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15046
17907 75TH PL W
ADDRESS: t -] 40^Z
M
TAX ACCOUNT/PARCEL NUMBER: e�b Z/ 7-3 % M19 607 X Q
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS(RECORDED)FOR:
CRITICAL AREAS: tii� ' / T.' DETERMINATION: ❑ Conditional Waiver ❑ Study Required Waiver
DISCRETIONARY PERMIT #'
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DA
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DA
OTHER:
LID
LOT: BLOCK:
LATEMP\DSTs\Forms\Street File Checklist.doc
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City. of Edmonds PEST No: 9870
PERMIT EXPIRES
SIDE SEWER PERMIT_ L!/
Address of Construction:
Property Tax Account Parcel No. 00 4-770 0011 0 "Z-7 • 00 0 I
Attach copies of all access and utility easements /1/ Verified and Approved by
Owner and/or Contractor: !
Contractor License #:S1 L\IE- S0 ::�N 0�, 14 Building Permit #: ®Y'"
Single Family Invasion into City *Right -of Way: ❑ Yes K No ,
❑ Multi -Family (No. of Units *RW Construction Permit #
❑ Commercial (No. of Units ) Cross other *.*Private Property: ❑ Yes ❑ No
❑ Public **Attach .legal description and copy of recorded easement.
78
Owner/Contractor
"Z
Owner or con ractor s'�IatAkNacknowledgement statement: Date
By signing for this perI ceat I have read the City's public handout entitled
ide Sewer Specifications, and shall comply with all City requirements outlined therein.
9 CALL DIAL -A -DIG (1-800-42;�5555) BEFORE ANY EXCAVATION 2
2 FOR INSPECTION CALL 425-771-0220 extension 13
24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REQUESTS
FOR OFFICE USE ONLY.
Permit Fee $ Repair Fee �'�° Issued By:4�k4&4
Trunk Charge $ %ei— Date Issued:
Assessment Fee $ 2714A Receipt No:
City Permit Surcharge Fee $ 00 Total Fees Paid $ �75
NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED.
Job Site Ready YES NO Date: Initial:
Partial Inspection: Date: N1464 Initial:
Partial Inspection: 'IDate: Initial:
FINAL INSPECTION APPROVED: Date: 2 d Initial: tT As -built to Street File: ❑
`- PERMIT MUST BE POSTED ON JOB SITE t-
White Copy: File ,Green Copy: Inspector. Buff Copy: Applicant
L;temp;bldg;fornns;sspennitj l g4/00
M.H. #7
M.H. #8
n _�_ . 2.5'
0
C.O.
4' DEEP 4 pL/C
�Q A\ �r-3.51' .
M.H.. #1
A.
10' ESMT.-Z/"*N
>s
of ED* CITY OF EDMONDS SIDE SEWER AS —BUILT
d ADDRESS HOMEOWNER
17907 — 75th Place West
CONTRACTOR SCALE
Silver City Construction Inc. XTS
DATE DRAWN PERMIT
1890 8-26-04 BY K. Haney NO- 9870
TE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
It Iu MAILING ADDRESS
o %Q )�. 14 -1
CITY ZIP TELEPHONE
00av-t 2S 5u I
NAME
I�eS��tJS
ADDRESS-
ZIP CIT � D` 1 C�l • ``. �0�Ss TELEPHONE
NAME 2flJ, 817 #
ADDRESS
I
" PERMIT EXPIRES
sE �� PERMIT nn
ZONE a Jam) NUMBER ('SL/�`/�'
JOB SUITE/APT#
ADDRESS / 7q0 7 765-11 (A- - /
(✓V
PLAT NAME/SUBDIVISION NO.
LOT NO.
sles
LID NO.
LID FEE $
RIGHT OF WAY PER OFFICIAL STREET MAP
TESPUBLIC
RW Approved
Per: Required
Street Use Permit Req'd
EXISTING PROPOSED
Inspection Required
Sidewalk Required
REQUIRED DEDICATION FT
underground
Wiring required
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
"i
/1
T
)q
YESA NO 13
t7
Z
REMARKS
z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
ZZ�
9
C R \4 (vNi S I-T4 •) N r— -119 23t GINEERING REVIE B Li DATE
FIRE REVIEWED BY DATE w
a
U.
CITY p
TELEPHONE
VARIANCE OR CU
SHORELINE OR ADB#"
<
1 INSPECTION
( AE 'D
BOND
POSTED
STATE LICENSE NUMBER EXPI ATION DATE
`p
S I L v t C C V� 6 y
BY
SEPA REVIEW
COMPLETE EXE pT:
EXP
SIGN AREAL"
ALLOWED . 'PROPOSED
HEIGHT
ALLOWED PROPOSED
PROPERTY TAX ACCOUNT PARC4--,NO.
® NEW NJ RESIDENTIAL. %` PLUMBING/MECH,;•r
❑ ADDITION ❑ ,#COMMERCIAL COMPLIANCE OR�
CHANGE OF USE
❑ REMODEL ❑ : MULTIFAMILY ❑ SIGN
GRADING FENCE
❑ REPAIR ^ t CVDS ❑ ( X• FT)
❑ DEMOLISH ❑ TANK ❑ OTHER .'
GARAGE RETAINING WALL FIRE SPRINKLER ,
CARPORT ❑ • ROCKERY ❑ FIRE ALARM,'
LOT COVERAGE
ALLOWED PROPOSED
O� i (J` L O/O
/U (o [
REQUIRED SETBACKS (FflM
FRONIr,,,SIDE , REAR
�� A� r!Y [I�
' O ✓
`PROPOSED SETBACKS (FT.)
FRONT. UR SID, REA, D
!}tea CG z
YYY 7 r z
PARKING..
R 'D PR IDED l
LOT AREA
Q J f
%P NING REVIEWE -J Y DATE
��(
�'�,J� , �(!� /
REMARKS
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
CHECKED BY
n !
T�[>
TYPE OF CONSTRUCTION
CODE
OCCUPANT
GROUP
NUMBER
OF 2
STORIES
NUMBER OF
DWELLING.'
UNITS /
CRITICAL UV
AREAS j. ,
NUMBER /,''
SPECIAL INSPECTION AREA
REQUIRED �,YES'..
r
;''��...�i; '-�S�r,':. ^�
OCCUPANT
LOAD
DESCRIBE WORK TO BE DONE���.-�y_l,
REMARKS z
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REO'D 9
_. •: - s r -
VALUATION
,L��% f.v
$�7/'7 ,5
Description FEE Description FEE
Plan Check — State Surcharge /_5��
HEAT SOURCE l�j� ING % IL0 SLOPE % � 1" o/ I +JCO
G� l `T �1 BuildiriglTVermit City Surcharge
PLAN CHECK NO: o1i �n VESTE1.9 DI !I?lumbin Base Fee
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COMERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180 DAYS
PERMIT LIMIT. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE C17Y'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S GBICIFNSATIObLINSURANCE AND RCW 18.27.
DATE
Mechanical
Grading
Engr. Review
Engr. Inspection
Fire Review
Fire Inspection
Landscape Insp.
Recording Fee
CALL
FOR INSPECTION
(425)
771•-0220
Plan Chk. Deposit 1 75e
Receipt # 0007
Total Amt. Due
Receipt #
APPLICATION APPROVAL
This application is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
receipt is acknowledged in space provided.
'FICIALS-SIGNATURE DATE
BY
ATTRNTIONV EXT 1333
IT IS UNLAWFUL Td USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
ORIGINAL -FILE YELLOW -
PINK -OWNER GOLD-)
STREET F16E
84 -- - ----_ 122.02'
ZAVALES DESIGN ASSOCIAT
-
. 130r, ZDA P.O. BOX 55512 R�C�
SHORELINE, WA 98155 - , \ \
206-362-2992 APR4
ao - -- _______ ________ PERM ��R
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LOT- COVERAGE411
�� ?6 �p n "•, • .: / Sim O,,
LOT AREA= 14911 S.F.
HOUSE & DECKS= 2185 S.F.
4 COVERAGE:
N
/ppb p `r^�� 2185/14911= 14.6%
R q 'jp
IMPERVIOUS SURFACES
2
PLAN 27676 HOUSE & EAVES= 2411 S.F.
DRIVEWAY & WALKS= 751 S.F.
SITE PLAN TOTAL= 3162 S.F.
SCALE 1'=20'-011 -
��' LEGAL DESCRIPTION
HEIGHT CALCS. LOT 27 'rt
SEE ATTACHMENT n
STORM A=95.3' RIM=100' SILVER CITY
B=94.7' p
c=98.5' CONSTR. INC. =A
D=97.9'
AVE. GR.: 386.4 /4=96.6' PO. BOX 1417 m >
MAX. HT.: 96.6'+25'=121.6' MUKILTEO, WA 98275 m m
ACTUAL HT.: 121.6' (206) 501-5490 z o
m
212- 4
ZONE
SETIMCK&
FRONT YS
SIDE lot
REAR
OTHER
HEIGHT �` S
m
E� ►Nc .3
t 84
ao--- ----__ -
---------� WATEIk & SEWER\ \
q— — g — _ _ _ _ _ _ INS� 2— ECTIONS`f EQ'D.
CALL-425-77,1,0220 EXT. 13$q
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LOT COVERAGE
A oz LOT AREA- 14911 S.F.
Q' 4it
-
HOUSE & DE- 185 S.F.
, , COVERAGE: C
v `/per 21855/14911= 14.6%
VLIMPERVIOUS SURFACES
HOUSE & EAVES= 2411.S.F.
DRIVEWAY & WALKS= 751 S.F.
i
SITE PLAN -
TOTAL- 3162 S.F.
SCALE 120'-0 "" �..... APPROVED AS NOTED
. 3� :.. f ... • . .. ..---
BY ENGINEERI. IG
I'RIGHT-OF-WAY CONSTRUCTION P
AND INSPECTION REQUIRE "� (T (�. 12064
Date: ®..�
STORM - bA CEPTNBLE TIGHTLINE
RiM=loo' FOOTING DRAI TIED INTO T MATERIAL
TO BE SDR 35.
DETENTION SYSTEM SCH 40 r��u A,
s N -12 RECEIVED
•,/o;.. - RANCOR STREET- JUL 13 2004
-�IL BUILDING DEPARTMENT
-�i� CITY OF EDMONDS
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STANDARADRAINAGE DETENTI& SYSTEM
WORKSHEET
QWNER CALL BY:
�.1 � �`
ADDRESS HONE:
DATE:
*****DESIGN DATA*****
IMPERVIOUS AREA PIPE DIA PIPE LG ORIFICE
/900 d 24"
DETENTION PIPE LENGTH LOCKING LID
(TYPICAL)
FINISHED
' MINIMUM
TIGHTL L'msEASURED FRO TOP OF
ONC BOX OR RISER
.SX TO 1% SLOPE
OUTLET CONTROL
MIN.
UPPER CATCH BASIN ORIFICE
CONTROL CATCH BASIN
SYSTEM CROSS SECTION
2'X2'X6' DEEP, 4-6' SPALLS OR EQUAL �.
L.
FROM CONTROL CH 2'X 21 3' DEEP, 3/4' CRUSHED ROCK xISTING GRADE
f
FROM CONTROL OUTLET .VASHEDFR�OCK ,
�R�N�
PERF Pl E TO BE EVEI
I--L= -� PERVCAPS
POHTOLCNOUNEMRAIN ROCK
RPRAP OUTLET
RUNOFF SPREADER. TRENCH
FOOTING DRAINS .SHALL NOT -BE CONNECTED W DETENTION SYSTEM
NOTES:
,
1. Call Engineering Division (771-0220) for a tightline and detention system inspection
APPROVED BY
before backfilling and for final inspections'
2, Responsibility for operation and maintenance of drainage systems on private property is the
naponsibility of the property owner. Material accumulated in.the.storage pipe must be flushed
DATE
out and removed from the catch basins to allow proper operation. The outlet control orifice
must be kept open at all times.
Impermeable
Area Sq. Ft.
2000
2500
3000
3500
4000
4500
5000
Table 1 — Detention Pipe Sizes
Required
Vol Cu Ft .
50
62
75
87
100
112
125
Note: Allowable Pipe Materials:
Impermeable
Area Sa. Ft.
2000
2500
3000
3500
4000
4500
5000
Pipe Diameter
15' 18' 24" 30"
40
28
16
10
50
35
20
13
60
42
24
15 Required pipe
70
-49
-28
-18 - length in feet
80
56
32
21
90
63
36
23
100
70
40
25
Reinforced Concrete
Aluminized Steel
Aluminum
CMP Asphalt Coated
N-12 ADS (Not permitted on roads)
Table 2 — Outlet Orifice Sizes
Outlet Orifice Diameter (Inches
5/8
5/8
3/4
3/4
7/8
7/8
7/8
Table 3 — Rectangular Catch Basin Requirements
Detention
Max. size
pipe diameter
knockout
< 18'
20"
18" to 24'
26'
24" to 36"
36'
36' to 42'
42"
*Source: Assoc. Sand
& Gravel Co. Standards
Catch Basin
Type
Type.l, CB 15
Type IL, CB 16
Type 11, CB 19 19. (48" Basin)
Type II, CB.19 19 (54' Basin)
5
Revised 3/16/95
12&'
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TEMPORARY CUNO''
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ENTRANCE REQUIR
STORM _
RIM=100'
APPR . ED AS NOTED
BY ENGIN �ERIN
�l c� 1200
PLAN 2767.E �.
SITE PLAN
SCALE 1 "=20'-0"
OWNER/CONTRACTOR IS RESPONSIBLE
`1 FOR EROSION CONTROL AND DAMAGE
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8101
18026
18027
18026
18027
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11
•
•� •• CA File No:
Critical. Areas Checklist
Site Information (soils'/topography/hydrolo /vegetation)
1. Site Address/Location:.. �!�j p �A-1
2. Property Tax Account Number;L 7 -T'� 31 �60 O-1, 1 bD o
3 Approximate Site Size (acres or square feet): /y 90 a s .�
4.. Is this site currently developed? — ,yes; no
If yes; how is site developed?
5. Describe the general,site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site. generally less than 15% (a vertical rise of 10-feet over a horizontal
distance of 66-feet).
Hilly: -.,:slopes, present on site of; more than 15% and less, than 30% (a vertical rise of 10-feet
over a,horizontal`distance of 33 to 66-feet).
Steep: grades of.greater' than 30°�6, present on site (a vertical rise of 10-feet over a horizontal
distance of less than 33-feet).
Other (please describe):
6. Site, contains areas "of: year-round standing water: / d ; Approx. Depth:
7. Site contains areas of seasonal standing water: D ; Approx. Depth:
What season(s) of the year?, /(
8. Site is in the floodway / y V floodplamn of a water course.
9. Site co twins a creek or anTare& where water flows across the grounds surface? Flows are year-round?
Flows are seasonal? (What time of year? ).
10. Site isiprimarily: forested ;meadow ;shrubs ; mixed
urban{landscaped (lawn;,shrubs etc): —
11. Obvious wetland is present on site: D/
_ For City Staff Use Only_,
1. Plan Check Number; applicable? 7,1
2. Site is Zoned? - - . , _ �� e- P -h etJ
3. SCS mapped soil type(s)? DI* Zvi of c
0
4. Critical Areas inventory, or C.A. In p indicates Critical ea on site. �Gt�y�s i0
5. Site within designated earth subsidence landslide hazard area?
t
G!
DETERMINATION
STUD_ Y REQUIRED WAIVER
.- .IReviewed by-, Date:
Swims w t-ri-4 �p_-o s t ail P 1 AL, wi ram.
Critical Areas Checklist.dod4.22.2003 � � 1 � Co MPL_ 1, 4► /C = w t -FH FGDc. ! 9 .0S .
Uty orEdmonds, ,."
Development Services D a,+
ep en
Planning Division
Phone: 425.771.0220
Fax:- 7 425-.771.022
Ci:Rec.elvec
'Receilpt!#
-OrIU61 Arlea"s
�, C r i t i i 6 a 1, A r e' a" "s
.Date, Mailed.;ta
77
11 � !", 4,�
The Critical Areas Checklist contained on this form. -is to.. _A iioi3e—rty7�lo'wner,.'-6i`"h'it
Aeri.auth6fiz6d representative,
be filled out by any person preparing a Development must fill out the checklist. . ' T 7i and nut 'sigwan jdate + t so it
d:
Permit Application for the City of Edmonds prior. to",. to,'the City. Tlie- City will review the checklist, make a
his/her submittal of the application to the City. a t�t e
precursory' site visit, and make 'dej on*0 h
The purpose of the Checklist is to enable City staff'to pub4pqu0t,.steps:nec6ssary, to,,,qompiete, a development
determine whether any permitapplication. -
potential Critical Areas are,,or
may be, presedo:ri�the subject property. The infi6rmation Pleik submit jiciTty, map,!along th, signed copy
City'
needed to complete the Checklist should be easily of this form to assist� , staff in findingand `locatingthe
available from observations- of the site or data available at specific- 1piece ,.,of'p'r'operty,,rde'scribed- on this form, in
City' Hall . (Critical areas inventories, maps, or soil, addition,, the,- applicant shall ,x include other pertinent
surveys). information (e.g. site ,plan, : -topog I raphy map,4 etc.) or
-studies in conjunction with this,Checklist to assistant staff
in completing -their preliminary assessment of the site.
The -undersigned applicant, and his/her/its heirs, -and assigns,- in consideration on the procepsing,of the application agrees
i - '. ihcluding�lreasoiiable
to release, indemnify, defend and hold the Pity of Edmonds harmless, from, any. and alFdama damages,: ges,
attorneys fees, arising from any action or infraction, based in whole or part upon false,_ misleading, inaccurate or
nt, or employees:
incomplete information furnished by the applicant, his/he /itj! agents
By my signature, I certify that the information and exhibits herewith submitted- are true and'c"'orrect to the best of my
knowledge and that I am authorized to file this application on the behalf, of the owner, as listed below.
SIGNATURE OF APPLICANT/AGENT DATE
Property Owner's Authorization
By my signature: I der* that I have authorized the above Applicant/Agent to, apply forr the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to , enter the; subject property.- for the
purposes of inspection and g attendant to this ap, I �71on
SIGNATURE OF OWNEGL!!?, IaL /0'
PLEASE PRINT CLEARLY
Owner/Applicant:
Applica nt'Represefitative:
Name -'-
Street Address
Street Address'
City
State
zip
city: State zip
Telephone:
7 e,1 .5_ -
f
Telephone:
Email address ( (optional): 4 t'
op At,
Email Ad'dress',(optio*nal)-
Critical Areas Cheicklist.docA22.2001'
PLANNING DATA
NAME: i ve/ (a1S7`. N.i wmz ATE: qlWo
SITE ADDRESS: I 17 0 - -75'T-k P1. We5r PLAN CHK#: O - 3
PROJECT DESCRIPTION: a JT-tvci O w
REDUCED SITE PLAN PROVIDED?: es No
MAP PAGE: qo % CORNER LOT: es No FLAG LOT: Ies IQ
ZONING: CRITICAL AREAS DETERMINATION #: 0 3 — I S5
❑ Studv Reaulred:
Waiver
Conditional Wah►er
SEPA DETERMINATION:
❑ Fee
❑ Checklist
❑ APO list w/ notarized form
4 (Needed for 500 cubic yards of grading, Shoreline Area- site within 200. ft. of Puget Sound or Lake Ballinger)
Exempt
SETBACKS:
Required Setbacks: i< <
Street:�Left Side: Right Side: 7 Rear: _ S
Actual Setbacks: , jj
Street: � S Left Side: d Right Side: (°t Rear: y
Street map checked for additional setback required? (Yes / No / DNA)
DETACHED STRUCTURES: /V/4
ROCKERIES: iv/4
0 FENCES/TRELLISES: N/,4
(� BAY WINDOWS / PROJECTING MODULATION: O K
i! STAIRS / DECKS: O K -
PARKING: Required: Actual: �L4-
LOT COVE I q ! o /
Calculations: �` �S/ i y� — N• o `o
BUILDING HEIGHT: STbf�. 1J�u�.� IClC>a '
Datum Point: Datum Elevation:
Maximum Allowed: S Actual Height: S
A.D.U. CREATED?: No Yes
SUBDIVISION: A/
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: es No
OTHER: jA/tl�Q
NewBPP1anningDataForm.D0C
•
•
0
$W noW17105
7035 170247529 17110 .� 73117814 ,7114 O 7120 /7029/700117118uj 7317 17104 7008 i 171 �i� / 17122
17126 7527 7517 7305 171 Io05/ o
7321 17110 17122 29 / 1
7712 J� ,7126
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t
17207 N .� <....., , .., . _ - t79Nfl S R1M,..
�i ♦5 m 72202 17201 7082
\ 7010 ,N 69� g •'•.
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O 7210 , 17206 17215 7062 6917
17228 17231 7507 7510 7305 17216 n N m 17223 M20 6915 17208
o
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7403 17229 7002 ..
7529 7515 7508 m 173Ea0SfSW 17210
i� o 17303 6905
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n
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a o it v 72 1% 17329 17318 Q m m n
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a
r o 1 no m
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7010 .... ...
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1�6 17500 17 ^ PL
m 7007 raze
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17522 7415 7401 7325 N 17521 17506 3
.�, N n N N n 17512 > 17611 $ R 17505 17510
17510 S
17517
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i 176TH ST SW6925 •ns,2
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y m
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n ^
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lets 7420
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17704CA
F 17703 5
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0 g
7226 1771
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N
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n 17806 17805
1 7522 7514 7502 7432 742d 7412 7,879 .. ,10� n �n iz n o it o 17804 17803 J
.. i. 17812 ,7g11 n n n P. 17806 o
• � 17e12 17811 1
gg C \na� �°� a 7329 oa 73l s .�,1 St sw 179TH ST SW 7003 178
4 � 7008 178M 17819 17820 17810
Q
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- � ISOTH ST SW
, 7930
_ 1e003w _� 180TH ST Sw
18004 �, 1g00o .....00
e ^ BOOS 7024 702g n ^ w ^ 18015 /8012 187 7114 710a m w �� 1g015 18017
11 ^ 6 18013 18012 1p t8024 18021
N
^ n ^ $ 18021 18020 18015 18020 18017 7� h n 18026 ,80,9 1
18023
1y.- 7 �� R1 18082 Q�' 1602
18101 .i,B 18026 18027 18026 18027
PLSW ,eo2o
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lent
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17
F
STANDARD DRAINAGE DETENTION SYSTEM
WORKSHEET
QR w2�1 CIM� AC fM CALF BY:
ADDP MS � � PHONE:
DATE:
*****DES/GNDATA*****
IMPERVIOUS AREA PIPE DIA PIPE LG ORIFICE
400 d 24'�
•MENTION PIPE LENGTH LOCKING LID
(TYPICAL)
FINISHED G
' NININUN
E
TIGHTL ASUREEMN TOP OF
ONC BOX OR RISER
3X TO iX SLOPE
LCLALTLET
OUTLET CONTROL
N1N.
UPPER CATCH BASIN ,ORIFICE '
CONTROL CATCH BASIN'
SYSTEM CROSS SECTION
2'X2'X6' DEEP, 4-6' SPALLS OR EQUAL
FROM CONTROL CS 2'X el 3' DEEP, 3/4' CRUSHED ROCK xISTING GRADE
FROM CONTROL OUTLET WASHED ROCK ,
OURT A MIN IOLNG.
PEO LEVEL
1 PERREFpPIPE V/_ END CAPS
S �p�
PRIORHTO VASHEY DRAIN ROCK
PLACEMENT
NPRAP OUTLET
RUNOFF SPREADER. TRENCH
FOOTING DRAINS SHALL NOT -BE CONNECTED TO DETENTION SYSTEM
NOTES:
,Q
1. Call Engineering Division MI-0220) for a tightline and detention system inspection
APPROVED BY
before backfilling and : for final inspections.
2, Responsibility for operation and maintenance of drainage systems on private properly is the
responsibility of the property owner. Material accumulated in.the-storage pipe must be flushed
DATE
out and removed from the catch basins to allow proper operation. The outlet control orifice
must be kept open at all times.
Table 1 — Detention Pipe Sizes
Impermeable
Required
Area Sq. Ft.
Vol Cu Ft .
2000
50
. 2500
- 62
3000
75
3500
87
4000
100
4500
112
5000
125
Note: Allowable Pipe Materials:
Impermeable
Area Sa. Ft.
2000
2500
3000
3500
4000
4500
5000
Pipe Diameter
15" 18" 24"
30"
40 28 16
10
50 35 20
13
60 42 24
15 Required pipe
70 ' 49 -28
-18 --length in feet
80 56 32
21
90 63 36
23
100 70 40
25
Reinforced Concrete
Aluminized Steel
Aluminum
CMP Asphalt Coated
N-12 ADS (Not permitted on roads)
Table 2 — Outlet Orifice Sizes
Outlet Orifice Diameter (inches)
5/8
5/8
3/4
3/4
7/8
7/8
7/8
Table 3 — Rectangular Catch Basin Requirements
Detention
Max. size
Catch Basin
pipe diameter
knockout
Type
< 18"
20"
Type.1, CB 15
18" to 24"
26"
Type IL, CB.16
24" to 36"
36"
Type 11, CB 19 19,(480 Basin)
36" to 42"
42"
Type 11, CB 19 19 (54" Basin)
*Source: Assoc. Sand & Gravel Co. Standards
5
Revised 3/16/95
w
N a6- — Q� .� c� CITY COPY
------Ro SLAB °co
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REgEIED \
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APR 2 3\, 004 `\
- PER COULTER \
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93,3
611
ab oS \ \�
3
•S � D �
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8
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APPROVED AS NOTED
/do BY ENGINEERIN
-rA A `l
PLAN 2767.E �.
d SITE PLAN 54LOSA��C��,
s� I SCALE 1 "=20dOrNER/CONTRAC '°i E
OR iS RESP06��1_ �..
TEMPORARY CONSTRUC FOR EROSION cat qOL AND D„MAGE
ENTRANCE REQUIRED �'
c. C_
. � S� p4 �
STORM �
RIM-100
' �y�\
'LI3 CLt
CIT -'cop 10-7 -7!5A'-A vJ
84 -- —-------
ZAVALES DESIGN ASSOCIAT
Z DA P.O. BOX 55512 . \
SHORELINE, WA 98155 -
206-362-2992
9004 \\
'COUkER
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cc
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6
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0Off/ \ \
196.0
f / s LOT COVERAGE
�
_p p 101_ 0 48; ; .. Yk; s 9� LOT AREA= 14911 S.F.
0
$fo>= .•:'r. ??,o;,:... c HOUSE & DECKS= 2185 S.F.
_ 4 .<, s� COV RAGE:
/po bB0%2185(14911= 14.6%
r..` . IMPERVIOUS SURFACES
PLAN 2767.B HOUSE & EAVES= 2411 S.F.
DRIVEWAY & WALKS= 751 S.F.
SITE PLAN TOTAL= 3162 S.F.
3 SCALE 1 =20 -0
LEGAL DESCRIPTIQN
HEIGHT CALCS. LOT 27 m
SEE ATTACHMENT
STORM A=95.3' J - I
RIM=100' B=94_7' SILVER CITY _ mC
C=98.5' CONSTR.INC. go
ao' z
..... _ _.... AVE. GR.: 386.4 /4=96.6' PO. BOX 1417 m cn
r MAX. HT.: 96.6'+25'=121.6' MUKILTEO, WA 98275 z o
3p'O ACTUAL HT.: 121.6' (206) 501-5490 m
21 04
m
ZONE 0S-g
SETBACKS:
FRONT -
SIDE (0
REAR
OTHER
HEIGHT s
Ta
f ws G � F, '4i�r .- b �.{::. r?*.{r`'+23�'x'.4�::�"-iir'#fAY,lr�a •f�,, arje,4„�
r•: �
ti..t i! !�c f (+ b -� 1{�s�dr..d'4e �1.y L �' •,�".� aAt -yam +'.!<b�'#�' Y�+' Ny
�'P'y I •�4 �/♦' ~, 1 f � }! r r*f / ! 9`X t 7 �"11I',�.w„ei =�W �
sue. '' Mgt .�'� s�,a+�ra�+t d _��,y � �'• ti .�'��t.'.+�v.�`��Ah�li����', �r�` �`P� � �
`"-' � ! ems.,..-:� �ii• � e 4 4 `� �s qt I-•sa^fi".¢'�,.c .*'�i'a5 '�'�'- �� `T+'='�`w;?Ylp :'y�'"�'J�I�:+�'i�r7..dG 1r
WL IMP
.«9L �," .' Pl+►p s 1Pt .me.µ d!> �,y��'"1<x aY -. p�(� ya�j�� $�� 1egt p`''.
