Resub rec'd 10.21.19.PDFJob #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date:
Est. Duration:
106358372
7/9119
Edmonds
Yes
9/23/19
1 Day (8 Hours)
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector
8503 216TH ST SW
EDMONDS, 98026
ANGELINA JANZEN 425-293-2585
Kiara Crofts 425-213-9205
Job Description / Scope of Work
INSTALL 42' OF 1-1/8" PE SCAT STUB AND 60' OF 1-1/8" PE SCAT EXT. SET A250 MSA O/L.
New Construction:
0
Construction Method
All Scat / Trenchless
PLAT Map: 164.068
S
— — — —
I
= Sewer
I
I
= Water
= Gas
8503
I
— — — = Storm
0 = Catch Basin
I
O = Fire Hydrant
I
216TH ST SW
PL
PL
oc
CL. . _ . _
. _ . _ . _ . _ . .
• . — — • — • — • — • —
• £L
,Ln
S�/
ws- — — — —
— — — — — — — —
— — — — — — — — — — — —S
G
SIDEWALK O
G
PL
— PL
2"STWIPI7'S
5738-1963
FIRE HYDRANT 75' E OF
J
J
d
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=
Ln
00
00
Work
Location
Size of Cut
Surface Type
110'
East
of CL
85TH PL W
&
17'
South
of CL
216TH ST SW
4X8
Asphalt
of CL
&
of CL
of CL
&
of CL
Service Information
Street Information
Job Type
Diameter:
1-1/8" PE
Flaggers #:
Arterial:
New Residential Svc
EFV:
1-1/8" - 2600 - 9999144
Police #:
TCP:
Tie -In Fitting
Meter:
A250
Speed Limit:
No Parks #:
Meter Loc:
03 - OL
Trolley Lines:
Mtr Hoods #:
Del Press:
6" W.C.
Traffic Signal:
Bus Stop:
Bollards:
2.5" #
4" #
I
I ADA Ramps #:I
Route #'s: