106321664 Pre-Inspect Form.pdfJob #:
106321664
Date:
3/22/17
Jurisdiction:
Edmonds
Right of Way Permit?
❑� YES ❑ NO
Est. Start Date:
05/15/17
Est. Duration:
8 Hours
PRE -INSPECTION REPORT ®PUGETSOUND ENERGY
Address: 20304 87TH AVE W
City / Zip: EDMONDS 98026
Customer: CYNTHINA MARKER 425-582-1981
CUST PHONE NUMBER
PM / Insp: Kiara Hays 425-213-9205
PHONE NUMBER
Construction Method
WORK DESCRIPTION:
Open Trench ❑
INSTALL 45' OF1-1/8"PESCATSTUBAND 30' OF1-1/8"PESCATEXT. SETA250OIL.
Trenchless ❑
PLAT MAP:
W CL S
202ND
G
ST SW
(= Fire Hydrant (70' from tie in)
O= Sewer Manhole
= Tree
i
PL
i I
O
' ID
I
N
D
r
LJJ
�
M
- a
o
_
N
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I00
FROM S PL SEWER
EXTENDS INTO LOT
I
S_________
_
__r
4—
PL
PL
■
G
W CL
S
Work Location
Size of Cut
Surface Type
f CL 202ND ST SW
&_3 'E
of CL 87TH AVE W
3X5
SOFT SURFACE
420
S f CL 202ND ST SW
& 4 W
f CL 87TH AVE—W
2X4
ASPHALT
'N S of CL
& 'E W of CL
❑ FLAGGERS # MPH
❑
TROLLY LINES
❑ BUS STOP #
❑ METER HOODS #
❑ OFFICERS # SPEED LIMIT
❑
TRAFFIC SIGNAL
❑ ARTERIAL
❑ NO PARKS #
❑ Commercial ❑ Altered Commercial
❑
Leak Repair
Service Information
❑ Template Bar
0 Residential ❑ Altered Residential
❑
CP Work
Diameter Meter
EFV ❑
Bollards 2.5" #
❑Multi -Family
y ❑ Replacement Service
❑
Pothole
❑ 5/8" 0 250
❑ 1800
❑Bollards 4" #
❑ New Constr. ❑ Main Maintenance
❑
Extension
11/8" ❑ 425
❑ 2600
❑� Stub ❑ Service Maintenance
❑ 11/4" ❑ 630
❑ 10,000 ❑ FUEL LINE PERMIT NEEDED
❑. Extension ❑ valve Maintenance
❑ 2" ❑ 1000
Fuel Line Length:
❑ Compete Sery ❑ Cut & Cap
Mtr Loc: O/L
Fuel Line Diameter: