way Construction?rmit Reqd. Lax_ &.40iowe F, Bond Reqd. for Public Improvements Street Name Sign Reqd. cn Other Signing Reqd. A Pre Permit Site Inspection -made on z ,-4 off BY: SEWER H .. W W WATER w STREET _ ENGINEERING Special Requirements listed in memo to--Cotmnmity Development Department, Building Division BY Date o All items •filled. in- on _Building Permit Application P4 BY Date ' Drawings Stairp.ed and Notations Made w BY Date Approved by Public Works Department Revised: lv 10-1977 . a ,4..,.. „-� y. `�t,.dy',t •t .:•i{��.. � � �1v RIGHT-O&W. �' ityr 0f vll' Monds rl PermitNo: 2005 n1 If Y CONSTRUCTION PERMIT Issue Date: A. Address or Vicinity of Constton` (1 Z B. -Type of Work (be specific): t6, C. Contractor:_ YY1 kA\ Y-N \ o01 �P YI e '7 I \41 da r Sf o a,►.� Joao b- 10 -7 a a 5O ss' - Contact: SAk C.IL 4 ` Mailing Address:,) 353a S. byLe V*ty Phone: ox'(n" `'11 D " `701J� State License #:A �I✓ t-t� Liability Insurance: Bond: $ City Business License #:• D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project ❑ EUC (PUD, VERIZON, PSE, COMCAST, OVWSD) ❑ ;Multi -Family ❑ Single Fa ly Other INSPECTOR: F. PAVEMENT CUT- X YES ❑ NO G. SIZE OF CUT j� X CONCRETE CUT: . ❑ YES ❑ NO ;:---G. ❑ Mail Approved Permit ❑ Call for Pickup APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands by his/her signature to this application he/she 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 attorney fees by, -.reason of granting 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 COMPILETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. ♦ 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) 296-1557305 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 ttie••workday1—/NO EXCEPTIONS - !A ♦ Three sets of construction drawings of roposed wo'r-k'are'required(v6i&tl a peVi"pplication. N. 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 OFTHE APERMIT AVAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS Signature: �(�(,n �A..e��Q Date: ) U ' / • O :.(Coniractor'or Agent) Approved by: Time Authorized-! V Speci,aI Conditions:., oid After:._ erg 1IL .L I ' J , /�//�/f/�[4 FO CITY USE ONLV' Rlght of way Fee 5 - . IDNruptlon Fee/F;bnd.l'Il:: Inspectlon�Fee.2l�,5[?.;�_�,�l�D� / ' ' Q J. Receipt No +---`^ Issued byef W�AA XW-taaz� REQUIRED INSPECTIONS: / in Call.425-771-0220, Ext. 1326 for a 24-hour voice -recorded inspection request line. II FINAL APPROVAL OF PERMITTED WORK: AA DATE: — Inspects Signature NO WORK SHALL BEGIN PRIOR PERMIT ODocuments and SettingsTurtisNy Documents\Forms\Engnmg\ROWpermit_ doc Revised 10/01/03 Pllchuck'Contrbctors, Inca Job #IM b_JI o�C Date i Sheet 1 of 1 NAME 1&' 14 av3HV HaoM avow , 0113W am X s WORK AREA • APPRUVED AS NOTED ,ZBYLENGIJNERING r Data:„ t- CHANNELR/UION DEVICE SPACING MPH TAPER TANGENT 50/70 40 80 45 30 60 30 20 Notes: 1. All signs and spacing to conform to MUTCD & City of MMMA Traffic Control specs. 2. Channellzing 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. Two flaggers will control aBemating one lane traffic. 1 7. Work area will be XG of C/L of -Adw & 0,52gof C/L of SPEED LIMB SIGN SPACING MPH "x" 45+ 500' 35 350' 30 200' 25 100, (15(r seatfle) (200' SeaTac) ROAD' WORK AHEAD • 28" TRAFRC CONE ® WORKAREA .� TRAFRC FLOW TtFLAGGER - WORK VEHICLE SIGN LO MON w R/W L IP GAS FLOW 2" PE IP 20'S 893-096 i PROP. 2" MPE IP MAIN..... ............ TIE— IN. FUSE 20'S C/L 2" MPE IP MAIN (___')S C/L 20'S C/L & 235-W C/L (---' )S C/L & (---' )W C/L 721 t� N M ALDER S EOM, 2" MPE CAP . .......... 20'S C/L & . 265'W C/L (--- ')S C/L & ( --- ')W C/L r � I 60' 3 60' R/W — — --�-3— — — R/W 2" PE IP 20'S 2" PE IP 20'S IP GAS FLOW 2" PE IP 20'S 912-932 890-111 .