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HomeMy WebLinkAboutWWP2703392PROJECT REQUEST FORM PLANNINGBUILDING/PUBLIC WORKS DATE: % p CONTACT: /fjrj{� , EXT. �7 FILE STATUS NEW OR ❑ EXISTING: FILE CODE (PRI-XX-XXXX): LOCATION My Work Space: ❑ File Bay Shelf #: 0 Other: PROJECT NAME/ FILE TITLE: /vliq->-{i, ,-6 j— (70 char cters DESCRIPTION OF PROJECT: L MeL✓ !L p' 6h UTILITY PERMIT # 14 7aa 121 LUA# WO# ADDRESS / STREET NAME(S): $' C t ?-Tl ' DEV: ; CNTR: ;OWN: /`�'/92T(N ; CNSLT/ENG: OTHER ALIASES: Circle Size of Waterline: 8" 10" 12" Circle One: ew Replace / Extension Circle Size of Sewerline: 8" 10" 12" Circle One: New / Replace / Extension Circle Size of Stormline: 12" 18" 24" Circle One New / Replace / Extension CHECK EACH DISCIPLINE INVOLVED IN PROJECT Ltr Drwg # of sheets ❑ TED ❑ ❑ (off site improvements) (include TESL) ❑ TRO ❑ ❑ (Signalization, Channelization, Lighting) WWP 'fin 2P 1-s (sanitary sewer main, include basin name) ❑ WTR ❑ ❑ (Mains, Valves, Hydrants) (inc. composite & HorizontalCtrl) ❑ SWP ❑ ❑ e PLR (CIP onlyxinclude basin name) (For Developer Files Only) ❑ (letter only) PLEASE CIRCLE THE DISCIPLINES WHICH NEED TO SIGN MYLARS WATER WASTEWATER SURFACE WATER TRANSPORTATION FIRE FOR FILE MAINTAINANCE USE ONLY g 01i6 1110:�I Return Address: City Clerk's Office City of Renton 1055 South Grady Way Renton, WA 98055 VVI�'����IYI'IfAI�I��N�I�N 20110801000253 CITY OF RENTON BS 63.00 PAGE-001 OF 002 08/01/2011 12:30 KING COUNTY, WA BILL OF SALE I Proj Name: �'jPArJ14CCg Property Tax Parcel IN ber: 1©2,3G 5 e q J Project File #: eet ec ' L`ib N A ess: t S e � G. Reference Number(s) of Documents assigned or released: Additional reference numbers are on page Grantor(s)• Grantee(s): 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: Leneth Size Type L.F. of Water Main L.F. of Water Main �^i L.F. of Water Main each of Gate Valves each of Gate Valves each of Fire Hydrant Assemblies SANITARY SEWER SYSTEM: Leneth Size Type L.F. of Sewer Main L.F. of Sewer Main J 1 L.F. of Sewer Main each of 164- F5 Diameter Manholes each of Diameter Manholes each of Lift Stations STORM DRAINAGE SYSTEM: Leneth Size Tyne C� L.F. of Storm Main R-3-13 F L.F. of Storm Main L.F. of Storm Main each of 1 Storm Inlet/Outlet each of " 'P=� Storm Catch Basin each of Manhole STREET I PROVMENTS: (I cludin Curb, Gutter, Sidewalk, Asphalt Pavg e ) Curb, Gutter, Sidewalk !/2* L.F. 4r, t t f � Asphalt Pavement: '- 3 1 S SY or L. F. of Width STREET LIGHTING: ' # of Poles t► 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. 0AForms\PBPW1BILLSALE2.D0C\bh Page 1 IN WITNESS WHEREOF, a'd Grantor hascaused this instrument to be executed this' �,5day of,/ 20/!. l -fuJc 7 ff LO N! .4-='N7- INDIVIDUAL FORM OF A CKNO WLED GMENT 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 20_�A, before me personally appeared NW LSS �Yc� �2 -j-qD to me known to be e--,o ,-- -i--,, i o � t-., ,. ref the corporation that r.,ON executed the within instrument, and acknowledge the said instrument to be the free .and voluntary act and deed of said corporation, for the uses and purposes therein v mentioned, and each on oath stated that he/she was authorized to execute said .