311 12TH AVE N.PDF1111111111
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311 12TH AVE N
CITY OF EDMONDS
PUBLIC JOS DEPARTM.ENT, ENGINE*ERINGOv 1 s8TREET FIL
.APPLI CATION FOR EIGHT-0
E 14AY CONSTRUCTION PERMIT
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES
Applicant to Complete Parts A and B
A. Permi.t to be issued to: -e r4-/ 04 Ll ir,
For Work at:(address or vicinity)'- A e, A) 1 t
C
Type of Work to be done: T CAT%f ek(Je-
(attach drawing when applicable)
Time Required -- Start:
Owner: LA�e�
Name TV -
Mailing Address
K W " L
City State Zip
Contractor: 5" C& b"C'
Name
Mailing Address
Finish:
"? -)
Telephone Number
State License Number
City State Zip Telephone Number
B. INDEMNITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages, or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including or not limited to the defense of any legal proceedings including defense
costs, court costs,. and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is respon sible for workmanship and
materials for a period of one year following the final inspection and accepta I nce
of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until
the final street patch is completed, at which time a debit or credit will be
processed for issuance to theapplicant.
Work is subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this permit must b avai ble at the job site for inspection
purposes at all times.
Signature* Date:
r o-r"Akt<nt
TO BE COMPLETED BJ_;2-SUINCZ-,-AGENCY: Ile 06 P7-
Date Issued : Plermit No.: 7X-,v Fee: R1
Security Bond:_4-��--
Time Authorized: -Re
APPROVED B
10-111v (Revised)
Date: 412�-71�rl
IbLbt FJ,qU1K1U-LN1b AFT, W BE UELULLD IN WNJUNUIUN WITH THE M
.-V1 THE DEPARTDENT OF TRANSW,1TION, WASHINGION , D. C.
CITY OF EDMONDS
- PUBLIC WORKS DEPAR.MvENT -
Construction Traffic Control Reauiren-ents
This notice is to set forth basic safety principles and standards to be observed by
all those who perform work in a public street, to provide safe and effective work
areas and to warn, control, protect, and expedite vehicular and pedestrian traffic.
General Requirements for Traffic Control Devices. Two-way traffic mist be maintained
during work performance whenever safe conditions are possible. Maintain all necessary
traffic control devices in proper condition and locations on an around -the -clock
basis until final work is completed and approved by the City of Edmonds. Provide
"Construction Ahead" warning signs in advance of the work area in accordance with the
following speedconditions: Under 25 m.p.h. -'500 lineal feet; over 25 m.p.h. -
1,000 lineal feet. Use'of high-level warning signs is recbnuended on all streets,
especially in restricted sight distance areas.
Street Closure Requiremnts,-(Refer-to Figure 6-4). "Street -Closed" signs and properly —
worded barricades, indicating street closed, in accordance with Manual on Uniform
Traffic Control Devices and City Traffic Code shall be provided at the nearest inter-
sections to the work area which will allow an adequate traffic detour routing.
Directional "Detour Route" signing shall be provided at all turns throughout the
detour route on streets of heavy congestion, high voluw-, or unusual directional
routing. Local access shall be provided whenever conditions allow safe passage.
Advance "Detour Ahead" signs shall'be provided 500 feet in advance of the detour
route intersection of work involved.
The Police, Fire, and Public Works Departments shall be notified--of--the.-act-ual.�t-reet---
closure location and'period, both at the beginning and end. Streets shall be reopened
immdiately upon completion of the actual work requiring the street closure.
It shall be the contractors responsibility to notify all abutting property owners
prior to comiencing any construction which my inpede traffic flow or cause the
te:mporary suspension of utility service. Notice should be provided 24-hours in advance
if construction when possible.
Channelization of Traffic Lanes for Two -Way Traffic Without Provision of a Flagman
T19-f—erto Figure 6-7). Provide aNv_ance warning signs 1,000 lineal feet in advance
of traffic lane channelization.-n=kings or as stated for -traffic -speed conditions.
'Detour" or "Lane Change" warning signs shall be provided 500 line�l feetin advance
of traffic lane markings.
Cones or barricades shall be placedat'a 15 to 30 foot spacing, in a tapered line,
at the lane change section for a distance of 100 to 250 lineal feet. For traffic lane
channelization, barricades are required to separate the actual wrk area from the
traffic thoroughfare routing.
One Lane Channelization for Two Directions of Travel With Provision of FlagTm (Refer
to Figure 6-5 and 6-6). Advance warning and lane change/detour signs placed at
1,000 and 500 lineal feet, respectively, in advance of traffic lane markings.
Barricades are required to separate the actual work area from the traffic thoroughfare
routing. One flagman is required at work section areas of short distances.
Two flagmen are required at a work section area of long distances or when end of one
lane section is not visible from one end to the other. One flagman, only, is to be
designated to control traffic direction changes.
Flagman must possess a card.certifying conpletion of the State of Washington,
Deparurent of Labor and Industries Flagman Course.
State Highway RoaStiay Locations (Refer to Fig. 6-5 and 6-7). Advance warning and one-
lane/detour traffic signs placed at 1,000 andl,500 lineal feet, respectively, in
advance of channelization markers. Distances my vary as to existing speed conditions.
Lmm change channelization taper markers placed at 30 lineal feet spacing for 300 lineal
feet in advance of wrk area. Other requirerrients as described fortwo-way or one -lane
conditions shall apply.
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ONE LANE
ROAD
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1000FT
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flq�le 6-4. fypi-I ppli,.,j.—
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ODI.
APPLICATION CARD No . .......
----------------
for
it City of Edmonds
SUDE SEAVER PERMIT
EASEMENT No - ----------
OUTSIDE INSIDE REPAIRS
------ PERM ..................
OWNER--'t.- ................
..... IT No.
........... ----------------------------------- -- ------- — CONTRACTOR
STREET
HOUSENo . ....... j .. Y ---- ------- ...... ----------------- ------------- — AVENUE LOT No . ..... / ----------------------------- ------------ ------------ BLOCK No - ------------------- ...............
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NAMEADD. ............................................. ........................ ...... ...............
APPROVE-0
JUL 28 1965
BACIWILL WORK ORDER ISSUED --- ............................ DEPOSIT, $
--------------------
DATE ------- By ...
SEWER WORK 011JAM ISSUBW . ............. ............ .............
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:1P P�413 TO THI. F6L
TEttN�.
LOWTNG:�
�.174e:* OWners 'of
t.Property
be'?�lbyed,to coijs - may �jt 'p'e
rmit, to construct
%;
t.,:side; 'area. DO-66t c.v levFer., inslde� pi4irty- if
2. bts[in ;ffi], I & A6.
Ord er any, p.6it - i'� e
OTE,� " lqo�T3—Top.,of sid6'se*' �n� H i�ctbr m t
er;must have eg4lat'Ons ove" Peqed.
least 30 inchei si,de,: se
"'in 9�ade's��r thi
No b6fids gove
-1 .. I . � 11. coverage 2t'projWrty line ii nebe
OTE 140 4� be per6btte
Trencnes��jn d. .
",d6e.'g .,. 4a
stre t' rt
falluj, must -be wjLje
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InPro!)�ei- wo,k-)�,tr�.settJed.and suyj .0,M,
-NOTE N I ace-o, sq��i restore�., .�ra �.of 2%.,*
ma * "d
-�77it is- tl@aWfi�j ter- Y, evelop."' e tl t
. . Y9!tun on :.-year of co r
to I�J' br'do' . . zt, mp
any oLhei Wgrk:thail-Is p v '
PUrtenaZj��j, '�pept%,t6j b ir"p�nsible for.
'the"pipe to,the' -for in the
ro
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