— 883-405 `RXW ;1. r, PL 0 T PLAN SCALE: I — 50 FITTER (CHECK BOX IF COMPLETE) Work area left in Clean & Safe condition Complete all Pipe Tables and Gas Pressure 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 Radius Foreman's Signature Company PILCHUCK Date E g STANDARD GAS CONSTRUCTION NOTES: 1. FIELD LOCATE ALL UNDERGROUND UTILITIES. EXCAVATOR TO CALL "ONE —CALL" TWO WORKING DAYS PRIOR TO TO CONSTRUCTION, 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 REQURRMENTS). 3. ALL CONSTRUCTION IS TO CONFORM TO PSE GAS OPERATING STANDARDS AND GAS FIELD PROCEDURES. 4. 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. 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 2550.1600. 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 REPORT" ON ALL METALIC PSE FACILITIES. CHECK BOX ON REPORT FOR WIRE BOX (TEST LEAD) INSTALLATION. B. 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 ACCESSIBLE, 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: ISYSTEM MAOP - AL PSIG 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 OPER kTING 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 NTH CP TECH. -------- -- -- PHONE— --- -- 17. NOTE ALL ACTUAL FOOTAGE, LOCATION AND MATERIAL CHANGES ON THE AS —BUILT IN RED. DENOTES FOOTAGE BETWEEN FITTINGS. GAS MAIN INSTALLATION/RETIREMENT Type/Work Pipe Size Type Estimated Length Actual Length Manufacturer INSTALL 2" MPE IP 30' CAS 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 Desi n Press 60 SYS MAOP 45 PROJECT PHASE NOTIF# ORDER# a O SAP Superior Service/Meter Service/Meter Servlce/Meter Service/Meter Ind. Service Ind. MSA Dis. Reg. / FT HP Svc/MSA Relocate Retirement X208807409 107025055 X208808109 106161457 Contractor: CONSTRUCTION COST CODES: 051.103.1 Project Manager Contact Information: KIM GRAY CELL: 425-290-2678 EMAIL: kim.GRAY@pse.com REV# DATE BY DESCRIPTION 3 2 1 COUNTY EMER SECT SNOHOMISH 4 1/4 SEC OP MAP SW-24-27-03 160.062 Vicinity Map WORK SITE E►ELL! T PLE CD ......- .... ........ ... V -•,.:.. . :•..� ' O ..... ........... .............. .......... .... IV. f l-)J ►�I AL O .+. .. .................................. 3 .IF.....: . CEUA :........................................... J �....... F L;... ................. 1p , r .:. ItAL).} . ...:...... ei :•' he., z.�. -. � i.-E .:................................ i- R+, 9MA'fyfMML9 a none uwo Owner/ Developer Contact Info JEFF & DEBORAH BOYER 718 ALDER ST. EDMONDS, WA 98020 ATTN: JEFF & DEBORAH 425-670-1687 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 CITY OF EDMONDS FUNCTION CONTACT PHONE I DATE PROJECT MGR KIM GRAY 206-418-4233 110 1 (a6 ENGR-GAS DRAWN BY AARON HEATH CHECKED BY EUGENE BROWN GAS WK CTR APPROVED BY me, M .54 CP APPROVAL PLAT MAP 163.066 MAPPING JOINT FACILITIES ARRANGEMENTS UTILITIES CONTACT PHONE# PUGET BOYER SOUND 2" MPE IP MAIN EXTENSION ENERGY 718 ALDER ST EDMONDS, WA 98020 DESIGNED BY PILCHUCK CONTRACTORS INC. N/A 253-841-6245 10/12/05 253-841-6271 10/14/05 206-418-4233 ,P Superior 107025055 r: SCALE: PAGE 1" = 50' 1 1/1 .F.! t STREET FILE _ GENERAL POOL SPECIFICATIONS POOL SIZE: 2.8 DEPTH: 14 TO ,{, -p SURFACE AREA: SO. FT. PERIMETER POOL CAPACITY . J �} GALS. FILTER 59 (4 MOTOR H.P. TURNOVER HRS. SKIMMER —MODEL SW4v„rr j ul J !!•. SKIMMER LINE Z MAIN DRAIN LINE RETURN LINE I ti BACKWASH TO (F.t + c.r/, LIGHT D9 a TIME CLOCK HEATER BOARD -SIZE Q BOARD SUPPORTS LADDER 5t J6 POOL CLEANER ROPERINGS .:_ pyt`� -W/ PI8FLOATS GRADING tt ✓' TREES/STUMPS FENCE REMOVAL -REPLACEMENT TILE COLOR POOL'DECKS BY it-G l : ►L S0. FT: $; COPING Cl� CANTILEVER O OTHER {j F a v %C 13AS LINE - _!ELECTRICAL SgLa..er 6J PACIFIC POOLS,- I�Cv 13300 SE 30TH BELLEVUE, WA 98005 (206) 747-7770 (206) 623-8374 CONTRACTOR 4223-02-PA-CI-FP-372NO PLAN APPROVAL Signature indicates owners approval of pool and equipment.loca- tions and all accessories listed hereon OWNER(S): �Y.' I' ; J Ste4.Cbr� SALESMAN: +-�^�= DATE: NAME: ! /1;� . u bd 25 eWarl_ ADDRESS: CROSS STREETS RES. 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