*04' puBttC �� instrument and that the seal affixed is the corporate seal of said corporation. Notary Public in and for the State of Washington Notary (Print)_ My appointment expires: c� Dated: 0:\Forms\PBPW\BILLSALE2.D0C\bh Page 2 Shamrock Glen Martin Property NAME OF PROJECT: TO: City of Renton Plan Review Section Planning/Building/Public Works 1055 South Grady Way 6`s floor Renton, WA 98055 COST DATA AND INVENTORY / 3-39 Z CITY WT - PROJECT - NUMBERS: S - O- TED- FROM: Bruce Knowlton CamWest Development 9720 NE 120` Place Kirkland, WA 98034 DATE: 6/23/ 11 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 PROPERTY IS LOCATED IlV KCWD #9 Length Size Type L.F. of _ L.F. of _ L.F. of i EACH of _ EACH of _ EACH of _ 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 WATERMAIN GATE VALVES VALVES GATE V S FIRE HYDRAN MBLIES $ TOTAL COST FOR WATER SYSTEM L.F. of SEWER MAIN 389 L.F. of 8 PVC SEWER MAIN L.F. of SEWER MAIN 4 EA of 48 DIAMETER MANHOLES Engineering Design Costs $ 4,208 City Permit Fees $ 2,522 Washington State Sales Tax $ 1,996 (Sewer Stub - line between sewer main and private property line) $ 6726 TOTAL COST FOR SANITARY SEWER SYSTEM $ 35,177 STORM DRAINAGE SYSTEM: Length Size Type 576 L.F. of 6 " PVC STORM LINE 320 L.F. of 8 " PVC STORM LINE 750 L.F. of 12 " PVC STORM LINE 16 EA of Type I STORM CB 4 EA of 48 Type II STORM CATCHBASIN 1 EA of 54 Type II STORM CATCHBASIN Engineering Design Costs $ 4,208 City Permit Fees $ 1,821 Washington State Sales Tax $ 0 TOTAL COST FOR STORM DRAINAGE SYSTEM $54,417 STREET IMPROVEMENTS: (Including Curb, Gutter, Sidewalk, Asphalt Pavement and Street Lighting) See Attachment "A" for quantities and construction costs. Cost of $99,855 , $175 WSST, engineering design costs of $4,366 for street design and lighting design, permit fees of $2,428 for a total of $ 106,824. SIGNALIZATION: (Including Eng. Design Costs, City Permit Fees, WA St Sales Tax) NONE. STREET LIGHTING: (Including Eng. Design Costs, City Permit Fees, WA St Sales Tax) Included in Attachment "A" and street improvements above. l TS S ,l l-C1Z Print signatory name (day phone#) forms/COSTDATA. DOC/bh J (SIGNATURE) Signs ry must be authorized agent or owner of subject development) Fvlhihit R Project Name: Martin Property Bid Scope Jurisdiction Renton Contractor Aero Date: 5/7/2010 Estimator: Bill VanHooser Sales Tax Rate: 9.5% Tax Cost Code Description Quantity Unit Unit Price Subtotal Tax Total Site Improvements - Infrastructure - Onsite 99,855.50 175.75 100,031.25 N 10 - 30 - 013 Import - Crushed Rock - Road Surfacing 393 TN 13.00 5,109.00 0.00 5,109.00 N 10 - 30 - 015 Paving - Fine Grade 2,315 SY 2.00 4,630.00 0.00 4,630.00 N 10 - 30 - 016 Paving -Base Lift 2,315 SY 9.00 20,835.00 0.00 20,835.00 N 10 - 30 - 017 Paving - Top Lift 2,315 SY 10.00 23,150.00 0.00 23,150.00 N 10 - 30 - 026 Curbs - Fine Grade 1,385 LF 1.00 1,385.00 0.00 1,385.00 N 10 - 30 - 027 Curbs - Vertical 337 Is 15.50 5,223.50 0.00 5,223.50 N 10 - 30 - 028 Curbs - Rolled 1,048 LF 16.00 16,768.00 0.00 16,768.00 N 10 - 30 - 035 Sidewalks - Import Crushed Rock 89 TN 7.00 623.00 0.00 623.00 N 10 - 30 - 036 Sidewalks - Fine Grade 388 SY 1.00 388.00 0.00 388.00 N 10 - 30 - 037 Sidewalks - Concrete 388 SY 25.50 9,894.00 0.00 9,894.00 N 10 - 30 - 040 Handicap Ramps 4 EA 650.00 2,600.00 0.00 2,600.00 N 10 30 070 Streetlight Bases 1 EA 3200.00 3,200.00 0.00 3,200.00 N 10 - 30 - 048 Street Signs 1 LS 2200.00 2,200.00 0.00 2,200.00 Y 10 - 30 -049 Permanent Signage 1 EA 1850.00 1,850.00 175.75 2,025.75 N 10 - 30 - 090 ISurvey Monuments 5 EA 400.00 2,000.00 0.00 2,000.00 Page l of 1 TRANSMITTAL DATE:%a�� Z/ "2y TO: Waste Water Utility FROM: SUBJECT: Submittal of Sanitary Sewer TV Tape Project Number. Project Name: I have reviewed the TV Tape(s) for the above project and the line(s) appear to be in acceptable condition at this time. I have reviewed the TV Tape(s) for the above project and the fine(s) are not in acceptable condition at this time for the following reasons: c/Corms/uti(iry/ww/-IMSFORM.DOC/MAB/bh SANITARY SEWER SYSTEM LOW PRESSURE AIR TEST PROJECT: S 5 3 `t) 7 c, 01)4 2T14 QLA 1 DATE:2Z/ l I INSPECTOR:'^/ PIPE LOCATION LENGTH MATERIAL PIPE SIZE PRESSURE TEST TIME RESULT TO FROM py C, % I � 3 `� •tom -Z l S 1 PVC LL- datacenter/forms/pbpw/utilitysystems/ww/sspressure.doc 02/2002 bh Citv . Renton Bravo Environmental 6705 NE 175th St Wa BRAV40w Kenmore. Wa 98028 o 98 28 Tel425424-9000 environmental4-9002 Fax E-mail Inspection Report / Inspection: 1 Date P/O. No. Weather Surveyor's Name Pipe Segment Reference Section No 3/8/2011 Dry jOEL vASEY 1 Certificate No Survey Customer System Owner Date Cleaned Pre -Cleaning Sewer Category u-304-1198 Jetting Street Martin Property Use of Sewer Upstream MH 4 City Renton Drainage Area Dowstream MH 3 Loc. details Flow Control Dir. of Survey Downstream Location Code Length surveyed 78.39 ft Section Length 78.39 It Purpose of Survey Joint Length Year Laid Dia./Height 8 inch Year Rehabilitated Material Polyvinyl Chloride Tape / Media No Lining Method Add Information 1:210 Position Observation MPEG Photo 4 0.00 Manhole / 4 00:00:22 11.13 Tap Factory Made, at 03 o'clock, 6", within 8 inches of 00:02:10 joint: YES 18.13 Tap Factory Made, at 03 o'clock. 6", within 8 inches of 00:03:01 joint: YES 29.99 Tap Factory Made, at 09 o'clock. 6", within 8 inches of 00:04:02 joint: YES 51.61 Tap Factory Made, at 03 o'clock, 6". within 8 inches of 00:05 33 joint: YES 53.27 Tap Factory Made. at 09 o'clock, 6", within 8 inches of 00:05:59 joint: YES 3 78.39 Manhole / 3 00:07:28 OSR OMR SPR MPR OPR SPRI MPRI OPRI 0000 0000 0 0 0 0 0 0 Martin Property // Page: 1 City . Renton Bravo r nliali 6705 NE 175th St Wa BRAV*io Kenmore. Wa 98028 o , 9 028 Tel 425-424-9000 environmen�'a Fax 4254E-mail. 9002 Inspection Report / Inspection: 1 Date P/O. No. Weather Surveyor's Name Pipe Segment Reference Section No. 3/8/2011 Dry jOEL vASEY 2 Certificate No Survey Customer System Owner Date Cleaned Pre -Cleaning Sewer Category u-304-1198 Jetting Street Martin Property Use of Sewer Upstream MH 3 City Renton Drainage Area Dowstream MH 2 Loc. details Flow Control Dir. of Survey Downstream Location Code Length surveyed 148.50 ft Section Length 150.62 ft Purpose of Survey Joint Length Year Laid Dia./Height 8 inch Year Rehabilitated Material Polyvinyl Chloride Tape / Media No Lining Method Add Information 1:390 Position Observation MPEG Photo 3 C 2.02 Manhole / 3 00:00:31 23.19 Tap Factory Made, at 03 o'clock, 6", within 8 inches of 00:01:40 joint: YES 86.02 Tap Factory Made, at 03 o'clock, 6", within 8 inches of 00:05:20 joint: YES 104.52 Tap Factory Made, at 09 o'clock, 6", within 8 inches of 00:06:51 joint: YES )2— 150.52 Manhole / 2 OSR OMR SPR MPR OPR SPRI MPRI OPRI 0000 0000 0 0 0 0 0 0 Martin Property // Page: 1 Citv Renton Bravo Environmental 6705 NE 1751h St Bmve Kenmore. Wa 98028 Tel 425424-9000 environmenta 25-424-9002 Fax. E-mail. Inspection Report / Inspection: 1 Date P/C. No. Weather Surveyors Name Pipe Segment Reference Section No 3/8/2011 Dry jOEL vASEY 3 Certificate No. Survey Customer System Owner Date Cleaned Pre -Cleaning Sewer Category u-304-1198 Jetting Street Martin Property Use of Sewer Upstream MH 2 City Renton Drainage Area Dowstream MH 1 Loc. details Flow Control Dir_ of Survey Downstream Location Code Length surveyed 46.74 ft Section Length 51.43 ft Purpose of Survey Joint Length Year Laid Dia./Height 8 inch Year Rehabilitated Material Polyvinyl Chloride Tape / Media No Lining Method Add Information 1:135 Position Observation MPEG Photo 2 4.69 Manhole 12 00:00:00 11.13 Tap Factory Made, at 03 o'clock. 6", within 8 inches of 00:01:28 1 joint: YES 1 51.43 Manhole / 1 00:04:04 OSR QMR SPR MPR OPR SPRI MPRI OPRI 0000 0000 0 0 0 0 0 0 Martin Property // Page: 1 Citv : Renton Bravo Environmental 6705 NE 175th St BRAV* Kenmore. Na 98028 Tel 425424-9000 environments Fax 425-424-9002 E-mail Inspection Report / Inspection: 1 Date P/O No. Weather Surveyors Name Pipe Segment Reference Section No 3116/2011 Dry jOEL vASEY 4 Certificate No Survey Customer System Owner Date Cleaned Pre -Cleaning Sewer Category u-304-1198 Jetting Street Martin Property Use of Sewer Upstream MH 1 City Renton Drainage Area Dowstream MH EXISTING Loc details Flow Control Dir of Survey Downstream Location Code Length surveyed 110.77 ft Section Length 110.77 ft Purpose of Survey Joint Length Year Laid Dia /Height 8 inch Year Rehabilitated Material Polyvinyl Chloride Tape / Media No Lining Method Add Information 1:285 Position Observation MPEG Photo 1 0.00 Manhole / 1 00:00:00 26.77 Tap Factory Made, at 09 o'clock. 6". within 8 inches of 00.03:37 joint YES lmanN 110.77 Manhole / EXISTING 00:07:12 QSR pMR SPR MPR OPR SPRI MPRI OPRI 0000 0 0 0 0000 0 0 0 Martin Property // Page: 1