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Job #: 106324566
Date: 5/8/17
Jurisdiction: Renton
Right of Way Permit? 0 YES ❑ NO
Est, Start Date:
Est. Duration: 1 day
PRE -INSPECTION REPORT
Address: 2821 INC: 16TH ST
City / Zip: RENTON, WA 98056
Contact: Gurminder Kaur 206-407-7210
PM / Insp: Kevin Haibeck ffsp - 05
PHONE NUMBER
WORK DESCRIPTION:. Instal/ 43 of 14/8"
PE complete svc
(15' scat stub in R/W_ '
28
scat
extension on_arober-tv)-and
set A425
MSAw/rea. 7400191...
2600 FFV
____
El New Construction
-
- _ _ - _ _ -
-
_ - - _
Existing
1
lj000
PLAT
205.084
FX/SrjN�
i
4
G
10949� 8 10447 je
17
WORK` O
AREA
CL
2817 2821
-
'
16
th
I
St
--
-
42901
_
_--- w
490
Jr /P
2909
29141
0
�I 5
4—
N
Work Location
Size
of Cut
Surface Type
15 S
f CL 4 NE 16TH ST
& 242' K.Wfif
CL JEFFERSON AVE NE
3'
X 5'
Asphalt & S/W
NSofCL
_
& CL
NSofCL
& EWofCL
❑
FLAGGERS # MPH
❑
TROLLY LINES
❑ BUS STOP #
❑ METER HOODS #
❑
OFFICERS #
SPEED LIMIT
❑
TRAFFIC SIGNAL
❑ ARTERIAL
❑ NO PARKS #
❑
Commercial
❑ Altered Commercial
❑
Leak Repair
Service Information
❑ Template Bar
❑
Residential
❑ Altered Residential
❑
CP Work
Diameter Meter
EFV
El Bollards 2.5" #
❑
Multi -Family
❑ Replacement Service
El
Pothole
El 5/811 ❑ 250
[1
775
El
❑
New Constr.
El Main Maintenance
El
Extension
[D1-1/8" 2) 425
El
1800
Bollards 4" #
❑
Stub
❑ Service Maintenance
❑ 1-1/4" ❑ 630
E
2600
❑ FUEL LINE PERMIT NEEDED
❑
Extension
❑ Valve Maintenance
❑ 2" ❑ 1000
❑
10,000
Fuel Line Length:
Compete Sery ❑ Cut & Cap
Mtr Loc: OL/03
❑
N/A
Fuel Line Diameter: