HomeMy WebLinkAboutWTR2702331 W-2331
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PROJECTNAME:
ALAS:
CONTRACTOR(IF KNOWN): _lo c Q 1 FL-S c o— 1 T• CO • _
PROJECT NUMBER: VJTfZ 2 l - 2231
WORK ORDER NUMBER: 88097
STATE CONSI'.REPORT 1''
SIGNED BY: N&I WQAk
/ lit
YEAR PROJECT TAKEN INTO PLANT: q
RECORDED BILL OF SALE: ��5 I o95�9 IO 3D0 I5
RECORDED EASEMENT: �I 80 5'LO 1 0 gQSO S Z o 10 8P� °l fl0S0 189 Z
COST DATA INVENTORY: PIPE$ 4 Le" HYDRANT$
BACKFLOW TESTS: Y N
PURITY'rESI: no.taken_ Test No(s) 5
PRESSURE TEST:
rMeNIt�6T MAt4A&e4z: K4Y(ZE�.l k Tf121c,*
Ucemenll\
CONSTRUCTION REPORT FOR PUBLIC WATER SYSTEM PROJECTS
Effective Septembe•9, 1983 the following Regulation applies: WAC 246-290-040(3)-A construction report
shall be submitted to an-1 accepted by the department within sixty days of completion and prior to use of any
project for which plans and specifications have been approved by the department for projects designed by a
professional engineer. The construction report must be signed by a professional engineer. The report shall
state in the opinion of the signee whether the project has been constructed in accordance with approved r'--is
and specifications and the installation,testing and disinfection of the system were carried out in accorde .
with department regulations.
a) If a project is being completed in staged construction,attach a map and description of portion of project
being certified as completed as approved on date given below.
b) As future portions of staged construction projects are completed,each mv-be certified as required by
WAC 246-290-u40(3).
c) Additional certification forms are available upon request from DOH offices listed below.
• City of Renton "' DOH Water System No. 71850t.
200 Mill Avenue South
Renton,WA 98055 Referendum No.(if any)
PROJECT NAME AND DESCRIPTIVE TITLE: Date Specifications Approved
City of Renton Water System by Department of Health
King County August 18, 1993
Renton Project Number W r K 27 Z 33 I (1990 Comprehensive Water System Planl
Project Title: Teffcrson AkleO c A401twtcvt�S
The undersigned engineer or his authorized agent has inspected the above-described project,which as to
layout,size and type of pipe,valves and materials,reservo;r and other designed physical facilities has been
constructed in accordance with specifications approvei'y the Secretary,Department of Health,and in the
opinion of the engineer,the installation,testing and disinfection of the system was carried out in accordance
with the specifications approved by the(ary. A ' /' >
l V� wt4
•[�� � •� '•� Engineer
Engineer's SealK�el
ft
ALAqwil 2S
Date
Please return completed form to DOH office checked below:
NW Drinking Water SW Drinking Water Eastern Drinking Water
® Environmental Health ❑ Environmental Health 17 Environmental Health
1 1511 Third,Suite 719 Mail Stop 7823 1500 W F arth,Suite 305
Seattle,WA 98101 Olympia,WA 98504 Spokar ,WA 99204
11 DIVISIONS\LMLInES\DOCS\96-367.DOC
(future Ad*w:
City Clack's Oaks
City of Ran W
Rtmtoo,WA 98055.2199 e
gaw
W.Z331
�� Gn�sC VATA M
BILL OF SALES Proper+l Tas rind Namher
4•
PrajaR Fde 1: W-g I ueet tatiaa: AMr t•
Retereaa Number(-)of Doamm4.niDod r ttlased:Mdilimal ydarame ambers are on Pale
L7 Craator{a): y ) P , 1t Grantee
%-,,4, of .
"P 1. s;ity of Renton,a municipal Corporation
.J 1IW ,2, QA eem.nddctivm'a
The Creator,as-coned chore,ter,and 4 consideration of mutual bacfiU,hereby Incas.bugamv.
the Gmatea,Y Emma sv, I the fd!ooiog dtamw PQmnal PoPortY
N"1 WATERSYCTI M: WalaM.ta
L.F.of �' gt.'�.� Water Main
'� tiy,,v• LF.at ' /LF.Ofw.ta Mato
S.
each of �3 G.tevdra
. H w
of ¢° = Gatevd
00� ech of Fite Hydrant Aw®bliu
&AMARYaEWERSYSTaL ice+ IYl� Scwamain
L 'of of Sewer Msm
L.F.of
LF. Sawa Main
each of - Ihameta Manhole.
S each of D=wt-Madalve
each of Dumas Mudw!s
STORM DRAINAGE SYSIrdt: I&II&
L.F.of r JSita La Storm line
swrmLinc
LF.of Stain Lice
�t LF.of Stang falebOtdlst
�or
of �^ Slutm Catch Basin
cub of Muttnle
S-. SFREETIMPROVEMFMS: Ooc!uding Curb.Gutter.SidewdkM'!wltPavrmmU
$ Curb.Gutter.Si&*A i+ 1..F. Width
Asphalt Pavement: �`S Y or LF.of
STREET LIGHTING:
TE
€ N of Poles all and every PC",
Dy thi.emveyaoee.Oeantm r n ill wvnt cad defend 1 rate hereby made onto the GtaeYae Winn
� a pecaow,whomwever,4wlld!y rLimiog a to e4im the same. ILis rmvrYaoae ala0 bind 0e heirs,a wl�aes O
$ adm!dm,dlaa and..alga.krcm. _. ralt a
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H;V'pyaYalYY.l(WKKD011I1BN18A1.LAOC�IIAD
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LETTER OF TRANSMITTAL
FROM: MELODY A.CHERRY
DATE:OCTOBER 29,1997
PROJECT NAME: JEFFERSON AVENUE FAMILY HOUSING
BE: COPIES OF PRECONSTRUCTION MEETING MATERIALS
Water Utility -�I- i0 • &,,I'- — ® Building Division
® Wastewater Utility Public Works Conatr Inspector
® Surface Water Utility ® Flre Prevention
i Maintenance Services
® 'Transportation Systems
Attached please find copies of:
PERMIT ® BILLS OF SALE
RECEIPT COST DATA INVENTORY
LETTER OF SPECIAL BILLING ® EASEMENT(S)
® STUB SERVICE AGREEMENT ® COPY OF AS-BUH.T
PRECON NOTES
PRECON ATTENDEES
® DRAINAGE REPORT
® MEMO•WATER B'.L.AKDOWN
® MAP WITH NEW MAINS AND VALVES
® OTHER
cwcrsacoNsmnwsu
- I
IMRCITY OF RENTON Construction Permit
Permit Number C9702.65
Permi;sion is hereby given to do the following described work,
according to the conditions hereon and according to the approved
plans and specifications pertaining thereto, subject to compliance
with the Ordinances of the City of Renton.
Work Description
INSTALL UTILITIES FOR JEFFERSON AV FAMILY HOUSING
INCLUDING WATER, SEWER, STORM DRAINAGE WITH VAULT
AND LIGHTING WITH PAVING AND STREET IMPROVEMENTS.
ALL CONSTRUCTION IN ACCORDANCE WITH CITY OF RENTON
CODES AND THE ADDENDUM AS AMENDED AT THE PRECON
HELD 10/22/97
Job Address
1000 JEFFERSON AV NE
Owner
CCS/RENTON LIMITED PARTNERSHIP
100 23RD AV S
SEATTLE
WA 98144
Contractor
JOHN DANIELS CONSTRUCTION INC Contractor's License JOHNDI.231KE
2232 PACIFIC Contractor's Phone (509) 542-8141
BELLINGHAM, WA 98226 City License 1092
Contact CCS/RENTON LIMITED PARTNERSHIrontact'sPhone '< 06-328=5648
Other Information
Date Issued 10/22/1997 Work Order 8�31Sgo�?
Date ofExpira,ion 08/20/1998 Parcel Number
Date Finaled Inspector's Name THOMPSON, DAN
Inspector's Phone 999-1828
It is understood that the City of Renton shall be held harmless of any and all liability,damage or injury
arising from the performance of the work described above. You will be billed time and material for any work
done by City staff to repair damages. Any work performed within the right-of-way must be done by a
licensed,bonded contractor. Call 277-5570 one working day in advance for inspections.
Locate utilities before excavating.
Call before you dig-48 Hour Locators 1-800424-5555
1 hereby certify that no work is to be done except Subject to compliance with the Ordinances of the
as described above and in approved plans, and that City of Renton and information filed herewith th,s
all work is to conform to Renton codes and permit is granted.
ordinances.
X X
Applicant Public Works Rep
THIS PERMIT MUST BE POSTED AT THE JOB SITE AT ALL TIMES.
BD3103e oatw,.f
AUTHORIZATION OF SPECIAL BILLING
DATE: October 22, 1997
PROJECT NAME: Jefferson Avenue Family Housing
PROJECT NUMBER: C970265
WORK ORDER No.: 89097 V
It is the intent of this letter to authorize the City of Renton to bill the undersigned for all
costs incurred relative to the referenced project,by the City of Renton for the following
work:
TIME 4ND MATERIALS FOR AM AND ALL ROAD CLEANUP EFFORTS
PERFORMED BY CITY FORCES OR CITY CONTRACT.
ALL OVERTIME FOR LVSPECTION AND RELATED ACTIVITIES, BUJ ABLE
AT A RATE OF FIFTY DOLLARS(S50.00)AN HOUR
TIME AND MATERIAL FOR ANY WORK PERFORMED OR CONTRACTED
BY CITY STAFF TO REPAIR DAMAGES !!R ENFORCE COMPLIANCE WITH
CONSTRUCTION PERMIT CONDITIONS.
ANY CHLORINATION OR WATER MAIN INSTALLATION CHARGES
INCURRED FOR WORK BY OR EQUIPMENT OR MATERIALS SUPPLIED BY
THE CITY OF RENTON.
BILL24G TO BE SENT TO:
(Please print)
Name: St q,,u;e- C) urm%N 1' q,LMpw%t�
Company: L(.S W L J
Address: I DO- 13r* A\X• S , Se,asmf' 0oft 1%1"ly_
Phone:Pb1'Qt-61L`Q� pat_ (-)Ax) 3�e— 5LZ1
Own /Developer or Authorized ent
►
I
MEETING ATTENDANCE RECORD
PROJECT: Jefferson Avenue Family ftousin¢ DATE: October 22, 1997
i LOCATION: Sth Floor Conference Room COORDINATOR: Kavren Kinrick
NAMUMNIPANY ADDRESSCM/nr PHONE
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r��yL--ft� ,-�r,,�'fir�1s S� nz.e�,.�•�il ��blol
ii)tVYt�Ln u�—
PLEME NOTE:Ifyou wish to receiwthe mmut ofthism jng your full eddrc mue be liaed.
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WHEN RECORDED RETURN TO:
City Clerk's Office
City of Renton
'W„"" ,A 98055,11 200205150013
Renton,WA 98055-it89
ITrap [p5 11.es � 1W , 5 M
KING COLIN Na
Document Title: UTILITIES EASEMENT
Grantor: Hume Investments Ltd.
Grantee: City of Renton, a Municipal Corporation
Legal Description:
Abbreviated Legal Description:
Full Legal Description: THE NORTH 15.00 FEET OF A PORTION OF
LOTS 8, 12 & 13 OF FRED AKERS REAL ESTATE NO. I IN VOL. 63, P.
72 IN KING COUNTY WA.
a., Assessor's Tax Parcel Nos.: 0089000090
o Project File No. C970265
0
.n
o UTILITIES EASEMENT
N
O
O
N That said Grantor(s), for and in consideration of mutual benefits, do by these presents, grant,
bargain, sell, convey, and warrants unto the said Grantee, its successors and assigns, an
easement for public waterline with necessary appurtenances over, under, through, across and
upon the following described property (the ''right-of-way") in King County, Washington,
more particularly described above(the "Property").
For the purpose of constructing, reconstructing, installing, repairing, replacing, enlarging,
operating and maintaining water lines, together with the right of ingress and egress thereto
without prior institution of any suit or proceedings of law and without incurring any legal
obligation or liability therefor. Following the initial construction of its facilities, Grantee may
from time to time construct such additional facilities as it may require. This easement is
granted subject to the following terms and conditions:
I. The Grantee shall, upon completion of any work within the property covered by the
easement, restore the surface of the easement, and any private improvements
disturbed or destroyed during execution of the work, as nearly as practicable to the
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A eh
�h¢
' -IR4"1 , 1ls.m.ax nd...,e • .xmol+l.�M14TMMfJYltl.�wm. W
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condition they were in immediately before commencement of the work or entry by the
Grantee.
2. Grantor shall retain the right to use the surface of the easement as long as such use
does not interfere with tt.e easement rights granted to the Grantee.
Grantor shall not, howevt•, have the right to:
a. Erect or maintain eny buildings or structures within the easement.
b. Plant trees, shruns or vegetation having deep root patterns which may cause
damage to or interfere with the utilities to be placed within the easement by
the Grantee, or
C. Develop, landscape, or beautify the easement area in anv way which would
unreasonably increase the costs to the Grantee of restoring the easement area
and any private improvements therein.
d. Dig, tunnel or perform other forms of construction activities on the property
which would disturb the compaction or unearth Grantee's facilities on the
right-of-way, or endanger the lateral support facilities.
e. Blast within fifteen(15)feet of the right-of-way.
Notwithstanding anything to the contrary contained herein, Grantor shall have the right to
relocate the easement to another portion of the Property at Grantor's sole cost and expense,
�+ provided that in connection with such relocation, Grantor complies with the terms of
n
n Paragraphs 1 and 2 hereof. However, Grantor may not relocate the easement if it will
materially interfere with the present or future operations or maintenance of the utility line.
This easement shall run with the land described herein, and shall be binding upon the parties,
r� their heirs, successors in interest and assigns. Grantors covenant that they are the lawful
owners of the above properties and that they have a good and lawful right to execute this
r„ agreement.
0
e
N 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.
26621902'.101497 -2. EASEMENT AGREEMENT
CPROCTCCSVIENTON
I
n an ,
i
IN WITNESS WH^EREOF, sat.' vrantor has caused this instrument to be executed this 20
day of L'± 1 j02,
^ 1997.
} �A-k Wk a s4y�- As LA-k .
PROVINCE OF s
as.
CITY OF u
On this D day of 1997, before me, a Notary Public in and for the
Province of } C (o;ice duly commissioned and sworn, personally appeared
3-n,r rJ .5 4(1,•w�- known to me to be the individual ,-med in and who executed the
foreg ' g document, and acknowledged to me that he/she sign,a the same as his/her free and
voluntary act and deed for the uses and purposes therein mentioned.
I certify that I know or have satisfactory evidence of the person appearing befo a m1 and
making this acknowledgment is the person whose true signature appears on this dc.cumcnt.
.n WITNESS my hand and official al the day and year in this certificate above written.
cn
o �
0
v-
o
Print Name
o NOT4RY PUBLIC in and for thp Pro�ce
N of L •• residing at �.t
My commissioners . -t era e
2662\W1:10/14M -3- EASEMENT AGREEMENT
MOLTMMENTON
I
1
MAP EXHIBIT 'ON. M CASE
AT . I ( DEX
ASE
�a. PAGE 5 AVE N.E.
