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HomeMy WebLinkAboutWWP2703522PROJECT REQUEST FORM PLANNINGBUILDINGIPUBLIC WORKS DATE: ,? CONTACT: k-7 .e +,-,_ EXT. FILE STATUS 0 NEW OR ❑ EXISTING: FILE CODE (PRl-xX-xxXx): LOCATION 0 My Work Space: 10 File Bay Shelf #: ❑ Other: PROJECT NAME/ FILE TITLE:i�- 0 characters max) UTILITY PERMIT # 7d U'/ UU G U LUA# ,I WO# ADDRESS / STREET N (S): % / v DEV:�,Gc�i.�ti�✓��°`�C✓ ;OWN: ; CNSLT/ENG: OTHER ALIASES: Circle Size of Waterline: 8" 10" 12" Circle One: New / Replace / Extension Circle Size of Sewerline: 8" 10" 12" Circle One: New / Replace / Extension Circle Size of Stormline: 18" 24" Circle One New / Replace / Extension CHECK EACH DISCIPLINE INVOLVED IN PROJECT Ltr Drwg # of sheets ED (offsite improvements) (include TESC) ❑ ❑ (Signalization, Channelization, Lighting) (sanitary sewer main, include basin name) WTR ❑ 1/� (Mains, Valves, Hydrants) (inc. composite & HorizontalCtrl) ❑ SWI) ❑ ❑ (CIP only)(include basin name) ❑ PLR (For Developer Files Only) ❑ PLEASE CIRCLE THE DISCIPLINES WHICH NEED TO SIGN MYLARS WATER WASTEWATER SURFACE WATER TRANSPORTATION FOR FILE MAINTAINANCE USE ONLY File Codes File Alias Date Entered and Labels Made nC (letter only) Return Address: City Clerk's Office City of Renton 1055 South Grady Way Renton, WA 98055 I�IIII�'IIInIIIInVVIIfYllnllll'n�I�IIA!V� 20110210001178 CITY OF RENTON BS 63.00 PAGE-001 OF 002 02/10/2011 13:46 KING COUNTY, WA BILL OF SALE I Proj Name: -De I a ✓) e �V I` Property Tax Parcel Number: i . 23 0 S9 3 L SS Project File #: 3S o2 S eet.I terse tion: Address: e ,? e t A-1 E PL_ 46 Reference Number(s) of Documents assigned or released: Additional reference numbers are on page Grantor( ): LL Gra( 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: Length Size Type L.F. of Water Main L.F. of Water Main L.F. of Water Main each of Gate Valves each of Gate Valves each of Fire Hydrant Assemblies SANITARY SEWER SYSTEM: Len Size Type S�� l I lD L.F_ of V C_ Sewer Main S- 3 L.F. of Sewer Main L.F. of Sewer Main each of 1A 1?1 Diameter Manholes each of Diameter Manholes each of Lift Stations STORM DRAINAGE SYSTEM: Len th Size T e C7 O L.F. of (Z — Storm Main �� 1 (5 L.F. of Z� „ _ Storm Main `� L.F. of Storm Main each of Storm Inlet/Outlet each of Storm Catch Basin 1 each of I Manhole Z-i pe L STREET IlVIPROVMENTS: (Including Curb, Gutter, Sidewalk, Asphalt Pavement Curb, Gutter, Sidewalk 1 7 L.F. Asphalt Pavement: 2 SY or L. F. of Width STREET LIGHTING- # of Poles bl I _ OO Q 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 convevance shall bind the heirs, executors, administrators and assigrns forever. O:\Fortns\PBP W\BILLSALE2.DOC\bh Page I IN WITNESS WHEREOF, said GpRta has caused this instrument to be executed thisL"l day of INDIVIDUAL FORM OFACKA'OWLEDGME'YT Notary Seal must be within box STATE OF WASE NGTON ) SS COUNTY OF KING ) I certify that I know or have satisfactory evidence that 20 ) 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 ;;xpir s: Dated: REPRF.SEt\T4TIVE FORM OFACKArOVVLEDGVF*VT Notary Seal must be within box STATE OF WASHNGTON ) 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 OFACKArOVfZEDGMEAT Notary Seal must be within box STATE OF WASHINGTON ) SS f,tlit//V/�, DICT ���i COUNTY OF TONG ) On this / � day of �1�nu 20 It , before me personally appeared >10.4 �! EXP�gE•' tC4hrk _./ to me known to of the corpuration that a. = executed the wrtrlrin instrument, and acknowledge the said instrument to be the free CV: moo' and voluntary act and deed of said corporation, for the uses and purposes therein • mentioned, and each on oath stated that he/she was authorized to execute said '., `.. BAN p'�, •'���`.�� instrument and that the seal affixed is the corporate seal of said corporation. .?110 « , Notary Pu lic in and for the State of Washington Notary (Print) i?"lara � ea6 c.t My appointment expires: Dated: -'Arl- 0:\FotmsTBPW\BILLSALE2.DOC\bh Page 2 COST DATA AND INVENTORY -�-P-0(< be (a rse f ct - - NAME OF PROJE oh CITY PROJECT NUMBERS: WTR- S WWP- SWP- TRO- TED TO: City of Renton FROM: ` 11 (G I�-90 / /1Ss C{ ' �y L Plan Review Section 19 A) E �; -Lc— Plan Z9 O Planning/Building/PublicWorks fP 14212,0(A )cz— ctk��n� 1055 South Grady Way 61 floor Renton, WA 98055 DATE: 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 L.F. of L.F. of L.F. of L.F. of EACH of EACH of EACH of Size Type (Cost of Firekirdrants must be listed separately) Enginee ' g Design Costs Ci ermit Fees ashington State Sales Tax SANITARY SEWER SYSTEM: WATERMAIN WATERMAIN WATERMAIN WATERMAIN GATE VALVES GATE VALVES GATE VALVES FIRE HYDRANT ASSEMBLIES TOTAL COST FOR WATER SYSTEM $ Size Type ringth G4 L.F. of PAC- SEWER MAIN L.F. of SEWER MAIN L.F. of SEWER MAIN EA of DIAMETER MANHOLES Engineering Design Costs $ GOB City Permit Fees $ Washington State Sales Tax $ 0 (Sewer Stub - line between sewer main and private property line) $ TOTAL COST FOR SANITARY SEWER SYSTEM $ O STORM DRAINAGE SYSTEM: Length Size Type (c C) 0 L.F. of (Z H b <� STORM LINE l C; L.F. of STORM LINE L.F. of STORM LINE EA of STORM INLET EA of 1' STORM CATCHBASIN 2- EA of Z STORM CATCHBASIN Engineering esign Costs . $ 2500- City Permit Fees . $ 5 (0 9 8 Washington State Sales Tax $ 2 Lf 7-7 TOTAL COST FOR STORM DRAINAGE SYSTEM $ A0 7 �S STREET II VROVEM NTS: (Including Curb, Gutter, Sidewalk, Asphalt Pavement andStreet-izg g) L/ -% S CL-v /0 v !3 uj t a S/ �nai Z(o�s0 SY Qs�h �3y(oZ� 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) avlG� ..dCyN L4 `ISy . IGOG Print signatory name (day phoney orms/COSTDATA.DOC/bh (SIGNATURE) (Signatory must be authorized agent or owner of subject development) SANITARY SEWER SYSTEM L W PRESSURE AIR TEST PROJECT: Av-k-- Sv hl-) (-,ie DATE: INSPECTOR: i "© LOCATION LENGTH PIPE MATERIAL PIPE SIZE PRESSURE TEST TIME RESULT TO FROM z u ? 'eve._. 7l � �- v To S S 4 1/ 195 to t�2.7 dataceoter/forms/pbp w/utilitysystems/ww/sspressurc. doc O2/2002 bh TRANSMITTAL DATE: TO: Waste Water Utility FROM:n.' t SUBJECT. Submittal of Sanitary Sewer TV Tape Project Number. �5y Project Name: J t✓ 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/fOMW' tiliry/wwflMSFORM_DOC/MAB/bh Pacific Concrete Services 26220 79th Av S Kent, WA 98032 Phone:253-856-2572 Fax:253-859-5087 Project Name: Asset ID: City: DELANEY PARK DPS 240 TO DPS C/O RENTON SUBDIVISON Date Pipe Width: Pipe Height: Pipe Type: 9/20/2010 8 8 PVC Direction: Surveyed Footage: Weather Upstream 139.5 Light Rain DPS Cro 0, PACIFIC PC-- CONCRETE SERVICES Address: DELANEY PARK SUBDIVISION Surface Condition: Asphalt Tape/Media n Lt At 139.5 It I 'stop & save At139.5ft121. Clean Out - Clean Out 10.0 ft 20.0ft 300ft 40.0 ft 50.Oft 60.0 ft 70.0 ft 80.0ft 90.Oft 100.0ft 110.0ft 120.0 ft 130.0 ft ►� At00ftJ f START US - Start Inspection Upstream 240 TV Inspection with Pipe -Run Graph Page 1 of 1 Pacific Concrete Services 26220 79th Av S Kent, WA 98032 Phone:253-856-2572 Fax:253-859-5087 PACIFIC P C S CONCRETE SERVICES Project Name: Asset ID: City: Address: DELANEY PARK DPS 240 TO DPS 230 RENTON DELANEY PARK SUBDIVISON SUBDIVISION Date Pipe Width: Pipe Height: Pipe Type: Surface Condition: 9/20/2010 8 8 PVC Asphalt Direction: Surveyed Footage: Weather Tape/Media # Downstream 67.7 Light Rain DPS 240 y ►_ At0.0ftJ M START DS -Start Inspection Downstream _ Y At67.7ft.1 �r}} stop & save DPS 230 TV Inspection with Pipe -Run Graph Page 1 of 1 Pacific Concrete Services 26220 79th Av S Kent, WA 98032 Phone:253-856-2572 Fax:253-859-5087 PACIFIC P C S CONCRETE SERVICES Project Name: Asset ID: City: Address: DELANEY PARK DPS 230 TO DPS 220 RENTON DELANEY PARK SUBDIVISON SUBDMSION Date Pipe Width: Pipe Height: Pipe Type: Surface Condition: 9/20/2010 8 8 PVC Asphalt Direction: Surveyed Footage: Weather Tape/Media # Downstream 222.0 Light Rain DPS 2301 (f y (►_ AtO.OftJ. M START DS - Start Inspection Downstream YJ LAt47.5ft9l. At 50.4 ft 3/. J L' LAT- Lateral connection LAT - Lateral connection r At89ft J L J L At 86.5 ft 9f. LAT - Lateral connection � r o LAT -Lateral connection O N N N N N N �$ 76 At124.1 ft3/. J L�' �' J L At 126.1 ft 9/. LAT - Lateral connectionCn LAT - Lateral connection At 169.4 It U J L y i J L At 167.5 It 9/. LAT - Lateral connection LAT - Lateral connection At 205.8 ft 3L J L. I 4 J L At 203.7 ft 9t LAT -Lateral connection LAT - Lateral connection V y At 222.0 It J. stop & save (( 'JDPS 220 TV inspection with Pipe -Run Graph Page 1 of 1 Pacific Concrete Services PACIFIC 26220 79th Av S Kent, WA 98032 Phone: 253-856-2572 Fax: 253 859 5087 P C S CONCRETE SERVICES Project Name: Asset ID: City: Address: DELANEY PARK DPS 220 TO DPS 210 RENTON DELANEY PARK SUBDIVISON SUBDMSION Date pipe Width: Pipe Height: Pipe Type: Surface Condition: 9/20/2010 8 8 PVC Asphalt Direction: Surveyed Footage: Weather Tape/Media # Downstream 291.0 Light Rain DPS 220 '% ��� j �_ At0.0ft.L =h START DS - Start Inspection Downstream At27.2it3/. J L. � y_j LAt25.2it9/. LAT - Lateral connection LAT- Lateral connection At73.8ft3/. J L. LAT - Lateral connection At117.5ft3/. J L. LAT - Lateral connection Al 157.9 it 3L J L Y LAT- Lateral connection At 198.3 It 3/. J L. Y LAT - Lateral connection At 236.9 it 3/. 1 0 LAT - Lateral connection At268.5ft3L J Ll LAT - Lateral connection �J LAt71.8ft9/. LAT - Lateral connection At111.ift9/. LAT - Lateral connection v- yJ LAt156.2itW LAT -Lateral connection _ YJ LAt210.9it9/. LAT - Lateral connection VJ LAt251.7fit 91. LAT- Lateral connection y At291.0ft1. 'stop & save TV Inspection with Pipe -Run Graph Page 1 of 1 Pacific Concrete Services 26220 79th Av S Kent, WA 98032 Phone:253-856-2572 Fax:253-859-5087 Project Name: DELANEY PARK SUBDIVISON Date 9/20/2010 Direction: Downstream Asset ID: DPS 210 TO DPS 200 Pipe Width: Pipe Height: 8 8 Surveyed Footage: 44.2 City: RENTON Pipe Type: PVC Weather Light Rain DPS 210I li PACIFIC P C S CONCRETE SERVICES Address: DELANEY PARK SUBDIVISION Surface Condition: Asphalt Tape/Media # y ►_ At00ft Jt•)i) START DS - Start Inspection Downstream 100ft 200h 300ft 400fi v y o At44.2ft.1 99X- STOP - Inspection Stopped DPS 200 TV Inspection with Pipe -Run Graph Page 1 of 1 Pacific Concrete Services 26220 79th Av S Kent, WA 98032 Phone:253-856-2572 Fax:253-859-5087 PACIFIC P C S CONCRETE SERVICES Project Name: Asset ID: City: Address: DELANEY PARK DPS 200 TO DPS 205 RENTON DELANEY PARK SUBDIVISON SUBDIVISION Date Pipe Width: Pipe Height: Pipe Type: Surface Condition: 9/20/2010 8 8 PVC Un Paved Direction: Surveyed Footage: Weather Tape/Media # Upstream 106.5 Dry DPS 205&//1� kt At 106 5 tt r stop 8 save 100, 20.0 ft 30.0 ft 40.0 ft - 0 0 50.0 ft 5 VD v 60.0 ft 70.0 ft 80.0 ft 90.0ft 100.0 ft ►� At00ft 1. M START US - Start Inspection Upstream DPS 200 TV Inspection with Pipe -Run Graph Page 1 Of 1 Pacific Concrete Services 26220 79th Av S Kent, WA 98032 Phone:253-856-2572 Fax:253-859-5087 PACIFIC P C S CONCRETE SERVICES Project Name: Asset ID: City: Address: DELANEY PARK DPS 200 TO DPS 110 RENTON DELANEY PARK SUBDIVISION SUBDIVISION Date Pipe Width: Pipe Height: Pipe Type: Surface Condition: 9/20/2010 8 8 PVC Un Paved Direction: Surveyed Footage: Weather Tape/Media Downstream 64.6 Dry DIPS 2001 i t•— AtO,Oft I START DS - Start Inspection Downstream v v _ At64-6 tt >>>>> stop & save DPS 110 TV Inspection with Pipe -Run Graph Page 1 of 1 Pacific Concrete Services PACIFIC 26220 79th Av S Kent, WA 98032 P C S Phone:253-856-2572 Fax:253-859-5087 CONCRETE SERVICES TV Inspection with Pipe -Run. Project Name: Asset ID: City: Address: DELANEY PARK 110 TO 100 RENTON DELANEY PARK SUBDIVISON SUBDIVISION Date Pipe Width: Pipe Height: Pipe Type: Surface Condition: 10/18/2010 8 8 PVC Other Direction: Surveyed Footage: Weather Tape/Media # Downstream 327.3 Dry DPS 1101 y ►y At 0.0 ft !. *))I- START DS - Start inspection Downstream 100.0ft c M r N N � MCq L N N Q � 200.0 ft 300.0 ft • At 327.3 ft l M STOP - Inspection Stopped 100 TV Inspection with Pipe -Run Graph Page 1 of 1 Pacific Concrete Services 26220 79th Av S Kent, WA 98032 Phone:253-856-2572 Fax:253-859-5087 PACIFIC P C S CONCRETE SERVICES Project Name: Asset ID: City: Address: DELANEY PARK DPS EXISTING TO DPS 100 RENTON DELANEY PARK SUBDIVISON SUBDIVISION Date Pipe Width: Pipe Height: Pipe Type: Surface Condition: 10/18/2010 8 8 PVC Other Direction: Surveyed Footage: Weather Tape/Media # Upstream 55.4 Dry DPS 100* _ I • At55AIt )r STOP - Inspection Stopped 100tt 20.Oft +� v v ui i,ii� N t 30.0 ft m 40.0 ft 50.0 ft 1111111110 START US - Start Inspection Upstream EXISTING TV Inspection with Pipe -Run Graph Page 1 of 1