4 +L.( � Y`'^'�_. 45�•A. Ifj!Y��} I�i�y��i9�T�i3'I�� �.' 'S �i+ -'tea +W'A
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mussp.,.-2A�.t'71►'' ^'.� ,'�
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4't':,�.:7�r iF%'A•�7Ke.� ty4it4'k'-wo8�"
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:s;t�,•�j:. FN!�.'�°A.,vw.1 ?rti'�.31i _� �p ^�`"� i1'.�!it�S �w �ii>-�v` �+�. �
6
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siz
- - - To c cry S-)VG
Pic
_-- ---� __ WATER &SEWER
INSPECTIONS REQ'D. �\
4 - _CALL 425-77
- - _ 1-022Q EXT. V326 �\
$olo,,�
8Oil
\ \ \ \
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14
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p 1 PRo
L
LOT COVERAGE
0,011 -p LOT AREA- 14911 S.F.
HOUSE & DECKS= 2185 S.F.
COVERAGE:
/oo 21855/14911= 14.6%
VLIMPERVIOUS SURFACES
HOUSE & EAVES= 2411.S.F.
1 l SITE PLAN DRIVEWAY & WALKS= 751 S.F.
d; TOTAL= 316�r''rS
l'-�OVED AS NOTED
SCALE 1.,'.=20,_ 0„ BY ENGINEERI G
RIGHT•OF-VJAY CONSTRUCTI0 MIT `790� _7S � ,
AND INSPECTION REQU Date:
STORM . q�CEA1'IGH INE f 3
RIM=100' OT MATERIAL
FOOTING DRAINS N
TO RE TIED WNTO SDR 35
DETENTION SYSTEM SCH 40 RCEIVED
N-12
CITY R JUL 13 2004
•�BUILDING DEPARTMENT
�. CITY OF EDMONDS
City of Edmonds Permit Noc<AD
RIGHT-OF-WAY. CONSTRUCTION PERMIT Issue Date:
A. Address or Vicinity of Co'nstruction:
B. Type of Work (be specific):L-D&J *JAAt4 (A71(A-C14 IA16WL—
V_ JI
-, C. Contractor: "'i XINQ_�' C' Conta-c�.JC&YN_V'k �C�NN'JC)\N T�
IN 1.
Mailing Addreq==tR) a-) Phone:_ 9 C�' •
State License # Q 92) `0�0 Liability Insurance: z�� Bond:.$ zW
T
City Business Licen-se #:
R
D. Building Permit # (if applicable).04 16. Side,SewerPerrhiti# (if applicable):_
E. R Commercial El Subdivision F1 City Project 6,�y(0ibkKERIZON, PSE, COWAST, bPVASD')
❑ Multi -Family Single Family F-1 Other
WSPECTOR:
F. PAVEMENT CUT: ❑ YES G. SIZE OF CUT x
CONCRETE CUT: ❑ YES NO
G. El 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
COMPLETED 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) 296-155-305 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 the workday - NO EXCEPTIONS.
Three sets of construction drawings of proposed work are required with the permit application.
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 PM OPY OF THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS
Signature: Date:
\(Co *ctr Agent)
FOR'CITY USE'ONLY.''
Approvedby:
Time Authorized: Void. After � J 139- 1.. _]Qisruptipn� Fee/fundjfl;
Special Conditions: C&LS:MJC,-r iqF_4
1.9
-S 'To OVTotal Fee:- '*1IA4 _5
Recei6t,
Issued
s by:
REQUIRED INSPECTIONS:
Call 425-771-0220, Ext. 1326for a 24-hour ice -recorded inspection request line.
FINAL APPROVAL OF PERMITTED WORK: -1 A /--A DATE:,
s
I
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
C\Documents and SettingsTunisNy Documents\Fomis\Engnmg\ROWpemit_.doc Revised 10/01/03
1 do •.�; :4
Ci of EdmondsPermit No: �ZC04"024%
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date:
f 1
A. Address or Vicinity of Construction: 1-19 0 7 P 75 P L LJ
B. Type of Work (be specific): TO -1- n1 4(2k„ 1 � �' (oaS YnGxi Y3 I t �J
6_1r_. , nc ) Ab .ter s W , --) ►' W 0,1r✓ r)4 7s PL
C. • Contractor: Poc�nu� A,✓1 � Contact: 3u 9
Mailing Address: s v(Doe - A.y �i Phone: d o U —L)) g - c_J Z 3 3
State License #:P1 L e.l-1 °, lot Io R Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. 0 . Commercial ❑ Subdivi''sion ❑ City Project4 ❑ EUC (PUD,.VERIZON, PSE, AT& T, OVWD)
❑ Multi -Family. Single Family ❑ Other'
INSPECTOR:.
F"--'- AVEMENT CUT: ❑ YES ❑ NO G. SIZE OF CUT '' X
CONCRETE CUT: ❑ YES ❑ NO y• ,s.,
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. h
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.
♦ Traffic control and public safe ., sl4if be in accordance with City regulations as required by., the City Engineer. Every
flagger must be trained as required by (WAC) 296-155-305 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 the workday — NO EXCEPTIONS.
♦ Three sets of construction drawings of proposed work are required with the permit application. R
I HAVE READ
THAT I MUST
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
g ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS ANb ACKNOWLEDGE
SCE THE PINK COPY OF THE, PERMIT A VAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS
aignarure: i `.v -- -
(Contractor or Agent)
FOR , ITY USE ONLY
Approved by: _
f: Time AuthorizedlVoid After "t.�► /.2c '' � 1 t
Special Conditions:fJ,&*-J-kC 7V
)ttl: ANr_)/0a rX)N Y 77??N "A ilN74I H
AAIM <:A7 f-3gAATiaty p-44k-144 .d-rf_ G., r-y eoc
LLr:tG�%GVA-m fZ._;, S t. Lt>F' 12. S rr2AU t All PZO/z e'
Date:
Fee:,✓�,i, �7j
�i c"O. �5i�/
Restoration Fee:
Total Fee: :5- 7..:57 0
Receipt No:
Issued by
G„ —
UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT C19.DE (Phon 425-7 1-0220, Ext. 1326)
FINAL APPROVAL OF PERMITTED WORK:. r DATE:
Inspector's, Signaturef
For inspection requirements see Enginee 'ng"I%"spechori-�I'><iforma'fion handoutZ/��(�5
G-0
NO WOIZK SHALL BEGIN PIZIOIZ TO 1I,,IZM1T ISSLANCI:
Pilchuck Contractors, Inc. aacxo
Job #'107021340
Sept 29, 2004 s v
Sheet 1/1 Rob Inglis 3'0�'"�
S
ALLOW ACCESS TO ALL
DRIVEWAYS
3 WORK AREAS
5' x 3' EACH
Notes:
1. All signs and spacing to conform
to the MUTCD and City of Edmonds
Traffic Control specs.
2. Channelizing 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. -
b. Work area will be 341' N of C/L of
180StSW&21'Wof75PIW.
APPROVED AS NOTED
BY ENGINEERING
�o< Date: l h 7
180th ST SW
LEGEND
•
28" TRAFFIC CONE
®
WORK AREA
TRAFFIC FLOW
c�6
1
FLAGGER
oI
SIGNAL LIGHT
WORK VEHICLE
SIGN LOCATION
PROP. 2" MPZ IP MAIN
PIRLD LOC..
R" SHORT STOPPZR
TBST LEAD & BOX �•
20 NPB TRANSITION PITTING
341'N, 21'W C L 4 �
S
BND OF N (2- KPZ CAP)
PI.CLD LOC.__A� C/L, 'R
Ab
op
Op
♦ � cry
♦ \ i dlF�� . �J�
.roc 51 �Co ♦ � / Z�
i
B 'TH ST SAS
EX. 4" STW IP 13'N T I D -1 i
1962 J-3704 L ... �. ,�,� .... �Nft ..=
i
i 60 -RI6,
PLOT PLAN
SCALE: I" - 50'
FITTER (CHECK BOX IF COMPLETE)
Work area left in Clean ,& Safe condition.
❑
Complete all Pipe Table:; and Gas Pressure Stamp.
❑
Field changes Red —Lined on as —built.
❑
Material verified and Chian es 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.
❑
FonaNmart'a ftwbllteOM"_..
W . _ WE
STANDARD GAS CONSTRUCTION NOTES:
1. FIELD LOCATE ALL UNDERGROUND UTILITIES. CALL "ONE —CALL" TWO WORKING DAYS PRIOR TO CONSTRUCTION, IN
WESTERN WASHINGTON CALL- 1-800-424-5555. IN KITTITAS COUNTY CALL: 1-800-553-4344
2. ALL CONSTRUCTION IS TO CONFORM TO PSE GAS OPERATING STANDARDS AND GAS FIELD PROCEDURES.
3. 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.
4. 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.
5. ANY CHANGE IN ROUTE, TIE—IN METHOD OR ADDITIONAL MAIN FOOTAGE MUST BE APPROVED BY PSE GAS ENGINEERING
SERVICES.
6. COMPLETE 'PIPE CONDITION REPORT' ON ALL EXPOSED EXISTING PSE FACILITIES. CHECK BOX ON REPORT FOR WIRE
BOX (TEST LEAD) INSTALLATION.
7. ACTIVE SERVICES DENOTED BY: XXXX
8. PIPELINE MARKERS AND WARNING SIGNS SHALL BE INSTALLED AND RECORDED BY THE CONTRACTOR PER PSE GAS
OPERATING STANDARD 2525.2500.
9. 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 REDILY 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 PSE GAS ENGINEERING SERVICES.
11. SYSTEM MAOP DENOTED BY: ISYSTEM MAOP = 45 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. GAUGE AND MONITOR USE OF ALL STOPPERS AND SQUEEZES TO ENSURE ADEQUATE FEED. (USE MANOMETER FOR
LP SYSTEMS)
15. RESTORE ALL DRIVEWAYS SUBJECT TO OPEN CUT TO ORIGINAL OR BETTER CONDITION.
16. PURGE POINTS AND PRESSURE TAPS TO BE INSTALLED PER PSE GAS OPERATING STANDARDS 2525.3400, AND 2525.1200.
17. COORDINATE INSTALLATION WITH CORROSION CONTROL RICK KESSLER AT 206-571-7908.
GAS MAIN INSTALLATION/RETIREMENT
Type/Work
Pipe Size
Type
Estimated
Length
Actual
Length
Manufacturer
fNS A L
2"
GAS MAIN PRESSURE & TESTING
TYPE TEST-1—PRESSURE
TESTED BY
DATE ON
TIME ON
DATE OFF
I
TIME OFF
TYPE TEST
PRESSURE
TESTED BY
DATE ON
TIME ON
DATE OFF I
TIME OFF
[Design Press 60 1
SYS MAOP 45 PSIG
PROJECT PHASE
NOTIF#
ORDER#
SAP Superior
Service/Meter50899910
Servicelmeter
Service/Meter
ServicelMeter
Ind. Service
Ind. MSA
Dis. Reg. / FT
HP Svc/MSA
Relocate
Retirement
—X877033614
107021640
106139632
Contractor: CONSTRUCTION COST CODES:
041-103-1
Project Manager Contact Information:
KIM GRAY
425-290-2678 CELL PHONE
kim.gray ftse. com
REV# DATE BY DESCRIPTION
3
2
1
SNOHOMISH
114 SEC
SW 08-27-04
UTILITIES
CONTACT
PHONE#
ER SECT
4
MAP
156.068
Vicinity Map
-Owner/ Developer Contact Info
JAMIE SCHWARTZ
17907 75TH PL W
EDMONDS. WA 98026
ATTN: JAMIE SCHWARTZ 425-921-2425 office
CALL (800) 424-5555
2 BUSINESS DAYS BEFORE YOU DIG
THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF FACILITIES
N/A
FUNCTION
CONTACT
PROJECT MGR
KIM GRAY
ENGR-GAS
DRAWN BY
MLOCK
CHECKED BY
KIM GRAY
kS WK CTR APPROVED BY 00,KIM
MCNSEC CP TECHNICIA RICK
AT MAP
159.070 MAPPING
JOINT FACILITIES ARRANGEMENTS
PUGET J"II1' SCHWABTZ
ENERGY INSTALL 8" B' LP HAW
17007 76T8 PL 0'
DESIGNED BY PILCHUCK CONTRACTORS INC. L'DYONDS, O'A 080A0
EDMONDS
PHONE DATE
206-418-4233
206-418-4217 r0-1
206-418-4233
206-418-4233 11411
SCALE: IPA(
1"-50' 1
Nov. 23 2004 09:57AM
YOUR LOGO
r YOUR FAX NO.
NO. OTHER FACSIMILE START TIME. USAGE TIME MODE PAGES RESULT
01 92064184260 Nov.23.09:55AM 01'41 'SND 02 OK
i
TO TURN OFF REPORT. PRESS 'MENU' #04 SET.
THEN SELECT OFF BY USING 'JOG -DIAL'.
FOR FAX ADvwrpGE ASSISTANCE PLEASE CALL 1-800-HELP-FAX (435-7329).
City of Edmonds Permit No: 1-026,5
RIGHT—OF—WAY CONSTRUCTION PERMIT Issue
A. Address or Vicinity of Construction: 1-7') U 7 ` L
B. Tyke of Work (be specific): Tb —� J--z � cal 1 C>1 (C)Ct `
l� I Q _70 a i Ly 4 G cry.
C. Contractor: Contact: J 16 1 C.4 14 Y C9 Y �4
Mailing Address: (} v O A2_ _-k v kJ Phone: Ci V ,�, % �J G U -L I V S
State License #: �� L I Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ CityProject ❑ EUC (PUD, VERIZON, PSE, AT& T, OVWD)
❑ Multi -Family Z;;--Single Family ❑ Other
INSPECTOR: A'/" (� 'f-"y m-- C � /i '�-/a ky%
F-- PAVEMENT CUT: 0 YES ❑ NO G. SIZE OF CUT X S�
CONCRETE CUT: ❑ YES ❑ NO
INDEMNITY Applicant understands by his/hbv_ 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
COMPLETED BYCITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
♦ Traffic control and public safe% shall be in accordance with City regulations as required by the City Engineer. Every
flagger must be trained as required by (WAC) 296-155-305 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 the workday - NO EXCEPTIONS.
♦ Three sets of construction drawings of proposed work are required with the permit application.
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS ANb ,;fKNOWLEDGE
THAT I MUST MAKE THE PINK COPY OF THE PERMIT AVAILABLE ONSITE AT ALL TIMES FOR INSPECTIONS
Date: l G l z - (/
(Contractor or Agent)
r—
UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT CODE (Phone 425-771-0220, Ext.1326)
FINAL APPROVAL OF PERMITTED WORK DATE:
Inspector's Signature
For
see
Information handout.
'Iu
NO NNORK SIIALL llF(,'IN PRIOR TO 1'1? 011T ISSI4A.M'F
City of Fdmonds Permit No:
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date:' �y
A. Address or Vicinity of Construction: � 67 5 1,5
B. Type of Work (be specific):T(!;� 1 Y I ��Cci�1 . � i�C l S � l G " 0 U 2 X ` /J 0_ 1 L.
lt� iJj
C. Contractor:
Mailing Address: _1 ,:�) �,. C) V1 e (_:,t U fJ
State License #: r �i l -C i 10- � ) U l VY ) r+
Contact:
Phone:-y/
Liability Insurance: Bond:
F (,,
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision,,.----- ❑ CityProject ❑ EUC (PUD, VERIZON, PSE, AT& T, OVWD)
❑ Multi -Family Single Family ❑ Other
INSPECTOR: uAij(. n [ 5 Z /I ,l r L rs /V t'i G=r
F. PAVEMENT CUT: fZ YES ❑ NO G. SIZE OF CUT J� X
CONCRETE CUT: ❑ YES ❑ NO
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 ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE INAL
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.
♦ 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) 296-155-305 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 the workday - NO EXCEPTIONS.
♦ Three sets of construction drawings of proposed work are required with the permit application.
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 OF THE PERMIT AVAILABLE ON SITE'' AT ALL TIMES FOR INSPECTIONS
Signature: — x €Alt Date: a ' C�b
(Contractor or Agent)
N4
f~
NO NVOlM SHAI.I, 14]GIN P121012 TO P1,:12iV1lT ISSFAN(+',
Oom &\q Z�� k-�- 6,4 -
lfIuleM4
V'o
No
Uu - vEv
ftf
10-1 I TO..
WtEDthDM�sj
U- Ni��
Nam[ $E IAAg-e�c�r G ND
fls +F C':ONDal o N a � ftft"OAL- . 'Im s egaTrcGt stT� O�tiS OF
NO�C ►N�'C 'C� CR-�"C�A.fJtl�"Ct��D �N ��