17
8.66' 5`9'1018"W S24109'0 E
5'W p I
N89'45'45'W 89'/SYS'W N69Y3'45'W
/ s 124.6 54,14' 96.07'
°s• �"` �FAED Ak.ERS 16
REAL ESTATE 16 � I
,�•r. as \'�
NO.
1__ W
W
abp`h �'1"o,�r N$ nry --- - gm
,� � ,
PR_
96.21'C- IN 68'S5'S9" 1 7 DEED I R 17s O
i ' Z
. 4'
ti 8 i
1 14
N78'OS'00"E 1.11' r
i 13 � Q
/fiEPLAT OF BLOCKS 12,13J4, n •` I (N>6�'Oo•g•% 15.00 m N Z
z5/ 30. 37 8 38 CORRECTED 173DDi �z I J
an c e PLAT MGHLANDS NO. 2
a n 3t J•T• 1 O 5.215'1DEEp - I cc
0'*Y� �� p o W. 00R.'LOT a MIT
LL� S.E. OOR. LOT /3"'
•/'V 14 I n I
<azj \ w r 12
10
I30' 30' I
J
n MON. IN CASE
i (TYPICAL)
LEGEND:
EASEMENT AREA /• / .'pT ■Ayji..
'`
F
Plann
��r�p/J��,� [ ineering ,,�I1691
2YE gurveytng /�V.19'c/J�-:..
_Pe_nhallegon associates Consulting Engineers, Inc. o-vusn�2s�97
v5n 9ltlli YTRi6T 1<IR%LWD. q 960JJ (20A) 6:^>-2C 14
I
MAP EXHIBIT MIT �
PAG. 5 AVE. N.E.
�1W
25P'S1'00"W �Q'^
5.00'
W I
e .49�0'4 -W 1497 . n
8.66' '04"E
I '4 '45"W N89 Y5'45"W
. 124. ) 86.14'07 96.0TNB9'45'45"W l51
0.638hp arvd�
I
3
FRED AkERS 16 I
/ REAL ESTATE I
PROP. i/NE ,` 8' 96.21'
/ - 68'S5'R 1 r 7 I s Z
- t 75.54' DEED
r
D 6 I I'
/ 7 . �i N'18T15'00-E 14
f________-_13 IQ
N16'05'00-.E SrlAl' r 13 111111 v
1.11'................ /•Y
�ZS'7 REPEAT OF BLOCKS 12,13,14, N 55 r (N>6 j6,00"Iy 15.00 I inn _
S/ 36, 37 & 38 CORRECTED • >e• 4• 1J5.33•DEfDi i,R I Q
C '+..... 4
PLAT H%LANDS NO. 2
d.
0 re r 121 `'W Co P/ate: / •,..s.w. mx.r LOT 8 o
A• Q tl H �1�
S.E. . LOT 1]COR '. pH S.+
03.
ZI P
o r I i
30
i
NON. IN CASE
(TYPICAL)
LEGEND:
EASEMENT AREA
Engineering
Planning
Surveying
Penhallcgon_Associates Consulting Engineers, Inc_. �/26/97
)50 30.'tli 9TPdET hlP.)(IdNO, NA 9E050 (206) E2Y-2CId
I `M�nrwrr.Mwn"•�. gip` wvun'4vemx+� �
i xFry�4
3
Shot Plat (Sf1PL R _
REQUEST FOR PROJECT N Prelitt•_Pig (PPN
CAG# )
To: Technical Seryrces Date ZQ ao "� WON
�"o97 cpxrta
From: Plan Review/Project Manager J�A y F-g,) K r T1-r-. r
Project Name JJ0 r
-,f'U�0•'C1�7�+'1 �1p yi
(!0 china mu)
Description of Project:
ircle Size of Waterline: 10" 12"
Circle One: Ne or Extension
Circle Size of Sewerline: 8" 10" 12" Circle One:
Circle Size of Stormline: 12" i5" 18" 24" Circle One: New or Extensiop
Address or Street Name(s) 1�A ,01 Al
0;
- AJr /n'a sr K11CKaAti1p r4j; ,t)6
Dvlpr/Contractor/Owner/Cnslt::-3(Z f-~Ckbt)Aj PrN Vd
(70 cb n ctt mac)
Check each disc,pline involved in Project Lir Drwg 0 of sheets per discipline
V� Trans-Storm ❑ ❑ `
(Rwdw.y/DniMp) (Or ua:
(include TFSC theeu)
O Transportation tSpu n nq Oun rjindnn,Udhdng) O ❑ _
❑ Wastewater ❑ ❑
^/ 5wury Scwu Hun Cndude bum none)
V Water (Hunt ❑ „•f
,Vunt.Hydnnu) IJ
❑ Suface Water (rncw mmpoti�c❑ tn k Hnnnul CO 5)weu)
r
Improvements ( L )intivdc b,oin n.me) `
TS Use OnlyE
jai to.au rn•��. ..�.. �� ,,,,,,,, _
C (aueka T"Un9 laboratories.Inc. 0
I 240 S.Ham" S.Rtft.WA 9B10B
WATER BACTERIOLOGICAL ANALYSIS
SAMPLE WIKTION.READ 96TRUCTI0NS ON 61CK OF WLDENROD COPY
■RrtnrrbeM N nW 1DIIeIwId,y,tIR1A aAl d nlaabd.
OATS COLLECTED TIME COLLECTED COUNTY NAME
.d.,n a.. ..M, �:pp
AY
\ TYPE OF SYSTEM ;�i�
19lIC SYSTEM.COMPLETE0IN �r 4CA"
WaY ouEL
i NAME Or SYSTEM
SPEOFXUXAff
2 v 7Z.Goo 'E`E"gtE
DAY( 1999-/92�
EVENING 1 )
SAMPLE COLLECrEO BY:(NMr) SYSTEM OWtERMGIL:(MMnA)
WAMTIP-
TYPE MOUND WATER U,oS SUMACE BMLUlaK:E
�U"`AOE wALFIELD nSM."" ❑ ED. DODION.TION
PITlRT1E v OTMER
. ,NO REPORT M.(PLAN Fi NMM.Amer ra Cea
wWNama Q
TYPE OF 9ANVU(d"ROUTINE
any ar N Bia aaFwln)
DRINKING WATER Oaim CAAO l_TOW_rn�)
dvctv"a 8 „a
LMAAMa aOrrr __
REPEAT SAMPLE
PSI coGIO,T PraMlaa BAD r
om �1
Q PAW SOURCE WATER So- P = TAW C.N.
„t•W jg-t CONSTRUCTION w REaMRS I� Fql c4wp
❑OTHER 1SPAetrl
11FuARNs.�/}iPCE'S ;J9�►1/(,t 7fi,!'C?J1/ �Gx%�'ikJ7/
MIS UBE ONLYIOR9IKINO VIATE11 RESULTS
U1SATWACTORY.0,0 n PlAAaIn O SA ACTI)RY,
PIEPFAT I--�E.Cd PIaAN E.C k ADIMI
REOUSm LJ rlodta.rd O F.rl dlyd
OTHER LABORATORY RESULTS
TOTALOpUFORM 1T1b,M 1: COI! /I ,N
FECAL COUFORM`110E IN PLATE 0OUN1_AN
ANOTHER SAMPLE REOURED
SAMPLE NOT VESTED BEWUSE. TEST UNSUITABLE BECAUSE
❑I—II L^ib RA eq n OrFwM Be.nn
LJ W"mAaYr� I�a8_51 TNTC
AmalbY Aam TWEOMNn
�----- EAaYa 010,1t
SEE REVERSE SIDE Or GREEN COPY FOR EXPLANATION Or RESULTS
UIB ND AODITq W 1W;NI D N[CEIYFD Br
psflS/3�3 �aa� 8 /�„I
r15'a,�c,t:.
DATE RLgIILD - WpUlpq.. 'E