Resub rec'd 10.2.19.pdfJob #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
106357674
7/26/19
EDMONDS
Yes
10/14/19
1 Day (8 Hours)
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector:
704 13TH WAY SW
EDMONDS, 98020
LISA FERRENDELLI 425-802-4053
Kevin Williams 425-691-7573
Job Description / Scope of Work
From 2" PE main run new complete service to single family home(36' scat stub with 64' scat
New Construction:
extension) Set A-250 OL @ Inches
-POT HOLE TO VERIFY WATER SERVICES
Construction Method
LOCATION NEER CROSSING WATER
MAIN-
All Scat / Trenchless
PLAT Map: 165.066
t
N
84 N 8 N 5/8" l\APE
5/8" 1vIPE
2000
2000
J 719
o
w 8
M N
721
0
LUCL_ o
707
o
N
P
-I
I�
M.
R wso' 13th Way SW
2' MPE IP 22'N r
Poly Water lines
I �� _ _ _
— — — —
pot -hole to verify
/ — —
� _ _ _ _ _ _ Power
— — _ Water
any crossing
_
3 Watef ' - — — —_ _ _
Services I
_ _ — -
Sewer
I
p New Asphalt
—
0
ti
A-250
1-1/8" PE
.r
R
0-
708
I
Work
Location
Size of Cut
Surface Type
22'
N
of CL
13th Way SW
&
279'
W
of CL
7th PL S
3x5
Dirt/Asphalt
5'
N
of CL
13th Way SW
&
284'
W
of CL
7th PL S
3x4
Asphalt
1'
S
of CL
13th Way SW
&
284'
W
of CL
7th PL S
2x2
Asphalt
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
Arterial:
New Residential Svc
EFV:
1-1/8" - 2600 - 9999144
Police #:
TCP:
Yes
Tie -In Fitting
Meter:
A250
Speed Limit:
25
No Parks #:
Yes
Meter Loc:
03 - OL
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
0
Bollards:
2.5" #
4" #
ADA Ramps #:
Route #'s: