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1313 OLYMPIC AVE.PDF1313 OLYMPIC AVE PROJECT REVIEW CHECKLIST PROJECT NAME:ANe)kQ-L0 /'r(. ,,TIA) CO PLAN CHECK #: PROJECT ADDRESS: 13/3 04�- Ic- ff RECEIPT DATE: Setbacks/Variance/Setback Adjustment Conditional Use Permit ADB Requirements Other Zoning Requirements Underground Wiring Required Lot Slope 15% SEPA Environmental Checklist/Hydraulics Permit Tree Cutting Plan Plat/Subdivision Requirements Legal Description Verification Quit Claim/Street Dedications Easements - Public/Private Engineering Storm Drain Review Fee Engineering 2.2 Inspection Fee Drainage Plan On -Site Setback - Top of Bank, Stream, Water Courses Setback - Storm Drain Line Open Ditch - Existing Culvert Required Culvert Size Shoulder Drainage/Shale Open Runoff Catch Basin Required Driveway Slope & Vehicle Access , ,dA Sidewalk Required Curb & Gutter Required Curb Cut For Driveway Required Street Paving Required Right -Of -Way Construction Permit Required Street Name Sign Required Other Signing Required Bond Required For Public Improvements FEMA Map Check/Water Table Side Sewer Availability _ Calculate Sewer Connection Fee If No LID #22 Create Street File Existing Water Mgin Size Water Meter Size Service Line Size Water Meter Charge Required '�(j---- Hydrant Required Hydrant Size Existing Fire Line Charge Required - Sprinkler Street Cut Miscellaneous Reviewed By: FIRE PLANNING W* V v ENGINEERING PU LIC WORKS .".."� "SSP t, � H— c�►-,� � p � �cc„ N F- U G F- O U M O U W 0: N a W ~ W LL 1„ U W D W W F- tn = Q (n to [] W f- W F- 0 1 io Q �7CJ W or W W Q, d W F- 3 N W cll� N E .--� N co d' to t0 n OOO� O T to t0 f\ coQti O N N N N N N N N N M M M M M M M M M M W W F- H Q Q im m w F- F- d d W W U U W W 64 Q Q d d d' Ln t0 F-, 00 M O ri N M d' .to .t0_ .tom. 00.01. . O " " -1 1-1 -1 .-- i 1" .-i N 1-4N -'�'�.2�-s+'"�*4 �� ',artluµ•1p,v , f ,, .: � L'�(i�`��VtY' "'n�" �rKr�:y.�1 '� City sof. Edmonds ' RIGHT-OF-WAY ,CONSTRUCTION PERMIT:g� Permit Number. 14 ��. Issue Date: 890 199- A. Address or Vicinity of Construction: 1313 Olympic Av x+(9701093) a B. Type of Work (be specific): Install Service C. Contractor: Washington Natural Gas Mailing Address: 1179 75 St SI1 FvPrPtt State License #: 98203 D. Building Permit # (if applicable): Contact: Mariamne Kingsbury Phone: 156-75nA 77596 Liability Insurance: Bond: $ Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project a Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other INSPECTOR: INSPECTOR: RW F. Pavement or Concrete Cut : ® Yes ❑No G'. Size of Cut:( x H. Charge $ APPLICANT TO READ_ANI INDEMNITY. Applicant understands and by his signature to this application, agrees to hold 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 or 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 COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. 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 the permit will be available onsit at all times for inspection purposes. Signature: Date: 10-16-96 170Agntrac r or en ) CALL DIAL -A -DIG. PRIOR TO BEGINNING WORK FORCITY UBE�QNLY (�W ' ,�� RIGHT OF WAY DEPOSIT APPROVED BY: z f, Jill NO WORK SHALL BEGIN PRIOR TO PERMIT SUANCE Eng. Div. 1994 FIELD INSPECTION NOTES Comments Di_ (Fund 111 - Route copy to Street Dept.) CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: - M NaturNGw A V*4*Vk)n Ener9Y CUT"V' Y I Addendum to: City of Edmonds Right of Way permit Application Submitted by: Mariamne Kingsbury Engineering Aide Washington Natural Gas 1356-7500 %7596 i 010 IV 'D ref OL I� V 2 7, J Job qqo I OR 3 OL -YM P► c- V Watermain depth v3o'T P J2 Z- gas main Key: -W- Water -G- Gas -SS- Sever -. ' Water hydrant p Water valve Washington Natural Gas Company 1122 75th Street S.W., Everett, Washington 98243, (206) 355-3331 °N E City of Edmonds RIGHT-OF-WAY CONSTRUCTION PERMIT Permit Number. 9� - Issue Date: A. Address or Vicinity of Construction: 1313 Olympic Ave specific): GTE top ace, operate, an ma nt n a buried service B. Type of Work (be wi re f rom exi sti n pedestal #9946 at 1312 Ol m i c Ave 18 9 0- 19 then east to a residence a ymp cAve. o plow ee an push one road 29 feet. Please see attachhed sketch. Mary A. Bower, Permit Coordinator C. Contractor: GTE Northwest Incorporated Contact: Dennis Alexander 771-9036 mobile 388-1358 W. Casino ltd Mailing Address: Everett,Wa 98204-1440 Phone: Mary 206/4RR-1628 or 710-4130 .State License #: Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): F. Pavement or Concrete Cut: ❑ Yes MNo G. Size of Cut:x H. Charge $ Please see attached sketch. APPLICANT TO READ AN GN to— 0,C.� INDEMNITY: Applicant understands and by his signature to this application, agrees to hold 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 or not limited to the defense of any legalproceedings including defense costs, and attorney fees by reason of granting thispermit. 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. 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 the permit will be available on site at all times for inspection purposes. TIME AUTHORIZED: VOID AFTER tS DISRUPT ION' FEE/FUND 11'1: m E. ❑ Commercial ❑ Multi -Family INSPECTOR: ❑ Subdivision ❑ Single Family ❑ City Project ❑ Other INSPECTOR: ® Utility, (PUD, GTE, WNG, CABLE, WATER) 2100-9130010 242310 Wl%;• ,J. F. Pavement or Concrete Cut: ❑ Yes MNo G. Size of Cut:x H. Charge $ Please see attached sketch. APPLICANT TO READ AN GN to— 0,C.� INDEMNITY: Applicant understands and by his signature to this application, agrees to hold 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 or not limited to the defense of any legalproceedings including defense costs, and attorney fees by reason of granting thispermit. 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. 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 the permit will be available on site at all times for inspection purposes. TIME AUTHORIZED: VOID AFTER tS DISRUPT ION' FEE/FUND 11'1: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994 m RESTORATION FEE ' PERMIT FEE TOTAL ,V _ RECEIP,T FEE: `. ;ISSUED BYc° - NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994 FIELD INSPECTION NOTES Comments• Diagram; (Fund 111 - Route copy to Street Dept.) CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Vl VIM PUSH ; SAS 7 w zt 7 LA In rn 0 !A COO SSL 'ON 41= k C G 0 C.). < 0 pig .-IiCR,orno CA n z 100 M-CoAoffl 2-OCCA io I. !r=tl:130 96/40/0T