HomeMy WebLinkAboutWTR2703166PROJECT REQUEST FORM
PLANNINGBUILDING/PUBLIC WORKS
DATE:. CONTACT: EXT.
FILE STATUS I YNEW OR ❑ EXISTING: FILE CODE (PRl-xx-xxxX):
LOCATION 1 ❑ My Work Space: I ❑ File Bay Shelf #: I ❑ Other:
PROJECT NAME/ FILE TITLE: m� 1 CG 1 0t-1( E 1 I CA 1 !�q
(70 characters max)
i)F.qCRTPTiON OF PROJECT:
UTILITY PERMIT # U 0'40 1 ` LUA# CH - Oa I WO# 8(0 0C&
ADDRESS / STREET NAME(S): I1-(4 \ a. - OVU �4
DEV:��iY�S V�b� I�iICNTR: 1�ee ; CNSLT/ENG:
OTHER ALIASES: R-R Y M-Pd1 C26 C'Pll%'
Circle Size of Waterline:
8"
10
12"
Circle One:
New / Replace / xtensio
Circle Size of Sewerline:
8"
10"
12"
Circle One:
New / Replace / Extension
Circle Size of Stormline:
4P
18"
24"
Circle One
e Replace / Extension
CHECK EACH DISCIPLINE INVOLVED IN PROJECT
Ltr
Drwg # of sheets
[, TED
❑
❑
(off site improvements)
(include TESC)
❑ TRO
❑
❑
(Signalization, Channelization, Lighting)
❑
❑
(sanitary sewer main, include basin name)
VTR
❑
❑
(Mains, Valves, Hydrants)
(inc. composite & HorizontalCtrl)
SWp
❑
❑
(CIP onlyxinclude basin name)
L' PLR
(For Developer Files Only)
❑ (letter only)
PLEASE CIRCLE THE DISCIPLINES WHICH NEED TO SIGN MYLARS
WATER WASTEWATER SURFACE WATER TRANSPORTATION FIRE
IMR MY. MAiNTAiNANCE. USE ONLY
File Codes
File Alias
Date Entered and Labels Made
D IA,''�lSo�1
u-3►6�
Return Address:
City Clerk's Office
City of Renton
1055 South Grady Way 050316000023
Renton, WA 98055 CITY OF RENTON SS 20.00
PAGE001 OF 002
03/16/2005 08:44
KING COUNTY, WA
20050113000549
CITY OF RENTON DT 26.00
PAGE001 OF 007
01/13/2005 09:43
KING COUNTY, WA
BILL OF SALE
Proj Name: IDC Oakesdale , LLCroperty Tax Parcel Ntunber362304—MA&
Project File#: U040187 Street Intersection: Address: S.W. 43rd St.
Reference Numbers) of Documents assigned or released: Additional reference numbers are on page
Grantor(s): Grantee(s):
1. IDC Oakesdale, LLC 1. City of Renton, a Municipal Corporation
2.
The Grantor, as named above, for, and in consideration of mutual benefits, hereby grants, bargains, sells and delivers to the
Grantee, as named above, the following described personal property:
WATER SYSTEM: Lenpth St�z T e
D
L.F. of 1U Water Main
L.F. of Water Main
L.F. of Water Main
1 each of 10" Gate Valves
each of " Gate Valves
—T
each of Fire Hydrant Assemblies
SANITARY SEWER SYSTEM: Leneth Size Tybe
L.F. of Sewer Main
L.F. of Sewer Main
L.F. of Sewer Main
each of Diameter Manholes
each of Diameter Manholes
each of Lift Stations
STORM DRAINAGE SYSTEM: Leneth Size Type
L.F. of Storm Main
L.F. of Storm Main
L.F. of Storm Main
each of Storm Inlet/Outlet
each of Storm Catch Basin
each of Manhole
STREET IMPROVMENTS: (Including Curb, Gutter, Sidewalk, Asphalt Pavement)
Curb, Gutter, Sidewalk L.F.
Asphalt Pavement: SY or L. F. of Width
STREET LIGHTING:
# of Poles
By this conveyance, Grantor will warrant and defend the sale hereby made unto the Grantee against all and every person or persons,
whomsoever, lawfully claiming or to claim the same. This conveyance shall bind the heirs, executors, administrators and assigns forever.
0:\Forms\PBPW\]3H1SALE2.DWbh Page I
IN WITj$F-SS WHEREOF, said Grantor has caused this instrument to be executed this _ day of _,C, 20 §
INDIVIDUAL FORM OFACKNOWLEDGMENT
Notary Seal must be within box
STATE OF WASHINGTON ) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that
signed this instrument and
acknowledged it to be his/her/their free and voluntary act for the uses and purposes
mentioned in the instrument
Notary Public in and for the State of Washington
Notary (Print)
My appointment expires:
Dated:
REPRESENTATIVE FORM OFACKNOWLEDGMENT
Notary Seal must be within box
STATE OF WASHINGTON ) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that
signed this instrument, on oath
stated that he/she/they was/were authorized to execute the instrument and
acknowledged it as the and
Of to be the free and voluntary act of such
party/parties for the uses and purposes mentioned in the instrument.
Notary Public in and for the State of Washington
Notary (Print)
My appointment expires:
Dated:
CORPORATE FORM OFACKNOWLEDGMENT
Notary Seal must be within box
STATE OF WASHINGTON ) SS
COUNTY OF KING )
On this _ day of E 20 c: , before me personally appeared
r
_ �. �gSiON F+ !���
i r—j U r to me known to
NOTARI'
be of the corporation that
the imotrument, the instrument to be free
v0
executed wallin and acknowledge said the
�'•+
and voluntary act and deed of said corporation, for the uses and purposes therein
N '• %13 UG
mentioned, and each on oath stated that he/she was authorized to execute said
's
instrume and that the seal affixed the corporate seal of said corporation.
t``'�������`'��
Notary Public in and for the StatV of Washington
Notary (Print) 4-,j�{ S C�-e-y'
My appointment e ires:_ G 9
Dated: �C
0:\Forms\PBPW\BILLSALE2.D0C\bh Page 2
• ► COST DATA AND INVENTORY
IDC Oakesdale, LLC CITY WTR-
PROJECT WWP-
IDC Medical Office Building NUMBERS: SWP-
NAME OF PROJECT: TRO-
TED-
TO: City of Renton
Plan Review Section
Planning/Building/Public Works
1055 South Grady Way
Renton, WA 98055
FROM: Jason Hubbell
3►6`
Barghausen Consulting Engineers, Inc.
18215 72nd Ave. S.
Kent, WA 98032
DATE: 11-24-04
Per the request of the City of Renton, the following information is furnished concerning costs for improvements proposed to
be installed for the above referenced project.
WATER SYSTEM CONSTRUCTION COSTS:
Length Size Type
120 L.F. of 10 DI WATERMAIN
L.F. of _
L.F. of _
L.F. of _
1 EACH of 10 _
EACH of _
EACH of _
I EACH of _
(Cost of Fire Hydrants must be listed separately)
Engineering Design Costs
City Permit Fees
Washington State Sales Tax
SANITARY SEWER SYSTEM:
Length Size Type
WATERMAIN
WATERMAIN
WATERMAIN
GATE VALVES
GATE VALVES
GATE VALVES
FIRE HYDRANT ASSEMBLIES
$2,500
$7,600
$1,00
TOTAL COST FOR WATER SYSTEM $8,660
L.F. of SEWER MAIN
L.F. of SEWER MAIN
L.F. of SEWER MAIN
EA of DIAMETER MANHOLES
Engineering Design Costs $
City Permit Fees $
Washington State Sales Tax $
(Sewer Stub - line between sewer main and
private property line) $
TOTAL COST FOR SANITARY SEWER SYSTEM $
STORM DRAINAGE SYSTEM
Length
Size Type
L.F. of
STORM LINE
L.F. of
STORM LINE
L.F. of
STORM LINE
EA of
STORM INLET
EA of
STORM CATCHBASIN
EA of
STORM CATCHBASIN
Engineering Design Costs $
City Permit Fees $
Washington State Sales Tax $
TOTAL COST FOR STORM DRAINAGE SYSTEM $
STREET IMPROVEMENTS: (Including Curb, Gutter, Sidewalk, Asphalt Pavement and Street Lighting)
SIGNALIZATION: (Including Eng. Design Costs, City Permit Fees, WA St Sales Tax)
STREET LIGHTING: (Including Eng. Design Costs, City Permit Fees, WA St Sales Tax)
- 1 (-VA. e^ CS C7 , UV V M YNir I / 01- i a d'-7 7 Y_� �r� v vt �—,
Print signatory name (day phone#) (SIGNA )
(Signatory must be authorized agent
forms/COSTDATA.DOC/bh or owner of subject development)