106336109-7416 212 ST SW.pdf0 \:L L?,11(7.
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Please Rush
ROW PERMIT NO.: ENG
ISSUE DATE:
RIGHT-OF-WAY CONSTRUCTION
PERMIT APPLICATION
PROJECT NAME: 106336109
CONTRACTOR: PSE/Infrasource
Mailing Address: 1660 Park Lane, Burlington, WA 98233
State License #: INFRASL871 C2
City Business License #: N R-019840
CONTACT: Sue Sidick
Phone #: 425-457-6353
Fax #:
Email #: Susan.Sidick@pse.com
❑ Liability Insurance ❑ Bonded
ADDRESS OR INTERSECTION OF CONSTRUCTION: 7416 212th ST SW
ROW WORK ASSOCIATED WITH THE FOLLOWING TYPE OF PROJECT:
❑ Commercial ❑ Subdivision ❑ City Project ❑ Traffic Control (Only)
❑ Multi -Family ❑iC Single Family ❑ Other
❑ EUC (PUD, VERIZON, PSE,
COMCAST, OVWSD):
Is this permit part of a blanket permit?
ANY ASSOCIATED PERMITS?
❑ Yes ® No
BLD# ENG#
DESCRIPTION OF PROPOSED WORK (Be Specific) : Permission requested to install gas service
at approx 480' E C/I of 76th AVE W & 14' S c/I of 212th ST SW. (1 )5x5 concrete cut anticipated. Please rush due to
overlay.
WAS STREET OVERLAYED WITHIN THE LAST FIVE 5 YEARS? YES ❑ NO ❑ Year: 1063;
PAVEMENT CUT:
CONCRETE CUT:
❑ Yes ❑ No
❑ Yes ❑ No
If yes, indicate size of cut: 5
If yes, indicate size of cut: _
x5
x
RIGHT-OF-WAY
CLOSURE
AREA
TOTAL
DURATION
(NUMBER OF MONTHS)
Sidewalk 48 Hrs + LF
X
LF
SF
Alley 72 Hrs + LF
X
LF
SF
Parking 72 Hrs + LF
X
LF
SF
APPLICANT TO READ AND SIGN
*Traffic control and public safety shall be in accordance with City regulations as required by the City
Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and must have certification
verifying completion of the required training in their possession.
*Restoration is to be in accordance with City codes and Standards. All street -cut trench work shall be
patched with asphalt or City approved material prior to the end of the workday — NO EXCEPTIONS.
Indemnity: The Applicant has signed an application which states he/she hold the City of
Edmonds harmless from injuries, damages or claims of any kind or description
whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any of its departments or employees, including defense costs and attorney fees by reason
of granting this permit.
I have read the above statements and understand the permit requirements and acknowledge that I must
follow all requirements in order for the permit to be valid. Susan S1d1Ck
SIGNATURE
DATE 2/15/2018
Contractor or Agent
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Job #:
Date:
Jurisdiction:
ROW Permit:
Est. Start Date
Est. Duration:
106336109
2/7/18
Edmonds
Yes
3/12/18
112 Day
Puget Sound Energy Gas Pre -Inspect Form
Address:
City / Zip:
Customer:
PM / Inspector:
7416 212th St SW
Edmonds, 98026
Chris Lee 206-768-4266
JORDAN COOPER 425-623-5302
Job Description / Scope of Work
From 6" STW IP 14' S (377-1957) Stub New Commerical 2" PE Service at Proptery Line 15 '
New Construction:
No
(Due to Road
paving)
Construction Method
All Scat / Trenchless
PLAT Map:
162067
t
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----------------------------------
8 "EXISTING Water 4 I
---------
.._.._..—.._.._.._.._.._.._.._.._.._..
.._. 212thStSW
EXISTING Storm a ----------------j----------------
......
--------------------- J -L -----s------- - - - -..
8 "EXISTING Sewer .................€.....i .. ....... .... ..... .....
.. _ ..
..:.�....�..,.�..:.l.,..�.;......
(manhole marked in brown) ......................... ...:...
AAt
...:.... ...:... ....:... ...:......
6" STW EXISTII
..........
.................
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i EXISTING Water
EXISTING Storm I 2' PE Stub
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7416 212th
St SW
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Work Location
Size of Cut
Surface Type
480'
E
of CL
176th Ave W
&
14'
S
of CL
212th St SW
5x5
C
of CL
&
of CL
Of CL
&
of CL
Service Information
Street Information
Job Type
Diameter:
2" PE
Flaggers #:
Y
Arterial:
Y
New Commercial Svc
EFV:
2" - 10000 9998737
Police #:
N
TCP:
Y
PUGET
SOUND
ENERGY
Meter:
F I I
Speed Limit:
35
No Parks #:
Y
Meter Loc:
02 - OFL
Trolley Lines:
N
Mtr Hoods #:
N
Del Press:
2 PSI
Traffic Signal:
N
Bus Stop:
N
Bollards:
2.5" # 1 1 4" # I
ADA Ramps #:I
N
I Route #'s:
I N
p� N
N— — — — — —
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MINIMUM TAPER LENGTH = L (feet)
LANE
POSTED SPEED LIMITS
WIDTHS
20
25
30
35K295
45
10
70
105
150
205
475
11
75
115
165
225
495
12
80
125
180
245
540
Notes:
1. All signs and spacing to conform to the MUTCD
and City of Edmonds standards.
2. All sidewalks, driveways, exits and egresses shall be
completely clear unless otherwise indicated.
3. Channelizing devices are 28" traffic cones.
4. Sign size can be a minimum of 48" x 48" and shall not
obstruct pedestrian access.
5. Crew is required to leave a minimum of 11' for traveling
lane width.
6. Alert affected residents and businesses.
7. Work to take place between 9 a.m. and 4 p.m.
8. Valve work will be 14' SCL of 212th St SW at 500'
ECL of 76th Ave W.
9. If used, place NO -PARK signs 72 hours in advance
of the day that the work is to be done.
Z-9W
PUGET
' SOUND
ENERGY
Job#106336109
7614 212th St SW, Edmonds, WA
February 14, 2018
Sheet 1 of 1 stephen.gadke@pse.com
(425) 424-6431
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CHANNELIZATION
DEVICE SPACING
TANGENT
TAPER
MPH
80
40
55/70
60
30
35/45
40
20
25/30
W9-1 B
SIGN SPACING
"X"
55 +
800
60/65
500'
45/55
350'
35/40
200'
30
100,
25
W4-1 B
M6-2
Puget Sound Energy
Traffic Control Supervisor:
Stephen R Gadke
Card No. 010741
Exp.5/31 /2021
stephen. gad ke@pse.com
(425)424-6431
�
LEGEND
®
28" TRAFFIC CONE
VQ
VALVE LOCATION
TRAFFIC FLOW
UNIFORMED
POLICE OFFICER
�•cE .
IT"
FLAGGER
WORK VEHICLE
SIGN LOCATION
WARNING FLAG
O
ARROW BOARD