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Job if:
106324230
Date: 5/1/17
Jurisdiction: PENTON
Right of Way Permit? 2 YES ❑ No
Est, Start Date:
Est, Duration: 1 day
PRE -INSPECTION REPORT
Address: 14916 133RD AVE SE
City / Zip: PENTON, WA 98058
Contact: Anthony Stephens 530-559-7862
PM / Insp: Kevin Haibeck fffP9 05
PHONE NUMBER
WORK DESCRIPTION: ,
Intal 54 of 1-1/8"
PE comp/ete svc-(20' scat Stub in R/W_,'
39
scat
extension_on Droderty) and set A425 MSA
w1reou/ator 7400191.0 2600 EFV.
❑New Construction
-- -
-- �
- - --- --
-
21 Existing
PLAT 210.086 N
SE 149tH
/ CL
ST
/
�► s
� �
M
/
f
/ WORK
AREA
14916 133rd
Ave SE
44
it
qq
/
/
/
/
Work Location
Size
of Cut
Surface Type
190' S f
CL
SE 149TH ST
_
& 10' OgLW
f CL 133RD AVE SE
XX
5'
ASPHALT
190' S f
CL
SE 149TH ST
&..j5L.LtXof
CL 133RD AVE SE
XX
5'
GRAVEL
N of
CL
& E W
of CL
❑
FLAGGERS #
MPH ❑
TROLLY LINES
❑ BUS STOP #
[:1 METER HOODS #
❑
OFFICERS #
SPEED LIMIT ❑
TRAFFIC SIGNAL
❑ ARTERIAL
❑ NO PARKS #
❑
Commercial
❑
Altered Commercial ❑
Leak Repair
Service Information
❑ Template Bar
I]
Residential
❑
Altered Residential ❑
CP Work
Diameter Meter
EFV
El Bollards #
El
Multi -Family
El
Replacement Service El
Pothole
❑ 5/8" El
El 775
El "
R]
New Constr.
❑
Main Maintenance El
Extension
0 1-1/8" 0 425
El
El
1800
Bollards 4 4" #
❑
Stub
❑
Service Maintenance
❑ 1-1/4" ❑ 630
2 2600
❑ FUEL LINE PERMIT NEEDED
❑
Extension
❑
Valve Maintenance
❑ 2" ❑ 1000
❑
10,000
Fuel Line Length:
0
Compete Sery
❑
Cut & Cap❑
Mtr Loc: OR/08
N/A
Fuel Line Diameter: